The State of Wellness
The State of Wellness
Leading The Way: Everything You Need to Know About the Oregon State Board of Nursing
You have likely heard about the Oregon State Board of Nursing (OSBN), but how does the organization interact with and support Oregon nurses? Join us for a conversation with Dr. Sarah Wickenhagen from the Oregon State Board of Nursing as she raises the curtain to give us an inside look at the governing board. We're not just talking about the nuts and bolts of licensing and investigations—though we cover that too—but we're also diving into the shifts in communication and professional support that OSBN is pioneering in 2024.
The State of Wellness podcast is hosted by the Oregon Center for Nursing, the state's nonprofit nursing workforce center. Learn more at oregoncenterfornursing.org.
Welcome to the State of Wellness podcast, because nurses need a trusted place to share, collaborate and talk about what matters most to the Oregon nursing community and profession as a whole, brought to you by the nonprofit Oregon Center for Nursing. Now here's your host, Janna Bitten, Executive Director for OCN.
Jana Bitton:All right and hello everyone, and welcome to a brand new episode of a brand new podcast that we are calling the State of Wellness, which is a podcast for Oregon nurses, brought to you by the Oregon Center for Nursing, and my name is Janna Bitten I'm the Executive Director for the Oregon Center for Nursing and I'm the host for your podcast and I'm really excited about our guests that we're going to be having today.
Jana Bitton:She is a friend of the Oregon Center for Nursing, a longtime friend of the Oregon Center for Nursing and a huge advocate for nursing in the state of Oregon and, frankly, the Pacific Northwest in general and let me rephrase that for all of the places that she has traveled and worked in all of her many lives. So, yes, this is so. I really want to welcome to the show today Dr Sarah Wickenhagen from the Oregon State Board of Nursing. Welcome.
Dr. Sarah Wickenhagen:Thank you very much, janna. It's really an honor to be here today, and I just want to thank you so much for inviting me.
Jana Bitton:Well, I'm inviting you, but I should also give you and your team over at the Board of Nursing some credit because, quite frankly, this podcast was your idea.
Dr. Sarah Wickenhagen:Well, I wasn't going to say that?
Jana Bitton:Well, I was going to say that this was your idea First place.
Dr. Sarah Wickenhagen:Well, to caveat that we are looking at ways that we can get our message out in a variety of ways, and so for a long time we've wanted to do this, and I'm just really excited that we get to partner with you, who has been an amazing partner of ours at the board. So this is wonderful, and if we can get our message out to a different group of people, or to more people, we're in yes, well, lucky for you and lucky for everybody else who's tuning in right now.
Jana Bitton:That's what we're going to talk about today. It's just the overall basics and understanding what the Oregon State Board of Nursing is and how it supports Oregon nurses and why we need it in the first place. But before we get into all of that, let's introduce everyone to you, because I might know you pretty well, and there are people who know you pretty well just in the nursing community, but there might be some people who don't know you so well. So tell me a little bit more about yourself.
Dr. Sarah Wickenhagen:Sure. So I have been a nurse coming up on 30 years and I have a variety of experiences at the bedside outpatient, acute, chronic. I've had different levels of authority in nursing, you know, been a bedside nurse and been a charge nurse and been a department level nurse within outpatient settings. And I also just retired from the Army and my last role in the Army was as a hospital commander and I think all those experiences have basically directed me towards my role here at the board.
Jana Bitton:That's great. Which is what is your role at the board?
Dr. Sarah Wickenhagen:So I am the lead policy analyst and legislative analyst for the Board of Nursing, and then my particular specialty area is advanced practice registered nursing Excellent.
Jana Bitton:Okay, how long have you been doing that for?
Dr. Sarah Wickenhagen:So I have worked in a variety of roles for the board for about 10 years. I've had a couple pauses in there for various reasons like deployment and things, but overall it's been about 10 years at the board.
