A Sad Day For Nursing In California
This post will be a little different than my others. I’m not going to offer any great advice or offer any tips. Today, I just need to say that I am saddened and dismayed by the Board of Registered Nursing process and the decisions that they make regarding nursing in California. Today, two career Registered Nurses are going to surrender their registered nursing licenses because the BRN refuses to make allowances in their probation requirements for RN’s who have been working as nurses for 25 years or more. Actually, I am heartbroken that there wasn’t more that we could have done to help them and I am furious with the process.
Both of the RN’s are dealing with the ramifications of a Driving Under the Influence (DUI) conviction. This is the first offense for each. Each nurse is in her 50’s. Each nurse has been practicing for over 25 years without incident, one at the bedside, one as specialist in informatics. Clearly, these nurses are not a public risk. Clearly, they are not a public threat. Clearly, these DUI’s have no bearing in any way whatsoever on the ability of these nurses to continue doing what they do. But the BRN filed an accusation to revoke or suspend their RN licenses anyway.
I suppose that part is understandable. I suppose just the filing of the accusation makes sense, right? The BRN doesn’t know these women. They don’t know when they file the accusation that these nurses are 3 years or less away from retiring after having served as an exceptional California Registered Nurse for almost 3 decades, in their respective capacities. The BRN doesn’t know that the RNs have never had a work related complaint or issue and that each has an exemplary career and has acted as a preceptor and trainers for countless other RNs. All the BRN sees is the conviction come in from the DOJ as a result of the RN being Live Scan fingerprinted and a file gets created and goes to the BRN’s enforcement division to begin the disciplinary process. The beginning of the process is for the BRN to assign the matter to a Deputy Attorney General who then files an accusation calling for revocation or suspension of the license. I guess I can live with that. At this point, I suppose that seems fair: everyone is in the same boat.
It is this next part that I CANNOT live with. Once the accusation is filed the RN has the opportunity to argue that her license should not be revoked or suspended. She hires an attorney to help her navigate the complexities of the Accusation process. The nurse submits mountains of mitigating evidence to show that this is a first offense, that there has been an exemplary career without incident, that the nurse has been an RN for over 25 years and that the nurse is close to retirement. This information is reviewed by the same deputy attorney general and then submitted to the BRN itself to show why this particular nurse should not have their license revoked or suspended.
And do you know what the BRN does? Do you know what they offer to these nurses in lieu of revoking a 25 year old RN License? They offer the exact same probation terms to these 2 nurses that they would have offered to a nurse who had purposely diverted medication from their hospital for months and months on end. They get the same offer as a nurse who has had 2 DUI convictions and has been fired from 4 hospitals. They get the same offer as a nurse who is 6 months out of school who had a DUI and took out a block’s worth of mailboxes. This is a problem. In short, it is a travesty.
The BRN and the State of California’s Department of Consumer Affairs slaps the exact same rules and restrictions and requirements on each and every nurse, regardless of the mitigating evidence they are able to provide. Why bother with the process BRN? Why require nurses to submit mitigating evidence to show that they are not a public threat if you are just going to cram the same cookie cutter discipline down their throats? Oh…. The RN may elect to go to a Hearing to get e better deal? Let’s look at that.
At a number of recent Hearings, our attorneys have been able to convince an Administrative Law Judge to lessen or omit certain requirements of probation for nurses such as the two I’ve been discussing. Rns with 20+ careers, who have been promoted up the ladder to Directors of Nursing or Charge Nurse positions, are asking that the BRN lessen the requirement of Probation #9 so that they can keep their jobs. The Judges are agreeing. Especially since the rationale for #9 is: The condition prevents the respondent from engaging in the practice of registered nursing in situations where there is no close supervision and/or where the respondent could have undue authority over others and access to controlled substances. If the RN isn’t being disciplined for diverting meds, what is the point of that rationale? Administrative Law Judges are coming back with reasonable decisions and recommendations to the BRN that the RN be placed on probation, but in light of her experience and career record, she be given some slack. I can live with this.
What I cannot live with is the BRN overturning the decision of a Judge and ruling on the record, or essentially saying “too bad, we don’t like that ruling, we are going to do what we wanted to do in the first place and you’re stuck with 1-19 for 3 years.” This has been happening to our clients recently and it is repulsive. Who are you BRN to overrule a Judge’s decision? You weren’t at the Hearing. You don’t know this nurse. You didn’t see her or hear her case. How can you just say “No?” And infuriatingly, the BRNs answer to me is the same answer that your parents gave you when you were a little kid: “because we can, and that is all there is to it.” And they are right. They can. And they are right. That is all there is to it.
The fact that the BRN can impose cookie cutter discipline and can overrule a judge’s decision does not make it right, nor does it make it any easier to live with… and that is why it is a sad, sad day for nursing in California. Because rather than use the process to get a fair result, 2 career California Registered Nurses are simply giving up, surrendering their licenses and retiring because at this stage in their lives, it isn’t worth fighting for.
Shame on you BRN. Shame on you DCA. Shame on you California.