Kaci Hickox and her license to practice nursing in Maine Oct 30 2014

The right wing nut jobs are going crazy about Ebola.

First off, before you go anywhere, check out one or the other of my two books on Amazon. Yes, I am a USA Registered Nurse, with both teaching experience and adult critical care experience; yes, I have worked with infectious diseases though not Ebola; and yes, I try to convey to my readers about the experience of nursing in a Low Resource Setting. I have a nursing license in the country of Nepal and I’m currently living in Kathmandu teaching critical care nursing.

Get to the Point?

I heartily applaud Kaci Hickox, RN, BSN, MPH for her work with Ebola victims. On the internet I found a small PR piece about her from the U of Texas at Austin, which gives a short version of her CV. She is the kind of person we need on the front lines fighting this illness.

Ms. Hickox has become a celebrity, by a strange twist of fate. Most likely she would not be famous unless Chris Christie, the Governor of New Jersey, hadn’t tried to wrongfully imprison her in The Garden State. I do not know any USA nurse that would voluntarily forego a daily shower or opportunity to practice meticulous hygiene; What was Christie thinking?

One thing that makes me laugh is so many comments saying that the Maine Board of Nursing (MEBON) should pull her license – i.e., take it away or prevent her from working in Maine. A fellow nurse went so far as to find the MEBON website where it lists possible disciplinary actions.

This is simply not possible. Why? because Ms. Hickox does not have a Maine RN license in the first place.  (you can search for the licnese of an RN in Maine, online). For that reason, the MEBON can not do anything about her. From what I can tell, Ms. Hickox is going to Maine to chill out for awhile and await the 21-day period. It’s a fine place for that sort of thing.

As an aside, this reminds me of that famous quip by the late John Silber of Boston University. They asked his opinion of nuclear power. He replied “Maine is a good location for a nuclear power plant-where the damn thing could have an accident and not hurt anybody.”(sic). This did not endear him to the people of Maine.

disclaimer: I don’t speak for the Maine State Board of Nursing. I am writing this because I doubt that the Board will make any statement. It’s not a political agency.

Nursing licenses, like most professional licenses, are administered on a state-by-state basis. The exception is the “multi-state nursing license compact,” of which Maine is a member, but even then, Maine has no jurisdiction over Ms. Hickox. If you don’t have a nursing license in Maine, and you don’t try to practice nursing in Maine, the Maine State Board of Nursing will not do anything about you.  It’s not in their mission.

The Board’s mission is “to protect the public” from incompetent or impaired nurses and to regulate the practice of nursing. Since Ms. Hickox is hanging out at her boyfriend’s house and not seeking employment, she is no threat to the public.

The Board can only act against the license, not the person. The Board can not put a person in jail.

Finally, it is crystal clear that Ms. Hickox in engaging in public advocacy in the highest tradition of American democracy and the Code of Ethics for nurses.  Any nurse knows that the most important part of their job is to “speak truth to power” and that is what she is doing.  Boards of Nursing in general are reluctant to use their authority  to limit this type of activity. To give a corollary from Medicine, Bill Frist, the doctor/former Senator from Tennessee, did not lose his license to practice medicine despite his pronouncements about Terri Schiavo.

Finally, even if Ms. Hickox does develop the fullblown illness, it does not change the validity of her position on the abuse of power taking place. She is presently not contagious. She is following the CDC guidelines. Christie ( and now LePage) need to actually seek the advice of scientists, and stop making things up as they go along.

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6 Comments

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6 responses to “Kaci Hickox and her license to practice nursing in Maine Oct 30 2014

  1. Rachel Hugens

    Thanks Joe, beautiful description. I’ve been on Kaci’s FB page defending her decision and it’s amazing how uninformed, fear based selfish people we have in our country. The hateful comments directed at Kaci are appalling. I would think the simple fact the Duncan exposed so many more people before he was diagnosed and no one else has developed ebola (except the 2 nurses when he was contagious) could quell the fear. The selfishness that we didn’t care as long as it was in Africa killing Africans also is an embarrassement. We need more people like Kaci.

