Nevada State Board of

Nevada State Board ofNevada State Board of

HOW TO RESPOND WHEN YOUR APN CERTIFICATE IS AUDITED

June 2009

CONGRAT

ULA

TIONS

GRADUATE

S

I HAVE A QUESTIONABOUT SCOPEOF PRACTICEWhat Can I Do?

MEDICATIONSAFETY EDUCATION

WHY WOULD I WANT TOBE A CHIEF NURSE?

NATIONAL CERTIFICATIONI renewed my license butI haven’t received itin the mail yet!

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3Nevada State Board of Nursing l Toll-Free 1-888-590-6726 l www.nursingboard.state.nv.us

contents21

Board and Advisory Committee Meetings 5You’re In Good Company 5

Nurse Practice Act 5But I Don’t Even Have a Child! 7

Haven’t Practiced For Five Years? 7Use Website To Verify Active License/Certificate 15

Don’t Submit A FraudulentApplication! 15Mailing List Reminder 15

Toll-Free Consumer Hot Line 20Board Members 25

Change of Address Form 27Disciplinary and Licensure/Certification 28

Staff Directory 30

Circulation includes more than 34,000 nurses,nursing assistants and student nurses.

8

11

The mission of the NevadaState Board of Nursing is toprotect the public’s health,safety and welfare througheffective regulation of nursing.

Editors:

Dean EstesDirector of Finance/Technology

Debra Scott, MSN, RN, APN, FREExecutive Director

5011 Meadowood Mall Way,Suite 300Reno, NV [email protected]

The Nevada State Board ofNursing News publishes newsand information quarterly aboutBoard actions, regulations, andactivities. Articles may be reprintedwithout permission; attribution isappreciated.

NEVADA STATE BOARDOF NURSING5011 Meadowood Mall Way,Suite 300Reno, NV 89502-6547phone—888-590-6726fax—[email protected]

2500 W. Sahara Ave., Suite 207Las Vegas, NV 89102-4392phone—888-590-6726fax—[email protected]

WORLD WIDE WEB

www.nursingboard.state.nv.us

C O N T A C T

The Board extends a big THANK

YOU to our advertisers. Because

of your support, we are able to

provide this magazine at no

cost to every Nevada licensee

and certificate holder.

For Advertising information contactJane Saunders atVoice/Fax: 267.295.1889email: [email protected]

4

If I Have A Question About Scopeof Practice What Can I Do?

How to Respond When YourAPN Certificate Is Audited

8Meet the Staff: Melissa Myers 11

12APN Practice Audit Checklist 14

Medication Safety Education 18Board Takes Steps to Become Green 19

Why Would I Wantto Be A Chief Nurse? 21

The Truth About NursingAssistant Trainees In Nevada 26

Words from the President

6Words from the Executive Director

AS WE ENTER the 21st century, technologycontinues to play a huge role in how things aredone. In my last article, I discussed theinevitability of change. In the NSBN’s businessmeeting that will be held in July; we plan todiscuss the elimination of the “hard card”license. This action is being considered forseveral reasons.

Seventy to eighty cards are returned to theNSBN office each month marked “non-deliver-able”. The card was initially created to be a bar-rier against fraud, and sadly it is not. Because oftechnology, licensure verification is available onthe NSBN website 24 hours a day, 7 days a week.

Technology is only a benefit if we implementit completely. It is frustrating when a newprocess is implemented and the old processremains in place, making double the workinstead of the intended outcome of lessening thework burden. Since the technology now exists toverify licenses on line, the need for a hard card isless evident. In my opinion, it only makes senseto eliminate the card.

This change is not without angst. The biggestconcerns are “Will I still be notified by theBoard of my pending renewal?” and “I havealways had a card; what will I do without one?”

Currently the NSBN, by regulation, sends arenewal reminder to each nurse. But many ofthese reminders, like the hard cards, arereturned, come back to the board, never reach-ing the intended receiver. This wastes dwindlingresources and isn’t efficient.

Perhaps it is time for each individual nurse tobe prepared to be responsible for renewinghis/her own license. Your license is renewed

every two years, on your birthday, so it is not arandom date that continually changes. Becausethere is an expectation that 30 continuing edu-cation hours be obtained throughout that two-year period, it is a deadline that requires fore-thought and planning.

Given those two requirements, license renew-al should occur in an orderly fashion, not one ofsurprise. Remembering your renewal date shouldbecome a part of your ongoing professionalresponsibilities.

In my 40 year nursing career, I have had tomake many adjustments to change. I think it isunreasonable to expect that everything remainsthe same. I have actually been appreciative ofmany of the changes. For example, Do you reallymiss glass syringes? (for those of you old enoughto have used them…remember how the medi-cine would leak out if you didn’t steady theplunger in the barrel?) Do you really miss wash-ing glass thermometers? (and ruining an entirebatch by using hot water?)

Perhaps it’s time to retire the dinosaur of a“hard card”. It can become a souvenir of yourpast. It can go on the shelf with your cap andyour nursing cape. As time passes, your grand-children can sell it on E-bay as an antique. Aswe continue to move forward into the 21st cen-tury, we can embrace the convenience of today’stechnology, while at the same time, conservingour resources.

4 Nevada State Board of Nursing l Toll-Free 1-888-590-6726 l www.nursingboard.state.nv.us

Wordsfrom the President

Doreen Begley, MS, RNPresident, Nevada State Board of Nursing


DO YOU HAVE A QUESTION?If you have questions regardingnursing practice, the first place tolook is inside your Nurse PracticeAct. If after reading it, you still havequestions, call the Board. If it is anissue that needs further definition,you may request the Board issue apractice decision. The Board willthen ask its Nursing AdvisoryPractice Committee to research theissue and make a recommendation.

FOR MORE ANSWERS—GET INTO THE ACTThe Nevada Nurse Practice Act is a5-1/2” by 8-1/2” booklet. It’s just$5 if you buy it at the Reno or LasVegas office, and $8 by mail (makecheck or money order payable to theNevada State Board of Nursing).

THE ACT IS ON THE WEB The Board’s websitewww.nursingboard.state.nv.us has alink to the state laws (NRS), regula-tions (NAC), and practice decisionswhich make up the Nurse PracticeAct. It also contains a separate sec-tion on practice information, includ-ing guidelines for determining scopeof practice.

LEARN ABOUT THE ACT ANDEARN TWO CEsTake the Nurse Practice Act (Nevada)continuing education course atwww.learningext.com. For only $12,you will learn about the role of theBoard and your legal responsibilitiesas a nurse or CNA, and earn two con-tact hours of continuing education.

MEETINGS AND OPENINGSThe openings (listed in parentheses) willoccur in the next six months. All meet-ings will be held via videoconference inReno and Las Vegas.

Advanced Practice AdvisoryCommittee (one)August 18, 2009November 3, 2009

CNA Advisory Committee (two)July 7, 2009October 22, 2009

Disability Advisory Committee (one)October 23, 2009

Education Advisory Committee (one)August 7, 2009October 23, 2009

Nursing Practice Advisory Committee (one)June 9, 2009August 4, 2009October 13, 2009

B O A R D TA L K

BOARD MEETINGS

A seven-member board appointed

by the governor, the Nevada State

Board of Nursing consists of four

registered nurses, one practical

nurse, one certified nursing assis-

tant and one consumer member.

Its meetings are open to the public;

agendas are posted on the Board’s

web site and at community sites.

