They’re not completely recession proof, but the healthcare industry is still going strong, even in “today’s economy.” (Oh how I hate that expression) And even with all the commotion over healthcare reform, and dire warnings from Republicans and health insurance companies about how improving access and care will be the undoing of our nation, healthcare is still running strong.

So its a good place to look for a job. Still. I know, there have been complaints from nurses about layoffs, inability to find jobs, and so on, that is reminiscent of the early 1990s–when the industry created an artificial nursing surplus in order to cut costs. And it backfired major league. As it will do now.

But nursing isn’t the only job in town. In fact, there are a lot of careers that pay better, have better hours, are less messy, are as rewarding, require as much skill or more, garner you more respect, and have a rosy future. The American Medical Association has a really good website devoted to healthcare careers, other than physician. I came across it when I was doing research for an article and I was really impressed. At first glance it doesn’t look like much, but that whole list is “clickable.”

Okay, so we’ve heard about the nursing shortage. Now it’s time to pick on another group of healthcare workers–physicians.

Apparently, several parts of the country are facing physicians shortages, or will be facing them. And it seems to be mostly primary care doctors. Gone are the days of Marcus Welby, who not only was always at work, but didn’t seem to have to concern himself about reimbursement, insurance, malpractice (now who would dare to sue Marcus?), cost cutting, etc. In fact, Marcus seemed to have all the time in the world to stick his nose into other people’s business.

But 10 articles popped up on Google news this evening, about physician shortages, and in places as widespread as Hawaii, Santa Cruz in California, Muncie in Indiana, Japan, Australia, Texas, and Grand Junction in Colorado.

Interesting but not all that surprising.

Yes, you. If you’re a nurse or physician or other healthcare worker who is currently living in the U.S. on a temporary visa, that visa can turn to citizenship in just a matter of six months. The only catch is that you have to join the military, but it might not be a bad trade-off if your goal is to settle permanently in the U.S.

From the NY Times:

Military officials want to attract immigrants who have native knowledge of languages and cultures that the Pentagon considers strategically vital. The program will also be open to students and refugees.

The Army’s one-year pilot program will begin in New York City to recruit about 550 temporary immigrants who speak one or more of 35 languages, including Arabic, Chinese, Hindi, Igbo (a tongue spoken in Nigeria), Kurdish, Nepalese, Pashto, Russian and Tamil. Spanish speakers are not eligible. The Army’s program will also include about 300 medical professionals to be recruited nationwide. Recruiting will start after Department of Homeland Security officials update an immigration rule in coming days.

I got a cute little note from the California Board of Nursing a few days ago. When a letter arrives from them, and it’s not time for the obligatory renewal, you always have to brace yourself for the unknown. As in….”what the %&?%! do they want?”

You have to expect bad news, as in wanting to suck more money out of license holders, or adding new requirements to getting a license or renewing it. In this case, I was right on target. The California BRN has now decided that all nurses must be fingerprinted, as a safety measure.

I can see if this was a new ruling for nurses who are first obtaining a license in the state. That would make more sense. But no, they want everyone to be fingerprinted, even if you were first licensed during the California Gold Rush!

And what’s more, the fingerprinting is done at your own expense (of course), which according to the BRN, runs about $5-$45. And then the BRN will charge each nurse a $51 “processing fee.” Phew, do you smell scam? I can smell it all the way up north in Washington state.

The Dumbness of it All

I have often criticized our current licensing system, as it is set up primarily to provide income to the state and not to improve patient safety or maintain the highest levels of competence.

According to the BRN’s website, the cost of fingerprinting is $51. How they came up that as a processing fee taxes the neurons. Is this the right amount they need to make up for possible cutbacks to their budget? Did the nice girls and boys at the BRN not get their Christmas bonus this year, or are they going to have to postpone gettin their office bathroom remodeled?

As to how many nurses this involves–I don’t know. According to a fact sheet from the California Healthcare Association, there are about 275,000 RNs with active licenses in the state. Many were probably were licensed before 1990, so it is safe to sayIs this just a ploy to help the poor beleagured state of California balance their budget, by requiring all nurses to suddenly get fingerprinted? California began to require fingerprinting in 1990, so there are definitely quite a few who will be forced to pay this fee if they want to keep an active CA license.

On the other hand, it may be an impetus for nurses no longer working as such, but who just maintain an active license, to say, “The hell with you. Hasta la Vista, baby, take the license and shove it.”

Second, what’s with the retroactive bit? I’ve been licensed in California for over 20 years, have no infractions against my record, and indeed, my nursing record is spotless. Would requiring my fingerprints suddenly make the world safer for humankind?

According to their website, the BRN says that the reason they collect fingerprints is:

Why are registered nurses being required to be fingerprinted?

