Mississippi Board of Nursing
Lynn Langley, DNP, FNP-BC, ANP-BC, CPHQ
Interim Executive Director
Mississippi Board of Nursing
llangley@msbn.ms.gov
Phone (601) 957-6289
Objectives
 1. Explain role and function of the
Mississippi Board of Nursing.
 2. Understand the function of the Nurse
Recovery Program and the Office of
Nursing Workforce.
 3. Identify grounds for disciplinary
actions and duty to report.
Mississippi Nurse Practice Law
Mississippi Board of Nursing
 Legally charged to protect the public by Regulating the practice
of Nursing.
 Mississippi Nurse Practice Law defines the practice of nursing;
(73-15-5)
Administrative Code
Mississippi Board of Nursing
Mississippi Administrative Code
Title 30: Professions and Occupations
Parts 2801 – 2900
 The authority of the Mississippi Board of Nursing
is to promulgate rules and regulations for the licensure of registered nurses,
advanced practice registered nurses, licensed practical nurses, expanded role
licensed nurses and certified hemodialysis technicians as provided for in the laws
of the Miss. Code Ann. Sections 73-15-17 (a), &73-15-101.
Purpose and Function
 The Mississippi Board of
Nursing is authorized by
Miss. Code Ann., 1972
Chapter 15, to protect the
public through the process
of licensure and regulation
of nursing practice.
Functions of the Board
 Establish standards of nursing practice through rules and
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regulations.
Regulate the practice of nursing.
Approve applicants for licensure examinations.
License qualified applicants.
Certify qualified applicants to function in the expanded role.
Discipline those associated with practice violations.
Support effective relationships within the healthcare community.
Provide educational resources relative to licensure and practice.
Consider public opinion, responses and relationships.
Composition of the Board
 There shall be at least one
(1) board member from
each congressional district
in the state.
 However the physician
member, consumer
representative member and
one (1) registered nurse
shall be at large always.
Composition of the Board
 Thirteen (13) members
 Two (2) nurse educations
 Three (3) registered nurses in clinical practice
 Two (2) associate or diploma degree
 One (1) basic nursing preparation a baccalaureate degree
 One (1) registered nurse at large
 Four (4) licensed practical nurses
 One (1) licensed physician who is member of the State Board of
Medical Licensure
 One (1) consumer of health services
Appointment of Members
 Members (exception of the
physician) is appointed by the
Governor with advice and
consent of the Senate from
lists of nominees submitted
by any Mississippi nursing
organization and/or
association.
 Mississippi Nursing Practice Law ~73-15-9
(1), (2), & (3)
Qualifications of Members
 Citizen of the United States
and resident of the State of
Mississippi
Qualifications - Registered Nurse
 Graduation from an
approved educational
program.
 At least five (5) years of
nursing experience.
 Employed for at least the
past three (3) years.
 Currently registered to
practice in Mississippi.
Qualifications - Licensed Practical
Nurse
 Graduation from an
approved educational
program.
 At least five (5) years of
nursing experience.
 Employed for at least the
past three (3) years.
 Currently registered to
practice in Mississippi.
Accountability – Each Member Shall
 Possess a current, active and unencumbered Mississippi
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nursing license.
Protect the public.
Make responsible and educated decisions and be accountable
for such decisions.
Maintain the integrity of the board.
Participate actively in business meetings, assigned hearing
panels and committees.
Collaborate with other board members.
Accountability: Each Member Shall Not
 Disclose confidential information gained by reason of his/her
official position or authority on the board.
 Use his/her official position on the board to secure
unwarranted privileges or exemptions for self or others.
 Use confidential information for private or public gain.
 Incur more than two consecutive absences from meetings.
Terms
 Members are appointed in
staggered terms for four
(4) years.
 No member may serve
more than two (2)
consecutive full terms.
Officers
 President
 Secretary
 Treasurer
 Mississippi Nursing Practice Law ~~73-
15-11 (1)
President’s Duties
 Preside over all meetings of the board.
 Make decisions for the board, between meetings, which require immediate
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action.
Gain consent and appoint all members of ad hoc and standing committees..
Remove any member not fulfilling obligation to a committee.
Oversee presentation of board’s annual budget…
Present to Personnel Board any changes in status of executive director
Serve as the board’s official representative to legislative groups…
Retain the right to vote on all board issues
Sign appropriate legal documents…
Serve as counselor and advisor to executive director
Serve as ex-officio member of all standing and special committees.
