National Nurses United

C A L I F O R N I A N U R S E D E C E M B E R 2 0 0 5 19 T he California Board of Regis- tered Nursing (BRN) will be celebrating its centennial in December 2005, and what an illustrious century of patient protection and consumer advocacy century it has been. As a regulatory agency, the BRN has marked a century of progress in the area of advocacy for California patients and healthcare consumers. Creation of BRN and Licensing Act At the turn of the century, the idea of nurse registration emerged in order to separate trained from untrained nurses as a means of protecting the public. Pa- tients were confused about who was qualified to deliver nursing care but were unable to advocate for them- selves, hence the profession addressed the problem on their behalf. In March 1905, the California Leg- islature enacted a law providing for qualified nurses to be issued certifi- cates of registration by the Board of Re- gents of the University of California. The Board of Regents had the power to set standards, administer examina- tions, approve educational programs, issue certificates, and revoke certifi- cates of registered nurses. Use of the title "registered nurse" without certifi- cation was a misdemeanor. In August 1913, the Legislature formed the Bureau of Registration of Nurses under the State Board of Health, whose charge was to adminis- ter the examination and registration of qualified registered nurses, to accredit schools of nursing, and to revoke li- censes of nurses found to be unsafe to practice. Use of the title "registered nurse" was unlawful unless the person was registered by the Bureau. The Bu- reau of Registration of Nurses was placed under the State Board of Public Health, within the Department of Pub- lic Health, in 1927. In September 1939, legislation cre- ated the Board of Nurse Examiners within the Department of Professional and Vocational Standards, and five reg- istered nurse board members were ap- pointed by the governor. With this 1939 legislative change, the mandatory Nursing Practice Act (NPA) was estab- lished describing the practice of nurs- ing and moving registration to licensure with a defined scope of prac- tice rather than registration. The title "registered nurse" has continued over the years although regulation is now at the licensure level rather than the reg- istration level. In 1975 the Board's name was changed to its current Board of Registered Nursing. BRN Mission The BRN is committed to protecting the health and safety of consumers and promoting quality registered nursing care in the state of California. The BRN implements regulatory programs and performs a variety of activities to achieve its mission including: Setting educational standards for pre- licensure and advanced practice nurs- ing programs Issuing and renewing registered nurse li- censes and advanced practice nursing certificates. Implementing an enforcement program to take disciplinary action against reg- istered nurses' licenses for violations of the Nursing Practice Act. Managing a diversion program to inter- vene with registered nurses whose practice may be impaired due to chem- ical dependency or mental illness. Monitoring and providing input on legis- lation and regulations. In its ongoing efforts to effectively and efficiently fulfill its statutory man- date, the BRN developed and annually revises a strategic plan, implements a program of continuous improvement, and assumes a proactive leadership role in the identification and resolution of is- sues that impact the education, licens- ing, and disciplining of registered nurses. Sunset Reviews In 1994 the Legislature mandated boards within the Department of Con- sumer Affairs to undergo sunset re- view. The boards were required to analyze the need for continued regu- lations of the profession and the effec- tiveness of their regulatory programs. The BRN, with support from the California Nurses Association, suc- cessfully passed the sunset review in 1996 by demonstrating that the regu- lation of registered nursing is essential for public health, safety, and welfare. Legislation was enacted in 1997 reau- thorizing the BRN for a six-year period. In the 2002 sunset review the BRN recommended that "In light of increas- ing complexity of nursing care, ad- vances in health care technology, and the nursing shortage, the need to regu- late the profession of registered nurses is greater than ever. The BRN should be reauthorized." In addition, it is more important than ever for the Board of Registered Nurses to remain independent. CNA provided strong testimony in support of reauthorization. As nursing practice and healthcare evolve, the public re- lies on the Board of Registered Nursing in its role as patient advocate to ensure that registered nursing activities are performed in a safe and competent manner by qualified RNs. The BRN was subsequently reau- thorized for four years and is up for sunset review in 2006. Board of Registered Nursing: RNs Have a Duty and a Right to Act as Patient Advocates One of the key shapers of the RN pa- tient advocacy role is the California Board of Registered Nursing. Prior to 1985 the basic standards of competent performance did not reflect dynamic changes in nursing. By the early 1980s, contemporary nursing care became more specialized, involving more so- phisticated patient care activities. The Nursing Practice BRN Turns 100 A strong history of patient advocacy Submitted by Hedy Dumpel, RN, JD and the Joint Nursing Practice Commission

• Cover