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Empowering Nurses at the Bedside and in Business

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Author Archives: Lorie A Brown, R.N., M.N., J.D.

  1. Top 10 Ways to Lose Your Nursing License (Please Don’t Try This at Home)

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    We know you didn’t go through nursing school, boards, night shifts, and bodily fluids of every variety just to lose your license over something avoidable. But the truth is—even good nurses can get into hot water.

    So let’s break it down: the Top 10 Ways to Get in Trouble with Your Nursing License—and how to stay far, far away from them.

     

    🚩 1. Charting Before Doing the Thing

    Pre-charting your shift “because you know what you’ll do” might seem efficient—until it isn’t. If something changes and the record doesn’t match reality? That’s called fraud, friend. Chart in real time. Your license will thank you.

     

    💊 2. Pocketing or Mismanaging Meds

    Whether you forgot to return a refused med or signed off on a waste you didn’t witness, it’s a red flag or keeping a narcotic in your pocket for more than 30 minutes. If a narcotic audit doesn’t add up, your name could be in the spotlight. And that’s not the kind of attention you want.

     

    📱 3. Oversharing on Social Media

    Posting that patient room selfie might seem innocent (especially if no one’s in the photo), but HIPAA violations don’t play. And screenshots live forever. When in doubt, don’t post about work. Period.

     

    😬 4. Getting Too Friendly With Patients

    That sweet little old lady who wants you to take her bank card and PIN to the ATM? Or the discharged patient sliding into your DMs? Even dating a patient after your care is concluded. Set boundaries. What starts as kindness can end in a Board investigation.

     

    🍷 5. Showing Up… Under the Influence

    This one’s obvious, but still makes the list. Whether it’s alcohol, recreational substances, or misused prescriptions—don’t do it. Even one mistake can be career-ending. Get help if you need it. No shame in protecting your future.

     

    📄 6. Fluffing That Résumé or Job App

    Left off a job where things didn’t go so well? If your employer finds out (and they will), it’s not just termination—it could be a licensing board issue. Honesty > Hype.

     

    📞 7. Ghosting on Mandatory Reporting

    You see neglect, abuse, or unsafe conditions—and do nothing? That’s not just unethical, it could be illegal. Nurses are mandatory reporters for a reason. Don’t let silence cost someone their safety or cost you your license.

     

    🩺 8. Practicing Outside Your Scope

    Just because you can do something doesn’t mean you should. Policies differ between states and facilities. That skill you were allowed to do at Hospital A might not be allowed at Clinic B. When in doubt, check your scope and policy.

     

    📆 9. Letting Your License Expire

    You’d be amazed how many nurses forget to renew. Practicing with a lapsed license = unlicensed practice = big trouble. Set a reminder. Write it on your forehead. Tattoo it on your stethoscope. Just don’t let it lapse.

     

    🔐 10. Sloppy or Incomplete Documentation

    “If you didn’t chart it, it didn’t happen” is still the golden rule. Document thoroughly, factually, and in a timely fashion. The Board doesn’t care how short-staffed you were if something goes wrong and your notes are missing.

     

    💡 Final Thought:

    Nursing is in your DNA. Your license is your lifeline. Protect it like the precious gem it is. These top 10 aren’t just worst-case scenarios—they’re real reasons nurses end up under investigation every single day.

    So, stay sharp, stay ethical, and keep on doing what you do best: caring for others while caring for yourself and your career.

  2. What Did You Just Write About Me?!

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    Protecting Yourself in the Age of MyChart and Open Notes

    If you’re a nurse in 2025, chances are you’ve already had a patient quote your charting back to you — word for word — from their phone.

    Welcome to the age of MyChart, Open Notes, and patient transparency.

    We’re not in the pre-portal days anymore, friends. Everything you document is instantly available to patients and their families, and in some cases, their attorneys. So how do we stay honest, thorough, and legally safe while also not starting World War III with a note?

    We’re here to help. Nurse to nurse.

     

    🛡️ 1. Keep It Clean: Stick to the Facts

    What did you see? What did you hear? What did you do?

