Sunday, July 12, 2009

LA Times reports delays and lack of oversight in disciplining problem nurses leave public at risk

When fellow nurses reported Owen Murphy Jr. for behaviors such as twisting the jaw of a patient, slamming an elderly patient against a mattress and telling him "I said, Stay in bed", ignoringalarms on vital-sign monitors, hurling a thirsty patient's water jug against the wall and shouting at coworkers, they assumed the board would take action. Murphy resigned under pressure, but California's oversight board failed to take any disciplinary action for three years, the LA Times reports. The article says that the public is unaware of the risk due to delays of this kind, even for egregious misconduct, leaving nurses free to practice who have "histories of drug abuse, negligence, violence and incompetence".

Reporters examined the case of every nurse who faced disciplinary action from 2002 to 2008 -- more than 2,000 cases in all -- as well as hundreds of pages of court, personnel and regulatory reports. They interviewed scores of nurses, patients, families, hospital officials, regulators and experts.

Among the findings:

* The board took more than three years, on average, to investigate and discipline errant nurses, according to its own statistics. In at least six other large states, the process typically takes a year or less.

"It's really discouraging that when you do report people . . . they don't take action," said Joan Jessop, a retired chief nursing officer in Los Angeles who filed multiple complaints with the board during her 43-year career. "What is so frightening to me is that these people will go on and do it to somebody else."

* The board failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. Reporters identified more than 120 nurses who were suspended or fired by employers, disciplined by another California licensing board or restricted from practice by other states -- yet have blemish-free records with the nursing board.

* The board gave probation to hundreds of nurses -- ordering monitoring and work restrictions -- then failed to crack down as many landed in trouble again and again. One nurse given probation in 2005 missed 38 drug screens, tested positive for alcohol five times and was fired from a job before the board revoked his probation three years later.

* The board failed to use its authority to immediately stop potentially dangerous nurses from practicing. It obtained emergency suspensions of nurses' licenses just 29 times from 2002 to 2007. In contrast, Florida's nursing regulators, who oversee 40% fewer nurses, take such action more than 70 times each year.

UPDATE: Schwarzenegger sweeps out nursing board

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