The Nursing Board also regularly seeks to reach an agreement with a nurse, so it can avoid a potential costly court fight, Brekken said.
“Certainly, there are instances when the order may not be as strong as the board initially proposed,” she said.
Brekken said the board is also guided by Minnesota’s Criminal Rehabilitation Act. That law, passed in 1974, directs almost all state licensing boards to allow professionals with convictions to practice if they can show they have been rehabilitated.
The board has required hundreds of actively licensed nurses to be monitored by the state or has limited where they practice as part of their discipline. In other cases, Brekken said, continuing education is more appropriate for nurses who make mistakes.
The only conduct that results in a mandatory suspension for a nurse in Minnesota is failing to pay taxes or child support.
Sometimes suspending a nurse’s license is the appropriate response, Brekken said. She pointed to the case of William Melchert-Dinkel, who lost his license in 2009 after he was accused of going on Internet chat boards, posing as a female nurse and encouraging people to commit suicide. Prior to that, Melchert-Dinkel was disciplined twice by the board and allowed to keep his license, records show, including after he was disqualified from providing direct patient care by the state Department of Human Services for physically abusing nursing home residents.
The board also has reinstated licenses at least 100 times since 2008.
One of those was Donna Evjen, who sent a phony letter in Brekken’s name to her boss explaining a board action. Records show Evjen was also fired from a nursing job after her employer discovered discrepancies in her handling of narcotics, and she lost another job for poor performance and lied to the board about it. In May 2012, Evjen also tested positive for cocaine before taking a job. The board met with Evjen in January and allowed her to keep her license, even after finding she may have gotten the cocaine from a vulnerable adult. She is not allowed to work in a supervisory position.
Giving troubled nurses a second chance “is part of living in the United States,” said former board member Kristina Malone, a licensed practical nurse.
“We try to believe in second chances if there’s a reasonable expectation that that person has done what they should to fix whatever was going on in their life and they’re going to be safe again,” she said.
Edie Brous, a nurse and attorney who represents nurses in front of boards in Pennsylvania, New York and New Jersey, reviewed more than 20 disciplinary cases for the Star Tribune and concluded that Minnesota is not nearly as punitive compared to those states.
“If you’re using nitrous oxide on the job [or] having sex with patients, you’re done,” she said, referring to misconduct that hasn’t cost Minnesota nurses their licenses. “In my states, that license would be revoked.”
Dayton called the board justifying its actions under the Criminal Rehabilitation Act a “cop-out.”
“If the law is outdated or defective or incomplete and somebody dealing with that law, if it prevents them from doing what they should be doing responsibly, then their responsibility is to communicate that to the governor’s office, to the chairs of the House and Senate committees with that responsibility to change the law,” he said. “And the fact that they don’t take responsibility for what they’re doing is a real danger sign right there.”
Neglected, still licensed
Elda Bothun felt in such good health at 83 that she had gone two years without a checkup. The Richfield woman retired in her late 70s after a lifelong nursing career and devoted herself to cooking, playing bridge, knitting, volunteering and spending time with her husband. When she did see a doctor, tests discovered a bulging blood vessel in her abdomen.
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