Wall St. Journal blog questions nurse practitioners’ connections with Pharma reps
Written on February 18, 2011 at 12:13 pm, by admin
Food for thought — NPs may be too chummy with drug reps. See the blog and how the commenters respond.
http://blogs.wsj.com/health/2011/02/17/nurse-practitioners-get-free-meals-from-pharma-too/
Why we have too few women leaders
Written on February 7, 2011 at 11:15 am, by admin
There’s an interesting clip at http://www.ted.com/talks/sheryl_sandberg_why_we_have_too_few_women_leaders.html. Sheryl Sandberg, COO of Facebook, talks about “Why we have too few women leaders.” In summary, she gives the following advice:
1) Sit at the table. (If there is a meeting, don’t sit off to the side. Raise your hand to make comments. Negotiate when you want something.)
2) Make your partner a real partner. (She’s talking about life partners here.)
3) Don’t leave before you leave. (She notes that once a woman decides to have children, typically she stops raising her hand and leans back from success, often long before she is even pregnant.)
It’s worth a listen.
Nursing audit
Written on February 1, 2011 at 11:46 am, by admin
I am working on an audit tool for hospitals to use to evaluate and improve documentation by nurse practitioners and nurses. My intention is to provide a “nursing audit” service to hospitals. The audit focuses on three things: documentation to support billing, documentation to defend against malpractice claims and documentation to communicate about patient safety issues.
I have two packages in mind, one where I provide the tools and the hospitals conduct the audit and one where my office provides the staffing to do the audit and a report detailing what went right and how the system needs to be changed to improve. If anyone reading this has expertise with nursing audits, I’d love to talk, and maybe even hire you.
“I’ve been terminated”
Written on January 24, 2011 at 10:19 am, by admin
I have been getting two types of queries in greater numbers than ever before in my 20 years of practice as an attorney. One is “I have been terminated, I think wrongly. Can I sue?” The other is “My practice has been audited and Medicare (or Blue Cross) wants thousands of dollars back. What can I do?”
This entry is about the first query. Employment law varies somewhat from state to state. The best advice is likely to come from an attorney who specializes in employment issues. (I don’t.) So, consult an attorney in your state who specializes in employment law. Here are the basics, which the employment law specialist can build upon:
In general, an employer can terminate with or without cause — “at will” — unless a) the employee has a contract which states specific reasons why the employer may terminate or b) the termination infringes upon Constitutionally guaranteed rights, or c) one of a few other exceptions apply.
The U.S. Constitution prohibits firing based on race, color, gender, national origin, religion, age, disability or marital status. Terminating an employee for any of these specific reasons may violate state or federal law.
In addition to these rights, there may be state laws that protect employees from termination or retaliation for filing workers’ compensation claims, for attempting to enforce rights to receive overtime or the minimum wage, for asserting rights to work in a safe workplace, for refusing to commit criminal acts, for reporting for jury duty or military service or for being subject to a wage attachment for any one indebtedness.
In addition, it may be illegal for an employer to terminate an employee for refusing to break a law or for taking leave under the Family and Medical Leave Act (if the Act applies to the work setting). And, there may be recourse if the employer does not follow its own stated procedure or policy regarding termination.
Most of the time, however, employers fire people because they need to cut back expenses, and therefore someone has to go. So, most of the time, there is no recourse for the employee.
Four recent articles on Medscape
Written on January 20, 2011 at 4:48 pm, by admin
Here are four very recent articles I wrote which appear on Medscape (www.medscape.com):
You have to register to view, but registration is free.
Can I sue if I am bullied at work?
Can I sue another person for slander?
What constitutes fraud when billing “incident to”?
Three frequently asked questions about malpractice insurance
Career advice for nurses and nurse practitioners
Written on January 19, 2011 at 11:37 am, by admin
I get quite a few e-mails from nurses and nurse practitioners asking for advice about the next steps in their careers. Go to law school? Get a doctorate? Start an independent practice? Become a legal nurse consultant?
Here is what I have learned about careers in nursing. There are two routes — become an assistant to the expert or become an expert. Both can be rewarding.
If you are the assistant to the expert:
•Be very selective about to whom you hitch your star. He/she should be someone whose approach, ethics and knowledge you respect.
•He/she should treat you well and acknowledge that his/her day will go better if you are around. If not, leave and find someone more appreciative. Or become an expert.
If you want to be the expert (and you are a nurse):
•Chose a subject or specialty that physicians in the area aren’t already known for.
•Chose something well within your legal scope of practice, because you don’t want to be spending your time fighting off challenges.
•Chose something you are interested in, that can be expanded. For example, you might become an expert on management of symptoms of fibromyalgia. Later, you can expand that to management of symptoms of other conditions where there is chronic pain.
•Once you have chosen your area of interest, go to every conference on that subject, read every journal article and book on that subject, and monitor every blog on the subject.
•If your expertise is clinical, monitor your performance with your patients in a measurable way.
•Once you have amassed a reasonable volume of knowledge, volunteer to give a talk on the subject.
•Fashion the talk into an article.
•After you have written 10 articles, put them together to make a book. Once you have written the book, you are the expert.
What this blog is, and is not
Written on January 18, 2011 at 3:07 pm, by admin
A couple of months ago I visited the blog of a food writer someone had recommended — www.orangette.blogspot.com — and went back from time to time to see what she was doing. After I learned how to arrange feeds to my home page, viewing blogs became so easy that my occasional interest in blogs blossomed into a daily routine where I check my feeds for news and musings from other nurses, attorneys and hospital executives, as well as a few book and food writers. If you haven’t set up your own system of feeds, I highly recommend it.
I realized that I have some things to say about clinical practice, as it relates to the laws governing our health care system. Some of the things I have to say aren’t really appropriate for a journal article or Medscape article. A blog seemed like a way to share what I have learned, quickly and easily.
What I will do with this blog is comment on what strikes me in the course of going about my business of practicing law. I specialize in legal and business issues involving advanced practice nurses, physician assistants, physicians and the facilities that employ them.
What I will not do is breach the confidentiality of my clients. Or give free legal advice. Or moderate a whine-fest.
