Florida Nurses Continuing Education Mandatorey Hours

Florida Laws and Regulations

Course Highlights

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• In this course you will learn about Florida Laws and regulations, and why it is important to abide by them.
• You'll also learn the basics of stipulations and documentation, as required by the Florida Board of Nursing.
• You'll leave this course with a broader understanding of license renewals, and violations of practice acts.

About

Course By:
Kayla M. Cavvichio
BSN, RN, CEN

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The following course content

Chapter 464, known and often referred to as the Nurse Practice Act, is separated into two parts. Part I discusses the advanced practiced registered nurse, registered nurse, and licensed practical nurse. The purpose of this statue is to ensure that every nurse practicing in the state of Florida is held to and meets the minimum standards for safe practice. Because of this, nurses who do not meet the minimum standards or display a threat to society are barred from practicing nursing in the state of Florida. The Board of Nursing is the governing body for the Nurse Practice Act and deal with matters such as provide licensure, create rules, and manage disciplinary actions. Part II focuses on the certified nursing assistant. Chapters 456 and Division 64B9 are guidance and further statues that pertain to the nursing profession.

This course is designed to meet the requirements of Division 64B9-5 as it pertains to two continuing educational hours about Florida's laws and regulations of the nursing practice.

Introduction

The state of Florida has several statutes that govern the practice of nurses. These statues consist of Chapters 456 and 464 located in Title XXXII Regulation of Professions and Occupations . The Florida Administrative Code is where Division 64B9 is located.

Chapter 464, often referred to as the Nurse Practice Act, is separated into two parts. Part I discusses the advanced practiced registered nurse, registered nurse, and licensed practical nurse. The purpose of this statue is to ensure that every nurse practicing in the state of Florida is held to and meets the same minimum standards for safe practice. Because of this, nurses who do not meet the minimum standards or display a harm to society are not allowed to practice nursing in the state of Florida. The Board of Nursing is the governing body for the Nurse Practice Act and deal with matters such as provide licensure, create rules, and manage disciplinary actions. Part II focuses on the certified nursing assistant.

Chapter 456 is a statute that is directed at all health care providers and professions. This statute lists the provisions that Chapter 464 is built on.

Division 64B9 is part of the Florida Administrative Code that provides specific rules that p ertain to nurses and how the profession is regulated in terms of eligibility to take the examination of selected practice; set standards for nursing education curriculum and institutions; continuing education requirements; license renewal; rules for impairment of the nurse in the workplace and more.

This course is designed to meet the requirements of Division 64B9-5 as it pertains to two continuing educational hours about Florida's laws and regulations of the nursing practice.

1. What prior knowledge do I have of Florida laws and regulations surrounding nursing practices?
2. What prior knowledge do I have of laws/regulations terminology?
3. How do these pertain to me in my areas of practice?

Florida Laws and Regulations Terminology

1. Advanced or specialized nursing practice — completion of post – basic specialized, training, experience , and education that are appropriately performed by an advanced practice registered nurse. The advanced-level nurse can " perform acts of medical diagnosis and treatment, prescription, and operation " under the authorization of a protocol with supervision of a physician (2) .

2. Advanced practice registered nurse (APRN ) — any individual that is licensed in this state to practice professional nursing as defined above and holds a license in an advanced nursing practice , including (2) :

• C ertified N urse M idwives (CNM or nurse midwife)
  – Able to perform superficial or minor surgical procedures as defined by a protocol and approved by the employing medical facility or with a backup physician in the case of a home birth
  – Start and perform approved anesthetic procedures.
  – Order appropriate medications based on patient and condition.
  – Manage care of the normal obstetrics patient and the newborn patient.

• C ertified N urse P ractitioners (CNP):
  – Able to manage certain medical problems guided by facility or supervising provider protocols.
  – Manage and monitor patients who have stable, chronic illnesses . Start, monitor, and adjust therapies for select, uncomplicated illnesses.
  – Order occupational and physical therapy based on patient need.

• C ertified R egistered N urse A nesthetists (CRNA):
  – Able to order preanesthetic medications a s stated and approved by facility protocol s and s taff.
  – Determine and consult with supervising anesthesiologist about the proper anesthesia for patients based on labs, history and physical, and patient condition.
  – Assist with managing the patient in the post-anesthesia care unit.