    That’s your safe space.

    · ✅ “Patient reports pain at 8/10. Grimacing noted. Morphine 2mg administered per order.”

    · ❌ “Patient seems drug-seeking and whiny.”

    Keep it clinical. Keep it objective. Save the venting for the breakroom — not the chart.

    —

    🧠 2. Use Neutral, Professional Language

    We get it — when someone refuses meds, trashes the call light, or yells at you, it’s tempting to let that frustration leak into your notes. Don’t.

    Instead of:

    · ❌ “Non-compliant and argumentative.”

    Try:

    · ✅ “Patient declined ordered medication after education provided. Will continue to monitor and re-offer.”

    Tone matters. Patients (and their lawyers) are reading it.

    —

    ✍️ 3. Document Conversations Clearly

    Anytime there’s a refusal, concern, or escalation, make sure you chart:

    · What the patient said

    · What you said

    · Their response

    · What you did next

    Example:

    “Patient stated, ‘I’m not taking that pill.’ Risks and benefits reviewed. Patient verbalized understanding but continued to decline. Will readdress later.”

    You’re not just writing it down — you’re building your legal defense.

    —

    🔁 4. Chart in Real Time When Possible

    Let’s be real — end-of-shift charting happens. But if something significant occurred, document it as close to the time it happened as you can. The more time passes, the fuzzier the details — and the riskier the chart.

    —

    🧾 5. Ditch the Emotion

    This one’s tough. Nurses are human. But the chart isn’t the place to process feelings.

    · ❌ “Patient was rude and disrespectful.”

    · ✅ “Patient raised voice and stated, ‘You’re not helping me.’ Attempted de-escalation and remained present.”

    Stick to behaviors. Not feelings.

    —

    🔍 6. The Chart IS a Legal Document

    We’ve heard it a thousand times, but in today’s transparency culture, it’s more true than ever:

    “If it’s not documented, it didn’t happen. If it’s documented poorly, it did happen — in the worst possible way.”

    Protect your license by documenting with intention. Be honest, but be smart.

     

    👥 7. Ask for Backup When You Need It

    Not sure how to document something sticky? Ask your charge nurse, case manager, or risk management. You’re not on an island — and collaboration keeps everyone safer.

     

    🧰 Bonus: Know Your Charting System

    Some systems allow nurse-to-nurse notes or staff-only comments that aren’t visible in MyChart. Use those when appropriate — but still use professional language. HIPAA applies everywhere.

     

    Final Word

    Charting used to be just between us and our team. Now, it’s between us, our team… and the entire patient family group chat.

    But that doesn’t mean you stop being honest. It just means you sharpen your language, lean into objectivity, and chart with intention.

    Because in today’s healthcare world, your chart is your voice — and your shield.

  3. When the Shift Hits Hard: Real Talk on Surviving Bad Days in Nursing

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    Let’s be honest — not every day is a Florence Nightingale moment.

    Sometimes, it’s a patient yelling at you for something out of your control.
    Sometimes, it’s working short-staffed for the fifth shift in a row.
    Sometimes, it’s losing a patient — and having to walk into the next room like nothing happened.

    Bad days in nursing aren’t rare. But that doesn’t mean they don’t hit hard.

    As nurses, we carry a unique kind of weight — physical, emotional, spiritual. And when a bad day breaks us down, it’s easy to question everything: Why am I still doing this? Does this even make a difference? How much more can I take?

    If you’ve been there — or are there right now — this is for you.

    💢 First: Let Yourself Feel It

    This job demands so much strength that we sometimes forget we’re human. But suppressing emotion doesn’t make it disappear — it buries it until it leaks out in ways we don’t want.

    So if your shift crushed your spirit today?
    Cry in the breakroom. Vent in your car. Journal it out. Pray. Scream. Call your nurse bestie.
    Whatever helps you process it — do that.

    You’re not weak. You’re not dramatic. You’re human.

