During his 16 years as a nurse, Charles Cullen was fired six times, quit three jobs and attempted suicide at least once, and employers were never aware of his history. But now, coming off Cullen's claims that he killed dozens of patients, two U.S. senators plan to introduce legislation to prevent a similar situation from occurring in the future.
Sens. Jon Corzine and Frank Lautenberg, both Democrats from New Jersey, where Cullen worked and allegedly killed, are crafting a bill that would create a federal nurse database. Under their proposal, expected to be introduced after Congress reconvenes Jan. 20, employers who share information about nurses with each other-something many are currently loath to do-would be protected from lawsuits. State boards regulating nurses also would be notified when a nurse is being investigated. In addition, the senators have requested hearings by the Senate Health, Education, Labor and Pensions Committee on the matter.
The national databank would be accessible to all hospitals and other employers of nurses. Overarching federal legislation also would allow states to be aware of each other's actions against nurses. "Sen. Lautenberg wants to make sure employers can pass on this information without a fear of lawsuits," said Alex Formuzis, a spokesman for Lautenberg. It is not clear at this point how much congressional support the bill will generate, he said.
The proposal comes on the heels of Cullen's admission that he killed up to 40 patients by giving them lethal doses of medication. Prosecutors in New Jersey and Pennsylvania are investigating the claims. Corzine and Lautenberg want to repair what they see as a gaping hole in the safety of care provided by nurses. Information about nurses is severely limited because hospitals are unable, or unwilling, to share information about their backgrounds for legal reasons. The hospitals where Cullen worked have said they were by and large unable to pass on troubling information from his employment file to prospective employers because of a fear of defamation lawsuits (Dec. 22/29, 2003, p. 6).
Robert Rosseter, director of public affairs at the American Association of Colleges of Nursing, said the association would support any legislation that ensures patient safety, "but we certainly hope any proposal includes all healthcare workers, not just nurses."
Carmela Coyle, senior vice president of policy at the American Hospital Association, said a federal database could be a useful tool, depending on what kind of information it included.
Currently, hospitals must check with the National Practitioner Data Bank when they hire doctors. The databank contains information about criminal convictions, license suspensions and medical fraud convictions on doctors' records. However, hospitals have limited resources when doing background checks on nurses. Another federal database, the Healthcare Integrity and Protection Data Bank, has such information on nurses and other healthcare providers, but the information is not available to hospitals or the public.
The National Council of State Boards of Nursing launched a database in May 2003 containing information about nurses, including licensing verification and disciplinary actions taken against them. To date, 27 states have joined as members and another eight plan to join, said Kristin Hellquist, the council's associate director of policy and external relations. All of the nurses working in these member states are included in the database.
But there are no uniform rules about what hospitals must report to states because different states require different information about nurses. Hellquist acknowledged the council's database may not include all the information the senators want.
There also are no requirements for hospitals to share information with each other, Formuzis said. He said hospitals often are reluctant to share information out of fear of being sued for releasing what could be seen as confidential information.