Lawmakers in the House and Senate overwhelmingly support reforms to allow the Minnesota Board of Nursing to take more stringent action against problem nurses. But disagreements about the scope of reforms could stop them from becoming law.
The House version of the reforms approved Monday night by an 86-46 vote will require the board to suspend nurses who fail a state drug and mental health monitoring program unless they can prove they are not an imminent risk of harm to the public.
The House bill would also restructure the monitoring program in an attempt to make it more independent, said Rep. Tina Liebling, DFL-Rochester, who sponsored the bill.
The Senate bill, which passed 49-9, does not change the monitoring program. It also gives the Nursing Board more discretion on whether to suspend a nurse discharged from monitoring.
The Senate will have to pass another version of the bill before it can go to a conference committee with members from both chambers.
"It's possible we don't get anywhere," said Sen. Kathy Sheran, DFL-Mankato, who sponsored the Senate version of the bill. "That we can't get enough votes to accept our language, that they can't get enough votes to accept their language, and so we have no language referencing the Board of Nursing."
Last fall, Liebling and Sheran held a joint legislative hearing to determine what laws could better protect the public from troubled nurses. That followed a Star Tribune series that found the Nursing Board allowed nurses to continue to practice despite their histories of drug thefts and patient harm, criminal convictions or failed participation in state drug monitoring.
Since their hearing, Liebling and Sheran have taken different paths on the disciplinary reforms. Sheran said her bill initially started out as stronger, but "was whittled away not by me, but by members of the [Minnesota] Nurses Association and members of the Legislature."
In a statement, the MNA said it favors Liebling's version of the bill because it says the Nursing Board "shall act" to suspend licenses, yet encourages nurses to report voluntarily to state monitoring.
"The Minnesota Nurses Association has always favored the strongest policy toward the monitoring of health professionals with an addiction to controlled substances."
Both bills would revoke the license of a nurse convicted of a felony sex crime, and restrict the board from issuing a license to someone convicted of that offense. The board can only issue licenses to an individual convicted of a felony sex crime if certain conditions are met, including 10 years elapsing from the end of a criminal sentence.
Sheran and Liebling also don't see eye-to-eye on another bill pertaining to advanced practice nurses who want to practice without physician supervision, and other nurses who want to perform pain management procedures. Sheran sponsored and supports that bill, while Liebling is fighting against it.
That bill passed the Senate unanimously last week. A House version was indefinitely postponed Monday, after it was scaled back to only clarify the definition of an advanced practice nurse.
"There would be a whole category of practitioners where the only oversight will be from the Board of Nursing," said Liebling. "The Board of Nursing is struggling to supervise the people they already have."
Sheran said whatever differences she and Liebling have will not affect the outcome of nurse discipline reforms. While Nursing Board Executive Director Shirley Brekken assisted Sheran with the legislation on advanced practice nurses, Sheran said she remains committed to Nursing Board reforms.
"I'm the one person who has consistently communicated to the nurses who have been really putting barriers in front of efforts to strengthen the board, that I believe the board should have what they need in terms of authority in order to carry out their responsibilities," Sheran said.
Both chambers will have to approve any changes to nurse discipline reforms before the session ends May 19.