After reading this post, one might think that I have a bone to pick with the editors, and some reporters of the Los Times – and you’d be right!
For years, it has been my opinion that when it comes to nurses, nursing unions and the nursing profession the LA Times has been inconsistent and at times down right off in left field when it comes to nurses. My disagreement with the LA Times on this topic goes back many years, and started with an article they ran on nursing which reported, incorrectly, that the American Nurses Association (ANA), was some how representative of all California. When I read this article I quickly responded with a letter to the editor and provided them with data from the ANA itself showing that less then 11% of all active RNs were members of the organization nation wide . Did they run this letter, of course not, but they did run a very small correction in the Home section of the paper much later. The correction was so small it barely served as a correction at all since it was so small it was all but insignificant and surely hardly worth the ink that was used to print it. This episode would mark my first, but far from my last, run in with the LA Times Reader Advocate, Ms. Gold.
Over the years, I’ve been vigilant and responsive to articles that have run in the newspaper especially when those articles shed a bad light on nursing that was not deserved, or glossed over what were gross nursing mistakes because those nurses worked in some venerated institution. For far too long all forms of media have relied upon groups such as the ANA, California Nurses Association (C.N.A.) and other such ilk to provide them with data and information on all things nursing. I’ve nothing against the media citing these and other organizations as sources of information, they are after all groups that represent nurses and thus have some expertise in the nursing arena. What’s wrong is when the media blindly cite suspect facts from these organizations with little effort to fact check the organization’s statements. Such as when the ANA purports to represent the interests of the almost 3 million RNs; or when the C.N.A. labels itself the voice of the California RN – when neither of these facts are accurate, let alone true. When individuals such as myself take the time to educate the media and provide them with the correct statistics and facts the response is often the proverbial paternalistic pat on the head, as if we’re somehow ignorant but well-intentioned children.
Equally frustrating is when the media soft peddles the mistakes or bad deeds of an organization or institution they consider venerable. Not that long ago the LA Times and various other media outlets barraged us with the numerous medical and nursing misdeeds of the now defunct King-Drew Medical Center (KDMC). Now granted there were many serious medical/nursing and even management errors occurring in this institution, and the press would have been remiss if they failed to report the story aggressively. However, when two nurses at Cedars-Sinai nearly offed a handful of infants, including the Quaid twins, little was really covered. Oh yes, there was front-page article about the initial incident, then there was at least one or two “follow-up” articles. What I found striking about the handling of the nursing errors at both hospital was the way the articles were spun. Granted KDMC’s problem were nearly endemic, but the heparin incident at Cedars was also on a grand scale, but the article spun this serious nursing error and breech of nursing protocol as well there have been other heparin incidents and these are primarily due to the labels not being different enough between the adult and children dosages and the fault was much more a “labeling” issue and not really the fault of Cedars-employed nurses. As a RN I took issue with this redirection of blame, because as someone who had administered more than once dose of Heparin to infants during my career I knew precisely where the blame for this error lay, and it wasn’t with the labeling – it was squarely on the shoulder of the two nurses who failed to not only read the label, but to also implement the time honored and basic nurse practice of double checking of certain drugs (heparin being one of them). What is this double-checking I speak of, simple the first nurse checks the order, checks the medication, draws the ordered amount, then another nurse checks the order, inspects the bottle the medication was drawn from and then verifies that the appropriate amount has been drawn, as well as verifying that the correct patient is receiving the medication at the correct time and by the appropriate route all the while placing their initials at the appropriate stages and places (this describes a general overview of the procedure, some hospitals have even more detailed safety protocols in place). But why come down so hard, nurses are only human, and this was just a mistake. Perhaps, but Cedars is also a so-called Magnet hospital which is supposed to designate that they have a higher standard for nurses, and such a failure of basic nursing safety protocols is indicative of a hospital that is not worthy of claiming that its nurses are a “cut above”, since the heparin incident is not a “ordinary” nursing error, because as it turned out apparently the mistake happened not once but twice.
Which brings me to the ongoing LA Times investigative report about the California BRN and the handling of nurse licensure. In its December 27, 2009 – Inept nurses free to work in new locales (http://www.latimes.com/news/local/la-me-nurses27-2009dec27,0,2090185.story) the article took a detailed look at the licensing failures that occur because there’s no real national clearing house, i.e. national nurse license agency which can lead to nurses gaming the system and securing licenses in additional states when they have a suspended or revoked license in another state. This is a very real problem, since every state is solely responsible for the verification of a nurse who is applying for or renewing their license in that state. Some states have a better verification system then others, catching a nurse with an out-of-state suspended or revoked license then others (California falls into the not so successful verification system). As part of their research the LA Times reported interviewed the National Council of State Boards of Nursing (NCBSN), regarding this issue. The quote from NCSBN that really caught my attention was this one “Officials at the National Council of State Boards of Nursing said they don’t tell nursing boards how often to consult their database.” But wait a minute the NCBSN is comprised of representatives (most of the Executive Director) from each of our Nation’s state board of nursing! So what does this quasi-governmental agency really do; I call it quasi-governmental and not non-profit since it appears that its board is comprised entirely of representatives of governmental agencies. In my opinion very little is done to truly protect the nursing profession and the patients we care for, since when the Philippine test stealing scandal broke in 2006 the NCBSN stayed relatively silent on the matter (I wonder if this had anything to do with the fact that the NCBSN was in the process of opening an NCLEX testing center in that country?), if not for the local Philippine Nursing Association, the Association of Nurse Executives and a handful of nurse activist such as myself very little would have been done to force a retest of the suspect exam period. The NCBSN finally took a stand after the fact, so much for serving as a watchdog.
Though I think that its important that the LA Times reveals failures of our system of checks and balances, I think it’s equally important that they aggressively investigate agencies such as the NCBSN, that our BRN pays fees to and on which the BRN executive director (in this case the interim executive director) is a member of – if it cannot aid its board members to be better advocates for the profession then does it serve a purpose. Or perhaps the purpose it serves is to continue to charge fees for tests once administered and collected by the individual states thus consolidating power and wealth in the quasi-governmental agency that presents itself as a non-profit?
