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TsunamiKim

TsunamiKim

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TsunamiKim's Latest Activity

  1. i am really thrilled to be able to announce that despite your skepticism the important petition i launched on the petition stie demanding compliance accountability has now received over 2930 signatures and comments from the public and conscientious patient advocates working in healthcare. to review and add your comment to the petition please visit: http://www.thepetitionsite.com/takeaction/938995258 compliance line compliance obligations: what rules are necessary? and why? 1. compliance lines are duty bound to investigate all allegations of dangerous, negligent or fraudulent practice without delay or any regard for the status, current situation or alleged lack of credibility of the person reporting. reprimand or dismissal must never be sited as legitimate grounds for ignoring a report of potentially dangerous, negligent or fraudulent practices. without this stipulation a facility or organization guilty of violations can use stalling tactics to postpone an investigation indefinably and when reprimand of firing are permitted to negate the credibility of an informant this tactic will encourage intimidation to silence or remove an outspoken employee. 2. employees should be able to report to compliance lines without going through a “chain of command” in their workplace first as they may genuinely fear managerial retaliation. if reporting up through the “chain of command” is a prerequisite before contacting compliance it becomes impossible to report the abuse, negligence or fraud perpetrated by a manager and it leaves the employee vulnerable to a tangible fear of retaliation or dismissal. 3. there must be no postponement or delay before a compliance line agrees to investigate and very strictly monitor the dismissal of any employee who reports being targeted by management since waiting until after the grievance process, arbitration and all other avenues of recourse have been exhausted, cannot possibly offer adequate retaliatory protection to a vulnerable targeted employee in the interim. if an employee contacts their compliance line to report retaliation or wrongful termination, but the proceedings are not vetted for legitimacy and monitored for fairness then abuse of power and manipulation of the disciplinary system is encouraged. special attention must be paid to any evidence of irregularities or prejudicial behavior that precipitated a suspicious firing, 4. compliance lines must not be allowed to review allegations or charges concerning the conduct of an employee where written detailed documentation does not exist or the employee has never been permitted to review all of this documentation and therefore cannot respond to or refute its validity in any way. employees must never be denied full access to their own personnel file or pay records even after dismissal. a general category of event that might satisfy the basic reason given for dismissal is not valid without a detailed written documentation of exactly what occurred as, without such documentation and without the accused being allowed full access to it, the details can be changed and the seriousness escalated after the fact to secure permanent removal. if an employee does not know exactly what they were accused of doing they cannot possibly mount any defense at all against such nonspecific charges.there is no legitimate reason to deny an employee full access to their own personnel file or pay records. 5. a compliance line must document or provide the employee’s documented written response to all allegations or charges made against them giving that employee’s response statement equal attention and credence. an accused employee who is prevented from submitting documentation of their response to allegations is unfairly denied the right to prove their innocence and defend their reputation. no requirement for equal representation encourages false accusations that erroneously appear to go unchallenged by the accused: no charge is valid without response. 6. no employee should be discredited or removed with charges that are not documented in full and in writing in documents that are made fully and promptly available to the accused prior to the date of their discipline. a timeline of all included paperwork with submission dates must accompany this. no additional charges or embellishments added after a dismissal should be considered relevant or credible evidence of misconduct by the fired employee. charges or allegations against an employee that are not presented prior to an employee’s removal are simply not valid. the legitimacy of charges can only be verified by an accurate timeline of events leading up to the employee’s removal. without this stipulation employers can conduct a “witch hunt” where the targeted employee’s file can easily become a revolving door of late submissions and backdated entries accumulating unnoticed by the accused. 7. compliance lines must remain totally impartial without demonstrating bias towards protecting the facility or the organization’s best interests at the expense of an employee, especially with regard to supporting inequality by disproportionately ignoring the equal accountability and necessity for discipline of management found guilty of dangerous, negligent or fraudulent practices. when an employee is dismissed on the basis of an inconsequential minor infraction used to silence their protest, but the negligence or corruption they report is virtually ignored and no one is disciplined for actions that present a serious risk to people’s lives then the system is seriously biased. 8. a compliance line should not be managed or staffed by internal appointees with a vested interest in protecting the best interests of the facility or organization. a serious conflict of interest exists when compliance line staff are recruited from internal departments: they may anticipate another more lucrative transfer in future, if they protect the best interest of the facility or organization they are supposed to be monitoring in a fair and unbiased way. 9. when approached by an external agency a compliance line must demonstrate in detail the evidence on which their findings, even a finding of no cause for concern, plus their decisions regarding corrective measures and proportionate discipline following an investigation, are based. if a compliance line knows that their findings will be accepted without a presentation of the facts then they are under no pressure to really investigate at all. this will encourage meaningless cursory internal investigations to placate external agencies and evade external scrutiny. 10. a basic report of compliance line findings, even a finding of no cause for concern, plus decisions regarding corrective measures and discipline following an investigation should be made available to the person reporting in order to provide assurance that the situation has been handled appropriately by internal compliance. when an employee reports abuse, negligence or fraud they may have considerable worry over the consequences of inaction and they have a right to know that genuine corrective measures were taken, that people were held accountable and that they do not need to report the matter to any external agencies due to inappropriate compliance line inaction. 11. compliance lines are duty bound to investigate all allegations of retaliation and wrongful dismissal, despite any rulings against the employee, even after the employee has been permanently removed from the workforce and even if an employee has felt compelled or bullied into writing a solicited letter of resignation or accepting a settlement. if a compliance line can simply write off the need to investigate a case of retaliation or wrongful dismissal because retaliatory practices have succeeded in totally removing an employee or bullying them into writing a solicited letter of resignation to end all further abuse then this only encourages more aggressive, corrupt and relentless tactics. 12. compliance lines must be subject to external scrutiny by public agencies and government regulatory bodies. this is especially important when an employee removed under suspicious circumstances, reports strong suspicions of an inappropriately dismissive or purely cursory investigation with the complete refusal to pursue any charges against serious offenders without explanation, or valid evidence of an internal cover-up. when a facility or organization knows that public agencies and government regulatory bodies are powerless to subject them to external scrutiny, that they must accept the findings or corrective strategies of an internal investigation conducted by their compliance line without question, the manipulation and corruption of compliance lines is fostered and condoned. there is a very strong incentive for facilities or organizations to create an internal compliance line for the express purpose of avoiding external scrutiny and highlighting any outspoken “troublemakers” for swift removal from the workforce. this is the diametric opposite of the concept that inspired the creation of these compliance lines in the first place and the general public is left with fewer safeguards and protections than existed before their inception. to express your opinion regarding the urgent need for compliance line accountability visit "health petitions" at: www.thepetitionsite.complease review and comment on the petition: johns hopkins hospital investigation of wwhistlblower’s dismissal; demand compliance accountability: http://www.thepetitionsite.com/takeaction/938995258
  2. TsunamiKim

    Retaliation for voicing concern over unsafe pratices

    Hi TNNURSE, I am glad you are starting to expose the truth, I am still awaiting that opportunity myself. It is so important for the public to find out about the deliberate deceptive practices of both the so called "Risk Management" dept and these scam Compliance Lines. I am still trying to force the Compliance Line at my former Hospital to investigate the retaliation that removed me from my job in the OR for reporting deliberate negligent understaffing. The significance of my case is that it goes to show that even the universaly accepted top Hospital in America is not imune to such corrupt practices. One of the most vital issues in your case is the way the Hospital's Risk Management targeted the person reporting negligence and incompetence that was well know by most of your coworkers. Risk Management and Compliance Lines were set up to protect patients from harm not protect Hospitals from those who report negligent practice. This flaw must be fully exposed before and major change is going to take place. It is a painfull process for those who have been retaliated against like you and I. My Petition to force the Compliance Line to investigate my case now has 2600 signatures and growing by the day. Please check it out at the PetitionSite.com "Investigation of Whistleblowers Dismissal" Thanks.
  3. TsunamiKim

