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Sample Letter on Duty to Safeguard Patients
DATE
Joelle H. Stein
Board Counsel
Commonwealth of Massachusetts
Division of Registration
239 Causeway Street
Boston, MA 02021
Dear Ms. Stein,
This letter is being written in response to the
newly revised regulations proposed by the Board of Registration
in Nursing. Let me start by saying that it is apparent to me from
the most recent incarnation of the proposed regulations, that the
members of the Board have made some attempt to address the concerns
expressed by the nurses of the Commonwealth during the public hearings
held in the Fall of 1999. For this I applaud their hard work. However
at this time after reviewing the present document I feel compelled
to point out that there is much work left to be done.
While it is my opinion that the present document
still suffers from a great deal of ambiguity and redundancy, I am
more disturbed by what has been omitted. I am referring specifically
to Standard of Conduct Duty to Safeguard Patient, number
23 in the first Draft. It reads as follows:
A licensed nurse shall to the best of his
or her ability safeguard a patient from the incompetent, abusive
or illegal practice of any health care provider, ancillary personnel
or other person involved in a patient's care.
I am greatly concerned that the BORN no longer feels
that it is necessary for this critical standard to be adopted as a
part of the regulations that it now proposes. I can think of no greater
or more important standard than this one when discussing the duties
of a nurse, especially in the current health care climate. Nurses
are the sentinels of health care. In many cases we are the only voice
and last line of defense for our patients. They look to us to safeguard
them from a system of health care and institutions that increasingly
place the attainment of profit above the needs of the individuals
that they are supposed to serve.
Our mission, ethics and morals compel us to take action when we
are aware of potential harm to our community, our patients and our
profession. Under CMR 244 3.02 Responsibilities and Functions
—Registered Nurse section 3(g), we are informed that:
A registered nurse shall act, within his/her generic
and continuing education and experience to: (g) serve as patient
advocate, within the limits of the law.
If we as nurses promote advocacy as a key component of our primary
mission, and the BORN believes that "The mission of the Board of
Registration in Nursing is to protect the health, safety and welfare
of the citizens of the Commonwealth…." Then, I find it incomprehensible
that the Board would propose a set of standards that do not include
this fundamental duty.
I submit to you that in returning the language proposed previously
in the Duty to Safeguard Patients, you can eliminate the need for
the ambiguous, confusing and redundant language present in some
areas your most recent proposal. For example:
1) #26 Mandatory Reporting of nurses to the Board
2) #43 Violence
3) #47 Other prohibited conduct
Language pertaining to mandatory reporting could quite easily be
incorporated into the Duty to Safeguard.
Present indications are that our profession and its practitioners
are seen by the public to be the most trustworthy of any other profession
in the country. Trust is a difficult thing to earn and once lost
twice as difficult to regain. To omit the standard which affirms
our recognition of, commitment to, and acceptance of, our Duty to
Safeguard our patients and the safety of the public, would undermine
that trust. Omitting this duty would also effectively remove a key
tool that could be used by nurses to strengthen their resolve as
Whistleblowers and protectors of the public trust. I therefore urge
you to return this language to the regulation to be adopted as a
part of our standard.
Sincerely,
Back to BORN Reform
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