BOARD MEETING DATES

July 15-17, 2009 – Zephyr Cove

September 9-11, 2009 – Las Vegas

November 18-20, 2009 - Reno

ADVISORY COMMITTEESThe Nevada State Board of Nursing

is advised by and appoints mem-

bers to five standing advisory com-

mittees. Committee meetings are

open to the public; agendas are

posted on the Board’s website and

at community sites. If you are inter-

ested in applying for appointment

to fill an upcoming opening, please

visit the Board’s website or call the

Reno office for an application.

COME TALK TO THE BOARD

During each regularly scheduled meeting of the Nevada State Board of Nursing,Board members hold a Public Comment period for people to talk to them on nurs-ing-related issues.

If you want to speak during the Public Comment period, just check the meetingagenda for the date and time it will be held. Usually, the Board president opens thefirst day of the meeting by inviting Public Comment. Time is divided equally amongthose who wish to speak. For more detailed information regarding the PublicComment period, please call the Board.

WE’LL COME TALK TO YOUBoard staff will come speak to your organization on a range of nursing-related topics,including delegation, the impaired nurse, licensure and discipline processes, and theNurse Practice Act.

YOU’RE IN GOOD COMPANY

Active Nevada licenses/certificates on April 24, 2009

RN • 25,581LPN • 3,228CNA • 6,602


MOTHER’S DAY, FATHER’S DAY,Nurses Day, and Memorial Day. . . take amoment and remember those aroundyou for their significance in your life. Ihave had the privilege for the last fewyears to be one of the judges for theNorthern Nevada Nurses ofAchievement Awards Dinner. It truly isa gift to read the thoughts of the nurseswho have been nominated for the honorof being recognized by their colleaguesduring this celebration. Recounting theirexperiences in being a role model,describing what they are most proud of,and formulating advice they would givesomeone considering being a nurse arenot questions easily answered. The con-templation that goes into honestlyresponding to those questions brings pre-cious memories to mind.

Do you remember the first day youworked with an active nursing license?Do you remember the first time you putin an IV without someone looking overyour shoulder to make sure that you didit right? How about the first time youwatched someone be born, or someonedie? I remember the 4 year old withleukemia who ate his McDonald’s ham-burger in spite of his nausea, then vom-ited and promptly asked me if he couldhave another. I shared in the grief expe-rienced by the young Hmong motherwho labored all day to deliver her still-born baby, wrapped him in a blanketand sang to him while she rocked himgood-bye. I rejoiced when the 70 some-thing year old couple walked hand in

hand out of my office after surprisingthemselves at how each cherished theother. I am frequently in awe of thestrength, the wisdom, the sense ofhumor, and the commitment that peo-ple exhibit in this life.

The nurses we work with, thosewho are our friends, our sisters, oursons and daughters, or moms and dads,they amaze me in many ways—tack-ling the system that needs to berevamped, caring enough to encouragethose who have struggled before usand those who will succeed because ofthe foundation that we all have creat-ed together. We all share our wisdomand experience and find a new enthu-siasm from the interchange among themembers of our team. This professionaffords each of us the opportunity togrow and learn and give back to eachother, our colleagues, our partners, ourcommunity, and our patients.

Take some time today to rememberthose around you and honor their signif-icance in your life and in the lives ofothers. Know that each of you are sig-nificant in ways unknown to you anddraw strength from that knowledge.

Happy Whatever Day and bestwishes for a fabulous future.

Sincerely,

Debra Scott, MSN, RN, FREExecutive Director

Wordsfrom the Executive Director

Nevada State Board ofNevada State Board of

HOW TO RESPOND WHEN YOUR APN CERTIFICATE IS AUDITED

June 2009

CONGRATU

LATI

ONS

GRADUATES

I HAVE A QUESTIONABOUT SCOPEOF PRACTICEWhat Can I Do?MEDICATIONSAFETY EDUCATION

WHY WOULD I WANT TOBE A CHIEF NURSE?NATIONAL CERTIFICATIONI renewed my license butI haven’t received itin the mail yet!

Nevada StateBoard of

NURSINGNEWS

MagazineSchedule

ADVERTISING (COPY) DEADLINES

PUBLISHING DATE AD DEADLINE

August 25...........August 1

November 25 .....November 1

February 25 ........February 1

May 25 ...............May 1

For advertising informationcontact Jane Saunders at

Voice/Fax:267.295.1889

email: [email protected]


Nurses must take a refresher course

Haven’t Practiced For Five Years?

According to NAC 632.192(4): An applicant for renewal ofa license who has not prac-ticed nursing during the imme-diately preceding five-year peri-od must complete a course orprogram approved by the boardif he has otherwise satisfiedthe requirements for renewalset forth in this chapter andchapter 632 of NRS.

For more information and alist of approved refresher courseproviders, please visit theBoard’s website or call theBoard office.

We often hear this lamentfrom people whose applicationshave been returned to thembecause they didn’t think thechild support section applied to them.

But we don’t have a choice.It’s federal law that requiresapplicants to complete the childsupport section, even if theydon’t have children.

Your application will not beprocessed if you do not answerboth questions in the child sup-port section of the application.

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Scope of practice questions are frequent callsto the Board of Nursing. Do you have ques-tions about what is within your practice orthe practice of a co-worker? Well, chancesare if you are asking the question, so areother people, so let’s find an answer.

Where to Start. The first place to look for an answer to any

scope of practice question is in the NursePractice Act (NPA). Chapter 632 of theNevada Revised Statutes and the NevadaAdministrative Code deals with all ofthe laws for the Nevada State Board ofNursing. The NPA can either beaccessed online through the Board ofNursing’s website or a copy can bepurchased from one the Board ofNursing offices. Included in this sec-tion you will be able to answer somequestions on whether or not a task iswithin the scope of practice of thenurse or the CNA. However, obvious-ly not all tasks can be listed, so whereto go from there?

Practice Decisions.Maybe the question has already been asked and

answered by the NSBN Nursing Practice AdvisoryCommittee. Again, practice decisions can beaccessed electronically at the Board’s website or they can be found in the back of the NursePractice Act. Still haven’t had your

question answered?

Decision Tree and Policy and Procedures

Any of you who have ever called theBoard of Nursing and asked if a cer-

tain task is within the scope of prac-tice of a nurse or CNA have

probably been referred to eitherthe Scope of Practice

Decision Tree or to yourfacilities policies and pro-cedures. This would beyour next step. Locatedagain online and in the

NPA is the decision tree.So let’s start there. The

By AMY CLARK, BSN, RN

IF I HAVE A QUESTION

ABOUT SCOPE OF PRACTICE

WHAT CAN I DO?


Decision Tree is a toolthat is extremely help-ful in determining ifyou are practicing with-in your scope. If youanswer “no” to any ofthe questions, stopbecause you are out ofyour scope of practice.Sounds simple enough,right? Not always, if youare still unsure, checkyour facility’s policies and procedures. Nopolicy or procedure? Well, then maybe itis time to ask the Nurse PracticeAdvisory Committee.

Nurse Practice AdvisoryCommittee (NPAC)

The NPAC is made up of at least 10nurses who are knowledgeable in all areasof general nursing practice in Nevada andtrends in national nursing practice. Thepurpose of the committee is to advise andreport to the Board on matters related tothe establishment of state standards ofnursing practice.