    burnout in the OR

    In Answer to HRM672’s Questions: Why not send in a relief person? This is a very good question. The strain on the OR’s over-stretched staffing is far greater at night and on weekends as the off-shifts are minimally covered to start with. This is where the dysfunctional system of “zero redundancy of personnel” is breaking down and causing the greatest problems. In many States a Nurse can be mandated to cover a complete second shift for a total of 16hours on the job. However, equally few US States insist upon the staff receiving even a single relief break, which is now becoming dangerous. XXXX Documentation of unsafe staffing is the key to forcing Hospitals to address this issue, before more patients are placed in danger. Only through “Incident Report” documentation of the “danger to the patient” on occasions where someone is left stranded in Surgery for 12hours straight can we separate the true emergencies from the negligent abuse of one particularly inconsiderate Manager. The obligation is for a Manager to insure that her staff are functioning safely and order them to break scrub when they can no longer be expected to do so. That Charge person should have to justify why no relief was sent into an OR to break someone out after 8, 10 or 12 hours of continuous standing at the field without a break. If there is no legitimate reason for an abandonment incident like this and these incidents happen repeatedly then the person responsible should face discipline. On your second point: Please don’t get me wrong about the OR, it is a fascinating clinical area in which to work and I still want to return to my job in Surgery. However, frustrations lead to volatile and abusive outbursts when systemic problems are not dealt with and when staff become unnecessarily fatigued through unreasonable work demands. Surgeons can be very intense and demanding people to work alongside. They can also be hedonistic, arrogant and downright rude, but we must remember that we are assisting them while they are engaged in some very challenging procedures. My best advice is to take note of the minor frustrations that tend to precipitate an outburst and try to eliminate them. After I had been at my former Hospital for less than a year a Surgeon I had the greatest respect for made me the target of a humiliating outburst. It was not about whether he had the right to criticize my performance; it was doing so in such a rude and demonstrative way, in front of half a dozen coworkers! I wrote him a letter expressing my concerns, but then tormented over handing it to him. One of the Anesthesiologists read the letter and said how it expressed the collective concerns of so many of us in the OR regarding most of our Surgeons. She asked me if she could show it to her boss. I didn’t quite realize that her boss had just been appointed Dean. I agreed as long as all of the names were removed. I did not intend to target this one Surgeon as the worst offender, as he really wasn’t. “The letter” took on a life of its own going from rookie OR Tech to the new Dean in one leap. I hoped that my letter would “shake a few trees;” now it seemed like it might Napalm the forest! The Dean called a meeting of all his chiefs of Surgery and they were all instructed to read “the letter.” He said this kind of behavior has to stop and it has to stop now. The then Head of Surgical Nursing delivered a copy of the letter to the Surgeon who had lambasted me during an OR case; a meeting took place half an hour latter. He apologized for his behavior and told me of his frustrations. I felt truly committed to eliminating those frustrations if I could. I also met with the Chief of Surgery in the days that followed; at one point he made a startling admission that in hindsight made a lot of sense. He said: “often, when we raise our voice and yell at OR staff it is not because of anything that they have done, but we have reached a particularly crucial point in the case and things might not be going so well so we become angry and loud.” Not his exact words, but you get the drift; we might very rarely be the source of frustration although we are frequently the recipient of a rude outburst. In the coming weeks I was pleasantly surprised to see that a new initiative got underway and I was really impressed by such positive action. Fellow staff members warned me that, “nothing ever changes around here,” but I remained optimistic that this time it would be different. Six new separate interdisciplinary OR comities agreed to meet once a week and these meetings lasted for several months. The objective was to create “A Perfect Day in the OR’ and we were asked to address all of those debilitating frustrations that bothered us and try to come up with suggested solutions. Between all six committees we produced a one inch thick binder brimming with information, potential problems and positive suggestions. An “OR Retreat” was organized at Baltimore’s Inner Harbor and several hundred OR employees from all disciplines and specialties gave up Saturday afternoon to attend unpaid. I was thrilled to be there, knowing my efforts had provided the catalyst for this positive initiative. It was my birthday and this was the best present I could have received. Unfortunately, very shortly after that the Hospital’s reform agenda to create a better work environment was abandoned. The situation deteriorated rapidly as core priorities changed in favor of staff cut-backs to lower costs. The Head of Surgical Nursing left and her replacement was not even seen in the Surgical suites for the first eight months. The drastic policy changes to force the higher paid tenure Nurses to leave were unpopular enough to precipitate a “Nursing Exodus” from our Hospital. My efforts to bring Management’s attention to this issue by suggesting Nurse retention measures were not welcome; I was told: “this happens every once in a while.” All of the identified problems causing such frustration in our historic old OR were conveniently swept under the rug. The “Perfect Day in the OR” became an elaborate wall exhibit to delude JACHO on one of their meticulously choreographed scheduled visits. The OR employees paid for that con with their personal time and dedication; quite understandably they felt used. Jaded and disillusioned staff were now far less likely to come forward in the future realizing how futile their input has been. The agenda was corporate profits above patient safety or a tolerable working environment; nothing changed except for the worse. The OR continued to hemorrhage Nursing staff and then rush new Nurse Grads through orientation as swiftly as possible; many were dangerously ill-equipped to take on their responsibilities. The “OR Retreat?” We had received our futile positive action session, been allowed to vent, now we were supposed to return to the same stagnant mindset as before: “don’t rock the boat.” The multiple minor frustrations remained as the layout of our vintage OR required creative solutions that Management was not interested in accommodating. Managers are rarely in the OR when the dysfunctional skin stapler gets hurled across the room, so why not purchase the cheaper model? Cost-cutting, especially in the area of negligent under-staffing, only exacerbates the difficult frustrations we face in Surgery. “The letter” earned me a letter of commendation from the Dean. Eventually my outspoken behavior was no longer acceptable to new Management; in the end I was targeted for removal and fired as a tragic consequence of reporting under-staffing in the OR. Fatigued staff vent, intolerance reigns and tempers flair: this is the OR at its worst. Surgery can be very stressful even when things seem to be proceeding perfectly; the source of anger might be an unconscious patient, but the recipient of wrath is often the Nursing staff. Not fair, but try not to take it too personally, sometimes the Surgeon will humbly apologize after the case. Pay attention to staffing needs, try to eliminate fatigue and unnecessary minor frustrations and you will work in the most intriguing and rewarding area of the Hospital doing the most incredibly fulfilling job. I hope this helps, Tsunami Kim.
  4. TsunamiKim

    burnout in the OR

    Great to read the last post Staceyp413 as this is how it should be, consideration, give and take, but always focusing on what is best for the patients. Keep up the great attitude as we need more like you. Unfortunately, the toxic work environment is driven from the very top and Charge Nurses get lumbered with implementing under-staffing. The “redundancy” of personnel that is so important for safe coverage is being stripped away as an unnecessary expense. It was the Hospital policy in the late 90s that started to force Nurses out. The “occurrence” policy and rolling sick bank time into Vacation time as one smaller pool of available time off. The tenure Nurses felt penalized most loosing over a week of vacation time, not exactly a reward for dedication: some quit. There was a domino affect in our ORs because the more Nurses quit the fewer were left behind to cover call. The more Nurses felt trapped by the burden of heavy call commitments the more they considered leaving. We had an exodus of experienced Nurses and plugged the gaps with travelers. Then the Hospital offered the traveling Nurses a big fat bonus for committing to a few extra weeks. This was a real smack in the face for our regular staff who did not receive the bonus and were now seriously overburdened with call since travelers did not take any call. If Management had set about designing a plan to make the workplace more intolerable they could not have done a better job, but I think they knew exactly what they were doing. They called their self-created exodus a “nursing crisis” and used it as an excuse to mandate overtime and do more with less staff. They were laughing all the way to the bank. Around this time the above strategy was being implemented in all parts of the Hospital in facilities all over America to maximize profits while making care unsafe. Now we come to redundancy of personnel. No spare people, you do without a break. During the regular shifts breaks are accommodated between cases if the unit is short staffed. But what happens when it is the weekend, in the middle of the night? Calling in a call team person to relieve someone in Surgery is an expensive option, so they remain trapped for the duration. I would often try to take my breaks between cases if I could because of providing consistency to my Surgeon. I would go for 6-8 hours without a break no problem and I never complained unless it was beyond 8hours and for no legitimate reason. However, this flexibility gets taken for granted, to the point where no one considers whether you are still functioning safely. Not all Charge Nurses were so inconsiderate, but the one that was most inconsiderate to me was the Manager for off-shift personnel. No point reporting a Manager in a Hospital where Managers are never held accountable. I did report and it cost me my job. Leaving someone stranded in Surgery for 10-12 hours presents a risk to patient care and I feel that it should be documented in an “Incident Report” as a potential danger to the patient. In a real emergency no one is going to object if they miss a break, but this should not become part of the regular coverage routine and identifying such incidents might prevent this. It would have documented the repeated abuse of the one Manager at my former Hospital who was always dumping on her staff and perhaps she would have felt compelled to be more considerate in future. Certainly the onus should not be on the person scrubbed to beg for relief and somehow prove that they made this request. On the worst occasion, where I was left for 12hours during a Liver Transplant, the call team personnel should have been in the OR on stand by for Trauma. There was a requirement under COMAR that as a Level One Trauma Center we must be able to man a Trauma OR in 15minutes or less. If a Trauma had come to the OR on that particular Saturday night I would have lost the Circulator from my room for well over an hour while the call team person was contacted to come in. My Nurse would not have been just next door either, as the Trauma rooms were down the corridor in another building. This was a very stressful 12hour Transplant case with my patient on bypass; it was not going at all well and the Surgeon was new to our team doing his first Liver at our facility. The Circulator was relieved briefly and told to “run to the bathroom quickly” as if emergency cases were on their way. Under such circumstances you do not tie up the main desk with calls begging for relief. When the abusive Manager finally entered the room at 6:00AM I told her I was about to pass out and needed someone to take over the clean up. I did not think this was unreasonable after 12hours in Surgery, but I had to repeat my request three times before she even acknowledged I had spoken. She then gave me another assignment to complete before I was permitted to break scrub. I do not know what part of “I am about to pass out” she did not understand, but disobeying her meant getting written up.. When I discovered that there had been no pending emergencies all night and that this abusive Manager had left me stranded out of pure selfishness I reported her negligent conduct and abuse of power up the chain of command. My complaint was completely ignored. The Manager was never disciplined, but by accusing me of “causing a scene in the patient care area” for daring to protest her abuse I was verbally reprimanded. This was a common practice from our Managers; always meet the complaint with a complaint about the informant. That way the most outspoken could be identified and another strike against them might be useful in removing them. When this same Manager was about to change her regular shift duty so that I would have to work virtually alone with her every Saturday night I requested reassignment. I referred to my concern over her past abuse of power by stating that I felt we had reached a ”toxic level of dangerous.” I was told “she probably will not do that again,” but within a few short weeks I was forced to take unpaid leave and then fired. In identifying this particular incident I had inadvertently highlighted a serious violation beyond this deplorable act of abandonment. The fact that no call person was bought in to stand by for Trauma was a clear violation of our obligations under COMAR regulations. However not calling in the call team to stand by for Trauma had been a well established cost-cutting strategy for some time. I believe it may have been introduced and was certainly implemented by the abusive Nurse Manager, who also taught Trauma classes. A month after I was fired the OR abruptly changed their policy and started calling in their call team to stand by for Trauma. At my Arbitration Hearing OR Managers admitted that I had been left stranded in Surgery for 12hours, but said the ER was busy and I hadn’t asked for a break. I guess telling your Manager you are about to pass out does not count as asking for a break. When I bought this matter to the attention of MIEMSS the Maryland Trauma agency I expressed the concern that this misinterpretation of the regulations might extend to other Baltimore Trauma facilities. I made a sworn statement to their States Attorney, but they never got back to me. When I called a few weeks latter I was told that the situation I had identified “didn’t specifically endanger Trauma patients.” I read this to mean the following: if we were forced to abandon a complex case, even one where the patient was on bypass, for over an hour to open a Trauma OR in an adjacent building it was OK to risk that other patient’s care as long as we met our Trauma obligation. I never received anything in writing from MIEMSS. As with so many other Government agencies charged with protecting public safety I was expected to disprove spurious false allegation of disruptive behavior that left my credibility in question. This was almost impossible as I was never allowed to see exactly what the alleged disruptive behavior pertained to. There was no proper documentation of particular event just vague comments about staff feeling threatened. Five years latter I have still seen nothing more than an unsubstantiated one line catch all phrase; that is what my former Hospital calls “transparency.” Due to their success in portraying me as a “disgruntled former employee seeking revenge” the Hospital has never been investigated properly regarding negligent staffing issues. If you are always considerate with your team, as it appears you are, in an emergency they will be there for you and back you 100%. Taking a break during Surgery must be determined by what is safe for the patient. In a real emergency, compromises might need to be made. There is a point where concentration begins to flag, blood sugar drops and all you can think of is racing to the toilet ASAP. This is not conducive to anticipating the needs of your Surgeon. It is the duty of a charge Nurse to protect the safety of OR patients my ensuring that their teams are not struggling to function in such a state where they might make a serious mistake. The onus is on that Charge Nurse to order a person to break scrub at the first possible opportunity when they realize someone has remained at the field for too long to function safely. How long is too long? We must bear in mind that, as I stated at my Arbitration Hearing, “no one is more important than the patient unconscious on the OR table.” Five years on I am still speaking out about what happened. I feel it is important to document such abuse. I have posted comments on other threads regarding the retaliation and wrongful termination for Whistleblowing I have also started new threads on the toxic work environment, compliance issue and lack of Compliance Line protections. I would really like to hear some consensus of opinion on how long is too long for someone to maintain concentration while scrubbed into Surgery? I want the actions I am currently taking to help in pushing for tighter regulations on the break policy to protect OR patients, but also in other clinical areas. Redundancy of personnel is a vital safety requirement besides making for a better work environment. Documenting abuses and negligent under-staffing is the only way to prevent financial priorities from overburdening Nurses to the point of burnout in all clinical areas Staceyp413 I just hope you will keep doing what you are doing as we cannot afford to allow good Nurses to burnout or scare any more experienced Nurses into leaving the profession. Stick with it, Tsunami Kim.
  5. TsunamiKim