Jana Bitton:So I think it's kind of interesting because you're starting out by saying that you're a policy analyst. I'm going to guess that there are a lot of people nurses, especially in Oregon that are like wait, wait, wait, what now? The OSPN? As a policy analyst, I don't even know what that is. I thought that they just had people that did investigations or other things like that. So let's go back to the basics. Let's kind of start at the beginning. Why do we have a licensing board for nurses? What is the Oregon State Board of Nursing supposed to do anyway?
Dr. Sarah Wickenhagen:So we work for Governor Kotek and all the other governors before her, and our specific role is to provide public safety and with that we do that for nurses through licensing, through education and sometimes investigations, and so that's sort of the umbrella that we come under, but our first priority is always public safety.
Jana Bitton:I think that's the one thing that a lot of people are like why would you even need to do this? It's like, well, nurses are kind of dealing with a lot of sensitive things and we want to make sure that people are safe with that. Okay, so the Board of Nursing has policy analysts, which is you. Who else works there?
Dr. Sarah Wickenhagen:So we have people every day that deal with our IT, we have people that deal with our finances, right, so we just have sort of those everyday functionalities that we have to have People that keep the lights and the phones on.
Dr. Sarah Wickenhagen:And then we also have a specific number of folks that work in our investigations department, which is sort of self-explanatory, but a variety of level of folks that support that area, from investigators to nurse investigators, to folks that are law clerks, basically that get records and subpoena, and then we have other folks that make copies and answer the phone. And then we have the licensing department. So same thing. We have a variety of level of people that work there and some have also specialty areas in regards to if they process the nursing assistance certificates or the other levels of licensure. So licensed practical nurse, registered nurse and then advanced practice nurse, and all of those together also include the policy analyst team and we also have specialty areas. So I mentioned mind is around advanced practice nursing, but we also have specialists around nursing assistance and then licensed practical nurses and registered nurses, as well as education in the state of Oregon, and all that together I think we have over 50 employees Easy.
Jana Bitton:Like you wouldn't think that it would take that many people, but it takes that many people. Okay, you've talked about the people who get paid that are working. This is a government agency, right? So these are the people that are working for a state government agency, but you have a whole board of they're not technically employees, right? Can you tell us a little bit about who are those people and how are they kind of related to the people that are employees, that's?
Dr. Sarah Wickenhagen:a great question. So we work for the board, so we are considered board staff, and so we're the people that are there Monday through Friday, those 50 folks who also include my executive director, which I left out, rachel Prusak yeah, I feel like I should mention that I have a boss and that she is, you know, the glue that keeps the organization together.
Dr. Sarah Wickenhagen:We all work under her direction for the board itself and the board itself are nine volunteers and they come from a variety of places. So let me just sort of tick down the list. And all of this is determined by, actually, oregon regulatory statute. So basically, our organ Constitution Outlies who will serve on the board and that the board is necessary, and all sort of the Parameters and rules of that. So, out of that, these nine people, we have an LPN, we have two direct care registered nurses, we have a nurse manager.
Dr. Sarah Wickenhagen:We have a nurse educator and we have two public members that also serve on the board, as well as a nursing assistant. I think I ticked all the boxes. It's nine people, and they are selected by the governor for a term of three years, which can be renewed, and so we have those service matter experts, if you will, in those areas of practice, as well as the public members, and I think that that's actually a really great balance for us because they're their average everyday people that at some point have touched nursing, like with a family member or they themselves, I mean. So they sort of have a balance to the people that are in the profession. So I do think it's an excellent model. And they volunteer. So they come every month for a Online meeting and then every quarter we have a two-day full meeting and they participate in that again as volunteers.
Jana Bitton:I think the thing that I think that is actually really cool about the board structure, because I've been involved in attending board meetings, in OSBN meetings, you know, for years, and I think that hearing the perspective of those public members has always been really impressive to me, I have to say, and I've known a lot of different people who have Served as a public member and I've always been really impressed with that.
