I am frequently asked why nursing boards are so harsh. The Boards are composed of nurses and shouldnât the Board understand the situations in which nurses get involved?
California has had issues with their Board. California has a separate Board of Nursing for Registered Nurses and one for License Vocational Nurses. The RN Board is called the Board of Registered Nursing (âB.R.N.â). In some parts of the country, licensed vocational nurses are called licensed practical nurses, L.P.N.
In 2009, the Los Angeles Times and ProPublica analyzed the records of 2,400 California nurses who faced disciplinary action by the Board between 2002 and September 2009. What they found was that many of these nurses were allowed to continue in their practice while they still had serious allegations against their licenses. The investigation process took so long. They were left free to practice for years while the investigations continued. Many of these nurses simply moved to another state where they continued to practice
The then governor, Arnold Schwarzenegger, replaced most of the B.R.N. due to the extreme length of time it was taking the Board to discipline egregious conduct. It is my opinion that the other Boards learned of this and did not wish to become the subject of criticism and publicity like in California.
However, despite the previous California problems, it appears that the California Board of Registered Nursing is still having issues due to delays in resolving complaints against nurses accused of negligence involving patient injury or death or posed a serious risk of harm to others.
At the closing of 2016, an auditorâs report showed that there still was a delay in resolving these complaints. The audit reviewed 40 cases between June 1, 2013, and June 30, 2016, and found that the Board failed to resolve 31 of those complaints.
There was one complaint against a nurse for a toddlerâs death in which there was a delay in referring it to the Consumer Affairs investigators. This complaint took more than 3 years (39 months) to resolve during which time the nurse was allowed to continue to practice!
One of the concerns with the California Board was that its stateâs Medical Board has 1 staff member for 900 licensees while the Nursing Board has 1 staff member for 3,000 licensees. I know that funding is a big issue for these Boards. But, when you look at the Medical Board compared to the Nursing Board, the former has more staff and takes much less action against their licensees than does the latter.
I think Nursing Boards are a representative of nurses. In my addresses, I often provide case studies and ask my audience what they would do if they were a member of the Board in those matters. Some interesting responses included taking actions that would be more serious than that which the Board actually took.
Unlike the Nursing Board, the Medical Board protects its licensees. It may not be appropriate for Boards to protect doctors who are not safe to practice but, at the same time, excessive action against nurses is also is inappropriate. When a nurse is accused of the same conduct as a physician and if nothing is done against the physicianâs license while sanctioning the nurse for the same conduct, that is not proper.
I am hoping that the Board can find a middle ground when protecting the public as well as rehabilitating the nurse. While I am an advocate for nurses, if a nurse should not be practicing then there is nothing that can be done to help them.
Do you believe Nursing Boards are excessively harsh? If so, what would be your suggestion(s) to resolve this? Let me know your thoughts below.
Jeff Obrien says
Nursing boards actually chastise nurses thrice or more: once when an investigation starts, the nurse is fired. A second time fired again when after a years passage or more, the nurse is actually charged, even if the conduct has ceased OR never occurred. A third punishment is the inability to get a new job, and this is before the actual/stayed suspensions have even been instituted! The process is insanely harmful, and the nurse isn’t protected in any way, because the “negotiated” or “obtained consent” based punishments are cookie cutter often, even after counsel has met with the board. Paint it any pretty color, but life is usually destroyed for a nurse who is subjected to this process in the form of something like a foreclosure after legal fees, unemployability, license flagging for future employers, and repeated firings. A board doesnt understand that. A board doesnt understand how the mounted stress of the process can destroy the health of the nurse. A board doesnt understand that the family is affected in devastating and dramatic ways during an investigation BEFORE the outcome is realized and punishment is dealt. Go to a board meeting for a discipline…they are public. Look at the board members after researching to the process, and if you listen to the proceeding, it will be manifest that these are people who are incapable of caring. The very profession that is vocational in seeking those to act compassionately is unable to do so via its own governing board, and therein lies the issue.