    Retaliation for voicing concern over unsafe pratices

    one reason hospitals act so quickly when they sense the slightest whiff of trouble, (as in honest reporting of negligence), is that they are aware of these statutes of limitations while the wronged nurse is all too often unaware. management will strike almost preemptively before you realize the danger, and then behave as if they are following normal guidelines while they deliberately stall for time. when you have a good track record you are even more vulnerable as you simply cannot believe they will get away with their dishonesty. management tends to go for the “nut case” accusation with really dedicated nurses so they can say your behavior was due to “stress” and it all sounds plausibly. the more you protest, the more obsessed and deranged they can portray you to inquiring external agencies. time and distance equals zero accountability. even the recourses like a compliance line and risk management, supposedly built into the system that defends our right to report negligence, are frequently designed to sabotage those efforts. they expect you to go up the chain of command first, then once that has resulted in a wrongful termination you are supposed to adhere to the hr disciplinary process next. if you follow this course of action to its logical conclusion they fire you for reporting a problem, then they take months or even years to finalize the process before you are eligible for “protection.’ then, cruel joke, you have no right to any recourse as you are no longer an employee! this was the policy of the compliance line at my former hospital. the statute of limitations has run out, you have sabotaged your legal options by agreeing to a corrupt arbitration hearing without being informed that it was binding and now the press are not interested because “it has been too long.” political representatives are also compelled to back off until hr has completed their dirty work and an employee discredited by dismissal is not trusted to inform public agencies of problems in an unbiased way. you are now considered a “disgruntled former employee seeking revenge!” it gets worse. approaching accreditation agencies, government agencies, nursing boards is an uphill battle that requires you to do the impossible: prove that you did nothing wrong. for some bizarre reason your hospital is able to show fabricated documents behind your back that you are bared access to; this makes it even more difficult to defend yourself as you are never quite sure what you were charged with doing. i am british and this level of corruption and injustice boggles my mind. when i was preparing for my arbitration hearing, my own union lawyer prohibited me from mentioning any of the numerous acts of retaliation perpetrated by my managers as he said it would prove that i was just out to get revenge! this lawyer dictated how the case would be handled; telling the arbitrator about two weeks of forced time off without pay was one of may things i couldn’t bring up. i told the union lawyer that i felt that i was going into my arbitration hearing “bound and gagged” and i only went ahead with it because the compliance line demanded that i must pursue all other recourse before they would investigate my case. guess what, they lied: the compliance line never had any intention of investigating my case. as if my union lawyer had not done enough damage by barring my evidence he then put an unauthorized admission of my guilt in writing no less than three times in his summation to the arbitrator which he then kept from me for over a year. i nearly bought a complaint against that lawyer with the bar association, but i was about to loose my home and everything i owned so i retreated to the uk for a well deserved nervous breakdown. it would have taken an act of god to win my arbitration case under those conditions and, in case you are wondering, no i will never trust a union or a lawyer ever again. the very existence of a compliance line allows a hospital to handle problems internally and keep regulatory agencies out; great for the hospital, devastating for employee protections and safe patient care. we cannot allow compliance lines to continue advertising “protection from retaliation for whistleblowers” when in reality they insist on letting management and hr chew on you and spit you out first; then they honor the corrupt self-serving decision to remove you, no questions asked! the entire hr process must be carefully monitored for fairness to insure that employees who are fired are being fired for a legitimate reason, especially when they have reported retaliatory managerial misconduct prior to being fired. whistleblower protections for healthcare workers need to be uniform national policies with enforceable legislation to back them up. i only hope that by forcing an investigation of how the johns hopkins compliance line covered for the hospital to secure my wrongful termination i can guilt them into making major regulatory changes. this is highly unlikely to help me with my case, but it may put pressure on hopkins to make far reaching changes through the organizations they have been so influential in creating. tangible safeguards for the future, worthwhile changes in policy; that will give me the personal achievement i long for, probably the very most i can look forward to after five years of abject misery. there are many useful links in the petition i created and i am encouraging nurses to not only sign, but leave comment about the wretched situation we are facing in us hospitals. to see this petition, go to: http://www.thepetitionsite.com/takeaction/938995258 visit the care2 site to read a personal letter of appeal from me; go to: http://www.care2.com/c2c/share/detail/91853 thanks for your support, tsunami kim.
  6. TsunamiKim

    Let's call Oprah

    great example of what i had advised other nurses to do in order to get the word out there. thank you for providing the link. i feel the need to repeat what i had put earlier...... remember: "the pen is mightier than the sword" last, but certainly not least, you can get your message out there by writing a "letter to the editor" at a newspaper or magazine. letters to the editor get printed and statistics show they are one of the most widely read sections of the newspaper. you see a story about a bad patient outcome due to negligent hospital care: tell them why these situations happen. you see an article on a car crash after a nurse drove home exhausted and fell asleep at the wheel: tell them why these incidents happen. you read about a medication error that kills a patient: tell them why these mistakes are made. you see a article on a healthcare ceo promoted to a position with a big fat salary: tell the public what is draining the coffers of healthcare! you see another tale of woe over the "nursing crisis:" tell the public the real reason behind this exodus. tell it like it is: this is a "nursing exodus!" just keep writing; remember: "the pen is mightier than the sword" keep documenting and keep writing, tsunami kim
  7. TsunamiKim

    Let's call Oprah

    time to send a delegation of nurses directly to oprah’s headquarters while dateline or 60 minutes might be persuaded to do a piece, in reality, it would probably be quite short, perhaps too short to accurately depict the quagmire into which overburdened nurses are sinking. i still think oprah is a good outlet for voicing our concerns and our best option to reach public notice. i know there are nurses who do not feel positive about oprah, but we need to look at things like her time slot, the volume of air time coverage her show could provide and her target audience with large numbers of women who are responsible for the health and safety of their families. i think we need a nurse or, better still a small delegation of nurses, in chicago to make an appointment to talk directly to a decision maker at harpo. who ever goes must be well prepared to demonstrate the volume of factual data that has already been written regarding the “nursing exodus” and how deliberate under-staffing for profit is harmfully impacting patient care. i refuse to call this “exodus” by any other name as it only buys into the healthcare industry’s shallow, profiteering excuses. the higher ranking these nurses, the more years of diverse and collective experience among this nurse delegation team the better. it is more likely for harpo executives to take a unified group of nurses seriously which is what we want. it will not hurt for them to think we are looking at other news programs, but flatter them with the impression that they are the fist and best choice. before going you will need to hold strategy meetings to insure that you present a strong, clear, concise and above all unified message; choose a main spokesperson carefully. so, do we have a few dedicated chicago nurse volunteers? my second message is write, write, and write some more……… “the pen is mightier than the sword” i have just posted my petition on thepetitionsite.com go to: http://www.thepetitionsite.com/takeaction/938995258 review my petition as an example of what we might be able to accomplish with a dedicated nursing petition. i have talked about this for a many months and now it is out there. i am waiting on tender hooks for it to be visible on their home page, but it is still being checked out by their monitoring team. i must show patience with this process since after including so many links they now need to make sure that none of them leads to a dodgy website; at least i am guessing this is the hold up. what is important is that it is available to receive signatures and you can visit the site to sign by following the above link. if you need to understand what has motivated me to post this petition and what i hope to accomplish you can visit my action alert share on the care2 sister site, go to: http://www.care2.com/c2c/share/detail/91853 i am pleased to report that nurses are not just signing, but they are making comments about the dangerous situation they are facing in healthcare. this commentary is very important and very powerful for several reasons. firstly the petitions on the site are highly visible in the public domain to a general audience of ordinary citizens who are all potential patients. while voicing your concerns among one another here is still important you are “preaching to the converted” as it were. we need the general public to know the real reasons why nurses are being driven out of nursing and how this exodus is making patient care unsafe with medical errors more prevalent. secondly, if you sign the petition and leave a comment, you should take note of where those comments will eventually be delivered and how that can benefit our cause. one of the two target recipients of this petition is a highly respected doctor who is in a powerful position at the top of a well recognized organization called: the center for innovation in quality patient care. we need this organization to pay more attention to the real reasons for medical errors by addressing under-staffing and allowing nurses a safe avenue to report problems without fear of retaliation. if this is not addressed then all of their other tweaking of regulations regarding patient safety issues are completely redundant. i have contacted this doctor several times, but my paperwork was always shuffled sideways to await the outcome of the hospital’s corrupt process of hr. perhaps his hands were tied by existing policy, but we need to tell him loud and clear that such policy is not working to protect nurses from retaliation and the policy itself needs to change. it is too late to correct the damage done to me now, however my case is merely one very bad example of how the system is seriously broken. most of the nurses signing my petition have done so anonymously as this is possible on the site. this in itself makes a powerful statement to potential patients who read your comments; as one nurse reveals she has signed in this way because she is “frightened.” do not feel bad about signing anonymously, your concerns are valid. let the public know that we want to act as patient advocates, but are being bullied into silence: this is the very real and tragic message that must be addressed. presenting a pattern of evidence to the center for innovation in quality patient care and other organizations showing that nurses are afraid to speak out as patient advocates will i hope force them to address the issue properly at last. this is a powerful organization and they can usher in industry wide changes, just keep sending them the evidence. in the links of my petition there are a large number of organizations you can contact regarding these issues to voice your concerns. the petition is intended to act as a resource for other healthcare activists. the more letters are sent to these organizations the better. there are also links to research papers and other useful data that can be presented to further the nursing cause. my petition is just an example i hope my petition will serve as an example to you of one way we could consider accomplishing our goal. i would like to see a new dedicated nursing petition created by the nurses who are voicing concerns here on this site. the petition could target oprah to do the feature on nursing issues that we have been discussing in this thread. this petition could be a collective effort with the best writer putting together the finished submission. this does need to be taken on by nurses currently working in us healthcare not a banished brit railing from across the pond! so: which nurses are interested in submitting a new petition? remember: “the pen is mightier than the sword” last, but certainly not least, you can get your message out there by writing a "letter to the editor" at a newspaper or magazine. letters to the editor get printed and statistics show they are one of the most widely read sections of the newspaper. you see a story about a bad patient outcome due to negligent hospital care: tell them why these situations happen. you see an article on a car crash after a nurse drove home exhausted and fell asleep at the wheel: tell them why these incidents happen. you read about a medication error that kills a patient: tell them why these mistakes are made. you see a article on a healthcare ceo promoted to a position with a big fat salary: tell the public what is draining the coffers of healthcare! you see another tale of woe over the “nursing crisis:” tell the public the real reason behind this exodus. tell it like it is: this is a “nursing exodus!” just keep writing; remember: “the pen is mightier than the sword” keep documenting and keep writing, tsunami kim
  8. TsunamiKim

