When I read the article and the editorial I knew that many people will cheer the limiting of licenses to those with criminal histories, but I think they tend to focus on horrific crimes and don’t realize the impact made on people who commit crimes due to a lack of knowledge or because they are young or with the best of intentions.  If you do not speak to such people daily, then you cannot know the heartache and problems for the licensee or the ultimate ramifications for the public.  What about a licensee who is wrongly accused (it happens more than you think:  bad investigations, witness lies, evidence corrupted) and then convicted (Oh, and it does not matter the licensee received deferred adjudication since some regulatory boards consider deferred adjudications as convictions.).  A situation I have seen over and over is during a divorce or custody hearing, one of the spouses accuses the other of some crime and then lie or plant evidence; the other spouse is sure the law will find on their side since they are obviously innocent, but the legal system does not always work that way, so the innocent ex-spouse is now facing an investigation by the regulatory board.  The criminal incident has nothing to do with the licensee’s profession, but the licensee is investigated then disciplined and  loses their job and is now on public assistance because no one wants to hire them.  It happens again and again, professionals attempting to find work outside of their profession will not be hired because the potential employers think they will leave too soon, are too over-qualified, will challenge them for their position etc and a highly educated professional remains unemployed.

Mr. Dexheimer discusses so many cases where the state’s result does not appear to be justified; that there is no nexus between the criminal charge and the practice of that particular profession.   One of the examples involves pharmacist Emmanuel Kanu who lost his pharmacist license, not because of patient care issues or as a result of actions which could harm the people of Texas (potential patients/clients), but because he did not complete the proper documentation when he sent donated medications to a clinic in a third world county.  Mr. Kanu, a pharmacist with no patient care issues for 17 years, is now removed from being able to care for the Texas public for 10 years; how is this outcome reasonable or just? Would one consider Mr. Kanu to be a criminal?  Is his failure to submit the proper documentation in order to send these medications so heinous that we need to waste tax payer funds to convict him and then remove him from the professional workforce?

I also fear the public will ignore the message of this article (and the subsequent editorial) because it deals with “ex-cons” or those with criminal incidents when the message is so much more–the regulatory agencies are vested with great power and there can be an unfair and unjust tendency to abuse and overuse that power; once again, it depends on the individuals within the agency–there are some excellent staff members who warrant great respect, but there are also some who are not protecting the public, they are just punishing.

The problem our attorneys face is most licensees cannot afford to fight the regulatory boards and they are faced with accepting discipline which is not warranted or in some cases, even legal.  But, it is not clear sailing for those licensees that do choose to fight because as seen in Mr. Dexheimer’s article,  like Mr. Kanu, the licensee pays the money to fight the regulatory board, the licensee wins at the State Office of Administrative Hearings (SOAH) only to have the case overturned by the regulatory board.  This is such a wide spread problem that our attorneys testified during the last Legislative session urging Texas lawmakers to support a bill which would make SOAH decisions final and if either party wanted to appeal at district court, they could do so.  Making SOAH decisions final avoids the “second chance at the licensee” actions which occur now when boards overturn SOAH Judge recommendations.  Making SOAH decisions final levels the process and makes it fair for all involved.

These are problems which should be addressed and the regulatory system, if it is going to be vested with so much independent power, should be fair and just and able to stand up to scrutiny.  Ask yourself, who is on the side of the licensee?  Who is making sure there are enough professionals to provide care to the people of Texas?  Is the system driving good professionals out of practice or turning them into cynics who no longer see the benefit in caring?  The public, the boards, and licensees need to be aware of all sides of a situation; not jump to conclusions; and consider the ultimate impact on all.

Recently, I have received several inquiries regarding “setting aside board orders.”  This cannot be done and this is misinformation.  While criminal incidents can sometimes be expunged or sealed, administrative actions currently cannot be removed from one’s license.  Once a disciplinary action occurs, the history remains even once the “probation” is complete.

There’s more to being a nurse than meets the eye, especially if you’re a nurse practitioner. At one of the highest levels of nursing there is, nurse practitioners are generally qualified to examine and diagnose patients. Some states even allow them to prescribe medication.

While they must work under the supervision of or in tandem with doctors, most nurse practitioners usually have autonomy in educating families on the need for preventive measures and in ensuring their general wellbeing. They generally work in rural and underserved areas, treating families, children and communities and teaching them about health, prevention, self care and other skills that are necessary to keep disease at bay. Nurse practitioners need to have at least a graduate degree and generally specialize in family practice, pediatrics, cardiology, acute care, women’s health, adult practice, geriatrics, occupational health, palliative care, and anesthetics (as a certified registered nurse anesthetic).

If you want to become a nurse practitioner in Texas, here’s some information that you’ll find useful:

• Nurse practitioners are called Advanced Practice Registered Nurses (APRN) in this state
• You must be a registered nurse with a license that is valid in Texas
• You must also complete a master’s or doctoral program in any specialty of your choice that focuses on advance practice nursing, one that is approved by the Board of Nursing or accredited by a national accrediting agency recognized by the Board of Nursing.
• Your graduate program must be at least a year in duration and include a practicum program or a preceptorship.
• You must become nationally certified in the specialty of your choice before you can apply for a license to practice as an APRN in Texas.
• The Board of Nursing does allow you to practice as an APRN while you’re waiting for the results of your certification examination. You need to procure an interim license from the board for this purpose.
• If you plan to study online for your advanced degree, most universities allow you to complete your practicum program at a healthcare facility in your area. Check with your school for your available options.
• As an APRN in Texas, you can hope to earn around $85,000 per year; the sum tends to increase if you specialize in acute care settings like neonatology and emergency care and decrease if you opt for general medicine and family practice.
• There are many accredited universities in Texas that offer graduate nursing programs, and to learn more about them, you could check out the information available on the website of the Texas Board of Nursing.

By-line:

This guest article was written by Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools . Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com