Getting Started with the NPAC

Once you have reached this point,there is now some work to be done. Wantto feel like you are back in nursing schoolagain? Well, here you go. First, go onlineto the Nevada State Board of Nursing’swebsite. There, under the Practice andDiscipline section, you can download aform entitled Practice Decision Requests.This form will be your template. Answeras many questions as you can on theform, as that will be the greatest help tothe committee. And how do you find theanswers to these questions? Well, this iswhere the back to nursing school partcomes in. Research, research and moreresearch.

ResearchIf you have access to CINAHL

(Cumulative Index to Nursing and AlliedHealth Literature), this is a wonderful

place to start. ThroughCINAHL, you can accesspeer-reviewed journals,studies, and articles thatmay have been writtenon your topic. Next lookto professional nursingorganizations. Does theNevada NursesAssociation, or NationalOrganization forOncology Nurses, or

whomever the experts may be, have anopinion on your topic? When those areashave been addressed, then look at whatother State Boards of Nursing are doing.All fifty states, and some of the territo-ries, have web sites that can be accessed.Some are easier to navigate than others,but all are accessible. Start on the web-sites, and just as you did with Nevada’swebsite look under their Nurse PracticeAct and their practice decisions. If theinformation is not available online andyou think it merits a call to the Board,you will find that all the Boards are morethan willing to provide you with ananswer (or direct you to your facility’spolicies and procedures or decision trees).How many boards you contact is com-pletely up to you, but when you presentyour question to the committee, you wantto be able to present as accurate andcomplete a picture as possible about whatthe research shows and what the trendsacross the country already are.

The Committee MeetingAt the meeting you will be asked to

present your question and all of the won-derful research that you have completed.The committee will then discuss thequestion. If it is decided that there is fur-ther research needed, they may assign itto a committee member or create a taskforce to do that further research.

ResolutionAfter all of the research is completed

and has been brought back before thecommittee if needed, the committee will

discuss the issue and take all evidenceinto consideration. The committee thenvotes on whether or not to recommend tothe Board to adopt the practice decision.If the answer is yes, then the practicedecision is placed on the agenda for thenext Board meeting.

The Board MeetingNow the day has come to bring it to

the Board. The Board will listen to any-one who wishes to come forward and tes-tify, whether it be for or against the prac-tice decision. They will take all the testi-mony as well as the recommendation ofthe NPAC, the research, and all the evi-dence presented, into consideration andthen they can vote. The Board can voteto either send it back to committee formore research, vote to adopt the practicedecision (as is or as amended) or they canvote to not adopt the decision. Andhopefully at the end of all this you willhave an answer.

Hope to see you at the next NursePractice Advisory Committee meeting,by the way, as I’m sure you guessed, youcan find their meeting dates and times onthe Nevada State Board of Nursing’s web-site at www.nursingboard.state.nv.us.

The Board bids a fond farewell

to Marilyn Schmit, RN, and

welcomes Amy Clark, RN, BSN

to her new position as the

Applications Coordinator for

the Board. Prior to entering

the nursing field, Clark had 9

years experience in law

enforcement. Amy has been

with the Board for one year as

a nurse investigator and will

now bring her expertise to the

applications process.

Congratulations Amy!

Amy Clark



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Melissa Myers

Melissa Myers is the Board’s newest

employee. She began work as the

receptionist for the Las Vegas Board

office in January 2009.

In between answering many tele-

phone calls, Melissa greets and helps

people who walk into the office;

Melissa is scanning applications and

documents into the Board’s database

or doing quality assurance.

What she likes most about her job

working for the Board is that she

loves meeting all the different people

that come through our doors.

If she could tell readers about the

most important thing about her job it

is that she tries to help everyone to

the best of her abilities. With a large

number of walk-in customers in our

Las Vegas office, Melissa works dili-

gently to help everyone as quickly and

as efficiently as possible. “Helping the

licensees and certificate holders of

Nevada is my number one priority!”

Myers attended high school in

Arizona and is currently attending

The Art Institute of Las Vegas. She is

working towards an Associate of

Science in Culinary Arts and will be

attending College of Southern

Nevada (CSN) for a Bachelor’s

Degree in Culinary Management.

In her free time she rides her horse,

“Griffith”, and trains kids/adults to

ride horses. She has a rescued Saint

Bernard named “Bear” who is her joy.

She loves to go to car shows, old and

new...mainly to drool.

Meet the Staff Melissa Myers

Melissa Myers

Most importantly,you must respond tothe Board’s request fordocuments in a timelymanner. Failure to com-ply may result in yourbeing disciplined by theBoard. Now let’s try toquash your fears ofbeing audited.

You might be won-dering why the Boardchooses to audit you.The law requires thatwe audit a portion of licensees that haverecently renewed to determine if nurseshave the documents to support theirattestation on their renewal applicationsthat they have met the requirements forrenewal stated in the Nurse PracticeAct. For RNs, we audit whether or notthey have documentation to show thatthey have completed the required 30continuing education hours. It is morecomplicated for advanced practitionersof nursing (APNs). The Nevada StateBoard of Nursing does random monthlyaudits on all licensees and certificateholders who we regulate. Your chance ofbeing audited based on the number ofnurses we audit is that most nurses willbe audited about every 4 years. No

promises, though, sincethe names we audit arepicked strictly by ran-domizing thelicense/certificate num-bers in our database.

APN specific auditinformation

Board staff start theaudit process by sendinga letter to the APN whohas been chosen foraudit after we have

received the randomized license/certificatenumbers from our IT department. The let-ter is sent to the address of record in ourdatabase. (Caution: Nurses who neglectedto change their addresses of record after amove have been disciplined by the Boardfor noncompliance with the audit processbecause they didn’t get the audit letter northe letter noticing them of their Boardhearing.) The letter contains directions forsubmitting the information which thenurse will send to the Las Vegas office.The audit checklist which accompaniesthe initial audit letter was developed toassist in gathering the requested docu-ments. The APN has 30 days to gatherand submit the information; the letter willstate when the information is due.

Board staff review the continuingeducation certificates. The remaininginformation is reviewed and updated inour database file. This is our qualityassurance process to make sure that wehave the most current information onfile. There is then a final review of all ofthe audit documents. If any informationis incomplete or missing, the ExecutiveDirector’s administrative assistant willsend the APN another letter requestingthe missing information.

Most APNs who are audited submitall of the requested information, but wehave had many calls with questions aboutexactly what documents will meet therequirements of the audit. In addition,the documents we request are those thatthe APN must have at her practice site.The nurse’s protocols, the collaboratingagreement, a copy of the DEA numberand the national certification documentshould be kept at the practice site. Ifaudited, those documents will be readilyavailable to be copied and submittedwith the audit form.

Information YOU as an APN Must Remember

APNs in Nevada may not practice inNevada unless they have a currentNevada collaborating physician. If you

By PATTY SHUTT, LPN, LAS VEGAS SITE OPERATIONS SUPERVISOR

HOW TO RESPONDWHEN YOUR

APN CERTIFICATE IS AUDITED

Patty Shutt


terminate your agreement with one doc-tor, you may not practice until you havesubmitted the new physician agreementwhich includes your practice site or sites.If you are not able to obtain a currentNevada collaborating physician, you mustput your certificate on inactive statusuntil you and your new collaboratingphysician have signed a new agreementwhich has been submitted to the Board.If you move out of state and practice else-where, you must place your APN certifi-cate on inactive status.

