Our data-driven investigation, “When Nurses Fail,” found that hundreds of nurses with records of unsafe practice, patient harm, criminal charges or convictions continue to practice in Minnesota. A state monitoring program for drug-addicted health professionals allowed nurses to continue despite abusing drugs or alcohol, stealing from their patients and failing numerous drug tests.
Nurses with histories of drug use, crime or neglect were able to obtain licenses and find jobs because of flaws in the state background check system. Patients were unaware that their nurses had troubled backgrounds. One parent inadvertently hired a nurse with a history of making crystal meth. That nurse stole prescription drugs from the parent’s disabled daughter.
The initial reporting started last April, when reporter Jane Friedmann suggested we look at chiropractors who had sexual relationships with patients and were still allowed to practice. I thought that was interesting, but wanted to broaden the scope. I began looking at all state licensing boards’ disciplinary actions. Eventually, I requested data about actions against nurses and discovered that numerous nurses convicted of sexually assaulting patients were still licensed. Intrigued, I requested a list of all nurses disciplined by the board, something that was provided at no charge.
Further research found that other nurses had been disciplined for charges or convictions of drug crimes, assault and theft – including against their own patients.
From there, I was assigned to examine the oversight of nurses not only by the state but by other agencies that regulate the profession, including a program for addicted health care professionals, the state Department of Health and the Department of Human Services.
The key was to begin building a Microsoft Excel spreadsheet of nursing disciplinary actions since 2010, now numbering more than 1,040. This formed the backbone of all the reporting. It allowed me to see how often nurses were given repeat chances by the board, how many were charged or convicted of crimes, how many were accused of harming patients, how many were accused of abusing drugs, how many lied to the board and how many were discharged from state monitoring.
With each entry in the spreadsheet, I also wrote a summary of the reasons for the board discipline. I took care to note, when possible, where a nurse worked, if the nurse had been fired for misconduct, if a nurse was accused of diverting drug or obtaining drugs through fraud and how often the nurse had been before the board.
This was extremely time intensive. It took me several hours each day throughout the summer to build the database. I also realized about several times while building the database that there were fields I wished I had included, requiring me to go back and update entries. I was fortunate to be in a newsroom where these stories were the only thing I was asked to work on.
Once the database was finished, I used pivot tables and filters to determine how many nurses who had been disciplined since 2010 were still practicing despite criminal accusations, abusing drugs or alcohol, lying to the board and harming patients.
Using Microsoft Access database manager, we also used names and dates of birth to match nurses with a state court table of criminal convictions. Our results showed 100 nurses who should have been disqualified from providing direct care under state law.
We also reviewed thousands of records of Health Department and Department of Human Services complaints and inspection reports; hundreds of criminal, civil and administrative law files and police reports and included that information in the database.
A death database from the state Department of Health helped us identify names of patients and locate patient families.
When we shared our findings with Gov. Mark Dayton, he said the actions of the board were outrageous and vowed to take “whatever action is necessary” to change how the board viewed discipline. The legislature convened a hearing, where the board acknowledged it needed new laws to better discipline nurses. Both the head of the nursing board and key legislators have called for an audit of the board, which will likely take place this year.
In addition, the state nursing board said it would remove more than 100 nurses from practice after being made aware of their criminal backgrounds.
Brandon Stahl is a report for the Star Tribune in Minneapolis. Contact him at Brandon.Stahl@startribune.com. Follow him on Twitter @b_stahl.