Business Goal of Enhancing Public Safety



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Business Goal of Enhancing Public Safety BOARD OF REGISTERED NURSING JANETTE WACKERLY, MBA, RN SUPERVISING NURSING EDUCATION CONSULTANT 916-574-7686

www.rn.ca.gov Board of Registered Nursing 1747 North Market Blvd., # 150 Sacramento, CA 95834 916-322-3350

L.A Times Articles: When Caregivers Harm: Problem Nurses Stay on Job s Patients Suffer Reform of California Nursing Board s Discipline System Shows Early Progress State Board Seeks Swifter Action Against Errant Nurses Loose Reins on Nurses in Drug Abuse Program Charles Orenstein and Tracy Webb http://www.propublica.org/series/nurses

Mission Statement Protection of the public shall be the highest priority for the Board of Registered Nursing in exercising its licensing, regulatory, and disciplinary functions. Whenever the protection of the public is inconsistent with other interests sought to be promoted, the protection of the pubic shall be paramount.

The BRN Oversees As of March 2012 RN 386,545 CNS 3,124 CRNA 2,094 CNM 1,220 NP 16,641 PHN 52,513 RN Psych/Mental Health listings 386 Continuing Education Providers 3,437

Licensing Program 2011-2012 Applications Licenses/Certs Registered Nurses Received Examination 27,227 Endorsement 9,496 Licenses 22,948 Issued Certificates 5,045

Board of Registered Nursing APPLICANTS AND LICENSEES WITH ENFORCEMENT ISSUES

Application for Licensure by Examination

Have You Ever? HAVE YOU EVER HAD DISCIPLINARY PROCEEDINGS AGAINST ANY LICENSE AS A RN OR ANY HEALTH-CARE RELATED LICENSE OR CERTIFICATE INCLUDING REVOCATION, SUSPENSION, PROBATION, VOLUNTARY SURRENDER, OR ANY OTHER PROCEEDING IN ANY STATE OR COUNTRY?

Have You Ever? IF YES, PLEASE PROVIDE A DETAILED WRITTEN EXPLANATION, INCLUDING THE DATE AND STATE OR COUNTRY WHERE THE DISCIPLINE OCCURRED. YES NO

Have You Ever? Have you ever been convicted of any offense other than minor traffic violations? If yes, explain fully as described in the applicant instructions. Convictions must be reported even if they have been adjudicated, dismissed or expunged or if a diversion program has been completed under the Penal Code or Article 5 of the Vehicle Code.

Have You Ever? HAD TRAFFIC VIOLATIONS INVOLVING DRIVING UNDER THE INFLUENCE, INJURY TO PERSONS OR PROVIDING FALSE INFORMATION MUST BE REPORTED. THE DEFINITION OF CONVICTION INCLUDES A PLEA OF NOLO CONTENDERE (NO CONTEST), AS WELL AS PLEAS OR VERDICTS OF GUILTY. YOU MUST INCLUDE MISDEMEANOR AS WELL AS FELONY CONVICTIONS.

Applicant File Review Process Applicant file review prior to July 2010 In July 2010 the application review process was evaluated and changes were made Applications with convictions or license discipline take longer to process

TOPIC Enforcement issues facing applicants and licensees.

Fingerprints FINGERPRINT RESULTS ARE DISSEMINATED AT DIFFERENT LEVELS DEPENDING ON THE ENTITY MAKING THE REQUEST

Applicants should be prepared to provide the following documents: Certified arrest (must be verified by arresting agency) and court documents for each conviction Have nursing student obtain certified documents as soon as possible to be submitted with their application for licensure Personal letter of explanation for each incident: Failed the exam; DUI; etc

Applicants should be prepared to provide the following documents: Why it happened, what is being done to prevent a reoccurrence Letters of Reference letters from people who knew you during the times of difficulty Work Evaluation(s) from clinical instructors for health related work as a nursing student

Applicants should be prepared to provide the following documents: IF EXAM IS FAILED, A 2 ND APPLICATION WILL BE REQUIRED REAPPLY TO TAKE THE EXAM AND GO THROUGH COMPLETE ENFORCEMENT PROCESS AGAIN

What Nursing Programs Can Do The school is a lower level screening that the BRN uses for licensure purposes It is recommended the nursing student review documents needed to provide background history prior to entry into the nursing program

What Nursing Programs Can Do Be mindful of students, accepted into the program, with a previous conviction Remind students to be truthful and factual in their letter of explanation to the BRN enforcement staff Letters of reference should come from individuals who are aware of any previous conviction(s) and can speak to the applicant s past history

What Nursing Programs Can Do Encourage students to submit all required documents at the time the application is submitted to the Board of Registered Nursing Promote alcohol free celebrations when students reach school milestones such as completing finals or graduation to avoid DUIs and other problems.