Jana Bitton:The other thing that really impresses me is that it's a true, in the true way that we're trying to like Enact our government right when we're trying to take care of our communities and be as fair as we possibly can. Yeah, you have staff that we are paying to do this work, but we also have these volunteers that are coming in and trying to Trying to sort out the big masses sometimes and trying to do just do what's the best that they know how for nursing in Oregon. So the state board of nursing has undergone a lot of changes, especially over the last year. Can you highlight maybe two or three or four or however many, like I mean you know, maybe the biggest one being your brand new Director, which you know we conveniently forgot to mention in the beginning, but now we can talk about a little bit more. What are some of the changes that have happened at OSBN over the last year or so?
Dr. Sarah Wickenhagen:Sure. So we had a transition in leadership. Our previous executive director retired, and so we did a massive search to find the right person and we landed on a terrific leader who'd already sort of proven herself in the state as a Representative and then also as an advanced practice nurse and a nurse educator, and that's Rachel Prusak, and she started with us this summer, and so we're just now coming over the six-month mark, I guess I would say. Maybe it's a little bit longer, maybe seven, but she did an initial assessment of the agency and Also had some specific direction from the governor, and so she's she took some initial time to look at our, our processes and the staffing that we had, and she's, you know, has a way forward for us and really sort of the overall picture of that is Well, yes, we are there to support the state around public safety, we're also there to support nursing, and so that's a new, that's a new direction for us, which sounds a little ironic, but again, I think before we were very focused on the public safety aspect, but now we sort of want to broaden that approach again, still maintaining public safety but also working on the relationships that we have with our nurses in the state and the stakeholders in the state, and so we want to provide information that is digestible, that makes sense, that people understand.
Dr. Sarah Wickenhagen:We've gotten a lot of feedback that the Nurse Practice Act which we'll talk about in a second, I'm sure isn't easily understood, or folks just have a lot of confusion about X topic and so they wanna get guidance on that, and so in the past it's been hard for the public and nurses to maybe get those answers. And then we're looking at our communications. So we're looking at things like this the podcast. We're looking at working on our website and making it more user friendly. We are sending out more messages via email and on our listserv to let people know when we're having meetings, that there's a committee that's open and we're seeking volunteers. So we really are focusing on trying to get more community involvement and more grassroots nurses at the bedside involvement in what we're doing. And honestly it's a very exciting time and it's honestly a thrill and a privilege to see this happen.
Jana Bitton:Okay. So when people talk to me about the Board of Nursing the number one question that has been asked actually that nobody's really asked me this question in a while, but for a while the question they ask is why doesn't the Board of Nursing answer their phones? So why, dr Wiccan Hagan, does the Board of Nursing?
Dr. Sarah Wickenhagen:not answer their phones. So I very much appreciate the opportunity to address this and then also tell you the way going forward. So we had some staffing challenges with COVID and also we had folks that weren't in the office, Right.
Jana Bitton:so we had In addition to the staffing shortages, so that you were having with COVID and people not being able to be in the office. Let us not forget, like you had, oregon had almost 10,000 emergency authorizations that came through during that time. So it's like you have people that weren't working, you had people that were not in the office and systems that were not designed for that, and then you have this influx of I mean, what was it at the time of seventh? It was like it was almost 10%, it was like seven or 8% increase All of a sudden, just like came at everybody all at once. So let's also give you that caveat, okay, because I remember at the time I'm like I get it, I kind of get it. What?
Dr. Sarah Wickenhagen:is happening. I appreciate that. So, yes, so we had some challenges at the agency, and so the leadership decision at the time was the most consistent way that we can communicate with the public and with each other is email, and so we went basically to an all email model. But I don't wanna say that COVID is over. I would say that COVID is stabilized for the most part when we've adapted and we also have put some processes in place that have us on the pathway for opening a call center, and so we are going to see that, I'm suspecting within the next few months, but certainly within the next six months, and folks will have an opportunity if that's the method that they would like to receive feedback on would be to call the board of nursing and then the phone would be answered and you would get a response in that moment in time. Yeah, excellent.
