Changes urged in discipline of problem nurses

The Minnesota Board of Nursing protects patients in its discipline of problem nurses, but the process can take so long that it puts patients at risk, according to a legislative auditor report released Thursday.

The audit recommended nearly two dozen improvements and reforms for the Nursing Board, the state's largest health licensing board.

The audit followed a Star Tribune investigation published in 2013 that found the Nursing Board frequently allowed nurses to practice despite records of unsafe care, patient harm and theft of narcotics from the workplace.

The report concluded the Nursing Board's disciplinary decisions "adequately protected the public," saying that the board between 2009 and 2014 "imposed suspensions more than any other form of discipline."

"If anything, the board has tended to err on the side of public safety in disciplining nurses," the audit said.

But the board takes an average of 200 days to suspend nurses, the audit found. In some cases, nurses facing suspension were able to work for a year or more after a complaint had been filed.

"This is troubling, because nurses can generally work while a complaint is being resolved," Jo Vos, the manager of the report, told a Minnesota House committee on Tuesday.

Rep. Tina Liebling, DFL-Rochester, said the report "vindicated" the Nursing Board's disciplinary actions. Liebling, who was one of the most vocal lawmakers calling for reform of the Nursing Board, noted that the legislative auditor was able to review nonpublic data to reach its conclusions. But Liebling said she was "deeply concerned" about how long it takes to suspend problem nurses.

"Please reassure me that that big concern that we all had last year is being addressed," Liebling asked Nursing Board director Shirley Brekken. "We want to know that when somebody flunks out of the HPSP that somebody's eyes are on that case immediately."

Brekken said the board was aware of the problem before the audit and is working on solutions. One of those, she said, is to immediately suspend a nurse perceived as a threat to the public. The Nursing Board took that action seven times in 2014, but only four times in the four years before that.

That was the intention of a law co-sponsored by Liebling last year that required all licensing boards to immediately suspend health professionals when they pose an immediate risk of harm. The legislation also revoked the licenses of nurses convicted of felony sex crimes, required employers to report nurses who have stolen drugs and required the HPSP to provide more information to the Nursing Board about nurses who have harmed patients.

The audit also found that the board is inconsistent when it disciplines nurses. Complaints were more likely to be dismissed when nurses were on the disciplinary panels, rather than a member who is not a nurse.

The auditor recommended that the Legislature give the Nursing Board greater authority to investigate and dismiss complaints.

Brekken told the House committee that the audit was valuable, and that the Nursing Board will work to implement many of the changes recommended.