My Motives. My Purpose. My Dream.

….Having just been released from the hospital for the second time in a week, I came home optimistic and ready to get back to work, scheduling more meetings with state health committee members, cleaning up my draft of the healthcare whistleblower bill I want to see passed, and setting up meetings with patients that wanted to help in the effort.

To my surprise….well, maybe not such a surprise…I was presented with yet another situation in which nurse(s) didn’t want to be affiliated with me because of what a Board of Nursing had to say about me several years ago, and the opinions of SEVERAL nurse bloggers who took it upon themselves to continue their assassination of my character not even knowing the full extent of the details involved in my case with Banner and the AZBON.

Its unfortunate. So here are the true facts— The AZBON LEFT OUT key witnesses that could have exonerated me and testified that I DID FOLLOW HOSPITAL POLICY when educating my patient. The AZBON left out that the Nurse Manager on my case Frank Fausto, lied when asked if I went up the chain of command to report a patient safety concern. The AZBON left out key information from the medical records that indeed shows I initiated a nurse order and has kept the medical record locked. The Arizona Board of Nursing has allowed nurses who have harmed patients, violated HIPPA, ammassed several aggravated DUI’s. diverted drugs, and even killed patients—back out there to practice with only the slap of a hand and a private reprimand.

Here are some more facts: I never hurt a patient in my life. I never under dosed or overdosed a patient. I never stole drugs. I never came to work intoxicated. I never left my posts. I never neglected or failed my patients.

Perfect? That was never a claim on my part. Ever. I was, in fact, just like you. Trying hard to toe the line in a corporatized environment that made me call into question my sense of morals and ethics every day. But social media and a board hell bent on painting a picture can do a whole lot to your life.

But the American Nurses Association wants you to have “moral courage.” They want you to stand up for your patients no matter what. What they don’t tell you about are the consequences to that.

Well, folks, here they are.  The best part?  You’re a criminal —for life. You don’t get to have a life anymore.

Truth be told, this nation never gave its people the option to choose those who have changed our way of being, our way of life, or our way of thinking—aside from a President or local government officials. No one handed out ballots for people like Martin Luther King or Rosa Parks or even Florence Nightingale. And before you start screaming to the masses, I am NOT comparing myself to them, ya dig?

Here’s the thing. People just saw a problem and spoke up. And did something. And didn’t stop doing something until the problem was fixed. I live by what is called a categorical imperative. I learned this in my undergrad years and never forgot it. It was the very heart of my  nursing practice:

“You do for the sake of doing, not for what it will get you or where it will get you or how it will impact your personal circumstances or your comfort or your reputation—you do that which will benefit the greatest amount of people for the better.”

This was the spirit that kept me going up the chain of command to report a patient safety violation on the night of April 12, 2011. Its the same spirit that kept me fighting for my license and the same spirit that kept me fighting for the first amendment rights a board of nursing wanted to take from me.

It is the same spirit that has kept me fighting to protect the interests of nurses and patients today. My license may have been taken, but nurses are continuing to be harmed and patients continue to die TODAY.

Want to know my motive straight from me? There it is. So lets quit with the rumors. If I wanted to profit I would have finished the damn book by now and Lord knows I have enough material for three.

What matters to me is making sure not one more nurse loses their livelihood, their ability to provide for their families, their ability to adhere to a code of ethics they swore to uphold, impacting the rising number of senseless deaths each year  that result from nurses unable to report unsafe situations or medical/surgical errors they know about.

You think you are in a state that is covered? You’d be surprised. I was. And its why I have been trying to fix it. I’m not in this for a license. I’m not in this for revenge. I’m in this because too many nurses and patients are getting hurt, and quite frankly, that IS HOW LAWS GET CHANGED. By people getting hurt. Or by a hole in the justice system.

Thankfully I don’t need permission or approval to get published. I don’t need permission to go see lawmakers or to make changes to current legislation, or to go speak before committee.

I don’t need permission or approval to be ME. And to be authentic and not watered down.

I don’t need permission to be part of a change movement.

I don’t need permission to help right what is so very wrong in our profession right now.

I don’t need to be “liked” to make change that benefits my colleagues and patients or the future of this profession.

I don’t need to be “perfect.”

All I “need” is the desire to do good, to change what is bad, and to help make it better so no one else goes through the same thing.

