A law bearing the namesake of former nurse and convicted serial killer, Charles Cullen, is good in its intent but harmful in its execution. This is the opinion of two nurse attorneys representing nurses impacted by the law.
Kathleen Gialanella, RN, JD, LLM, and JoAnn Pietro, RN, JD, say the Cullen Law often targets the wrong people and ruins the careers of healthcare professionals — often nurses — who never should have been reported to the N.J. Division of Consumer Affairs or their licensing boards.
About the Law
The Health Care Professional Responsibility and Reporting Enhancement Act was signed into law in May 2005 and requires healthcare professionals or entities to notify the division when they have information regarding the incompetence, impairment, or negligence of a healthcare worker who could endanger patients.
It also mandates criminal background checks of healthcare professionals seeking licensure in New Jersey. The law was intended to prevent another case like Cullen’s, who kept getting hired at different hospitals during his 16-year career, despite a questionable employment record. He claims to have killed up to 40 patients but was convicted of killing 29 and is currently serving 11 consecutive life sentences. Some experts estimate he killed closer to 400 patients.
“Once Cullen was caught, in my opinion, the state got very nervous and essentially threw the baby out with the bathwater,” said Pietro, an attorney in New Jersey. “From a nursing perspective, Charles Cullen is an aberration.”
Unfair targets
But under the stricter reporting laws, she says, nurses are being reported for medication errors, substance abuse issues, or for conduct seen as incompetent but are really the result of inexperience. And the consequences of getting reported to the New Jersey Board of Nursing, which is part of the Division of Consumer Affairs, can be devastating.
One of the provisions Gialanella objects to is that under the law, the employer who reports a nurse to the board has an obligation for the next seven years to disclose to any prospective employer that that nurse was reported.
“It’s an albatross around someone’s neck for seven years, and it doesn’t matter if the board took no action. If you are a prospective employer and you have an applicant who has been terminated and reported to the board, you’re going to think twice about hiring that nurse — or not hire them at all. That’s a huge concern,” she said.
Gialanella, who practices in New Jersey, also argues with the time allotted for nurses to mount a defense. “Within seven days of an action, it has to be reported to the board. Say you’re a nurse who makes a practice error and is terminated for that error — that leaves very little time to protect yourself,” she said.
Pietro said nurses are also unfairly targeted because they are hospital employees and can be reported by hospitals. Physicians, on the other hand, are not considered employees but have privileges at hospitals. Hospitals aren’t reporting physicians who make mistakes under this law, Pietro said.
She added that many of the nurses being reported are new nurses, and they are examples of inexperience being mistaken for incompetence. “New graduates are getting caught in this web and are being deemed incompetent when they’re still just learning,” Pietro said. “We don’t have a residency program, and there’s very little mentoring, so new nurses are thrown to the wolves. In the past, they would have been nurtured and had months of orientation.”
Words of wisdom
If a nurse suspects that they might be close to being reported, Gialanella and Pietro offered this advice:
- Find another job. “If you see the handwriting on the wall, voluntarily resign and walk away,” Pietro said. “If you don’t leave and are terminated, you could be in a situation where you might not get another job.”
- Don’t resign while you are under investigation. “The Cullen Law says that if a licensee resigns from a job while under investigation, that has to be reported to the professional board,” Gialanella said.
- If you’re terminated and told you’re being reported because of the Cullen Law, seek an attorney’s advice as soon as possible. “As the licensee tries to find new work, the former employer may be reporting information about the employee that may make it almost impossible to find additional work,” Gialanella said.
- Understand that you have a right to see the same reporting notice the hospital gives to the board at the same time that it is given to the board. Request a copy of the supporting documents as well, Pietro said.
- Know that the law says that the professional does not have to be reported for substance abuse if that person is willing to check into a licensed recovery and monitoring program.
Amy Loughren, former colleague of Charles Cullen, worked with the investigators who ultimately arrested him. As portrayed in the Netflix movie The Good Nurse, Loughren weighed in on the Cullen Law and its effects on the nursing industry.
“The Cullen Law was a knee jerk reaction to an incredibly complicated issue which involved hospital negligence. Nurses cannot continue to pay the price for organizations’ errors,” noted Loughren. “Real changes need to be made to this law including the criteria for which a nurse can be reported.”
“The law’s heart was in the right place. However, it’s the individuals who covered up Charles’ crimes that have yet to be held responsible,” she added.
Loughren was featured in a recent NurseDot podcast episode, “The Good Nurse,” where she discussed how poor risk management systems allowed Cullen to continue killing and how the repercussions of these failures continue to impact the healthcare system today.
Editor’s note: This post was originally published in February 2009 and has been updated with new content.
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