1,000 Nurses Call on Congress to Act Now on Patient Safety

Gathering Highlights Growth of National Nurses Movement

More than 1,000 registered nurses from across the country rallied in Washington DC Wednesday, raising an unprecedented, unified voice for patient safety reforms and new, national standards for patient care conditions and standards for nurses.

The event was sponsored by the nation’s largest nurses’ union and professional association, the 155,000-member National Nurses United, which came to Washington to press the case for quality of care legislation that was not part of the national healthcare bill enacted earlier this year, and to build on the unity of RNs who are NNU members from coast to coast.

In addition to a march, rally, and conference, the RNs visited nearly 100 members of Congress, prodding legislators to work on the unfinished business of healthcare reform, quality of care and patient safety. The actions coincided with National Nurses Week.

Noting recent national attention on the West Virginia mining disaster and the Gulf Coast oil spill, NNU Co-President Jean Ross, RN said that “similar accidents happen every day away from the media spotlight in U.S. hospitals and other healthcare settings. It’s time to act to protect our patients and our communities.”

"We're the voice of not only nurses but patients across the country,” said NNU Co-President Karen Higgins, RN. “When we leave this room I want everyone to remember that. When it comes time to make decisions about healthcare and people say 'leave it to the experts,' tell them 'I am the expert.' "

Among the legislative solutions are S 1031/HR 2133 that would, among other components, establish minimum ratios of nurses to patients for all U.S. hospitals, modeled after a successful California law, and S 1788/HR 2381 which would also promote nurse retention and reduce patient accidents and injuries by establishing safe patient lifting and handling policies.

Sen. Al Franken of Minnesota, author of S 1788, hosted a hearing on the bill Tuesday at which several nurses on hand for the week cited experiences that demonstrated the need for the bill.

Speaking Wednesday to an NNU rally across from the Capitol, Franken told the RNs, "You are the ones we look to for advice, comfort, expertise and care. You are tireless advocates for the country's well-being. You're the ones we trust to care for our loved ones, that's what your expertise is, and it's simply unacceptable that you're putting your own health on the line to care for patients."

"Now it's time to make sure that all nurses in all states have access to a safe workplace. One injured nurse is one too many. Employers have a fundamental obligation to put in place a safe working environment for all workers and nurses are no exception," Franken said.

Rep. Lynn Woolsey of California, speaking to the nurses, also emphasized why the bill is needed, "We don't need to create another patient in the process of caring for one."

U.S. Labor Secretary Hilda Solis, who also addressed the conference, told the nurses that more than 36,000 health care workers were injured by lifting and transferring patients, according to 2008 Bureau of Labor Statistics data. In addition, she said, 12 percent of nurses who plan to leave the profession cited back injuries as a contributing factor.

“What a waste when the career of an experienced nurse is ended years or decades too early because of an easily preventable back injury,” Solis said. “In these days of ever-rising health care costs, what a waste of money to pay workers compensation and disability for easily preventable back injuries.”

S 1031 author Sen. Barbara Boxer of California and HR 2133 author Rep. Jan Schakowsky of Illinois also spoke the NNU event about the ratio legislation which, according to a groundbreaking study from the University of Pennsylvania released last month, could have cut post-surgical patient deaths by 14 percent in New Jersey and 11 percent in Pennsylvania, two comparable states the researchers compared to California.

"We know that nurse-to-patient ratios work, and it is time to enact them around the nation. California was the testing ground and it's working," Boxer said. "Too often you are overworked because of staffing levels that are inadequate and that is unacceptable."

The Penn study, from noted researcher Linda Aiken, RN, PhD, documents “what California nurses have seen every day at the bedside since passage of the law -- safer care conditions, an enhanced quality of life for patients, and, as an added bonus, reduced burnout for nurses which mitigates the nursing shortage,” said California RN and NNU co-president Deborah Burger.

NNU is also seeking passage of HR 949/S 362 to restore equal collective bargaining rights for Veterans Affairs nurses.