    Let's call Oprah

    this from an earlier post of mine: "we trust nurses to recognize critical trends in their patient’s vital signs, but we deny their instincts with regard to their own basic needs and fitness for duty. this is disrespectful and, all too frequently, downright dangerous; nurses know when they need to eat, drink and rest. they also know when they should call in sick and not come in to work caring for vulnerable patients! however, if a mistake is caused by under-staffing, untrained assistive personnel or fatigue, will the hospital managers who created this appalling situation be held accountable? i doubt it." we still pretend that we do not trust nurses to decide that they require additional staff to monitor critical patients or larger numbers of less critical patients. managers and hospital administrators know that their nurses are perfectly capable of determining when the current staffing level is leaving them dangerously overwhelmed. they use an insidious combination of guilt, insecurity and vanity to deliberately under-staff clinical areas. 1. guilt: how could you be so selfish as to abandon your patient? 2. insecurity: why are you so incapable of coping with a few extra patients? 3. vanity: a really professional nurse would just get on with the job no matter how swamped with patients the unit became. don't buy into this c**p; it is all about the money - fewer staff: bigger profits. if your gut tells you it is unsafe: go with your gut. so much paperwork is dumped on nurses to protect the hospital. it is time to start fighting back with their weapon: paperwork. start documenting under-staffing; document missed breaks; document mandated overtime: document everything just as a conscientious nurse should. at my former hospital i suggested a minor protocol refinement that would require the circulating nurse to document on an incident report when a scrub nurse or tech. was left abandoned, scrubbed into surgery, for a period greater that 6-8hours. why? because of the inevitable loss of concentration and extreme fatigue after extended periods continuously scrubbed into surgery. forget the luxury of putting your feet up; there are basic necessities dictated by basic human rights and simple human dignity. most importantly: a member of the or team going without water; food; or a run to the bathroom for 8 - 10 or 12 hours presents a tangible danger to the patient unconscious on the or table. any potential "danger to the patient" should be documented in an incident report. does this mean that in an emergency we would be demanding breaks at the expense of patient priorities? no, it creates a paper trail and this documentation is vital. this simple documentation requirement would identify a particularly abusive manager like the one who left me stranded in surgery for 8, 10 and on one occasion 12hours straight. it would also identify the stubborn and aloof professional practice model that considered other or staff incapable of coping during a short break in their specialty cases. it would identify chronic under-staffing and the dangerous lack of redundancy among unit personnel. most of all it would be on record; which is exactly what the cost-containment police do not want. the or is a very restrictive place to work as i am sure you all know. during most surgery we do not sit down for the whole case and one gets use to not being ably to scratch an occasional itch. the vigilance necessary to protect the sterility of the field does not allow us to drop our guard and we are supposed to be anticipating the needs of the surgeon. “cruise control” is not an option during surgery! but if no one comes to relieve you then you are stuck there for the duration. try calling for backup on the phone you cannot even touch! however, other critical care areas are being hung out to dry in the current ruthless, profit first, environment. lack of redundancy of personnel means no real break coverage and ultimately this is very dangerous. how do icu nurses cope when a fellow nurse asks to have her patients monitored while she leaves the unit briefly? with critical patients there are critical occurrences. so what if their nurse was in the bathroom when they coded? redundancy allows for these situations and is therefore essential to patient safety especially in critical areas. so did that famous hospital where i spent five years in the or adopt my protocol refinement? not on your life. did the maryland board of nursing even bother to send me a polite form letter to say they might look into the possible need for tightening regulations? never; they were too busy protecting the best interests of their state icon. they were not about to concede that the person being unjustly demonized by that prestigious institution might actually have a valid point. as part of the “collateral damage” of deliberate under-staffing i am banished from my profession while “america’s best hospital” continues to win accolades and garner international acclaim for pioneering patient safety initiatives. how safe is it to continue passing sutures and instruments during transplant surgery after 12hours when you are on the verge of collapse? no legitimate reason necessary, no emergency, just an abusive manager who thought techs did not deserve a break and that no one needs to eat at night anyway. this is ok in maryland because, as in so many us states: “breaks are at the discretion of the employer.” i documented the incident in a complaint to my supervisor, but eventually i was the one wrongfully terminated for daring to rock the boat. one does not criticize a manager ,and they are never disciplined, no matter how blatantly abusive they are to their staff. i was supposed to be compliant and just leave, but i didn’t so they wreaked my entire career. we must close the loopholes that permit this and similar under-staffing abuses. as abhorrent as these stressful abandonment situations were for me; the forgotten victim is, as always, the patient. nurses need to use their strong evaluation skills to determine when their own abandonment in the workplace puts the patients in their care at unreasonable risk of harm. if there is risk, document that risk, as it is only by creating the paper trail that these cost-cutting administrators dread that we will ever force them to do what is safe for the patients. shame on the maryland board of nursing for not prioritizing basic patient safety above protecting your precious national icon! the pen is mightier than the sword: keep documenting dangerous staffing inadequacies! do not allow these for-profit hospitals to use your dedication to compromise safe patient care, tsunami kim.
  9. TsunamiKim

    Let's call Oprah

    too late to write much now and i will be off line tomorrow. moveon.org use the e-mail your representative tactic i mentioned earlier; we should contact them for tactical help on how to do this. also my friend in maryland who started lariam action usa said we should select one of our members from chicago to contact the harpo studios there and arrange to go in for a one on one meeting re doing a show on nurses. she thinks oprah is a great avenue due to her likely sympathetic target audience and the length of her shows. 60 minutes will give you less than 20minutes on a segment and she knows this stuff first hand. she says tell oprah we are giving her first option and make it sound like all the networks are hot on our tail. by the way for all you service men’s wives out there: if your husband took lariam, an anti-malarial medication, while serving overseas you should go to her site and find out more about this highly toxic drug. the site is lariam action usa, check it out, tsunami kim.
  10. TsunamiKim

    Let's call Oprah

    [color=#465663]first let's stop the bickering and infighting as it accomplishes nothing and gets us nowhere fast. we need to "re-brand" the problem: the us does not have a "nursing crisis" the us has a: "nursing exodus" why is this point so important? because the so called "nursing crisis" is fueling the problem by allowing greedy self-serving for-profit hospitals to continue their campaign of deliberate under-staffing. it gives these healthcare facilities the perfect excuse to mandate overtime, deny breaks, overburden nursing staff with excessive call and replace those who are driven out by these measures with new nurse grads or untrained assistive personnel. we know that it is these policies that are driving nurses to leave the nursing profession in droves. nurses will not accept more abuse and the ongoing dangerous compromises in patient care, but we do another disservice to the integrity of nurses by allowing the media to focus on pay issues alone. most nurses who have left still maintain their nursing license: we need to offer tangible solutions for how to bring these disillusioned nurses back into nursing. here are just a few of the 250 links that i have included in my petition; testimony provided by nurses with suggestions for correcting these problem with tangible solutions. http://edworkforce.house.gov/hearings/107th/fc/nurses92501/mccullough.htmsept. 2001 testimony before committee on education & the workforce http://bhpr.hrsa.gov/nursing/nacnep/shortagetestimony.htmnursing shortage issues hrsa: multiple links http://www4.nationalacademies.org/news.nsf/isbn/0309090679?opendocument substantial changes required in nurses' work environment to protect patients from health care errors: the national academies http://www.leg.state.nv.us/70th/minutes/am-hh-990406-ab586.html testimony in nevada proposing changes in legislation someone with stronger computer skills than me could set up an online channel for appealing to political representatives, oprah etc. the typical page is a data entry format with boxes for name, address, e-mail etc. the state is selected in one box that triggers contacts to the appropriate senators, members of congress and the governor for that particular state. you provide a basic standardized form letter with the main impact of your message spelled out. tell a political representative realistic ways to fix a very serious problem and they may just listen. battles over pay are best left out as they are easily seized upon as the sole motivation and other avenues, like nursing unions, are more appropriate for raising pay issues. there is then a sign and send option with possibly a print out version too for those who want to mail a letter. when you press send an e-mail submission is automatically routed to the representatives for your state. this is not about which letter or e-mail gets read, it is about volume. the print out option would have your message with the sender's address and the correct address for the sender to mail it to at the top. the reminder to: "please place this in a red envelope and mail to the above" might be heeded by at least a proportion of the potential snail mail senders. i think the red envelope idea is a good one as it also provides an easily recognizable press "hook." the headline "hundreds of red envelopes descended on capitol hill......." would be a great start to a media blitz. "beware of the red snow!" most people now want the easy out of the electronic message, but simplicity is the key to boosting numbers. you can use the same approach to appeal to oprah: we create a form letter that can be sent electronically. you can even suggest a "cut and paste" option to direct nurses to take your letter and splice it into their oprah message in her web site box. this would provide uniformity and an uncomplicated demand for her to take action: simplicity is the key to boosting the number of responses. we then create a press release that states the aims of our campaign to "end the nurse exodus;" or whatever really says it all, we are up for suggestions here. we can use pr free to disseminate that message to newspapers and media outlets across the us. the press release would direct people to "go to" the site where signatures could be added to letters to representatives and oprah. have an optional box that has "nurse?" "healthcare professional?" or "concerned potential patient?" i do not know how to set up this data entry box thing, but there are examples of this all over the internet. who knows how to get this done and is prepared to take this on. it would have greatest impact if we create an organizational name and even better if we launch during nurses week! i suggested t.e.a.m.: "transparency for equal accountability in medicine," but others may have a better idea on this. timing is crucial with pr so if a new campaign with a new site is created then that is when the release has to go out; yesterday's news is not news. content: there are different initiatives being proposed in various parts of the country. instead of reinventing the wheel we need to ask our representatives to adopt the bills being proposed elsewhere. we all know what patient care issue areas we most need to target: mandated overtime; nurse patient ratios; the relief break policy; the call in policy; regaining decision making control; whistleblower and retaliation protections. new jersey just introduced new whistleblower protections for healthcare staff, but it appears california is leading the way in other areas. we need to cherry pick the best ideas from around the country. here are three of the examples that i included in the links of my petition: http://www.njwec.org/fs_cepa.html new jersey on employee duty to report & rights to protection http://www.theorator.com/bills109/s351.html the bill: "safe nursing & patient care act 2005: http://www.nccusl.org/update/uniformact_summaries/uniformacts-s-meta.aspmeta: ending "at will firing the nurse to patient ratios cannot afford to be overly simplistic; it is not just the number of nurses on duty but safe experience levels in the nursing staff mix. relying on a certain number of assistive personnel is fine as long as ratios of supervision levels are safe, training is adequate and they do not simply provide a cheap replacement for experienced nursing care. if the patients had a clear idea of how experienced their nurse was from a mandatory displayed badge then the hospitals would not get away with their policy of replacing all tenure nurses with less experienced staff. when a minimally trained nursing assistant is referred to as a "nursing associate" the patient has the false impression that they have an associate degree level of training. this works well for hospital under-staffing to maximize profits, but it guarantees unsafe patient care. this title was introduced to deviously disguise inadequate training: we need standardized titles for assistive personnel with matching standardization of their training as directed by experienced nurses. assistive roles should provide a steady progression of training levels that lure less experienced staff into full nursing training as a reward for dedication and years of service. entry level workers who see the possibility of proper training to a higher level as a realistic option for the future if they work hard and stick with the job feel invested in the job. healthcare facilities need good thorough cleaning to control infection rates and nurses need proper backup with staff who will fetch supplies and stock areas. we all need to start working as a team and thinking as a team. this has always been important to me after spending so many years as a crew member offshore; a captain needs all crew members to pull together as a team. i was on the first us women's challenge yacht racing team campaigning to compete in the 1989/90 whitbread round the world race. when we failed to get sponsorship i did one grueling southern ocean leg aboard the maxi "with integrity" and watched my best friend swept overboard into the icy water at 50degres south. he was in the frigid water for 30minuts and almost died; it made me realize how important it was to function as a strong unified team. this near tragedy reinforced my team ethic as i formulated my own whitbread racing team in preparation for the next race, but it was not to be. hurricane andrew compelled me to disband team pro-maxi and go join medical volunteers in devastated south dade; it was the eureka moment that coaxed me into medicine. i bought my boat captain "team" thinking, "team" ethic with me into the medical arena. i draw many parallels with what works to make situations safe at sea since a serious medical emergency demands the same type of team commitment to work well, remain focused and maintain a safe environment for the patient. we need the public to join us in our team commitment to patient safety. this is why i came up with the team name as my suggestion for an organization name, just my two pence worth. all other positive suggestions up for grabs, but let's not procrastinate about this as what needs doing, needs doing now! also, while all input must be respected, we should at least try to keep this positive.......... fair winds & following seas, tsunami kim.
  11. TsunamiKim

