Governor proposes Nursing Board reform? Absorption? - page 2
Governor proposes Nursing Board reform? Absorption? Update from the Governor's Office January 5, 2005 Governor Acts on Reforming Corrections and Cutting Waste In his State of the State... Read More
Jan 9, '05Dear Governor,
I am not a California resident but a member of the nursing society and the health profession. I am deeply concerned about the latest information regarding your plans to disband nursing or physician organizations. many times organizations may seem to over lap but in fact serve separate purposes. One instance that comes immediately to mind is politics, while we have a President to oversee the entire nation, we also have Governors to oversee each state as well as mayors to oversee each city or province. While all of these offices are in effect striving to serve the people and make America the greatest country in the world. I doubt that you would consider their purposes identical and then deem all but the highest office of no use. Many things are this way. The medical field especially need to be regulated and have many Boards to oversee many objectives.
Nursing in America and the world in general is struggling to find support and acceptance to a new generation of specialties. Nurses are overworked and under appreciated and generally in accordance with our duties, responsibilities and accountability under payed. We (the nursing community) need more support and the help of our elected officials to see these things through to a greater understanding and higher degree of assistance. Now is not the time to denigrate nurses or the nursing profession, we are the backbone of the medical profession. If you think about where you and your loved ones will end up when you become ill or infirm you must consider this question, Do you want someone that has no college education and no advanced training tending to the needs of you and your loved ones? Professionals are named such for good reason, we are educated and trained and show aptitude and skill in our chosen field. When you need a Lawyer you would not grab someone off the street and have them argue your case, certainly you would not allow a butcher or a barber to perform surgery on you or your loved ones. You should not want to diminish nursing care to that of a certificate earned in six weeks.
Certified nursing aids are wonderful as well and obviously are in great demand but the core of the medical field is the nursing staff. You would do well to rethink any position you have that considers nursing as otherwise.
I know this is pretty vague as to point but I did send something at least.
Jan 9, '05Bump for these questions
How can the BON be disbanded? I mean nurses have to have a BON to regulate licensure right? If the BON is felled then how would nurses obtain licensure? There are obviously still students paying tuition to become BSNs and if there is no way to license them after graduation what is their actual title? I must not be understanding the whole picture. Are these the secondary Boards he is attacking? Such as the CNA(Ca. Nurses assoc.)? Please someone in the know make this clear to me.
Jan 9, '05Gov. Arnold Schwarzenegger sounds more and more like a "Hitler" persona to me. He needs to go back to making movies, and leave American politics to Americans who were born and raised in America and have more respect for it than he has been giving it. :stone Who voted him into office anyway! :angryfire Bet they regret their choice since that time.
He never helped me when I was in Cali, so I suspect he isn't going to do anything worthy for anyone but rich folk there. Makes me never want to live there again, and I've always loved Cali, too!
Jan 10, '05http://www.calnurses.org/?Action=Con...3043680fbdfd3f
Governor's Call to Eliminate Public Oversight on Nursing
Poses Immediate Threat to Public Safety, says Nurses Assn.
Part of Larger Campaign to Deregulate Healthcare Protections
On Behalf of Healthcare Industry Corporate Interests
Gov. Arnold Schwarzenegger's proposal today to eliminate the Board of Registered Nursing, along with other consumer protection professional boards, threatens to wipe out a century of vital public oversight of the professional practice of nursing and care delivery, posing a serious threat to public health and safety, the California Nurses Association said today.
The governor is proposing to eliminate the independent member board of the BRN and place it directly under the Schwarzenegger administration, which has been far more receptive to the wish list of the healthcare industry than the concerns of consumer, patient, and other public advocates.
A hearing on this and other changes announced today are planned for later this month in Sacramento with final recommendations that will ultimately be voted on by the legislature. CNA, the state's largest organization of RNs representing some 60,000 RNs, will vigorously oppose the elimination of the BRN.