    🛑 Don’t Take It Personally (Even When It Feels Personal)

    That patient who lashed out? They’re scared.
    That family member with the attitude? They’re desperate for control.
    That supervisor who gave you grief? Might be barely keeping it together themselves.

    Yes, boundaries matter. And no, you don’t have to tolerate abuse.
    But sometimes, recognizing the hurt behind the hostility helps you carry it with less shame.

    🌊 Find One Anchor

    On a terrible shift, find one thing to cling to:

    • A patient who said “thank you”
    • A moment of laughter at the nurse’s station
    • The fact that you showed up when you didn’t have to

    Even on the worst days, there’s usually one thread of purpose or kindness. Grab onto it like a life vest.

    🔁 Decompress Before You Spiral

    If you go straight from a nightmare shift to home life without decompressing, everything starts to blend: the anger, the sadness, the exhaustion.

    Try this:

    • Sit in your car for five minutes in silence before you drive
    • Change your clothes before stepping inside
    • Take a hot shower as a ritual to wash off the day
    • Tell your people, “I had a hard shift. I just need some time to come down.”

    Protect your peace. You’ve earned it.

    🧠 Talk About It (Really)

    Nurses are notorious for bottling things up. We’re trained to power through — but that doesn’t mean we should.
    Whether it’s a co-worker you trust, a therapist, or your dog, let it out. You can’t pour from an empty cup, and stuffing it down doesn’t make you stronger — it makes you brittle.

    You deserve support. Not because you’re fragile, but because what you do is hard, and you shouldn’t have to carry it alone.

    ❤️ Remember Why You Started — But Also Know It’s Okay to Change

    Some days, your “why” will carry you.
    Other days, it won’t even show up.

    And that’s okay.

    If the bad days are piling up… if the joy feels far away… if you’re dreading the next shift — it’s not failure to consider a new path. Whether that means a different unit, a non-clinical role, or something outside the box entirely — you are allowed to evolve.

    Your nursing license is not a life sentence. It’s a foundation.

    ✨ Final Words from One Nurse to Another

    Bad days don’t make you a bad nurse.
    They make you a real one.

    You’re doing more than you know.
    You are holding the line between chaos and care.
    You are the steady hands in the storm.
    And even when you feel broken — you are making a difference.

    So take a breath.
    Take care of your heart.
    And when you’re ready… show up again.

    Because the world still needs nurses like you. Especially on the hard days.

  4. NO ROOM FOR “HE SAID/SHE SAID” IN NURSING PART 2

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    I often receive calls about communications or actions which are taken out of context usually leaving the nurse in trouble because there is no way for her to defend herself. It’s a “he said/she said” situation.

    Employers are likely going to believe the patients and not the nurse. Unfortunately, the same can be essentially true with the Board which can entertain hearsay, but it just can’t form the basis of their opinion.

    In the hustle of your 12-hour shift, the handoffs, the Code Blues, and constant interruptions, it’s easy for communication to get muddled or people to take things out of context. That’s when the dangerous “he said/she said” scenarios creep in. Especially if you are the only person in the room with the patient or doing home care.

    These moments can have real consequences, not just for our licenses, but for our patients. Anybody can report a matter to the Board which then has an obligation to investigate it. In fact, videos are the worst because sometimes they don’t have audio and, depending on the angle, things can look worse than they really are and can be taken out of context.

    I suggest acting as if it is a video that’s recording 24/7. Anything that you don’t want to be seen or heard on video, do not do!

    If you have a situation that you believe could be taken out of context, make sure you chart it. Charting who said what is your best defense because the they were charted at the time.

    Were you concerned about the patient and called the physician? Chart it! Was

    there a change in condition and you alerted the charge nurse? Chart it? Did the patient or their family refuse treatment? Chart it!

    Be specific. Be objective. Avoid emotional language or assumptions. Just the facts. The clinical, thoughtful, caring actions you took.

    If you have any concerns about a patient or a family member saying something that may get lost in translation, make sure that you go to the room with another nurse or witness with you.