• C linical N urse S pecialists (CNS):
  – A nurse who is prepared in a CNS-focused program that meets the requirements of a typical APRN program.
  – Additionally , they are trained in the area of expertise as it pertains to the advanced practice of nurses.

3. Board — the Board of Nursing (2) .

4. Licensed practical nurse (LPN) — any person licensed in this state or holding an active multistate license under s. 464.0095 to practice practical nursing as defined below (2) .

5. Practice of practical nursing — the performance of select actions including the management of certain treatments and medications, while taking care of the ill, injured, or infirm; prevention of illness, promotion of wellness , and health maintenance in others under the direction of a registered nurse, or a licensed provider: physician, osteopathic physician, podiatric physician, or dentist; and the teaching of general health principles and wellness to the public and to students other than nursing students. A practical nurse is responsible and accountable for making decisions that are based upon the ir educational preparation and experience in the profession (2) .

6. Practice of professional nursing — the performance of actions requiring substantial specialized knowledge, judgment, and nursing skill based on applied principles of physical, psychological, social, and biological sciences which shall include, but are not limited to (2) :

• The nursing process consisting of assessment, nursing diagnosis, planning, intervention, and evaluation , of care; teaching and counseling of the ill, injured, or infirm in matters of health ; prevention of illness, promotion of wellness, and maintenance of health of others.
• The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner as they are authorized to do so by the laws of this state to prescribe such medications and treatments.
• The management and education of other individuals in the theory and performance of any of the acts described above such as nursing students.

A professional nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience (2) .

7. Registered nurse (RN) — means any person licensed in this state or holding an active multistate license under s. 464.0095 to practice professional nursing as defined above (2) .

8. Registered nurse first assistant (RNFA) — means a registered nurse who assists in surgery while in the hospital setting under a physician . They help maintain cost-effective and quality surgery for patients in the state of Florida. They must be certified in perioperative nursing via core curriculum approved by the Association of Operating Room Nurses, Inc. (2).

1. What license do you currently hold?
2. Have you held another license in the past?
3. What types of other licensed providers do you work with?
4. What specifics of Florida laws and regulations pertain to your area of licensure?

Board of Nursing: Members and Headquarters Location

Thirteen members sit on the Board of Nursing in Florida with their headquarters located in Tallahassee . These members are approved by the Governor of the state and consist of a diverse group of individuals. Seven of these members are RNs who have been practicing for a minimum of four years. One of these seven must be an APRN, a nurse educator from an approved program, and a nurse executive. Three of the total membership should be LPNs with a minimum of four years of practice, just as the RNs. The remaining three members are individuals who have no connection to the nursing profession and are not affiliated or contracted with a health care agency, facility, or insurance company. One member must be 60 years or older. All members of the Board must be residents of the state of Florida. Terms last for a total of 4 years, and at the end of each term the Governor can , but does not have to, appoint a successor to the position (2) .

The members of the B oard have a few duties. Their primary job is to ensure that nurses practicing in the state of Florida are doing so safely. They must ensure that nurses are abiding by Florida laws and regulations.  In order to do this , the B oard members can create and implement rules or provisions to the Nurse Practice Act.  They must approve educational programs for institutions wishing to teach nursing. They can take disciplinary action against a nurse for violation of the Nurse Practice Act or other Florida laws and regulations. Citations, fines, or disciplinary guidelines can be issued by the B oard as well (2) .

1. How many members are on the Florida Board of Nursing?
2. What does the board have to do regarding Florida laws and regulations?
3. Who reports to the FL BON?

Licensure by Examination and Endorsement

Initial licensure requires an individual take an examination for their desired profession: NCLEX-RN, NCLEX-LPN , and either the American Nurses Credentialing Center (ANCC) or American Association of Nurse Practitioners (AANP ) version for those wishing to become an APRN. In order for the Board of Nursing to approve an individual to sit for their desired examination, a list of requirements must be met in full (4) :

• Must correctly complete an application for the desired examination and submit a fee set by the Board.
• Submit to a background check conducted by the Department of Law Enforcement.
• Must be in good physical and mental health and is a recipient of a high school diploma or equivalent.
• Has completed the following requirements:
• Graduate from an approved program on or after July 1, 2009 OR
• Graduate from a prelicensure nursing education program that has been determined to be equivalent to an approved program by the Board before July 1, 2009
• Must have the ability to communicate effectively in the English language as determined by the Department of Health through another examination.