The exception to the requirement of aNevada physician is for the APN who isemployed by the Veterans Administration(VA). If you are employed by the VA,you do not necessarily have to collaboratewith a Nevada physician. Nevada APNsemployed by the VA may be audited andwill be required to submit the same docu-ments as APNs who are working outsideof the VA system. The only difference isthat your physician will be employed bythe VA and may not have a currentNevada license. Your physician musthave a current license in another stateand the Board will accept the agreementalong with other documentation providedby the VA. Should a VA Nevada APNdecide to work outside the VA setting,the Nevada APN will then be required to

submit a collaborating agreement with aphysician who is licensed in Nevada.APNs not licensed in Nevada may notpractice outside of the VA system unlessthey get licensed/certified in Nevada.

You will have 2 types of collaboratingagreements, one is the one page documentfor the Board of Nursing, it can be found onour website www.nursingboard.state.nv.us,it must be on letterhead and signed byboth the APN and the physician withall the practice sites listed. This agree-ment is the APN alerting their regulato-ry board (nursing) they are collaboratingwith this physician. The second agree-ment is for the Board of MedicalExaminers and this document can befound on the Board of MedicalExaminer’s (BOME) website; this docu-ment must also be signed by both theAPN and the physician and must benotarized for the Medical Board. Thisdocument is the physician alerting hisregulatory board that he is collaboratingwith the APN. The Board of Nursingdoes not need the BOME document, norcan it be copied and submitted to theNSBN as the collaborating agreementfor the NSBN. Letters submitted withjust the information of starting with anew physician will not be acceptedbecause more information is required.

Please use the format which is availableon our website.

The following document is the actualchecklist Board staff use to process youraudit. Under Auditor’s Comments, wehave provided a description of the infor-mation needed to complete your audit.All of this information should be readilyavailable at your practice site so that youmay copy it and submit it to the Boardwhen audited. The information requestedis nothing out of the ordinary. We arelooking for evidence that your protocolsare reviewed on a regular basis andrevised to reflect current practice andthat you have a quality assurance processin place. Your agency may require sched-uled formal protocol reviews, but this isnot required by Nevada regulation.

If you are not certified through anational certifying/credentialing body,you must have a publication which out-lines the customary standards for yourtype and specialty of advanced practicewhich must be kept at your practice site.These publications are available on thenational certifying bodies’ websites.

This article is our attempt to alleviateyour concerns and answer the questionsthat arise when you are audited. Shouldyou have further questions, please don’thesitate to call Board staff for assistance.


Have I gotten your attention? At its March, 2009

meeting, the Nevada State Board of Nursing directed

Board staff to begin the process of writing new regula-

tions to require national certification for advanced

practitioners of nursing in Nevada.

The committee and the Board have voted to sup-

port the concept of requiring national certification for

APNs in Nevada. This would require a change in the

Nevada Administrative Code, an entirely public

process. Implementation must be carefully planned

and the importance of including “grandmothering” cur-

rent APNs, especially those who graduated from their

education program before the June 1, 2005, cut off

for Nevada’s requiring a Masters in Nursing to be cer-

tified as an APN.

In September, 2009, the Board will be consider-

ing the concept and wording for a regulation change

in the future. If you are interested in being involved

in this potential change, please check the Board’s

website on a regular basis for announcements of

public workshops and the hearing for regulation

promulgation.

The Advanced Practice Advisory Committee Believes that APNs in Nevada Should Hold National Certification


APN Practice Audit ChecklistPlease return this form with the materials being submitted for audit to:

Nevada State Board of Nursing, 2500 W. Sahara Ave., Suite 207, Las Vegas, NV 89102-4236

Practitioner: _________________________________________________________________________________________________

APN Specialty(ies): _____________________________________________________________ Audit Date: ___________________

ITEM REQUESTED RECEIVED AUDITOR'S COMMENTS

Auditor(s): _________________________________________________________________ Date completed: __________________

1. Current, signed protocols, including:

a. documentation that collaboratingphysician(s) have expertise withinyour area(s) of specialty,

b. evidence of current national certifi-cation, if no national certificationthen evidence of national standardsof practice available at practice sitethat APN practice meets standardsof customary practice for medicalspecialty;

c. classes of drugs, if you have pre-scribing privileges and evidence ofcurrent DEA certification

d. documentation of last date of reviewby collaborating physician(s)

2. Current, signed collaborating physicianagreement(s).

3. Documentation of 800 hours of APNpractice within the preceding fiveyears.

4. Documentation of process or systemused for quality assurance and signifi-cant outcomes of the system, includingevidence of physician review.

5. Certificate of completion for mandatoryfour-hour bioterrorism course.

6. Certificates of completion for 15 hours ofcontinuing education directly related toAPN specialty(ies) and 30 hours of contin-uing education required for RN license

1. a. You must submit:❏ Copies of current protocols with the date of the

last review of protocols (month & year) ❏ A copy of your collaborating physician’s license

with specialty or a copy from the Board of MedicalExaminer’s website printout showing specialty

b.❏ A copy of your National Certification showing certifica-

tion specialty, with the number and expiration date ❏ If not certified, then a copy of the front cover of the

publication used for customary standards of care inyour specialty (what you use in practice as a guidelinefor what your specialty allows you to do nationally)

c.❏ A list of the classes of drugs you are allowed to

prescribe in your practice❏ Copy of DEA card with number and expiration date

d. Documentation showing the last time your physicianreviewed your protocols, including date.

Please submit a copy of your current collaborating agreement

Submit a letter on letterhead from employer/ office manag-er/ Human Resources stating employment hrs as APN andtitle of person providing information

The frequency that your charts are reviewed, was there anycomments or changes, did it result in policy/protocolschanging and evidence physician has done the review. If nochart review, then describe the process that you use forquality assurance, eg. peer review.

Copy of Bioterrorism course certificate of completion.Course must be at least 4 hour course which meets therequirements in NRS 632.343 #3 a-e (check our websitefor specifics)

Copy of continuing education certificates which total atleast 45 hours (30 for RN and 15 hours directly related toyour APN specialty)


VA SIERRA NEVADA1\3 BKNEW AD

OR REVISED ADTO COME

As it states on your renewal applica-tion, you must keep copies of your con-tinuing training/education certificatesfor four years, in case you are selectedfor random audit. If you cannot proveyou met the renewal requirements fornurses (30 continuing education cred-its) or CNAs (24 hours of continuingtraining/education), your application willbe considered fraudulent and you may besubject to disciplinary action.

Nurses: the Board is also auditingfor compliance with the one-timerenewal requirement for a four-hourbioterrorism course. You must keep acopy of your bioterrorism certificate ofcompletion indefinitely.

Don’t Submit A FraudulentApplication!If you swear you completedCEs, you must be able toprove you did if you’re audited

The Board sells its mailing lists tovarious organizations, based on theirapplications. Examples include theNevada Nurses Association, whichmails its newsletter RNformation to allactively licensed Nevada nurses; con-tinuing education providers; uniformcompanies; and researchers. If youwish to remove your address from theBoard’s mailing list, you may do so bymaking a request in writing.

Just send an email to the Board,or mail a signed letter to the LasVegas office. Please include your fullname, address, and license or certifi-cate number. If you choose to removeyour address, you will still receive offi-cial Board communications such asthis magazine, the NSBN News, butyou will not receive the material sentby the organizations that purchase theBoard’s mailing list.

Mailing ListReminderYou can request to be removed

USE WEBSITE TOVERIFY ACTIVELICENSE/CERTIFICATEEmployers — when you’re

verifying that someone has an

active license or certificate,

the Board encourages you to use

our website verification system.

