National Nurses United

patient's illness was no longer well de- fined and the outcomes became in- creasingly unpredictable. In 1985 the BRN adopted a law which mandated that an RN "Acts as the client's advocate, as circumstances require, by initiating action to improve health care or to change decisions or activities which are against the inter- ests or wishes of the client, and by giv- ing the client the opportunity to make informed decisions about health care before it is provided." This means that RNs holding a Cal- ifornia license have a legal mandate to act as patient advocate. RNs are re- quired to always respect and defend the wishes of their patients and to con- sistently act in the best interest of their patients. This also means RNs must recognize those circumstances which require patient advocacy. In an environment where the de- skilling of the nursing process is one of the healthcare industry's top prior- ities, RNs must continue to fight in- tensely to preserve their ability and right to advocate for their patients and to be able to use their discretion and independent professional judgment. The hallmark of nursing is autonomy, unimpeded by cost containment schemes where profit overrides ac- countability. Assault on the California BRN: Governor Calls to Eliminate Public Oversight of Nursing On Jan. 6, 2005 the Governor pro- posed eliminating the independent oversight role of the Board of Regis- tered Nursing (and other 88 regulatory member boards), threatening to wipe out a century of vital public accounta- bility of the professional practice of RNs and care delivery, and posing a se- rious threat to public health and safety. The nine-member Board serves as an independent policy-setting body for the BRN. Seven of the members are ap- pointed by the governor, one by the Senate President Pro Tempore, and one by the Assembly speaker. Board members include five registered nurses (three direct-care RNs, one educator, and one administrator), one physician and three public members. Excerpt from CNA's Testimony "The Governor's current proposal for the Board of Registered Nursing would politicize professional licensing deci- sions, abolish independent public over- sight, and compromise consumer protection," stated CNA in testimony against the BRN's dissolution. "The BRN in California has a proud history as a public protection agency with a Member Board that is account- able to the public and the consumers. Its primary purpose is to guarantee uniform safety standards to California patients, including long-established standards of practice an RN must sat- isfy in California. Especially critical is the obligation that RNs in California are required to advocate for patients in acute care hospitals and other set- tings—even when it is against the eco- nomic interest of their employer . A public board, providing oversight of the staff and accountable to the public, is critical to the ability to protect this pa- tient advocacy role from undue influ- ence of healthcare corporations which have sought for years to redefine the RN professional practice and under- mine the ability of RNs to protect pa- tients. Those corporate interests would have a much greater opportunity to do so under the Governor's proposal. "RN board members bring both their expertise and their legal mandate for patient advocacy to their role. It has been clear that their expertise is needed because the board has faced complex enforcement cases as well as practice and educational policy dilemmas." After CNA and other RNs provided strong and persuasive testimony to the Little Hoover Commission on the ex- tremely negative impacts the proposal will have on public safety, the governor withdrew his proposal, concluding that "this proposal will benefit from further review." Congratulations The California Nurses Association is proud to congratulate our California BRN for its long-standing and illustri- ous history as a public protection and patient advocacy agency. Sources: California Board of Registered Nursing: Sunset Review Report, dated Sept. 3, 2002. California Board of Registered Nursing: www.rn.ca.gov Hedy Dumpel, RN, JD is Chief Director of Nursing Practice and Patient Advocacy for the California Nurses Association. Special Recognition When, as a result of managed care, patient standards sharply deteriorated in our hospitals, Ruth Ann Terry, MPH, RN, BRN executive officer, showed unparal- leled courage and determination that became instrumental to the adoption of numerous patient/consumer protection initiatives. Terry (right) is shown here accepting the National Council of State Boards of Nursing (NCSBN) Award in Recognition of the BRN Celebrating 100 years of Nursing Regulation. She is also the recipient of the NCSBN 2004 Meritorious Service Award. The role of the BRN is to protect patients and healthcare consumers, not the RN. Only an independent BRN can protect our patient advocacy role. RNs have a duty and a right to act as patient advocate. 20 D E C E M B E R 2 0 0 5 C A L I F O R N I A N U R S E Nursing Practice

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