    You became a nurse because you care. Because you show up with compassion, even on the hardest days. But caring doesn’t mean staying quiet. It does not mean trusting that you will remember what you said because things can be taken out of context. Be sure anything that could possibly be used against you is documented in the record. Don’t be afraid to write your part of the story.

    If you are terminated over one of these situations, be sure to put your version on the termination papers so that there is a record, and the Board can see it if further investigation is required.

  5. From Bedside to Business: Exploring Opportunities for Nurses

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    What if your nursing expertise could become the foundation of a thriving business? For many nurses, exploring entrepreneurial opportunities offers a chance to expand their impact and take control of their professional futures. Nurses possess a rare combination of clinical knowledge, communication skills, and problem-solving abilities, making them uniquely suited for diverse business ventures. Let’s explore some exciting paths where you can transform your expertise into business success.

    1. Legal Nurse Consulting

    Imagine turning your experience in patient care into a career as a legal nurse consultant (LNC). Attorneys need nurses to analyze medical records, interpret complex healthcare issues, and provide expert opinions in legal cases. Whether it’s malpractice claims or personal injury cases, your insights as an LNC can make a powerful difference.

    1. Health and Wellness Coaching

    With your background in health promotion and patient education, becoming a health and wellness coach is a natural fit. You can guide clients toward healthier lifestyles, offer disease prevention strategies, or support them in managing chronic conditions. This business allows you to work one-on-one with clients or even host group coaching sessions.

    1. Education and Training

    Nurses are natural educators, and there’s a huge demand for training in healthcare-related topics. You can create courses or workshops for healthcare professionals, patients, or caregivers. Topics like CPR certification, chronic disease management, or workplace wellness programs can be turned into profitable ventures.

    1. Freelance Writing and Content Creation

    If you love to write, consider becoming a freelance medical writer or content creator. Your expertise can shine in blog posts, patient education materials, or even textbooks. Companies and organizations are always looking for professionals who can translate complex medical information into clear, engaging content.

    1. Private Duty or Concierge Nursing

    Some patients or families seek personalized, high-quality care outside of the traditional healthcare system. Private duty nursing or concierge nursing services can allow you to offer one-on-one care, helping patients manage their health in the comfort of their own homes.

    1. Starting Your Own Clinic or Practice

    If you’re an advanced practice nurse, such as a nurse practitioner, opening your own clinic can be a fulfilling way to serve your community. Whether it’s a family practice, mental health services, or a specialized clinic, this path offers both autonomy and the chance to make a direct impact.

    1. Medical Device or Healthcare Product Consulting

    With insider knowledge of patient care, nurses are valuable consultants for companies developing medical devices or healthcare products. You can provide insights into functionality, usability, and patient needs, shaping products that improve outcomes.

    1. Creating a Product or Service

    Do you have an innovative idea? Many nurses have launched businesses creating products like nursing-specific gear, patient care tools, or even apps that address healthcare challenges. With the right support, your idea could become the next big thing.

    1. Nurse Influencing and Advocacy

    Social media platforms have given rise to nurse influencers who share tips, advocate for change, and promote healthcare products. If you’re passionate about educating the public or raising awareness, this can be both rewarding and financially sustainable.

    1. Consulting in Healthcare Systems

    Hospitals and clinics often seek consultants to improve workflow, compliance, or patient safety. As someone with firsthand experience, you can offer valuable insights to enhance operations and outcomes.

    Your Business, Your Legacy

    Starting a business is not without its challenges, but as nurses, we’re no strangers to hard work, dedication, and perseverance. The opportunities are vast, and the potential for personal and professional fulfillment is immense. Whether you’re looking to supplement your income, find a creative outlet, or fully transition into entrepreneurship, there’s a path that fits your strengths and passions.

    If you’ve ever thought, “Can I really do this?” the answer is a resounding yes. Nurses have the skills, the heart, and the drive to build businesses that change lives. So why not take that first step? Explore, dream, and create something extraordinary. The world is waiting for what only you can offer. If you would like to see 101 Ways to Become a Nurse Business Owner check it out at https://empowerednurses.org/101-ways/

    What business idea resonates with you the most? Share your thoughts—we’d love to hear your story and celebrate your journey!