It’s quick, convenient, and it’s

updated within one business day

of renewal or initial issuance. You

can also call the Board for

verification at 888-590-6726.

Both methods ensure you have

the most up-to-date information

about the license or certificate

status of your employees and

potential employees.


RESERVED FOR AD SPACENEW 2 - PAGE FEATURE AD

TO COME


RESERVED FOR AD SPACENEW 2 - PAGE FEATURE AD

TO COME


Medication administration hasbecome increasingly complex over the38 years I have been a nurse. A cultureof safe medication administration is vitalto the practice of professional nursing.A number of years ago, I created an

assignment for nursing students inwhich they would interview a staffnurse and a charge nurse about med-ication errors on the unit. I wantedthe students to learn about incidentreports, procedures of calling doctors,and how hospitals track errors toimprove care. The really wonderfulthing the nursing students were consis-tently told by nurses is that whenevera nurse made a medication error, thenurse had not followed the five rightsof medication administration: Rightpatient, Right medication, Right dose,Right time, Right route—inflation innursing education has increased therights to between 6 and 10.Much to my surprise, during the

over five years I made this assignment,85% of all student nurses reported theywere told that medication errors werenot reported unless notable harmoccurred. Obviously, this is one of theGAP areas between practice and edu-cation, which may be impacted by thelegal liabilities in healthcare.Nursing is entering a new age of

accountability. Nursing medicationerrors now are front-page stories alert-ing consumers to the need for a cultureof safety in healthcare. Resources arebeing developed which enable nursesto be alert to types of medicationerrors that have occurred in hospitalsso that safeguards can be put in place.One resource for Nevada nurses

that is easily available if you haveonline access is the Nurse Advise-ERR newsletter. ISMP Nurse Advise-ERR is a federally certified publicsafety organization whose editor is a

nurse. There is a monthly newsletterthat gives specific case examples ofmedication errors, analysis of howthey occurred and suggestions ofchanging hospital or nursing practiceto minimize risk. The January 2009issue discusses smart pumps, misreadOxycontin and Oxycodone orders andlook-alike names like Jantoven,Januvia and Janumet. This newsletterhas had an increase in readership of1million nurses in 2007. Nurses allover the country are working as indi-viduals and in groups to improve thenursing safety culture.The newsletter utilizes the Federal

Aviation Administration definition ofa safety culture. It may be wise fornursing administration to actively pur-sue continuous improvement of safemedication administration as eachnurse’s individual responsibility.Surveillance and vigilance is at theheart of expert nursing practice.

“Safety culture is the enduringvalue and priority placed onworker and public safety byeveryone in a group at everylevel of an organization. It refersto the extent to which individu-als and groups will commit topersonal responsibility for safety,act to preserve and enhance andcommunicate safety concerns,strive to actively learn, adaptand modify (both individual andorganizational) behavior basedon lessons learned from mistakesand be rewarded in a mannerconsistent with these values.”

— Federal AviationAdministration reports 2002

A safety culture is the responsibilityof each and every nurse. How haveyou taken individual responsibility tobe a safe nurse this month?

MMEEDDIICCAATTIIOONN SSAAFFEETTYY EEDDUUCCAATTIIOONNBy ROSEANN COLOSIMO, PHD, RN, EDUCATION CONSULTANT

Much to my surprise,

during the over five years

I made this assignment,

85% of all student nurses

reported they were told

that medication errors

were not reported unless

notable harm occurred.


While conservation of energy andresources is not new, it has never beenmore pertinent than at this time.Regardless of our personal opinionsabout global warming, ozone, andwaste products, it just makes commonsense to reduce, recycle and reuse. Weat the Board of Nursing have takensteps in this regard and are continuallylooking for ways to reduce our impact.

The follow is a brief list ofsome of our efforts toreduce our carbon footprint:

• We are using a document scanningand imaging system and eliminat-ing paper whenever possible. Wehave saved an estimated 4,000sheets of paper per Board meeting(6 times per year) by utilizing thissystem to have paperless Boardmeetings. We also are utilizing thissystem to email resource informa-tion packets and agendas to ourcommittee members for committeemeetings (5 committees, approxi-mately 56 members, meeting aminimum of 4 times per year).

• We shred and recycle all paper inour office.

• We hold many meetings via video-conference between our offices toreduce travel.

• We have online renewal of licen-sure and are diligently working ononline initial applications.

• We recycle all office equipmentand computers.

• We are eliminating storage of filesby scanning the documents andshredding the paper documents.

• We have made the Nurse PracticeAct, disciplinary actions lists, and

all meeting minutes and agendasavailable on our website.

These steps have saved massiveamounts of paper, streamlined someprocesses and are laying the founda-tion for more services to be availablevia computer. Can we do more? Yes!With your assistance and cooperation,we can.

Future green initiatives weare considering:

• Eliminating the mailing outof the disciplinary actionslist. They are available onthe website and are pub-lished in this magazine.

• Eliminating or greatlyreducing the mailing outand receipt of paper person-nel lists. We currentlyaccept them by email andare happy to send notifica-tion that way if you providean address to us.

• Eliminating the licensureand certificate renewalpostcard notification thatare sent out to each of youevery two years. We cur-rently receive approximate-ly 200 a month back marked non-deliverable from the post office.Renewal is every two years onyour birthday—an easy day toremember. Query yourself on thewebsite verification system to seeyour expiration date.

• Eliminating the hard card licenseand certificate. We currentlyreceive 75 to 80 cards back eachmonth marked non-deliverable.The card was created to be a bar-rier against fraud, but sadly it is

not. Verification of licensureand/or certification is available 24hours a day, 7 days a week via ourwebsite. There currently are sev-eral states that have already elimi-nated their hard card nursinglicenses or are in the process ofdoing so. This would save theBoard thousands of dollars eachyear, estimated by our accountantat approximately $35,000.00, andeliminate plastic refuse.

In these very difficult economictimes, we are doing our part tokeep costs under control withoutreducing or eliminating anythingthat would present a barrier to pro-tecting the public. Keep watchingthis magazine and our website forfuture announcements andupdates. If you have any sugges-tions on how we can further reduceour carbon footprint, please don’thesitate to send us an email.

BOARD TAKES STEPS TO BECOME GREEN

Kathleen M. JonesNurse Attorney

28 yrs experienceRN since 1981

Attorney since 1993

MURPHY JONES LLP

Las Vegas Office

2855 La Casita AvenueLas Vegas, NV 89120cell: (702) 271-2122

Office/fax (702) 434-5316

[email protected]

Kathleen M. JonesKevin C. MurphyOffering legal servicesfor all Nursing Board

related matters, including disciplinary

defense and licensing issues.

FREE INITIALCONSULTATION


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For more information about Renown Health or to apply, visit www.renown.org

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TOLL-FREE CONSUMER HOT LINE

CALL 888-590-6726

The Nevada State Board of Nursinghas a hot line to help consumerswho have questions or concernsabout the nursing care they or theirloved ones are receiving. Pleaseencourage your friends, families andpatients to call the hot line if theyhave concerns about nursing care.And remember, if you or anyone elsewishes to file a complaint against anursing assistant or nurse, it must bedone in writing. Complaint forms canbe requested by calling the hot line orcan be obtained by visiting theBoard’s website.

