Findings: Some temp nurses unfit for the job

Los Angeles Times

Agencies that supply temporary nurses to the nation’s hospitals are taking perilous shortcuts in their screening and supervision, sometimes putting seriously ill patients in the hands of incompetent or impaired caregivers.

Emboldened by a chronic nursing shortage and scant regulation, the agencies vie for their share of a freewheeling, $4 billion industry. Some have become havens for nurses who hopscotch from place to place to avoid the consequences of misconduct.

An investigation by the nonprofit newsroom ProPublica and the Los Angeles Times found dozens of instances in which staffing agencies skimped on background checks or ignored warnings from hospitals about subpar nurses on their payrolls. Some hired nurses sight- unseen, without even conducting an interview.

As a result, fill-in nurses with documented histories of poor care have fallen asleep on the job, failed to perform critical tests or stolen drugs intended to ease patients’ pain or anxiety.

“A lot of them are really bad nurses,” said Sandra Thompson, a nursing supervisor at Northridge Hospital Medical Center and Sherman Oaks Hospital, both in the Los Angeles area. “Sometimes I see them here [at Northridge] and think, ‘I wonder how long before I see them over [at Sherman Oaks]?’”

Some agencies are diligent about checking nurses’ records, said Joey Ridenour, executive director of the Arizona State Board of Nursing.

Others are not. As a result, if wayward nurses want to work, “I think it’s easier to hide in the registries,” Ridenour said. “Some just sign them up.”

Among reporters’ findings, based on disciplinary records, personnel files, court documents and interviews:

UAgencies hired nurses who had criminal records or left states where their licenses had been restricted or revoked. At least three agencies employed a nurse in California whose license had been suspended in Minnesota for stealing drugs at a string of temp jobs. One used him after he’d been convicted of doing the same at a nursing home in Santa Rosa, Calif.

UTemp agencies shuffled errant nurses from one hospital to another, even as complaints mounted. A Culver City, Calif., agency continued sending one nurse to hospitals despite more than a dozen warnings that she was ignoring patients and sleeping on the job. Before the agency hired her, the nurse had been convicted of 12 crimes, including prostitution, carrying a concealed weapon and cocaine possession.

UNurses who were in trouble at one agency had no problem landing a job at another. An Oklahoma nurse cycled through at least four Southern California agencies in a year, accused of pilfering drugs at each. Before her final stop, she was arrested in her home state for calling in prescriptions while posing as a doctor’s-office employee.

Failings in the temp industry are magnified in states where nurses are in particularly short supply, such as California. Almost every facility, from rural medical outposts to prestigious hospitals, must occasionally rely on temporary help.

When staff nurses err, hospitals typically retrain or monitor them. Temp nurses often are just exchanged for replacements, never receiving further guidance.

Industry executives and health-care administrators say the agencies are invaluable to hospitals and nursing homes when nurses take sick days or go on strike and when emergency rooms are swamped.

Nurses find the jobs attractive because they can visit other places and control their schedules — all while collecting premium wages, bonuses and sometimes travel and living expenses. Some work locally while others are employed by “travel” firms that send them all over the United States. (They must have licenses for states where they work.)