Chancery Court Overturns Tennessee Board of Nursing Discipline


Chancellor Ellen Lyle of Davidson County Chancery Court reversed the disciplinary actions order by the Tennessee Board of Nursing against my client, a Tennessee registered nurse (referred to hereafter as “the RN”). Chancellor Lyle’s decision, which was issued July 24, 2015, overturned the Board of Nursing’s Amended Order, issued pursuant a hearing before the Board of Nursing last August 2014. Chancellor Lyle’s decision, which can be found in its entirety here, reversed the Board of Nursing’s suspension of the RN’s license based on the Board’s finding that the RN was addicted to drugs or alcohol to the degree of interfering with nursing duties, and that she was unfit, incompetent, and/or unprofessional due to the use or removal of drugs from the hospital where she worked. In her reversal, Chancellor Lyle found that the only statutory violation supported by the record was that the RN was unprofessional for having in her […]

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Sex, Drugs, Alcohol & Prescription Medicine: When Can Your Personal Life Jeopardize Your License to Practice?


Alex Fisher and Erin Tolbert, the creator of MidlevelU, discuss personal and professional boundaries for health care professionals. The original article and video, published on MidlevelU, can be found here. Although Erin and Alex discuss personal and professional boundaries in the context of nurse practitioners, the same advice applies to other health care providers. Romantic Involvement with Patients The most important question to ask when considering romantic involvement with a patient is “Is this a former or current patient?”. Nurse practitioners and physician assistants should never date current patients. Should you find yourself interested in a patient, first and foremost transfer their medical care to another provider in the practice before proceeding. If you do proceed, do so with caution or you could find yourself charged with sexual misconduct. This blog post from MidlevelU outlines the ins and outs of what’s allowed when it comes to romantic involvement with a former patient. Drug and […]

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How Little Does the Government Have to Prove to Revoke Your License?


This post, written by Alex Scarbrough Fisher, was originally published on midlevelu.com, and can be found here. It is republished with the permission of MidlevelU.com. Just how little does the government have to prove to revoke your nurse practitioner license? This post looks at the legal standard required to prove facts in a contested case hearing in order to impose discipline on a nurse practitioner. Even though this delves into more technical legal concepts than in the norm on MidlevelU, it’s important to understand how much, or rather, how little, the Department of Health has to prove in a licensure action against an NP. Burden of Proof In a contested case hearing involving a discipline action brought against one’s advanced practice nursing license, the Department of Health carries the burden of proof. The burden of proof is the legal term used to describe the threshold a party seeking to prove […]

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Medical Records: What Needs to be Included from a Legal Standpoint?


Alex Fisher and Erin Tolbert, the creator of MidlevelU, discuss what needs to be included in medical records from a legal standpoint. The original article and video, published on MidlevelU, can be found here. Although Erin and Alex discuss medical record keeping in the context of nurse practitioners, the same advice applies to other health care providers, including physicians and physician assistants. Included in this video are some suggestions for best practices that health care providers should use when prescribing controlled substances to back up their decision making and protect themselves from disciplinary action. These recommendations include: Document a complete social history including a history of drug and alcohol abuse. Get a pain management contract in place and maintain this as part of the patient’s medical record for individuals who are prescribed these types of medications on a long-term basis. Consider drug testing patients who are prescribed controlled substances. Make sure your practice has […]

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What Nurse Practitioners Need to Know Before Agreeing to License Restrictions


Attorney Alex Fisher recently had the opportunity to visit with Erin Tolbert, the creator of MidlevelU, an online resource for health care providers such as nurse practitioners and physician assistants, and discuss how nurse practitioners are regulated as a profession. The original article and video, published on MidlevelU, can be found here. Although Erin and Alex discuss restrictions in the context of nurse practitioners, the same advice applies to other health care providers, including physicians and physician assistants. If you’ve been notified of pending disciplinary action against you as a nurse practitioner, agreeing to a simple restriction on your license rather than a more formal disciplinary hearing may seem like the obvious best choice to diffuse the situation. Perhaps the Board of Nursing puts an agreement on the table that allows you to practice provided that your charts are simply reviewed by a physician. Not too shabby given the alternative, right? A restriction […]

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