Executive Summary

Issue 1: Licensure of the Practice of Registered Professional Nursing Is Needed to Protect Public Interest.

This report is a Regulatory Board Evaluation which requires by law a determination of whether or not the Board is necessary for the protection of public health and safety. In determining if there is a need for the Board of Examiners for Registered Professional Nurses (RN), a primary consideration is whether the unregulated practice of the profession would endanger the health and safety of the public. The finding of this issue is that licensing Registered Nurses is necessary for protecting the citizens of West Virginia.

The RN must have knowledge from various disciplines in addition to the basic nursing skills which are taught through a prescribed curriculum. RN's are also independent in practice and are sometimes the sole source of advice and supervision for Licensed Practical Nurses who may be administering medications and/or treatments. Registered Nurses' workplaces are primarily within the confines of the hospital setting. In West Virginia, there were 21,950 RN's licensed during fiscal year 2000. Of that total, 79.5% worked within a hospital setting.

The Registered Professional Nurse is a profession which is directly involved with public safety and health. RN's are responsible for exercising knowledge based decisions effecting health care, performing numerous highly technical skills and certain administrative roles as well. Licensure ensures a minimal degree of competence relating to the skills required of a RN. Regulation of licensure for registered nurses provides a systematic and organized approach to licensure which ensures statewide conformity and standardization of rules and procedures

Every state licenses and regulates Registered Professional Nurses. WestVirginia has two separate licensing boards of nursing although most states license and regulate the nursing profession through one board.In addition to licensing almost 22,000 individuals, the board is responsible for accrediting seventeen schools in West Virginia including a total of nineteen programs. These programs prepare persons for initial licensure by the board.

Recommendation 1

The Legislative Auditor recommends that the Legislature continue to require Registered Nurses be licensed by the State of West Virginia.

Issue 2: The Board Complies with the General Provisions of Chapter 30.

The Board of Examiners for Registered Professional Nurses has complied with applicable state laws and rules. These laws and rules, primarily found within the Board's own article of Code and in the general provisions of Chapter 30, are important in the effective operation of a licensing board.

The Board of Examiners for Registered Professional Nurses requires continuing education which became effective on January 1, 1997. Every odd year, each individual applying for a license must certify that they have completed 30 contact hours (one contact hour is equivalent to 50 minutes of consecutive instruction) of continuing education within the prior two-year period on their renewal form. The Board has established a list of parameters for continuing education violations.

As required by law, the Board has submitted legislative rules (CSR §19-9-1) describing the complaint process. This rule provides, among other things, that complaints are logged by the Board, the complainant is sent an acknowledgment of the receipt of the complaint and the licensee is notified of the complaint by a Notice of Complaint and given an opportunity to respond to the allegations contained in the complaint. The Board keeps track of all complaints received against each licensee utilizing a database to account for each complaint. The Board states that each complaint is responded to in approximately one week and that complaints are reviewed by the Disciplinary Review Committee which consists of Board members and Board staff. In FY 2000, the average complaint was resolved in 222 days, which is over seven months. The Board states that the reason that cases take this length of time is because most nurses are represented by an attorney which increases the amount of time it takes to reach a final resolution.

Financial self-sufficiency of regulatory boards is required by West Virginia Code §30-1-6(c). The Board has a total budget for FY 2001 of $833,728. The Board's licensing fees and administrative fees imposed against its licensees are remitted to the Board's special revenue fund, and the fines imposed are remitted to the State's general fund in accordance with the Code §30-1-10. The Board is self-sufficient through its licensing fees.