Will NJ Join the Multi-State Nursing Licensing Group?

Recently, the New Jersey State Assembly voted unanimously to advance the latest version of a Bill that would enable the Garden State to sign on to a growing collaboration that already includes Delaware, Maryland and most of the Southeast.  The Bill was sponsored by Democrat Herb Conoway, Jr. who presented the Bill in June of 2016.  “The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and uniformity of nurse licensure requirements throughout the state promotes public safety and public health benefits,” reads the latest version of the Bill.  Some nursing groups however have raised concerns that joining the pact could lower the standards of the State of New Jersey.  They point out that potentially less stringent requirements of other states would enable prospective nurses to find employment in New Jersey to the detriment of New Jersey residents.  As of 2005, the group comprising the consortium who have adopted the legislation had grown to 25 states.  Multi-state licensing legislation is pending in five additional jurisdictions including New Jersey and Massachusetts.   If the State legislature elects to adopt the legislation, it will need to do so shortly as there are only a handful of voting dates available before the legislation ends in...

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Changes and Delays Plague the NJ Board of Nursing

It is no secret that the New Jersey Board of Nursing has been in crisis.  Currently, there are approximately 4,000 applicants of nurses and home health care aides whose applications have been pending for many months.  This at a time when the State is in dire need of such health care talents. In July of this year, the Board’s Executive Director, Dorothy Smith Carolina abruptly resigned citing a “staffing crisis” and lack of cash to pay for personnel necessary to make the Board work efficiently. A majority of the Board members signed a July 25 letter directed to the Governor citing the Board’s deficiencies and need for personnel.  In the words of Senate Majority Leader Loretta Weinberg (D-Bergen), “The inability of this vital State Board to carry out its mission is effecting families and the strength of the State’s health care system.  This situation must be remedied immediately.” In October, Governor Christie responded.  He named approximately a dozen nurses and other observers to serve on the nursing board less than a week before lawmakers were scheduled to discuss the vacancies and their effect on the citizens of New Jersey.  Missing from the appointments was the appointment of the Board’s president, Patricia Murphy who was “relieved of her duties”. Murphy was removed from her position and testified before the State Senate, that, “The division has not filed any of the positions that are vacated by professionals with professionals.”  Some senators are calling for a total overhaul of the Department and requesting outsiders provide an objective assessment.  Critics of the Governor’s appointments point out that only one Board staff member has actual nursing experience.  Many of the staff members assigned to the Board also report to managers elsewhere creating inefficiencies and potential conflicts, observers allege.    Former president Murphy advised the New Jersey State Senate that the Board needs a full-time executive director, a position that has been filled by an acting employee-whom the speakers praised for her efforts – ever since former executor director Dorothy Smith Carolina left in frustration earlier this...

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Non-Competition (Restrive Covenant) Agreements: How Likely Are They to be Enforced?

Elsewhere on my websites, I have discussed the legal factors which determine whether or not a non-competition agreement is enforceable.  Physicians  are served well to consider the practical question of whether or not such agreements are likely to be enforced, assuming they may be from a purely legal perspective.  A number of factors weigh in to this analysis.  1.  The Economics.     Consider whether it is worthwhile for the former employer to incur legal fees, time, and resources to enforce the non-competition clause.  Let us assume that you seek employment at a location which is in violation of your contract during the time when such employment is prohibited by the contract.  Does your new employment cause a financial  detriment to your previous employer?  In the absence of an economic detriment,  the chances that the former employer will seek to prevent your new employment are smaller.  On the other hand, the departure of a physician from a practice to another one in the same geographic area may mean that a substantial client base will have reason to follow the departing physician.  This type of financial harm may lead your employer to enforce the contract, for the financial benefit of the practice. 2.  The Terms. Does your non-completion agreement provide that if you are in violation of the non-competition clause that the prior employer would be entitled to attorneys’ fees and costs of suit?  If the answer is yes, then the former employer has more incentive to bring an action knowing that they are likely to prevail in their attempt to recover attorneys’ fees and costs of suit.  Without the language, a practical attorney will advise a prior employer that the fees and costs incurred will not be recoverable.  Similarly, some non-competition agreements have a liquidated damages clause which provides that the departing doctor agrees to pay liquidated damages (a fixed sum) equal to a specified amount for each day that the doctor is found in violation of the non-competition clause. The  terms of your contract may tip the scales in favor of, or against, litigation. 3.  Other Factors. Other, more personal factors may weigh in the employer’s decision.  For example, is the departing physician leaving on “good terms”?  If so, one way to avoid...

