Nurses: From Hero to Villlain - Episode 23

About Our Guest: Maggie Ortiz has been a Critical Care Registered Nurse for 22 years working primarily in the hospital setting. Maggie holds a Master's Degree in Nursing Leadership. Maggie has worked in rural small hospitals to large Level I hospitals in the US. Her experience includes: ER, ICU, Cardiac Cath Lab (Interventional Cardiology) taking heart attack call, Interventional Radiology with Neuro and Trauma Interventions, and Surgical area pre and post, sedation nurse in various departments. Maggie has worked as a local temporary agency help nurse as well as taken travel contracts in these areas.

Maggie spent a short time at a Board of Nursing as an Investigator and after hearing and seeing the lack of due process that was extended to nurses left and became an activist and advocate for nurses. There are 400,000 nurses in Texas and 5 million in the United States so she saw a need and is the CEO of ADVOCATES FOR NURSES PLLC which helps advocate for nurses. Assisting nurses in various capacities working alongside them and their lawyers.

Maggie's extensive experience with sedation and a lack of screening criteria for appropriate anesthesia, drove her to create a patient screening tool in her master's degree. This tool assesses the criteria for a patient to have sedation administered by an RN and or by an anesthesia provider. This was piloted and implemented within the organization which improved patient outcomes.

Maggie for the last year has worked as a patient advocate working alongside patients and their families during this trying time and seeing the flipside of healthcare.

Maggie was also an expert witness for medical malpractice and is an expert for administrative (board of nursing) cases. Maggie is very familiar with the Nurse Practice Act as it pertains to the nurse's license in any state as well as the standard of care in nursing.

Maggie continues to be a change-maker by not only acting on what she has experienced in her vast career as a bedside nurse but also from other nurses across the nation. Maggie takes this and works with state and federal representatives to make change for nurses through policy

Advocates For Nurses Links:
https://www.advocatesfornurses.com/
https://www.facebook.com/advocates4nurses/

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TRANSCRIPT:

[00:00:00] Naseema: Welcome, welcome my financially intentional people. You guys need to know this woman. So today we are joined by nurse advocate Maggie Ortiz, and we are gonna be talking about the from being a nurse hero to a nurse villain.

Pretty much all you have seen in the media over the last couple of years since nurses have been fighting back to protect their salaries, to protect their lives as a nurse, is this villainization of nursing the beginning of time, nurses have been considered the most trusted profession.

But Maggie has always worked in the shadows of Working with the board of nursing because she has a lot of nurses who have gotten themselves in trouble. Come out on the other side. So I'm gonna turn the mic over to Maggie and she will explain to you her background, how she what she has seen over the last couple in nursing.

And what does this have to do with finances? This affects our pockets in a major So even if you're not a nurse, is still gonna be a good episode for you because it's about advocacy and welcome, Maggie. thank you so much for joining us on a Financially Intentional

[00:01:32] Maggie: Glad to be here. Glad to be here. There's just so much happening in the world, and just like you said, your license is literally your ability to practice and that is actually your income. And so most, mm-hmm. Nurses, when I, when I do any kind of teaching, when I do any kind of education at all, and it doesn't really matter you're discipline quite honestly, because just think about if you're a teacher, if you're a lawyer, if you're a nurse or a doctor, when you get handed your.

Privileged to practice. You just got HA handed your administrative card, so that puts you under administrative law, a different type of law than civil or criminal. But we have seen nurses, right? All over the media in all three of these courts. That is your ability to practice. That is your livelihood and that is a big deal,

[00:02:23] Naseema: So how did you, how did you get started working and what, well, let's start with your background as a nurse and then talk about how you started helping nurses. So I've

[00:02:33] Maggie: been a nurse for 23 years. All pretty much critical care. My started in the I C U. I had my ADN first. I was an ADN nurse for 17 years.

Spot on. Anyone mad respect for associates, nurses, the bulk of your education is associates. I'll leave that alone. So practice for 17 years, I C U, the emergency room, pre-op pacu, endoscopy, interventional radiology. Cath lab electrophysiology. Along with that, doing just like most of us do, maybe some local agency.