    Let's call Oprah

    i would be more than happy to make several trans-atlantic phone calls to grab the attention of the right people in the us media. this is not as expensive as it sounds believe me as i have no spare cash available to me anymore. while i was forced to leave the us due to the hardship of loosing my home after wrongful termination from my job for blowing the whistle on hospital negligence i am still actively campaigning to correct this matter. if i can find out how to get access to the right contact info i will do this on behalf of the nurses left stranded in your us for-profit healthcare system that certainly knows how to silence dissenters. my career has been virtually scuttled by the powerful hospital that demonized me, but i really have nothing left to loose anymore. with the tenacity of a cornered rat or that famous symbol of dogged determination, the british bulldog, i will simply not give up and go away, ever! i believe that my case was a truly shocking example of ignored negligence, inhumane working conditions and serious abuse of power. however, all of this is also very easily proven to be true under the right scrutiny, hence the petition i will be posting soon. the links in this petition, while slowing things down right now, will prove a valuable resource to you all as this struggle goes forward. i found numerous articles on the real reasons behind the “nursing crisis,” the patient to nurse ratio, the harmful affects of fatigue and how these factors contribute to medical errors. i cannot jump the gun and post this yet, but i can send a draft copy containing the links to anyone who contacts me through my message box. as tedious as the delays are i must also time this carefully with a well organized press release. i have found a means to disseminate this press release effectively and affordably using a site called pr free. the site is at: https://www.prfree.com/contact.html . for a small donation they will enhance my submission’s access to the media and this is probably a worthwhile investment for anyone considering opting for a press release. even something as trivial as paying a quite small donation has to rely on the help of my us friends as i lost all access to credit during my futile attempts to hang on to my baltimore home. this ongoing reminder that i will never be creditworthy again is a humiliating nuisance, but will not deter me for very long. we need to seriously think about getting more media attention focused on nursing issues. i am good at pr, but my personal resources are really restricted by the above circumstances. another link of mine goes to a workplace fairness site and they have media lists for sending out a press release option as well at: http://capwiz.com/workfair/dbq/media/ when i worked at the most prestigious hospital in maryland i spoke up on behalf of nurses when i first saw them exiting our or in droves. first their “vacation time” and “sick bank time” was rolled into one cutting their overall access to time off by over one week a year for most nurses. then there was the introduction of the “occurrence policy” that made it a disciplinary offence to call in sick more that three times a year! these little incentives to quit got rid of the more discerning older nurses and increased the call burden on those left behind. no one had a right to a life outside work: there was more call, mandated overtime and, well you all know the story. surgical techs. were impacted by the nursing shortage too, lack of knowledgeable tenure nurses to support us in surgery plus we shared the increased call and schedule coverage burden. however, the worst organizational changes targeted nurses so my comments could never have been misconstrued as self–serving since i was not a nurse. i went to the then director of surgical nursing and said we cannot afford to loose this many of our most experienced nurses, we have a “nurse exodus” right now. she said: “oh this just happens every once in a while.” the reality of it is that it works really well for them, so they just make it happen every once in a while. we are seeing it all over the us: a toxic work environment drives out the most experienced nurses. at my former hospital the new nurse grads were paid only fractionally more than us as or techs, but they were lining up to take the place of experienced tenure nurses. with the best teaching nurses gone, they took on too much responsibility just barely out of training, but they were ready to make major compromises to earn their reputation at the “best hospital in america.” now my former hospital has earned the designation of a “magnate” nursing institution, but i doubt that the basic work environment has changed. new nurses are not “magnetized” to that hospital because of the excellent pay or exemplary working conditions of the most prestigious teaching institution in the country, they are thinking about how good it will look on their resume if they can just put up with the supper demanding bs and stick with their really tough or job. the surgical department is still dominated by the same or management team that left me stranded in surgery continuously without a break for 8-10 and 12 hours. just one month after i left, for some mysterious reason, they felt compelled to start calling in their call team to stand by for trauma as required under comar. this same group of corrupt managers who retaliated against me for daring to complain about inhumane treatment and their inadequate trauma coverage, even lied under oath at my arbitration hearing to secure my dismissal. corrupt is corrupt: if they will cross the line once they will not hesitate to do it again in the future: they need to be removed! i am not trying to be vindictive here or seek revenge. simply put: all employees must be subject to exactly the same level of discipline for patient negligence and misconduct, from the top manager to the person mopping the floor. i have always remained very vocal on behalf of the nursing cause and you may be surprised to learn that i am not actually a nurse. i have to admit that, unfair as it may seem, i have enjoyed better clinical opportunities by avoiding the nursing license. at my first hospital techs started most of the ivs, drew blood, inserted ng tubes, fowleys etc. while nurses were tied up with medical legal documentation. at my last hospital the circulators in the or were constantly running for supplies that should have been retrieved by ornas. they were pestered by surgeons beepers that should have been left with secretarial staff at the main desk. once again i was deterred by the copious amount of paperwork and lack of opportunities to scrub into surgical cases as a nurse. not very fair perhaps as i was essentially working under someone else’s license as a tech. i had had more than enough responsibility when i captained yachts on trans-atlantic delivery crossings, so it was not like i didn’t take responsibility for people’s lives very seriously. however, responsibility and accountability must come with some degree of control. in a previous post i elaborated upon this as my main reason for the decision not to become a nurse and i will reiterate the point here: rns are saddled with the full accountability associated with working under their license, but without sufficient authority to insure that the patient environment is genuinely safe. responsibility without appropriate control is the real downfall of the nursing profession today; as a yacht captain offshore it was my license, my responsibility, but under my command. for this reason i have never elected to become a nurse, but believe me it's no disrespect to this noble profession, far from it. i also believe that us nurses are greatly undervalued and appallingly misused; their talents are frequently squandered and they are forced to tolerate serious disrespect on a daily basis. assistive personnel should have taken over some of the more mundane routine tasks, thus freeing up experienced nurses to concentrate on more important patient care issues. instead they are assigned another mindless drudgery task, filling out excessive paperwork! ambulance crew’s have reduced paperwork with well designed forms. hospitals should revamp nursing forms to place more emphasis on computerized data entry and leave more time for direct patient care. before entering conventional medical institutions i was especially well attuned and sensitive to the problems of fatigue; i was at sea for over twenty years delivering yachts offshore. as a us coast guard licensed captain i was responsible for the welfare of my crew while at sea; ensuring that they did not become sick, exhausted and fatigued was a top priority. as a captain it is necessary to watch your crew like a hawk to spot tell tale signs of any potential medical situation long before they come to you for assistance. mid-ocean evacuation by helicopter is expensive, dangerous and sometimes impossible; it was my job to make sure those on board stayed fit. a captain can choose who is qualified to sail with them, who is fit and rested enough to stand a night watch and how many people it takes to man the vessel. in the majority of cases this level of control is denied to nurses even when they are assigned as the charge nurse. we trust nurses to recognize critical trends in their patient’s vital signs, but we deny their instincts with regard to their own basic needs and fitness for duty. this is disrespectful and, all too frequently, downright dangerous; nurses know when they need to eat, drink and rest. they also know when they should call in sick and not come in to work caring for vulnerable patients! however, if a mistake is caused by under staffing, untrained assistive personnel or fatigue, will the hospital managers who created this appalling situation be held accountable? i doubt it. i know that i have not raced ahead of myself in considering drawing media attention to my own situation. i went up the chain of command first: it got me fired. i trusted in the integrity of the hr process: they cheated, lied and suppressed documents to help rubber stamp my removal. i appealed to the hospital’s internal compliance line to protect me from retaliation and investigate the negligence issues: they refused to protect me and only vowed to “keep an eye on” the negligence issues. i went through an eeoc mediation: eeoc was shown paperwork i was denied access to. i asked the maryland commission on human relations to investigate: they were shown fabricated rule violations that did not exist when i was fired. i appealed to the maryland trauma agency meimss: i was told that the alleged comar violations, “did not specifically endanger trauma patients.” i appealed to the maryland board of nursing, jcaho and the board of healthcare quality all of whom buckled under the power of maryland’s biggest employer. i attended an arbitration hearing that i was not informed would be binding: the top or nurse manager in that hospital deliberately lied under oath to victimize her subordinate and permanently remove me from my job. it has now been over five years of patiently wading through the correct procedures in the right order and being denied justice time and time again. during that time i have even had access to the press, but determined to wait for justice to take its course i remained silent about my wrongful termination; misplaced loyalty and faith in a corrupt system. i became quite adept at getting good press coverage for an unrelated cause, even scoring a cover story in the city paper, but still i said nothing about my lying, cheating, negligent hospital. this should prove my personal integrity beyond any doubt, but no more mr. nice guy: i am turning to the press for justice now. the most powerful thing in favor of forcing real changes is the sheer might of that prestigious institution: they simply cannot afford bad press. this is a big bargaining chip that we can use to persuade them to institute changes that will reverberate throughout the entire healthcare industry. this is a very realistic possibility and it is what drives me at this late stage. i have no hope of financial compensation, but i need to know that the appalling personal sacrifices i was forced to endure, like the loss of my home as i was driven into debt, were not in vain. as for opera she is more than a little familiar with baltimore city as this was where she got one of her first big career breaks. we need to consider formulating an advocacy group and i put my ideas on this subject into another previous post: i have sent "citizen opinion" letters to my us senators and congressman plus i am considering launching a new advocacy group i call "team" rather than targeting any particular medical institution or hospital, i would like to create an advocacy group that really helps level the playing field with regard to all medical facilities, but paying especial attention to "iconic" institutions to insure that they do not receive special immunity from scrutiny as they did in my case transparency for equal accountability in medicine : t.e.a.m. not another "support group," but the " t.e.a.m." advocacy group?" it would take good solid support from nurses to head this up and, being the other side of the atlantic, i might have little input beyond launching an idea, but i think it is very necessary. any ideas or input please let me know. if you have waded through all this, i must apologies for its length, thank you for bearing with me, fair winds & following seas, tsunami kim.
  12. TsunamiKim

