July 29, 2025 • 32 mins
The digital age has created a dangerous crossroad where social media culture meets healthcare licensure, and the consequences can be devastating. Our conversation with Maggie Ortiz, CEO of Advocates for Nurses and a former Texas Board of Nursing investigator, pulls back the curtain on what actually happens when nurses go live on social media while at work.
"It's the epitome of unprofessional conduct," Ortiz explains, detailing how a single video can trigger a cascading series of investigations. What many practitioners don't realize is that livestreaming while wearing your badge constitutes multiple violations simultaneously – from HIPAA breaches and privacy concerns to policy violations and theft of time. Even more alarming is how seemingly anonymous patient information can be pieced together by viewers, creating serious legal liability.
The regulatory aftermath is where things truly become nightmarish. Board investigations can stretch 2-3 years, formal charges arrive via certified mail, and the financial burden of defending yourself can be overwhelming. One violation in Texas can trigger investigations in every state where you hold a license, creating a professional crisis that spans borders. Ortiz shares actual examples of formal charges documents, walking through how allegations transform into potential license suspension or revocation.
Yet amid these sobering realities, there's practical guidance. Ortiz outlines essential tools for nurses to protect themselves, including understanding your state's practice act, properly documenting unsafe assignments, and using the decision-making framework from the National Council of State Boards of Nursing. Perhaps most eye-opening is her reminder that nursing boards exist to protect the public, not to advocate for the practitioner.
Whether you're a new graduate or seasoned healthcare professional, this conversation provides crucial insight into navigating the intersection of social media and professional licensure. Your career depends on understanding where the boundaries lie before crossing them inadvertently.
Get more information, details and resources on Know Your Regulator - https://www.belolaw.com/know-your-regulator
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:01):
This podcast is for educational purposes only does
not constitute legal advice anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
Speaker 1 (00:13):
You're listening to Know your Regulator, the podcast
that inspires you to engage.
I am your host, simone Murphy,and today this is a special
episode.
We're featuring the latestinsights from our Healthcare
Pros Charting Texas series.
That's a collection of focusedconversations just for medical
professionals, so we're going tobe talking about something
that's as modern as it isdangerous going live on social
(00:35):
media while holding a nursinglicense.
To walk us through it.
We are joined by Maggie Ortiz,a nurse advocate and former
Texas Board of Nursinginvestigator.
She's been on both sides,conducting investigations and
now educating nurses on how tostay protected, compliant and
proud of their practice.
Thanks for joining us, maggie.
Hey, good morning, it's good tohave you.
(00:59):
This has been a pretty hottopic right now, especially,
you've got a pretty uniquebackground as a former you know
nursing board investigator.
What is the first thing thatwould trigger you know the board
of nursing's interest in a caselike this?
Speaker 2 (01:19):
More likely than not, it's going to be someone
sending in this video, so itwould roll onto the
investigator's desk in some formof a link to a video and email
or because traditionally I wouldget a folder and have to open
up the folder.
But, like you said, in theevolving day and age, for the
investigator as well, that wouldmore likely than not be a link
(01:40):
to a video.
Whatever platform, it doesn'tmatter whether it's LinkedIn or
TikTok or Instagram, or itdoesn't matter where this is
generating from.
You're just video on your ownphone.
It's just not appropriate atall.
It's it's the epitome ofunprofessional conduct.
Yeah, For so many reasons, Ithink that I would hold that,
(02:01):
not not just the nurses, butanyone who holds a professional
license and unfortunately seemsto be prevalent in the last few
years amongst the nursingpopulation.
But this is a cultural poorpractice and we we never do that
.
So the board of nursing mostcertainly would be looking at
(02:21):
that.
The HIPAA, the privacyviolations, the policy
violations, because it'sconsidered a theft of time as
well.
If you're going live on any ofthese platforms, more likely
than not you're making somemoney as well.
So now you're double dippingwhile you also have a badge on
(02:41):
hold a professional professionallicense recording at your job
while you're doing your job.
And it may be.
People take for granted that itwill be a verbal name.
That is possibly said, we writenames or there could be
abbreviations of names, andpeople like that's not a big
deal, but it is, because peoplecan place you at your job and
(03:02):
sally sue, your neighbor at thejob the same time that you were
there and all of a sudden theirname is on a board.
And then there's because peoplecan place you at your job and
Sally Sue, your neighbor, at thejob the same time that you were
there and all of a sudden theirname is on a board and then
there's a diagnosis in thebackground and they can put
those two letters together withwhen you were working.
And then, when they do see whatI mean, go down a bad rabbit
hole.
Speaker 1 (03:19):
A separate kind of trend going on is when someone
feels wronged or, you know,consumer feels wrong, they kind
of post it and they've got these.
You know people who are able todig up all this information.
I think it's incredibly naiveto think that they that you know
people who are watching thisvideo or are on the internet,
who see this type of content,wouldn't be able to do that same
(03:40):
type of research.
It can happen, and to thinkthat it wouldn't or that it
won't happen is just, you know,like I said, naive.
And you know better than that.
You can do better than that.
You know.
Come on.
Speaker 2 (03:54):
That's where I was going to chime in as well is
that I also have to say assomeone who's been practicing
for 25 years.
I'm very proud of my professionand that is not upholding the
integrity of our profession.
And what's the message we'regiving to patients as well when
we do stuff like that?
No we don't need that light onus, especially now.
It's the epitome ofunprofessional conduct, because
(04:15):
I also like to remind nursesswing that door the other way,
take your badge off and lay inthe bed.
Speaker 1 (04:19):
Would you be?
Speaker 2 (04:20):
okay with them TikTok-ing you out or
Instagram-ing or Facebook-ing.
Live out while you're just atyour job and all of a sudden
you're plastered all over.
Remember, it's a privilege tohold a license and that's the
board's words, not mine, andthat can be taken away from you.
That privilege has far-reachingramifications if that lands on
(04:43):
a desk at the board of nursing.
You and I both know that verywell.
Speaker 1 (04:46):
Yeah, absolutely so.
It's, you know, really clear.
The public kind of plays a bigrole in how this can get
escalated.
Let's kind of dig into exactlywhat's going on here and how it
crosses that line.
We're talking about, you said,you know they're live at work.
We're talking about theft oftime You're filming while you're
(05:09):
providing patient care.
There's absolutely just anumber of HIPAA violations that
can occur.
You know I'm sure they'repicking apart these videos when
they see them.
What should nurses really beaware of and and very conscious
of?
Speaker 2 (05:26):
So you and I are in the line of work in the law firm
that you work for representsanyone who would hold a
professional license, but a lotof times it's nurses and
physicians.
I do understand.
Is that correct, right?
So that's your perspective.
So you there see the providercoming to you.
I was within a board of nursingand then I was also.
(05:47):
I've been a legal expert, andthen on the civil side as well
as on the administrative side.
So I say all that to say a lot.
We have inside knowledge that alot of nurses don't know they.
We don't.
When we go to school, when welearn stuff about the rules and
(06:07):
regulations, we're drowning inmedical terminology and care
plans.
We memorize what we need toknow for the test as it pertains
to those rules and regulations.
But we're not criminals.
I need to know where the bonesin the ear, I need to know the
muscles when I'm drowning inthese acronyms.
