Massachusetts Nurse | November/December 2004

Monitoring the BORN: It's your nursing license that's at stake

By Mary Crotty
Associate Director of Nursing

The Massachusetts Board of Registration in Nursing (the "BORN" or "Board") is the legal entity charged with the application of the statutes and regulations¹ governing nursing practice and nursing education in the commonwealth. This includes investigating and taking disciplinary action against nurses for whom complaints are made to the Board.

Close monitoring of the BORN will be a priority of the Massachusetts Nurses Association in coming months. It is imperative that we bring to your attention the importance of the BORN to your professional career—as well as the fact that actions taken by the BORN can lead to discipline and loss of your nursing license.

In situations where errors or omissions by nurses are caused by system problems or deficiencies, or where retaliatory action by a supervisor or, less frequently, a patient, is the source of a complaint to the BORN, the members of the BORN have not been addressing root problems or system deficiencies. They frequently make a pass at meeting their legal obligation to investigate the merit of the complaints by cursory review without complete facts or expert witness assessments of what likely occurred. They scrutinize and punish the nurse who is in the line of fire. BORN staff have quite clearly stated and demonstrated to the MNA that the BORN's charge does not include an exploration of the culpability of anyone other than the targeted nurse. They do not search for facts beyond those presented to them. This works to the advantage of those nurses who are informed, proactive and who seek professional guidance in the process of responding to a charge filed against them with the BORN.

It is the intention of the MNA to scrutinize BORN activities closely and to engage in whatever action might be called for to ensure more appropriate regulation of the practice of nursing in the commonwealth. Member's of the MNA's nursing department attend every BORN meeting and we are strongly encouraging nurses to attend as well—even to drop in for part of the meeting day. Your presence will be noted and will leave an impression on the BORN. The meetings are public (with the exception of the adjudicatory portion of the meeting), and upcoming meeting dates are posted on its Web site at www.mass.gov/dpl/Boards/rn/ (under "Calendar").

Upcoming BORN meetings are scheduled for Dec. 8, Jan. 12, 2005 and Feb. 9, 2005. Meetings begin at 9 a.m. and run until about 4:30 p.m., but you have the flexibility to come and go during the meeting. Guests sit along the wall and may not speak at the proceedings, but have an opportunity to engage BORN members—as well as MNA staff—during breaks or before or after the meeting. The BORN meeting site is their office near the Fleet Center at 239 Causeway Street, Suite 500 (2nd floor) Boston. The building is located within two blocks of North Station and within a few blocks of the T's Orange line/Haymarket stop. Parking is available in nearby lots.

In the last several months, no nurse observers (other than MNA staff) have been apparent at the meetings, and very few nurses appear to be represented at the disciplinary hearings by legal counsel. Those few nurses who have sought legal representation generally appear to receive the appropriate due process required to respond to charges that might be capricious or arbitrary. They also appear more likely to benefit from lengthier, more detailed presentations of the facts to the BORN, and as a result receive more reasoned outcomes from the BORN. Attorneys often seek an expert RN witness who can clarify for the BORN the nature of the facts behind a case. Counsel can also explain to nurses the importance of getting letters of support from colleagues to accompany the "facts" of the case as BORN investigators present them, and how to challenge, question and refute unfair, unreasonable—or untrue—charges.

If you have any questions or concerns about attending meetings or about other BORN activities, please contact Mary Crotty, RN, MBA, JD, and associate director of nursing at 781.830.5743 or at mcrotty@mnarn.org.

1 Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education. View the relevant laws online at at www.mass.gov/legis/laws/ mgl/gl-13-toc.htm.