It is important to note that there is a section dedicated to the scenario of it an individual fails the examination or does not take it within six months of graduating.

Any individual that does not pass their examination of choice after three attempts must take a Board – approved remediation course before they are allowed to sit for the examination again. From there , they are able to take the test three more times before remediation is required again. Reexamination must be done within six months of taking the approved remediation course (2) .

If an individual does not take their examination within six months of their graduation, the individual must take an exam preparation course approved by the Board. It is to be advised that the individual must pay for the course without the use of federal or state financial aid (2) .

C ourses successfully completed in a professional nursing education program that are at least equivalent to a practical nursing education program may be used to satisfy the education requirements for licensure as a licensed practical nurse (2) .

If a nurse hold s licensure in another state or US territory decide s to obtain Florida licensure can do so through endorsement. The state of Florida requires those who apply to submit a nonrefundable fee, completed application, and fingerprints for a criminal background check. The Florida Board of Nursing will not issue a license to an individual that is under investigation at the time of applying (2) .

Military Spouses

Applying for a license through endorsement is a route that can be used for nurses who are following military spouses on official military orders. Nurses must have actively practiced nursing two of the three years prior to applying for a license. Military s pouses also have the option of obtaining a 12-month temporary Florida license if they meet the requirements: holds a valid nursing license in another state, has a negative criminal background check, has not failed their licensure exam, and has not had any disciplinary action taken against them in another state (1) .

Licensure by Compact

Over 30 states in the US have created legislation to allow nurses to work under one multistate license. This means that a nurse who is originally licensed in Florida could work in any other state that participates in the Nurse Licensure Compact without obtaining licensure for each state they wish to work in as long as they have a multistate license . This has proven to be very useful over the years due to the growing nursing shortage and global pandemic.

Many states like Florida are offering to provide multistate licenses to nurses during their initial examination. If a nurse does not obtain a multistate license initially, they are able to do so at a later time. They must pay a fee and submit fingerprints for a background check. Nurses must also meet any other requirements set by the state of Florida.

It is important to note that in the state of Florida, the nurse who holds the compact license must claim residency in the state. If the nurse were to claim residency in another state, they would no longer have a multistate license.

1. Do you feel as though Florida's Board of Nursing has a diverse nursing population?
2. Who do you feel should appoint members to the Board?
3. What information were you required to provide to the Board of Nursing when you applied to take your exam?
4. Have you obtained licensure through endorsement, either it be in Florida or another state?
5. Do you think more states should participate in the nursing licensure compact?

Delegation to the Unlicensed Assistive Personnel (UAP) or Unlicensed Personnel (UP)

Delegation is defined by the Nurse Practice Act as the transfer of a task or activity during a specific situation by a qualified nurse, through licensure and experience in the task, to a competent individual. Different facilities may have various ways of determining the competence of the individuals, but ultimately the decision rests with the RN or LPN. The licensed provider must determine the difficulty of the task, the potential for predictable or unpredictable harm or rapid change in patient condition, and level of communication required with the patient. They must also consider resources available and skills the UAP at their facility is allowed to do (4) .

When delegating , it is important to assess the UAP's skill set through validation or verification. The nurse should provide clear communication when it comes to the task delegated and explain the desired outcomes. They should also explain what undesired outcomes could occur, what should be done if an undesired outcome does happen when the task should be completed, and if supervision is required. The nurse should follow up to ensure that the task was done correctly and within the set time frame. The nurse should be aware that the delegated task and any outcomes of the task are the nurse's responsibility, and they are ultimately held accountable for it. So, if it's an important task, it may be better to do it yourself (4) .