But I'm not.
I'm not a criminal, I'm notgoing to do anything unethically
(06:28):
.
So therefore, they don'tunderstand the rules and
regulations.
And what should nurses know?
And I'm going to broaden it outa little bit, not just Texas,
but I'm going to talk aboutevery nurse in the United States
or anyone who holds aprofessional license.
There was going to be roughlythree sections that every entity
that gives someone theprivilege to practice is going
(06:49):
to have in their basic rules andregulations.
Standards of practice.
That's pretty obvious, right.
That will give you the guidance, whether you're an RN, an LP,
an MD, an NP, pt, insertwhatever letters you are the
guidance right Under yourstandards of practice.
Unprofessional conduct it'sgoing to list out what is some
(07:11):
things that unprofessionalconduct.
You're going to look at that aswell.
That should be a basic guideand then grounds for discipline.
Those are three sections thatanyone who holds a professional
license, even if you're a realestate agent or whatever you are
every entity is going to listthose things out and those are
(07:31):
pages long, not 300 pages.
You care about those threesections and then use AI, use a
tool.
I go to Cornell Law which dumbsit down for me and I say I'm
helping a nurse in a lawyer inFlorida.
Bring me up the rules andregulations as it pertains.
No one's asking anyone toreinvent the wheel, but re
(07:54):
introduce yourself to yourmodality.
That's like number one is justunderstanding the rules and
regulations.
Then you hit on another thingpolicy, and let's just talk
about that.
Now, Texas does, I believe, havea good structure as it pertains
(08:14):
to the rules and regulationsand we do have a traditional
board of nursing People who havea compact license or don't
practice necessarily here.
They don't have a traditionalboard of nursing.
They fall under, let's just say, the california, under the alj.
You know, miss michigan, maybehhs or dhs, but someone is
(08:34):
housing the rules andregulations that dictate your
professional license, um.
So you just need to make surethat you're um introducing um
yourself to that.
But use ai or some of thesetools to dumb it down for you
and just say hey, I'm in Texas,I'm going to be coming to Texas,
I'm taking an assignment there.
Dumb it down for me under thesethree sections and then give me
(08:55):
some guidance.
I'm an LPN, can I administerblood?
Can I do some of these things Imay be able to do in Alabama
state over, but now I'm comingto Texas, can I do that?
So you utilize these tools.
Speaker 1 (09:07):
It can get really ugly when you have a lack of
understanding of what you'vedone or what violations may have
occurred.
You can get the ombudsmaninvolved, and I mean we're
talking.
There could be criminal chargesIf you're, you know, messing
with insurance.
If insurance catches wind, youbetter bet they want to save
(09:29):
money.
They'll come after you.
You know there's just a lot ofdifferent ways that things could
go and they'll all be happeningat the same time.
Don't think it'll be one rightafter another.
You'll be out money.
You'll be searching for lawyers.
You'll be calling Maggie saying, hey, what can I do?
Speaker 2 (09:48):
You know how did all these four letter agencies get
into my life?
Because all of a sudden you'regetting letters, and it's not
just from the board of nursingand I'm just using the board of
nursing loosely because we'retalking about our state, but
insert any state.
If you come to this state andlet's just say that you have
five other licenses, you and Iknow what that looks like.
You come to this state andsomething happens here.
(10:10):
You get reported to this boardof nursing.
Those other boards could comeafter you.
Speaker 1 (10:15):
In fact I've got some formal charges that I'll throw
up here in a moment.
And they had changed the boardof nursing.
They had a notice that camefrom the Board of Nursing.
They changed it and thensubmitted it and posted it out
to news outlets and for peopleto see and I mean, wow, to your
(10:37):
nursing license.
You really just ticked off theboard of nursing and they're
definitely going to be, you know, not happy with that, but we're
talking about that is now a.
That's a, I believe, federaldocument.
Speaker 2 (10:51):
I was about to say, is that not?
And again, now we're leaving mylane a little bit.
You altered a state documentthat might be a federal, I don't
know, right, yeah, exactly it's.
Speaker 1 (11:04):
I think it's absolutely up there with the
large heavy offenses.
So I mean, that's one one waythat you know you could get some
criminal charges, civil charges.
I mean people have the abilityto sue you civilly if they feel
like you know you videotape them, chat filter on a patient.
(11:28):
You know, yeah, they canabsolutely turn around and sue
you.
Not only then will you bebattling the board of nursing,
but you'll be trying to duke itout in civil court as well, and
I know that that's just going todrain tons of resources not
definitely not a position youwant to find yourself in at all,
and that's why it's so crucialto understand and, if you don't
(11:50):
know, get help from someone likemackie or an attorney or you
know the number one thing isthat you have to get a lawyer.
Speaker 2 (12:02):
Bottom line is if you're involved in any
litigation, I don't care if it'scriminal, civil, you get
arrested.
It's for you're in new orleans,it's your 21st birthday, you
are getting crazy on, you knowbourbon and you are arrested.
And you are for you know publicintoxication.
Unfortunately, I'm not tellingyou it's right, but you and I
(12:23):
both know the board of nursingwill be involved, because you do
.
You will also have to reportthat when you go to renew your
license and or you will have tolook at the rules and
regulations in your state.
When does it say you'resupposed to report an arrest?
Then we're going to go back tothat policy.
I promise you and I've seen itbecause I've had nurses reach
out to me who've gotten DUIs,who unfortunately, were in
(12:45):
leadership, and they reached outto me and said what do I do?
I said, well, we got a coupleof things you need to look at
and I just provide education.
Number one you do need a lawyer.
Number two well, number one,you better have professional
liability insurance.
Number two with thatprofessional liability insurance
, you're going to call thatlawyer and you're going to start
talking to them.
Number three you know what thepolicy says at that organization
More likely than not as well,especially as a leader.
(13:07):
It's going to say that if youget a DUI or PI, you are
arrested.
You will have to let youremployer know, and then your
employer can leverage thatagainst you as well.
So you do have to understand,because if you show up to your
job, whether you're inleadership or not, and the
policy does say that you'resupposed to report, and let's
(13:29):
just say, for example, you're onbusted and you and I both know
this is a thing and your picturegets sent to oh I don't know
the CNO, and I would love totell you that it's never been a
thing You're more likely thannot going to get terminated
instead of you responsibly goingto your leadership.
And maybe just now because insome states if you're terminated
that's automatic retelling youhave to tell the board of
(13:50):
nursing because they want toknow if you're terminated.
And not only that, now, that'son your application or your
resume that you can never lieabout you, and I know that a
lawyer is not cheap, that aninvestigation could go on to two
to three years.
You have more than one type oflitigation.
The financial burden could beso profound.
But all these things, one event, I think we're all we're trying
(14:13):
to point out here, where oneevent whether you let culture,
whether and culture is havingyour phone on you all the time,
using it appropriately, goinglive, texting, talking about
patients on your first personalphone because I'm going to even
extend that a little more youand I both know that is a huge
no-no employer phone.
(14:37):
I'm allowed to use my employerphone that they've given me to
not TikTok out or live streamout, but to communicate.
The physicians can call me onmy personal phone on tiger text
and don't even get me startedwith that.