Jana Bitton:It kind of does this also kind of go along with what you were saying before about trying to communicate more with the community and like opening that up a little bit more.
Dr. Sarah Wickenhagen:It absolutely does, and we also wanna acknowledge that there is a certain type of nurse who is not someone who wants to email or wait for an email. There are folks that really prefer to communicate over the phone and people who wanna speak to another human being, and so we took note of that feedback and we are very close to having that be a reality.
Jana Bitton:Okay that's very cool. So you're working on stuff. It's coming along. What else? What do you kind of wish people knew more about OSBN?
Dr. Sarah Wickenhagen:Thank you for that. That's another question as well. I want folks to know that there is a lot more to OSBN than licensing and discipline. I think when folks immediately think of us, they think every two years I need to remember to make sure that I license. Or they think if I get a contact from them or I hear about them, I think, oh my gosh, I could lose my license. They immediately go to like the worst case scenario at the board, and I I I'm thrilled to have the opportunity to say that there's so much more that we do there on an everyday basis. That is actually in a category that I would describe as advocacy. So we have rules and regulations that are parameters that, at one side, keep all of our patients safe in the state, but on the other side, they afford our nurses an incredible scope of practice and opportunity for them to be excellent in their job and for them to be real professionals, and so I take a lot of pride in that.
Dr. Sarah Wickenhagen:I think that in Oregon we have for years have been recognized as a advanced state in regards to practice and opportunities in nursing, and so because of that that filters also through our office. So that sort of is a nice dovetail into what does a policy analyst do, and so our role is to write the rules about nursing practice and there are several different iterations and chapters that we can speak to individually, about settings versus what level of nurse someone is. But within all of that just sort of the general hierarchy of that is, we determine how long your license is good for, we determine the number of practice hours you should get. There are a lot of discussions right now and again it's another very exciting time at OSPN we're looking at how many hours you should practice within two years or should it go back to five years. We're looking at should we incorporate CE somewhere in this mix. For instance, if you have a nurse step out of practice for whatever reason and they couldn't get their hours in whatever parameter that there is, is there an opportunity for us to look at, well, could they do CE instead or could there be a combination? So I love that and I think that that is wonderful, that we are open to those conversations. We're currently looking at that, and so that's another role that we have. We also represent you all to the state legislature, so whenever there is a question about, again, capabilities or a bill that has to do with nursing, we're the ones that are called upon for that expert testimony. And right now we're getting ready for legislative session, and so the bills haven't dropped yet. But I am certain that there will be bills that will be coming out of this next session that have an impact on nursing, and so we will look at those and we will determine who they apply to, whether it's a school nurse or whether it has to do with a health system, or where it's going to have an implication.
Dr. Sarah Wickenhagen:Back to the board of nursing Is there going to be a rule that we now need to change? How we are processing temporary licenses? Let's say so. That's another exciting thing that we do at the board of nursing. Another thing is that we regulate education in the state for nurses and for nurse assistants, and so we ensure that you get a great education as a nurse, and we make sure that there's good rigor and dependability or accreditation. We make sure that all those standards are being met for you as nurses, and so I think that's another important role. And then, in fact, we do investigations when we receive a complaint, but not every complaint equals discipline, and so I think that's also important to say that we close a lot of those things, and we can talk more about that later in detail, but we do a lot of things at the board, and so I think it's important to remember that we're deeper than licenses and discipline.
Jana Bitton:Yeah, it's almost like there are a lot of people who think that the only thing the board is is like the police, right, that you're the nurse police. You're like, immediately, if somebody's going to maybe make a mistake, they're not passing meds correctly, or something, immediately, the board of nursing is going to. You're going to somehow magically know there's going to be some massive communication that's going to come through some system on their license and they're going to immediately get into trouble and the answer is we're all human. Well, this is what you call me Absolutely.
Jana Bitton:We're all human. Yeah, we do find the bad actors you do need to find those things, but other times it's like we just we're working together to try to make this all work.
