CON EP 62: Nutrition Labels and Nurses Losing Their Licenses

Nutrition Labels and Nurses Losing Their Licenses

The updated nutrition labels appear on the majority of food packages. Manufacturers with $10 million or more in annual sales were required to update their labels by January 1, 2020. Manufacturers with less than $10 million in annual food sales were needed to update their labels by January 1, 2021. Makers of most single-ingredient sugars, such as honey and maple syrup and certain cranberry products, must be changed until July 1, 2021.

FDA Changes Nutrition labels

How much people eat and drink has changed since the last serving size requirements were published in 1993. For example, the reference amount used to set a serving of ice cream was previously 1/2 cup but is now 2/3 cup. The reference amount used to establish a serving of soda changed from 8 ounces to 12 ounces.

New Label, What is the difference?

Goal: To make sure consumers have access to more recent and accurate nutrition information about the foods they are eating, FDA-required changes based on updated scientific information, new nutrition and public health research, more recent dietary recommendations from expert groups, and input from the public [1].

  • Servings: larger, bolder type
  • Serving sized updated
  • Calories: Larger type ( Calories from fat removed) 
  • Requiring nutrients – the list of nutrients that are required or permitted to be declared is being updated. It includes Vitamin D and potassium on the label. Calcium and iron will continue to be required. Vitamins A and C are no longer needed but can be formed voluntarily. They can voluntarily declare the gram amount for other vitamins and minerals. 

According to Nationwide Food Consumption Surveys, Vitamin D and potassium are nutrients Americans don’t always get enough of, and when lacking, are associated with an increased risk of chronic disease. Vitamin D is essential for its role in bone health, and potassium helps to lower blood pressure.

In the early 1990s, American diets lacked Vitamins A and C, but now Vitamins A and C deficiencies in the general population are rare. Manufacturers are still able to list these vitamins voluntarily.

  • Daily Values Updated: Daily values for nutrients like sodium, dietary fiber, and vitamin D have been updated based on newer scientific evidence from the Institute of Medicine and other reports such as the 2015 Dietary Guidelines Advisory Committee Report. 

For the nutrients with DVs that are going up, the %DVs may go down. For example, the DV for total fat has been updated from 65g to 78g. That means that a packaged food with 36g of total fat in one serving (previously 55% DV) has 46% DV. See below for a side-by-side comparison of the information on the original and new nutrition labels.

For example, the DV for sodium has been updated from 2,400mg to 2,300mg. That means that a packaged food with 1,060mg of sodium in one serving (previously 44% DV) now has 46% DV.

  • New: “Added sugars,” in grams and as percent Daily Value, must be included on the nutrition labels. There are different labeling requirements for single-ingredient sugars. Consuming too many added sugars can make it challenging to meet nutrient needs while staying within calorie limits. 
  • Updated: The footnote now better explains what percent Daily Value means. It reads: “*The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice.”
  • While continuing to require “Total Fat,” “Saturated Fat,” and “Trans Fat” on the label, “Calories from Fat” was removed because research shows the type of fat is more important than the amount.

Serving sizes example: 

  • Originally, the serving size for ice cream: 1/2 Cup = 200 calories
  • New Serving Size for ice cream 2/3 = 270 calories
  • For soft drinks, 12-ounce (120 calories) and 20-ounce (200 calories) bottles will be labeled as one serving since people are likely to drink the entire amount in either size container in one sitting. 
Nutrient Original Daily Value Updated Daily Value
Calcium 1000mg 1300mg
Dietary Fiber 25g 28g
Fat 65g 78g
Magnesium 400mg 420mg
Manganese 2mg 2.3mg
Phosphorus 1000mg 1250mg
Potassium 3500mg 4700mg

 

The total intake of Carbohydrates decreased from 300g to 275g. Protein stayed the same at 50g. Saturated Fats remained at 20g. Cholesterol remained at 300mg. 

Nurses Losing Their Licenses

RaDonda Vaught, a former Vanderbilt nurse criminally indicted for accidentally killing a patient with a medication error in 2017, was stripped of her license by the Tennessee Board of Nursing in July.

She still faces a pending criminal trial, including a charge of reckless homicide and the possibility of jail time, set for next year.

Vaught could not find Versed, she overrode a cabinet safeguard that unlocked more powerful medications, then searched for “VE” in the cabinet’s search tool and chose vecuronium by mistake. Vaught then overlooked numerous warning signs that she selected the wrong drug, including a label on the medical bottle that read “WARNING: PARALYZING AGENT,” according to court records.

