Safe Nurses, Safety for Nurses

The Portland Tribune carried a Peter Korn article last week on Senator Avel Gordly’s call for changes in oversight of licensed nursing practitioners (Registered Nurses, Licensed Practical Nurses, Certified Nursing Assistants, and others) by the State Board of Nursing. An independent audit last year found problems with the Board’s ability to respond to complaints, and in their monitoring and re-instatement of staff with mental illness or drug abuse problems, assigned to the Nurse Monitoring Program. Senator Margaret Carter also supports bills being considered by the Legislature. From the Tribune:

“Last week Sen. Avel Gordly, I-Portland, said she would sponsor a bill that would take operation of the Nurse Monitoring Program out of the hands of the nursing board, and require the board to contract with an outside entity to run it. Many state nursing boards and the Oregon Board of Medical Examiners, which oversees physicians, currently operate in just the way Gordly’s bill proposes. They keep discipline in the hands of the boards, and separate from the people who run the programs that provide help to licensees dealing with addictions.”

Nursing is life-and-death work. It is team work. We take responsibility for our own actions and patient assignments, and we rely on co-workers on our shift, and the ones before and after, to do their jobs well and to ask for and give help when needed. In most situations, staffing levels are barely adequate; in some, there are critical shortages that are unsafe for both patients and staff even when each one is functioning at maximum capacity. Nursing teams simply don’t have the leeway to carry a non-functional co-worker on an ongoing basis. Helping out a little extra because someone has a migraine or is worried about a sick family member can be accommodated; physical disabilities can be incorporated into the team’s functioning; even longer-term leaves for a nurse to take care of personal or family problems will be covered by caring co-workers. Allowing a chronically impaired nurse who is unsafe to practice independently to continue to carry a full load endangers both patients and other nurses.

I’m glad to see attention to this serious issue, and hope funding will be allocated by the Legislature to ensure proper assessment, management, and follow-up of impaired nurses, for the safety and well-being of both patients and practitioners. I support the intent of Senator Gordly’s bill.

Not mentioned in the Tribune article is another bill, HB 2022, which addresses patient to nurse violence. Nursing is one of the most dangerous professions; 48% of all workplace assaults are by health care patients. I work on a small inpatient unit with 20 beds. I know three nurses who have been permanently disabled and/or had to retire due to injuries inflicted by clients at work. And the hazard isn’t confined to psychiatric units, although we’re more prepared to expect and manage workplace attacks. Patients and families hurt staff on medical units and in nursing homes and outpatient settings, too. Both patients and practitioners need more assistance with protection from the Legislature.