No, because am I following thepolicy as it pertains to tiger
texts?
I'm not, and only that.
Am I willing to hand over myphone for discovery, and only
(15:00):
that?
Am I willing to hand over myphone for discovery?
Speaker 1 (15:02):
Not for my organization.
Speaker 2 (15:03):
Stop it, right, right oh not a chance, no, exactly.
Speaker 1 (15:07):
Well, let's take a look at these formal charges.
We'll kind of just I want tojust showcase what they look
like for everyone and then we'lltalk about.
You know, we've we've reallyoutlined the risks.
We'll kind of talk about sometools and some rules to be very
mindful of.
Speaker 2 (15:24):
So formal charges are beyond what the allegations
would be.
So the complaint would come andthe investigator could send out
an allegation.
Some states will just send outa complaint we were talking
about earlier.
Texas will send out a full onallegation.
If there's solid evidence we'llgo back to the live streaming.
(15:47):
There is actual evidence of theconduct.
It's just non-negotiable.
There's no way to get around it.
More likely than not, you'regoing to be sent formal charges,
like she has presented here.
The first piece of it is thenurse's basic information.
This is a formal documentthat's generated.
This is what I would have beencreating, created.
It was just a basic templatethat I was bleeding in the
(16:10):
nurse's name, the violations itwas word perfect folks and I did
say word perfect and it wouldbe stopped so it wouldn't be an
allegation.
You see, here is charge one, somoved from the allegation to
the actual formal charge, alwayslisted out as honor about this
(16:31):
date.
This time it's very basic.
This one just happens to be afamily nurse practitioner.
It would be licensedpractitioner, it would be
whatever your credentialing wasRN and then would move on to.
You are the respondent and theTexas Board of Nursing are
alleging this against you on orabout this date.
This time We'll list out someviolations, like we referenced
(16:53):
in the very beginning, underunprofessional conduct, grounds
for discipline and standards ofpractice.
That's why I said it wasimportant to know that, because
that's where these violationswould have been pulled from.
So they'll reference those.
You get a notice.
This is basic, just kind oflanguage, legally language.
That's put it there.
(17:15):
You are being noticed.
The notice is this formalcharge that would be sent to the
nurse via certified mail.
That's why it is required foryou to keep your address up to
date.
If you do not respond to theboard of nursing or if they send
this to you more than threetimes, that can lead to the
revocation of your license.
When you involve your lawyer,which you should absolutely do,
(17:36):
so that's a layer of relief, Ifeel like, for the nurse as well
.
You're not getting thatcertified letter.
That can be very stressful forthe nurse.
Your legal team will keep youup to speed, but your lawyer
will receiving that letter, thatany other communication from
the board of nursing.
So it is a level of comfort foryou and protection.
All of this even if you get aformal charge.
(17:59):
I want you to know as well.
It is not hopeless.
It is absolutely not hopeless.
You have legal representation.
You understand the process,even if this I know this is just
a little bit of a rabbit hole,but one of the little trigger
warning number one reasons why anurse will take their life or
attempt suicide is a bordernurse and complaint or formal
(18:20):
charges.
Nurse will take their life orattempt suicide as a border
nurse and complaint or formalcharges.
So it is not hopeless.
You get legal representation.
You work through the process.
All of this stuff, to a certainpoint, is negotiable.
That's why you have your lawfirm.
The violations can be looked at.
The different violations couldbe offered up.
The allegation can be rewrittenif it's not written
appropriately.
When I was the investigator, Iwould have something very basic
(18:44):
that I was writing up theallegation um up and it may not
be the full and complete story.
Speaker 1 (18:49):
Therefore, your legal team can come back and
negotiate stuff with the board,even if it's sent in uh, the
formal charges yeah, no, and I'dactually like to really
piggyback off that We've handleda case where social media was
presented as evidence, right.
(19:10):
So we're talking about, I mean,this is the board of nursing is
saying here, here it is, we'vegot it.
Our firm love this.
Our firm argued that thatevidence was insufficient,
unauthenticated, that thosewitnesses were unreliable, they
(19:30):
weren't credible, and thisperson ended up getting a
disciplinary order, but with CEcredits and with an attorney.
This really just speaks to how,how Essential, essential use
the right word Essential.
Yes, they modified the findingsto include a statement that the
(19:54):
accused had completely denied.
All of these allegations, right,all of these allegations, right
.
So there are things that yourattorney can do to negotiate, or
there's just a plethora ofoptions that your attorney knows
because they studied the lawand they understand this process
that you aren't aware of, thathappens behind closed doors,
(20:17):
that people aren't runningaround going hey, guess what my
attorney got me?
You know, two weeks instead of16.
It's not something people arerunning around saying.
So, absolutely, explore what anattorney can do for you and
your case.
Speaker 2 (20:35):
It's essential and, like you said, I say that every
day, all day.
That's the number one thingthat I say, because we don't
learn the nursing law Again.
I'm not here to tell you that anurse is not going to make a
mistake.
Our nurse doesn't do somethingwrong, but that doesn't mean
that you should be punished, orfor the rest of your life, or
again.
I'm not talking about someonewho's intentionally harming
(20:57):
someone.
I'm talking about an nurse intheir everyday life.
Sure, this is a social mediathing.
Is this, you know?
Should any nurse be going live?
No, but they're going to do therestitution, they're going to
do time and should they be ableto go on with their life?
Yes, and that's why you haveyour legal representation to
help you mitigate and that'swhat she's saying mitigate the
outcome, because I'm here totell you, the nurses reached out
(21:18):
to me once they're done withthe law firm, and now it's a
year, it's two years from now.
They're like now I'm on theselists, now I'm on these, or they
do without the lawyer.
They are on these lists, buttheir lawyer and myself were
thinking about no, no, no, no,no, so we don't agree to this.
So what we can agree to andwhere the lawyer, or even I mean
I've worked with your law firm,that's how we've crossed paths
(21:39):
Right, and I'm like hey, youknow, maybe this one, or you
know, I could see where a nursecould do this, because I am the
subject matter expert, I workedin that modality, right there, I
could speak to it a little bitmore and you're like that's a,
that's a great idea.
Or the lawyers like that's,that's, yep, we're going to do
this.
You know what I mean.
Those are all things that arevery much negotiable.
Speaker 1 (21:59):
What can license holders do nurses specifically,
to avoid this regulatory pitfall?
I know that we've touched on ita few times.
You know already this episode.
Obviously don't go live at work, but what are some other, maybe
not so obvious things thatnurses should be aware of?
Not so obvious things thatnurses should be aware of?
Speaker 2 (22:22):
So I'm going to plug myself just for a minute.
I do offer a charting course.
Oftentimes you and I both knowwhen we're looking at.
Now this is a little bitdifferent because we're
referencing primarily like avideo or something that's out
there, but oftentimes it isaround a practice and so what
you do or do not document is abig deal, and if you don't
(22:43):
document it, you know that itgets harder to validate.
You know what was done now,obviously, with the growing, you
know, staffing ratio issues,with us pushed to, you know
taking on more unsafeassignments, of course we do the
care first.
No one's asking you to chart inreal time.
(23:03):
That's not a reality.
What I'm saying is making surethat you're advocating for
yourself and you're not takingon an unsafe assignment.
