Nurses in trouble get second chances - Minnesota

Front page lead story in the Sunday Star Tribune investigates the Disciplinary actions of the Minnesota State Board of Nursing. Minnesota rarely throws nurses out of the profession for unsafe conduct. Records examined by the Star Tribune of more than 1,000 disciplinary actions by the Nursing Board over the past four years show that it tolerates or forgives misconduct that would end nursing careers in other states. Nurses Career Support News

Minnesota State regulators say they protect the public with a closer watch on caregivers accused of misconduct. Those who lost loved ones want them to do more.

Elda Bothun lay unconscious on her bed inside a Bloomington nursing home. She had stopped breathing, but the two nurses assigned to care for her had left the room.

A police officer, summoned by a delayed emergency call, tried resuscitating the elderly woman, with no help from the nurses. Then paramedics took over. It was too late.

At 5:05 a.m., Jan. 19, 2009, Bothun was pronounced dead.

A state investigation found a severe breakdown in Bothun's care just before her death and determined that the failure of nurses Elijah Mokandu and Meaza Abayneh to help her during the apparent heart attack amounted to neglect of a vulnerable adult. Police and the city attorney went further:

They charged the nurses with criminal neglect, a rare step in Minnesota.

The Minnesota Board of Nursing could have taken away the licenses of Mokandu and Abayneh. Instead, it directed them to take training classes and consult with other nurses about how to respond to emergency situations.

The two nurses were allowed to keep practicing...

Over the past 5 months, the Star Tribune has analyzed thousands of records and interviewed 50 people.

The Star Tribune's investigation found:

Quote
  • The board actively licenses more than 230 nurses since 2010 who have records of unsafe practice, including botched care that led to patient harm or even death.
  • Ninety-three nurses are allowed to practice despite having been charged or convicted of crimes such as physical or sexual assault and drug thefts-some against their own patients.
  • The board gives nurses who admit misconduct second, third and sometimes more chances to keep practicing.
  • Getting fired for incompetence, even multiple times, rarely means Minnesota nurses lose their licenses.
  • Minnesota is one of only 10 states where the board has no restrictions on granting licenses to felons, according to a 2012 survey of state nursing boards.

Gov. Mark Dayton called the Star Tribune's findings "shocking," and said the Nursing Board's actions puts patients at risk for harm.

"It would appear the board is more interested in protecting bad nurses than the public," he said. "Where does it come from that their job is to give subpar nurses chance after chance after chance?"

In an interview Friday, Dayton vowed to take "whatever action is necessary" to change how the board views discipline, starting with filling two currently open seats with members who will "understand these problems and insist on a very different approach.

"We'll do whatever is necessary to reconstitute the board, or revise its procedures or give them a very clear statement from both the executive and legislative branch that they need to set a much higher standard and enforce it," he said.

Read the full article here:

Minnesota Board of Nursing tolerates nurse misconduct that would end careers in other states | Star Tribune

Here is a photo of the front page article (2MB)

Nurses, this is a long article, but worth the read.

What do you think about this? Please share your comments and opinions.

I agree with you its sad about loved ones thinking loved ones will live forever, and it is not natural to break ribs, insert needles and tubes, and we are not miracle workers. We also cannot make the decision on who should live or die by withholding treatment based on if we feel the person has has a fulfilling life, and we don't want to cause them any more pain . What you are saying makes perfect sense to me, as nurses we see these situations every day, but without a DNR order, the nurses should have started resuciatation

Specializes in LTC.

I wasn't expecting to see a nurse I work with named in that article... Wow.

I honestly didn't know that Minnesota had such lax laws.

Specializes in SN, LTC, REHAB, HH.

Those who are on the board and make these decisions should have their licenses pulled as well. IMO, they are just as responsible for letting incompetent nurses keep their licenses without so much as a censure. this kinda reminds me of how a parole board operates when they know darn well the criminal that is before them should never see the light of day, only to turn them loose on the public again where they'll return to their criminal ways again. I'm shocked at this but not surprised.

Wait, a person had a heart attack? And DIED? Shocked! I'm shocked!!!

....and at 83 years of age!

Specializes in Critical care, Trauma, CV-Surgery, Emerg.

