Working Outside the Law - Working Outside The Law ti CW...

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Unformatted text preview: Working Outside The Law ti CW 3316 Lott: i36i‘E‘Jilig she was an Scott Williams 'E’EEH'EC'iS woman fooled the swim“ RN it would be impossible without a license in an tion is paramount to getting ‘ ican'On of a person’s cre- as simple as logging onto ois woman apparently spent 1 decade working as a pediatric nurse for at least two pediatricians before it was discovered she did not have a nursing license in Illinois or any other state. Nanette M. Stults was convicted in 1996 V in Illinois' 18th Judicial Circuit Court of practicing nursing without a license and was sentenced to one year of supervision. _ She alsoreceived a $250 fine and was ordered to perform 60 hours of public Service employment. - Her experience raises the questions of how often something like this happens and what employers can do to sure the nurses they employ have the licenses and certifications they claim. When is a nurse not a nurse? Stults’ testimony — and the testimony of others in the case — shows how it is possible for someone to practice nursing without a license if that person is able to perform cer- tain nursing tasks and it is assumed the per- son has a license because he or she has been employed as a nurse elsewhere. Nancy Brent. RN, MS, JD, who worked as a nurse for 12 years before becoming a lawyu in 198], says she believes physicians and others use nurses and other health care professionals in mpacities outside the scope of their practice. "I'm sure it happens on a regular basis; it's just a question of getting caught," Brent says. The case calls into question whether a per— son can legally perform tasks outside the scope of his or her practice if a physician delegates those tasks and whether someone can legally call him or herself a nurse provided he or she does not refer to him or herself as a registered nurse. Stults, for example, referred to herself several times on her resume and job applica- tions as a "pediatric nurse" without ever claiming to be a registered nurse. Brent says Illinois law not only requires someone working as a registered nurse or licensed practical nurse to have a license, but it also restricts use of the term "nurse" to individuals who are licensed to work as one. "You can't use the term ’nurse’ or any- thing in relation to [being a] nurse unless you have a license to nurse,” Brent says. Stults, who unsuccessfully appealed her conviction to the Second District Appellate Court of Illinois, testified she never claimed to have a nursing license and was never asked for one until 1994, 14 years after she began working for a pediatrician in Downers Grove, Ill. Her testimony and other information on the case come from a unanimous appellate court opinion authored by Justice Michael J. Colwell explaining the legal justification for denying Stults’ request for a reversal. Her side of the story ‘ The opinion, which describes Stulm as an "unlicensed medical assistant." states Stults tes- tified at trial that her responsibilities at the Downers Grove office consisted of what she had been doing "years before in pediatric nursing." According to the opinion, Stults graduat- ed from an Illinois high school and soon enrolled in a medial assistant’s program in Wisconsin. She then entered a one-year intanship in pediatrics and wait to work in a Milwaukee pediatric clinic. While working at the clinic, she enrolled at Marquette University, where she studied child psychol— ' ogy and infant and toddler nutrition. Afier completing classes at Marquette, she enrolled in‘an RN program in Milwaukee, where she stayed for 20 months before drop- ping the program "in academic good stand— ing."' Stults testified she left the program because her husband, who Was in the Air Force, had been transferred to California. Stults also testified her duties at the Downers Grove office included giving immunizations and assessing physical meas— urements of children and placing those , resuls on medicalcharts, She. said she later took a job at another pediatricians office where she performed telephone triage, administered immunizations and respiratory treatments, and removed umbilical cords. Stults testified she drew blood via finger sticks and performed diet counseling over the telephone when mothers called to ask questions about formula problems or about the switch from formula to solid foods. Her “nursing career” came to an end in 1994 when the business manager for the pediatrics practice where she worked asked for a copy of her license. Stults testified she was shocked and wondered whether every— one at the clinic thought she was a nurse. She said she decided to resign because she didn't get along with the business manager. But the court said The physician who hired her testified Stults had listed her occupation as "pediatric nurse" several times on her resume and said the description led him to believe he was hiring someone with "some sort of nursing certificate or license." On cross—examination, Stults testified she believed a pediatric nurse