Problem nurses would face license suspension, stricter state oversight
Minnesota Senator Kathy Sheran, right, and House member Tina Liebling, left, of the House Health and Human Services Policy Committee and Senate Health, Human Services and Housing Committee listened in during a review of the Board of Nursing's licensing and disciplinary processes Wednesday, Nov. 13, 2013.
Legislators overwhelmingly passed new measures to tighten the state’s oversight of problem nurses, requiring immediate license suspensions when they put patients at imminent risk. The bill now awaits the approval of Gov. Mark Dayton.
The legislation follows a Star Tribune investigation last fall that found the Minnesota Board of Nursing often failed to remove dangerous nurses from practice, prompting Dayton to say in November that the Nursing Board was “asleep at the switch.”
The series of articles prompted a joint legislative hearing, at which the Nursing Board said it needed more disciplinary authority and more information about problem caregivers from employers and a state drug monitoring program.
Despite bipartisan support, key differences in the House and Senate bills threatened to derail the reforms, until legislators reached a compromise earlier this week. The final bill adopted the stronger language from the House that would force the Nursing Board to more quickly investigate complaints and suspend the licenses of problem nurses. In exchange, House members dropped reforms they sought of the state monitoring program.
The House sponsor of the bill, Rep. Tina Liebling, DFL-Rochester, said that if the legislation is signed by the governor, it will be the first of many steps needed to reform the Nursing Board. She said the Legislature may also look to make changes to other health boards in the wake of the revelations about the Nursing Board.
“We need to make sure that everybody is meeting a high standard,” Liebling said.
The Star Tribune series revealed that since 2010, 260 nurses were still allowed to practice despite harming patients, stealing drugs or lying about their criminal histories. The Nursing Board currently can decide whether to suspend nurses it believes pose a risk to patients. The new legislation takes that discretion away by requiring immediate suspension if the Nursing Board has probable cause to believe that the nurse presents an imminent risk of harm to patients.
That change applies to all health licensing boards, although it will be up to each one to determine imminent risk of harm. If a board has not investigated a case and made a final decision in 60 days, the suspension will be lifted.
Nursing Board Executive Director Shirley Brekken could not be reached for comment Friday.
The Star Tribune also found that nurses can spend months in the monitoring program while missing or failing drug tests. If they were kicked out of the program, it could take many more months for the Nursing Board to act. The newspaper discovered 67 nurses for whom the monitoring program became a revolving door, as they failed out of the program, only to be sent back.
More than 100 nurses were still licensed despite criminal histories that would bar them from providing direct care, the Star Tribune found through a review of state records. That finding prompted the Department of Human Services to disqualify 72 nurses from working with patients.
Last week, the Legislature passed a separate law expanding background checks for up to 200,000 care providers.
Other measures in this week’s bill that supporters say will improve patient safety:
• Revoking licenses of nurses convicted of felony sex crimes, unless they have met standards to show they are safe to practice.
• Requiring employers to report to the board nurses who have stolen drugs.
• Requiring the monitoring program to report to their licensing boards care providers who harm patients, steal narcotics, or abuse drugs or alcohol on the job.
• Allowing all health boards to discipline care providers who flunk out of the monitoring program.
Early versions of the bill required the monitoring program to report more information about its participating health professionals, but critics said that could discourage use of the program and stigmatize drug addiction.
The Legislature also authorized its auditor to examine whether the Nursing Board and the state monitoring program are adequately protecting patients. That report should be completed before the beginning of the next session.
“I’m sure we’ll be revisiting this next year to see if the reforms have worked, and to look at the board based on what the [legislative auditor] tells us,” Liebling said.
The Senate sponsor of the bill, Sen. Kathy Sheran, DFL-Mankato, said she wanted to wait for the auditor’s report before proposing additional legislation.
The legislation that was passed on Thursday also enjoyed support from the Minnesota Nurses Assocation, the state’s largest nursing union. Although last year, the MNA accused the Star Tribune of waging a smear campaign against nurses, the union on Friday praised the legislation.
“Its measures will help enhance the protection of patients,” the MNA said, “and it rightfully treats substance use disorder as a chronic, manageable disease.”
Brandon Stahl • 612-673-4626