Want to fault me for that? Hold it against me? Judge me for it? Fine.

But in the same moment, ask yourself what you’ve done to not only walk the harried journey it takes to get there—but to accomplish the goals.

Until then, judge me not for the fact I spoke up and had ALOT of false things said about me and people who continue to HATE me.

Judge me for the fact I am a human being who is seeing other human beings get hurt and I’m just trying to do my part to make it right.

Fault me for that? Cool. Judge me for it? Look at yourself when you do it.

Try and make my voice useless and irrelevant– and my contribution to this profession I earned my right into ( I worked hard for that BSN and MSN just like you did)  and sacrificed to be a part of?

Never.

 

 

 

 

 

 

The Arizona Board of Nursing: Posturing Against Gay Nurses?

     Imagine working a good portion of your life as a nurse practitioner. You’re settled into your own practice, established in life. You have the latest BMW SUV out there, a beautiful home, the best dogs ever….and loving parents who are bursting with pride every time you come up north to visit. You would think that graduation day was just yesterday by the way they beam at you over the dinner table during every Sunday dinner.

     The seasons come and go in a small northern Arizona town. The leaves are boldly beautiful in the fall, the snow sparkles in the winter. As you sit in a cozy living room having coffee and homemade cookies with your parents over a holiday weekend its hard not to breathe it all in…..this is your reality, your life. Everything is preciously simple, predictable…. and yet so peacefully, unbreakably, enduring. You take pride in the fact you can care for them, oversee things to make sure they are well provided for. There is nothing in this world you can’t give back to them after all they have done to help you through school.

Life. Is. Great.

Until it isn’t.

Until it won’t be anymore.

Until all that remains of your life are just fleeting embers floating away in the wind……

Such is the story of one nurse practitioner I began corresponding with in 2013. He had been following my case for quite some time and was frustrated with his counsel. It seemed to him that his attorney was more interested in placating the Arizona Board of Nursing than representing his interests. A short time later he would take his defense into his own hands by doing all the legal work himself in order to ensure that his own bests interests were being kept front and center.

He stayed up many days and nights at a time doing legal research, studying other nurse’s cases, emailing back and forth with me. The following are highlights of this nurse practitioner’s journey battling the Arizona Board of Nursing.

Valerie Smith: Special Consultant to the executive director

Joey Ridenour, Executive Director of the Arizona Board of Nursing

As most nurses know, it’s  easy for virtually anyone to file a complaint against one’s license. In Nathan’s case this was no different. In August of 2011, a patient who became angered by a question Nathan had asked him during a psychiatric assessment, filed a complaint against his license. The patient would later contact the board to “quash” the complaint, advising the Board of Nursing that he did not want Nathan to be disciplined for no reason. Nathan recalls “The guy filed a rambling similar complaint on a NP co-worker at the same time. Hers disappeared… mine didn’t. The only difference I could see was an ASU connection. She was a grad and a preceptor and had good connections there.”

The complainant’s request fell on deaf ears…the Board of Nursing would continue their hunt into Nathan’s past…and into every private aspect of his life. Instead of dismissing the complaint against Nathan, they came up with 12 “Factual Allegations” UNRELATED TO THE INITIAL COMPLAINT to potentially charge him with.

For a period of 13 months Nathan’s case sat on a desk and was passed off from investigator to investigator until it landed on the desk of University of Phoenix Assistant Dean of Nursing and 2014 RN.com “Giving Excellence Meaning” Award Nominee—a Nurse Practitioner herself, Janeen Dahn. From the point she picked it up, Nathan recalls, everything went to hell—AND FAST.

As per usual for most nursing board investigations, (depending on who you know) the state uses all its time, technological, and financial resources to delve into the life of a nurse. Nathan’s case was one that required the “special knowledge and tactics” of Valerie Smith—the on again off again retired consultant that me and others believe is “brought out of retirement” for the more “problematic cases” such as Nathan’s and mine. The AZBON’s hired gun, Valerie Smith has a background primarily in psychiatric nursing (no general med surg. just psych.) and is notorious for “diagnosing on the spot.” (She did as much on the stand during my administrative hearing when I cross examined her)

The common denominator among nurses who come to me with their stories is their interaction with Valerie Smith. Nathan and I were similar in the sense that we fought the charges and sought to secure our constitutional and/or Civil Rights during a process that ceremoniously strips them away from a nurse. HIPPA does not apply to ANY NURSE under investigation. The Arizona Board of Nursing has within its grasp the ability to subpoena any and all legal, medical, and psychiatric/pharmacy records. They can, and will, use what they find within those records against a nurse whether it is relevant to a case or not.

