In my previous blog post (Ir)regulation of the Health Professions, I briefly told the story of my run-in with the Virginia Health Regulatory Board, and how I was investigated by them for nine months. They (I think—I still have no written proof) then closed my case due to insufficient evidence. An independent state audit of the Virginia Health Regulatory Boards around the time of my encounter with them revealed that it took the Board of Medicine on average over two and a half years to conclude cases, and the Board of Nursing took over a year. In almost all cases, including ones involving serious violations, the Board of Medicine allowed physicians to continue practicing pending the outcome of the investigation. In contrast, the Board of Nursing usually ordered the nurse to not practice pending their final decision at the conclusion of the investigation. The Board of Nursing was the only health regulatory board to summarily suspend the license of nurses prior to the conclusion of the investigation. In the Virginia audit report, the authors pointed out that such long time delays in processing investigations posed a serious threat to public safety. They also stated that long delays in case processing placed an unfair burden on respondents (providers accused of wrong-doing).
Not having access to any written reports on my own case—including not knowing what I was accused of doing in the first place, I can only go by the notes I took during my meeting with the Attorney General at the time. From what I can gather, the Boards of Medicine and Nursing were disputing scope of practice standards for nurse practitioners and I was a likely test case. I remember testifying at a special hearing of the Virginia legislature about nurse practitioner scope of practice and why reforms in state laws were necessary for the provision of safety net services. Virginia remains one of the worst states in terms of nurse practitioner scope of practice. I don’t plan to practice there anytime soon, but I do hope they get their (nurse practice) act together. I know they are working on it.
JOSEPHINE ENSIGN 