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The Georgia Board of Nursing wants a divorce.
After years of poor communication, lingering resentments and suspicious maneuvering, the nurses want out of their long-term relationship with Secretary of State Brian Kemp. It's been coming for a while, but Kemp's sudden decision to remove the board's executive director was the final straw.
When the board meet last week in Macon, the room was filled with nurses and nursing students from around the state. They were concerned about plans, revealed last month, to remove Executive Director Jim Cleghorn and replace him with the executive director of the board of cosmetology, which regulates nail salons among other things.
Kemp’s decision galvanized state nursing leaders who spread the word among Georgia’s 158,000 registered nurses.
“I have to ask myself is this personal?” Linda Streit, dean of the Georgia Baptist College of Nursing at Mercer University, said at the meeting. “I think it’s personal for a lot people in this room.”
After meeting with the heads of several nursing programs and representatives of the nursing lobby, Kemp backtracked and suggested the personnel swap could be delayed six months. But he stood by his decision in the name of “cross-training” his staff.
Kemp sent his legislative director, Chuck Harper, to the meeting to offer that Cleghorn’s replacement not be made for another year, six months longer than he first proposed. It was the wrong move, both in tone and substance, and the board rejected it out of hand.
Like an inattentive spouse, Harper seemed to lack a basic understanding of the board’s complaints.
Referring to Kemp’s latest timetable for replacing Cleghorn, Harper said, “I thought that is what you wanted.” Nurses in the audience laughed out loud at that.
“We want to keep our executive director,” Brenda Rowe, the outgoing president of the nursing board, replied.
It didn’t help that Kemp’s latest olive branch came as a total surprise to the board. This just emphasizes the lack of communication between Kemp and the nurses, board member Nancy Barton said.
“We have outgrown the current organizational structure,” Barton, an administrator at Northeast Georgia Medical Center in Gainesville, said. “The type of communication — or lack thereof of communication and collaboration — with the board is negatively impacting the board’s ability to move the profession forward.”
By the end of the meeting, the board was making plans for January when lawmakers return to the Capitol and nurses can lobby to pull the board out of Kemp’s professional licensing division. If they are successful, the nurses will join the the boards of dentistry and pharmacy, both of which left the Secretary of State’s office in 2013 and became independent agencies.
Kemp, nurses trade talking points
Kemp’s broken relationship with the board is bad news for anybody who might find themselves on the jabbing end of a nurse in Georgia. Along with licensing all of the nurses in the state, the board regulates 78 nursing education programs and is responsible for investigating and disciplining nurses who violate the standards of the profession.
That last part — rooting out and removing rogue nurses — is the scariest part of their work and has proven the most difficult.
Since the 2012 fiscal year, nursing complaints have doubled, largely due to a change in the law that requires employers to report bad nurses to the board rather than quietly firing them and letting them continue to practice elsewhere.
That's a change the nursing board fought for, even while complaining that the Legislature and the Secretary of State's office did not give them the enough resources to handle their existing caseloads. At one point, complaints were waiting an average of 15 months to be addressed and the board had a backlog of thousands of unresolved cases.
In recent years, the nursing board got additional staff and money and has trimmed the backlog of discipline cases. A fact sheet handed out by Secretary of State staffers at last week’s meeting points out that Kemp has assisted in getting more resources for the board and pushed the board’s legislative agenda. The board had it’s own fact sheet touting advances they claim were made because of Cleghorn’s leadership.
Officially, Kemp wants to replace Cleghorn in the name of “cross-training.”
Privately, nursing leaders tell me they believe Kemp is trying to reign in a rogue licensing board by installing a more trusted employee as its head. A couple of state lawmakers who are watching the situation told me the move smacks of sexism, since the nursing profession is overwhelmingly female.
Nursing board state’s largest
The Professional Licensing Boards regulates and licenses 39 professions ranging from interior designers to wastewater plant operators, but no profession is as large as nursing and no board generates as much revenue. Kemp can be expected to fight to retain the board both on philosophical and financial grounds.
When the dental and pharmacy boards petitioned the legislature for permission to leave, Kemp complained to lawmakers that the move would be financed out of his office and would result in new spending. Kemp's spokeswoman recently told me that allowing the nurses to go their own way would also be less cost efficient.
I took a look state spending since dental and pharmacy left and found modest increases in budget since those board’s became independent. Since the 2014 fiscal year, the pharmacy board budget has increased 12 percent, while the dental board has risen 13 percent — most of that increase came in the boards’ second budget, when the cost of doing business became more clear.
Kemp’s budget for the remaining professional licensing boards has increased 26 percent over the same time period. Harper told the nursing board that the “lion’s share” of that money has gone to them, but board members immediately shot back that they had to beg for improvements to deal with an increased workload.
“We are the biggest board and bring in the most dollars that we never see,” Phipps said.
Increasingly it appears this is a marriage that cannot be saved.
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