  2. She has been tested for Ebola 2x & is negative – twice the results were negative. Also she has not commited any crimes. There is no legal reason to “lift” her license. Nor is there a rational basis for suggesting it. I am restraining the impulse to express my opinions strongly. This suggestion reveals the ignorance & extreme stupidity of the persons who made it. They are as ignorant & stupid as Darryl Issa & Steve King — & opthamologist Paul.

  3. The latest is the know nothing Gov. of Maine says he will back down from the quarantine if she takes – another – blood test. From the Aroostook newspaper: “This could be resolved today,” the governor told ABC News. “She has been exposed and she’s not cooperative, so force her to take a test. It’s so simple.”
    Attorneys for the state visited a superior court this morning seeking a judge’s permission to administer the blood test, LePage said.”
    This is a violation of the 5th Amendment. Notice the use of the word “force”. The 5th Amendment protects against being required to testify against your self — “No person … shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; ” For one thing, she has not committed any crime also, she is already being deprived of liberty as well as due process. The Maine ACLU & — finally — ANA have spoken against the illegal behavior of Gov. Know Nothing Muscleman LePage.

  4. TN

    The debate and the law should be based on science. A good place to start is the forehead scanner used to accuse Ms. Hickox. Where is this scanner now? Let’s have scientists test it for accuracy and precision. How does it compare with the best-known methods of taking body temperature? What is the rate of and reasons for false positives (which amount to false accusations, given the threat of confinement)? How is the scanner calibrated, and were procedures followed to calibrate it correctly?

    Do nurses and doctors use such scanners to take temperatures of their patients? If not, why not?

    • The CDC guidelines are explicit about the instruments appropriate to take temperatures: oral thermometers, tympanic scanners, and rectal thermometers. Assuming something approximating a 9-5 work day, temperatures will be lowest in the middle of the night; slightly higher in the morning when a person awakens; and rises throughout the day. Of course traveling throws off all biorhythms so Kaci’s temp would have been unpredictable in the NJ airport because she had flown so far.

      I participated in some thermometry research with an R.N. who has done a lot of it, and she was still looking for a genuinely reliable device. We were testing a paper forehead disposable strip in the newborn nursery. 1) The forehead scanner IS used presently in physician’s offices. 2) taking by those other means requires a knowledge of proper technique. I taught nursing for over 25 years and found that I had to constantly address technique even with senior students — and — and staff R.N.s & techs & L.P.N.s. I saw inaccurate technique in the hospital & outside clinics every day. 2) Oral temps need to be taken for a minimum of 5 minutes, the thermometer needs to be under the tongue, touching the large artery at the back of the mouth, and cannot be measured within 30 minutes of eating or drinking fluids, or of exercising. Also the person should not have been talking for at least 5 minutes, because of the passage of air in and out of the mouth, which may lower the temp. 3) With rectal thermometers the temp is usually 0.5 degrees F higher than an oral temp taken at the same time on the same person. Also the person taking the temp rectally needs to verify that there are no feces in the rectum, which would produce an elevated temp because of fecal fermentation. 4) for tympanometers — look up the directions, I don’t have them to hand, but that also requires careful technique.

      I very much doubt if that forehead scanner had been calibrated. I have found that hospital tympanometers aren’t calibrated unless a nurse c/o to biodevices office. They are delicate and often inaccurate because of this.

      My point: temperature is not a reliable indicator of active disease. The press reported — inaccurately — that Craig Spencer’s Temp was 103 degrees F when he called the health authorities — corrected reports said it was 100.3. That is quite a difference! Had it been 103 he would have been burning with fever & would have called much sooner. At least he had a baseline for his temperature pattern – but it was that in combination with other sx which occasioned his call.
      Pat McKnight, R.N.., M.S.N.., M.P.H. (Health Educator and retired Asst. Prof of Nursing)

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