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Nursing board needs bigger fix

The entrenched problems of the Oregon State Board of Nursing will not be easy to fix. In recent years, the nursing board has failed its primary duty, which is to protect the public from unqualified, abusive, drug-addicted or criminally inclined nurses. After months of intense scrutiny from this newspaper and the governor’s office, the nursing board is beginning to show signs of improvement. But it also is clear that transformative change will be impossible unless new nursing-board leaders can uproot an agency culture that for too long has enabled denial and the cover-up of glaring mistakes. We are encouraged that the new executive director of the nursing agency, Holly Mercer, is trying to shake up that culture. Indeed, Mercer is uncovering even deeper problems than previously had been revealed. As reported in last Friday’s Portland Tribune, Mercer recently wrote a letter to the Health Care Committee of the Oregon House of Representatives describing alarming discrepancies in agency files dealing with discipline and investigation of nurses. Alter employee attitudes Mercer and her new deputy have discovered that when nurses are placed on probation for disciplinary reasons, most aren’t complying with the terms of their probation. She also found more than 100 examples where complaints had been filed against nurses but never investigated. And a review of a nurse monitoring program — which helps nurses stay on the job while trying to overcome addictions — showed that three-quarters of those enrolled aren’t fulfilling the requirements to participate. Many of these recently revealed problems apparently are traceable to one staff member who disposed of files or failed to follow up with nurses on probation. But these types of failures will sound all too familiar to those who have kept up with the Portland Tribune’s coverage of the nursing board over the past two years. To begin to alter that track record, it is essential for Mercer to change the attitudes of employees who work for the nursing board. And the way to start that process is to find out which employees knew about past practices such as missing files and untracked probations. Top-to-bottom reform needed Mercer and the nursing board of directors also must fully examine the agency’s monitoring program for addicted nurses. This program is allowing nurses to continue working even though they miss or fail drug tests or neglect to check in with their monitors. We believe the nursing board has an inherent conflict of interest in operating the monitoring program. The board’s duty is to safeguard the public, not to rehabilitate nurses. The addiction-recovery work should be left to an independent entity, as it is in some other states. While Mercer is addressing long-neglected issues with the nursing agency’s staff, others are advocating for change at the top — with the nursing board of directors. We fully agree with Rep. Mitch Greenlick of Portland that the nine-member board should have more public members and fewer from the nursing profession. We also agree with critics who say Gov. Ted Kulongoski should be more aggressive in removing board directors who haven’t sufficiently protected the public in the past. New leadership will make a difference — but it only can accomplish so much without establishing a new culture throughout the state board of nursing, including the agency’s staff.