I've done travel contracts, freestanding emergency rooms, day surgeries you know, the normal things I think that we all kind of transition out and do when I had been a nurse for about 15 years. Was at a free start standing emergency room, just like tired, you know, like everyone else. They started messing with my hours and scrolling through, looking for jobs, and I think it was even on LinkedIn, there was a job for a nurse, investigator four at the board of nursing, and I was a policy person.

I did like policy. That's just how I was driven. I was like, absolutely. Interviewed, it is a rigorous interview because they do need to know that you're basically gonna be able to sanction your own, right? So they need to know that you can be unbiased. Got the job. I was there. I only stayed for about six months.

I learned stuff there that I did not know existed. Like I don't feel like they extend nurses due process. I am not the only one who feels like this. I do not stand alone. And so what does that mean? Like why should a nurse have to respond to allegations within 30 days? And all that nurse has is literally two or three sentences on or about this date at this time.

You were employed here and this is what you did go. No, you shouldn't be responding to that until you have your full and complete file.

[00:04:29] Naseema: And meanwhile, these people have lawyers. They have litigate you, they have people like you that are investigating, and so it's like one against a whole system.

And you're expected to respond at the same level that they would come at you with. And it's just, it's so unfair. Well, and then you have a

[00:04:48] Maggie: criminal investigator that's possibly investigating you, and in your response, you put a bunch of medical words in nursing how is that criminal investigator investigating a practice case?

So I started, I just couldn't stay. I did go to national training for an investigator, which I was there with just like I said, other disciplines, PT people who were gonna go back to pt, O T M D, same thing. Everyone goes to the same national training. So I did that, but I just, I was seeing things there that I had concerns about.

For me personally, morally and ethically, I couldn't stay. I bounced out and then I started asking questions like, so if a nurse really is being retaliated against or really not getting a defense that they should have, who will they tell? Mm-hmm. No one, there is no oversight. And when I went to go see my representatives, which I did cuz I wasn't gonna let it go for me, it just, at that point I knew that I wasn't called to nursing.

I was called to nurses. I wasn't like a baby or you know, everyone has their own nursing story. I wasn't like a teenager or you know, a child, like I wanna be a nurse. That wasn't it for me. I got pregnant at a young age. I left home at a very young age. I. I was gonna become, join the Air Force. I was in ro, O T C, all of it, boot all.

I did all of it. And then they were like, just sign right here, your child away. And I was like, it. No. And I started school and then I just decided along my journey. My grandmother was at the Cleveland Clinic, one of 18 people ever diagnosed, and my cousin was an ICU nurse and I was like, no, this is what I'm gonna And so I changed my path. I became a nurse. I went to the I C U, spent my, pretty much my life in critical care, but never, I mean, I felt like I was good, a great, you know, a good nurse, competent nurse, but it wasn't called until what happened. And then now I've been on this journey for about eight.

Or so years. And for Texas, you can make a complaint about the nursing board to the nursing and that's the way that it should be. Mm-hmm. And all I want for nurses is for there to be a third party entity that they can go to and say, this is what's happening to me. Will you help me A through the process?

Or it's unfair, or I was charged with this or that. And it was within the standard of care. Cuz I that, I have seen where a peer review in Texas found a nurse not guilty, they didn't have a pharmacist in their building. The pharmacist tech as is at a chemo place, self-reported a medication error and they were friends.

It's just a, a small place. The next day she self-report it. They report the nurse, not the pharmacy tech. It gets worse when it does get investigated. There is no pharmacist, the pharmacy tech is not verifying this with a tele pharmacist, which is legal. They can watch them, mix it under the hood, they can show them the vial.

They mix it under the hood, whatever their process is, but doesn't involve us

[00:07:58] Naseema: It doesn't have anything to do with us. Like she got, yeah, I'm like, I'm blown away. Cause like, Like, okay, but that's because the nurse had the license. A pharmacy tech is technically a certification and they do pharmacist.

But

[00:08:13] Maggie: how about the organization that

[00:08:18] Naseema: I don't understand. So who was supervising the pharmacy tech?

[00:08:22] Maggie: And there's the and there it is.

