A sign of the times? California’s nursing board becomes a casualty

By March 7, 2012 Nursing

They say it only takes a few bad apples to ruin a barrel. Just as other licensed professions in California battle with the few that can tarnish the reputation of the many, so goes the nursing profession. The head-turner with nursing, however, is that people’s lives are at stake and the public (and state government) tends to zero in on it. If you couple that with unsuccessful pension negotiations during tough economic times by a state whose deficit is off the charts, an entire agency can fall victim to the budget-cutting axe.

California Watch‘s Christina Jewett reports, “(Governor) Brown vetoed the bill that would have extended the board’s charter to 2016 after balking over possible pension obligations. In doing so, he dissolved the board after 106 years of operation. Employees charged with overseeing the licensing of more than 350,000 nurses are now part of the state Department of Consumer Affairs, where they continue the administrative work, such as processing applications for would-be nurses and investigating complaints.”

But this latest development wasn’t the first hit. In 2009 a previous governor, Arnold Schwarzenegger had already fired half the nursing board. Back then, however, it wasn’t about money; it was about incompetence. Soon after Propublica and the Los Angeles Times had published an article that cited systemic failures in the board that had both hurt patients and wasted taxpayers’ money, the gauntlet had been thrown and cataclysmic changes were in the making. “The board failed to use its authority to immediately stop potentially dangerous nurses from practicing,” wrote Propublica’s Charles Ornstein, Tracy Weber and Maloy Moore. “It obtained emergency suspensions of nurses’ licenses just 29 times from 2002 to 2007. In contrast, Florida’s nursing regulators, which oversee 40% fewer nurses, take such action more than 70 times each year.”

The agency, it seems, was not aggressive enough to tackle both issues and survive.  Jeannine Graves, who served as president of the nursing board before its demise, voted against an interagency agreement that gave authority over board functions to the Department of Consumer Affairs.  Despite her contention that she and her group accomplished much during their tenure, Governor Brown subsequently fired her a day after the vote took place.

Long before the ProPublica investigation, William Heisel, contributing editor of University of Southern California’s Reporting on Health  newsletter, looked for contrasts between the Department of Consumer Affairs, which now oversees the state’s nurses, and the Medical Board of California. Reporting for the Orange County Register on the Medical Board’s seeming unwillingness to police its licensees, he contacted the Department of Consumer Affairs and found the department’s staff to be surprisingly competent. “For every 100 licensees they had under their jurisdiction, they had fewer investigators than the medical board. But they were actually out looking for problems while the medical board was just waiting for complaints,” says Heisel.

Will California reprise its nursing board someday? Perhaps. What remains to be seen, however, is what will happen without the board in charge. Those in the nursing profession would be wise to heed this heads-up – a new corner that has been turned by a regulatory agency that has a reputation for taking abuses much more seriously than did the now-defunct nursing board. Look for more stringent enforcement from Consumer Affairs than was experienced with the BRN and as a result, an increase in proactive enforcement rather than reactive enforcement techniques. We may see increases in temporary suspension orders, increases in the severity of penalties imposed, and perhaps less willingness on the part of this regulatory agency’s to settle cases on terms more favorable to nurses.

Now a professional freelance, writer and journalist, San Francisco native Dena Kouremetis began her writing career during her 23 years in real estate industry. One of her passions is reporting on legal issues as they pertain to peoples’ livelihoods in the state of California.

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