     

     

  6. Your Best Defense is a Strong Offense: Avoiding ‘He Said, She Said’ in Nursing

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    It was 2:45 a.m. when it happened. I had just sat down for the first time all night. One of my patients, a sweet elderly man with dementia, had been restless and in pain since midnight. I had given him his scheduled pain medication around 1:30 a.m., documented everything, and even noted his verbal response: “Thank you, honey. That’s better.”

    But an hour later, his daughter arrived for a surprise visit. I walked into the room to hear her saying, “You mean they haven’t given you anything for pain?”

    The patient, confused and tired, simply nodded.

    The daughter was furious. She stormed to the nurses’ station and demanded to speak to the charge nurse. “My dad said no one’s given him any medication all night—what happened to his morphine. Who took it?”

    Suddenly, I was under investigation. A missing narcotic. A patient who couldn’t clearly advocate for what had or hadn’t happened. And only my word against theirs.

    I thank God every day that I had documented the administration immediately—time given, response observed, and a double-check of the count with the Pyxis.

    That note saved me.

    That tiny timestamped detail was the only thing that kept a simple misunderstanding from becoming a reportable event.

     

    🖊️ If It’s Not Documented, It Didn’t Happen

    We say it all the time—but we forget how true it is until we’re standing in the hallway trying to explain something from memory.

    In my case, having accurate documentation of the med, the response, and the count saved me from a nightmare. It reminded me that our charting is our shield.

    Even when we’re exhausted, behind, or overwhelmed—documentation must come first. It’s not just about protecting ourselves—it’s about protecting our patients, our license, and the truth.

     

    🗣️ Say It, Repeat It, Document It

    Every interaction—especially those involving meds, verbal orders, or patient complaints—needs clarity and confirmation.

    Repeat the order back. Clarify what the patient wants. If someone questions your care, document that too. “Patient expressed concern that pain medication was ineffective” is a legitimate entry.

    You’re not just covering yourself—you’re building a clear, consistent trail of communication that can speak on your behalf if needed.

     

    👀 Keep Your Notes Objective and Professional

    What saved me wasn’t just that I charted. It was how I charted. No vague terms. No “seems like.” I included the direct quote from the patient and the specific time of administration.

    Let your chart reflect what you saw and heard—not what you think or assume. That’s the difference between a defensible note and a questionable one.

     

    🙋‍♀️ Don’t Be Afraid to Escalate

    If something doesn’t sit right—say something. If a family member is accusing you, bring in your charge nurse. If a provider’s order feels off, clarify it. Trust your instincts.

    And always, always write an incident report if you think the situation might come back around later. It’s not tattling—it’s protecting.

     

    🤝 Watch Out for Each Other

    Nursing isn’t a solo sport. If you’re administering a narcotic, ask a coworker to verify it with you. If you’re having a difficult conversation with a family, invite your charge nurse to be present.

    One witness can make all the difference.

     

    💬 Final Thoughts: This Could Happen to Any of Us

    That night, I didn’t do anything wrong. But if I hadn’t documented the med when I gave it—if I hadn’t written that the patient verbally responded—it could’ve been a very different story.

    We all became nurses to help people. But part of helping is protecting the care we give with clear, consistent communication.

    So to my fellow nurses: Chart like your license depends on it—because sometimes, it does.

    And remember, no matter how fast the shift moves, you matter too. Your voice. Your name. Your reputation. They’re worth protecting—every single time.

  7. Creating Change in Nursing Without Losing Your Job

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    Nurses see firsthand what works and what doesn’t in healthcare. We’re the ones at the bedside, coordinating care, catching medication errors, and advocating for patients who might otherwise be overlooked. But pushing for change in a system resistant to it? That can be risky.

    Too many nurses have faced retaliation—being labeled as “difficult,” denied promotions, or even fired—just for speaking up. So how do you drive meaningful change without putting your career on the line?

