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Nurses need tighter oversight in New York State

A nurse tending to a patient.

A nurse tending to a patient. Credit: iStock

Nurses are society’s caregivers, on the front lines of medical treatment and often the professionals most involved in our health care.

But what happens when nurses commit serious crimes or harm their patients? In New York State, background checks or fingerprints are not required to get a nursing license or to renew one. What’s more, the state doesn’t discipline nurses as quickly as other states; it relies on them to self-report criminal convictions every three years, and it can’t suspend them in emergency situations without a hearing and approvals.

Those findings, from an investigation by the nonprofit news organization ProPublica, are disturbing. So are the stories behind them. There’s the nurse who ignored a patient in agony. The patient died, and the nurse kept her license for nearly six years. There’s the nurse who faked his own death, spent time in prison on a felony charge, didn’t disclose the conviction, renewed his license, and has since been accused of sexually abusing a sedated patient. His New York license is active. Another nurse, accused of drowning a 2-year-old girl in a bath, faces second-degree murder charges. Her license, too, is active.

Bizarrely, the agency responsible for nursing licenses and discipline is the state Education Department, through its Office of the Professions. The state Board of Regents has final authority. Certainly, the department has other priorities besides nursing licenses and discipline. Also, state lawmakers say the Office of the Professions doesn’t have the staff or powers to do the job well. It shows.

So, if the Office of the Professions continues to handle nursing licenses, it must be given the resources it needs, including funds to develop an electronic licensing system. But that’s not enough. The state must make sure that those overseeing our health care are doing it right.

Medical doctors and physician assistants are licensed by the Office of the Professions, too, but they are disciplined by the state Department of Health’s Office of Professional Medical Conduct. Nurses should fall under the same system as doctors. Health department officials can summarily suspend a doctor’s licenses in an emergency, or when a doctor is convicted of a felony. That power should apply to nurses, too.

Education Department officials have defended their work, saying there’s no need for massive shifts in authority or jurisdiction. But the bad examples, combined with clear holes in the system, must not be dismissed. As State Sen. Kemp Hannon, who chairs the Senate Health Committee, said: “I think a case has been made for substantial change.”

It’s up to the State Legislature to prioritize this issue. Right after ProPublica’s report was published, Gov. Andrew M. Cuomo said he’d consider having the health department oversee nurses if the Education Department couldn’t do it. Lawmakers said that would be difficult politically. Legislators from health committees and higher education committees would all play a role in making decisions, and they’d have to address the interests of many players, from the various state agencies to the patients to the nurses themselves. But this is too important to be stuck in political squabbles. There must be better discipline, an opportunity for timely license suspension when necessary, criminal background checks, more accountability — and a change in authority.

Our health depends on it. — The editorial board