Health & Welfare | Daily Report

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A Senate committee is recommending that the state nursing board seek funds to audit continuing education providers, citing a California Watch report that described how the board came to approve a bogus and absurd course.

The issue will be discussed today in a Senate hearing meant to examine the consumer-protection role of numerous professional licensing boards.

In October, I wrote about a Los Angeles group that decided to test the gatekeepers who approve classes meant to keep nurses up to date on the latest medical advances. In California, nurses are required to take 30 hours of continuing education classes every two years.

The group, the Committee for Skeptical Inquiry, submitted paperwork to teach a class, which would include instruction on "Chinese shyu," or snake oil, and "canupiary flexibility," a concept fabricated by the group. Also in the curriculum was "apophenia," the practice of seeing meaningful patterns in meaningless information.

The nursing board fell for the ruse and approved the course.

Based on information available at the time, I reported that the board’s approved continuing education providers had not been audited since 2006. However, staff of the Senate Business and Professions committee dug deeper [PDF] and found there had been no audit since 2001.

The Senate staff report makes no mention of another controversy surrounding continuing education for nurses: Some have decried its use in nurses union organizing.

Assembly member Curt Hagman, R-Chino Hills, carried a bill last year meant to outlaw such activity. A bill analysis explains why:

According to (Hagman), it has come to his attention, through a complaint from a member of the California Nurses Association (CNA), that CNA has offered continuing education credits to some members of the association as an inducement to attend CNA political events. The author points out that in doing independent research on this matter, it is apparent CNA also offers continuing credits to nurses attending classes focused upon lobbying and political organizing.  

(Hagman) has provided committee staff with a description of a class that CNA will be offering in September 2010 (titled) "Social Advocacy: Advancing Powerful Patient Advocacy and Nurses Values for California." The description indicates that this course examines the RN's unique ability to be the driving force in advancing a powerful RNs' values agenda in the regulatory, legislative, and their policy-making arenas on behalf of patients, families and communities.

The bill would have required nursing education to “contain only content relevant to the practice of nursing.”

The bill died, though. The California Nurses Association opposed it on these grounds, according to the bill analysis:

The California Nurses Association points out that this bill unfairly singles out RNs, and undermines an RN's legal duty to advocate in the sole interest of patients. CNA points out that the duty to advocate on behalf of patients takes place in a number of different ways, including collective patient advocacy, which is often a topic during continuing education courses. Second, CNA indicates that this bill would keep RNs in the dark about important legislative and regulatory developments in the health care field in which they practice. 

At today’s hearing, the Senate Business and Professions Committee will recommend that the nursing board consider adopting a continuing education pilot project that requires nurses to “periodically demonstrate ongoing clinical competence as required for licensure renewal.”

The background paper [PDF] prepared for today’s hearing says the approach “is one that the (Board of Registered Nursing) should consider as a way of looking at performance-based (continuing education) with a focus on the nurses keeping abreast of their clinical practices rather than taking courses which may have no bearing on their day-to-day practice.”

The hearing scheduled for today will primarily focus on reforms spurred by a Los Angeles Times and ProPublica investigation of nursing board enforcement.

A report prepared [PDF] for the hearing said the news articles spurred a number of audits and reviews of other health professional licensing boards, focusing on drug rehabilitation programs, enforcement and public disclosure.