|
Mass Board of Registration In Nursing Complaint
Committee's Handling of Barry Adams Complaint Raises Serious Concerns
About Nursing Board's Commitment To Treat All Nurses Equally and
Fairly
MNA Calls for Demonstration on March 8 As
Full Board Hears Complaint Which Raises Issue of Whether Those Who
Create Unsafe Patient Care Conditions Will be Held As Accountable
As Those Forced To Practice Under Those Conditions
Click
here for directions to the BORN Demonstration
The Massachusetts Nurses Association, through its
Campaign for BORN Reform, continues to exert pressure on the Board
of Registration in Nursing and the Cellucci Administration to address
the issue of fair treatment and equal accountability for all nurses
in the Commonwealth. The BORN Reform Campaign was initiated
by a group of concerned MNA members last year in response to a number
of actions taken by the BORN, including its introduction of controversial
standards of conduct for nurses, its punitive treatment of the Dana
Farber Nurses, and its reluctance to hold nurses equally accountable
in the Barry Adams complaint.
On February 23, 2000, the BORN's Complaint Committee
had held its long-awaited hearing on the Adams complaint, making
recommendations to the board on the sufficiency of the evidence
to proceed with disciplinary action against Adams former director
of nursing and nursing home administrator, who had fired Adams for
his efforts address the unsafe staffing conditions at Youville Health
Care in Cambridge. The BORN, whose complaint committee had originally
dismissed the key components of Adams complaint back in September,
was moved to reconsider its position after a firestorm of protest
and activism by the nursing community and legal initiatives taken
by Adams' legal defense team.
In November, the BORN announced it had re-opened
Adams entire complaint and postponed action until January.
However, in January, the BORN once again delayed action on the complaint,
first filed in 1996, to allow the attorney for the nurse administrator
charged with unprofessional conduct and patient neglect in the complaint,
to prepare a response to the charge.
On February 23, 2000 the complaint committee met
to reconsider each of the allegations individually, without considering
them as a whole, and without addressing the central question raised
by the complaint, which is: Is it ethical and professional
for a nursing administrator to fire a nurse to silence his attempts
to advocate for safer staffing conditions; and to deliberately fail
to acknowledge and address nurses' assessments and pleas for safe
staffing conditions at Youville. Their decision was to forward
the complaint on to the full BORN for consideration at its meeting
on March 8, 2000, with a recommendation that there was insufficient
evidence to support three out of four sections of the complaint.
The Complaint Committee did decide there was sufficient evidence
to find the Director of Nursing failed to timely file a complaint
which she made against Adams to the BORN.
According to Adams' attorneys, and supported by
a number of observers at the meeting, the Committee considered the
complaint in a manner that appeared to predispose the committee
to support its dismissal. The evidence to support Adams' claims
was not consistently or accurately considered by the committee.
For example, the committee claimed there was no corroborating evidence
to Adam's charge that he was warned by a his immediate supervisor
that the nursing director had threatened him with termination if
he didn't stop raising concerns about unsafe staffing conditions.
Yet a sworn affidavit from Adams supervisor supporting Adam's allegation
was available to the committee in their packet but was not considered
or discussed. Ironically, that very supervisor had come to
the original hearing on Sept. 22, 1999 to testify in person about
this issue, but the committee had refused to allow her to speak
citing their prior decision to dismiss that allegation, a decision
later reversed by the full BORN.
The committee also never addressed the issue that
Adams had been terminated for his actions, nor discussed the ethical
implications of his case. Specifically, they never even
addressed the connection between staffing conditions and the documented
evidence of poor patient outcomes and neglect presented by Adams.
Evidence of reports from DPH, HCFA and the board that oversees nursing
home administrators, all of which found significant deficiencies
in nursing care at the facility were referenced as not providing
enough specific evidence to warrant a finding that the Director
of Nursing had demonstrated unprofessional conduct for failure to
correct those deficiencies. One of the committee members commented
that "I think a complaint that suggests no changes in staffing by
the Director of Nursing is equivalent to patient neglect is a huge
leap," even though the committee had copies of an NLRB decision
which held that Adams' concerns about patient care were substantiated
and included numerous letter from Adams detailing patient falls,
medication errors and incidents where unattended patients were left
lying in their own urine because of deplorable staffing conditions
at the facility.
"The committee's handling of this complaint was
disgraceful," said Julie Pinkham, MNA Director of Labor Relations
who witnessed the proceedings. "When the board reads its own
regulations regarding delegation and supervision it is clear they
read them as applying only to the direct provision of care. They
do not seem to read the regulations as applying to administrators'
allocation of resources. They don't see the provision of staffing
as the assignment of staffing and therefore see no clear accountability.
This rash attitude has and will inevitably harm patients, which
is in direct violation of the Board's mandate."
If the full Board follows the lead of its complaint
committee, it does not seem likely that the Adam's complaint will
receive a final favorable outcome at the March Board meeting.
A favorable outcome would be that the standard to hold all licensed
nurses in Massachusetts accountable to the same set of regulatory
standards was upheld in the Adams case. Such an outcome would
be consistent with a statement made by the Director of Consumer
Affairs, Jennifer Davis Carey in a letter to MNA, who said, "As
regulators, we must ensure patient safety while maintaining fairness
for regulated licensees…Of course, we expect that any regulations
or standards, will be applied consistently to all licensees."
The MNA BORN Reform Committee members will be attending
the March 8 BORN meeting. If you receive your Massachusetts
Nurse before this date, all nurses are urged to join the Committee
from 9 – 12 at the Board of Registration in Nursing to support Barry
Adams. We urge BORN members to review the evidence in its
entirety and to ask the following questions prior to making the
final decision: Was patient safety impacted at Youville by
poor staffing conditions? Did the nurses administrators have
responsibility to protect patient safety? Did they abdicate
that responsibility by terminating Adams and disciplining other
nurses who had attempted to address concerns about staffing?
Is it ethical or professional for a nurse administrator to act in
such a manner?
Click
here for directions to the BORN Demonstration
For more information about this situation, call
the MNA Department of Communications at 800.882.2056 x717 or email
to dschildmeier@mnarn.org
|
