In providing a better understanding of the mentality behind my submission to Senators and my Congressman on "At Will Firing" I should perhaps elaborate on my own background. I am very well traveled and therefore able to bring to this argument the experiences of living in other countries on several different continents. Many Americans do not chose to travel overseas, few even own a passport, and the pitifully brief vacations allowed by US employers provide little opportunity for much more than a well organized canned holiday getaway. It is far harder for people who are so thoroughly insulated from external world opinions and influences to obtain a balanced objective notion of how their own country really "stacks up" on issues like personal freedoms and basic rights.
Despite the "life, liberty and the pursuit of happiness" BS rhetoric, America is definitely not very free and US citizens are enslaved by the most torturous working schedules of any civilized people on earth! American's are encouraged to get very defensive when you question the validity of these ideal, but that is the most treacherously clever part of the con perpetrated by your major corporations who currently have an unhealthy stranglehold on US Government. The isolationist no one can tell us attitude is helping to keep ordinary Americans in the dark about liberties enjoyed overseas. The standard work week in France is less than 40 hours not more. Quality of life goes beyond material acquisitions to embrace the quantity of time spent outside work. In comparison to Europe the US press is very tightly regulated to feed the correct supportive propaganda to the masses. You tout the best Healthcare system in the world so let's not mess with the finer points of who does not gain access to it. People in the UK have been appalled by how grossly disproportionate, disengaged and removed from reality the US Media has become. The adverse consequences remain carefully screened out by the Press to dupe ordinary citizens into supporting decisions that affect people all over the world.
In contrast some of our BBC presentations are shockingly irreverent, but we have come to expect and appreciate their candor even when it may seem in very poor taste. Our heated and frequently sarcastic Parliamentary debates would be unsurvivable for politicians who rely on speech writers to judiciously choreograph their public presentations and buff their latest PR spin. The British public is not easily distracted by inconsequential dalliances while major domestic and foreign policy issues are grossly mismanaged. Genuine accountability might not be immediate, but it is generally inevitable. A few of even our most intrepid politicians would rather face an angry Rottweiler than a verbal attack from Newsnight's Jeremy Paxton and contemplating the next scathing commentary from the Independent makes them cringe. In such a harshly critical political environment that demands a greater degree of accountability, those who screw up better know when to bow out fast. There is far less opportunity for special interest groups to manipulate those in Government or subvert the mainstream public's resolve on issues we feel strongly about. Internal investigations do not take a cursory glimpse at the facts and give up to avoid upheaval they are genuinely thorough probes to uncover the truth.
Our local NHS trust at Hastings Conquest Hospital is undergoing one such highly publicized probe into alleged abuse right now. While many area residents are alarmed by the latest revelations I am encouraged to see that the trust has had the balls to listen to ordinary employees, take their concerns seriously and thoroughly investigate these allegations. Americans must demand the same level of accountability from their Health Care Facilities and the Public Agencies who are supposed to be monitoring their conduct. The total sham Compliance Lines and so called "Risk Management" departments that are simply a front to give a strong public appearance of compliance remind me of the tale of the "Emporia's new clothes!" Agencies like JACHO, Advocacy groups and in many cases your own Board of Nursing, (review the Barry Adams story), are buckling to corporate pressure, not protecting basic patients rights. The independent reporting of those who seek to uphold patients rights and protections is buried in the shuffle. These flaws must all be thoroughly exposed and the system revamped in the public interest.
Once my Petition is posted I hope you will review some of the numerous links and carefully consider how you are being treated as US Citizens, because some of the realities are quite brutal. You will see links to UN documents included to give you a balanced perspective on the reality you are currently dealing with in the US: Hospital employees and Medical professionals have less rights and poorer working conditions than Prisoners of War under the Geneva Convention! We need to draw this stark comparison to shock US politicians into understanding that all human beings deserve humane treatment. Is it humane to compel an employee to go without food, water or urination for 12hours straight using threats of the dire consequences of patient abandonment? While your Hospital may still retain the right to mandate a 16hour shift they are not bound by law to allow you to eat even once during that time period and your bodily functions are in most cases totally at the discretion of your employer! For a working POW it would be considered "cruel and inhumane punishment" to inflict such hardship, but it's OK for America's beleaguered Hospital staff?
