'Compact' allowed dangerous nurses to work in multiple states

On the heels of last month's news that roughly 3,500 nurses who had previously been penalized in other states were licensed to work in California comes more news of the same ilk. Another ProPublica investigation, this time reported in USA Today, finds that a 24-state compact created 10 years ago to help get nurses out to needy areas has, in some areas, backfired, instead allowing dangerous nurses to get rehired with little to no background checking. 

While the Nurse Licensure Compact, in essence, allows nurses to obtain a multistate licenses quickly--meaning help is disseminated faster--no "central licensing" exists, leaving the job of background checking up to individual states. One nurse, Craig Peske, who had been fired from a hospital in Wisconsin in 2007 for signing out 245 syringes full of the painkiller Dilaudid over a three-month span--nine times the average amount signed out by other nurses at the hospital--was able to find work again at a hospital in North Carolina because of the compact. 

"When I went to go for the job in North Carolina, I looked at the status of my license, and it was still active," Peske said, according to the report. "That kind of surprised me, so I figured I would take it." 

ProPublica found several other instances of the compact not working, including: 

• A nurse anesthetist, Stephen Woodfin, who stopped practicing as a nurse in North Carolina in 2006 due to substance abuse, but two years later passed out while helping with a surgery in a Texas operating room, bleeding from a vein in his arm. According to Texas Board of Nursing records, Woodfin had abused the narcotic Fentanyl.
• A nurse, Dayna Hickman, who currently works in critical care in Iowa, but whose license was suspended in Texas in 2006 after administering undiluted vitamin K too quickly to a patient. The patient died shortly after the incident. 

Despite the incidences, Jody Ridenour, the compact's national board chairwoman, insists that the compact is a good thing and that only a small percentage of compact nurses are disciplined outside of their home states. 

"I am very careful to say that this is not a cure-all," Ridenour told ProPublica. "I just believe it's better than what we had before." 

For more information:
- here's the ProPublica report, courtesy of USA Today
- check out this Charlotte Observer piece
- read these other ProPublica articles

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