After reading Christopher Cornue’s Disruptive Women in Health Care post last week on Nurses, Lawsuits, and Patient Safety, I was inspired to write my own post discussing ethical dilemmas rising from reporting wrong-doings in the workplace.
So in case you are not familiar with the recent case in Texas, skim the following press release from SafetyShare newsletter, Premier, Inc.
“Texas jury finds nurse not guilty for reporting a physician for unsafe practices.
It took the jury less than an hour on February 11, 2010, to return a not guilty verdict for the nurse, Anne Mitchell, of felony charges of “misuse of official information,” for reporting a physician to the Texas Medical Board for what she believed was unsafe patient care.
Since news of the criminal indictment – and Mitchell’s being fired from her job – first spread through the nursing community, nurses across the country have followed developments. Labeling the criminal indictments “outrageous,” an outpouring of support – and financial contributions to the Texas Nurses Association Legal Defense Fund – has continued.
According to a New York Times article on February 9, the prosecutors claimed that Mitchell intended to damage the physician’s reputation when she reported him to the Texas Medical Board, which licenses and disciplines doctors. Mitchell explained that she felt an obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures – including a failed skin graft that was performed in the emergency room, without surgical privileges.
Conflicts of interest seemed to be part of this case with allegations that this case was, in part, a result of the local sheriff being good friends with, and a former patient of the physician, and bending the rules to protect his reputation.
A number of nurses who had previous worked at the same Winkle County Rural Health Clinic testified in court that they left the clinic because of their concern about the care provided by the same physician that had never been addressed. The case is no less perplexing as to why Mitchell was even indicted – all witnesses (even the state’s) have agreed nurses have a duty to report unsafe care.
The verdict is a resounding win on behalf of patient safety in the U.S., as well as nurses and other healthcare professionals who play a critical, duty-bound role in acting as patient safety watch guards in our nation’s health care system. The greatest concern with this case has been the disbelief that a case such as this was even allowed to reach the trial stage and what a different outcome could have potentially meant for patient safety in this country. Even with an acquittal, the felony charges and trial had a chilling effect on many nurses who may think twice before reporting unsafe practices.
A civil lawsuit has been filed in federal court charging the county, hospital, sheriff, doctor and prosecutor with vindictive prosecution and denial of the nurses’ First Amendment rights. A complete summary of the case is available on the Texas Nurses Association Web site.”
Thoughts Expanded
Especially in the medical profession, if those working hand-in-hand with you do not feel protected to disclose wrongdoings, then who will? From an outsider’s perspective, I personally take this case to heart. Knowledge has power. Not coming from a medical background, my trust falls on the doctors and nurses to suggest best practices and procedures for me and my family.
And, to take this one step further, consider the fact that patients under the knife literally have “no say” in changes to protocol.
Ethically speaking, individuals fight an internal battle in these types of situations. Although they seem black and white in nature – unsafe patient care gets reported – human emotions and moral compasses start blurring the lines. Back lash from other co-workers, disruption to workplace flow, ruining a co-worker’s career, and many other ‘what-ifs’ could prohibit “tattle-telling.” So it is up to the Human Resource department to create an atmosphere of open communication where making wise choices, ethically speaking, are rewarded and not condemned.
So how can you ensure that core values crossover into every department company wide?
Listen to the closing remarks from Tim Keenan, President of High Performance Technologies, Inc, in his webinar for Winning Workplaces on keeping employee communication a premium.
I completely agree with Keenan on listening, acting on what you hear, and being shameless, relentless, and creative in incorporating employee thoughts. When employees feel their positive ideas are being heard they are more likely to bring forth troublesome issues without second guessing the decision.
The outcome of this case can be marked as a victory for nurses. No need to fear! Nurses should feel protected to speak their thoughts when it comes to patient safety. If nurses do not feel they can grab hold of the reigns who will keep doctors from running wild? Alright, that may be largely exaggerated, but you get the drift!
How do you keep lines of communication open in your organization? Comments welcome!
If any nurses on your floor are expected to deliver and titrate I.V. drugs, this resource should prove beneficial. Take the angst and qualm out of calculating I.V. drip rates with these simplified equations from Ira Grene Reynolds, BSN, RN, PCCN-CMC in American Nurse Today.
Health Reform – controversial topic, yes, I know!
In response to Mac unveiling the new, controversial iPad, our good friends at 