    Let's call Oprah

    “fight bigotry with excellence” i believe this quote is attributed to oprah. i just read through all the posts and found a lot of negativity when we should be focusing on action. i do not feel the need to discredit oprah’s journalistic credentials or her personal motivations: even if it were justified, which i doubt, it gets us nowhere. we need to focus on tangible goals and on informing the general public of how the sometimes inhumane conditions under which we are forced to work directly endanger our patients: ordinary members of the population at a time when they are at their most vulnerable. this is not just about nurses and the so called “nursing crisis” it is about every man, woman and child in the us and the very real dangers of the current “nursing exodus!” one important factor should be born in mind here: the audience who watch oprah’s show on a regular basis are extremely sensitive to the underlying issues that we should be focusing on raising. 1. dangerous staffing levels that overstretch healthcare workers to their breaking point: how can we properly care for our patients when we remain so consistently overwhelmed? 2. mandated overtime that forces badly fatigued nurses to continue working past the point of exhaustion: who is held responsible when an exhausted nurse makes a mistake or a serious medical error harms a patient? 3. no redundancy of personnel to cover breaks so nursing staff are left stranded for 10 or 12 hours without the opportunity to eat, drink water or even urinate: how can we possibly be expected to function in surgery, in the icu or any medical unit for that matter, when we are almost comatose from such inhumanely abusive demands? 4. the extreme level of personal accountability that comes with the rn license without adequate authority or genuine control especially over dangerous understaffing situations: how can any nurse be held responsible for negligence when they never had the opportunity to demand the proper backup or qualified help? 5. proper protections from retaliation by managers for conscientious healthcare workers who blow the whistle on negligence: how can we protect our patients from harm if we are bullied and intimidated into silence by risk of job loss with career jeopardizing character assignation? oprah’s audiences have families and their families need safe quality health care. they will be the recipients of substandard attention on a hospital unit that is understaffed. it might be their own daughter’s promising nursing career that ends when she crashes her car after a 16hour shift. their father, mother, wife, husband or child might be the patient on the or table who is briefly “abandoned” when no relief arrives and their nurse insists on breaking scrub after 12 grueling hours of continuous standing at the field without a break. we are human beings too! although they will be the ones eager to seek accountability from rn licensed personnel when the mistake is made and their family member is harmed due to a “preventable medical error,” they need to know where the real fault lies much of the time. they must be made to realize how helpless nurses really are to control a safe staffing environment and that their outrage should target the greedy for-profit institutions and corrupt managers who prioritize their “bonus” over safe patient care. they and their loved ones are the patients harmfully impacted by unreported negligence while hospital staff remain successfully intimidated into silence by self-serving managers protecting powerful corporate interests. on the basis of her audience’s interests oprah is an ideal format to showcase a very real crisis like this. due to the above reasoning i think that oprah would be a very good outlet to broadcast our message. however, i think oprah is motivated the most by people and groups who have clear cut positive goals with regard to change. she may be far less inclined to listen to complaints without solutions. a previous post remarked on this too: what do nurses what? what do you hope to accomplish from highlighting your appalling working conditions? those eager to silence nurses will try to diverge from the most relevant issues and make everything just about pay. would being paid a whole lot more help you to choke down the abuse, the inhumane demands, the risks you are forced to take when you are left stranded? we must insist on identifying this artificially created crisis in realistic terms: “the nursing exodus.” statistics show the number of rn licenses in all us states; how many rns choose not to work in nursing? how many have been forced out of hospitals as “downsizing” makes the environment less workable and more dangerous for those left behind? this is not just about nursing pay, it never was. deliberate understaffing and the toxic work environment are driving the nursing exodus. let’s stay on task and not dilute the impact with petty infighting over personal preferences and doubts about whether oprah is the right person or the best choice for propelling our concerns into the media spotlight. why stop at oprah or try to select the perfect spokesperson anyway? no one single avenue will ever be enough to get this issue dealt with. i was also told that michael moore is right now actively soliciting health care horror stories for a new film project. i have contacted him with no reply yet, but one has to understand how difficult the task is to sift through all of the submissions to find the most worthwhile and effective cause to spotlight. this is the problem with contacting oprah as well. i think targeting the above issues in order to prevent medical error horror stories is the most worthy goal and we need to persuade michael moore, oprah and others that this is the case. my own course of action will be to post a petition on the petition site very shortly. i realize that targeting just one particular compliance line’s failure to investigate the wrongful termination of one employee in retaliation for blowing the whistle on negligence in one hospital’s or may seem personal and perhaps even futile. however, the hospital is very prestigious and my hope is that their iconic status will compel them to take far reaching actions that could force changes industry wide. their influence is huge as they are involved in the upper echelons, the very top organizational level of patient safety, advocacy, ethics and medical law groups in the us. their current very public stand on patient safety will seem like so much sanctimonious preaching, hype and hypocrisy if they do not agree to take appropriate action in my case. to publicly refuse to do an investigation casts doubt on their integrity as well as the credibility of their compliance line and other compliance hot lines delivering similar empty whistleblower protection hype right now. my own situation has been elaborated upon in several other threads under the name tsunami kim, but the issues of understaffing, breaks, retaliation etc. have been subjects discussed by numerous nurses visiting this site. we need to do something about it now. the reason my petition has been delayed for so long is due to the links i have added to help readers focus on the real issues faced by nursing staff today and how these issues negatively impact patient care. it will be a valuable resource document because of the links so watch out for it and i hope i can count on strong support from conscientious nurses like you once it is posted. i have also begun writing a book that i call “iconic immunity,” about my experiences as a whistleblower and the mighty institution that silenced me. the book will focus on many of these important nursing issues, the necessity for all institutions to follow regulatory guidelines and the dangers of allowing any facility to hide behind their iconic status placing them beyond public scrutiny. we all need to be more proactive if we hope to change the current situation. we must focus on what we should try to accomplish by gaining media attention. no one media figure has the power to fix the problems we face and we will never even get her attention unless more than one of us gets in touch with her. there are other potential candidates and additional avenues to approach them. we could post a petition on the petition site that specifically targets appealing to opera or michael moore for help. we all need to do something as it will not do itself! tsunami kim.
  13. TsunamiKim

    Break anyone??????????????????????