"Today's announcement is an unconscionable power grab by a governor who wants to abolish independent agencies created to protect the public exclusively for the financial benefit of corporate interests, such as the multi-billion dollar health care industry that has been one of his primary donors and supporters," said CNA Executive Director Rose Ann DeMoro.
DeMoro tied the governor's proposal to a "larger plan, the deregulation of public protections overall, that will have an immediate and deleterious effect on the health and safety of all Californians."
The Board of Registered Nursing, for example, was created by the state's first Nursing Practice Act in 1905, to establish uniform standards for the education and licensure of registered nurses to protect public safety. The law was part of a national movement, sparked by numerous scandals to establish safeguards and crack down on the abuses of wealthy corporations in many walks of life.
Today every state in the U.S. has an independent nurse licensing board. California's, however, has achieved national distinction with some of the toughest requirements intended to assure public safety.
A key California BRN provision is the requirement that every RN, as a condition of licensure, be obligated to advocate for their patients, even when it runs counter to the economic incentive of their employer. Patient advocacy means, for example, challenging decisions to prematurely discharge a still gravely ill patient or the ability to override an improper medication order that could endanger a patient.
That requirement gained added significance in the 1990s, a decade marked by the growth of managed care and the push by many hospitals to slash patient care standards to cut costs or increase profits regardless of the impact on patients.
"Without a BRN, RNs will no longer have that independent role that patients count on at a time when hospitals and other healthcare employers have made it clear that budgetary considerations take precedence over patient safety," said DeMoro.
"Without a BRN, more RNs will be subject to the loss of their livelihood if they speak out on behalf of their patients. Without a BRN, we will lose statewide standards and independent oversight, meaning patients and their families will never know when they enter a hospital door if that hospital is adhering to even the most minimal nursing care safety standards," DeMoro added.
Gov. Schwarzenegger's bid to abolish the BRN, said CNA, dovetails with his November emergency order to overturn key portions of the 1999 law establishing safe, minimum RN staffing ratios in hospitals. In both cases, the beneficiary will be hospital corporations at the expense of patients and nurses. CNA has filed a lawsuit to reverse the order.
"Gov. Schwarzenegger hopes that the public will ignore his repeated demagogic attacks on 'special interests' such as nurses who care for the most vulnerable in our population or teachers who educate our children, while promoting the agenda of the state's wealthiest corporate interests," said DeMoro.
"CNA will never accept the elimination of basic health and safety standards that protect the lives of millions of California patients," said DeMoro. "The time to take a stand is now."
Jan 10, '05The BRN Board is responsible through its Education and Licensing Committee to ensure that the educational institutions and programs have the appropriate standards for RN candidates to adhere to. They make the decisions about whether some fly by night for profit school should be licensed or not. They are the ones who make sure that students are not being taken for a ride by a school that does not prepare them to pass state boards, and receive proper clinical instruction.
I fear that without this oversight, we will see shady programs prey upon students --promising them an education that may not be up to standard---and creating a harder time for current staff nurses to orient these new grads who are at a severe deficit.
Jan 12, '05I always felt in my gut that Arnie had fascist leanings. This thread only reinforced what I felt all along.
Jan 14, '05He vetoed the Lift Team Bill.
So what if you hurt your back or shoulder?
Has the governor or the legislature tried to regulate insurance companies or limit how much their rates go up?
Insurance companies are big contributors to Arnold.
A UC Davis study found they have been successful at is slashing benefits, up to 70% for workers on permanent disability for job related injuries.
Posted on Tue, Jan. 11, 2005
Workers' comp rates fall slowly
By George Avalos
CONTRA COSTA TIMES
The savings that were supposed to sprout from reform of California's wobbly workers' compensation system seem to be elusive so far....