What does that look like inTexas?
I'm going to say 217.11.1S isthe person making that
assignment, which I don't feelis safe, and then T me accepting
that assignment.
Are you asking me to violatethe nurse practice act?
(23:26):
There's a tool I just gave youknowing the nurse practice act,
our state is very specific.
But then you say are you askingme to violate that?
And then they pause.
Then you're going to doubledown and say you're going to
deviate.
Now you know a different typetype of law.
Medical malpractice isknowingly and willingly taking
on an unsafe assignment.
Are you asking us you and I andall the leadership for me to
(23:49):
take on an unsafe assignment?
Because the definition ofmedical malpractice is knowingly
and willingly taking on anunsafe assignment in a
professional, respectful manner?
You could have in a manilafolder I I like to say print it
out.
This was two, 17, 11 on yourbadge.
We all have these little badgebuddies.
You know what I mean.
Pin that on the back of yourbadge and you're just going to
(24:12):
read from that.
It's not you, it's the board ofnursing, in a professional,
non-heated tone.
Number three in Texas we do havesafe Harbor.
Now number four is ADL acceptdespite objection.
Let me be really clear, and youknow this as well ADO accept
despite objection is a tool usedby unions.
I know that can be considered acuss word.
(24:32):
I don't have any problems withthat tool, whatever that is.
But let me just be real clear.
That is not safe harbor and Idon't know what that looks like.
If the board of nursing doesnot approve that piece of
documentation and you acceptdespite objection, that will be
produced in civil, criminal andpossibly Board of Nursing
litigation.
That is not the same thing assafe harbor, which enacts the
(24:56):
peer review process to have yourassignment looked at for you.
Ideally then you would leveragethe 217, 11, 1, s and t I just
named two, but there could beother things.
If you don't have the education, training and knowledge, that's
another under those threesections.
That I said is a 10 minute readthat you could now leverage.
(25:16):
Do not take for granted yourorientation.
Do not take for granted yourorientation.
Do not take for granted yourorientation.
It is owed to you.
Do not let them make you thinkthat it is not your right to
have that.
It is.
And then I'm going to lean backin on how do I have the
education, training andknowledge that I am quoting the
Board of Nursing.
If you're not affording me anorientation, then you would
(25:39):
quote that.
If you're saying that I don'tget six, uh, 12 weeks, you're
going to go to evidence-basedscience, research to pull that
in.
And then you're going to leanin on the board of nursing,
where it does say that I amtouching on something.
I'm not sure if you're aware ofthis happening in my, in the
nursing environment, wherethey're not extending the new
(26:00):
nurses a full 12 weeks, and I'mnot even tied to 12 weeks
because if I'm working in thenursing environment where
they're not extending the newnurses a full 12 weeks, and I'm
not even tied to 12 weeksbecause if I'm working in the
ICU, how do you know in 12 weeksthat I'm going to be ready to
manage someone who's criticallyill on my own?
You don't.
So come back to the table,reevaluate that and then you
work out a plan, but you lean inon the board of nurses saying
(26:23):
that I have the education,training and knowledge to take
care of this person on my own.
But you see what I mean In all,even tone, even tone.
I did not change my tone andand a respectful and I'm not
going to tell you you're notgoing to get harassment.
But if you all stand togetherand you all have the same
knowledge, if you all standunited to charge nurses and
(26:44):
taking patients, but you usethese tools and you stand united
, and all I did was quote therules and regulations.
I didn't quote anything else.
That was it.
Speaker 1 (26:54):
That was it.
Yeah, I mean, I think it'ssomething that nurses have been
dealing with for a long time, sothose are fantastic tools for
people to feel empowered and beable to put their foot down when
they know that things aren'tright.
Speaker 2 (27:11):
I have free resources on my website charting tips and
then just some basic stuffabout board of nursing
investigations, cause I do thinkthat all nurses I I'm about a
little bit scared straightbecause you and I know if, if
they're coming to either one ofus, the process has already
started, exactly.
Speaker 1 (27:31):
Yeah, something's already happened.
Speaker 2 (27:34):
Two to three years more likely of your life.
The financial burden, theunknowing, the when is the next?
It's all these things that youand I hear every day that I
don't want for you, I don't wantfor any nurse.
So the more that you understandthat, that the board of nursing
and just as we wrap it up,because the thing that's not
beaten to us enough and maybe alittle mind blowing to you but
(27:58):
we're not really taught that theboard of nursing is not there
for us.
Speaker 1 (28:02):
Yeah, no, it was.
I think that is mind blowing.
And there's a yeah, you wouldthink that the board who granted
you the license would kind ofkeep you in their corner, right,
but no, they're there toprotect the public and that's,
that's really big.
They regulate your license andyou know they don't.
(28:23):
Say that again we're on theregulator Right, you got to know
your regulator and that's whyit's it is.
This is we've created this tohelp kind of bridge that gap
between I don't understand thisor even if you're you're reading
(28:44):
it, you don't really understandwhat you're reading and you've,
you have to, you just have to.
You've got to figure it out.
Speaker 2 (28:48):
This is where you leverage the tools that we're
talking about Cornell law, ai,whatever you're using, plug it
into to to AI.
You're coming to Texas, youpractice here, you're a new
nurse and you're trying tofigure out what exactly is my
scope of practice in an ICU, ina surgery center, in a home
health setting and leveragethese tools that we already have
(29:10):
in our environment to help you.
If nothing else, it'll get youthe link to the Texas Board of
Nursing or the National Councilof State Boards of Nursing.
And the last tool that I'mgoing to leave everyone with as
we wrap it up, that I talk aboutin my charting class and
anywhere that I speak or I doanything across the nation, is
(29:32):
the decision-making framework.
It is eight questions that youare asked and please bring up
the visual folks, you need tolook it up.
It comes from the NationalCounselor, state Boards of
Nursing, who gives guidance toevery state to put the rules and
regulations in, and one ofthose is the decision-making
framework.
It goes one through.
(29:54):
Eight says what yes or no.
It's either yes, you move on,or no, it's a stop.
And the last one is numbereight Are you willing to accept
the responsibility of youractions.
The big one.
It's huge when you make thatfinal decision, whether it's
you're going live on socialmedia, you're, you know, doing
(30:18):
something, you're copying,you're pasting, you're deleting,
you're doing something in yourworkplace and your little
nursing guts telling you folksdon't do it.
Speaker 1 (30:28):
Don't do it, you better be willing to accept the
responsibilities, those actionsand all those consequences that
come with it.
Speaker 2 (30:38):
Yes, and the reporting to a board of nursing
the mirror, because one of thequestions that people don't
realize if you're arrested or ifyou're, in salt, involved in
civil litigation or you're foundnegligent in civil litigation.
Early on in my career, one ofmy very good friends and I did
help for her to get her licenseback after she got her revoked
because she was involved incivil litigation where they
(31:00):
found her civilly negligent fora pressure ulcer.
Her husband was active duty,she moved, didn't update her
address something that couldhave easily probably been
handled but because she didn'tget those three letters that led
to the revocation of herlicense, not just one, but all
her license fell.
So one act you and I both knowcan lead to so many other things
(31:27):
.
So, yes, are you willing totake responsibility for your
actions?