Inspections completed by statelicensing agencies may result in theidentification of violations of the NursePractice Act (NPA) by RNs, LPNs andCNAs. Ultimately, it is the chief nursewho may be held accountable for theconduct of nursing employees based onNAC 632.224 which provides that aRN who is employed as a chief nurse isresponsible for the management ofother personnel under her supervisionand shall “create a safe and effectivesystem for delivery of nursing carewhich complies with nationally recog-nized standards”. If violations arefound during a survey or complaintinvestigation by a licensing agencyinspection and the surveyors identifythat the chief nurse may be responsiblefor a potential violation of the NursePractice Act, a complaint will be sub-mitted to the Board for possible action.

Taking this situation into considera-tion, why would anyone want to be achief nurse? If every violation of everyperson who works in my facility foundduring an inspection is forwarded tothe Board for action and ultimately Imight be held responsible for their con-duct, resulting in action taken againstmy license as a chief nurse, why wouldI take a chief nurse position?

First, the state licensing agencydoing the survey analyzes the datafound during the survey to ascertain

By FRED OLMSTEAD, GENERAL COUNSEL, NEVADA STATE BOARD OF NURSING

WHY WOULD I WANT TO BE ACHIEF NURSE?


whether or not a law has been violated.Only when and only if there is evi-dence of a violation, is the situationsubmitted to the nursing board forreview. The nursing board then does avery thorough investigation to find outthe facts of the case, always maintain-ing an objective perspective on theconduct of the nurse involved. Veryoften, it is evident that the chief nursehas made positive changes in her facili-ty policies and procedures, has inser-viced her staff, and has rectified thedeficiencies that led to the initial com-plaint investigation. Most importantly,because of the changes that have beenmade in nursing services, the originalreason for the complaint investigationno longer threatens patient safety. Thechief nurse intervened to meet herresponsibility under the Nevada NursePractice Act.

Let’s take a closer look at the regula-tion that gives guidance to chief nursesin how to protect themselves fromproblems with the Board. NAC632.244 is seemingly a double-edgedsword. First, the bad news is that chiefnurses may be disciplined for failing to“create a safe and effective system fordelivery of nursing care.” On the otherhand, NAC 632.244(2) clearly pro-vides guidelines for conduct. It states:

A registered nurse who is employed as achief nurse is responsible for the manage-ment of other personnel under his supervi-sion and shall:

(a)Establish the authorized scope ofpractice for the nurses he supervis-es and establish and document aprocess to carry out, maintain andimprove the knowledge, skills andability of those nurses to providesafe and effective care.

(b) Before assigning those persons,verify their ability to carry outsafely duties which are identified ina written policy and to follow theprocedures established by theemploying agency.

(c) Establish written guidelines to befollowed by personnel under his

supervision for receiving andadministering prescriptions. Theguidelines must include proce-dures for:

(1) Identifying the type of patient tobe served;

(2) Identifying the intended medicaltreatment; and

(3) Resolving any questions relatedto a prescription, if the prescrip-tion is not received directly froman advanced practitioner ofnursing, a licensed physician, alicensed physician assistant, alicensed dentist or a licensedpodiatric physician.

(d) Ensure that the guidelines estab-lished pursuant to paragraph (c)are available at each site wherenursing care is provided under thesupervision of the chief nurse.

To comply with NAC 632.224, achief nurse must:

• Establish written policies and pro-cedures which includes a process tocarry out, maintain and improvethe knowledge, skills and ability ofthe nurses and CNAs at her facility.The written policies and proce-dures, if followed, will provide safeand effective nursing care.

• Make sure that all nurses andCNAs at the facility are competentto follow the established writtenpolicies and procedures and areduly licensed/certified in Nevada topractice nursing.

• Make sure the written policies andprocedures are available at all nurs-ing stations or practice sites.

• Have a safe patient staffing planwhich is clearly followed in theallocation of nursing personnel forpatient care.

If a chief nurse does all of theabove things, in regards to the respon-sibilities of the chief nurse, she hascreated “a safe and effective system fordelivery of nursing care.” The chiefnurse has met the requirements of the law under which she will bejudged, and absent any other facts,will not be disciplined for violatingNAC 632.224.

The State of Nevada needs morechief nurses. Fear of being disciplinedby the Board of Nursing should notprevent nurses from stepping up andtaking charge to create a safe andeffective healthcare delivery systemfor her nurses to work in and to pro-vide safe care to the residents ofNevada. Nevada needs nurses toaccept a chief nursing position in afacility even if the system may haveareas needing improvement. If a chiefnurse accepts a challenging positionand establishes effective policies andprocedures that are followed by hercompetent staff, she will therebyestablish a safe and effective system.That chief nurse need not worry aboutbeing disciplined by the Nevada StateBoard of Nursing, as long as she meetsthe requirements of the NPA.

22

Nevada needs nurses

to accept a chief nursing

position in a facility

even if the system may

have areas needing

improvement. If a

chief nurse accepts a

challenging position and

establishes effective

policies and procedures

that are followed by her

competent staff, she will

thereby establish a safe

and effective system.


Need Representationbefore the State Board?

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Applications/Renewals Random Audits/Denials Unprofessional Conduct Fraud/Falsification of Records Abuse/Neglect of a Patient DUI/Chemical Dependency/Diversion All forms of Disciplinary Action Self Reports Settlement Negotiations Hearings/Appeals/NDB Disputes Probation Support & More

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We have moved!!! Please note our new mailing address below.

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Email: [email protected] • Website: www.tlsinghlaw.com

Tracy L. Singh, RN, JD

Doreen Begley, MS, RN

President, RN Member

Term expires 10/31/12

Betty Carlgren, LPN

Vice President, LPN Member


Carrie McMurray, CNA

Secretary, CNA Member


Kelly DeMaria, MSN, RN

RN Member


Belen Gabato, MS, RN

RN Member


Sandra Halley

Consumer Member


Patricia “Tish” Smyer, DNSc, RN

RN Member


BOARD MEMBERSThe Nevada State Board of Nursing is a seven-member board

appointed by the governor of Nevada consisting of four registered

nurses, one licensed practical nurse, one certified nursing

assistant, and one consumer member.

If you wish to contact a Board member, please write c/o Nevada

State Board of Nursing, 5011 Meadowood Mall Way, Suite 300,

Reno, NV 89502-6547; call 1-888-590-6726; or email

[email protected]

BOARDAUTHORITYThe Board has authorityonly over its licensees andcertificate holders and notover the facilities in whichthese individuals practice.The Board enforces theNurse Practice Act (thelaw regulating nursingpractice), with funding forall of its activities comingsolely from the fees paidto the Board by licenseesand certificate holders.The Board does not haveauthority to take actionon issues that are of anemployment nature, orthose that relate to thenursing profession as awhole. These matters arebest dealt with by thestate labor commissioner,nursing associations,labor unions, or othersimilar entities.



The Nevada State Board ofNursing is clear on the requirementsof the Nevada Nurse Practice Actregarding Nursing Assistant Trainees(NATs) and Certified NursingAssistants (CNAs). Please review tomake sure that your facility is utilizingNATs appropriately.

Nursing Assistant Trainees must:

• Have completed at least 16 hoursof a Board approved training pro-gram before being allowed to workin any facility as an NAT.

• Only work for 4 months as an NAT per NRS632.285.

• Only work for 4 months regardless of whetherthey have not tested, tested and passed, or testedand failed.

• Work as an NAT only once during their lifetimefor 4 months. For example: A student works 4months as an NAT and does not complete theprocess to become certified by the Board. Threeyears later, the same student enters anotherCNA training program. This student has alreadyworked for 4 months as an NAT and is not qual-ified to do so again.

