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Florida Board of Nursing

The Intervention Project for Nurses (IPN) was established in 1983 through legislative action to ensure public health and safety through a program that provides close monitoring of nurses who are unsafe to practice due to impairment as a result of misuse or abuse of alcohol or drugs, or both, or due to a mental or physical condition which could affect the licensee's ability to practice with skill and safety.

Many RN's or LPN's have to submit to drug testing and treatment through the Intervention Project for Nurses. The following are frequently asked questions which can be found on the projects website that most health professionals may have. If you feel that you have been wrongfully accused or they have set excessive work restrictions call our law firm today. We represent medical professionals before the Florida Department of Health, the Florida Board of Nursing and the Florida Department of Hearing Officers (DOAH).

Frequently Asked Questions- Intervention Project for Nurses.

What is impairment?

Impairment is a condition that results from the use of mind/mood altering substances, distorted thought processes found in the psychologically impaired or a physical condition that prevents the nurse from providing safe patient care. Impairment is characterized by the inability to carry out the professional duties and responsibilities in a reasonable manner consistent with nursing standards. This guide will focus only on impairment caused by chemical dependency.

There is no resolution of problems associated with chemical dependency without effective intervention or treatment. Coworkers often feel frustrated and helpless. Staff morale may deteriorate while the chemically impaired nurse becomes more impaired. As chemical dependency progresses, the potential for compromising patient care increases. Cognitive functioning, decision-making, reaction time, judgment and the ability to handle stress are increasingly affected.

Who may make a report to the Intervention Project for Nurses (IPN)? Any person suspecting impairment of a nurse's ability to provide safe nursing care may report this nurse to IPN and/or the DOH. Under Florida's Mandatory Reporting Law, all licensed nurses must report any suspected impairment in practice to IPN and/or the DOH

Will a nurse still be able to practice nursing while participating in the Intervention Project for Nurses (IPN)?

Initially, the nurse may be required to refrain from nursing practice during the evaluation phase and any resulting treatment. The nurse may resume nursing practice when given authorization to do so by IPN. The approval for a return to nursing practice is based upon recommendations from approved treatment providers in consultation with IPN staff. Practice limitations are often required during the early phase of return to practice.

What are some of the signs and symptoms to look for that may indicate a nurse is experiencing problems with chemical dependency or other conditions that may impair his/her ability to provide safe nursing care?

While the following is not intended as a complete list, they include increases in absenteeism, which may be more pronounced following scheduled days off, subtle changes in appearance and/or behaviors that escalate in severity over time, as well as decreasing competence in patient care. The usually quiet nurse may become talkative and gregarious, or the reverse may occur, where the nurse becomes isolated and withdrawn from peers who were once professional or social contacts. The nurse may overreact verbally, snapping at colleagues, or become disproportionately angry or emotional in response to situations that were handled appropriately or calmly in the past.

Why should a nurse choose to participate in the Intervention Project for Nurses?

The IPN staff can assist the nurse in obtaining appropriate treatment, continuing care, and ongoing support. If the nurse has violated the Nurse Practice Act, IPN participation is an alternative to disciplinary action by the Florida Board of Nursing. If the nurse is already involved in the disciplinary action process through the DOH, an IPN representative will be present. When that nurse’s case is heard before the Florida Board of Nursing, IPN can confirm that the nurse is engaged in the recovery process.

Does IPN provide evaluation and/or treatment for nurses?

IPN does not provide the evaluation and/or treatment required, but does provide referrals to Board-approved Addictionist, Psychiatrist, and/or other treatment professionals. These Addictionists, Psychiatrists, and/or treatment providers are located throughout the State of Florida and referrals will be made to a provider geographically closest to the nurse's place of residence.

What are the costs/fees for IPN participation?

Unlike some of the other professional alternative to discipline programs, IPN does not charge a fee for participation. The nurse is responsible to pay for the cost of all evaluations and/or treatment that may be required. For those nurses who are required to submit to random drug testing, they are responsible for the cost of all laboratory testing that is performed.

Florida Board of Nursing is the state government agency established by law to protect the public by regulating the practice of Nurses in the state of Florida. Florida Board of Nursing is responsible for the implementation and enforcement of any state laws related to nursing license, nursing practices, nursing education, and Florida nursing schools. Nursing Board members are generally made up of both members of the public and those within the nursing profession, such as Registered Nurses. Members of the Florida Board of Nursing may be appointed by the Governor and/or the state of Florida Legislature.

