The state's Board of Registered Nursing has discovered that some 3,500 of its nurses have been punished for misconduct by other states — hundreds even had their licenses revoked — while maintaining clean licenses in California.
As many as 2,000 of these nurses now will face discipline in California, officials estimate. That's more registered nurses than the state has sanctioned in the last four years combined.
The board's discovery was prompted by a Times/ProPublica investigation last year that found hundreds of instances in which California nurses had been sanctioned elsewhere for sexual abuse, neglect, rampant drug use and criminality but could work freely in California.
The "massive" onslaught of new disciplinary cases is going to be "a very significant challenge," said Paul Riches, a deputy director for the state Department of Consumer Affairs, which oversees the agencies that license and police health professionals.
After last year's report in The Times, California ran its list of 376,000 active and inactive nurses against a database maintained by the National Council of State Boards of Nursing, to which nearly all states voluntarily report their disciplinary actions. Among the matches were nurses who had been disciplined by multiple states, sometimes for the same incident.
California officials said they couldn't disclose the names of any nurses who turned up in the search until a formal disciplinary charge is filed in this state. While those cases are pending, the nurses remain free to practice in California.
Nurses are not required to inform the board when and where they are working, but officials said they would file emergency petitions to suspend nurses from practicing if they believed there was a public safety threat.
A review of disciplinary records by reporters easily found cases involving current California-licensed nurses, some reflecting serious misconduct. Among them:
? Marci Nablo, who surrendered her Florida nursing license in 2007 after admitting that she stole the painkiller Fentanyl from patients' pain pumps, replaced it with saline and injected the drug under her tongue. She also was accused of paying a hospital janitor for urine and hiding it in her bra so she could pass a drug test. After she stole drugs in Pennsylvania, her license in that state was suspended in 2008.
? Karen Vivian, whose license was suspended by Nebraska in 2008 after she made nine medication errors, including putting ear drops into a patient's eye. A mental health exam found that she had bipolar disorder that "made her vulnerable in the work environment," board records said. A year later, she also surrendered her Minnesota license.
? Gregory Ashmore, whose Tennessee license was revoked in 2002 after he engaged in sexual intercourse with a patient at the mental health facility where he worked.
Ashmore, who lives in the Northern California town of Fairfield, declined to comment on his case. But when asked whether he should have been disciplined by California, he said it was up to the nursing board to decide.
Vivian lives in Nebraska and is not working as a nurse. But she said she'd thought about moving to California, where her license remains clean.
She said California should know about every case involving one of its nurses, even though she considers hers less serious than drug-using nurses or those with criminal records.
"Why don't they check the national databank?" she asked. "They can get the information the same way you did.... If I'm a patient, I would want to know."
Nablo could not be reached for comment.
California's nursing board has historically done little to check whether its nurses were running into trouble anywhere. Until late 2008, the state did not require nurses, when renewing their licenses, to reveal whether they'd been disciplined elsewhere. The board checked their records against the national council's database of disciplinary actions only when they initially applied for a California license. Board President Ann Boynton said the board now plans to pay the national council to run checks of California nurses on a quarterly basis.
The risks of not checking can be serious. The Times/ProPublica investigation detailed cases in which nurses sanctioned in another state moved to California and were later accused of misconduct.
Nurse Beverley Cathey, for instance, came to California after being put on probation in North Carolina in November 2006 for failing to account for drugs she'd signed out, falsifying records and providing negligent care. Four Los Angeles-area hospitals filed six complaints against her in August and September of 2007, according to records from a temporary staffing firm that hired Cathey.
The California board did not file a public accusation against her license until August 2009, nearly two years after North Carolina indefinitely suspended her.