A Certified Nursing Assistant:

• May not practice in Nevada until the Board has

issued a certificate to practice asa CNA.

• A temporary CNA certificateis valid for 6 months only andmay not be extended. This is aone time only temporary cer-tificate.

• Must have 24 hours of contin-uing education/training everytwo years to renew their certifi-cate. The CEs must be withinthe scope of practice of aCNA.

• Must have 40 hours of employment as a CNAevery two years to be eligible for renewal.

• The Board conducts random audits of CNAs andlicensed nurses for compliance with continuingeducation hours and/or work hours as they haveattested on their renewal applications. Whenaudited, failure to provide proof of continuingeducation hours and/or employment hours isgrounds for denial of renewal for CNAs and for-mal discipline for licensed nurses.

You may wish to review NRS 632.285, in additionto NAC 632.193, new regulations added April 17,2008, in the Nurse Practice Act. You can find theseon our website at www.nursingboard.state.nv.us underthe Nurse Practice Act link on the home page. Pleasecontact Board staff if you have any questions.

By CHRIS SANSOM, BSN, RN, DIRECTOR OF OPERATIONS

Chris Sansom

THE TRUTH ABOUT NURSING

ASSISTANT TRAINEESIN NEVADA


Now you canchange your

address on line!The law requires you toinform the Board whenyou change addresses

You’re required by law toinform the Board, in writing, ofany address change, including azip code change. The easiestand fastest way for you to makeyour address change is to go tothe Board’s website and clickon the Address Change link.You may also send an email to [email protected],call the Board and request anaddress change form, or mail asigned letter to the Las Vegasoffice. Remember to include yourname, license or certificate typeand number, former address,current address, social securitynumber, and date of birth.

CHANGE OF ADDRESS FORM

▲ NAME (LAST, FIRST, MIDDLE) ▲

▲ TYPE OF LICENSE ▲

▲ LICENSE NUMBER ▲

▲ DATE OF BIRTH ▲

▲ FORMER ADDRESS ▲

▲ CITY, STATE, ZIP CODE ▲

▲ CURRENT ADDRESS ▲

▲ CURRENT ADDRESS ▲

▲ CITY, STATE, ZIP CODE ▲

▲ TELEPHONE # ▲

▲ SIGNATURE ▲

Mail to: Nevada State Board of Nursing2500 W. Sahara Ave. #207Las Vegas, NV 89102-4392

MOVING?MOVING? Reach more than34,000 nurses,

nursing assistants and student nurses.

For advertisinginformation contact

Jane Saunders at

Voice/Fax:

267.295.1889

email:

[email protected]

While there has been recent mention of eliminating thehard license card, the Board continues to issue hard licensecards to all licensees/certificate holders.

We get inquiries each day from nurses and CNAs wonderingwhy they haven’t received their cards in the mail. Once alicense has been issued, either initially or by renewal, thecard usually follows in the mail 10-14 days later. The Boardutilizes the services of an outside vendor so the actual timingcan vary and is beyond our immediate control

The Board’s online verification system remains the mostreliable and up-to-date source for licensure/certificationverification. The validity of the card can only be guaran-teed on its date of issue. After that, a license/certificatemay be revoked by the Board or have disciplinary actionimposed and the hard card will not indicate that. If youare concerned about your status, please check our websiteor call the Board office. The Board does NOT requirenurses/CNAs to have the license card in their possessionwhen they are practicing. As long as yourlicense/certificate is active and unexpired in the Board’sdatabase, you may practice the full scope of nursing that

you have been licensed or certified for, even if you don'thave the license card in your possession.

Many nurses tell us that their employers require a copy ofthe license hard card for their personnel files. While anemployer may require a copy of the actual hard card, theBoard discourages employers from using it as proof of licen-sure/certification. Licenses/certificates may be renewed twomonths in advance of your expiration date. To ensure thatyou have your license card to show your employer prior toyour renewal date, please make sure you renew yourlicense/certificate with ample time to receive your new card.

At the Board’s request, license cards are not forwarded by thePostal Service. If you have moved or have placed your mailon hold, your license will be returned to our office. In fact,the Board receives many returned license cards each day fromnurses/CNAs who did not update their address properly.

Eventually, the Nevada State Board of Nursing plans to dis-continue sending out hard license cards. We would verymuch like to hear your opinion on this plan. Please email usat [email protected] with any suggestions thatyou might have regarding this plan.

I renewed my license but I haven’t received it in the mail yet!


Please note some disciplinary

orders by the Board may not be

effective yet due to legal notice

requirements. Please call the

Board office to obtain further

information regarding the

effective dates of these outcomes.

Araneta, Lourdes, RN09114: License sus-pended for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(26) violation of state/federal nursinglaw/regulation.

Ayele, Alemzewd, LPN13690: Agreementfor Reprimand for violation of NRS 632.320(7) unprofessional conduct, and NAC632.890 (20) inaccurate recording, falsifyingor otherwise destroying records, and (27) cus-tomary standards of practice.

Bennett, Traci, RN31277: Agreement forProbation for violation of NRS 632.320 (1)fraudulent application, (7) unprofessional con-

duct, and NAC 632.890 (16) failing to prop-erly document controlled substances.

Bergamini, Joanne, RN21397: Agreementfor Probation for violation of NRS 632.320(5) controlled substances and/or alcohol, (7)unprofessional conduct, (14) failing to com-ply with Board order, and NAC 632.890(18) diversion of equipment or drugs, (27)customary standards of practice, and (35)failing to comply.

Brock, Angela, RN37862: Agreement forProbation for violation of NRS 632.320 (7)unprofessional conduct, (14) failing to complywith Board order, and NAC 632.890(18) fail-ing to comply, (27) customary standards, and(38) fraudulent license.

Brooks, Sarah, RN47425: License suspend-ed for violation of NRS 632.320 (7) unprofes-sional conduct, and NAC 632.890 (26) viola-tion of state/federal nursing law/regulation.

Brown, Alisa, CNA009434: Certificatesuspended for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(26) violation of state/federal nursinglaw/regulation.

Carpenter, Valerie, CNA001165:Agreement for Reprimand for violation ofNRS 632.320 (7) unprofessional conduct, andNAC 632.890 (20) inaccurate recording, falsi-fying or otherwise destroying records, and (27)customary standards of practice.

Carranza, Angela, CNA022290: VoluntarySurrender of Certificate in Lieu of OtherDisciplinary Action for violation of NRS632.320 (7) unprofessional conduct, (14)

failing to comply with Board order, andNAC 632.890 (9) impaired practice, (10)positive drug screen on duty, and (35) failingto comply.

Coleman (Rojas), Marrilyn, LPN11740:Agreement for Reprimand and Fine of $100for violation of NRS 632.320 (14) failing tocomply with Board order.

Crawford, Dallas, CNA017749:Agreement for Fine of $100 for violation ofNRS 632.320 (7) unprofessional conduct, andNAC 632.890 (37) practicing without anactive certificate.

Darling, Edna, RN31828: Agreement forReprimand for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(40) professional boundaries.

Elieff, Maria, CNA023645: Agreement forProbation for violation of NRS 632.320 (2)criminal convictions, and (5) controlled sub-stances and/or alcohol.

Fish, Noreen, CNA023646: Agreement forProbation for violation of NRS 632.320 (2)criminal convictions, and (5) controlled sub-stances and/or alcohol.

Hampton, Shirley, RN32884: Agreement forFine of $400 for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890

Please do not use this listof disciplinary actions forverifying licensure orcertification status.