Jan 16, '05i am a foreign nurse in the process of obtaining my nclex through the california board of nursing.if this is true then we are all in for a rude awakening.seems like big business could be responsible for this.has the govener ever mentioned an alternative to his proposels.
for the love of mike you just dont dismantle an establishment/s ie nursing/physian boards without calculating the consequences.
he is either on some serious medication or the effects of them are waring off.
arny get a grip:imbar
Jan 29, '05http://www.arnoldwatch.net/
Plan to reduce boards bashed
Little Hoover Commission hearing gets an earful from legislators, others about risks in consolidation.
By Kevin Yamamura ...quot; Bee Capitol Bureau
Thursday, January 27, 2005
Gov. Arnold Schwarzenegger's plan to eliminate 88 state boards and commissions faced strong resistance Wednesday from an independent oversight panel, an early indication that the Republican governor's reorganization effort may have problems moving forward.
In its first public analysis of Schwarzenegger's proposal, the Little Hoover Commission expressed fears of reduced public oversight and excessive consolidation of state functions. The 13-member commission is responsible for providing recommendations to lawmakers before they consider the governor's reorganization plan.
The proposal calls for the elimination of panels such as the Medical Board, the Board of Registered Nursing and the Student Aid Commission. In many cases, duties would shift to state agencies that answer to the governor. But some advisory boards, such as one on Asian American issues, would be dissolved entirely.
Fred Aguiar, secretary of the State and Consumer Services Agency, which would inherit many of the responsibilities from the endangered panels, met a flurry of tough questions after he introduced the governor's plan as a way to increase efficiency and improve customer service.
Little Hoover Chairman Michael Alpert criticized Schwarzenegger's desire to eliminate 11 medical boards and consolidate their roles under the State and Consumer Services Agency. At one point, Alpert said he feared investigators of auto repair shops would also take on medical malpractice cases in a spirit of efficiency.
"I'm a little worried about a guy who goes out to investigate a car repair shop and then when he isn't busy and the Medical Board is busy, he goes out and investigates a doctor for malpractice," Alpert said.
To Alpert's visible dismay, Aguiar responded that there is "no reason why you couldn't cross-train investigators to deal with medical-related issues."
Consumer advocates and nurses opposed to the governor's plan seized on the comment as an egregious example of how Schwarzenegger is pursuing consolidation at the expense of expertise. In an interview later, Aguiar said he had been misunderstood; he instead meant that medical investigators could be cross-trained only across different medical fields.
Opponents testified against the plan as a "power grab" by Schwarzenegger, suggesting the governor is seeking to extend his own power over functions now controlled by boards and commissions.
"I would suggest that for the governor to consolidate this in a way that they're accountable to him just consolidates the authority of the governor, and that's not good for the system of checks and balances," said Art Pulaski, executive secretary-treasurer of the California Labor Federation.
The California Nurses Association had the largest presence Wednesday, with more than two dozen representatives to protest the potential cut of the registered nursing board. CNA President Deborah Burger said the change would give health care corporations too much power.
Little Hoover commissioners critiqued the plan for its potential to reduce the public's role in public policy decisions now handled by the 88 boards and commissions. They said the public currently can attend board and commission public hearings.
"To me, it appears we're simply sacrificing the public's oversight role at the expense of pennies on the dollar of opportunity," said Assemblyman Mike Gordon, D-El Segundo, a commission member.
Aguiar, however, said the public would have more protections and access because the reorganized government would be able to respond more quickly to consumer problems. The administration in its plan asserts it would offer a public workshop process that it believes would be more valuable than board meetings.
Aguiar also criticized the current system for creating a situation in which boards and commissions have backlogs of two to three years in reviewing cases.
"This proposal does not lessen consumer protection," he said. "The staff that currently receives, investigates and enforces against complaints will continue to do so. The only change is that instead of reporting to a board, they will report to the (agency) director."
In other testimony, Victoria Bradshaw, secretary of the Labor and Workforce Development Agency, outlined a plan to consolidate three labor-related appeals boards.
Bradshaw highlighted the fact that some existing board members receive six-figure salaries for doing little work. In the proposed consolidated board, members would continue to make six-figure salaries, but would serve at the governor's will, meaning they could be fired at any time, she said.
