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Terry, at the helm for nearly 16 years and on staff for 25, acknowledged that the pace of the disciplinary process has "always been unacceptable" and said the system was being streamlined. But she blamed other parts of the state bureaucracy for delays and was vague about what changes would be made.
Later, the state Department of Consumer Affairs, which oversees the board, sent reporters a three-page list of "process improvements." Many were mundane or incremental adjustments -- such as revising disciplinary guidelines or planning expert witness training. Others seemed more directly aimed at reducing delays: adding staff, meeting with investigators about stalled cases and using computer systems to better track complaints.
Patricia Harris, acting chief deputy director of the department, stood behind the board. "I think they do a good job," she said.
It's impossible to measure the number of nurses whose conduct endangers patients, but it is presumed to be a small fraction. The board disciplines several hundred a year.
Even a small number of troubled nurses can have wide impact, however. Registered nurses are required to perform or oversee complex treatment, and each can see dozens of patients a week.
Patients generally don't have a choice in which nurse they get. Most trust that, at minimum, the government wouldn't allow a nurse with known problems at their bedside.
In California, the board's vigilance is especially important. The state has among the fewest registered nurses per capita of any state, with an estimated 654 working nurses for every 100,000 residents, compared with 836 nationwide.
Putting even greater strain on the nursing supply is a unique state law that limits how many patients each hospital nurse can treat at one time.
With demand outstripping supply, nurses have readily jumped from one hospital to another, and employers have relied heavily on the board to screen out poor performers.
Despite its critical mission, the board faces little outside scrutiny or pressure to change its ways. Public board meetings, held five times a year, are filled with praise for staffers' efforts. During five meetings attended by reporters since November 2007, Terry never focused on the delays in discipline.
And board members -- including both nurses and public appointees -- never publicly challenged staffers or urged quicker action even though they review every disciplinary action. (Board President Susanne Phillips said such questions are often raised with staff privately.)
While the board tarries, nurses like Owen Jay Murphy Jr. keep working.
In 2006, more than a year after Kaiser warned the board about him, Murphy was employed at Riverside Community Hospital. There, according to a criminal investigator's affidavit, he forcibly grabbed the face of a patient whose arms were tied down.
"I was helpless," said Christy Ledebur, now 50. "Why would they have someone like that working in an emergency room?"
Ten days later, Murphy punched and elbowed another restrained patient in the face, the investigator's statement said.
"I don't even recall the first two hits," said Murphy, 41, adding that his stress and anger at the time clouded his memory. "They said I hit 'em three times."
Riverside Community fired him in July 2006 and immediately alerted the nursing board, a hospital official said. He later pleaded no contest to misdemeanor charges in both incidents.
A month later, a patient at Arrowhead Regional Medical Center in Colton complained that Murphy had put her in a headlock and shoved her against the wall, leaving clumps of hair on the bed and floor, according to hospital officials and board records.
The board took its first public action in June 2007, filing a formal accusation detailing the administrative charges against Murphy.
The former Army medic said in an interview that he had been provoked in some cases by aggressive or mentally impaired patients. But he said he was a good nurse and confident that court-ordered anger management classes had taught him self-control.
Later, the state Department of Consumer Affairs, which oversees the board, sent reporters a three-page list of "process improvements." Many were mundane or incremental adjustments -- such as revising disciplinary guidelines or planning expert witness training. Others seemed more directly aimed at reducing delays: adding staff, meeting with investigators about stalled cases and using computer systems to better track complaints.
Patricia Harris, acting chief deputy director of the department, stood behind the board. "I think they do a good job," she said.
It's impossible to measure the number of nurses whose conduct endangers patients, but it is presumed to be a small fraction. The board disciplines several hundred a year.
Even a small number of troubled nurses can have wide impact, however. Registered nurses are required to perform or oversee complex treatment, and each can see dozens of patients a week.
Patients generally don't have a choice in which nurse they get. Most trust that, at minimum, the government wouldn't allow a nurse with known problems at their bedside.
In California, the board's vigilance is especially important. The state has among the fewest registered nurses per capita of any state, with an estimated 654 working nurses for every 100,000 residents, compared with 836 nationwide.
Putting even greater strain on the nursing supply is a unique state law that limits how many patients each hospital nurse can treat at one time.
With demand outstripping supply, nurses have readily jumped from one hospital to another, and employers have relied heavily on the board to screen out poor performers.
Despite its critical mission, the board faces little outside scrutiny or pressure to change its ways. Public board meetings, held five times a year, are filled with praise for staffers' efforts. During five meetings attended by reporters since November 2007, Terry never focused on the delays in discipline.
And board members -- including both nurses and public appointees -- never publicly challenged staffers or urged quicker action even though they review every disciplinary action. (Board President Susanne Phillips said such questions are often raised with staff privately.)
While the board tarries, nurses like Owen Jay Murphy Jr. keep working.
In 2006, more than a year after Kaiser warned the board about him, Murphy was employed at Riverside Community Hospital. There, according to a criminal investigator's affidavit, he forcibly grabbed the face of a patient whose arms were tied down.
"I was helpless," said Christy Ledebur, now 50. "Why would they have someone like that working in an emergency room?"
Ten days later, Murphy punched and elbowed another restrained patient in the face, the investigator's statement said.
"I don't even recall the first two hits," said Murphy, 41, adding that his stress and anger at the time clouded his memory. "They said I hit 'em three times."
Riverside Community fired him in July 2006 and immediately alerted the nursing board, a hospital official said. He later pleaded no contest to misdemeanor charges in both incidents.
A month later, a patient at Arrowhead Regional Medical Center in Colton complained that Murphy had put her in a headlock and shoved her against the wall, leaving clumps of hair on the bed and floor, according to hospital officials and board records.
The board took its first public action in June 2007, filing a formal accusation detailing the administrative charges against Murphy.
The former Army medic said in an interview that he had been provoked in some cases by aggressive or mentally impaired patients. But he said he was a good nurse and confident that court-ordered anger management classes had taught him self-control.
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