    try a liver transplant, 12hours scrubbed into surgery with no break. yep that is 12 hours with no water, no food and no chance to pee! by the way you get used to the not able to scratch your nose thing. as a surgical technologist i was at the mercy of my charge nurse to send in a relief person so that i could break scrub. to just leave is of course considered: "patient abandonment," besides my liver transplant patient was on bypass. if this or manager was at all concerned about me or my ability to do my job, passing tiny sutures as fine as a human hair, she might have relieved me briefly herself. however, she was relentlessly abusive to everyone and she just didn't care. my former hospital really loved her because she has helped them to "downsize" as tenure nurses continued to leave in droves. new nurse graduates are much cheaper, more compliant and they tolerate abuse far better while trying to earn their reputation at the "best hospital in america." yes, that is how they treat their staff at the "best hospital in america" and they are still winning awards for excellence in patient safety! while a surgeon can, and should, demand that the person assisting him is relieved, nurses and technicians fall under the control of or management which leaves us vulnerable to the vagaries of inappropriate or coverage as determined by the hospital. as a consequence of hospital "downsizing" to cut costs redundancy of personnel has been severely limited to the point where during the off-shifts especially at night and on weekends there's no free staff to break people out of surgery for even a brief run to the bathroom! calling in call team people to provide relief breaks is considered an unnecessary expense, despite the fact that there is a clearly established link between fatigue and medical errors. the sterile team scrubbed into surgery are trapped without food or water until they are relieved; this also represents an unacceptable deprivation strain on the body. however there are no safeguards within the existing us employment laws or ocha standards to insure that critical hospital workers, including those in the or, are not left for hours of continuous, and dangerous, practice without a break. why you may ask? because "breaks are at the discretion of the employer." i was left stranded at the field without relief for 8, 10 and on the worst occasion 12 hours straight. these situations impacted my ability to concentrate as my blood sugar plummeted; each time i reported becoming sick, dizzy and faint to the point of nearly passing out. despite nearly passed out during these lengthy periods of abandonment in surgery, but my manager felt that i should be "evaluated for a sugar problem." it is not healthy to go without water or sustenance for over 12 hours; deferring bathroom use isn't healthy either. check out the site "void where prohibited" for more info on this problem. when i complained that my condition in response to this hardship presented a danger to my patients i was targeted for removal and then fired. incidents where any member of the or team is forced to remain on task for that long should be documented in an "incident report," as an extreme of this magnitude presents an unacceptable danger to the patient. i soon learned that any attempt to complain about a nurse manager's conduct was really futile. my hospital never disciplines their managers for any reason what-so-ever. so here is a question that i have posed elsewhere on another allnurses thread: "how long is too long to remain alert while scrubbed into surgery without a break?" this is the issue rarely addressed by hospitals: are they driving medical staff to continue working when it is unhealthy and unsafe for them as well as dangerous for their patients. we are not making cookies! people's lives are in our hands so why are members of the public so astonished when we make a medication error or leave a clamp inside a patient? they do not realize we are expected to work on the brink of collapse. i am trained as a wilderness emt and i was one of the founding members of the south florida d-mat team. one thing that is heavily emphasized in rescue and disaster response training is the need for team members to remain properly hydrated and pay attention to their own physical needs so that they do not become victims themselves. in a dire emergency it is easy to neglect your own needs, become week, dehydrated and exhausted: you will become a liability to your team under these circumstances and it is not well tolerated. i have fairly recently returned from six months as a medical volunteer out in aceh province, indonesia following the tsunami. i was pleased and reassured to find that the ngo personnel stationed in disaster zones are also encouraged to share this, team safety is patient safety, priority in carrying out their responsibilities. this vital component is absent or ignored in medical training for us hospitals. before entering conventional medical institutions i was especially well attuned and sensitivity to the problems of fatigue; i was at sea for over twenty years delivering yachts offshore. as a us coast guard licensed captain i was responsible for the welfare of my crew while at sea; ensuring that they did not become sick, exhausted and fatigued was a top priority. a captain can choose who is qualified to sail with them, who is fit and rested enough to stand a night watch and how many people it takes to man the vessel. in the majority of cases this level of control is denied to nurses even when they are assigned as charge nurse. however, if a mistake is caused by under staffing, untrained assistive personnel or fatigue, will the hospital managers who created this appalling situation be held accountable? i doubt it. hospital managers seem immune from such responsibility for their staff. they might as well have erected a six foot high banner in the lobby stating: "managers will never be held accountable for negligence or retaliation against subordinates." at my arbitration hearing the or managers admitted i had been left abandoned in surgery for 12 hours on one occasion. despite written hospital policies that clearly state it is the responsibility of the manager to organize breaks all they had to say in reply to why i was not relieved was "she didn't ask for a break" and the er (not the or) was busy! there was no defense as what ever the hospital management said was taken as gospel. the elimination of staff and minimal redundancy of nursing personnel means that even in most non-emergency situations there are no staff to give relief breaks. we must force hospitals to take this situation seriously as it is putting the health of staff and the safety of patients at unnecessary risk now here are some rather shocking facts for you long suffering nurses to evaluate. the reprints are taken from the un site and clearly show that pows have greater rights to humane treatment than most us workers, but nurses and other medical staff are particularly badly abused. it is only by drawing such shocking parallels that we can alert the desensitized america public to the plight of overstressed hospital staff. compared to many us healthcare facilities what is written below looks like a quite reasonable "benefit package." geneva convention relative to the treatment of prisoners of war adopted on 12 august 1949 by the diplomatic conference for the establishment of international conventions for the protection of victims of war, held in geneva from 21 april to 12 august, 1949 entry into force 21 october 1950 chapter ii quarters, food and clothing of prisoners of war article 26 the basic daily food rations shall be sufficient in quantity, quality and variety to keep prisoners of war in good health and to prevent loss of weight or the development of nutritional deficiencies. account shall also be taken of the habitual diet of the prisoners. the detaining power shall supply prisoners of war who work with such additional rations as are necessary for the labour on which they are employed. sufficient drinking water shall be supplied to prisoners of war. section iii labour of prisoners of war article 53 the duration of the daily labour of prisoners of war, including the time of the journey to and fro, shall not be excessive, and must in no case exceed that permitted for civilian workers in the district, who are nationals of the detaining power and employed on the same work. prisoners of war must be allowed, in the middle of the day's work, a rest of not less than one hour. this rest will be the same as that to which workers of the detaining power are entitled, if the latter is of longer duration. they shall be allowed in addition a rest of twenty-four consecutive hours every week, preferably on sunday or the day of rest in their country of origin. furthermore, every prisoner who has worked for one year shall be granted a rest of eight consecutive days, during which his working pay shall be paid him. as hawks in the administration debate the geneva convention's ruling on how long it is permissible to keep a prisoner of war in the standing position few rationalize that ordinary workers might deserve at least equal if not fractionally better treatment. 10 -12 full hours continuously standing is defiantly in the realm of cruel and unusual punishment, but it is ok for a surgical technologist in the "best hospital in america." legally in most us states breaks are entirely at the discretion of your employer unless you are under the age of 18. they do not have to allow a lunch break at all. while their must be facilities for you to use a bathroom there are no regulations pertaining to how infrequently you might be allowed to use them. while you are not legally entitled to any breaks at all your hospital can mandate you to remain on duty for a second shift: you could go for 16hours without food or water without the hospital technically breaking the law! if you abandon your post and your patient however there are consequences as you can be charged with "patient abandonment." this safety breach could cost you your nursing license, but usually the guilt trip is enough to keep you on task. here is an extract from another un web site pertaining to the working regulations formulated in accordance with unhcr guidelines to protect the rights of iraqi workers. let's call it: "benefit package number two!" this is an interesting reprint from a document that those who work under similar unreasonable, torturous or downright inhumane circumstances in the us should take careful note of: 43. hours of work are interspersed with one or more eating and rest periods of not less than half an hour. continuous work may not exceed five hours. the rest period in jobs which span two meal times ranges between one and four hours (labour act in force, art. 58). unhcr is helping to legislate more humane working regulations in iraq than are afforded to us workers even in critical jobs like healthcare! the "labor act" is a un document, please visit this site: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/e.1994.104.add.9.en?opendocument there is a good reason why on the airlines you are instructed to don your our own oxygen mask first before attending to the needs of someone else. however, in our hospitals we are taught that the obligation to our patient must preempt even the most basic self preservation necessities. we are encouraged to feel guilty about abandoning the patient to take a rest break or get something to eat, when instead we should be more concerned that in neglecting ourselves we will compromise the care of others. the zero redundancy of personnel, therefore no one to cover breaks, therefore just go without, situation is happening in all areas of numerous for profit hospitals throughout the united states. it is all about the money, as our conscience is being unfairly manipulated to enable big corporations to bleed healthcare dry. the real culprits in the abandonment of patients are the hospital administrators who are striving for greater profits with chronically few well trained staff while unscrupulous management help to facilitate this process. as i learned the hard way, choke it down or speak out at your peril; the hospital holds all the cards and you have zero rights. after five years of flawless service in the or i was fired without cause for asking to be treated in a humane manor! "at will" employment laws in most states mean that if you dare to complain you will be removed and there is little or no recourse to even minimal protection from retaliation for whistleblowers. i lost everything i had in the us and the hospital's lies may now sabotage my efforts to work as an unpaid overseas medical volunteer for an ngo in tsunami ravaged indonesia. i spent six months in aceh, but i need a stronger mandate to continue my work and that just isn't possible with the false allegation over my shameful exit from my prestigious former employer. they know how to ruin your entire life; they did it and so far they have succeeded. if you are forced to work for hours on end without relief, without water, food or a run to the bathroom, you will be compromise the care of your patients by risking medical error. do not accept the guilt of "patient abandonment" threats while your hospital rakes in the profits from negligent care. write an "incident report" to document inadequate staffing and inappropriate intervals without relief as they represent a tangible danger to the patients. i know, easier said than done when you have no voice and no protection in the workplace. nurses must speak out, some are less able to take on this daunting challenge due to family commitments, but we must support their efforts to force industry wide changes. this managerial negligence is fraud, as it defrauds the public of safe hospital care! there is further information on the topic of breaks, abandonment and retaliation etc. that i have elaborated on in allnursing threads and i hope you will view these other threads. [color=#333333]https://allnurses.com/forums/f8/re-blowing-whistle-deliberate-understaffing-and-toxic-managerial-practices-133423.html#post1432109 https://allnurses.com/forums/f100/re-do-hospital-compliance-lines-offer-genuine-protection-retaliation-139732.html#post1492339 https://allnurses.com/forums/f100/constituent-opinion-patient-advocate-hospital-staff-gagged-will-firing-139235.html#post1487926 https://allnurses.com/forums/f100/retaliation-voicing-concern-over-unsafe-pratices-131188-5.html after a five year battle i will be going public with a petition on the internet very soon. i have been held up due to serious computer problems and inadequate space to post the petition with all of the embedded links in place. the petition has over 200 links that will provide a valuable resource to other hospital staff and interested citizens by providing a valuable insight into the situation discussed here, but i need a web space for this "links heavy" version that will link to the main petition site. please contact me with suggestions if you can help. please look out for the basic format as it will be posted soon on thepetitionsite.com. i hope you will consider signing and passing this information on to your friends, fair winds & following seas, tsunami kim.
  14. TsunamiKim