As a Minnesota nurse, I too found this article very disturbing. I have been in nursing for 25+ years. First my BSN then went back for my MSN as an adult clinical nurse specialist. I graduated in 2011 with my MSN and have not practiced nursing since. I absolutely loved what I did as a critical care nurse, after finishing my classes and clinical hours and prior to giving my oral exam the hospital I was working for as a nurse clinician was in the process of doing a workforce reduction. After reporting an unsafe nursing practice, I was sent home on a Thursday afternoon and told not to return to the hospital until the following Tuesday. I was absolutely mortified given that Tuesday, December 9, 2008 was the day that the hospital was going to start handing out pink slips. The Monday before I was to return to the hospital I was fearful that I was going to be laid off and had been crying since having been sent home the Thursday before, I decided that I would update my resume in the event that I was laid off. Since the only thing I had left to do was to give my oral exam, I was updating my resume for work as an AHCNS. After working on the resume for some time (crying off and on while doing so) I decided to save the resume as a draft on my LinkedIN page, and inadvertently posted it to the site for the public to view. Of course the next day I went into the hospital and sure enough, I was given a pink slip. My boss insisted that I was not chosen for lay off do to my report to risk management and insisted instead that it was a business decision, but I knew that I had made a few people in high places very angry and could not shake my belief that I had been laid off for trying to protect patients from an unsafe practice. In fact, the entire situation shook me to the core.

I ended up clinically depressed for a very long time after that and never made arrangements with the school for my oral exam despite the fact that my Plan B adviser had approved my completed project and told me I was ready to defend the project in front of my 3 member panel. Instead, I disappeared into the walls of my house where I was haunted over what had happened and questioned whether I even wanted to practice nursing again. Eventually I did decide to approach the school and apply to deliver my oral defense of my Plan B project. This was in the spring of 2010. That is when things turned from bad to horrific. The Director of Nursing studies sent me a copy of the resume I had started working on with an email that read, "It appears there must be some misunderstanding. Your resume states that you have already graduated with your MSN;" $30,000.00 later (attorney’s fees to battle the School of Nursing and to be represented in front of the board of nursing), I now have a disciplinary action on my license and my name has been reported to the National Health Care Practitioner's data bank. At first sight, I had not even remembered ever starting to update my resume and instead believed that someone had duplicated my page, because when I went to LinkedIN to see it for myself, all I could find was my page with my BSN resume. It was weeks before I was able to find the page that had the resume which stated I had an MSN, and in fact, it was a totally different account. Honestly, to this day I still have no real recollection of ever doing it. I did remember being in a meeting with the other people in my office in which we were advised to update our resumes and get them onto LinkedIN and Monster in the event that one of us was laid off in the workforce reduction. After all was said and done, it was the beginning of the end for my career.

The board of nursing did not care about the misunderstanding despite the fact that I never used that resume to get a job, or that I, by merit, had been the recipient of two health care scholarships (each one totaling $5,000.00); had served in the United States Army and was discharged honorably; was the recipient of a Presidential Citation from the Society of Critical Care Medicine for all of my committee work; that I was an active participant of the investigational review board of the University I attended; or that I was a sitting member of the School of Nursing Alumni Society Board; that I was, and had been, a certified critical care nurse for 10 years; that I had been a research assistant for one of my professors while attending school; that I had a published paper; or that I actively advocated for k-12 students with disabilities so that they would get the education they deserved; or that I have three children, two of whom have medical disabilities and rely on me to care and support them. In fact, I have not worked since being laid off, because at first I was depressed and knew I should not be working, but now I am too humiliated to even apply for another position, because I don't want to be looked at as if I am a liar by any prospective employer.

Unfortunately I am an incest survivor who took to the streets at the age of 12, because I knew if I stayed at home I would not have survived, and as an incest survivor, shame is my middle name. It didn't matter to the board that I had eaten out of garbage cans and slept under bridges from age 12 until I entered the military, or that while living on the streets being raped by a stranger was less frightening than being returned home to be sexually abused by a person who was supposed to love and protect me. The board did not care that despite my extraordinary time on the streets that I never touched a drug or drank alcohol. The board did not care that the shame of my abusive past kept me from believing that I was actually worthy of doing something good with my life. I was 27 years old before I was able to muster the courage to tell anyone that I had never even graduated from high school. When I finally did get up the courage, I chose to tell a nurse in the admissions office at the local University. She immediately took me under her wing and helped me to believe in myself. Truth be told, she gave me life.

Now 25 years later, a mistake I made during a stressful time in my life has resulted in another group of nurses taking everything I worked so hard to accomplish; away. Their rationale; I endangered public safety. I can’t help but wonder where I would be today if instead I had a drug or alcohol problem, or because I had made the decision to have sex with one of my patients, or that I failed to rescue my patient who was decompensating from certain death. Perhaps if I had chosen to be a drug abusing nurse who steals her patient’s drugs, goes out drinking and crawls behind the wheel of my car to drive over to the hospital to have sex with one of my patients’, I too would have been shown leniency by the Minnesota Board of Nursing!

Specializes in Critical care, Trauma, CV-Surgery, Emerg.

If you read the story, this woman was an independent 84 year old who had made the decision to enter the facility to convalesce following surgery. If she had instead returned home with a home care nurse, something Medicare would have provided, arguably, 911 might have been called much sooner and she might still be alive today.