There are a few skills that cannot be delegated to the UAP:

• A skill that is not within the delegating nurse's scope of practice
• Activities that require the use of the nursing process or require specific education, nursing judgement, training, or skills.
• Initial assessments and progress evaluation as it relates to the patient's plan of care.
• Skills that an UAP has not displayed competence.

1. When is it appropriate to have a UAP do a task?

IV Administration by LPNs

As mentioned above, LPNs and RNs have a few differences in their scopes of practice. LPNs are able to administer and perform some parts of IV medication therapy as opposed to the RN. The definition of IV therapy administration is defined as the infusion or injection of a medication via the intravenous system. This method involves several aspects including: evaluating, observing, monitoring, discontinuing, titrating, management, planning, documenting, and intervening as needed during the administration. RNs do not always have to be onsite when delegating IV administration to an LPN but is important to know policies and when an RN must be present (4) .

LPNs cannot do any of the following (4) :

• Initiate blood or blood products or plasma extenders .
• Mix IV solutions .
• Administer or initiate cancer treatments such as chemotherapy or investigational medications .
• IV pushes with the exceptions of heparin or saline flushes .

 Note that LPNs may care for patients receiving these types of therapies, such as a patient who is actively receiving a blood transfusion, but they cannot do the above aspects.

 LPNs are able to (4) :

• Calculate and adjust flow rates.
• Observe and report any signs of adverse effects of IV medications .
• Assess IV insertion si tes and change dressings as educated and needed.
• Remov e IV catheters or needles from peripheral veins.
• Hang IV hydrating fluids.

In order for an LPN to administer IV medications through a central line Florida laws and regulations dictate they must do so under the direction of a RN and have four hours of IV therapy education on central lines. This four-hour requirement can be applied to the 30 total hours LPNs must do on IV therapy (4) .

LPN Supervision in Nursing Homes

According to Florida law LPNs are able to supervise other LPNs, certified nursing assistant (CNAs) or UAPs in the nursing home setting. In order to be considered for a supervisory position, the LPN must have comp l eted 30 hours of B oard approved, post-basic education courses under the supervision of a RN. The LPN must also have at least six months of full-time clinical experience either in a hospital or nursing home setting. If the LPN takes a course outside of the B oard's approval courses, the provider of said course must test the LPN and provide attestation of the LPN's competency (4) .

The supervisory LPN's role is to provide other LPNs, CNAs, and UPAs with guidance and inspection of their completed task as their pertain to their appropriate scope of practice. The LPN can only delegate tasks within their scope of practice and be assured that the one they are delegating to demonstrates competency (4) .

Certified Nursing Assistant (CNA)

The certified nursing assistant is similar to the UAP but in order to be certified they must have competed a background check conducted by the Board of Nursing, prove they are able to read and write, and pass the nursing assistant examination. Once the criteria listed has been met, CNAs can provide general care and assist with activities of daily living under the direction of a RN or LPN. They can also participate in postmortem care and perform CPR.

1. Think of your facility. What types of UAPs do you have? CNAs, Patient Care Technicians (PCTs)?
2. Are you aware of what Florida laws and regulations say you can and can't delegate to them?
3. Are there any LPNs where you work?
4. What are they able to do, and what types of patients are the able to take care of?

Maintaining Medical Records

For RNs and APRNs in private practice the Florida Nurse Practice Act has two rules in place when it comes to maintaining medical records . The first applies to the death of the nurse. Whoever legally represents the RN or APRN must post a notification in the county newspaper stating where the medical records are being stored and who to contact if an individual would like to obtain the records. The records must be stored for at a minimum of two years after the death of the nurse (4) .

At the 24-month mark, there must be several notices posted in the county newspaper, one notification for four consecutive weeks, that the medical records will be destroyed four weeks after the last day of the fourth week that the notice was published (4) .

The second rule pertains to a n RN or APRN that has terminated or relocated their practice. The rule states that the RN or APRN maintain and hold on to the medical records for a minimum of two years. They must let those that were patients know about the date of termination or relocation and where the medical records can be retrieved. The notice must be made public, such as in a newspaper, with a minimum appearance of four times over four weeks. A sign must be placed at the location of the business about the termination or relocation until the termination or relocation happens. This sign must tell patients about the opportunity to obtain their medical records (4).