Oversee presentation of executive director’s annual evaluation…
Prepare and present report at annual meeting.
Secretary’s Duties
 Preside and make decisions for the board, between meetings
in absence of president….
 Sign all board minutes.
 Keep the official tally of all board actions.
 Prepare and present report at annual meeting.
Treasurer’s Duties
 Work with executive director and accountant on budgetary
matters.
 Assist with board’s annual budget presentation to appropriate
commissions and committees.
 Present report at annual meeting.
 Perform secretarial duties in absence of secretary.
Meetings
 At least once every four (4)
months for the purpose of
transacting business.
 Disciplinary hearings and
business meetings are open
to the public.
Quorum
 Of the thirteen (13) board
members, seven (7)
members including at least
three (3) registered nurses
and two (2) licensed
practical nurses shall
constitute a quorum.
 Mississippi Practice Law ~~73-15-11 (4)
Standing Committees
 Executive Committee
 Nominating Committee
 Nursing Practice
Committee
 Advanced Practice
Committee
 Compliance Committee
 Other Committees
Parliamentary Procedure
 Published February 1876
by then U.S. Army Colonel
Henry Martyn Robert
(1837–1923) with the
short title Robert's Rules of
Order placed on its cover.
Robert’s Rules of Order, Newly Revised
 Governs the board,
published 2011
Programs Under the Auspice of MS
Board of Nursing
 Nurse Recovery Program  Office of Nursing Workforce
Nurse Recovery Program
 Operates within the Board of Nursing
 Approximately workload annually ….
 318 participants signed 5 year monitoring affidavits.
 50% of those completed the five year program with no relapse or non-
compliance.
 10% relapsed or engaged in noncompliance necessitating a second affidavit.
 40% were unable to maintain sobriety and were referred to the disciplinary
division for further action.
 Recidivism
 Out of the 60 percent who successfully completed the program, 7.5 % of
them violated following completion.
RN AND LPN Patterns of Abuse
 Cases involving RN’s and LPN’s most often involve the
diversion of wastes of opiate medications.
 Pre-charting and excessive administration of controlled
substances.
 Doctor shopping to obtain more medication than prescribed.
 Prescription forgery.
APRN Patterns of Abuse
 Writing and filling prescriptions for self administration using
patients or family member’s names.
 Doctor shopping to obtain excessive amounts of medications.
 Use of anesthesia agents.
 Diversion of fentynal, versed and other anesthesia
medications.
SIGNS AND SYMPTOMS OF IMPAIRMENT
OBVIOUS
 Slurred speech
 Sleeping while on duty
 Lack of coordination
 Unexplained absences from
the unit
 Frequent bathroom breaks
 Smelling of alcohol
 Glassy red eyes, or
pinpoint dilated pupils
SUBTLE
 Pulling and administering
more controlled medications
than other nurses.
 Patients complaining of
untreated pain.
 Preferring night shifts or
unsupervised settings
 Never wasting with a witness
 Never taking vacation
 Visiting home health patients
when not on duty
THE IMPAIRED NURSE
Board Intervention
 The MS Board of Nursing intervenes on a nurses practice
when that nurse’s addiction has caused violations of the
nursing practice law and administrative code to occur.
 Investigative cases that involve diversion, doctor shopping,
prescription forgery, and other drug related offenses are
referred to the Recovering Nurse Program.
Nurses Monitoring Programs
 1982 International Conference on the Addicted Nurse
launched a call to action to all states to create board based
programs for substance dependent nurses.
 The resolution was grounded on research showing that
having programs specifically for nurses resulted in earlier
identification of the disease, timely removal from the work
place, appropriate monitoring and safer return to practice.
Nurses Monitoring Programs
 The National Council of State Boards of Nursing took up
the cause and began promoting the formation of
advocacy programs to the boards of nursing.
 Mississippi created the RNP in 1982, the RNP is a
disciplinary program that results in action similar to an
administrative felony. While many of the other states
created programs based on a non-disciplinary model, the
Board in Mississippi felt that diversion and similar
violations of the NPL needed to be recognizable and did
not want impaired untreated nurses moving from state
to state anonymously.
Components of Monitoring
 Professional assessment conducted by a master’s or doctorate
level individual utilizing collateral information provided by
supervisors, co-workers, and family members.