It is easy to say that your Hospital does not treat you like that, but the operative word here is "yet." If and when you are left stranded and abandoned without relief for hours on end, in the majority of US states there is absolutely no legal recourse: that is what is so scary. As profit driven Medical facilities cut more and more staff to supply less and less basic coverage for sicker and sicker patients with zero redundancy of personnel to provide relief, the instances of abuse are bound to continue and even increase. Safe Nurse to patient ratios, an appropriate mix of competencies among staff, banning mandatory overtime and regulations on providing proper coverage for breaks are all vital before this situation gets further out of control. We must demand a totally safe method of reporting that will effectively protect all Hospital staff against retaliation and wrongful termination with properly functioning whistleblower laws. Risk Management depts. and Compliance Lines must be thoroughly vetted to insure fairness, honesty and integrity in internal investigations that must hold even the upper echelon of Management fully accountable. This will undoubtedly require putting an end to "At Will Firing." At the time I wrote my Citizen's Opinion I had virtually no knowledge of what a Whistleblower was, hence the failure to mention protections for such individuals. Now that I can consider myself among their conscientious ranks of patient advocates in Healthcare I realize that the issue of "At Will" employment and the stringent protection of Whistleblowers is intricately entwined.
Would laws like this cripple the business viability of Health Care Facilities? I think not. Why are so many professional Consultancy companies reaching the same conclusion that there is too much money squandered on top heavy Management? They can't all be wrong all of the time! This is nothing new; it is just getting steadily worse while Corporate America studiously ignores the facts. Although it might seem obscure, I would like to recommend a book that I read recently that turns most Management principals or their head. It was not written about Healthcare, but many of the basic principals could probably be successfully coapted for better, more efficiently "Managed Care." The book was written by Brazilian Businessman Ricardo Semler to describe the unconventional, radical transformation of his South American companies. I have lived in Brazil plus I have wealthy friends in business there; I could therefore recognize and appreciate Semler's accomplishments in what is at best a very challenging business climate that predominates throughout Latin America.
The book "Maverick" by Ricardo Semler is a "must read."
Ricardo Semler's most dramatic onslaught at SEMCO was among the multiple tears of upper Management which he streamlined and trimmed to an absolute minimum. He proceeded to rely heavily on demonstrating his trust, compassion and sound business sense by providing fair wages and exemplary working conditions for ordinary workers. This canny strategy propelled his several companies to the very top, earning record profits during times of serious recession, rampant "South American style" inflation and chronic unemployment that drove other, less enlightened, competitors out of business. He wholeheartedly embraced the Unions, while at the same time he was a real stickler for adhering to Government regulations and refusing to bribe officials to avoid accountability.
In Latin American terms he truly "broke the mold" to survive and prosper in one of the most hostile, often corrupt and almost impossible business environments on earth. Big Corporations in the US that have proactively worked in cooperation and respectful partnership with their staff have consistently excelled in their economic growth and business success. This is a pattern that works for people as well as it works for profit. The wretched alternative is to plunge into the same repugnant, amoral, abyss as Corporate mega monster Wal-Mart who appear to have fine tuned exploitation and abuse of employees at the expense of a PR nightmare that may someday cripple them. Do we really want our Hospitals run more like Wal-Mart or dare we insist on humane treatment for our Medical staff that will allow us to concentrate on our important medical roles and adequately protect our patients from harm? Hospitals and Healthcare in general need to look to this: "ethical principals to stimulate genuine growth" model for inspiration while they are still blessed with Nursing staff and Medical professionals who are arguably the most conscientious and dedicated workforce in the nation. Yes, profit does keep the doors open, but ethical business principals, the humane treatment of staff and safer patient care do not necessarily entail crippling the critical cash flow that is so essential for the day to day functioning of a Hospital.
As a "dang Furiner" from the UK I was compelled to study the US System of Government before obtaining Citizenship. I was also actively involved in Amnesty International in the US which helped me to evaluate just how US law officially stands on "Freedom of Speech." There were a few heated debates at our Fort Lauderdale chapter regarding this protected right and the sometimes decidedly abhorrent diatribe to which it rendered legal protection! These rights are being seriously eroded in the US since 9/11 and it is not a healthy compromise by any means. OK, so I am a "Tree Hugging, Bleeding Hearts Liberal" and proud of it. But what is our current alternative: to remain inhumanly driven like mindless automaton drones, dictated to by ruthless Corporations and a corrupt, business malleable, Government bureaucracy? Management might not always enjoy hearing the message, but shooting the messenger accomplishes nothing. In many cases the message bought forward by a Nurse is a warning that a patient could be harmed or killed by current standards of practice: how can Management afford to ignore such an important message? How can they in good conscience wait for the fatal mistake? Certainly there are those who are deluded into thinking that the worst will not happen; that it's not their problem; that cost containment must always come first. However, mistakes cost money too and the morbid reality of it is that there is no financial gain or expenditure savings in gross negligence.