To become a Licensed Practical Nurse, you must complete a state approved Practical Nurse training program, then pass a state sponsored practical nurse licensing exam. Practical nursing programs generally last about 1 year and are offered by vocational nursing schools, technical schools, and community colleges. The applicable license exam for all U.S. states is the NCLEX-PN, which was developed by the National Council of State Boards of Nursing. The NCLEX-PN exam is computer based and covers 4 subject areas: (1) Safe Effective Care Environment, (2) Health Promotion and Maintenance, (3) Psychosocial Integrity, and (4) Physiological Integrity.
The mission of the Department of Health, Division of Medical Quality Assurance (MQA) is to promote, protect and improve the health of all people in Florida. MQA, in conjunction with twenty-two (22) boards and six (6) councils, regulates six (6) types of facilities and more than forty (40) healthcare professions. MQA evaluates the credentials of all applicants for licensure, issues licenses, analyzes and investigates complaints, inspects facilities, assists in prosecuting practice act violations, investigates unlicensed activity and provides credential and discipline history about licensees to the public. We represent all LPN candidates and LPN before the Board and the Division of Medical Quality Assurance.
The Enforcement Program within MQA is responsible for analyzing and investigating complaints against healthcare practitioners and facilities from intake to final resolution, inspecting facilities, assisting in prosecuting practice act violations, and investigating unlicensed activity.