Strengthening the rights of direct care RNs and their ability to more effectively advocate for patients and their colleagues, was another major theme of the NNU gathering.

"We've got to say something in a united way that tells employers it's a new day in America and RNs are going to stand up and not take it anymore," NNU Executive Director Rose Ann DeMoro said.

The RNs unanimously endorsed a resolution to establish national collective bargaining standards that notes the growing attack by many hospital employers against nurses and patient safety conditions.

The resolution notes that NNU will oppose “concessionary agreements that are injurious to our patients, our members, and our profession that undermine all represented RN contract standards” that include reductions in health coverage, pensions and other retirement security, two-tier programs for new hires, and reductions that impair patient safety.

Additionally, the resolution pledges NNU to fight for enhanced RN staffing and other improvements in patient care standards, improved retirement security for RNs, limits on the introduction of new technology that displaces RNs or RN professional judgment, and additional workplace safety measures.

Texas Nurse On Trial After Reporting Doctor

February 8, 2010 A nurse in Texas is standing trial for reporting a doctor she thought was practicing bad medicine. Prosecutors have charged 52-year-old Anne Mitchell with making inflammatory statements about a doctor at a rural hospital in Kermit, Texas. She faces up to 10 years in prison. Mitchell says she was just trying to protect her patients. Kevin Sack of The New York Times says much of the case stems from local politics.



http://www.npr.org/templates/story/story.php?storyId=123502251

Schwarzenegger Replaces Most of State Nursing Board
by Tracy Weber - July 13, 2009 9:55 pm EDT
Tags: Arnold Schwarzenegger, California, California Board of Registered Nursing, Nurses


California Gov. Arnold Schwarzenegger (John Moore/Getty Images)California Gov. Arnold Schwarzenegger replaced nearly everyone on the Board of Registered Nursing late Monday, citing the unacceptable length of time it takes to discipline nurses accused of egregious misconduct.

Correction (July 14, 2009): This story incorrectly referred to former Board of Registered Nursing vice president Elizabeth O. Dietz as a professor of nursing at San Jose State. Although the board’s web site lists that as her current affiliation, the university said she retired in July 2008.

Update (July 14, 2009): Nursing Board Executive Officer Ruth Ann Terry Resigns [1]
Gov. Arnold Schwarzenegger replaced most members of the California Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious misconduct.

He fired three of six sitting board members [2] – including President Susanne Phillips [3] – in two-paragraph letters curtly thanking them for their service. Another member resigned Sunday. Late Monday, the governor's administration released a list of replacements.

The shake-up came a day after the Los Angeles Times and ProPublica published an investigation [4] finding that it takes the board, which oversees 350,000 licensees, an average of three years and five months [5] to investigate and close complaints against nurses.

During that time, nurses accused of wrongdoing are free to practice – often with spotless records – and move from hospital to hospital. Potential employers are unaware of the risks, and patients have been harmed as a result.

Reporters found nurses who continued to work unrestricted for years despite documented histories of incompetence, violence, criminal convictions and drug theft or abuse. In dozens of cases, nurses maintained clean records in California even though they had been suspended or fired by employers, disciplined by another California licensing board or restricted from practice by other states.

"It is absolutely unacceptable that it takes years to investigate such outrageous allegations of misconduct against licensed health professionals whom the public rely on for their health and well-being," Schwarzenegger said in a written statement.

Board member Andrea Guillen Dutton, in a resignation letter Sunday [6], said she was leaving in frustration. "Certain ‘bad actors' are jeopardizing the reputation of the entire nursing profession," she wrote. "This deeply saddens me."

"I have fought to defend the integrity of patient care throughout the state by holding the negligent accountable," she wrote. "However, I have grown increasingly frustrated by the board's lack of ability to achieve its stated objectives in a timely and efficient manner."

Besides Phillips, the other fired board members were vice president Elizabeth O. Dietz, a former professor of nursing at San Jose State, and Janice Glaab, a public affairs consultant.

Schwarzenegger's action Monday fills two of three vacancies on the board [2] and replaces four of the board's sitting members – all of whom had been appointed by him.