A Nurse who feels pangs of conscience over the dangerous compromises she is forced to make with regard to patient care will by personally devastated when their patient is unnecessarily harmed by the unaddressed problem. This impossible situation of helplessness, inability to speak out and guilt over bad practice is driving numerous excellent Nurses away from your US Hospitals: the "Nursing Exodus!" For those left behind the situation only gets worse, but the pathetic excuse will always remain unchanged: the so called "Nursing Crisis." But the sober truth is that it is just an altered version of the above reality: a "Nursing Exodus.".
WHO CREATED THE NURSING EXODUS? GREEDY SELF-SERVING HOSPITAL MANAGEMENT!
DO NURSES WANT TO RETURN TO HOSPITALS WHERE THEY CAN PROTECT AND SAFELY PROVIDE FOR THE NEEDS OF PATIENTS? YES! SO WHY DOESN'T MANAGEMENT CHANGE?
Lured by Managerial bonuses for "trimming the fat" some Nurse Manages have become blinded by greed and power to the point where they have entirely lost their moral compass. They have totally forgotten what it means to be a Nurse, perhaps forgotten their original motivation for becoming a Nurse. Now they are carnivorously devouring their own kind in a warped misconception of Nursing efficiency! Neglected and abandoned patients are the ultimate losers.
In my former Hospital they might as well have erected a six foot high banner in the lobby to read: "Managers will never be disciplined and held accountable for abuse or negligence." Managers rarely, if ever, faced discipline or any other personal consequences so why give up now when there is so little risk and guaranteed rewards? This must change. If a regular Hospital employee can loose their job for victimizing a coworker so should a Manager. Every one of the Hospital's disciplinary regulations should remain the same for the top CEO as it is for the most menial worker mopping the floor. If Hospitals are too self-serving and too spineless to discipline their own Management then the Board of Nursing must assert their power to censor the current appalling abuse of authority. They should be persuaded to take the unprecedented step of disciplining their own members for making unethical Managerial decisions that seriously endanger Hospital patients and issue punitive damages for all Managers who victimize and retaliate against those who attempt to expose the truth.
I have had a long time to think about how I would like to see my corrupt Hospital Managers disciplined; although I have no say in this and it will never transpire, I certainly do have my opinions. I think that one reasonable corrective punishment option is to mandate a very significant volunteer commitment in a Nurse related area of public service: it might help them to "find" or rediscover their broken moral compass. If fines are imposed, as a tangible deterrent to future lapses in judgment, they should be at least treble the dollar amount earned in any bonuses related to the associated dangerous cost cutting measures. Where the abuse of power includes victimization, or a deliberate act of retaliation is proven without any doubt, it should be grounds for permanently banning a Nurse from ever functioning in a Managerial Nursing role again. The toxic work environment will only be forced to change direction by instituting this harsh level of personal accountability among the ranks of Management: it is long overdue.
The "Orwellian" concept of policing the most inconsequential casual comments of staff to falsely obtain sufficient grounds for a punitive wrongful termination should be considered a violation of first amendment rights. An interviewed and probably intimidated office worker supposedly thought she might have overheard me muttering to myself that my Manager was a "*****." She may have overheard me say "its a *****" referring to my forced time off without pay and the multiple pay check errors I was enduring at that time. Barely discernable private mutterings are enough to get you fired? By contrast here in the UK I can stand on a soap box at Speakers Corner and truly vent; I can call my boss, the Prime minister and even the Queen of England anything I like any time and anywhere I like with zero consequences. In my best friend's response to the deceptive evaluation of her supervisor she documented her personal feelings about those who "brown nosed the boss" to gain favor from their line Manager. No, they did not have cause to fire her and she wasn't disciplined in any way. If you think she can maybe get away with such straight talk at a small private firm, guess again she is a Bailiff for the local Court System! Now that is real freedom of speech UK style. European workers do not get kicked around and abused by greedy Corporations; try gagging French workers and the entire country shuts down! However in my case in the US this badly misinterpreted hearsay product of eavesdropping was quickly enshrined among the compelling facts supporting my termination.