64B9-8.001 The Probable Cause Panel.
(1) The determination as to whether probable cause exists shall be made by a majority vote of a probable cause panel of the Board of Nursing.
(a) The Board establishes three probable cause panels of two persons each to be appointed by the Chairman of the Board. Each panel may have one former Board member serve, and at least one member of each panel must be an active licensee of the Board. No more than one member of each panel shall be a consumer member. One member of each panel shall be designated chairman. The Board may designate one panel to review the cases closed by the Department.
(b) One panel shall be designated as the North Florida probable cause panel and shall consist of members residing in the northern part of the state. Cases arising from the southern part of the state shall be referred to the North Florida panel.
(c) One panel shall be designated as the Central Florida probable cause panel and shall consist of members residing in the middle part of the state. Cases arising from the northern part of the state shall be referred to the Central Florida panel.
(d) One panel shall be designated as the South Florida probable cause panel and shall consist of members residing in the southern part of the state. Cases arising from the central part of the state shall be referred to the South Florida panel.
(e) It is the Board's intent to distribute the workload equitably among the three panels and to conduct meetings in a geographically convenient and economical manner for the panel members. A panel may refuse to consider a case that clearly belongs to another panel. However, it is not the intent of the Board to require mathematical and geographic precision. That one panel acted on a case which arguably should have been considered by another shall not be grounds to invalidate that panel's action.
(f) If a case needs to be reconsidered by the probable cause panel for any reason, the case must be taken to the panel which initially considered it.
(2) The panel shall:
(a) Suggest penalties for inclusion in any stipulations between the Department and the licensee, based on the material submitted by the Department, the Board's past treatment of similar cases, and the Board's disciplinary guidelines. All stipulations and terms shall be subject to approval or rejection by the full Board.
(b) Receive interim reports from the probation supervisor to consider referring potential problem probationers to the full Board or for further investigation and a probable cause determination.
(3) The panel may consider and recommend rules concerning disciplinary actions, procedures, and penalties to the full Board.
Specific Authority 456.073(1), (3), 464.006 FS. Law Implemented 456.073(4) FS. History–New 11-28-79, Amended 11-22-84, Formerly 21O-10.04, Amended 4-8-92, 9-22-92, Formerly 21O-10.004, 61F7-8.001, Amended 5-1-95, Formerly 59S-8.001, Amended 8-18-98, 4-28-99.
64B9-8.0045 Minor Violations.
For the purposes of Section 456.073(3), F.S., the Board deems the following violations to be minor:
(1) False, deceptive or misleading advertising in violation of Section 464.018(1)(g), F.S., provided no criminal prosecution resulted;
(2) Issuance of a worthless bank check to the Agency or to the Board in violation of Section 464.018(1)(a), F.S., provided the licensee does not continue to practice on an inactive license or the check was not in payment of a Board ordered administrative fine;
(3) Failure to report address change in violation of Rule 64B9-1.013, F.A.C., provided the licensee was not ordered to do so in a Board disciplinary order;
(4) Improper use of a nursing title under Section 464.015, F.S., provided no practice issue was involved or no criminal prosecution resulted.
Specific Authority 120.695, 456.073(3), 464.006 FS. Law Implemented 120.695, 456.073(3) FS. History New 11-16-95, Formerly 59S-8.0045.
64B9-8.005 Unprofessional Conduct.
Unprofessional conduct shall include:
(1) Inaccurate recording;
(2) Misappropriating drugs, supplies or equipment;
(3) Leaving a nursing assignment without advising licensed nursing personnel;
(4) Stealing from a patient;
(5) Violating the integrity of a medication administration system or an information technology system;
(6) Falsifying or altering of patient records or nursing progress records, employment applications or time records;
(7) Violating the confidentiality of information or knowledge concerning a patient;
(8) Discriminating on the basis of race, creed, religion, sex, age or national origin, in the rendering of nursing services as it relates to human rights and dignity of the individuals;
(9) Engaging in fraud, misrepresentation, or deceit in taking the licensing examination;
(10) Impersonating another licensed practitioner, or permitting another person to use his certificate for the purpose of practicing nursing;
(11) Providing false or incorrect information to the employer regarding the status of the license;
(12) Testing positive for any drugs under Chapter 893, F.S., on any drug screen when the nurse does not have a prescription and legitimate medical reason for using such drug;
(13) Practicing beyond the scope of the licensee’s license, educational preparation or nursing experience;
(14) Using force against a patient, striking a patient, or throwing objects at a patient;
(15) Using abusive, threatening or foul language in front of a patient or directing such language toward a patient.
Rulemaking Authority 464.006, 464.018(1)(h) FS. Law Implemented 464.018(1)(h) FS. History–New 11-28-79, Amended 3-16-81, 10-8-81, 9-11-83, Formerly 21O-10.05, Amended 4-21-86, 2-5-87, 8-2-90, 3-12-91, 9-16-91, 4-8-92, 9-29-92, Formerly 21O-10.005, Amended 9-7-93, Formerly 61F7-8.005, Amended 11-6-94, 5-1-95, 11-16-95, Formerly 59S-8.005, Amended 2-18-98, 3-23-00, 2-17-02, 7-5-06, 12-11-06, 4-28-09.
64B9-8.006 Disciplinary Guidelines; Range of Penalties; Aggravating and Mitigating Circumstances.
(1) The legislature created the Board to assure protection of the public from nurses who do not meet minimum requirements for safe practice or who pose a danger to the public. The suspensions, restrictions of practice, and conditions of probation used by the Board in discharging its duties under Sections 464.018 and 456.072, F.S., shall include, but are not limited to, the following:
(a) Suspension until appearance before the Board or for a definite time period and demonstration of ability to practice safely.
(b) Suspension until appearance before the Board, or for a definite time period, and submission of mental or physical examinations from professionals specializing in the diagnosis or treatment of the suspected condition, completion of counseling, completion of continuing education, demonstration of sobriety and ability to practice safely.
(c) Suspension until fees and fines paid or until proof of continuing education completion submitted.
(d) Suspension until evaluation by and treatment in the Intervention Project for Nurses. In cases involving substance abuse, chemical dependency, sexual misconduct, physical or mental conditions which may hinder the ability to practice safely, the Board finds participation in the IPN under a stayed suspension to be the preferred and most successful discipline.
(e) Suspension stayed so long as the licensee complies with probationary conditions.
(f) Probation with the minimum conditions of not violating laws, rules, or orders related to the ability to practice nursing safely, keeping the Board advised of the nurse's address and employment, and supplying both timely and satisfactory probation and employer/supervisor reports.
(g) Probation with specified continuing education courses in addition to the minimum conditions. In those cases involving unprofessional conduct or substandard practice, including recordkeeping, the Board finds continuing education directed to the practice deficiency to be the preferred punishment.
(h) Probation with added conditions of random drug screens, abstention from alcohol and drugs, participation in narcotics or alcoholics anonymous, psychological counseling, the prohibition on agency work, or the requirement that work must be under direct supervision on a regularly assigned unit.
(i) Personal appearances before the Board to monitor compliance with the Board's order.
(j) Administrative fine and payment of costs associated with probation or professional treatment.
(2) The Board sets forth below a range of disciplinary guidelines from which disciplinary penalties will be imposed upon practitioners and applicants for licensure guilty of violating Chapters 464 and 456, F.S. The purpose of the disciplinary guidelines is to give notice to licensees and applicants of the range of penalties which will normally be imposed upon violations of particular provisions of Chapters 464 and 456, F.S. The disciplinary guidelines are based upon a single count violation of each provision listed. Multiple counts of violations of the same provision of Chapters 464 and 456, F.S., or the rules promulgated thereto, or other unrelated violations will be grounds for enhancement of penalties. All penalties set forth in the guidelines include lesser penalties, i.e., reprimand and or course-work which may be included in the final penalty at the Board's discretion.

Pursuant to Section 456.0635, Florida Statutes, you are being notified that effective July 1, 2009, health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant has been:

1. Convicted or plead guilty or nolo contendre to a felony violation regardless of adjudication of: chapters 409 817 or 893, Florida Statutes; or 21 U.S.C. ss. 801-970 or 42 U.S.C. ss 1395- 1396, unless the sentence and any probation or pleas ended more than 15 years prior to the application.

2. Terminated for cause from Florida Medicaid Program (unless the applicant has been in good standing for the most recent five years).

3. Terminated for cause by any other State Medicaid Program or the Medicare Program (unless the termination was at least 20 years prior to the date of the application and the applicant has been in good standing with the program for the most recent five years).