Documents Required Certified arrest and court documents for each conviction Personal letter of explanation for each incident Certified copy of any disciplinary action against a health care related license

License Renewal Licensees are required to disclose any convictions or discipline since the last time the California RN license was renewed

How is my personal life relevant to my professional life You are a nurse 24 hours a day, 7 days a week Nurses are held to a higher standard than the general public

How is my personal life relevant to my professional life WHETHER AN APPLICANT OR A LICENSEE, A NURSE S BEHAVIOR DIRECTLY IMPACTS PUBLIC PERCEPTION OF THE NURSING PROFESSION, NURSING SCHOOLS, AND THE ULTIMATE TRUST, WHEN PLACED IN OUR CARE.

Substantial Relationship Criteria CCR Section 1444 An act can be disciplined and can be considered to be substantially related to the qualifications, functions, or duties of a registered nurse, if to a substantial degree it evidences the present or potential unfitness of a registered nurse to practice in a manner consistent with the public health, safety, or welfare.

Grounds for Action Drug Related Transgressions B&P Code Section 2762 It is unprofessional conduct for a person licensed under this chapter to do any of the following:

B&P Code Section 2762 (a) Obtain, possess, or prescribe, except as directed by licensed MD, DDS, or podiatrist, to administer, furnish, or administer to another, any controlled substance, dangerous drug, or device.

B&P Code Section 2762 (b) Use any controlled substance, dangerous drug or device, or alcoholic beverages

B&P Code Section 2762 to an extent or in a manner dangerous or injurious to himself/herself, any other person, or the public or to the extent that such use impairs her/her ability to conduct with safety to the public the practice authorized.

Controlled Substances Obtained and Possessed in Violation of Law Inconsistent Entries in Hospital Records RN signed the name of another, falsely altered & forged a prescription for Norco. RN obtained Demerol by fraud & deceit by taking the drug from hospital supplies. RN made grossly incorrect & inconsistent entries in hospital and patient records. When tested by hospital RN s sample was 100% water. When tested again, during our investigation, RN admitted to using her 4 year old son s urine. License Revoked

B&P Code Section 2762 (c) Be convicted of a criminal offense involving the prescription, consumption or self-administration of, any substance described in (a) or (b),

B&P Code Section 2762 or possession of, falsification of a record pertaining to, the substances described in (a), in which event the record of conviction is conclusive evidence

Conviction of Crimes Substantially Related to the Qualifications, Functions and Duties of a Registered Nurse RN left the scene of a hit and run accident. Later, RN admitted that he had hit the rear of a vehicle and would pay for the damages. While speaking, officers noticed slurred speech, bloodshot eyes and unsteady gait. RN was transported to Police Department for blood test. BAC.29% Loaded revolver, with hammer cocked, was recovered later from RN s vehicle. License Revoked

Alcohol Use and Abuse Drug Use and Abuse misuse of prescription drug Theft Boundaries and/or Sexual Offenses Internet Posting Twitter, Facebook

Enforcement Statistics 2011-2012 Complaints Received Licensee Disciplinary Actions: Revocation 121 Probation 131 Suspension/Probation 10 License Surrendered 73 Public Reprimand 3 Other Decisions 1 Total, Licenses Disciplined 339

Enforcement Statistics 2011-2012 Applicant Disciplinary Actions: License Denied 17 License Issued on Probation 10 Total, Applicants Disciplined 27

Additional Information for applicants with enforcement issues can be found on our website: www.en.ca.gov/enforcement/enfappdesk.shtml www.rn.ca.gov/applicants.licfaqs.shtml#disc

QUESTIONS???

"Nursing is a work of Heart! anonymous BOARD OF REGISTERED NURSING J A N E T T E WAC K E R LY, M BA, RN S U PE RV I S I N G N U R S I N G E D U C AT I O N CO N S U LTA N T ( 9 1 6 ) 5 74-7 6 8 6