 A substance dependency diagnosis.
 Admission by the nurse of violation of the nursing practice
law and administrative code as well as an expressed desire to
receive help.
Components of Monitoring
 Prompt removal from the workplace.
 Referral and admission to the correct treatment
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modality.
Signing a monitoring affidavit with the board.
Return to work agreement
Monitoring with random drug screens, reports,
prescription use and medical treatment documentation.
Aftercare treatment to include groups, counseling and
medication management where appropriate.
Components of Monitoring
 Participation in 12 step groups and recovery activities.
 Routine group meetings with RNP staff.
 Accountability
 Repetition
 Five year monitoring agreement
Office of Nursing Workforce
Provides:
 Educational programs.
 Determine continuing
education needs of nursing
workforce.
 Promote and coordinate
schools of nursing
opportunities.
 Apply for grants for
development
 Data collections on adequate
nurses in Mississippi.
Office of Nursing Workforce
 The Mississippi Office of
Nursing Workforce
(ONW) is dedicated to
furthering research and
analysis of solutions to
nursing workforce issues
for purposes of public
information.
 Mississippi Code 1972, 75-15-18
Duty to Report
 Failure to report to the
Board facts known regarding
incompetent or illegal
practice of any RN or LPN
Filing a Complaint
 Source of information will be
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kept confidential.
Report suspected problems at
once to your immediate
supervisor.
Do not discuss your
suspicions with others.
Write a comprehensive
report as soon as possible.
If you are not certain it has
been reported to the Board,
you can make a report
yourself directly to the
Board.
Conspiracy to and illegally dispensing and
distributing controlled substances
 MD, age 76, of Metairie, LA, pled guilty in federal court to four counts of dispensing
Schedule III and Schedule IV controlled substances outside the scope of professional
practice and not for legitimate medical purposes; and one count of conspiracy to
illegally dispense and distribute Schedule III and Schedule IV controlled substances
and mixtures of Schedule III and Schedule IV controlled substances outside the scope
of professional practice and not for legitimate medical purposes.
 MD was employed by Advanced Pain Management at clinics located in Metairie,
Slidell, and Gretna, LA. During his employment, MD knowingly used his DEA
registration to issue controlled substance prescriptions that were not medically
necessary or were issued for overlapping treatment periods for the same medical
condition.
 Sentenced to ten months in federal prison followed by three years of
supervised release and ordered to pay a fine of $40,000 and an
assessment of $500.00.
Misprision (concealment) of a felony
 According to court documents, MD was employed by Advanced Pain
Management at clinics located in Metairie, Slidell, and Gretna, LA.
During her employment, MD was aware of the clinics’ operations and
practices including the issuance of controlled substance prescriptions
without medical necessity or not in the course of usual medical practice
and the scheduling and treatment of hundreds of patients per day, often
seen by one doctor, and the clinics’ failure to comply with medical
standards applicable to pain management.
 Despite this knowledge, MD failed to notify any authorities or to
disclose the information in meetings with agents of the Drug
Enforcement Administration.
 MD was sentenced to six months in federal prison followed
by one year of supervised release and ordered to pay a fine of
$5,000 and an assessment of $100.00.
Grounds for Disciplinary Action
 Possessing, obtaining,
furnishing or
administering drugs to
any person, including self,
except as legally directed.
 Failure to report to the
Board facts known regarding
incompetent or illegal
practice of any RN or LPN.
Grounds for Disciplinary Action
 Had disciplinary action in
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another jurisdiction
Failed to meet generally
accepted standards of practice
Violated order of the board
Falsified or failed to make
essential entries on records
Addicted to habit-forming
drugs/alcohol
Misappropriated any
medication
Grounds for Disciplinary Action
 Physical, mental, or emotional
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disability that renders licensee
unable to perform nursing with
reasonable skill and safety
Engaged in conduct that
constitutes a crime
Engages in conduct likely to
deceive, defraud or harm the
public
Engages in unprofessional
conduct
Violated any provision of the
nurse practice law
Grounds for Disciplinary Action
 Unprofessional conduct
 Violating confidentiality
 Willful alteration of
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medications
Obtaining controlled
substances by unauthorized
means
Forging a prescription for
medication
Passing a forged prescription
Selling a controlled
substance
Questions???
 How far we have come.