Other action may have takenplace between the time thediscipline was imposed andthe time of publication. Toverify licensure or certificationstatus, please visit ourwebsite or call the Board.

ABBREVIATIONS

NRS Nevada Revised Statutes

NAC Nevada Administrative Code

Disciplinary and Licensure/Certification Actions taken by the Nevada State Board of Nursing for the period of January 24, 2009 through March 31, 2009


What are common types of disciplinary actions?When considering what kind of disciplinaryaction it should take, the Board always asksitself, “What is needed to make this personsafe to practice?” The answer depends onthe nature of the violation, and can rangefrom reprimanding an individual and orderingthe person to attend a remedial class torevoking the person’s license or certificate. Alldisciplinary action is reported to national dis-ciplinary data banks. Outlined in the NursePractice Act, NRS 632.325, disciplinaryactions available to the Board include:

Denial of ApplicationIf the Board denies an application for licen-sure or certification, it has determined thatthe individual violated the Nurse PracticeAct. In most cases, the denial is due tocriminal convictions and/or submitting afraudulent application.

Reprimand and/or FineIf the Board reprimands or fines a nurse orCNA, it has determined that the individualviolated the Nurse Practice Act. This actiondoes not prohibit or restrict the individual’spractice.

ProbationIf the Board puts an individual on probation,it means the nurse or CNA may work, but willbe working on a restricted license or certifi-cate and monitored by the Board for a specif-ic time period. The probation may alsoinclude practice and/or setting restrictionsand requirements like classes or randomdrug tests.

SuspensionIf the Board suspends a license or certificate,it means the nurse or CNA is prohibited frompracticing for a designated time period.

Voluntary SurrenderThis means the nurse or CNA has agreed tovoluntarily surrender his or her license or cer-tificate and cannot practice in Nevada. If theperson applies for reinstatement, the Boardweighs evidence of rehabilitation and remedi-ation when considering the application.

RevocationIf the Board revokes a license or certificate,it means the nurse or CNA cannot practicein Nevada for a minimum of one to a maxi-mum of 10 years. After that time, the nurseor CNA may apply for reinstatement if allthe requirements in the order of revocationhave been met. The Board weighs evidenceof rehabilitation and remediation when con-sidering the application.

(36) practicing without an active license.

Hasbrouck, Heather, RN41951: Licenserevoked for two years for violation of NRS632.320 (2) criminal conviction, and (5) con-trolled substances and/or alcohol.

Kinzalow, Lesley, TRN323295:Application denied for violation of NRS632.320 (7) unprofessional conduct, andNAC 632.890 (16) failing to properly docu-ment controlled substances, and (18) diver-sion of equipment or drugs.

Millick, Constance, RN18592: Agreementfor Probation for violation of NRS 632.320(7) unprofessional conduct, and NAC632.890 (16) failing to properly documentcontrolled substances.

Nicholson, John, CNA022064: Agreementfor Reprimand for violation of NRS 632.320(7) unprofessional conduct, and NAC632.890 (2) practicing beyond scope.

Nielsen, Dana, RN17264: Order ofReprimand and Probation for violation ofNRS 632.320 (7) unprofessional conduct, andNAC 632.890 (38) professional boundaries.

Nieto, Lydia, CNA021930: Agreement forReprimand for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(2) practicing beyond scope.

Omon, Isiramen, RN40303: Agreement forReprimand for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(16) failing to properly document controlledsubstances.

Parish, Barbara, RN25673: Agreement for

Reprimand for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(40) professional boundaries.

Plaugher, Sharmen, RN20776: Agreementfor Reprimand for violation of NRS 632.320(7) unprofessional conduct, and NAC632.890 (27) customary standards of practice.

Polk, Antonia, RN57735: License revokedfor three years for violation of NRS 632.320(7) unprofessional conduct, and NAC632.890 (18) diversion of equipment or drugs,and (27) customary standards of practice.

Robertson, Dorothy, LPN08913:Agreement for Probation for violation of NRS632.320 (7) unprofessional conduct, andNAC 632.890 (27) customary standards, and(39) pattern of conduct demonstrates failureto protect the public.

Robinson, Meesha, LPN13293: Licensesuspended for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(26) violation of state/federal nursinglaw/regulation.

Stevener, Cathy, RN14150: Agreement forSuspension and Probation for violation ofNRS 632.320 (5) controlled substances and/oralcohol, (7) unprofessional conduct, andNAC 632.890 (9) impaired practice.

Torres, Francis, RN61672: Agreement forProbation for violation of NRS 632.320 (7)unprofessional conduct, and NAC 632.890(27) customary standards of practice.

Findings of Guilt for Abuse,Neglect or MisappropriationPlaced on the Certified NursingAssistant Registry by the NevadaState Health Division's Bureau ofLicensure and Certification

Valencia, Maria, CNA022410:

Verbal/Physical Abuse

Ruiz, Gabriella, CNA015901:

Misappropriation of patient property

College, Teresa, CNA019911:

Misappropriation of patient property

Who can I call if I have questions about the complaintor disciplinary process?

The Board encourages you to callany time you have a questionabout the disciplinary process orwhat constitutes a violation of theNurse Practice Act. Just call theBoard and ask for one of thenurse investigators or the directorof operations.


Have a question? Give us a call.

Debra Scott, MSN, RN, APN, FRE, Executive DirectorStatewide Liaison and SpokespersonOrganizational and Public ManagementFiscal and Human Resource ManagementLegislative and Governmental RelationsAPN Advisory Committee ChairNursing Practice Advisory Committee Chair

Chris Sansom, BSN, RN, Director of Operations Program ManagementCNA Advisory Committee Chair

Fred Olmstead, General CounselLegal Counsel

Dean Estes, Director of Finance/TechnologyBudget, Accounting and Payroll Technology Support,Programming, Website

Roseann Colosimo, PhD, MSN, RN, Education ConsultantNursing Education ProgramsCNA Training ProgramsContinuing Education ProgramsEducation Advisory Committee ChairAdvanced Practice and International Graduate

Document Analysis

Patty Shutt, LPN, Site Operations SupervisorLas Vegas Site SupervisionAdvanced Practice Certificate Processing

Marianne Kadlic, Executive AssistantAssistant to the Executive Director SchedulingBoard Meeting Agenda and Arrangements Nurse Practice Act Publication

ADMINISTRATION5011 Meadowood Mall Way, Suite 300, Reno, NV 89502, 888-590-6726

[email protected]

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Lark Muncy, RN, Investigator Complaint InvestigationsNursing Practice Questions

Amy Clark, BSN, RN, Application CoordinatorApplication Review Fraudulent Application Screening

Kathleen Reynolds, BHS, RN, Compliance Coordinator Disability Advisory Committee ChairDisability Advisory Committee SchedulingProbation and Alternative Program MonitoringReinstatement Applications

Licensure/CertificationSarah Bowen, Licensure Specialist

Licensure Eligibility QuestionsEndorsement and Examination ApplicationsContinuing Education ProvidersInternational Nurse Graduates and Licensure IssuesRN/LPN CEU Audits

Patty Towler, Senior Certification Specialist CNA Registry MaintenanceCNA Certification and RenewalsCNA Program and Instructor ApprovalsCertification Audits (CNA, APN, CRNA)

SupportAriadna Ramos, Program Assistant

Endorsement ApplicationsLicensure Eligibility QuestionsSpanish-speaking Services for Consumers

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SUPPORT STAFF

NURSINGNevada State Board of

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