Building Back Better: Constructive Nursing Regulation

As governor of the first COVID-19 epicenter in the country, Andrew Cuomo challenged New Yorkers to think about how the state could “build back better” after the crisis. As registered nurses with experience in health law and policy, we have recommendations for transforming the boards of nursing. The manner in which nurses are regulated must be reformed, not just in New York, but throughout the country. It must begin by understanding the dangerous environments in which nurses are working.

Staffing, safety issues affect both nurses and patients.

In May, for example, Governor Cuomo reported that 12.2% of health care workers in New York city had been diagnosed with COVID-19. Nationwide, more than 164 nurses have died, often because they lacked adequate personal protective equipment. But COVID-19 is not the only dangerous situation. Long-term and psychiatric care facilities, as well as hospitals, are often dangerously understaffed, exposing nurses to violence. Nurses and other workers have been attacked and sometimes killed because they lack necessary resources and protections. Workplace violence is a growing threat which has not been adequately addressed by health care managers and administrators. Danger to patients occurs when nurses are expected to accept assignments outside of their areas of expertise. Nurses cannot care […]

2020-07-27T07:08:18-04:00July 27th, 2020|Nursing, nursing career, nursing perspective, patient safety|2 Comments
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Top 10 New AJN Posts of 2012

British Nurse and Baby, via Flickr/jdlasica British Nurse and Baby, via Flickr/jdlasica

By Jacob Molyneux, AJN senior editor/blog editor

Maybe, who knows, some social media content isn’t really quite as ephemeral as we usually believe. Some of our posts seem to keep finding readers, like 2009’s “New Nurses Face Reality Shock in Hospitals–So What Else Is New?” They’re still relevant and timely, addressing as they do some of the more perennial topics in nursing.

Our 20 most-read posts for the year include several others that aren’t “new” this year: “Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life”; “Confused About the Charge Nurse Role? You’re Not Alone”; “‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses”; “Is the Florence Nightingale Pledge in Need of a Makeover?”; “Do Male Nurses Face Reverse Sexism?”; “Fecal Impaction and Dementia: Knowing What to Look for Could Save Lives”; “Are Nursing Strikes Ethical? New Research Raises the Stakes”; and “One Take on the Top 10 Issues Facing Nursing.”

The upstarts. Putting aside posts that have shown a certain longevity, here are the top 10 new posts of 2012, according to our readers, in case you missed them along the way. Are they our best posts of 2012? We will leave that to you. Thanks to everyone who wrote, read, and commented on this blog over the past year.

1.

2016-11-21T13:08:45-05:00December 12th, 2012|healthcare social media|0 Comments
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What You May Not Know About Nurse Licensure

This month’s Legal Clinic installment in AJN is called “Common Misconceptions About Nurse Licensure.” Author Edie Brous, a nurse and attorney, lists these misconceptions:

  • 1. Nursing boards are nursing advocates. Not so, says Brous; they’re there to protect the public. “Because nurses care for vulnerable populations, the state that issues a nursing license has a social contract with the public to ensure that the licensee is qualified, competent, and ethical.”
  • 2. Private Conduct Isn’t Relevant to One’s Performance in a Professional Capacity. In fact, it can matter to a nursing board. The reasoning: “Conduct that reflects questionable judgment, impairment, or lapses in moral character may suggest to the board that a nurse poses a potential threat to the health, safety, and welfare of the public.” Ever neglect payment of student loans, child support, or taxes; have a substance abuse problem; commit a crime? It might be relevant.
  • 3. Disciplinary action taken by a state pertains only to that state. Not so: there’s a computerized system called Nursys (Nurse System) where nursing boards enter actions they take against a nurse and learn about actions taken elsewhere.
  • 4. Licensure is a right. “Rights are entitlements that are considered inherent and inalienable so they cannot be revoked, but privileges are granted by the state and are therefore conditional. As such, a nursing license may be restricted or revoked upon determination that the license holder poses a risk to the public.”

The article goes into more detail […]

2016-11-21T13:09:05-05:00October 19th, 2012|career, nursing perspective|9 Comments
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What to Do If the Nursing Board Takes Action Against You: A Lawyer and Former RN Advises

At 7 AM, when RN Michelle Flacco took over the care of 66-year-old Lester Scanlon, who had dementia and type 1 diabetes, she was notified that his blood glucose level was significantly elevated, at greater than 550 mg/dL. Ms. Flacco performed blood glucose tests three times during her shift, each time after Mr. Scanlon had eaten a meal, and each time his blood glucose level was elevated. However, Ms. Flacco didn’t notify Mr. Scanlon’s physician, nor did she administer insulin to the patient. The next shift, Mr. Scanlon was found unresponsive, with a very elevated blood glucose level. He was diagnosed with diabetic coma. The incident was reported to Ms. Flacco’s state board of nursing, and she was accused of professional incompetence. The board is seeking revocation of her RN license.

That’s the opening of “You’re Being Investigated by Your State Nursing Board” in the June issue of AJN. The case described is a composite, but it illustrates a situation that a nurse can find herself or himself in. The article, currently open access, is by Margaret E. Mangin, who practiced nursing for 12 years before becoming an attorney. For the past 26 years, she has practiced law in San Diego, primarily defending hospitals, nurses, and other health care providers. This is the latest installment of our Legal Clinic column. You might want to check it out. The table below gives the most frequent licensing violations, 1996 to 2006.

2016-11-21T13:09:59-05:00June 1st, 2012|nursing perspective|4 Comments
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Boards of Nursing and the Amanda Trujillo Case

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Amanda Trujillo

Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, “White Coat’s Call Room,” which has vowed to carry all the details once the case is decided.

One complaint raised by several people in response to our post was that the Arizona Board of Nursing wasn’t supporting Amanda. State nursing or medical boards are regulatory boards that exist to ensure the protection of the public and to regulate professional practice according to the law (in nursing’s case, according to nursing practice acts). They do not aim to protect the individual nurse, but to assure that all those who claim to be nurses are eligible to claim that title and practice within their scope of practice as defined by law.

Some historical context: Regulatory boards were set up back in the early 1900s, after nursing associations successfully lobbied for registration laws to keep out unqualified women who posed as nurses. In 1903, North Carolina was the first state to enact a nurse practice act; by the mid-1920s, all 48 states had laws regulating who could practice and who could use the title “registered nurse.”

Thus, boards of nursing are intended to protect the consumer and the […]

2016-11-21T13:10:42-05:00February 17th, 2012|Ethics, healthcare social media, Nursing|12 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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