Speaker 1 (31:33):
Thank you very much, maggie, for pulling this curtain
back on.
You know what really happenswhen social media collides with
the Nurse Practice Act.
Texas Board of Nursing getsinvolved, and that's obviously
not something you want to happen.
So here's your big takeawaySocial media is never personal.
When you're a licensedprofessional, what you post can
(31:54):
follow you straight into a boardinvestigation.
Make sure you're protectingyour patients, your
professionalism, most of all,your license.
Check out our links below tovisit Maggie's advocacy
resources.
Read the Texas Board of Nursingsocial media guidance, huge one
and more.
Be sure to subscribe, share andjoin us next month as we
(32:16):
continue charting the issuesthat matter to Texas medical
professionals.
Until next time, know yourrules, guard your license and
keep charting Texas.
Speaker 2 (32:26):
Know your Regulator.
The podcast that inspires youto engage.
This podcast is for educational purposes only does
not constitute legal advice anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
Speaker 1 (00:13):
You're listening to Know your Regulator, the podcast
that inspires you to engage.
I am your host, simone Murphy,and today this is a special
episode.
We're featuring the latestinsights from our Healthcare
Pros Charting Texas series.
That's a collection of focusedconversations just for medical
professionals, so we're going tobe talking about something
that's as modern as it isdangerous going live on social
(00:35):
media while holding a nursinglicense.
To walk us through it.
We are joined by Maggie Ortiz,a nurse advocate and former
Texas Board of Nursinginvestigator.
She's been on both sides,conducting investigations and
now educating nurses on how tostay protected, compliant and
proud of their practice.
Thanks for joining us, maggie.
Hey, good morning, it's good tohave you.
(00:59):
This has been a pretty hottopic right now, especially,
you've got a pretty uniquebackground as a former you know
nursing board investigator.
What is the first thing thatwould trigger you know the board
of nursing's interest in a caselike this?
Speaker 2 (01:19):
More likely than not, it's going to be someone
sending in this video, so itwould roll onto the
investigator's desk in some formof a link to a video and email
or because traditionally I wouldget a folder and have to open
up the folder.
But, like you said, in theevolving day and age, for the
investigator as well, that wouldmore likely than not be a link
(01:40):
to a video.
Whatever platform, it doesn'tmatter whether it's LinkedIn or
TikTok or Instagram, or itdoesn't matter where this is
generating from.
You're just video on your ownphone.
It's just not appropriate atall.
It's it's the epitome ofunprofessional conduct.
Yeah, For so many reasons, Ithink that I would hold that,
(02:01):
not not just the nurses, butanyone who holds a professional
license and unfortunately seemsto be prevalent in the last few
years amongst the nursingpopulation.
But this is a cultural poorpractice and we we never do that
.
So the board of nursing mostcertainly would be looking at
(02:21):
that.
The HIPAA, the privacyviolations, the policy
violations, because it'sconsidered a theft of time as
well.
If you're going live on any ofthese platforms, more likely
than not you're making somemoney as well.
So now you're double dippingwhile you also have a badge on
(02:41):
hold a professional professionallicense recording at your job
while you're doing your job.
And it may be.
People take for granted that itwill be a verbal name.
That is possibly said, we writenames or there could be
abbreviations of names, andpeople like that's not a big
deal, but it is, because peoplecan place you at your job and
(03:02):
sally sue, your neighbor at thejob the same time that you were
there and all of a sudden theirname is on a board.
And then there's because peoplecan place you at your job and
Sally Sue, your neighbor, at thejob the same time that you were
there and all of a sudden theirname is on a board and then
there's a diagnosis in thebackground and they can put
those two letters together withwhen you were working.
And then, when they do see whatI mean, go down a bad rabbit
hole.
Speaker 1 (03:19):
A separate kind of trend going on is when someone
feels wronged or, you know,consumer feels wrong, they kind
of post it and they've got these.
You know people who are able todig up all this information.
I think it's incredibly naiveto think that they that you know
people who are watching thisvideo or are on the internet,
who see this type of content,wouldn't be able to do that same
(03:40):
type of research.
It can happen, and to thinkthat it wouldn't or that it
won't happen is just, you know,like I said, naive.
And you know better than that.
You can do better than that.
You know.
Come on.
Speaker 2 (03:54):
That's where I was going to chime in as well is
that I also have to say assomeone who's been practicing
for 25 years.
I'm very proud of my professionand that is not upholding the
integrity of our profession.
And what's the message we'regiving to patients as well when
we do stuff like that?
No we don't need that light onus, especially now.
It's the epitome ofunprofessional conduct, because
(04:15):
I also like to remind nursesswing that door the other way,
take your badge off and lay inthe bed.
Speaker 1 (04:19):
Would you be?
Speaker 2 (04:20):
okay with them TikTok-ing you out or
Instagram-ing or Facebook-ing.
Live out while you're just atyour job and all of a sudden
you're plastered all over.
Remember, it's a privilege tohold a license and that's the
board's words, not mine, andthat can be taken away from you.
That privilege has far-reachingramifications if that lands on
(04:43):
a desk at the board of nursing.
You and I both know that verywell.
Speaker 1 (04:46):
Yeah, absolutely so.
It's, you know, really clear.
The public kind of plays a bigrole in how this can get
escalated.
Let's kind of dig into exactlywhat's going on here and how it
crosses that line.
We're talking about, you said,you know they're live at work.
We're talking about theft oftime You're filming while you're
(05:09):
providing patient care.
There's absolutely just anumber of HIPAA violations that
can occur.
You know I'm sure they'repicking apart these videos when
they see them.
What should nurses really beaware of and and very conscious
of?
Speaker 2 (05:26):
So you and I are in the line of work in the law firm
that you work for representsanyone who would hold a
professional license, but a lotof times it's nurses and
physicians.
I do understand.
Is that correct, right?
So that's your perspective.
So you there see the providercoming to you.
I was within a board of nursingand then I was also.
(05:47):
I've been a legal expert, andthen on the civil side as well
as on the administrative side.
So I say all that to say a lot.
We have inside knowledge that alot of nurses don't know they.
We don't.
When we go to school, when welearn stuff about the rules and
(06:07):
regulations, we're drowning inmedical terminology and care
plans.
We memorize what we need toknow for the test as it pertains
to those rules and regulations.
But we're not criminals.
I need to know where the bonesin the ear, I need to know the
muscles when I'm drowning inthese acronyms.
But I'm not.
I'm not a criminal, I'm notgoing to do anything unethically
(06:28):
.
So therefore, they don'tunderstand the rules and
regulations.
And what should nurses know?
And I'm going to broaden it outa little bit, not just Texas,
but I'm going to talk aboutevery nurse in the United States
or anyone who holds aprofessional license.
There was going to be roughlythree sections that every entity
that gives someone theprivilege to practice is going
(06:49):
to have in their basic rules andregulations.
Standards of practice.
That's pretty obvious, right.
That will give you the guidance, whether you're an RN, an LP,
an MD, an NP, pt, insertwhatever letters you are the
guidance right Under yourstandards of practice.
Unprofessional conduct it'sgoing to list out what is some
(07:11):
things that unprofessionalconduct.
You're going to look at that aswell.
That should be a basic guideand then grounds for discipline.