[00:08:24] Naseema: No one, like I, I don't get it. Like you can't, like a pharmacy tech can't prescribe a pharmacy tech. Only there to, but wasn't having

[00:08:34] Maggie: anyone watch them verify or mix their drug.

I. No

[00:08:37] Naseema: one. Right. I get it. But okay. That's why there's a pharmacist, right? That is the doctor that does a due diligence. Cuz I know a doctor can put it in an order and pharmacy will be like, hold on, this is contraindicated. Like this patient can have this. Like this is what we're gonna offer Instead.

There's checks and balances in the medical system that have to be withheld. And so it sounds like this organization was making scapegoat. For something that they didn't have in place so that they wouldn't get in trouble. But this happens all the time, you guys, and that's why you have to learn how It is a scary world out there because again,

[00:09:15] Maggie: it's an organization who has lawyers and a big team. This was a part of a big group, and again, it got to the point where this nurse was just, and I've seen it, and I'm not faulting any nurse, right? I never shame a nurse. I never, Emotionally, financially, and she was just done at the end of it, she wasn't.

She was just like, I'm done. It was like two years of her life. She was like, I don't understand. How is it that they don't see this? I don't understand because is it not on their responsibility to say, hold on, who, where was the pharmacist? Because this, the pharmacy tech, self reported, and then she should be investigated by her board because that she's tied to a pharmacist.

If there's not, then why isn't there? A criminal even conduct opened against that organization for not having a pharmacist on staff because you know what they have on staff now.

[00:10:02] Naseema: A pharmacist. Yes, a pharmacist. They have to correct. I mean, and that's, that's the thing, like, it's like pe do a lot and they just do it anyway and then ask for forgiveness later and then wait until they, like, basically wait until they get in trouble

[00:10:17] Maggie: So then again, I heard a nursing, the, in a small rural community, knowing this case here, not necessarily, it doesn't matter. The state to me, telling me in a rural community after 3:30 PM on Friday, all the way till Monday, have laboring moms, they're mixing up epidurals. Now, mixing up a drip is way different than mixing up an epidural you got, and only that what anesthesiologist will let you hand them something?

Oh no, I'm gonna go mix this up. Not under a hood. I don't know how to do it. Mm, no way. And most nurses don't know, and I just read this on TikTok. I read two of them what it says about what we are allowed to do in the pharmacy because there are rules. Can we be taught things? Yes. For sure, but if you don't have your boxes checked off and you are doing something, but you can be for sure, I'm never mixing up an epidural.

[00:11:05] Naseema: Stop it. Never, I don't even mix pit. Like there was a day that, that they used to try to make us mix Pitocin and like, no. The pharmacy can do it. I will take it. The thing is, we know medication doses, we know all these problem is in labor and delivery, things are going really, really fast. There's usually a lot of hands in the room and things get mixed up now, and there's no

[00:11:29] Maggie: statue of limitation in the, so you wanna talk about a unit.

There's no statute of limitations in labor and delivery. Say that again. Other, other cases. If someone dies or has a bad outcome, there's gonna be a statute of limitations. You know, where there's not. Labor and delivery because you have a child

[00:11:47] Naseema: involved, right? And that child, sometimes things don't show up until the child gets older.

And so they need to have an open period of investigation where they can go back and be like, this kid in high school is not functioning properly. They can relate that back to birth trauma. so that's why we have to be careful. But the thing is, is that things happen so fast. It's like when you're responsible for.

Administering medications that can be super high risk. First of all, your epidural goes into your epidural space in your back, which means that it goes your nervous And so there is seen one of my nurses, well, which can cause serious so I have seen one of my nurses grab an epidural bag.

And, and administered IV in their re person goes straight into shot. And that was just because the medications weren't safeguarded. Correct. So these are things that we need to root cause analysis for and it's like why we have a lot of safety measures. But one of those safety measures is we do not mix our medications.

Yes.

[00:12:57] Maggie: And that's what I say, leave your ego at the door. Same with the cath lab. I work in the cath lab, the emergency room. I've been on rapid response and code teams. You know what I like when the pharmacist is there, I'm not mixing up drips. That's a level of security that's not only there. Yes for you, but now that's your mom, dad, your brother and sister.

