this question was sent to a patient advocacy group in the us and pertains to the deliberate understaffing issue that i was fired for revealing. it is posted here under the general nursing forum rather than the or forum since the core problem, the toxic managerial practice of deliberate understaffing and the consequences for those who speak out, is one that we are all facing hospital wide.
how long is too long for a member of the sterile team to remain continuously scrubbed into surgery?
although the public might not understand that medical professionals including the surgeon must leave the or briefly during lengthy surgery, most conscientious practitioners realize that this is a normal safety measure necessary to combat fatigue. i am trying to get a consensus of feedback from those who routinely face this dilemma in the or as to what time frame is universally accepted as the maximum period that any member of the sterile team can be expected to safely function while scrubbed into surgery without a break. although i am now in the “nifa” training program to become a first surgical assist, even as a surgical technologist, performing the “scrub” role, i had to concentrate on anticipating the surgeons needs during a case. after how long would you consider that scrub role jeopardized by fatigue to the point where i might have lost concentration and focus on the operation?
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. “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. 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. the geneva convention strictly prohibits such inhumane treatment of working pows! how many normal human beings are expected to go for 12 hours without water, food or urination?
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).
there is a lot of talk about medical errors right now, but far less mention of the toxic work environment that now encourages mistakes. this situation is getting steadily worse. while “at will” employment laws silence those who dare to speak out, lack of a humane break policy condones driving hospital staff until they drop: is there any wonder that errors are on the increase? little wonder that a sponge or an instrument is inadvertently left inside the patient when the scrub is almost comatose after a 12hour ordeal in surgery. all the cross checking and safeguards are irrelevant if the hospital staff are trying to function while so severely fatigued, hypovolemic or hypoglycemic that they are at the point of either falling asleep or passing out. when will the various safety advocacy groups in the us finally address this very real problem and insist on proper protective legislation? there have been advances recently with limiting the residents working hours and trying to stop mandated overtime for nurses, but much more emphasis must be placed on eliminating unnecessary fatigue among all of our medical staff.
no one is more important than the patient unconscious on the or table. for my very prestigious maryland hospital the “nursing shortage” was a convenient excuse to justify unconscionable managerial abuse that seriously endangered my patient in the or. doctors and nurses face severe discipline when mistakes occur, but why isn’t a negligent hospital policy that condones drastic staffing cut backs ever recognized as the real culprit? in some cases administration even offers financial bonuses to encourage self-serving managers to implement inadequate staff coverage. then they fail to hold a repeatedly abusive manager accountable when they drive dedicated staff until they drop. this managerial excess is focused purely on saving money not saving lives; we need proper safeguards in place to cub this negligent profiteering strategy before patients are harmed. plus when staff are courageous enough to come forward and expose a pattern of ongoing negligent practices they must be protected from retaliation and taken seriously by accreditation agencies who’s duty is to protect the public. no medical institution no matter how iconic, prestigious or powerful should be immune to rigorous scrutiny, as this lack of oversight encourages bending the rules, ignoring regulations and cost cutting that is harmful to safe patient care.
relentlessly abusive managers are a very valuable tool in facilitating staff downsizing without layoffs; i call this the spineless approach to cost cutting, but it makes our hospital working environment extremely dangerous for the patients. the current nursing crisis has come about through this dangerous downsizing and the creation of the toxic work environment that is driving nurses to leave their chosen profession because they refuse to take unnecessary risks. the us does not have a “nursing shortage” it has a “nursing exodus.” the us healthcare industry is still consistently expecting all of our medical professionals to take bigger risks by making do with unsafe staffing practices. this issue desperately needs to be addressed so please post comments,
kim.
ps: the issue of retaliation and unfair dismissal of whistleblowers has been further elaborated upon by myself and other affected nurses on another thread:
re: retaliation for voicing concern over unsafe practices.this thread was started by an icu nurse, but the problems i have seen discussed on this and other threads represent the growing concerns of many silenced patient advocate nurses. there are some valuable suggestions on exposing patient safety issues and combating retaliation on the above thread. i will be taking further action very soon by posting a petition calling for a compliance line investigation into my case. please visit this other thread to comment on the issue there too and consider the importance of making our voices heard, many thanks.
