Dayton: Minnesota Board of Nursing 'asleep at the switch'

With audit proposed, governor said board needs to change its culture regarding discipline.

Gov. Mark Dayton said Monday that some members of the Minnesota Board of Nursing have told him they do not feel qualified to question the board’s staff when they review discipline cases of nurses accused of misconduct.

Calling the Nursing Board “asleep at the switch,” the governor said that dramatic steps may need to be taken to change its culture. He also said the Nursing Board staff’s statements at a legislative hearing last week that it needed more authority to discipline nurses were “finger-pointing” and “very difficult to believe.”

Dayton’s comments reflect growing expressions of concern over the Nursing Board’s disciplinary practices after recent reports in the Star Tribune. With support from the governor and key lawmakers, legislative auditor James Nobles said he now is preparing for a comprehensive investigation of the board.

The governor said Monday it was “premature” to say whether he would remove any board members but said “I want their assurances that they will immediately change their attitude and approach to situations.”

In an analysis of thousands of Nursing Board records, the Star Tribune has reported how some nurses have kept their licenses despite neglecting patients, stealing drugs from them or practicing while impaired. A member of the Nursing Board presides over each disciplinary hearing and participates in the decision on how to sanction the nurse.

Nursing Board Chairwoman Deborah Haagenson said she had never been told before that members didn’t feel comfortable questioning staff.

“If board members feel that there is a need for additional training, we certainly would want to know that and work to provide that,” said Haagenson, a registered nurse and a vice president of a Park Rapids, Minn., hospital.

Dayton said he would wait until meeting with the board and an audit is completed to decide what steps to take to correct problems he sees with the board’s culture. He can fill two open vacancies to the board, but he said he is concerned that will not be enough.

“Once you have a certain ethic established, good or bad, you replace two or three people” and nothing really changes, Dayton said.

The governor said he was unhappy with the board staff’s responses to legislators during a hearing last week.

“The board was saying they have no training and the staff said they have no authority,” he said.

Dayton said if the board staff was aware of fixes that could be made or had resource concerns, those issues had never been expressed to him as he prepared the last two budgets.

Dayton said he has spoken with “a couple” of board members from outstate Minnesota who said they do not feel that they have adequate training to question recommendations of the board staff. The Star Trib­une could not reach board members from outstate Minnesota on Monday.

Board Member Christine Norton, from Cottage Grove, said she has never had a problem questioning board recommendations. “And I have never been made me to feel as if I shouldn’t have spoken out,” Norton said.

Shirley Brekken, the Nursing Board director, said Monday she had not heard of those concerns from either the governor or board members, and declined to comment until she could verify the statements.

The heads of the state House and Senate committees that oversee the Nursing Board have already called for an audit. Joining those calls on Monday was House Majority Leader Erin Murphy, DFL-St. Paul. The latest reports “leave some questions about what is happening with current practice,” said Murphy, a nurse and former executive director of the Minnesota Nurses Association. The union last week also called for more scrutiny of how the state disciplines nurses.

Nobles said Monday that a legislative commission has to approve all audits, but he suspects that approval is forthcoming. With full access to the board’s records, Nobles said his office will review the board’s disciplinary actions and see how they compare to other state licensing boards and national standards. Nobles said an audit will also look at the practice of referring health care professionals with substance abuse and other health issues to state monitoring.

An audit would likely start in March, conducted by a team of two to three people and would take six months, he said.

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