Continuing Education (CE) Requirements

Florida laws and regulations require that for renewal of a nursing license , the nurse seeking renewal must complete a set amount of CE hours. Over the two-year period, 24 hours must be completed, one for each month. Two of those hours must be on the Florida Nurse Practice Act and the other laws that pertain to the nursing profession. Two hours are required on medication errors and how to prevent them. A one-hour HIV/AIDS is required for initial renewal but does not have to be repeated. There must be a two-hour course on domestic violence done every third renewal. As of August 2017, a two-hour course on recognizing impairment in the workplace is required with each renewal (4).

In the state of Florida , completed CE courses are either automatically reported to a tracking system created by the Department of Health's Division of Medical Quality and Assurance (MQA) or by the individual manually. Those who attend CE courses will obtain a certificate of attendance. It is advised that the attendee maintain a copy of those certificates for four years or more. For Florida, the provider of the course has 90 days to report to the tracking system, so if the date to renew is less than 90 days, it is suggested that the course be manually reported (4) .

If a nurse has two license s, such as RN and LPN or APRN and RN, they may be able to comply with both license requirements through one set of CE requirements. For example, a n RN who holds an LPN license can meet all of the LPN license CE requirements by completing the RN requirements (4).

Nurses who serve as expert witnesses and provide expert opinions in a written format can obtain 2.5 hours for each case according to Florida laws and regulations. The case must cite at least two current articles of reference and are being reviewed in regard to the Nurse Practice Act (4).

There are a few exemptions to the CE renewal requirement s (1) :

• If the nurse is on active duty for the US military within six months of the renewal date .
• This does not apply to short periods of active duty such as summer or weekend drills.
• This does not apply to those on duty in the US Public Health Service.
• If the nurse's spouse is a member of the US military and the nurse was absent from the state of Florida because of military duty.
• The nurse must provide adequate proof of the absence and the military status of their spouse.

1. What types of classes do you take to complete your continuing education? Online, in-person, webinar?
2. What Florida mandated classes do you have the hardest time obtaining?
3. Do you hold licenses in two aspects of nursing, such as LPN and RN, or RN and APRN?
4. If so how do you complete your continuing education requirements for both?

Disciplinary Action

The Florida Board of Nursing, as outlined in the Nurse Practice Act, holds power to discipline nurses as they see fit in regard to the violations of Florida laws and regulations. The Board created a variety of ways a nurse can be disciplined , ranging from probable-cause panels to citation s to disciplinary hearings. The severity of the violation reflects on which method the Board of Nursing may take (2) .

There are three probable-cause panels in Florida: North Florida, Central Florida, and South Florida. The purpose of these panels is to determine if there was "probable cause" or reasonable ground for the reported case. Essentially they decide if a case needs action taken when Florida laws and regulations are not followed. The members of the panel review each case and compare it to others of similar nature, how the Board treated the cases in the past, and what the Board's guidelines entail. The panel can recommend and consider rules regarding procedures, penalties, and disciplinary actions.

C itations can be given in lieu of other forms of discipline. The citation is issued within six months of a complaint being filed and contains the request for the recipient to fix the violation within a specified time frame. These violations are usually classified as "minor" in nature, such as false advertising, falsely using a nursing title, or failure to report the change of addres s or updates of information required by the Board. Other reasons a citation can be issued are a failure to report a misdemeanor within 30 days of a ruling or failing to utilize the law – required prescription drug monitoring system. Each of these citations can come with a fine, usually ranging from $100 to $250 in amount; however, if a nurse is found guilty of sharing passwords, codes, keys , or other forms of entry to a secure medication administration or information technology system a fine of $1,500 can be given. In addition, the nurse would have to take a two-hour CE course on legal nursing aspects within 60 days of the citation being issued.

The Board of Nursing has the power to take appropriate action against nurses that confirmed violation of Florida laws and regulations or of the Nurse Practice Act (2) :

• Probation , suspension, or revocation of a license
• Can be emergent ly done depending on the situation.
• Require CE course(s) to be done.
• Letter of concern
• Reprimand
• Give a fine
• Require a personal appearance in front of the Board of Nursing to monitor compliance .
• Restricting or limiting practice
• Referral to the Intervention Project for Nurses (IPN)

Any of these actions can be combined, depending on the severity of the violation. They can also accompany a fine determined b y the Board (2) .

