Pollman later learned that when the Arizona Board of Nursing heard her case in August, she'd be able to make a five-minute statement -- unlike in Colorado, where nurses are not allowed to testify before the board. In the months preceding that hearing, a friend put Pollman in touch with a lawyer who knew about a similar case in Colorado. An administrator at another Denver-area hospital had been charged by the Colorado Board of Nursing with violating the Nurse Practice Act in two incidents. In one, a patient died after nurses failed to recognize her symptoms and report them to a doctor. In the second, an intravenous needle was improperly inserted into an infant, and the fluid went into the baby's tissue instead of the bloodstream; the baby had had to undergo two surgeries to repair the damaged tissue. Even though the administrator had no contact with either of the patients -- and was even on sick leave when the second incident occurred -- she was issued a letter of admonition.
The administrator appealed the board's action, claiming that she wasn't responsible because the nurses in each of the hospital's seven departments report to their immediate directors, not to her. The Colorado Court of Appeals overturned the board in May. In his ruling, Judge Robert Kapelke wrote, "Respondent contends that the Nurse Practice Act does not authorize the board to discipline her for the conduct at issue here because she was not engaged in the 'practice of professional nursing' within the meaning of the Act. Under the circumstances here, we agree."
According to the Nurse Practice Act, the "practice of professional nursing" includes: "Providing therapy and treatment that is supportive and restorative to life and well-being either directly to the patient or indirectly through consultation with, delegation to, supervision of, or teaching of others."
Judge Kapelke determined: "In her administrative capacity, respondent was not providing evaluation of a patient's treatment. Therefore, we conclude that the Board exceeded its authority in disciplining respondent."
The decision came just in time for Pollman, who sent a copy of it to the Arizona Board of Nursing. She met with the boardmembers on August 19, but before they got to her case, they discussed several others. "The longer I sat there listening to other cases, the angrier I got at the State of Colorado. There were nurses who'd abused children, alcohol and drugs. I did none of those things, and yet I had been punished," Pollman says.
When it was Pollman's turn to testify, she was nervous. "You're sitting before a long table with nine people. It feels like you're on trial," she recalls. "If I'd had any idea of the ramifications that would come from signing that stipulation, I never would have done it. I had no idea it would cause me so much trouble in other states."
When she was done presenting her side, one boardmember asked Pollman if the person who was supposed to search the patient was a nurse. Pollman said yes. The boardmember then asked if the person in charge of the psychiatric unit at the time was a nurse. Again, Pollman answered yes. "She said, 'Those are the people who should have been disciplined,'" Pollman recalls.
The board voted unanimously to dismiss Pollman's case and grant her a license. "The investigator herself came over and hugged me and said, 'I'm glad it went your way,'" Pollman says.
"My family wants me to reopen my case and get it heard on appeal in Colorado, but I don't want to practice in a state that doesn't treat nurses fairly," Pollman says. "If the supervisory nurses in Colorado understood that the Board of Nursing is holding them responsible for anything their nurses might do -- that if their staff ever messes up, the board could go after them -- no one would want to be in a supervisory role in Colorado."
Nurses say having a complaint before the Colorado Board of Nursing is like walking around with a scarlet letter pinned to their chests.
The reason: The Nurse Practice Act requires employers to report nurses to the board for any violation of the Act, no matter how minor.
And a lot of minor mistakes are being made, they say, because of a nursing shortage in Colorado that came about in the mid-1990s. As managed-care companies nationwide looked for ways to cut costs, nurses were among the first casualties. Word of the subsequent shortage in nursing jobs spread and enrollment in nursing schools dropped.
The result is that in the past five years, fewer nurses have been left to work longer shifts and handle greater responsibilities. Mistakes, they say, are bound to happen.