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Will A Prospective Employer Change its Standard Physician Employment Contract for YOU?!

I am often asked by clients whether or not and offer made to them by a prospective employer is likely to make changes to the contract presented.   I sometimes respond with a question:  “Are you the Derek Jeter of your practice?!”   Put in another way, whether a prospective employer is willing to change its contract depends upon the amount of leverage you have.  Some clients are in a positon to bring an incredible reputation to the practice.  The practice wants to be affiliated with you and your reputation.  Sometimes, a physician may bring a book of business which the practice desperately needs.  Sometimes, there are personal relationships at stake which might compel the prospective purchaser to make the changes sought by my client.  And of course, sometimes a mix of all three variables are at play.   To continue the analogy, if you enjoy a stellar reputation and your skills are in demand, then you may very well be the Derek Jeter of your practice.  If that is the case, it is more likely then not that the prospective employer will modify its contract because you have leverage with which to bargain.  The same holds true if you have a substantial book of business to bring.     On the other hand, if you are just finishing your residency, and you have neither a stellar reputation (yet!) or a substantial book of business, the practice may not be willing to make the changes you seek.     Consider too, the challenges of the employer.  If it is a small practice, there might be need to treat all doctors in the same way, including some parity with regard to compensation.  Otherwise, if one or more of the other physicians learn of the accommodations which were made to you, the practice morale may suffer.  Furthermore, benefits which you might request which are unique to you but not to the others can cause the same problems.  Making accommodations for you might mean that the same accommodations must be made for the other employees.  This could cause the practice to incur additional costs.   Sometimes there are more fundamental practical considerations at stake as well.  Perhaps the practice is not inclined to incur legal fees for...

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RAMP and PAP Can Help

Romanowsky Law is often contacted by nurses and doctors whose licenses are in jeopardy because of a debilitating dependency on opioids, alcohol or other substances, or psychological disability.  In those cases, it is of utmost importance that clients acknowledge their dependency/disability and utilize a professional organization condoned by the New Jersey Board of Nursing or the Board of Medicine not only for rehabilitating themselves, but to preserve their ability to work as a nurse or doctor.   RAMP   The NJ Recovery and Monitoring Program (“RAMP”) was established in 2003 as an alternative to discipline.  The program is managed by the Institute for Nursing for the NJ Board of Nursing.   RAMP is a confidential voluntary program designed to encourage healthcare professionals, including nurses, to seek a recovery program before their impairment harms themselves or a patient in their charge.   Nurses who might otherwise be disciplined or lose their licenses are often referred to the program by the NJ Board of Nursing as a condition or alternative to discipline.   Nurses referred to the program are required to take random drug analysis tests, to seek counseling, and to otherwise be in contact with RAMP who reports to the nurse’s employers regarding the nurse’s status with RAMP.  Ultimately, RAMP will often report that restrictions once put in place are no longer necessary.   When a nurse is referred to RAMP, or if his or her employer reports a suspicion of chemical dependency or drug deviation to the Board, it is critical that the nurse work with the Board to create a consent order or private letter agreement governing the terms upon which the nurse may continue to practice while attending RAMP.   Romanowsky Law has helped many nurses through this arduous process with successful results.   PAP   Sometimes the nursing board will allow nurses to participate in programs offered by Professional Assistance Program of New Jersey (“PAP NJ”).  This organization is usually utilized by physicians.   The mission of the Professional Assistance Program of New Jersey is “to provide services to protect the public safety and welfare of the citizens of New Jersey through education, identification, evaluation, treatment planning and advocacy for licensed health care and other professionals in recovery from an impairing...

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American Nurses Association Reports As Many as 1 Out of 10 Nurses Has a Drug Addiction Problem

Nurses need help too.  Check out this moving story from a nurse who is hoping to help others.  Romanowsky Law can help too……. www.wcnc.com/news/health/1-in-10-nurses-addicted-to-drugs/347521562

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