Stop it. Come on, right? You know what I mean? It's all above you. Leave your ego at the door. We have those levels of security because people have had bad outcomes, respect, processes that are in in place for a reason. Now, you know what that's for you. 410,000 people are either injured or die from us annually.

Let me say that again. This is a $1 trillion problem. This, this country. It is statistically on some reports, the NIH says it is the third leading cause of death in the nation. And so who gives drugs? Let's just use that one. We do.

[00:13:49] Naseema: Yeah, we do. Yeah, we give the drugs. The thing is, The way that you fix the problem is to be able to safely report these issues understand, like I mentioned earlier, root cause analysis, so we can go back see where the problem exists so that we can systemic things in place to help you. Mitigate those problems, but the problem still persists because there are a lot of places where even though they say these processes are in environment, becomes a hostile environment.

scared to report it because they're scared to lose their job, therefore, they And that's the whole thing and how the finances advocacy, patient heavily tied to someone is scared to lose their job their livelihood because they know if they speak up.

For what is They will be villainized. They are

[00:15:01] Maggie: And so, and I do, when I do talk to nurses, I'm like, okay, so I, I hear you about your job, but don't just hear me out for just a second. I was like, I don't give a shit about your job. You know why? You know what? I care about your and if they're putting you in places where you're mixing up an epidural and lemme just tell you, both the mom and the baby die.

You know what? You're never gonna do work ever again because it will put you on the Office of Inspector General List, just like any of these nurses out in the media, right? Any of the big names that we know of, right? They are on the Office of Inspector General List, which means that you can't be bonded, which means that I've had nurses even from.

From the revocation alone, let's just say it doesn't even cross over to criminal conduct. If you get your nursing license revoked, that does put you on the office of Inspector Generalist. I had a nurse that was kicked outta law school master prepared nurse cuz you don't get to hold another degree. You will not be a cosmetologist, you will not be a real estate agent.

You cannot be bonded. She's working as a cashier at Trader Joe. She's a master prepared nurse who was in law school. You don't hold another license. You're on the Office of Inspector General List. You're not working. So I hear me. That's why when nurses call, tell me. I'm like, I don't give a shit about your job as a nurse.

There are five, well, a hundred million jobs out there. Come to me. You wanna, I mean, seriously, there's way too many things that you can do as a nurse. Stop and we are magical. No, your level of understanding of things, of your level ability to do things are so amazing. Lori Brown, she's an rn, jd, a nurse attorney, she talks about this in her book.

She represents nurses before the board of nursing. If you're at a place that you already kind of know is shady, they're not doing things that the way they're supposed to do, don't you think that those are the people that she represents And she talks about that. Don't wait for them to report you don't wait for things to happen.

And I'm not it. It is hard work and it's easy for me to say, just leave your job and now you're in a small town. But now you don't have a license. Now we're talking about something's totally different and now you're trying to get it back. And who are you gonna tell? I'll wait. Go ahead. I already know

[00:17:17] Naseema: the answer, but go ahead.

Right. Yeah, but I, I just think. Knowing that right. We need to know as nurses how to protect our license. So what are things that you talk to your clients proactively? Cuz I know you usually represent people are helping people not represent Cuz Yeah, you, yeah, exactly. You don't represent anybody, but you're more like a consultant So. First of all, let's, let's back up and let's explain what you do. I don't think that's clear for everybody. They know you, that you worked for the board and you stepped away. Yes. But then what role did that lead you to take on with

[00:18:03] Maggie: activist slash advocates. So I do go to the capital mm-hmm.

Ologist because I know it's the right thing to do. And then the other thing that I do is I do help nurses and their legal team when they're under investigation by a board. So I go through, A lot of times it's just the majority of support for the We go through their orders. What it means, I do a lot of education.

We go to the National Council, state Boards of Nursing, talk about what it means to be under investigation. like being You don't hear anything else. The lawyer is like the doctor spends how much time with you. And then bounces out a couple minutes, right? Yeah.