and a registered nurse are different. Jacqueline Waggoner, who worked as the nursing act coordinator for the Illinois Department of Professional Regulation at the time, testified a "pediatric nurse" in Illinois is a registered nurse with a specialty in pedi— atrics. That means a person cannot be a pedi- atric nurse without being an RN. Waggoner also testified only RNs or LPNs perform injec- tions of medications, physical assessments, suture removal, and counseling. Barbara C. Woodring, RN, EdD, president of the Society of Pediatric Nurses, says a reg- istered nurse degree certifies a minimal com- petency in taking care of children. Larger facilities require nurses to obtain additional certification as general pediatric nurses or advanced practice pediatric nurses, she says. Woodring, professor and associate dean at the University of Alabama at Birmingham, says the Society of Pediatric Nurses bestows the CPN (certified pediatric nurse) credential upon nurses who have one to three years in the field and pass a certification exam show- ing they have greater expertise in pediatric nursing than other nurses. To retain the CPN certification, she says, a nurse must remain working in pediatrics and complete a certain number of continuing education credits in pediatrics. : How'to ForGdt‘dWWWZidfiiEEoin " * 11' ‘ diesels Lewis _-... -Nurse Registered” under the .Professio . I _ _ I 'e per'sdn’s last name and'iirst initial orhis orlier liCense number. This will “ " Click enjfi ' WARN The trial court found Stults guilty of the practice of professional nursing without a license, stating the evidence was clear Stults "performed duties that are restricted to a nurse, particularly the various types of injec— tions and immunizations.” At the sentencing hearing, the trial court added that, although Stults had the ability and qualifications to perform the tasks, Illinois law requires a person to be licensed to perform those tasks. Stults testified —— and later raised the issue on appeal — that the physician for whom she worked had the authority to delegate certain duties to her and, as a medical assistant, she was therefore empowered to perform those func— tions. The appellate court disagreed, saying whether she performed her duties while proper- ly supervised was not the issue. The issue, the court said, was whether the duties she performed amount to nursing activi« ties limited to RNs and LPNs as defined by the state's Nurse Practice Act. The court ruled it was irrelevant whether Stults was supervised or whether the physician delegated the duties she performed. Brent says under Illinois law it doesn't matter that Stults' actions apparently did not harm any patients. She says the only thing the prosecu- tion has to prove beyond a reasonable doubt is whether the person participated in the actions and whether the person intended to be involved in these actions. necktie , ‘ - 'ng license in illinois r. u... u. Look-iipf' . afl-m ._.......H n” wintlow ' Brent says it is easy to find out whether someone has a valid nursing license. Detailed records of when and where someone received his or her nursing license are kept by the Illinois Department of Financial and Professional Regulation. She says employers, who are required to ask for a license when hiring a nurse, can check someones nursing license on the department’s website. A physician who allows someone to prac- tice nursing without a license could lose his or her medical license, face criminal charges, and open him or herself up to potential civil lawsuits from patients, says Brent. Cheryl Peterson, senior policy fellow for the American Nurses Association, says employers can check the validity ofa nurse's credentials by writing a letter to the certifying body. “I think every certifying body is supposed to be able to verify for an employer that that person has been certified and that certifica- tion is valid," Peterson says. She says the American Nurses Credentialing Center, the division of the American Nursing Association that provides certifications for a wide range of nursing specialties, charges a $20 fee to verify credentials. Scott Williams is afreelance writer. To comment on this story, e-mail jbOiuin’ give You the pei'son’s' full name, license number, active/inactive status, city and state,” ' p .' orig’in'aldate issued, current expiration date, and discipl' v Toiind out whether a nurse in Illinois has . ' ‘ - .Ibeen disciplined — Go to -' . , Click on p“Proiessional Regulation” . Click on “Disciplinary Reports" . a . .. - a _ I . Click on,“_Next_Pa9e” to divide the-reports into months : ~ f'. Click on the month in which you .believe the disciplinary action occur d' , .' For previous years, clickon‘lthe appropriate tab in the import right-hand corner ' :‘r'epiort indicates a person has been dis “Mined, clickjon the ‘PY”. inlhat field airy actions taken prior to 1990‘ar ti'o v'a'l bl _. 4 _ H ' lude the action taken {probatidn'rstiSpension df-lic'ense);‘thé- duration of th 'ary actions—taken nefl'he repertsthat are in. somelnstances; a: reasnnjflorfthegacn ...
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