But Little Hoover Vice Chairman Stanley Zax criticized the change because he said it would force members to carry out the governor's will.
"That sounds like a concept that exists in Syria or Russia, but I don't know of an appeals process that works in the free world with an at-will appointment," Zax said.
Jan 29, '05http://www.calnurse.org/?Action=Content&id=628
Why CNA Opposes the Elimination of Public Oversight for the BRN
There is no public savings by its elimination because the Board is supported by fees paid by nurses for their licensure as a registered nurse.
The BRN functions responsibly within a budget that created a significant reserve. In fact, $12 million paid by California RNs was loaned to the State from the BRN reserve to cover other state needs. Its public members do not receive salaries, only a small per-diem and travel expenses.
A public board, providing oversight of the staff and accountable in public, is the only way to protect its consumer advocate role from undue political influence.
The BRN includes four public members who are not licensed healthcare professionals, an RN representative of nursing administration, an RN educator, an advanced practice RN and two other direct care RNs plus a physician member.
The volunteer members provide current clinical, administrative, and nursing education expertise, critical for evaluating whether or not an RN's practice meets professional standards of safe care. The unlicensed public members provide balanced critical input into decisions that directly impact consumer safety.
The BRN was reviewed by the Joint Legislative Sunset Review Committee in 2003 and made a determination that the BRN should continue as an independent Board.
Without the requirement of a public meeting for all decisions, there is more room for inadvertent slanting of decisions to the detriment of the public and/or the profession.
Jan 29, '05You can see the video if you click the link.
The Little Hoover Commission is hearing from multiple constituencies today regarding the proposed elimination of nearly 100 state boards and commissions. One of the most vocal groups, nurses, says abolishing their oversight board is a bad idea.
Three weeks ago in his State of the State address, Gov. Arnold Schwarzenegger proposed cutting the boards and commissions to reduce bureaucracy and costs, saying "no one paid by the state should make $100,000 a year for meeting twice a month."
One board identified for elimination is the Board of Registered Nursing. Nurses say its elimination would compromise oversight of California nursing practices and put patients at risk.
Nurses want to know they have an agency willing to stand up for them. "I challenged the doctor and I said, 'No, this patient will not be going home, It is not safe.' And I know I am protected by the BRN so that I can advocate for my patients," said nurse Kelly Digiacomo.
Nurses worry that without the board representing them, hospital and business interests will have a bigger say in the kind of care a patient receives.
The California Nurses Association is already at odds with the governor over an emergency order issued last November to stay a law set to take effect January 1. That law would have required hospitals to have one nurse on duty for every five patients in medical and surgical beds. The current ratio is one nurse to six patents.
The Little Hoover Commission is an independent, non-partisan body charged with review all proposed government reorganization plans. It has nine members, five of whom appointed by the governor, along with two state senators and two assemblymembers.
Jan 30, '05oQuote from cheerfuldoerI am thinking the same thing you are. I have never heard of a more ego maniac since Hitler. I just couldn't believe what I have been reading. And he's going to run for PRESIDENT?Gov. Arnold Schwarzenegger sounds more and more like a "Hitler" persona to me. He needs to go back to making movies, and leave American politics to Americans who were born and raised in America and have more respect for it than he has been giving it. :stone Who voted him into office anyway! :angryfire Bet they regret their choice since that time.
He never helped me when I was in Cali, so I suspect he isn't going to do anything worthy for anyone but rich folk there. Makes me never want to live there again, and I've always loved Cali, too!
Jan 30, '05What is it with "Ahhhh-nold" and nurses, anyway??!! Ever since he took office, I've been seeing threads regarding several different issues he seems to have with our profession, and I frankly am glad I don't live in California anymore!
I miss the warm weather of my old home state, but I think I'll stay right here in Oregon, where it's cool and damp and no one assumes that a man who makes his living as a bodybuilder and an actor is somehow uniquely qualified to be Governor. :chuckle