It’s well known by now that a nurse’s personal life, their entire career, their physical and mental health history are all fair game. In many instances, the Board of Nursing pads its investigative reports with defamatory false “statements” from “coworkers” to further their case against a nurse. Sometimes—they go too far in their attempts to inflict harm–Most recently they made the mistake of publishing a nurse’s personal address, her email address, her social security number and date of birth on a public site. There is no maneuver that escapes them when they are in pursuit of a nurse’s livelihood. However, it should be noted once more–they apply the shock and awe approach to specific cases, and not all cases.

During the course of his investigation Nathan was shocked to learn that his medical records had been subpoenaed by and reviewed by Investigator Dahn. During a meeting with her, Dahn (allegedly) quizzed him about his sexual preference and his sexual practices as per what was written in his primary care physician’s progress notes. The words “high risk behaviors” were (allegedly) used by Dahn. He described to me the “three religious medals she wore” on her clothing as she interrogated him and how he found it ridiculous.

You see, Nathan is gay. “I outed in the 80’s…” he recalls.

Within all the medical records reviewed, Investigator Dahn (allegedly) included in the investigative report a one page progress note from his physician that discussed his gay status and his negative HIV status as well as other personal particulars irrelevant to the initial complaint lodged against his license:

“She (Investigator Dahn) (allegedly) made a big deal out of a few things: that I graduated from a diploma RN program. That my medical record said ‘high risk behaviors’. The investigative interview was a sham, she wasn’t even listening to me…conclusions were drawn. It’s a kangaroo system with zero objectivity. I was sure I had the justification, the rational data, and expert emails to justify my actions in the complaint. Then she (Investigator Dahn) hits me: “Why did you quit this job without notice? Why were you given a written warning at ___________? (I’m an NP) Why did you write yourself 2 separate anti-biotics in 2011? And a few more totally unrelated to the initial complaint. The board meeting was last Monday. Four days before that, my lawyer called to say the original complaint had not even mentioned that there were 12 items stating unprofessional conduct and failing to maintain minimum standards. I was like WHAT? I didn’t even get to answer to them. I still don’t know what they all are-I have an idea. They are now trying to railroad me into a 12 month probation… I’m not sure I even want to remain in the profession-I’ve been in clinical practice for 15 years.”

Janeen DahnPhD, FNP-BC: 2014 Nurse.Com GEM Award Finalist and Assistant Dean of Nursing at University of Phoenix

Nathan felt strongly that they were using his sexual orientation as a basis to establish that he wasn’t a safe practitioner, that somehow his sexual orientation would translate to him providing unsafe care to patients. Over the past few years, Nathan has had to go back and forth with the Board. It was his full time work searching for jobs, strategizing and reading up on the law in order to find ways to secure his constitutional rights throughout the process. It hasn’t been easy to do, as there are blocks to Constitutional Rights when you are a nurse under investigation in Arizona:

“It’s in the 4^th amendment to the Constitution, due process, searches of private matters, probable cause , double jeopardy all to protect our liberty=right to practice chosen profession from government action=AZBON. They claim they have to balance with public safety -no member of the public was at risk even if the crap they are claiming against me was true. There are checks in place so government or government agencies can’t make up things against you, to take your protected health information, to delve into personal private areas of your life. I was born and raised in Boston where all these crazy ideas began… it’s in my blood. I think around here people like to feel they can make up their own rules. I beg to differ, we’ll see. Odds are against me but I love a good fight.”

     When Nathan requested discovery of all evidence the Board of Nursing had against him, they denied his requests. One would think that a nurse can appeal to other government agencies for another set of eyes, an impartial party—to take another look. In Arizona such an agency does not exist. Nurses, patients, and other attorneys have appealed to the State Ombudsmen’s office numerous times (without response or resolution), the Auditor General’s office, the State Attorney General’s office, and state legislators themselves. The media itself—will not investigate the Board of Nursing’s actions against licensed professionals. They will however—investigate the Medical Board and the Dental Board. Go figure.

Former House Representative Steve Gallardo “came out” in 2014.

