State Nursing Boards Often Fail to Protect Patients
WASHINGTON, D.C. – State nursing boards are failing to protect patients from nurses who engage in sexual misconduct, according to a groundbreaking study by Public Citizen that was published today in Public Health Nursing.
Only 882 U.S. registered and licensed practical or vocational nurses have been reported to the National Practitioner Data Bank (NPDB) over nearly 14 years (from 2003 through 2016) because of such misconduct, according to the study.
Sexual misconduct by nurses is reported to the NPDB only if it results in an adverse disciplinary action by state nursing boards (or, less commonly, certain entities such as hospitals) or malpractice payments. The low number of nurses reported to the NPDB because of this misconduct—despite the fact that millions of nurses worked in the profession over the study period—suggests that many nurses who commit sexual misconduct go unpunished.
“Our findings, along with other published evidence, suggest that many nurses in the U.S. who exploit their patients are not being held to account,” said Azza AbuDagga, health services researcher for Public Citizen’s Health Research Group and lead author of the study. “When just a few of the country’s nurses are flagged for this exploitive behavior, something is clearly wrong. The #MeToo movement shows that this kind of abuse is pervasive in our society, especially when there is a power imbalance between parties. The potential for this abuse of patients is high for nurses, in part, because they spend long hours with patients, often providing care that involves close proximity to patients.”
The study is the first to analyze NPDB reports involving sexual misconduct by nurses.The study also found that although male nurses account for approximately 10 percent of U.S. nurses, males accounted for 63 percent of the nurses reported to the NPDB due to sexual misconduct.
The NPDB contains information about health care professionals, including nurses, who have been subject to adverse state licensing actions (or adverse action by other entities, such as hospitals) or had malpractice payments. This information is required by law to be reported to the NPDB.
According to the study, of the 882 nurses who faced consequences for sexual misconduct that resulted in NPDB reports, 866 were reported by state nursing boards. Nursing boards administered harsh punishments in most of these cases: 91 percent of such reports involved serious actions—including revocation, suspension or voluntary surrender of the nursing license. In contrast, state nursing boards took serious actions in only 75 percent of the nurse reports for other types of offenses.
However, nearly half of the nurses who engaged in sexual misconduct with patients that led to NPDB malpractice payment reports—16 out of 33—were not disciplined by state nursing boards for their misconduct, the study found.
AbuDagga co-authored the study with Dr. Sidney Wolfe, founder and senior adviser of Public Citizen’s Health Research Group; Dr. Michael Carome, director of Public Citizen’s Health Research Group; and Robert Oshel, retired associate director, Division of Practitioner Data Banks, Department of Health and Human Services.
“State nursing boards have full access to the NPDB data,” Carome explained. “They need to discipline nurses with malpractice payments for sexual misconduct to protect the public. Without such licensing action these nurses would simply be able to abuse more patients.”
Added Wolfe, “These results show that when state nursing boards take a disciplinary action, that action rightly tends to be more serious for sexual misconduct than for other offenses. However, state nursing boards need to heed such misconduct that led to malpractice payouts with the same regulatory vigor.”
The findings for nurses are consistent with those from a 2016 study by Public Citizen that showed that 70 percent of U.S. physicians—177 out of 253—who engaged in sexual misconduct that led to sanctions by hospitals or other health care organizations or malpractice payments were not disciplined by state medical boards for their unethical behavior.
The nurses with sexual misconduct-related reports identified in the new study accounted for just a small fraction (0.6 percent) of all nurses with NPDB reports that met the study criteria. Similarly, Public Citizen’s 2016 study showed that physicians with reports related to sexual misconduct accounted for approximately 1 percent of the total physicians with NPDB reports that met the study criteria.
“This suggests that state health professional licensing boards fail to protect patients who are victimized not just by nurses, but by others in the health care field,” Carome said.
Read the full study.