The California Board of Registered Nursing will no longer issue temporary licenses to nurses until the agency receives the results of their criminal background checks, part of a broad re-examination of the board's practices intended to more quickly identify and act against problem nurses.

Until Monday, nurses planning to work temporarily in the state could show up at the board's office and leave with their licenses the same day — a practice known as "walk-through" licensing — even though their fingerprints had not been run against law enforcement databases to check for prior convictions. If convictions were subsequently discovered, the board could cancel the license, but frequently the nurse would have already started caring for patients.

By comparison, nurses seeking permanent licenses cannot receive them until background check results are received.

"We are in the process of conducting a rigorous internal review of all of the Board's processes," Erin Shaw, spokeswoman for California's State and Consumer Services Agency, said in an e-mail. "As part of that process, it came to our attention that temporary licensees aren't being held to the same standard as other Board licensees."

Since last fall, ProPublica and the Los Angeles Times have detailed numerous lapses in the board's oversight of nurses. In October, stories showed how dozens of felons were able to keep their licenses for years before the board acted against them. And last month, an investigation found that the board took more than three years, on average, to investigate and discipline nurses accused of sometimes egregious misconduct, including violence against patients and stealing their drugs.

Last month, California Gov. Arnold Schwarzenegger moved to replace the majority of the board, and its longtime executive officer resigned. The newly appointed board meets tomorrow (PDF) to discuss recommendations to speed up investigations.

In the fiscal year ended June 30, 2008, the latest with available data, the board issued nearly 9,400 temporary licenses, which are valid for six months. The new rules also apply to interim permits, given to applicants who have completed nursing courses but have not received results of their licensing exam. The board issued 8,500 such permits in fiscal 2008.

"Consumer protection should come first and all nurses should be held to the same enforcement standard," Shaw said.

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