Statement from Vaught: “I won’t ever be the same person,” Vaught said, failing to hold back tears. “When I started being a nurse, I told myself that I wanted to take care of people the way I would want my grandmother to be taken care of. I would have never wanted something like this to happen to her, or anyone that I loved, or anyone that I don’t even know. I know the reason that this patient is no longer here is because of me.”

Reasons Nurses Lose their License

Most nurses enter the profession with the best interest in mind. But sometimes, things happen that we cannot control. For example, in the Boards of Nursing (BON), many states will suspend a nurse’s license if she has been arrested or convicted of a DUI, public intoxication, or diversion, which is taking drugs intended for patients. Stealing or possessing controlled substances or illegal drugs may also result in a revoked license [1]

Each year 7,000 nurses have some discipline put on their licenses. When a Board disciplines a nurse, it can usually do 1 of 4 things.

  • Give the nurse a reprimand which is like a slap on the wrist.
  • Place the nurse’s license on probation.
  • Suspend the license.
  • Revoke the license.

Let’s dive deeper into the reasons why nurses can lose their licenses. 

Failure to pay Child Support 

    1. If a nurse fails to pay child support, the courts may temporarily suspend their nursing license.
    2. All 50 states have provisions that authorize the suspension or revocation of licenses for failure to pay child support; this includes professional and occupational licenses. 
    3. The state’s requirements may also include the need to comply with the court’s rulings within a set timeframe or risk permanently losing the license.

Patient Abuse and Neglect

    1. Abusing patients is a serious matter and is more likely to revoke licenses. Elderly patient abuse is the most prevalent. 
    2. First discussed in the 1970s, abuse of older adults was a largely hidden, private matter for many years rather than an issue of social, health, or criminal concern [2].
    3. As of 2018, there were 52.4 million adults 65 and over in the United States. By 2040, that number is expected to climb to 80 million, comprising nearly 21% of the total population.
    4. Global estimates from a recent meta-analysis reflect that one in six elders, or 15.7%, in the community experienced past-year abuse.

Sexual Misconduct

    1. Sexual misconduct may include boundary violations between nurses and patients or nurses and other healthcare workers.
    2. In most states, nurse-patient relationships are a significant violation and cause for disciplinary sanctions, including the revocation of a license.
    3. Sexual misconduct outside the workplace, including convictions, may also result in disciplinary action. 

Drug-Related Violations

    1. It is estimated that 10% of nurses will misuse drugs or alcohol at some time during their career.
    2. Nurses report higher rates of prescription drug abuse due to their access to these medications at the workplace.
    3. Along with working while impaired, nurses have lost licenses due to drug or alcohol-related convictions.
    4. Diverting drugs for personal use, sale, or distribution to other patients provides grounds for losing a license.
    5. If you have previous offenses filed with the nursing board, you’ll be placed on probation – this can restrict your practice. If you violate those terms, your license may be revoked.  

Falsifying of Documentations

    1. For example, falsifying documentation can happen when you gave your patient a little extra morphine to help him get through the night, but you didn’t record it. Whatever the case, falsifying patient records is grounds for a license being suspended.
    2. Nurses who have a suspended license may provide an employer with a fake one, thinking that it won’t matter once the suspension is up.

Breach of patient confidentiality 

    1. Patient privacy is a big deal, and it’s the responsibility of nurses and other health care providers to protect that information. 

Probation 

Getting off probation scenario: (This is in the state of Indiana) A nurse must petition the Board and attend a hearing where the nurse is put under oath, and a court reporter transcribes the proceedings.

The nurse then must present an opening statement, call witnesses, introduce evidence, cross-examine any opposing witnesses, and then offer a closing argument. This is a legal proceeding, and the nurse has a right to be represented by an attorney.

The nurse must show that she has complied with every requirement of the probation and present that the conditions that led to her license being placed on probation are no longer present.

Revocation 

The revocation of a nurse’s license is the most severe discipline that a board of nursing can impose. The nurse immediately loses their license and cannot legally practice nursing.

The individual can apply for a re-licensure based on the board’s requirements. Requirements include a period before which re-licensure is not possible (e.g., 2 years) and the retaking of the NCLEX exam, as examples. It is important to note that re-licensure is at the board’s discretion [3].

Learn more about this topic in this full episode, click here for more 👇

SHOW NOTES:

0:00 Introduction with the hosts/affiliates/updates
2:01 FDA Changes Nutrition labels
4:15 New Label, What is the difference?
22:15 Nurses losing their licenses
30:10 Reasons Nurses Lose their License
31:03 Failure to pay Child support
33:46 Patient Abuse and Neglect
37:52 Sexual Misconduct
40:47 Drug-Related Violations
43:44 Falsifying documentation
46:28 Breach of patient confidentiality
47:25 Probation
48:25 Revocation
50:36 Concluding Statement and Thoughts

 

 

 

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