By Healthcare Law Attorney Alex Scarbrough Fisher
This is the second article in a series designed to inform nurse practitioners and other healthcare providers about steps that can be taken to avoid discipline by the Department of Health (if you missed the first part of the series, check it out here!).
4. Be cautious about your use of intoxicating liquors, narcotics, controlled substances, or other drugs or stimulants that would effect your ability to practice medicine.
Out of those nurse practitioners who receive severe discipline from a medical or nursing board, i.e., revocation or voluntary surrender of their license to practice medicine or nursing, the top three offenses are (1) sexual abuse, (2) murder, and (3) alcohol abuse. State medical and nursing boards take substance and alcohol abuse very seriously, so if a nurse practitioner realizes he or she has a substance abuse or alcohol addiction, he should proactively seek help, rather than waiting until his license is disciplined, or even worse- a patient is injured. Organizations such as the Tennessee Medical Foundation, for example, exist for the purpose of providing such professional assistance to healthcare professionals.
5. Be cautious about the prescribing of controlled substances.
States have strict regulations when it comes to prescribing controlled substances. Tennessee Code, for example, prohibits the prescribing of a controlled substance “not in good faith to relieve pain and suffering…or in amounts and/or durations not medically necessary, advisable, or justified for a diagnosed condition.” T.C.A. 63-6-21(b)(12). Nurse practitioners must be cautious when patients request specific controlled substances, and use discernment to determine whether a patient is requesting pain management in good faith. Additionally, nurse practitioners would benefit from having protocols in place to safely provide appropriate pain management. For example, requiring patients to sign controlled-substance agreement forms and implementing randomized toxicology screenings helps protect you as a provider.
6. Cultivate self-awareness about your mental and physical health.
Most states have guidelines around healthcare provider’s mental capacity to practice medicine. For example, it is a violation of Tennessee law to “engage in the practice of medicine when mentally or physically unable to safely do so.” T.C.A. 63-6-214(b)(18). If a nurse practitioner is going through a period of intense mental or emotional stress– the death of a loved one, a divorce, a difficult diagnosis of a family member- he/she should step back and consider how this may be affecting his/her work. If necessary, it is preferable for a nurse practitioner to scale back duties rather than risk harming a patient or losing one’s medical license. A nurse practitioner should also be aware of physical limitations and make a responsible decision should there come a day when he/she needs to limit the scope of practice based on his/her own health.
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