The mission of the Board is to protect the health and safety of consumers by promoting quality registered nursing care in the State of California. The Board fingerprints licensees as one way of ensuring that registered nurses are safe and competent practitioners.

Fancy words, but fairly meaningless. It may help weed out people who have a criminal record in California, and help keep nurses out of work environments where they should not be–ie, like a nurse arrested for drug dealing should not be in charge of the narcotics cabinet.

But because there is no national database of nurses, and every little Board of Nursing holds fiercely onto their turf and turns their nose up at the dreadful thought of a national license, there is no way of checking the record of nurses who enter CA from out of state.

Yes, the BRN, who claims to want to protect the public, does not want to lose their status and allow for true public safety. I’ve written on this before, but here is an example of how inept and dangerous the situation is.

I took my licensing exam in Wash DC, and was subsequently licensed. I went on to obtain a license in Virginia and in Florida, at the same time that my license was still current in DC. Now suppose I had killed a patient in Virginia, or was arrested in Florida for beating up my supervisor? And even served jail time?

Now, suppose that I lost my license in Virginia and/or Florida. Well, no big deal because I am still licensed in DC. And using my DC license, I can go back to work there, and never say a word about my tawdry record in Virginia and Florida and no one will ever know.

And I can take my spotless DC license and use it to apply for a CA license by reciprocity. Never mention that I previously had a license in Virginia and Florida.

How can that be, you may wonder. Well, the only way a BRN knows what states you’ve been licensed in is if YOU TELL THEM! How dumb is that? If they wanted to check my record, they would have to contact the boards in every state, to see if my name came up. Because we have no national database! And as well all know, no nursing board is going to do that.

So they think that by forcing all nurses now to submit fingerprints, they are going to make the public safer. It is really pathetic.

Now, it even gets better. The California Board will not accept fingerprints that you had done for another purpose, even if they were taken in California.

I was fingerprinted by my employer, school, or other state agency. Do I need to be fingerprinted for the California Board?

Yes, by law, fingerprint records are specific only to the requestor and results cannot be shared with others. Therefore, you must submit fingerprints to the Board. Although it may be inconvenient to submit fingerprints to multiple agencies, it protects your interest by ensuring that you know and authorize your records being sent to the requesting entity.

Whew, now doesn’t it sound like they are looking our for your interests? I mean, how dumb do they think people are. No, they are listening to the “ka-ching,” the money that will need to be forked over. What a scam, requiring repeated fingerprinting over and over again. Well, people do what they gotta do in hard times, and I guess this is Arnold’s revenge on all those nurses who won their case to keep the nurse=patient ratio law intact.

“You pay up or you die,” says the Governator.

So What Will I Do?

Well, when I first looked at it, my initial reaction was, “Yeah, and I’ve got swampland to sell you.” Like am I going to waste my time getting fingerprints, and pay for it no less? Just to help California get out of a money jam, created by corrupt and total mismanagment?

My next reaction was, wait! I already have been fingerprinted, as I worked for the military in California. But no, those prints are no good. The BRN only accepts “nice fresh prints” that are done exclusively for them.

So, I was going to write them a nasty-nice note, telling them that I could understand this is if it was part of a national nurse database, but the current system sucks and is dangerous.  A national license would eliminate the need for full fledged BRNs, and instead require just a small satellite in each state. So since the BRN in its present form exists just to support itself, they do not support national licensing. Which means that they don’t support public safety and this whole thing is a charade.

But then I saw that fingerprints are not necessary if the license is renewed on an inactive status, which mine is. I guess they’re not totally insane, as they are aware of the lost revenue of people like me who would just putting those inactive licenses in the shredder.

You see, CA charges you the same hefty fee ($85) whether the license is active or inactive, and it is actually less work for them to maintain inactive licenses because they don’t have to worry about continuing ed credits. So they love the inactive people—same price for less work.

Talk about scams…

Anyway, requiring the inactive folks to stick their fingers in ink would cause their revenue to plummet, because most of us would just tell them to take a flying f##k and to shove the license up their butt.

So the conclusion is that I will keep my inactive license, not get new fingerprints, and maybe seriously consider getting involved in making national licensing a reality.

Here is a link to the CA BRN’s schtick on fingerprinting:

Fingerprint Requirement for License Renewal

New year, new site.

Finally, the long awaited revamp. As you can see, it looks a little different and there are all of these strange little tabs on top, and new sections, and the style is slightly different. The reason for the revamp was to make the blog more focused, and easier to locate different topics.

Every article that has ever appeared on this site is still here, and can be found under “All Topics.” Some of them will have to be sorted out further and tagged, but for now, everything that doesn’t fall under the tabs above is just designated under the more generic All Topics.