Mm-hmm. And then so, and then oftentimes, you know, lawyers don't necessarily have a true intimate understanding of the Nurse Practice Act if they're not a nurse. So I'm a nurse. Mm-hmm. And I was an investigator, so I have an intimate knowledge of the Nurse Practice Act in Texas. same.

I mean, think about compact license. How many states are not there yet? They're all gonna be there. The section may be different in your state. It may be that you don't fall under a nurse practice act that you're under hhs. It doesn't matter. Your rules and regulations are pretty much the same because you know what?

They all go back to evidence-based science. Right. If you're deviating from that and a patient has a bad outcome and it's practice related, there it is. If it's criminal, it's pretty clear cut. If you get charged with a crime, a nurse who has a felony in any state, my understanding, please correct me if I'm wrong.

You don't hold a license? Not as a felony, not as a nurse. No,

[00:19:39] Naseema: not as a felon. Mm-hmm. That's just,

[00:19:41] Maggie: and that's the thing is that if we get a felon tied to abuse of adult or a minor, that's it. We're done. Right. That's why it cannot cross over to that

[00:19:51] Naseema: happen. So do you work for team or do you work with Directly with the So like if a nurse were to get in trouble, With the board, how do they get in contact with you? How do they start working with

[00:20:10] Maggie: you? Sure. So I have a website advocates for nurses.com. All my handles are the same. Nothing crazy. I keep it all advocates for nurses. I'm on every platform. Email me, text me, my phone numbers are all out.

You know my phone number's out there so you can reach out to me. I have had also administrative Law firms reach out to me to hire me officially as the So I've been an expert for a nurse and testified for a nurse, done helped with their rebuttal, their response, using my expert knowledge. Just like I would in the civil world.

I've been a civil expert as well. I do not do that any longer.

[00:20:52] Naseema: That's kind of how, so this is the thing that's the, this is why I wanted to clarify Usually legal teams have nurse experts. Yes, nurse legal consultants on their team, but they're usually. For like the boards or the people that are pressing charges against them, they're not there for the nurses, like they're there because like for example, if I was a OB legal nurse I know how to scrutinize those charts for errors.

So they're there to point out on the litigant side against you. so that's why I wanted to clarify. You don't work on that you work on the side of the nurses to advocate for them Correct. With all of your expertise. Correct.

[00:21:32] Maggie: And again, there are nurses that A, don't do anything and or B, who they did, they violated hipaa, they gave a wrong medication.

No one's perfect. Right? But it's understanding. So what are And let's talk about those. Mm-hmm. Let's, let's look at the Nurse Practice Act. What does it mean to, to what are allegations? Most nurses, were not legal people. So this is what your al, this is what an allegation means. So what is the next step?

So the next step is you're gonna give your written response. You are going to have the option to go to an informal I walked them through that. I have created worksheets and some videos that they can watch at their own pace, cuz again, it's like a cancer diagnosis. I give them stuff that they can digest at pace.

Maybe you learn something and you're like, oh okay. Maggie gave me this resource. Now I'm gonna go back to this video. Now I understand that. Or now I have a question about that and I have the resource to look at it because

[00:22:27] Naseema: unfortunately Okay, so when, when, when do you want people to first interact with soon as they hear from the, from the board of nursing. Like the moment before they respond. Oh, don't, before they do anything. No. Yes. Okay. No, no, no,

[00:22:44] Maggie: no. We'll look at it. And some nurses, you know, you if you have malpractice insurance, most nurses don't even know what that means. And then we look at that.

So you just call your malpractice carrier, just like if you got in a car accident or had. An injury to your home or something, and then they give you some guidance. So we start there. If they don't have that, then we talk about, you know, we look at their information, we walk through it, and then I can help them write a general denial to, and then ask for their full and complete file while they're looking for legal counsel.

[00:23:18] Naseema: Yes. Yes, yes, yes. And as someone who's been in this for so long, do you recommend that that nurses go through this just with you, or do you recommend them also engage their own legal counsel, at the same time? Oh yeah,

[00:23:37] Maggie: for sure. And that's the thing that I do, and mm-hmm. They have the. Association, the American Nurses Association of Attorneys.