I am sorry, but this is a classic case of nursing's failure to rescue. There is no reason both of the nurses should have left this patient alone. Unfortunately, this is all too common. I have worked in hospitals, one of which is located here in Minnesota, in which I have witnessed nurses who have failed to initiate ACLS protocol when patients clearly are decompensating and have met the criteria for initiation of ACLS. I am not talking about one incident, but many. The most obscene situation involved a patient who had been in VT at a rate of 250 for well over an hour on the telemetry unit. Despite a rapid response call that was made over an hour before the patient came to the unit, ACLS protocol had not been initiated despite the fact that there were 4 nurses, 2 new residents, and a nursing supervisor at the patient's bedside. Fortunately, the patient was brought to the ICU, at which time I advised that the patient needed to be resuscitated, but was ignored. I asked the crit care charge nurse who had responded to the rapid response call and whether defibrillation had been attempted, she advised that the residents did not feel that ACLS was warranted despite the fact that the patient was in significant distress. Their rationale was that they did not feel they could resuscitate a patient who was conscious, I of course asserted that there is a difference between being conscious with a brain that is receiving adequate oxygen secondary to adequate afterload, and then there is this patient's version of a brain without adequate oxygen who appears to be conscious, but instead is fighting for his life. The patient was given 1 mg of versed and a few joules of electricity, successfully rescued, and sitting up and visiting with his wife and daughter an hour later.

This man got lucky, other cases I know of have not been so lucky.

These nurses failed to respond to a patient who was having an acute MI which resulted in death. That is a sentinel event and they should have their licenses pulled. I could see making a mistake and being disciplined for it. I mean, we're all human and prone to error from time to time. However, they cost this person her LIFE. They do not deserve to continue to practice. What if it was your mom that gets them after they've been disciplined and not had their licenses pulled and the same thing occurs? Would you want them to be able to retain their license?? The punishment needs to fit the crime.

Just because some medical professionals are foreign, doesn't mean a damn thing, and that did not make the difference. I have worked with a huge variety of foreign nurses and doctors and they are very good at what they do. So, are you saying that if you went to be a nurse in another country and something like this happened during your care that it's because your foreign?? I don't think so. People need to look at both sides of the pic when it comes to stuff like this.

Even with a DNR order, they should have done something. DNR does not mean DO NOT TREAT.

I'm the DNS of a nursing home. I hire RNs only. If they don't have experience, their orientation is at least 6 weeks long. If they have nursing experience, but none in a nursing home, tHeir orientation is a month. I work with some of the smartest nurses I've ever met and since I've been an RN for more than 30 years, I can say that without hesitation. Some of the stupidest nurses I know work in the hospital. Let's not paint an entire industry with a broad brush because of these bad nurses.

Wished I'm had come and worked for you. I was just licensed in June, got my first real nursing job in August at a nursing home. Put in my 2 week notice 4 weeks later. I was given 6 days orientation total, 3 on the floor. Given 19 patients my first day out and 3 days later when it was noted that I could slam all the meds down them without being 2 hours late, I was given 29. I lasted 6 weeks and it was about 5 1/2 weeks too long. I think I'll look for something in the hospital now, I figure I can handle 10 patients without too much issue.

Also, the second day that I worked, I had one patient with a O2 stat of 83. Really, did she get like that overnight, No, she had been like that for quite a while. I called her Dr and he sent her to the ED. She was vented for 10 days in ICU. I guess having 29 patients doesn't do much for assessing their breathing.

Specializes in Trauma, Pulmonary and Thoracics.

I heard from a friend in long term facilities that there are 2 nurses. 1 Registered Nurse and 1 Licensed Practical nurse for 40-60 patients requiring long term care. And I am sure these patients have more than 1 diagnoses so the nurses must have a broad range of knowledge in respective specialties. And at the same time the patients usually have to be stable to be able to enter a long term care facility. That's the problem with LTC, there aren't enough nurses for that many patients and they should always have a more senior nurse on who knows what to do to guide the new nurses. But, nurses eat their young. We eat them we eat them we eat them and I don't understand why. There's too much drama in nursing.

I want to know what the patients code status was. Can we resuscitate the patient? or is it just comfort care, are we just comforting them until they are ready to pass away?

But it sounds like the nurses didn't even take time to assess the situation/patient before leaving the room just to make sure things are safe. Sounds like a case of neglect.

Specializes in LTC, assisted living, med-surg, psych.

It seems to me that the laws governing nursing practice should be uniform from state to state, just like our licensing exam. A nurse should not be able to get away with behavior in one state that would cost them their license in another.

Heck, where I live, a nurse can lose their license for smoking marijuana (and that's OFF the job), and I know one LPN personally who lost hers for doing a sharp debridement on a diabetic ulcer. Which was a TERRIBLE thing to do when she was not trained or licensed for that....but she didn't get a second chance, let alone a fourth or a fifth!

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