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    Background checks: What you may not know


    Owen Jay Murphy, Jr., wasn't the rule, but the exception.

    Photo: Getty images/rubberball
    As a nurse at Kaiser Permanente Riverside Medical Center, Murphy pushed patients against their beds, threw a water jug against the wall, and ignored the beeps emitting from vital-sign monitors, endangering patient safety all the while.

    After such incidents came to light, Murphy resigned in 2005, and Kaiser quickly reported his misconduct to the nursing board. But the board didn't take action. Murphy found work at two nearby hospitals, where he was accused of assaulting patients. He is one of more than 120 nurses who were "suspended or fired by employers, disciplined by another California licensing board, or restricted from practice by other states — yet have blemish-free records with the nursing board," according to a report published jointly by the independent investigative newsroom ProPublica and Los Angeles Times.

    Karen Flaster (Photo: courtesy of Karen Flaster)
    Although Murphy stayed in California, other area nurses — some healthcare travelers — moved to other parts of the United States when their professional conduct also came under scrutiny.

    In 2008 and 2009, California's Board of Registered Nursing came under fire from the media for its failure to investigate negligent nurses whose offenses were reported.

    Michele Sacco (Photo: courtesy of Michele Sacco)
    Last year, the Journal of Nursing reported several examples of nurses under investigation in states that are part of the Nurse Licensure Compact (NLC) — the initiative that allows registered and licensed practical/vocational nurses to practice in 24 participating states while maintaining one multistate license in their primary state of residence — who were able to slip through administrative cracks and find work in other states.

    Though stricter screening processes have been implemented in California because of the negative publicity generated during that period, the guidelines and policies for conducting background checks in the nursing field remain uneven. This is true also in the healthcare traveling industry, where the mobile nature of the business sometimes allows individuals who have broken the rules to move across state lines more quickly than state boards can respond to an allegation or charge.

    Despite recent changes in some state laws that were implemented to catch negligent nurses and increase patient safety, some industry experts say healthcare providers are unknowingly hiring sanctioned or disciplined nurses with a history of endangering patients, drug theft, and abuse as a result of insufficient background-checking processes and programs. Programs such as the NLC were originally put in place to stem nursing shortages, but they have unintentionally created a security loophole that could put patients, staff, and the organization at risk.

    By design, NLC is a decade-old partnership that allows a nurse, who obtains a license in one NLC state, to work in all of the other compact states. While 22 of the 24 states require some form of either state or federal criminal background checking (or both), the inconsistency of mandatory background-check processes reflects a larger issue within the healthcare staffing industry.


    Jennifer Walker
    Jennifer Walker is a freelance writer based in Baltimore.