So that's one of the first places that I send nurses to is that go to your state, click cuz the attorneys don't have a compact license, so the attorney does have to be in your state. So I can help, I can work in any state. The attorney has specifically work in that state, so I can work alongside you, either as your advocate or as an expert.

If I don't. Have that same modality, then I can't be your expert, but I'll help you find someone. Like I don't do labor and delivery. So if you came to me, so then I would reach out to someone who does labor and delivery, especially if it was so specific to your modality. If it was about something in general, like maybe a drug or a drug that I was familiar with, maybe it was some fentanyl or then if it was general enough.

But if it was very specific to your specialty, then of course then we would just pull on an expert for your modality. The unfortunate piece is that I don't know what happens to attorneys in after law school. They learn general things and then branch out to civil, criminal, and administrative, civil, criminal.

They know and respect experts. Civil cases can't be filed. That's why I get right? The legal nurse consultant reviews, it says, you need an expert for this. They call me cath lab ic, whatever it is, and then that person is the one who's writing up the happen in administrative law, so I've had to.

Tell attorneys no, you go back to the board of nursing and you want it in writing. This shows you where it says that she can't bring an expert. The last time they waited 15 minutes before her trial. Thankfully it was Zoom, I put on the, the coffee pot and I was like, let's do it. Put my hair up. I was like, Nope.

They dropped all 33 charges against her.

[00:25:29] Naseema: Ooh. Thank God. But that I was gonna ask you, and I just want to clarify, you did say it, You're licensed in the state of Texas, but you can help nurses correct?

[00:25:39] Maggie: Yes. I've helped nurses myself and I work with another advocate. She does have sanctions on her license.

That's how we connected. We've rep, we've helped n, I don't know, three, 400 nurses across the United States so far, and again, various different stages with different lawyers. And some of it is we're just going through their orders. Even sometimes post like, here are my orders and I don't even know what this means.

Mm-hmm. So then we consult and we talk about that and we go through it and make sure that they're reading cuz it's overwhelming to make sure they're not violating any of it, cuz the second they violated. That could be grounds for, for revocation, and they're scared. So we go through every single line and it's gonna be Unfortunately, the incidents of suicide people, if they do have orders as high, that's why I tell No one really knows. It could be anything. It could be retaliation, but even if they did don't do that. perfect.

[00:26:39] Naseema: There's so many. There's, and I want, that there are so many room, there's so much room for error the medicine, especially practice when you're in the hospital. And the thing is, is that, We have to put these things in place for patient I'm gonna harp on this again.

The only way that if it's a environment and if it's not a safe environment to report are going to happen. Over and over again. I know I have been in on both and, it, and it, it's not, sometimes it's not even organization based.

It could just be your leadership your leadership team operates. So I don't want people to think that this hospital is worse than the other. It's usually not that. It's usually down to the level leadership. I agree. How safe you feel reporting And so there, we know that the healthcare these are one of those, major, major to have safe spaces where we can say, we are seeing this problem .

[00:27:55] Maggie: The c m s report had in them in place said that a, a paralytics should never be searchable with a two. Letter search and there

[00:28:05] Naseema: it is. Yeah. That changed practice across the country. Cuz now in all the pixels you can't do a two letter search, nothing will come out. So, but it took her to go to criminal, the criminal system like that should have been in place at the institutional level when it happened.

And then it usually gets implemented. But because it was such a little, it was, it was an environment of hostility They villainized they put her in front of, you know, the and they made an example out of her, and it's not by mistake. And I, I also want to talk about because I feel like now that nurses are pushing back and say, I'm not gonna make more than somebody at target, nurses are having.

Ray, like you know, tags on their back because they are like, oh, well you wanna get paid like a living wage. Oh, now we're gonna come for you. Like, how dare you. How dare you. I've heard people say nurses making a living wage is the reason why the Wow. Like you're so ignorant.

Actually not, hold on. Look at paying a nurse, a living wage. living wage is actually protective. Of the healthcare you get that actually can advocate, and will advocate and are about systemic change and are about making sure that they prioritize patient safety so people have got it real twisted And really, really, been in the spotlight for some really and I think No, it is.

[00:29:45] Maggie: It is. And we keep, and I keep telling nurses, you keep pushing back. You keep setting your boundaries, you know, and I'll just read to you like staffing, you know, I tell nurses all this time, all the time.

