Nurses say state shortchanges licensing board

Georgia nurses are concerned that lack of funding for their state licensing board will create problems in protecting patients from an impaired, unlicensed or dangerous nurse.

A new law that goes into effect Monday will require nurses to report suspected professional violations to the Georgia Board of Nursing. But the Georgia Nurses Association (GNA) says the budget for the state’s nursing board is not sufficient to allow for proper regulation of their profession.

Currently, average licensure fees collected by the Secretary of State’s Office for registered nurses total about $4.1 million per year, while the budget appropriation for the operation of the nursing board is less than 50 percent of that, says Jeremy Arieh, a GNA spokesman.

A Georgia statute requires that the total amount of licensure fees charged by a professional licensing board “shall approximate the total of the direct and indirect costs to the state of operations of the board.” Based on that, the nursing board is not getting the full funding it is due, GNA says.

Significant process improvements could be achieved at no additional cost to the state with the appropriate level of funding, GNA says.

Recent problem cases in the U.S. nursing profession include that of a critical care nurse who worked in seven different hospitals over 16 years in New Jersey and Pennsylvania, raising serious concerns that he was doing harm.

Charles Cullen was eventually convicted of killing 22 patients. A report on the CBS program “60 Minutes’’ said that “there were suspicions at nearly all facilities, but none of them passed that information on to subsequent employers.”

A spokesman for Georgia Secretary of State Brian Kemp says the state’s Professional License Division database currently “does not allow us to report numbers based on the type of complaint’’ such as impairment or substandard practice.

But according to a November report from Atlanta-based wsbtv.com, there were 63 disciplinary cases involving drugs or alcohol for Georgia nurses in 2012. Fifty-two of them involved prescription drugs, and included everything from abuse to theft. In several cases, wsbtv.com reported, nurses even diverted drugs from patients.

Georgia’s nearly 115,000 licensed professional registered nurses constitute the largest population of licensed professionals in the state, GNA says. And Gallup’s annual survey states that nurses remain the most trusted profession — respected for “their honesty and ethical standards.”

But nurses, like all professionals, need mandatory reporting laws with adequate funding, the Nurses Association says.

“Mandatory reporting of unsafe practitioners and a fully funded due process system is essential so practitioners who are a known danger to the public can’t simply bounce from employer to employer,” says Deborah Hackman, CEO of the Georgia Nurses Association.

“The result of our state government’s habit of borrowing from Peter to pay Paul equates to a resource-starved professional licensure system,” adds Hackman. “The fundamental purpose of licensure is to protect the public.”

Most mandatory reporting laws follow the form of “if you see something, say something.”

Nurses point out that many of their substance-abusing colleagues can be helped. But they add that those who can’t be helped — or are unfit to be nurses due to other problems — must be eliminated from the ranks of the profession.

GNA  says the siphoning of these fees to other governmental purposes “starves the operation of the Board of Nursing and places the public at risk.”

State Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human Services Committee and is also a nurse, says “the problem is that no one can tell us the actual cost of the [mandatory reporting] program, but I certainly want to see this new law implemented as soon as possible. First and foremost, as a registered nurse, I am a staunch advocate for quality patient care that certainly includes safety.”

But Cooper adds, “Our state has been in a severe recession and funds have been needed for other essential services, such as the highway patrol, schools, and for foster children.”

One metro Atlanta nurse, who requested anonymity, told GHN that “while Georgia’s mandatory law will [take effect] in a few days, based on the lack of funding we may be worse off than we were before.”

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.