The Board of Nursing has also created an extensive list of reasons why a nurse can be disciplined (2 ):

• Sexual misconduct
• Unprofessional conduct
• Participating in c rime related to healthcare fraud .
• Making or filing a false report to appease state or federal law .
• Willfully hindering another individual in filing a report that is required by state or federal law .
• Testing positive on any drug screen when the individual has no medical / other reason for using the drug .
• Inability to practice nursing with satisfactory skill and provide safe patient care due to use of narcotics, drugs, alcohol, chemicals, or other substances that may impair an individual
• Inability to practice nursing with satisfactory skill and provide safe patient care due to a n illness, physical or mental condition .
• Failing to meet minimal standards of acceptable nursing practice .
• Accepting and performing professional responsibilities the nurse knows or has reason to know they are not skilled to perform .
• Delegating or contracting for the performance of professional responsibilities by a person who the nurse knows or has reason to know is not qualified by training, experience, and authorization required to perform .
• Failing to identify the type of license the nurse is practicing under through written (can include a nametag) or oral notice to a patient .
• Performing or attempting to perform healthcare services on the wrong-site or wrong procedure on the wrong patient . This includes unauthorized procedure s.
• Performing or attempting to perform healthcare services that are medically unnecessary or otherwise not related to the patient's diagnosis or medical condition (s).
• Being convicted or found guilty of or pleading nolo contendere  to a crime in any jurisdiction that directly relates to the practice of nursing or ability to practice nursing .
• Being convicted of or found guilty of, or pleading nolo contendere  to misdemeanors, related to failure to protect an adult from abuse, neglect, and exploitation; fraudulent practices; theft and robbery; or having committed an act of domestic violence or child abuse .
• Defaulting on a student loan that has been issued or guaranteed by the state or federal governmen t.

As with everything in life, the Board of Nursing has created guidelines for imposing discipline. They have a set minimum and maximum amount when it comes to fines. They have time frames for probation or supervision, conditions regarding probation or the reinstatement of a license. What route they decide to take depends upon the specific case being presented to them. Sometimes the circumstances presented to the Board are enough to elicit decisions that are outside the general guidelines. Some of these circumstances are (2) :

• Length of time a nurse has practiced.
• Presents a d anger to the public .
• Any visible effort at rehabilitation .
• Treatment and disciplinary hearing costs .
• Actual physical or other forms of damage caused by the nurse.
• Financial hardship s.
  

The Board has a timeframe in which a complaint must be filled. Most of the time , it's within a six-year window from the time the incident occurred. However, in certain circumstances—criminal actions, sexual misconduct, impairment of the nurse, or usage/diversion of controlled medications—the Board may go beyond the six-year timeframe. If action such as fraud, intentional misrepresentation, or concealment is utilized to hide the violation during the six-year period, the timeframe to file a complaint can be extended to 12 years from when the incident initially occurred (2) . All is dependent on the severity and complexity of failure to follow Florida laws and regulations delegated.

If the Board of Nursing suspends a nurse's license, or if the nurse agrees to have the licenses suspended to avoid further action against them, the nurse can file a petition to possibly have their license reinstated. Any final orders or terms issued during the initial suspension must be met in whole, and the nurse must be able to demonstrate the ability to perform nursing practice safely. Sometimes a time frame is placed for when a nurse can file a petition ; sometimes , there is not. If this is the case , then a nurse can appeal as soon as they are able to do so after meeting the terms and conditions given to them by the Board (2) .

The Board will determine what a nurse has to do in order to demonstrate safe practice. This is based on the violation. For example, a nurse who is working while under the influence of medications or alcohol may be ordered to attend a treatment program with proof of sobriety, references, and completion of any court – mandated sanctions. Nurses are often required to present to the Board of Nursing in person and speak on their ability to safely practice nursing (2) .