So we talk about staffing and what you can do. So let's talk about like just a little bit positive. You need to be able to use your rules and regulations. So I'll just tell you what Texas says. Now mo, all boards of nursing and I feel pretty comfortable. Please chime in here. I hate to say the word all.

Don't get involved with staffing. That's not their lane at all. But you know what they do put in place that like 2 17 11 1 a s talks about making a safe assignment. T is me accepting a safe assignment. So I use those. So are you asking me to violate 2 17 1 a s in a respectful manner? I mean, I'm here for you.

But also it are you asking me to knowingly and willingly take on an unsafe assignment, and I'm using quotation marks because that is the definition of medical malpractice. When I went to the last Nurses' association meeting here in Texas, they were transitioning over to new leadership. So I went and at the end they had questions and answers.

So, you know, I had to ask. And so I'm like, Hey, sir. So asking the lawyer. If a nurse, cuz pay, just like you said, and staffing were the biggest concerns that were being talked about by the nurses. So I pivoted off of that and said, Hey sir. So in reference to staffing, because Texas doesn't have any safe patient ratios, none of that, if a nurse knowingly and willingly takes on an unsafe assignment, is that the definition of medical malpractice?

Yes. I already knew the answer

[00:31:33] Naseema: gap straight up and down. Straight up and down. But people need to hear that. Correct. People need to hear that. So I have been fortunate enough to work in California, yes. Where we do have safe patient ratio, we have patient ratios in place and we have. Fair pay. Right? We have livable wages for most places have livable wages. Now, you, you, you will find those spots where it's not the case, but that's few and The, the bottom line is even in our we find ourselves in of ratio. And so we have these things called ados, right? And that's assignment despite objection.

So you fill that out. It's a, it is union paperwork. Your, your management has to acknowledge it that you're taking on this assignment. And so we have some things in place to help protect our But that is like kind of is a crazy situation. We are maxed out. And we are doing this assignment despite objection for, for the sake of being able to However, you are not obligated to take that assignment. You can be sent home, you can go home, can, be reassigned to another patient. Like all of these things you can as a nurse, if you don't feel safe in any situation, say, listen. I understand the need. I don't feel safe. I don't feel like my license will be protected.

You don't even have to say that. All you have to say is, is is an unsafe and you know, you brought out, you brought out the legal code. Like, I, I understand that. Like, that's like, okay. So people are gonna you know, people are gonna be scared to say yes when you bring out a legal code, but the thing is, is that what we can do to protect ourselves is in those situations, even if you don't have ados, you don't have union And this is what I learned from my lawyer. You send an email and you send it to the powers that be. You send it to your management, the C N O, you send it to HR and say, Hey, on this day, at this time, I was asked to take this assignment. I refuse to take this assignment because I feel like it violated care, I did not feel like I could assignment.

You have automatically protected yourself they then have to respond come back with an action step of how they could have handled that situation better or what they're doing systemically to fix that you know, so in the

[00:34:19] Maggie: state, in, in the non-unionized state, or even if you are in Texas or in New Mexico and you are at a union hospital, so we had one that went union in Austin.

I live in Austin, Texas. So I was asked recently if I'm at a union facility and Texas has Safe Harbor, safe Harbor and is a peer review process by the Texas Board of Nursing put in place by the Texas Board of Nursing, that every organization that has more than eight people has to have in place. It is supposed to initiate.

The obvious, a peer review process, not people in your leadership. There's specific rules, so you have to fill out both if you're at a union hospital, because all the A D O does in this state. My understanding, it's something, a violation for the hospital has nothing to do with the Board of nursing. If you do not fill out the Safe Harbor Farm in Texas or in New Mexico where the board of nursing has put that into place and you don't utilize it.

I don't know if they recognize just the a d O form. Now, I was told by union organizer that that has nothing to do with the board of nursing. That only has to do with something to do with the hospital, their codes and all that. But I don't, I, I've never worked at a union hospital. That's something newer to me.