Those are three sections thatanyone who holds a professional
license, even if you're a realestate agent or whatever you are
every entity is going to listthose things out and those are
(07:31):
pages long, not 300 pages.
You care about those threesections and then use AI, use a
tool.
I go to Cornell Law which dumbsit down for me and I say I'm
helping a nurse in a lawyer inFlorida.
Bring me up the rules andregulations as it pertains.
No one's asking anyone toreinvent the wheel, but re
(07:54):
introduce yourself to yourmodality.
That's like number one is justunderstanding the rules and
regulations.
Then you hit on another thingpolicy, and let's just talk
about that.
Now, Texas does, I believe, havea good structure as it pertains
(08:14):
to the rules and regulationsand we do have a traditional
board of nursing People who havea compact license or don't
practice necessarily here.
They don't have a traditionalboard of nursing.
They fall under, let's just say, the california, under the alj.
You know, miss michigan, maybehhs or dhs, but someone is
(08:34):
housing the rules andregulations that dictate your
professional license, um.
So you just need to make surethat you're um introducing um
yourself to that.
But use ai or some of thesetools to dumb it down for you
and just say hey, I'm in Texas,I'm going to be coming to Texas,
I'm taking an assignment there.
Dumb it down for me under thesethree sections and then give me
(08:55):
some guidance.
I'm an LPN, can I administerblood?
Can I do some of these things Imay be able to do in Alabama
state over, but now I'm comingto Texas, can I do that?
So you utilize these tools.
Speaker 1 (09:07):
It can get really ugly when you have a lack of
understanding of what you'vedone or what violations may have
occurred.
You can get the ombudsmaninvolved, and I mean we're
talking.
There could be criminal chargesIf you're, you know, messing
with insurance.
If insurance catches wind, youbetter bet they want to save
(09:29):
money.
They'll come after you.
You know there's just a lot ofdifferent ways that things could
go and they'll all be happeningat the same time.
Don't think it'll be one rightafter another.
You'll be out money.
You'll be searching for lawyers.
You'll be calling Maggie saying, hey, what can I do?
Speaker 2 (09:48):
You know how did all these four letter agencies get
into my life?
Because all of a sudden you'regetting letters, and it's not
just from the board of nursingand I'm just using the board of
nursing loosely because we'retalking about our state, but
insert any state.
If you come to this state andlet's just say that you have
five other licenses, you and Iknow what that looks like.
You come to this state andsomething happens here.
(10:10):
You get reported to this boardof nursing.
Those other boards could comeafter you.
Speaker 1 (10:15):
In fact I've got some formal charges that I'll throw
up here in a moment.
And they had changed the boardof nursing.
They had a notice that camefrom the Board of Nursing.
They changed it and thensubmitted it and posted it out
to news outlets and for peopleto see and I mean, wow, to your
(10:37):
nursing license.
You really just ticked off theboard of nursing and they're
definitely going to be, you know, not happy with that, but we're
talking about that is now a.
That's a, I believe, federaldocument.
Speaker 2 (10:51):
I was about to say, is that not?
And again, now we're leaving mylane a little bit.
You altered a state documentthat might be a federal, I don't
know, right, yeah, exactly it's.
Speaker 1 (11:04):
I think it's absolutely up there with the
large heavy offenses.
So I mean, that's one one waythat you know you could get some
criminal charges, civil charges.
I mean people have the abilityto sue you civilly if they feel
like you know you videotape them, chat filter on a patient.
(11:28):
You know, yeah, they canabsolutely turn around and sue
you.
Not only then will you bebattling the board of nursing,
but you'll be trying to duke itout in civil court as well, and
I know that that's just going todrain tons of resources not
definitely not a position youwant to find yourself in at all,
and that's why it's so crucialto understand and, if you don't
(11:50):
know, get help from someone likemackie or an attorney or you
know the number one thing isthat you have to get a lawyer.
Speaker 2 (12:02):
Bottom line is if you're involved in any
litigation, I don't care if it'scriminal, civil, you get
arrested.
It's for you're in new orleans,it's your 21st birthday, you
are getting crazy on, you knowbourbon and you are arrested.
And you are for you know publicintoxication.
Unfortunately, I'm not tellingyou it's right, but you and I
(12:23):
both know the board of nursingwill be involved, because you do
.
You will also have to reportthat when you go to renew your
license and or you will have tolook at the rules and
regulations in your state.
When does it say you'resupposed to report an arrest?
Then we're going to go back tothat policy.
I promise you and I've seen itbecause I've had nurses reach
out to me who've gotten DUIs,who unfortunately, were in
(12:45):
leadership, and they reached outto me and said what do I do?
I said, well, we got a coupleof things you need to look at
and I just provide education.
Number one you do need a lawyer.
Number two well, number one,you better have professional
liability insurance.
Number two with thatprofessional liability insurance
, you're going to call thatlawyer and you're going to start
talking to them.
Number three you know what thepolicy says at that organization
More likely than not as well,especially as a leader.
(13:07):
It's going to say that if youget a DUI or PI, you are
arrested.
You will have to let youremployer know, and then your
employer can leverage thatagainst you as well.
So you do have to understand,because if you show up to your
job, whether you're inleadership or not, and the
policy does say that you'resupposed to report, and let's
(13:29):
just say, for example, you're onbusted and you and I both know
this is a thing and your picturegets sent to oh I don't know
the CNO, and I would love totell you that it's never been a
thing You're more likely thannot going to get terminated
instead of you responsibly goingto your leadership.
And maybe just now because insome states if you're terminated
that's automatic retelling youhave to tell the board of
(13:50):
nursing because they want toknow if you're terminated.
And not only that, now, that'son your application or your
resume that you can never lieabout you, and I know that a
lawyer is not cheap, that aninvestigation could go on to two
to three years.
You have more than one type oflitigation.
The financial burden could beso profound.
But all these things, one event, I think we're all we're trying
(14:13):
to point out here, where oneevent whether you let culture,
whether and culture is havingyour phone on you all the time,
using it appropriately, goinglive, texting, talking about
patients on your first personalphone because I'm going to even
extend that a little more youand I both know that is a huge
no-no employer phone.
(14:37):
I'm allowed to use my employerphone that they've given me to
not TikTok out or live streamout, but to communicate.
The physicians can call me onmy personal phone on tiger text
and don't even get me startedwith that.
No, because am I following thepolicy as it pertains to tiger
texts?
I'm not, and only that.
Am I willing to hand over myphone for discovery, and only
(15:00):
that?
Am I willing to hand over myphone for discovery?
Speaker 1 (15:02):
Not for my organization.
Speaker 2 (15:03):
Stop it, right, right oh not a chance, no, exactly.
Speaker 1 (15:07):
Well, let's take a look at these formal charges.
We'll kind of just I want tojust showcase what they look
like for everyone and then we'lltalk about.
You know, we've we've reallyoutlined the risks.
We'll kind of talk about sometools and some rules to be very
mindful of.
Speaker 2 (15:24):
So formal charges are beyond what the allegations
would be.
So the complaint would come andthe investigator could send out
an allegation.
Some states will just send outa complaint we were talking
about earlier.
Texas will send out a full onallegation.
If there's solid evidence we'llgo back to the live streaming.