    1. Know Your Institution’s Policies

    Before making waves, know where the boundaries are. Every hospital or healthcare facility has policies on reporting issues, proposing changes, and escalating concerns. If your advocacy aligns with established procedures, you’re less likely to face backlash.

    Review your workplace’s policies on:

    • Patient safety reporting (incident reports, sentinel event procedures)
    • Chain of command (who to escalate concerns to)
    • Whistleblower protections (both internal and legal)

    Understanding these policies ensures you use the proper channels rather than stepping on the wrong toes.

    2. Build Allies, Not Enemies

    Change is easier when you have support. Identify colleagues who share your concerns, especially those in leadership roles. If you can present an issue as a collective concern rather than a personal grievance, it carries more weight.

    Ways to build alliances:

    • Join committees that focus on quality improvement
    • Engage respected senior nurses who can mentor you on navigating hospital politics
    • Collaborate with physicians, case managers, and other team members to strengthen your cause

    3. Frame the Problem as a Solution

    No hospital administrator wants to hear complaints without solutions. Instead of saying, “This is unsafe,” say, “Here’s how we can improve patient safety.” Propose ideas that:

    • Improve patient outcomes
    • Save time and money
    • Enhance compliance with regulations

    For example, instead of just pointing out that short staffing increases medication errors, present data on how an adjusted staffing model could reduce them and improve patient outcomes. Administrators respond better to well-structured proposals than to emotional arguments.

    4. Use Data, Not Just Emotion

    Passion alone won’t win battles—data will. Track incidents, outcomes, and trends that support your case. If you notice a pattern of falls in a certain unit, gather incident reports and compare them to staffing levels or patient acuity. Numbers get attention.

    Ways to collect data:

    • Use official hospital reports
    • Reference evidence-based research
    • Conduct informal surveys among staff to gauge widespread concerns

    5. Document Everything

    If you face resistance or retaliation, documentation is your best defense. Keep records of conversations, emails, and reports related to your advocacy. If management dismisses an issue and it leads to harm, your documentation could protect you and your license.

    Document:

    • Dates and times of discussions
    • Who was present
    • Any instructions or responses given
    • Follow-up actions taken (or not taken)

    If things escalate, having a paper trail ensures you can demonstrate that you acted professionally and responsibly.

    6. Know When to Escalate—And When to Walk Away

    Some battles are worth fighting. Others require a strategic retreat. If you’ve exhausted all avenues and leadership refuses to act on serious concerns, you may need to escalate outside the organization—through state nursing boards, patient safety agencies, or even legal channels.

    However, if your job becomes toxic and unsafe, sometimes the best move is to leave. No job is worth compromising your ethics or well-being.

    Final Thoughts

    Change in healthcare doesn’t happen overnight, and it rarely happens without resistance. But history has shown that nurses who advocate persistently—and wisely—can create lasting impact. The key is to be strategic, build support, and protect yourself along the way.

    Have you ever fought for change in your workplace? What strategies helped you succeed? Let’s continue the conversation.

  8. Nurses: Beyond a Reasonable Doubt is Only for Criminal Matters

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    Imagine standing in a courtroom, accused of a crime. The prosecution must prove your guilt beyond a reasonable doubt, the highest standard of proof in the legal system. That means every shred of evidence must point so clearly to your guilt that no rational person could doubt it. This is how our legal system protects individuals from wrongful conviction.

    Now, shift that image to your job as a nurse. Here, the rules are different. Your employer doesn’t need any proof at all to terminate you. They don’t even need a reason. Most states follow “at-will” employment laws, meaning you can be fired for wearing the wrong color scrubs, questioning unsafe practices, or simply because someone in management doesn’t like you. There’s no trial, no evidence required, and no appeal process.

    But it gets worse. If your employer reports you to the state Board of Nursing, you enter yet another legal realm—one where the rules are stacked against you. Unlike a criminal trial, the Board doesn’t need to prove your wrongdoing beyond a reasonable doubt. They don’t even need clear and convincing evidence. All they need is a preponderance of the evidence—meaning that if they believe there is just 51% chance that you did something wrong, they can take action against your license.