The alleged "Verbal Abuse" in the one "Harassing phone call" quickly multiplied into a false accusation of making a whole string of over 50 harassing calls. As I dared to defend my innocence the fabricated charges soon spiraled way out of control. Although this incident alleged that I had engaged in "disruptive behavior in the workplace," it actually referred to a phone call initiated by my Manager to discuss my schedule while I was at home worried about what I considered illegally imposed forced time off work for no apparent reason. When, despite my understandable anxiety, my Manager failed to provoke the row needed by her to help justify my removal I was falsely accused of screaming so loudly you could accurately determine the entire conversation on the opposite side of the office. The local phone company thought this claim was so outlandish they wrote a special letter explaining the basic limitations of standard phone equipment. I had upped the ante by not cowering in submission, so the "patient care area" conveniently relocated all the way to the opposite side of the Hospital, to the office of the Director of Surgical Nursing. This reinventing of the facts allowed the all powerful Director to undisputedly claim witness to the screaming episode. Just try screaming "I feel you are being unnecessarily inflexible" at the top of your lungs; you will discover it doesn't exactly lend itself to a high decibel exchange. That was the same Director of Surgical Nursing who unabashedly lied under oath at my Arbitration hearing so unconvincingly that no one found her new and unsubstantiated harrowing tale in the least bit credible.
Does the first amendment protect my right to insinuate that I feel my Manager is being "unnecessarily inflexible" in imposing two weeks of forced time off without pay while we attempt to find a compromise that allows me to return to work? At a second alleged "incident" would the first amendment have condoned my calling the false allegation about screaming into the phone a "blatant lie" or is the very act of obliquely insinuating that perhaps a Manager might have lied, subsequently created another legitimate reason for dismissal? Does the US constitution permit staff to stand with their hands on their hips or with their arms folded while on Hospital grounds, on a day off spent trying to resolve issues over pay and forced time off. I must confess that in all probability I may well have indulged in folding my arms and possible even placed my hands on my hips to relieve a twinge of backache, but I had no idea such "aggressive posturing" could scuttle my career. Is it really fair that a newly recruited office worker can be intimidated into declaring that their irrational subjective feelings of endangerment over such innocuous body language is a significant enough motive for Management to warrant your dismissal after 5years of exemplary service? Only in America!
In my British naivety I had assumed that potentially I had the right to truthfully claim absolute innocence without incurring further penalty and unwarranted discipline. In my innocence I had not thought to meticulously censure my every whispered comment for potential misinterpretation. How was I to realize that another employee could become so paranoid over my body posture that they considered it necessary to wreck my entire career? I doubt that this was their intent, but new employees are especially vulnerable to Managerial manipulation. If they had genuinely thought my voice was too loud they could have asked me to keep my voice down, but in fact they hadn't said a thing at the time. They didn't call Security either, but Management coaxed incriminating letters out of three unwitting staff as "witnesses" of an alleged "disruption." Most of what they wrote was just a factual account of perfectly innocent actions as I filled out my time sheet and asked questions. The disjointed subjective comment suspiciously tacked on the end of each letter could easily have been inspired by Managers faking concern over an employee that they might have claimed was "stressed," dangerously out of control and needed professional help. By enlisting their assistance to order a distressed employee into counseling, gullible new staff are readily conned into believing the concerns of Management are genuine.
I honestly believed at the time that my former Hospital would be expected to substantiate evidence, verify claims and show just cause to remove me: sick joke! The letter writers were kept out of the picture and not asked to elaborate on the reason for such obscure subjective feelings of threat. I had no idea that my Hospital could deny access to the above mentioned so called "letters of outrage" while deliberately lying about their contents, but they did. I couldn't have anticipated the hypocrisy of claiming "transparency" while not even permitting a single quotation from one of those letters while EEOC was free to review them behind closed doors at a Mediation 8months after I was fired. Eventually, when I read them for the first time I felt nothing but pity for these manipulated office workers. They had tried to be honest and factual in their solicited memos. Some points even verified my claims that I was being forced to take unpaid time off work. One described me as "visibly not happy" an understatement considering the stressful circumstances of the day. They documented no physical or verbal threats, loud possibly, but no swearing or screaming to support the charge of disruptive behavior, and only my allegedly aggressive stance accounted for the subjective feelings.
My former Hospital kept up this "smoke and mirrors" tactic for years. I had no idea they could keep all of my employee and pay files under wraps for 15months while showing them to investigators behind my back. I had no concept of the revolving door on my personnel file that kept accumulating additional solicited and backdated violations after I was fired. Two Minor Rule Violations were inserted months latter to beef up their case for presentation to EEOC, the Maryland Commission on Human Relations and the Maryland Board of Nursing. These fabricated disciplinary action forms, supposedly documented counseling which I had definitely not received; my signature, although not required, was conspicuously absent of course. I saw these forms for the first time 15months after I was fired. In England we would call that a "Witch Hunt." I thought that my Union contract would guarantee a few basic rights were upheld. They couldn't or wouldn't even verify when these new charges had appeared. I can confidently document the facts and the deception here. A web of lies? Not at the "Best Hospital in America" known for their legendary honesty, integrity and transparency? Not in a country that has so vigorously championed "freedom of speech?" Surely, not in "the land of the free, home of the brave?" If you expect more protection from your Constitution than this, it will mean fighting for it as it is being warped, diluted and seriously eroded all the time.