As the years go on and Joey Ridenour continues her “Command” role over Arizona’s version of “B613”– the Arizona Board of Nursing soldiers on in its effort to impede upon the basic Civil Rights of nurses. In my case—freedom of speech (my social media accounts are still monitored by the state) and in Nathan’s case—his status as a gay man who happens to be a nurse practitioner. Other cases involve nurses who are older in age. Yet, nurses with multiple DUI’s or multiple drug offenses are gently set free from the proverbial investigative web of wonder to resume their careers unscathed. Their records fiercely protected from the public’s eyes like the B613 files in Scandal. At one point, Nathan took note of several cases against ASU nurses that were dismissed by AZBON officials, but he and I were too busy to investigate further. The question still lingers.

Nathan has experienced other challenges on his road to justice. He lost his home. He lost his vehicle. He was unable to secure a job, but was finally able to get Circle K to hire him. He had to quit after a short while due to his declining health. His health status has taken a significant hit throughout this process. He has also watched his parents’ health decline these past few years as a result of the ordeal that has impacted not just him—but all of his loved ones and friends who have been on this road with him.

…..Just one day prior to his hearing before the Arizona Board of Nursing his father suffered a stroke and Nathan was unable to be with him because he was scheduled to do his own defense the following morning……

During the years we corresponded back and forth, supporting each other in the middle of the night as we struggled to put together our own cases and cope with our losses, he shared with me how he felt on one occasion he had gone out of state to visit his parents: “When I went back to MA for a job interview I saw my parents for the first time in 18 months and I couldn’t believe my eyes… they don’t even look the same. I think this has had an effect on them. They are both in their 80s. The last time I saw them they were vibrant and active, now they appear withdrawn, almost defeated.”

There is a lifelong guilt, the responsibility one bears upon their shoulders, when they choose to battle against the Board of Nursing’s injustice. It’s no longer about just you, everyone around you becomes a part of things. Everyone around you suffers with every hit you take. Your family, your friends, your significant others. In some way or another,  to some degree….they are affected by the point of impact.

     I have not yet heard back from Nathan about the outcome of his case. My guess is he is in MA caring for his ailing father and supporting his mother. I hope he triumphed. I hope he is able to recover what is left of his practice… more than that—I hope he is able to get back to living his life, one with peace and the self-realization that he is bigger, bolder and better than the process that has not just engulfed him spiritually, physically, and mentally—but has taken a good portion of his hard earned life from him.

     I don’t know what I would have done without those emails back and forth in the middle of the night the past few years…..our experiences and feelings mirrored each other’s in so many ways. I consider him my friend, my colleague, and a brother in all this….and I am proud to finally tell his story. Because he was and is so brave where others are not. Because he chose to keep getting up no matter how many times he was knocked down. Because he wanted to set an example and establish a precedent for all gay nurses.

I believe Nathan has an important message to get out there—BEING GAY DOES NOT EQUATE WITH BEING A DANGEROUS NURSE. BEING GAY DOES NOT MEAN YOU ARE ANY LESS OF A GOOD SOLID PRACTITIONER THAN THE NEXT NURSE. BEING GAY CANNOT BE USED AS A PREDICTOR OF FUTURE BEHAVIORS AS A NURSE PRACTITIONER, OR A NURSE FOR THAT MATTER. BEING GAY SHOULD NOT BE A PRECURSOR FOR LOSING ONES HARD EARNED NURSING LICENSE. BEING GAY DOES NOT GIVE THE STATE OF ARIZONA THE RIGHT TO USE THAT STATUS TO TAKE AWAY THE LIVLIHOOD AND STABILITY OF ANYONE. BEING GAY IS NOT A VIOLATION OF THE NURSE PRACTICE ACT.

THE DEFINITION OF A NURSE…..should not EXCLUDE people on the basis of race, gender, ethnicity, religion, socioeconomic status, or sexual preference. The question is, just how far will state lawmakers allow ANY STATE to go when it comes to persecuting nurses on the basis of these very factors? More importantly—how low will the profession allow itself to be taken down before making a stand that supports acceptance, tolerance, and the high standards we’re expected to uphold as touted within the Code of Ethics for Nurses?

Maybe—this case is a sign that our profession has arrived at a point in time that The Code, The Oath, and the very tenets that Nursing was built upon no longer matter…