California's Board of Registered Nursing oversees more licensees, some 350,000, than any state nursing agency in the country. It is responsible for ensuring that nurses at patients' bedsides are not only competent, but sober, sane and law-abiding. So when we became suspicious that the board was fumbling its duties, leaving members of the public at risk, we wanted to ground our reporting in more than anecdotes, although those were rich and plentiful. Figuring out how to do this proved both time-consuming and hugely rewarding.

We first became interested in the board after we spent much of 2003 and 2004 investigating a long-troubled public hospital, Martin Luther King Jr./Drew Medical Center, in South Los Angeles. The stories revealed how nurses were accused of turning down patients' cardiac monitors, then not noticing as their conditions deteriorated, giving the wrong medications, ignoring patients in distress, falsifying records and even sleeping on the job. Yet when we followed up years later, we found some of these nurses continued to have licenses. Others had been disciplined long after our stories ran. We decided to review recent disciplinary actions by the board and found that the King/Drew nurses were not the exception, they were the norm.

The board's own internal statistics, which we obtained through state Public Records Act requests, showed it was in trouble. The board, headed by the same executive director for 16 years, took more than three years, on average, to investigate and discipline errant nurses. Several boards in other large states handled the same process in a year or less.

Our challenge was to show the dangers of this delay. We decided to use Microsoft Access database manager to enter and analyze all of the accusations filed and disciplinary actions taken by the board from 2002 to 2008—involving more than 2,000 nurses. Some files were upwards of 70 pages long.

We began by getting acquainted with how the disciplinary process worked. Potential employers and the public can check the board's online site to determine whether a nurse is licensed and whether the nurse has been formally accused of misconduct or incompetence or disciplined for such behavior. If an accusation or disciplinary action has been filed, it is generally available in a PDF version on the board's Web site.

Each accusation contained similar information, but unfortunately not in a uniform fashion. Each included the nurse's name, license number, license date, accusation date, prior discipline and the details of each cause for discipline taken by board.

We used Access to build a database form that fed into multiple tables — all of them connected by each nurse's unique disciplinary number. We used the Wizard tool to design the form, but had to edit the layout to meet our needs. The form included basic information on each nurse. We then had sections for:

• Criminal convictions (noting the case number, county, conviction date, charges, whether it was a misdemeanor or felony and whether drugs or alcohol were involved)
  

• Discipline imposed by other state nursing boards (state(s), dates, type of discipline and reason—we had a checkbox listing most common reasons)
  

• Misconduct in hospitals (hospital name(s) or employer(s), the start date, end date, number of patients involved and the type of misconduct)
  

• Participation in board's program for substance abusing nurses (enrollment date, termination date and the reason for termination)
  

• Prior discipline by the board
  

• Violations of board-imposed probation (reasons why)

Tracy Weber and Charles Ornstein are senior reporters at ProPublica, a nonprofit investigative news organization in New York. Prior to joining ProPublica, they were investigative reporters for the Los Angeles Times.

Maloy Moore, senior librarian at the Los Angeles Times, has spent the last decade teaming with reporters on breaking daily stories and the paper's most prominent investigative projects.