Nurses Work in California with Criminal Backgrounds

Many nurses have slipped through the cracks in California. In a review by the The Times and ProPublica (a non-profit investigative newsroom) found that regulators acted late or not at all after being informed that nurses had committed serious crimes. In some instances, nurses were given their license renewals after reporting their own felonies to the California Bureau of Vocational Nursing and Psychiatric Technicians.

"Obviously the public isn't protected," said John Brion, the assistant clinical professor at Duke University School of Nursing. "If you have a person who's already been convicted and served their time and they haven't even been charged by the board...I would really question what's wrong with the system.

Licensed, vocational nurse Carlito Manabat Jr. is one case. Accused by two patients of sexual battery and molestation while under his care in 2006, Manabat pleaded no contest. He served six months in jail and registered as a sex offender. In February of 2008, he renewed his license, checking the "Yes" box that indicates he has been convicted of a crime. Two years later, the bureau is investigating the matter. Meanwhile, Manabat has been nursing and continues to do so as the case is still pending.

Discrepancies such as this are quite common at the bureau. The investigation revealed that 27 nurses had 3 or more criminal convictions, and 3 had more than 9.

Hospitals and clinics rely on the information provided by the bureau to vet potential new hires. The bureau blames low staffing and received approval last year to hire more staff to handle the demand. Some nurses are fingerprinted, but not all. The only other method of checking up on nurses is to rely on their own integrity. They check that "yes" box if they've been convicted. The bureau is huge and most of the fault is likely administrative, but when public lives and health are at risk, is there really any excuse?

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Anesthesiologists To Undergo Random Drug Testing

Two hospitals: Massachusetts General Hospital in Boston and The Cleveland Clinic Foundation in Ohio have recently implemented a random drug testing program that focuses on their anesthesiologists. The Cleveland Clinic ran a survey in 2005 and discovered that 80% of those in the profession were found to be abusing drugs. Even more frightening, 19% of those were reported dead from drug related causes.

Dr. Michael G. Fitzsimons, administrator for the substance abuse program of the department of anesthesia and critical care at Massachusetts General Hospital in Boston explains, "The problem is that we are exposed to, and we have the use of, very highly addictive and potent medications."

Drug testing doctors is problematic. Doctors are well aware of the signs and symptoms of drug abuse and know how to mask those signs. Not only that, but they are fully aware of the best, most effective ways, of beating a drug test. This would mean observed tests, an invasion of privacy for those who don't abuse the drugs, but little else could be done to insure nobody was cheating.

Dr. Raymond Roy of Wake Forest University in Winston-Salem, N.C. tells a story of a young resident in his anesthesiology program who would arrive at work early to get just high enough to avoid going into withdrawal and return home each night to use heavily. The young man died of an overdose soon after completing a drug rehabilitation program. The unfortunate death of his young resident led Dr. Roy to ask his other doctors if they had noticed any signs of abuse. 100% of them reported that had suspected nothing.

The doctors find the incidents rates to be the same, but are hoping for multi-institutional studies that will help understand if the program is effective in staving off drug users.

The hospitals offer treatment programs and often allow the abusers to return to the program once they are clean. But the death rate for treated residents that return to the program is 1 in 9, as a result, hospitals are looking to find other ways to keep addiction at bay, including reining in the already tight regulations on narcotics and their availability in hospitals.

The institutions participating in these programs should be commended for taking action against a problem that has existed for years. The rehabilitation programs are impressive and the ability to return to the program is respectable. Doctors understand addiction is a disease and as they are called to do, they are fighting that disease with all the tools they have available to them.

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