(15:47):
There is actual evidence of theconduct.
It's just non-negotiable.
There's no way to get around it.
More likely than not, you'regoing to be sent formal charges,
like she has presented here.
The first piece of it is thenurse's basic information.
This is a formal documentthat's generated.
This is what I would have beencreating, created.
It was just a basic templatethat I was bleeding in the
(16:10):
nurse's name, the violations itwas word perfect folks and I did
say word perfect and it wouldbe stopped so it wouldn't be an
allegation.
You see, here is charge one, somoved from the allegation to
the actual formal charge, alwayslisted out as honor about this
(16:31):
date.
This time it's very basic.
This one just happens to be afamily nurse practitioner.
It would be licensedpractitioner, it would be
whatever your credentialing wasRN and then would move on to.
You are the respondent and theTexas Board of Nursing are
alleging this against you on orabout this date.
This time We'll list out someviolations, like we referenced
(16:53):
in the very beginning, underunprofessional conduct, grounds
for discipline and standards ofpractice.
That's why I said it wasimportant to know that, because
that's where these violationswould have been pulled from.
So they'll reference those.
You get a notice.
This is basic, just kind oflanguage, legally language.
That's put it there.
(17:15):
You are being noticed.
The notice is this formalcharge that would be sent to the
nurse via certified mail.
That's why it is required foryou to keep your address up to
date.
If you do not respond to theboard of nursing or if they send
this to you more than threetimes, that can lead to the
revocation of your license.
When you involve your lawyer,which you should absolutely do,
(17:36):
so that's a layer of relief, Ifeel like, for the nurse as well
.
You're not getting thatcertified letter.
That can be very stressful forthe nurse.
Your legal team will keep youup to speed, but your lawyer
will receiving that letter, thatany other communication from
the board of nursing.
So it is a level of comfort foryou and protection.
All of this even if you get aformal charge.
(17:59):
I want you to know as well.
It is not hopeless.
It is absolutely not hopeless.
You have legal representation.
You understand the process,even if this I know this is just
a little bit of a rabbit hole,but one of the little trigger
warning number one reasons why anurse will take their life or
attempt suicide is a bordernurse and complaint or formal
(18:20):
charges.
Nurse will take their life orattempt suicide as a border
nurse and complaint or formalcharges.
So it is not hopeless.
You get legal representation.
You work through the process.
All of this stuff, to a certainpoint, is negotiable.
That's why you have your lawfirm.
The violations can be looked at.
The different violations couldbe offered up.
The allegation can be rewrittenif it's not written
appropriately.
When I was the investigator, Iwould have something very basic
(18:44):
that I was writing up theallegation um up and it may not
be the full and complete story.
Speaker 1 (18:49):
Therefore, your legal team can come back and
negotiate stuff with the board,even if it's sent in uh, the
formal charges yeah, no, and I'dactually like to really
piggyback off that We've handleda case where social media was
presented as evidence, right.
(19:10):
So we're talking about, I mean,this is the board of nursing is
saying here, here it is, we'vegot it.
Our firm love this.
Our firm argued that thatevidence was insufficient,
unauthenticated, that thosewitnesses were unreliable, they
(19:30):
weren't credible, and thisperson ended up getting a
disciplinary order, but with CEcredits and with an attorney.
This really just speaks to how,how Essential, essential use
the right word Essential.
Yes, they modified the findingsto include a statement that the
(19:54):
accused had completely denied.
All of these allegations, right,all of these allegations, right
.
So there are things that yourattorney can do to negotiate, or
there's just a plethora ofoptions that your attorney knows
because they studied the lawand they understand this process
that you aren't aware of, thathappens behind closed doors,
(20:17):
that people aren't runningaround going hey, guess what my
attorney got me?
You know, two weeks instead of16.
It's not something people arerunning around saying.
So, absolutely, explore what anattorney can do for you and
your case.
Speaker 2 (20:35):
It's essential and, like you said, I say that every
day, all day.
That's the number one thingthat I say, because we don't
learn the nursing law Again.
I'm not here to tell you that anurse is not going to make a
mistake.
Our nurse doesn't do somethingwrong, but that doesn't mean
that you should be punished, orfor the rest of your life, or
again.
I'm not talking about someonewho's intentionally harming
(20:57):
someone.
I'm talking about an nurse intheir everyday life.
Sure, this is a social mediathing.
Is this, you know?
Should any nurse be going live?
No, but they're going to do therestitution, they're going to
do time and should they be ableto go on with their life?
Yes, and that's why you haveyour legal representation to
help you mitigate and that'swhat she's saying mitigate the
outcome, because I'm here totell you, the nurses reached out
(21:18):
to me once they're done withthe law firm, and now it's a
year, it's two years from now.
They're like now I'm on theselists, now I'm on these, or they
do without the lawyer.
They are on these lists, buttheir lawyer and myself were
thinking about no, no, no, no,no, so we don't agree to this.
So what we can agree to andwhere the lawyer, or even I mean
I've worked with your law firm,that's how we've crossed paths
(21:39):
Right, and I'm like hey, youknow, maybe this one, or you
know, I could see where a nursecould do this, because I am the
subject matter expert, I workedin that modality, right there, I
could speak to it a little bitmore and you're like that's a,
that's a great idea.
Or the lawyers like that's,that's, yep, we're going to do
this.
You know what I mean.
Those are all things that arevery much negotiable.
Speaker 1 (21:59):
What can license holders do nurses specifically,
to avoid this regulatory pitfall?
I know that we've touched on ita few times.
You know already this episode.
Obviously don't go live at work, but what are some other, maybe
not so obvious things thatnurses should be aware of?
Not so obvious things thatnurses should be aware of?
Speaker 2 (22:22):
So I'm going to plug myself just for a minute.
I do offer a charting course.
Oftentimes you and I both knowwhen we're looking at.
Now this is a little bitdifferent because we're
referencing primarily like avideo or something that's out
there, but oftentimes it isaround a practice and so what
you do or do not document is abig deal, and if you don't
(22:43):
document it, you know that itgets harder to validate.
You know what was done now,obviously, with the growing, you
know, staffing ratio issues,with us pushed to, you know
taking on more unsafeassignments, of course we do the
care first.
No one's asking you to chart inreal time.
(23:03):
That's not a reality.
What I'm saying is making surethat you're advocating for
yourself and you're not takingon an unsafe assignment.
What does that look like inTexas?
I'm going to say 217.11.1S isthe person making that
assignment, which I don't feelis safe, and then T me accepting
that assignment.
Are you asking me to violatethe nurse practice act?
(23:26):
There's a tool I just gave youknowing the nurse practice act,
our state is very specific.
But then you say are you askingme to violate that?
And then they pause.
Then you're going to doubledown and say you're going to
deviate.
Now you know a different typetype of law.
Medical malpractice isknowingly and willingly taking
on an unsafe assignment.
Are you asking us you and I andall the leadership for me to
(23:49):
take on an unsafe assignment?
Because the definition ofmedical malpractice is knowingly
and willingly taking on anunsafe assignment in a
professional, respectful manner?
You could have in a manilafolder I I like to say print it
out.
This was two, 17, 11 on yourbadge.
We all have these little badgebuddies.
You know what I mean.
