WORCESTER, Mass.—Responding to a state official's accusations, the director of the state Division of Registration yesterday defended procedures used in reviewing the credentials of replacement nurses at Worcester Medical Center.

Meanwhile, the state Department of Public Health has launched a full inspection of the center, where nurses are on strike. The inspection comes after two incidents of bungled patient care that led the hospital to fire three replacement nurses last week. However, a state health official said the inspection had been planned before those incidents.

William G. Wood, Division of Registration director, countered a charge by Secretary of State William F. Galvin on Tuesday that the Board of Registration of Nursing, which licenses nurses in Massachusetts, rushed through the licensing review in what Mr. Galvin called a "reckless effort to assist Tenet Healthcare Corp. import strike-breaking nurses."

Tenet is the owner of the medical center.

Mr. Galvin's request that the board's action be investigated by state Inspector General Robert Cerasoli and the Legislature's joint committee on governmental regulations came a day after the state Department of Public Health released reports revealing that three replacement nurses had been fired for patient mistakes. 

The DPH report indicated that two of the nurses had left a surgical patient unattended and the third brought a newborn to the wrong mother for feeding.

When Tenet-employed nurses announced in March their intention to strike the newly opened medical center, Tenet brought in about 125 replacement nurses hired through U.S. Nursing Corp. of Denver. Those from outside Massachusetts had to apply for in-state licenses.

Mr. Wood said the board did nothing reckless or improper in expediting the application process.

"If following the law is being reckless, maybe he has a point," Mr. Wood said. "The board followed the same procedures as it always does. It verified the same information. It just put extra staff on to do that."

Mr. Wood said the nursing registration board often accelerates the licensing process for out-of-state nurses in response to a hospital's request. For example, he said, hospitals on Cape Cod sometimes make such requests to bring on extra nurses from other states to handle increased patient loads during the summertime influx of tourists.

"We don't take sides in labor disputes," said Mr. Woods. "Hospitals are our customers. We responded to our customers. This was standard operating procedure."

Mr. Wood added that two of the three nurses fired by Tenet had held Massachusetts licenses for several years and did not need to have their licenses verified before being hired for duty at Worcester Medical Center. 

The third nurse, who did hold a license from another state, met the registration board's licensing standards in that the board was able to verify that the nurse was a graduate of an approved school, had passed the national nursing exam and had no criminal actions or disciplinary history.

Fran Brown, spokeswoman for Mr. Cerasoli, said the inspector general is prohibited by law from disclosing whether and how he intends to respond to a request for an investigation.

Neither state Sen. Michael W. Morrissey, D-Quincy, nor state Rep. Daniel E. Bosley, D-North Adams, responded to phone calls yesterday requesting comment on Mr. Galvin's call for an investigation. The two are co-chairmen of the governmental regulations committee.

With the strike now in its 35th day, a 12-member team is scheduled to continue its inspection of the medical center. 

According to Paul R. Jacobsen, deputy state commissioner of health, the inspection crew consists of five nurses, a social worker, a dietitian, two life-safety code workers, a laboratory surveyor, a radiation technician and a representative of the federal Health Care Finance Administration. They arrived at the center Tuesday afternoon and will remain for several days.

Mr. Jacobsen said the "top to bottom" inspection, launched at the request of Gov. Paul Cellucci, is designed to uncover any deficiencies that might affect patient care. 

The inspection team entered the hospital the day after the DPH released its report revealing the firing of the replacement nurses, but Mr. Jacobsen said the inspection had been previously planned and was not motivated by that event. He said that under DPH regulations, any deficiencies found during the inspection must be relayed to medical center officials, who will have 10 days to come up with a correction plan.

Mr. Jacobsen said that while all hospitals in the state are subject to such comprehensive inspections every three years, the decision to inspect the new medical center was spawned by the DPH's desire to do everything possible to maintain patient-care standards during the strike.

"We're holding this hospital to higher standards," Mr. Jacobsen said. "We want to ensure that care quality is up to the standards that everyone expects."

Worcester Medical Center spokeswoman Paula L. Green said her understanding is that the inspection team would be at the hospital at least through tomorrow.

"We're not quite sure why this is happening, but they're here, and it seems to be going fine," she said. "We have been working with the Department of Public Health since the strike began, so I can't imagine they will find anything new, unique or different."

"If they're doing a legitimate inspection, they'll find some things," responded David J. Schildmeier, spokesman for the Massachusetts Nurses Association, which represents the striking nurses. " ... We think a closer look should be taken."

Ms. Green said she was not aware of any other nurses beyond the three fired last week to be terminated for patient-care errors, but she said it's possible others may have been asked not to return after working an initial shift or two.

"There may have been some that had some probationary period, and we did not ask them to return, but these were the first where we said 'This happened. You have to go.' "

Both sides in the contract dispute are slated to return to the bargaining table at 10 a.m. today. The meeting is the first between medical center management and representatives for the striking nurses since April 21. 

© 2000 Worcester Telegram & Gazette  

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