Dr. Sarah Wickenhagen:Absolutely, and I can speak more to the fact of you know we do. We do look at the whole situation when we do receive a complaint and, honestly, most of the complaints we close right away Because sometimes they're not even given to the right agency. So, for instance, you know, people might be confused about what level of person is in front of them. You know, maybe it was a physician or maybe it was a medical assistant, who we don't regulate. So sometimes it just we get complaints that have nothing to do with the board of nursing and sometimes, you know, there there are things that are not a violation of the rules.
Jana Bitton:So, for instance, you get a complaint anyway, even if it's not a violation of the rules.
Dr. Sarah Wickenhagen:We sure do, we sure do. So it could be. You know, my health care company didn't cover this visit. Okay, that doesn't have anything to do with the Board of Nursing. You know, we do our best, or our due diligence, to help that person, to get them to the right source of finding the answer for that, but that's not the Board of Nursing. So, yes, we get a variety of complaints that again have nothing to do with nursing itself.
Jana Bitton:That might require its own episode. Okay, don't you think?
Dr. Sarah Wickenhagen:I do. I can talk about the investigation process and discipline honestly, on and on and on. I'd be happy to go into further detail anytime.
Jana Bitton:All right. One last question. It seems like the theme of today has been how do we connect that the Board of Nursing is really reaching out to the community, and so the next question is how best can the community reach out to the Board of Nursing, how best can that communication happen? Or if somebody sees a rule or something that doesn't make any sense, how do they connect with you? What's the best way?
Dr. Sarah Wickenhagen:So we have a dear abbey of sorts at the Board. There is a link on our website which we will provide and it basically gives any person at any location the ability to email my team of policy analysts and you can ask those questions and again we'll direct you to the right place. But if you have a scope of practice question or you would like us to do a presentation for you at your individual job site or your health system, we're happy to come and talk about a specific issue. If it's a school of nursing, same thing we do all those things quite frequently. We're very busy with education sessions about that.
Dr. Sarah Wickenhagen:And then I would say, as a part of being more plugged into us, I would say continuing to listen to this podcast, because I am certain there's going to be great information that's going to come out, as well as reading our Sentinel newspaper we have that come out quarterly and all of those issues, at least for the last two years, are on our website and you can basically do a search of a topic and you can find that in a journal article of sorts That'll be there for you, and then just perusing the website or attending our meetings. So we, all of our meetings are open to the public and they're published on our calendar. You can click on the link. You can look at the agenda. We're very transparent about the things and the projects that we're working on and we encourage anyone who's interested to be a part of that.
Jana Bitton:Perfect. Well, thank you, I think we're trying to keep these to a digestible. You're on your commute kind of a thing.
Jana Bitton:And this might be relatively interesting. So we're going to wrap it up right now. Thank you so much for listening to this inaugural episode of the State of Wellness, this podcast for Oregon nurses. We are going to put some links in the show notes to the Dear Abby email that Dr Wiccan Hagen talked about and also some links to the website, the Sentinel all of the things. We're going to put those in the show notes. So pay attention to that.
Jana Bitton:Don't forget to subscribe to this podcast, because you are going to be driving into work, you are going to be getting ready for work in the morning, you are also going to need something that is just going to put you to sleep at night, and this is going to be that thing for you. So go to wherever you get your podcast hit. Subscribe so you don't miss any of the episodes of the State of Wellness, and you can find all of our information in our show notes and our past episodes over at the Oregon Center for Nursingorg. Also, you can get contact information there for Dr Wiccan Hagen If you have a question you can check in with her.
Jana Bitton:You could also have. You could also reach out to us. If you hear something and you're like you know what you guys need to do a podcast about blah blah blah. We are so excited to do a podcast about blah blah blah, let us know. Or if you want to come on, let us know. So thanks for joining us. Until next time, stay well.
Speaker 1:Thank you for joining us on the State of Wellness podcast, and if you need more information, show notes, past episodes or resources, go to OregonCenterForNursingorg and subscribe wherever you listen to your favorite podcasts so you never miss a future episode.