    And here’s the most shocking part: hearsay is admissible. Hearsay is an out of court statement offered to prove the truth of the matter. A single complaint from a disgruntled patient, a misunderstanding between coworkers, or even an anonymous report can put your entire career on the line. You don’t have the right to cross-examine your accuser the way you would in a criminal case. You may never even know exactly who made the accusation.

    So why are nurses—trusted professionals who dedicate their lives to caring for others—held to such an unforgiving standard? Why is it that an alleged criminal gets more protections under the law than a nurse fighting for their livelihood?

    It’s a question that haunts those who have faced the system firsthand. A nurse can work 20, 30, even 40 years without a blemish on their record, only to have one accusation—without solid proof—lead to suspension, probation, or even revocation of their license. It’s a reality that too many nurses have faced, and one that too many don’t realize until it happens to them.

    So, what can nurses do?

    1. Document everything. If you didn’t document it, it didn’t happen. Keep personal records of incidents, concerns, and conversations—because when accusations arise, your best defense is solid evidence.

    2. Know your rights—but don’t assume they’ll protect you. If you’re called before the Board, understand that this is not a fair trial in the way you might expect. Seek legal representation immediately.

    3. Advocate for change. Nurses must push for reforms in how Boards handle complaints. No professional should lose their livelihood over unsubstantiated claims.

    4. Support each other. Nurses are often left to fight these battles alone. Stand with your colleagues, speak up when you see unfair treatment, and work together to protect the profession.

    Nursing is more than a job. It’s a calling, a passion, and for many, a lifelong identity. Yet, the system does not protect those who dedicate their lives to it. It’s time for nurses to recognize the precarious nature of their profession—not to live in fear, but to take action. Because while justice demands beyond a reasonable doubt, a nurse’s fate can be decided by nothing more than suspicion.

    And that is something that needs to change.

  9. If It’s Not Documented, It Wasn’t Done: A Nurse’s Perspective

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    I remember the first time a seasoned nurse looked me in the eye and said, “If it’s not documented, it wasn’t done.” I was a new nurse, fresh-faced and eager, still trying to keep my feet under me during a 12-hour shift that felt like a marathon. At the time, I thought documentation was just a formality—something we did at the end of our shift when we finally had a moment to breathe.

    But experience, and a few hard lessons, taught me otherwise.

    The Reality of Documentation

    Nurses do incredible things every single day. We assess, intervene, advocate, and sometimes perform miracles in the most challenging of situations. We hold hands, catch symptoms before they escalate, and make judgment calls that can mean the difference between life and death. But if none of that is documented, it’s as if it never happened.

    Documentation is not just about covering ourselves legally—though that is a very real and necessary part of our practice. It’s about continuity of care. It ensures that the next nurse, the physician, the entire care team, and even the patient’s family have an accurate picture of what is happening. It tells the story of our patient’s journey, one note at a time.

    When It Matters Most

    I’ll never forget a case where my documentation made all the difference. A patient had subtle but concerning neurological changes during my shift. I documented everything—his altered speech, slight confusion, and the increasing weakness on one side. I called the rapid response team and immediately pushed for a stat CT scan. That patient was having a stroke.

    Without thorough documentation, those early signs might have been overlooked. He might have been written off as just “a little off” that night. But because every nurse in his care documented carefully, he got the life-saving treatment he needed in time.

    The “I’ll Do It Later” Trap

    We all know the feeling—running from one patient room to another, answering a call light while hanging an IV, getting pulled in six different directions. It’s easy to say, “I’ll document later.” But later turns into hours, and by then, the details are fuzzy. Was it 10:30 or 11:00 when that BP dropped? Did I administer 4 mg or 2 mg? We are human, and memory is imperfect. Real-time documentation protects not only our patients but also ourselves.

