When Occupational Safety and Health Becomes Interstate Commerce

If you're an occupational health nurse and you use the telephone to offer guidance to an injured or ill employee calling from another state, did you know that you are participating in interstate commerce?

If you''re an occupational health nurse and you use the telephone to offer guidance to an injured or ill employee calling from another state, did you know that you are participating in interstate commerce? Furthermore, do you realize that you need to have a valid nursing license not only in the state where you live and practice, but also in any states where you offer medical guidance to employees?

Lynn S. Muller, an attorney, municipal court judge and registered nurse, offered an update on liability and practice issues for occupational health nurses attending the American Occupational Health Conference and Exhibition held this week at Chicago''s McCormick Place Convention Center. The American Association of Occupational Health Nurses, co-sponsors of the conference, offered the session.

"Occupational health nurses deal with more regulations, more rules, more people…how you people manage is beyond me," she told her audience.

She explained that the simple, everyday questions people pose to one another - "How are you?" "How do you feel?" - are a slippery slope for occupational health nurses. "If you''re talking to an employee," said Muller, "''How do you feel?'' is a dangerous question because that starts an assessment."

It''s especially tricky if the nurse is in one state and the employee in another. "If you use the telephone, then that''s interstate commerce," she added, noting that many occupational health nurses oversee health programs for facilities in more than one state. She advised her audience to make sure they''re licensed in other states if they are expected to offer occupational health services to employees in those states and to have liability insurance other than that provided by their employers, and to document their actions when helping employees.

If a nurse is sued by an employee because of care offered for injuries or illnesses suffered on the job, said Muller, the first thing the employer''s insurance company will do is try to diminish the employer''s liability in the case by finding fault with the care offered by the nurse; claiming the nurse acted in a way that excludes him or her from coverage. If that care was competent and fully documented, then the nurse stands a better chance with the insurance company and in a court.

Muller also advised occupational health nurses not to hand out any medication, over-the-counter or otherwise, to employees. "If you dispense medicine, that''s practicing medicine and violating pharmacy laws," she told her audience. "Why put yourself in that position? Let the employee choose."

She suggested getting a dispenser cabinet filled with medications such a headache remedies and cold pills and allowing employees to pick what they want to take. Or, as an alternative, offer the employee a choice of several medications and allow him or her to choose.

For anything other than very minor injuries or illnesses, Muller offered this prescription: Make a phone call.

"I''m big in favor of sending liability out the door. 911 is the best way to send liability out that door. Once you''ve made that call and done basic first aid, you''ve reduced your liability. Reduce or eliminate liability and once you''ve done that, insure against it," she advised.

by Sandy Smith ([email protected])

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