I learned something from union people all the time, but now it's civil or criminal. So tell me about the ADA form. Do you think anyone cares? And in Texas 1514 is a physician statement that was passed in 1983 that says that I have a duty to a patient that supersedes a hospital policy or a physician order, and I'm quoting that that was because a patient came to the emergency room with chest pain.

The nurse went to the ER, physician 1983, they didn't have services like we do now. And he said, we don't have anything. Send 'em down the road. She did. That patient had a bad outcome. Texas board nursing got involved and passed that position statement. And if nurses don't know what a position statement is, that's the law for us.

So it's 1514 in this state that says that I'm quoting again that I have a duty to the patient that supersedes the hospital or physician order. So I will be asked, so what, what did you do again? I'm sorry. So you accepted that unsafe assignment. I'm sorry, what was there? A disaster. Was there anything happening?

I mean, so tell me again why you did that and now if it goes civil or criminal, I want you to go to the grocery store cuz that's the jury. I want you to look around cuz that's the people you're gonna be selling your story to go. Don't do it. Don't

[00:36:55] Naseema: do it. Yeah. I don't want them representing me. Think that all those nurses out here are overpaid and please but.

To wrap things up, Maggie, I just want you tell the people how they can get in contact with you, at what because I know you, I don't want people to until they are charges or facing charges from the board of nursing. protect themselves.

What resources do you have for those people? And then what you have for Sure.

[00:37:34] Maggie: So I have a couple webinars. One of 'em is on our Renegade and I'll give you that information. Very reasonably priced.

You can get a CE for that. I do do mentoring and coaching. I do charting classes. Those are all on my website. You just have to reach out to me. I am working on an ebook for nurses being deposed. Not very long, but that's the other thing that nurses don't realize, like, or reach out to me like, oh, no big deal.

I'm being deposed. I'm like it is actually. So I talk about that. So I have charting tips under investigation. I'm being deposed, help, I'm being deposed, so I have those resources. You can go to my website, advocates for nurses.com, can email me, advocates for nurses at Gmail,

[00:38:26] Naseema: all my, and I'll have all those, these things.

Yeah, I'll have all these things in the show notes, but just the whole point of all of this is that, if you. Are under investigation and do go through of losing livelihood. So these are things that you need to do able to advocate for yourself and protect And you wanna engage an advocate as early as nine times outta 10 they can help you, you said, you have that, you help that nurse. 30 charges like that is ridiculous. Dropped And, and if you had been working, if she had been working with Maggie in the charges wouldn't even been in place because she would've been able manage that situation.

And so it's just staying in front of these It's just like We know it's out there. We know it exists. our licenses are our livelihood. And like you said, you don't wanna be a cashier at Trader Joe's any other capacity in any other because you have gone through these litigations.

this is heavily financial. Maggie, you have seen families destroyed by this process, so this is very, very real. And so this is why I wanted podcast to talk about this because affects generations of It's not just the mom or it's not just the nurse, the families that it impacts. so we have Be proactive in protecting ourselves and first and knowing our rights. Because when it happens, you have legal have these systems that can strip you of protect thank God for advocates like Maggie and lawyers that can protect most people just don't know that these so they don't engage them.

In time for all you are out here lives making sure that we can into nursing. We didn't get into nursing to hurt anybody. Correct. We got into nursing to help and that, and that is why, you know, take on a huge burden just to make That you so I don't want anybody to

[00:41:20] Maggie: Agree. Thank you. Thank you. Thank you. Yeah, appreciate it. And again, any nurse can reach out to me. It is not about money. Reach out if you need help. Just reach out to me honestly. We'll send up a time to talk and see what I can do for

[00:41:35] Naseema: Yes, so please, I'll have all the links in the show reach out, make sure you're following,

[00:41:42] Maggie: TikTok. Maggie, lots of videos. She's free nuggets.

[00:41:45] Naseema: There she is on the, she is on the tick to the talk. clock, the clock app. So make sure you're following her there. It just like, as a resource to have in your back pockets.

You always, you always hope it's just You hope that you Use it, but you have it there in place. So again, thank you so coming on financially intentional podcasts. I shared to know that you are out there and to help.

you.

[00:42:19] Maggie: Thank you.

Thank you. for having

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