    What Happens When It’s Missing

    I’ve seen cases where missing documentation created serious problems. A nurse who swore she turned a patient every two hours—but had no record of it—was blamed for a pressure ulcer that developed. A patient who received pain medication, but because it wasn’t documented, the next nurse unknowingly gave another dose, leading to an overdose. A legal case where a nurse’s care was called into question simply because there was no written proof of what she did.

    Nurses don’t go to work thinking about lawsuits, but documentation is our strongest defense when care is questioned. Your documentation will save you every time. If you didn’t chart it, you didn’t do it.

    Making Documentation a Habit

    So how do we make documentation a priority when we barely have time to breathe?

    · Chart as you go. If you wait until the end of the shift, details will slip through the cracks.

    · Be specific. Instead of “patient is confused,” write “patient confused, unable to recall place/time, repeating questions.”

    · Use objective language. Chart what you see, hear, and assess—not assumptions or opinions.

    · Double-check before signing off. A quick review can catch missing pieces before you clock out.

    The Nurse’s Legacy

    At the end of the day, our documentation is our voice when we’re not there to speak for ourselves. It is our patient’s history, our professional integrity, and our protection all in one. Every note, every entry, every little detail matters.

    We are not just nurses; we are storytellers of healing, safety, and advocacy. And the way we tell that story? It starts with documentation.

    So the next time you’re tempted to put it off, remember—if it’s not documented, it wasn’t done. And we all know better than that.

  10. Enjoying the Journey: A Nurse Business Owner’s Guide to Fulfillment

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    Building a business as a nurse entrepreneur is not for the faint of heart. It takes grit, determination, and a willingness to step into the unknown. You’ve poured your expertise into something beyond bedside care, and that leap alone is worthy of celebration. But in the pursuit of success, it’s easy to get caught up in the hustle and forget to enjoy the journey.

    The Trap of Constant Striving

    As nurses, we are wired to focus on outcomes—healing patients, completing tasks, and ensuring compliance. That mindset often carries over into business, where we push ourselves to meet deadlines, land clients, and achieve financial milestones. While goals are essential, they shouldn’t come at the expense of your well-being and joy.

    Too many business owners fall into the trap of, “I’ll be happy when…” thinking. When I hit six figures. When I land my dream client. When my schedule is full. But if you don’t learn to appreciate the process, you’ll find that each milestone quickly fades, replaced by the next big goal.

    Redefining Success

    Success isn’t just about revenue—it’s about building a life that aligns with your values. Why did you start this business? Was it for flexibility, financial freedom, impact, or creativity? When you reconnect with your ‘why,’ you’ll find joy in the small wins, not just the major victories.

    Did you receive positive feedback from a client? Did you finally master a new skill? Did you take a much-needed afternoon off without guilt? These moments matter. Your journey is made up of them, not just the finish lines. The goal of any business is to keep playing. That is the only way to win. There is no business nirvana like oh when I get this…The key is to enjoy the journey.

    Practical Ways to Enjoy the Process

    1. Celebrate Small Wins – Don’t wait for massive milestones to acknowledge your progress. Keep a journal or list of achievements, no matter how small.

    2. Take Breaks Without Guilt – Rest fuels creativity and productivity. Give yourself permission to step away, recharge, and return stronger.

    3. Find a Support System – Surround yourself with fellow nurse entrepreneurs who understand the highs and lows. A strong network can provide encouragement when challenges arise.

    4. Make Time for Passion Projects – Don’t let your business consume your identity. Whether it’s volunteering, a hobby, or spending time with loved ones, nourish the parts of yourself that exist outside of work.

    5. Reframe Setbacks – Every challenge is an opportunity to learn. Instead of seeing obstacles as failures, view them as stepping stones to growth.

    Final Thoughts

    Running a business is a marathon, not a sprint. If you wait until you’ve “made it” to enjoy yourself, you’ll miss the best parts of the adventure. Success is not just the destination—it’s found in the moments of learning, growing, and making a difference along the way.

    So, take a deep breath, appreciate how far you’ve come, and find joy in the journey. Because this is your story, and every step matters.

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