    Retaliation for voicing concern over unsafe pratices

    I feel bad knowing that you will face another cruel lie tomorrow; the “investigation” is pretty much guaranteed to be just another sham. These futile “going through the motions” exercises accomplish only one goal, DELAY! The fancy titles “Risk Management,” “Compliance Line” and other so called “Patient Safety” Hotlines are just what so many Hospitals have laughingly created to con the public into believing they are capable of self-policing. The Fox takes care of the Fox and all that’s left of the hens is a few pitiful feathers! The sum result of my former Hospital’s supposedly thorough “Compliance Line Investigation” into the issues that I raised was nothing in writing, no well documented report or outlined strategy for correcting the problems I raised. I was just told casually over the phone: “there does seem to be some truth to what you have reported, but we have decided to just keep an eye on things.” They only very reluctantly agreed to bother investigating after insisting on deferring all possibility of reviewing the retaliation issue until after I had pursued all other options first. Only by isolating the negligence charges for separate more urgent action was I able to insist on any investigation at all! And this is Compliance? What action did they take? None, it was just a stalling tactic to placate the idiot employee while they put some serious distance between the complaint and the now further removed, discredited terminated employee. The rules of engagement are dictated by them, for their benefit and to help remove and silence dissenters like you. Expect them to dredge up the “Nursing shortage” as part of their lame excuse to make what you reported seem totally plausible and acceptable, they rarely fail to use this piece of BS. The old Nursing shortage excuse is very elastic, expansive and all inclusive; it can be used to cover up the most heinous of negligence crimes. Surely patient abandonment is only committed by the poor Nurse who dares to request a humane break in her overburdened schedule? TNNURSE thanks for that ABC news piece I have included this as one of the Links on my Petition. We need America to wake up to who the real culprits of negligent abandonment are. I will be so glad when we can stop resuscitating the ”Nursing shortage” excuse and call “time of death” on this sleazy deception. I am getting set to blow the lid of this scam once and for all. I may never have access to a day in court, they cheated me out of that, but that might well prove to be their downfall. No pending legal case means I have nothing to hold back, nothing to loose, and I will expose everything now, all the dirty little secrets, no holes barred. I have a strategy that includes a real “shame on you” exposure of not just any old Compliance Line, but the Compliance Line of the “Best Hospital in America;” the same Hospital that uses their sham Compliance Line and prestigious nationally acclaimed programs to hide negligence and deny accountability. Their public visibility on these issues with pious proclamations of honesty, integrity and transparency will lay them open to justifiable accusations of hypocrisy. All of the stall tactics that I fell for, the legal recourse I was cheated out of, will come back to haunt my former Hospital as it clearly demonstrates that, in good faith, I sought all other recourses first. I was even featured several times by the press without ever once taking the opportunity to reveal the details of my dispute with the Hospital over wrongful termination. I developed a well established reputation with several journalists, prompting one to do a big cover story. I diplomatically skated around any details of my working situation by saying that I was “on a sabbatical from my job in the OR at Hxxxxxx.” With no more expansive mention of my tragic personal battle for reinstatement after wrongful termination or the reasons behind my removal, they remained free of scrutiny: this took incredible restraint on my part. So much for taking the moral high ground; my former Hospital crawled in through the moral sewer! As difficult as it is to make this so much more public now, I am convinced it is in the public good. Your stories here have been a driving force in helping me to reach this point of firm conviction and I thank you all for it. Because of the stature of the institution and the programs that they have initiated, supposedly to deal with patient safety, the sheer hypocrisy of their response to my case is truly disgraceful. I hope the public will see that and it will prompt calls for more stringent controls and independent scrutiny over these types of so called “self policing.” It will be very hard for them to keep preaching their own virtues without finally dealing with their corrupt handling of my case. To add more weight to the call for accountability there is already one Petition on the Petition site from a patient who, after suffering a medical error, received the same devious cover-up and harassing tactics that I did. There is even a potential third Petitioner interested in joining the demand for accountability which will give us a whole lot more clout. His wife was another former patient who was treated with deception and lies after serious errors were made; their story is already posted elsewhere on the Internet. This meets an ethical journalistic requirement of reporting not the isolated experience of one individual, but exposing a pattern of behavior, documented by three credible witnesses, that should rightfully be brought to the public’s attention. My biggest worry is that the Petition will be ignored, that few will see it, let alone sign it. This will be especially crucial in the first two weeks while it remains on the entry page for the Petition Site where it is most visible. It will only stay on page one if it gains popular support with a high volume of signatures. I will need a lot of help getting the support and signatures I necessary for my Petition to remain in that high visibility spot. This is perhaps a valid way for Nurses to campaign for change and others might consider creating a Petition too. The reward of signing my Petition is two fold. One: it contains over 200 useful links making it more of a research document than a Petition. Two if we can shock the people I am targeting into taking notice then I believe they will feel compelled to investigate and make significant changes to Compliance policies to save face. Another important part of buffing their tarnished image will be to use a tactic they have employed to their advantage before. They may well try to usher in industry wide changes as a means of riding out the PR storm, which was how they responded to the tragic death of a pediatric patient who fell victim to negligent oversight at their Hospital a few years ago. The program they set up in response to that incident and various other efforts they made were truly admirable. However, these bold initiatives are futile as they will remain inadequate and ineffective unless reliable safeguards to stringently protect whistleblowers from retaliation are put in place. I hope to create a media storm that will prompt a similar shock response, as that has the potential for providing beneficial reform across the country that will affect all medical professionals and our patients.. Although the events that bought me to this point remain a personal battle for vindication, the above motivation could benefit us all and finally provide the healthy, genuine safety protections for patients we are all seeking. The importance of your posts regarding other similar experiences of retaliation against Nurses attempting to protect patients from harm is that the individuals I have targeted must realize that this is not just one battle about one incident and their help is needed to effect change. When I say “targeted” I refer to their ability to correct the current situation not any particular past involvement with corrupt practices. I try to think the best of people and prefer to imagine that they have no idea of the gapping holes that exist within their own Compliance program. I like to think that both men would have taken action if they had not been duped into thinking that I was just a “disgruntled former employee seeking revenge;” I hope my persistence and this Petition will convince them otherwise. If they ignore this very public call for an appropriate investigation that they were obligated to conduct several years ago, but fraudulently reneged on, they will be under suspicion too. I will want to post the names and contact information for both of these influential Doctors on this site so that Nurses can call them and request that they take action. Their names will be on the Petition and their contact details are readily available on the internet, but it would be helpful to post them here. It will be similar to posting an appeal to call your Senator and providing the number. I am confused and do not want to break any rules here: is this permissible within the rules of this site to post their names and phone numbers? The tenure of any calls must focus on polite calls for change. It is important to convince these two influential individuals that there is a great need throughout the US Healthcare system for “Risk Management” and “Compliance Lines” to come under stricter scrutiny, for Managers to show just cause before firing someone and for HR to do more than rubber stamp the corrupt removal of outspoken employees. Your personal stories of victimization and retaliation must convince them that the problem is far greater than just what has happened at their Hospital. Although I felt deeply betrayed by everyone at my former Hospital and, so far, totally ignored by these two Doctors both of whom I have written to several times, I realize that they generally excel at “noble causes” and I must enlist their help not insult, annoy or antagonize them. In calls to them I would ask that you do the same thing; by focusing on what they are capable of doing to improve patient safety nationwide we can possible enlist their help in accomplishing something tangible at last. A strong showing of support in Petition signatures and a few strong reminders of their duty to the public may convince them to take my warnings seriously at last and take a more critical look at their Compliance Line, HR and a few out of control Managers. They should be encouraged to understand that there are tangible benefits for Hospitals too, as focusing on the real dangers will help prevent further harm to patients and future expensive settlements. Please moderators let me know if posting these two names and contacts is OK in this context? I am fast approaching my posting deadline and I need all the help I can get, thank you all for your support, Fair Winds & Following Seas, Tsunami Kim. PS: Tsunami Kim is calling for your help. The Picture shows me with two "SHEEP" Medical Volunteers, calling home from the PACTEC Internet Tent at the UN Compound in Meulaboh. I want to go back out, but vindication clearing away the false allegations against me stands in the way of gaining the credibility I need to obtain an NGO backer to support my ambitious program in Aceh.
  15. i just discovered an internet site called health ethics trust (a division of the council for ethical organizations.) i posted the following as an inquiry after joining talk-about-compliance. is it acceptable for a compliance line, that publicly on the internet boasts protection from retaliation, to refuse to provide this much needed protection until all other avenues of recourse have been exhausted through hr etc., eeoc, arbitration first? this in effect is asking an employee to endure what can be an extended ordeal of several years of corrupt managerial maneuvers targeting them for permanent removal in order to silence their allegations of negligence. in other words: we cannot protect you from retaliation until your hospital has finished retaliating? the failure of the compliance line to even attempt to verify whether the initial excuse given for dismissal was valid initiates this extended postponement of retaliatory protection. only the firm insistence that the abuse and negligence issues should be dealt with separately and without delay prompts a half-hearted look at multiple serious patient safety problems. there is no report of findings or a plan for corrective measures to be taken just a verbal comment acknowledging that there is truth to the allegations and that the compliance line has decided to "just keep an eye on things." this is hardly a reassuring statement in consideration of the extreme personal sacrifices taken by a reporting employee and the ongoing onslaught of aggressive career destroying retaliation. however, there is an assurance that this alleged retaliation will be investigated after all other recourse has been exhausted. in my case this excruciatingly painful and humiliating ordeal took nearly three years! as in my case, most powerful and determined hospitals will succeed in these corrupt procedures to permanently remove an outspoken employee from the workplace. with me this was achieved through a succession of lies, deceit, fabricated backdated insertions into my personal file all of which was concealed from me, but shown to external agencies behind my back to discredit my reporting of safety violations. by damaging my credibility this sabotaged all of my separate attempts to have external agencies investigate the ongoing negligence issues for the public good. the process of dismissal is trusted as legitimate at least partially due to the presence of a compliance line. compliance line inaction is actually far worse than no compliance line at all! because of the complete lack of any type of compliance line investigation, scrutiny or monitoring of my personal files, the hospital's hr dept., or the managers spearheading this corrupt process, the hospital was free to use whatever means necessary to pursue their goal of retaliatory discharge totally unimpeded. my employee file was a revolving door of late submission document to help bolster an untenable case. this process was nothing short of a "witch hunt!" once these retaliatory measures have resulted in a permanent ruling against the employee the compliance line can then refuse to investigate the issue of retaliation as the former employee no longer works for the organization! in other words: now that your hospital has succeeded in their corrupt retaliatory dismissal efforts we can no longer consider investigating this alleged retaliation as you are no longer an employee! despite the earlier assurances that if all else failed i could expect my hospital's compliance line to finally investigate the retaliatory discharge practices they continue to refuse to deal with my case. the chief investigator who had originally made this commitment to me was too spineless to even tell me that they had had no intention of ever investigating my case. he refused to answer my calls and had the mighty hospital's legal department send me a letter ordering no further communication. does this example represent the level of compliance you recommend to support ethical conduct and encourage reporting of fraud, abuse and negligence in healthcare facilities? is it appropriate for any compliance line to boast being "independent and impartial" when it was initiated and then run by a long-term internal hospital appointee? this chief compliance officer has since been rewarded with another top level post within the same organization? i am compelled to believe that it was in the best interests of this chief investigator to set up a program that protected the agenda of his hospital in victimizing an outspoken employee they had chosen to silence with retaliatory dismissal. what protections are in place to insure that compliance lines are not simple a damage control pr front prepared to cover-up negligence issues for financial reasons? what assurances do regular hospital employees have that they will be protected from retaliation if they have the courage to report, fraud, abuse or negligence? proclamations on the internet may fool the public, but what guarantees that a compliance line abides by their own advertising promises? what recourse is left to me now that the compliance line has failed in their duty to protect by adamantly and consistently denying access to an investigation into my retaliatory discharge? this inquiry will be posted on a nursing site as other betrayed nurses expect answers too. we want more honesty, integrity and genuine transparency since under current conditions we are helplessly unable to report negligence and abuse without fear of serious retaliation. we want to know why these so called "compliance lines" are hindering not helping to insure safer patient care? we want to understand the warped logic behind the "hands off" policy that ignores retaliatory practices until a hospital has succeeded in the corrupt removal of an outspoken employee? please answer with honesty as many patients still remain at serious risk, kim
  16. 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
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