But wait, another heinous crime was committed! On the first occasion, while I was engaged in "disruptive behavior in the workplace" from my home down the road, a workman had accidentally knocked my kitchen phone off the wall and abruptly slammed down the receiver. My quaint old house was such a labyrinth of a place I had phones all over the place, at least six. The one that got whacked was badly placed on a wall just beyond a two foot wide archway and it had been knocked off the wall before. I was on an upstairs phone and I hung up right after I heard the bang. Thinking that it was my boss who slammed down the phone to run to a stat OR page on the overhead I failed to call her back. It was the end of a frustrating discussion and she had insisted on a Friday meeting in her office; it was over and I thought she was attending to an urgent page.
What I wasn't to know at the time was that she was a good 10minutes from the OR planning her entrapment as best she could while aware she couldn't legally tape my call without my consent. In the light of copious other lies told by Management I rather doubt that she was on the other side of the Hospital in the Directors office, but that's irrelevant anyway. If this had been a genuine disciplinary situation then my previous 5years of flawless service should have allowed me the benefit of the doubt in explaining this minor accident with the phone. But my Manager had a clear cut agenda: she had a pathetically feeble excuse, but she went with it anyway. Only in America!
I had made a complaint about being left stranded in surgery abandoned for 12hours continuously scrubbed at the field without a break. I was concerned that under such extreme circumstances of deprivation, where I admittedly became sick, dizzy and faint, I might make a mistake and cause harm to a patient. Following this admission that I had difficulty handling extended periods without food or water I was forced to take time off without pay as "I presented a danger to the patients!" I was attempting to change my shift assignment alarmed because the negligent OR Manager who had repeated this abuse several times without disciplinary consequences was about to change to an assignment where I would work virtually alone with her on a minimally staffed night 16hour evening/night shift every weekend. Her belief that subhuman employees did not require the consideration of a break was well tolerated by Managers who were not forced to work under her abuse mandate that demanded zero redundancy of personnel on the off-shifts. Her negligent policy of not calling in call team staff to stand by for Trauma was a violation of our own Hospital's written staffing policy and the COMAR regulations for Trauma coverage. But, she saved the department a lot of money and they must have loved her for it.
This relentlessly abusive Manager was responsible for single handedly driving dozens of really good OR Nurses to leave our Hospital so you can imagine how valuable she was to self-serving cost cutting Management. Selfish and myopic Managers feel distinctly threatened by even the hint of an idea. For a subordinate that make suggestions was automatically regarded as criticism of their rule. They must be swiftly eliminated. Most of the brilliant ideas of employees are left smoldering among the feeble groans of dissatisfaction of an oppressed workforce. Innovation and creativity is stifled in a working environment where the employees are "gagging" by an unhealthy code of silence induced by threats. This is frustrating for staff and strangles the life out of a business no matter what type of business it is. This situation breeds anger and discontent; it cannot possibly stimulate growth or devise ways to creatively accomplish more with less. It might have been one of the premier teaching institutions in the Nation, but we were never really encouraged to learn or think creatively. I didn't fit the mould of complacent, compliant idiot so they ousted me: what about freedom of thought?
I never want to work in a place where I feel the need to "keep my brain stuffed in a matchbox" again; it would take a frontal lobotomy for me to remain permanently disengaged from creative thinking. Unfortunately, the majority of Hospitals are looking for the complacent, compliant idiot type; perhaps any and all US Hospitals would have reacted to me in a similar way. I knew that if I could not protect patients in "the Best Hospital in America" it would be an even worse situation at a lesser institution.
Thankfully I have discovered my niche, an area of Healthcare where creativity and innovation are greatly appreciated assets, working as a Medical Volunteer for an NGO in the developing world. I spent 5months in a Hospital in Aceh Province, Indonesia following the Boxing Day tsunami. I want to go back out and continue my task there, but it is a tough challenge without the support of a major foreign NGO to cover expenses and provide a strong mandate for implementing my plans. My totally shattered credibility is still an obstacle to employment. I hope that by being completely honest about my wrongful termination and exposing the facts on the Internet I can finally put this past nightmare to rest, pick up the pieces and move on with my life. I can empathize with the disaster victims of Indonesia who lost so much; in helping them I can let go of my own pain. No one deserves a life sentence of punitive retaliatory injustice for daring to protect patients from harm: I hope this New Year I will finally see vindication, reconciliation and an apology for the damage done. Slim chance, but I live for that hope. Your support here on this site sustains me, and I thank you all,
Fair Winds & Following Seas, Kim