State lawmakers are calling for an investigation of the Minnesota Board of Nursing's disciplinary practices, saying more needs to be done to protect patients from potentially dangerous nurses.
The head of the Senate committee that oversees licensing boards, Kathy Sheran, DFL-Mankato, said she will seek an audit of the board and a legislative hearing to examine the board's actions.
"We need to determine … that the process of reviewing complaints creates an outcome that assures public safety to the best of our ability," she said Friday. "How can we strengthen it? How can we do it better?"
The call for scrutiny follows a Star Tribune report Oct. 6 that the Nursing Board has forgiven or tolerated misconduct in Minnesota that would end careers in other states, based on a review of more than 1,000 disciplinary actions taken since 2010. Since that time, the newspaper found that the board has actively licensed more than 260 nurses who have records of unsafe practice, including botched care that led to patient harm or even death.
"If there are gaps in the disciplinary process, we want to know about it and improve upon it if we can," Nursing Board Executive Director Shirley Brekken said Friday. "The board is always looking at its processes from a variety of perspectives, not only efficiencies, but effectiveness."
A Star Tribune review of board actions released on Wednesday found an additional 23 cases where the board allowed a nurse accused of patient harm or unsafe conduct to continue to practice. That includes Mary Clausen, who was found to be "deliberately indifferent" by a federal jury last December in the care of a former Ramsey County inmate who nearly died from tuberculosis.
The inmate, Marchello McCaster, lost 41 pounds in 54 days in custody, had to have the lining of his heart removed, and still has significant health problems, said McCaster's attorney, Bob Bennett.
About 150 others required treatment including hospitalization after contracting either latent or active tuberculosis, Bennett said.
Clausen was also discharged for noncompliance from a state program that was monitoring her efforts to overcome alcohol dependence, according to the board report.
Clausen's attorney, Robert Mahoney, declined to comment because her case involved patient care.
Another nurse, Frederick Strege, was allowed to keep his license despite the board finding that a vulnerable adult protection order had been issued against him.
In February 2010, a court in Washington state found Strege financially exploited his mother, and "engaged in conduct constituting mental abuse" of her, the order said. Strege denied the allegations, according to the Minnesota Nursing Board.
The board also reported that Strege had more than $145,000 in judgments entered against him related to his mother.
The board ordered him to pay a $1,000 fine, take continuing education courses, and file a report with the board addressing what he learned.
Protecting the public
Sheran, chairwoman of the Senate Health, Human Services and Housing Committee, met this week with Brekken. Sheran said she came away with concerns that the board doesn't have the resources it needs to handle the volume of complaints it receives and that the staff and board members may need training to emphasize the responsibility of protecting the public.
"There may be multiple reasons for why the outcomes may be falling short of what our goal is," Sheran said.
Sheran and Rep. Tina Liebling, DFL-Rochester, chairwoman of the House Health and Human Services Policy Committee, said they will ask Brekken to testify at a joint hearing of both committees.
They said they will also ask the Legislative Auditor to examine the Nursing Board and other health professional licensing boards with a similar approach to discipline.
"I expect there will be a number of findings and suggestions for change," Sheran said.
"We need to understand more about how they strike this balance between protecting the public and making sure that people who can be rehabilitated and practice safely under certain conditions, that they monitor those conditions," Liebling said. "There is a balance to be struck there."
Brekken said she welcomed the chance to testify at a hearing and participate in the audit, saying she initially proposed it to Gov. Mark Dayton.
The governor said in an Oct. 4 interview that "it would appear the board is more interested in protecting bad nurses than the public."
Dayton's spokesman, Matt Swenson, said Friday that "pursuing an [Office of the Legislative Auditor] review is an appropriate next step and one the governor strongly supports."