Pin that on the back of yourbadge and you're just going to
(24:12):
read from that.
It's not you, it's the board ofnursing, in a professional,
non-heated tone.
Number three in Texas we do havesafe Harbor.
Now number four is ADL acceptdespite objection.
Let me be really clear, and youknow this as well ADO accept
despite objection is a tool usedby unions.
I know that can be considered acuss word.
(24:32):
I don't have any problems withthat tool, whatever that is.
But let me just be real clear.
That is not safe harbor and Idon't know what that looks like.
If the board of nursing doesnot approve that piece of
documentation and you acceptdespite objection, that will be
produced in civil, criminal andpossibly Board of Nursing
litigation.
That is not the same thing assafe harbor, which enacts the
(24:56):
peer review process to have yourassignment looked at for you.
Ideally then you would leveragethe 217, 11, 1, s and t I just
named two, but there could beother things.
If you don't have the education, training and knowledge, that's
another under those threesections.
That I said is a 10 minute readthat you could now leverage.
(25:16):
Do not take for granted yourorientation.
Do not take for granted yourorientation.
Do not take for granted yourorientation.
It is owed to you.
Do not let them make you thinkthat it is not your right to
have that.
It is.
And then I'm going to lean backin on how do I have the
education, training andknowledge that I am quoting the
Board of Nursing.
If you're not affording me anorientation, then you would
(25:39):
quote that.
If you're saying that I don'tget six, uh, 12 weeks, you're
going to go to evidence-basedscience, research to pull that
in.
And then you're going to leanin on the board of nursing,
where it does say that I amtouching on something.
I'm not sure if you're aware ofthis happening in my, in the
nursing environment, wherethey're not extending the new
(26:00):
nurses a full 12 weeks, and I'mnot even tied to 12 weeks
because if I'm working in thenursing environment where
they're not extending the newnurses a full 12 weeks, and I'm
not even tied to 12 weeksbecause if I'm working in the
ICU, how do you know in 12 weeksthat I'm going to be ready to
manage someone who's criticallyill on my own?
You don't.
So come back to the table,reevaluate that and then you
work out a plan, but you lean inon the board of nurses saying
(26:23):
that I have the education,training and knowledge to take
care of this person on my own.
But you see what I mean In all,even tone, even tone.
I did not change my tone andand a respectful and I'm not
going to tell you you're notgoing to get harassment.
But if you all stand togetherand you all have the same
knowledge, if you all standunited to charge nurses and
(26:44):
taking patients, but you usethese tools and you stand united
, and all I did was quote therules and regulations.
I didn't quote anything else.
That was it.
Speaker 1 (26:54):
That was it.
Yeah, I mean, I think it'ssomething that nurses have been
dealing with for a long time, sothose are fantastic tools for
people to feel empowered and beable to put their foot down when
they know that things aren'tright.
Speaker 2 (27:11):
I have free resources on my website charting tips and
then just some basic stuffabout board of nursing
investigations, cause I do thinkthat all nurses I I'm about a
little bit scared straightbecause you and I know if, if
they're coming to either one ofus, the process has already
started, exactly.
Speaker 1 (27:31):
Yeah, something's already happened.
Speaker 2 (27:34):
Two to three years more likely of your life.
The financial burden, theunknowing, the when is the next?
It's all these things that youand I hear every day that I
don't want for you, I don't wantfor any nurse.
So the more that you understandthat, that the board of nursing
and just as we wrap it up,because the thing that's not
beaten to us enough and maybe alittle mind blowing to you but
(27:58):
we're not really taught that theboard of nursing is not there
for us.
Speaker 1 (28:02):
Yeah, no, it was.
I think that is mind blowing.
And there's a yeah, you wouldthink that the board who granted
you the license would kind ofkeep you in their corner, right,
but no, they're there toprotect the public and that's,
that's really big.
They regulate your license andyou know they don't.
(28:23):
Say that again we're on theregulator Right, you got to know
your regulator and that's whyit's it is.
This is we've created this tohelp kind of bridge that gap
between I don't understand thisor even if you're you're reading
(28:44):
it, you don't really understandwhat you're reading and you've,
you have to, you just have to.
You've got to figure it out.
Speaker 2 (28:48):
This is where you leverage the tools that we're
talking about Cornell law, ai,whatever you're using, plug it
into to to AI.
You're coming to Texas, youpractice here, you're a new
nurse and you're trying tofigure out what exactly is my
scope of practice in an ICU, ina surgery center, in a home
health setting and leveragethese tools that we already have
(29:10):
in our environment to help you.
If nothing else, it'll get youthe link to the Texas Board of
Nursing or the National Councilof State Boards of Nursing.
And the last tool that I'mgoing to leave everyone with as
we wrap it up, that I talk aboutin my charting class and
anywhere that I speak or I doanything across the nation, is
(29:32):
the decision-making framework.
It is eight questions that youare asked and please bring up
the visual folks, you need tolook it up.
It comes from the NationalCounselor, state Boards of
Nursing, who gives guidance toevery state to put the rules and
regulations in, and one ofthose is the decision-making
framework.
It goes one through.
(29:54):
Eight says what yes or no.
It's either yes, you move on,or no, it's a stop.
And the last one is numbereight Are you willing to accept
the responsibility of youractions.
The big one.
It's huge when you make thatfinal decision, whether it's
you're going live on socialmedia, you're, you know, doing
(30:18):
something, you're copying,you're pasting, you're deleting,
you're doing something in yourworkplace and your little
nursing guts telling you folksdon't do it.
Speaker 1 (30:28):
Don't do it, you better be willing to accept the
responsibilities, those actionsand all those consequences that
come with it.
Speaker 2 (30:38):
Yes, and the reporting to a board of nursing
the mirror, because one of thequestions that people don't
realize if you're arrested or ifyou're, in salt, involved in
civil litigation or you're foundnegligent in civil litigation.
Early on in my career, one ofmy very good friends and I did
help for her to get her licenseback after she got her revoked
because she was involved incivil litigation where they
(31:00):
found her civilly negligent fora pressure ulcer.
Her husband was active duty,she moved, didn't update her
address something that couldhave easily probably been
handled but because she didn'tget those three letters that led
to the revocation of herlicense, not just one, but all
her license fell.
So one act you and I both knowcan lead to so many other things
(31:27):
.
So, yes, are you willing totake responsibility for your
actions?
Speaker 1 (31:33):
Thank you very much, maggie, for pulling this curtain
back on.
You know what really happenswhen social media collides with
the Nurse Practice Act.
Texas Board of Nursing getsinvolved, and that's obviously
not something you want to happen.
So here's your big takeawaySocial media is never personal.
When you're a licensedprofessional, what you post can
(31:54):
follow you straight into a boardinvestigation.
Make sure you're protectingyour patients, your
professionalism, most of all,your license.
Check out our links below tovisit Maggie's advocacy
resources.
Read the Texas Board of Nursingsocial media guidance, huge one
and more.
Be sure to subscribe, share andjoin us next month as we
(32:16):
continue charting the issuesthat matter to Texas medical
professionals.
Until next time, know yourrules, guard your license and
keep charting Texas.
Speaker 2 (32:26):
Know your Regulator.
The podcast that inspires youto engage.
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