The two remaining members are Nancy L. Beecham, appointed by the governor in 2006, and Dian Harrison, who was appointed last year by Assembly speaker Karen Bass.

Neither Beecham nor Harrison could be reached late Monday, nor could any of the departing board members.

Schwarzenegger's statement said his "administration is dedicated to protecting public health and safety, and the new board will act quickly and decisively to achieve that goal."

Fred Aguiar, secretary of the State and Consumer Services Agency, said in an interview that the new board would be asked immediately to come up with a plan to eliminate the case backlog. "This plan needs to include how many more investigators are needed, how much that will cost. … I want to know now."

California Board of Registered Nursing executive officer

Ruth Ann Terry (Liz O. Baylen/Los Angeles Times)


The governor's decision does not directly affect the standing of Ruth Ann Terry, who has been the board's executive officer for nearly 16 years and a staff member for 25. Only the board has the power to hire and fire the executive.
Terry, reached late Monday, hung up on a reporter, saying, "We don't have anything to say."

But Aguiar suggested Monday that Terry and other staffers could be vulnerable. The governor "supports the new board in its commitment to protecting patients – and if that means cleaning house, including board staff, so be it," he said. "The days of excuses and status quo are over. It's broken and we're going to fix it."

The Times and ProPublica

In an interview last week, Terry acknowledged that the system needed to be "streamlined" but blamed other parts of the state's bureaucracy for delays.

Early Monday, Terry and her assistant executive officer, Heidi Goodman,

"Ruth and I are aware of the grim picture painted by this article," they wrote, "however, the board members, managers and supervisors know that you work very hard to carry out the mission of the board to protect the healthcare consumers in California and we appreciate all that you do."

Presented with the investigation's findings Thursday, board President Phillips, a family nurse practitioner and associate clinical professor at UC Irvine, said she supported Terry "absolutely – without question."

"The issue of patient safety is of the utmost importance to this board," she said. "It's not that we are ignoring a situation where there are delays. We absolutely are not."

Questions about the board's leadership were first raised last fall

In addition to the governor's action, the state Senate Business and Professions Committee, which has jurisdiction over the board, plans to hold a hearing next month to address the issues raised in The Times' article.

The committee will look at introducing legislation that would appoint an "enforcement monitor" to evaluate the board's discipline process and make recommendations, said Bill Gage, the committee's chief consultant. Such a monitor was appointed at one time to work with the Medical Board of California, which regulates the state's doctors.

Consumer advocate Ken McEldowney said the board members need to do more than just fill seats.

"The leadership is key," said McEldowney, executive director of Consumer Action, a San Francisco-based national consumer advocacy and education membership organization.

"It just appears to me that they don't care."

The six new board members are: Ann Boynton, 47, of Sacramento, a former undersecretary for the Health and Human Services Agency; Judy Corless, 58, of Corona, a clinical nursing director at the Corona Outpatient Surgical
Center since April 2009; Jeannine Graves, 49, of Sacramento, a staff nurse for the Capitol Surgical Associates and the Mercy San Juan Medical Center; Richard Rice, 60, of Imperial Beach, a former chairman of the Unemployment Insurance Appeals Board; Catherine Todero, 57, of La Mesa, director of the school of nursing at San Diego State University and a professor there; and Kathrine Ware, 50, of Davis, a nurse practitioner for the Vascular Center Clinic at the University of California Davis.

These positions do not require Senate confirmation, and the compensation is $100 per working day.


[8] when The Times and ProPublica reported that nurses with serious or multiple criminal convictions kept their licenses for years before the board acted against them. As a result, the board now requires every nurse to submit fingerprints [9], which can be matched against arrest records. Renewing nurses must also disclose any convictions or discipline by other states.sent an e-mail to all board staff members encouraging them not to lose heart [7].found that the board relied heavily on Terry and her staff [4]. At five public meetings attended by reporters since November 2007, Terry never focused on the delays in disciplining errant nurses. Neither did board members, even though they must vet all disciplinary actions.