The three-strike policy is utilized when it comes to reinstating a license. If a nurse has been found guilty on three separate occasions of a complaint pertaining to drug/narcotic usage or the diversion of medications from patients to the nurse for personal use or to sell , the Board will not reinstate the license (2) .

Relicensing a nurse who has had their license revoked is similar to wh at happens when a license is suspended. However, the nurse must reapply for the license and meet all conditions set by the Board. Nurses may have to sit for another examination or take B oard approved continuing education if the nurse has been out of practice for an extended period of time. They may require a nurse to participate in Florida's Intervention Project for Nurses (IPN) program or at least be evaluated for it (2) .

Nurses are held accountable for reporting the action s of other nurse s and a ny misconduct to the Board of Nursing. They must document and report failure to follow Florida nursing and regulations.  They must report sexual misconduct or healthcare fraud. If they know or have reason to believe that another nurse is not practicing safely or is practicing under the influence of alcohol or medications , they are required to report it.

1. Do you know anyone who has had action taken against them regarding the Nurse Practice Act?
2. If so do you know the outcome?
3. What are some other violations that you think might violate the Nurse Practice Act?
4. What do you think is the most severe violation?
5. Do you think that the Board of Nursing's list of potential actions that could be taken against a nurse's license is fair?
6. If you were on the Board what types of disciplinary action would you recommend when someone does not follow Florida laws and regulations?

Florida's Intervention Project for Nurses (IPN)

Created in 1983 under the authority of the Nurse Practice Act, IPN was designed to protect the public through monitoring nurses whose skills have been compromised due to improper use of medications or alcohol or the impairment of mental of physical health. IPN is not a treatment center. Instead, they provide nurses with access to B oard-approved practitioners who specialize in addiction, mental health, and other medical conditions. They also conduct monitoring after a nurse has been discharged from treatment, interventional training, consultations, and advocacy for those who participate (3).

As mentioned above, nurses have an obligation to report themselves or nurses who are or they have reason to believe are unsafely practicing nursing while under the influence of alcohol or medications. If a nurse self-reports or is reported to the IPN only and they successfully complete treatment and five-year monitoring , the report is confidential. If the Board of Nursing becomes involved, either through a failure to report or failure to complete treatment, disciplinary action may be taken (3) .

Initially , nurses are not able to practice during th e initial evaluation and when the determination of treatment is being made. After that, it is up to the discretion of the IPN and the providers involved in the treatment. Restriction s on a nurse's practice are often implemented during the beginning phase of treatment (3) .

In order to be determined "fit to practice", the nurse must meet all requirements set by their providers and the IPN. They must sign a n advocacy contract, submit to random drug tests, verbalize understanding any practice restrictions, and be involved in a weekly support group for nurses (3).

1. Do you think the IPN should be a treatment center as opposed to a resource center?
2. Should the status of a nurse who has enrolled in this program, willingly or not, be confidential , even if they do not meet the requirements stated in Florida laws and regulations ?
3. Do you think a nurse should be allowed to practice nursing with set limitations while involved with IPN?

Summary

Despite the extensive outline of the Nurse Practice Act and other Florida laws and regulations provided in this course, it does not provide a complete narration of all Florida rules and/or laws pertaining to nurses. In addition to this course, it is imperative for nurses to stay on top of new legislation being proposed and put into effect regarding their profession and continually review the content in the state laws. Nurses who trave l to other states to practice their profession should be educated on each state's rules regarding nursing practice as it can differ from state to state. A conscious effort should be made to follow Florida laws and regulations set in place in order to practice safely and legally in the state of Florida.

References + Disclaimer

1. The Florida Senate. "Chapter 456." Chapter 456 – 2018 Florida Statutes – The Florida Senate , www.flsenate.gov/Laws/Statutes/2018/Chapter456
2. The Florida Senate. "Chapter 464." Chapter 464 – 2018 Florida Statutes – The Florida Senate , www.flsenate.gov/Laws/Statutes/2018/Chapter464/All
   
3. Intervention Project for Nurses , 2016, www.ipnfl.org/
   
4. State of Florida. Department List – Florida Administrative Rules, Law, Code, Register – FAC, FAR, ERulemaking , www.flrules.org/gateway/Division.asp?toType

Disclaimer

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