We must abide by one of the core principles of Nursing training and do as Nurses are consistently taught to do: Document everything! Hang on to every scrap of paperwork; if not for yourself and your own law suite now, do this as a testament to the truth and save it for latter. Remember that core principal you were taught as a trainee Nurse: "If you didn't document it, it never happened."NegligentHospitals and toxic Managers will rely on your lack of documentation, but good, thorough conscientious Nurses are their downfall as they will document everything. Your Hospital will count on intimidation and retaliation forcing you to go away; they will count on humiliating you into silence. They will avoid all written comments at all cost, because liars can be easily caught out by their lies on paper. If they lie to make a verbal false allegation, later they can adapt what was said to fit any evidence that might refute it; if they are caught on tape or they put something in writing, they are then unable to play this trick of modifying it latter. One major hallmark of an institution that is lying is their dire reluctance to put anything in writing: Smoke and Mirrors!
I was confident enough in the truth of my allegations to make sworn statements in good faith to Public Agencies. I knew I was revealing details under oath on several occasions, but I was very sure of myself and very sure of the facts. People do not risk jail time to fabricate false statements of accusation for no reason; it is too risky: unlikely to work and far too high a price to pay for a very slim chance at revenge. A "disgruntled former employee" would have moved on long ago and would not be pushing to give sworn testimony before a Court Hearing or Public Tribunal. This obvious detail should have lent genuine credibility to my statements, but the Public Agencies were not ready to see their famous iconic Medical establishment challenged. They were ready to ignore and explain away all the secrecy that my former Hospital insisted upon, as if this practice was perfectly normal? This deeply flawed general strategy perpetrated by Agencies that are supposed to oversee, regulate and provide accreditation to protect the public interest is what desperately needs to change immediately to protect whistleblowers from retaliation.
If anyone tries to scare you with threats of bringing a legal suite against you, remember it's only slander or defamation if the statement you made is proven to be false. If you have come forward in good faith a minor omission or technicality cannot be used to prosecute you unless you are proven to have fabricated evidence or deliberately lied with malicious intent. The onus is on them to prove that what you have alleged is untrue. If your charges of negligence and retaliation are all totally truthful and factual then it will be very hard for them to conclusively prove that black is white. They can no longer just allude to your possible motive as tangible or conclusive evidence and get away with it. In Court the burden of proof favors the truthful and only those who have lied are reluctant to risk testimony under oath when the ramifications of committing perjury in a Court of law include time behind bars!
Do not shy away from their false charges against you. Meet them head on by documenting what they have falsely accused you of in writing, then challenge it with facts. They are terrified of this scenario as they may now have to substantiate false allegations in Court or pretend that they were not made in the first place. I have seized upon many of my former Hospital's false accusations, some that were so ludicrous no one in their right mind would believe them. When my former Manager went overboard trying to embellish her accusations of harassing phone calls with: "sometimes her calls to me would total five hours in one day," now that was a real peach! Beyond that why would anyone in their right mind tolerate over 50 harassing phone calls and take no preventative action what-so-ever. No "cease and desist" written warning, no witnessed counseling session, no taping or tracking of calls, no contacting the Hospital Security to discus the mounting threat, no supporting documentation at all to back up the claim. Beyond that as my Manager she was responsible for "reinventing" my schedule so that I was assigned to an OR where my contact with her went from the former rare occasional chance encounter to seeing her day in day out. Who would do that if they genuinely felt threatened?
The Hospital asked if I might agree to a Mediation through EEOC an agency they had a good track record of manipulating in the past. I didn't know this at the time and foolishly agreed, thinking that this futile EEOC Mediation would be fair and impartial, but there was no hope of that. At one point, behind closed doors, in a private separate room where I was excluded access, some sort of office planner of fabricated list of calls was shown to an EEOC Mediator. Following this revelation the Mediator was totally convinced I had made over 50 harassing phone calls to my OR Manager. Since I was not permitted to see this "evidence" there was little I could do to challenge it barring trying to convince her it was fabricated. THERE IS NO LEGITIMATE REASON TO REVEAL INCRIMINATING EVIDENCE IN SECRET. If this "evidence was valid, my former Hospital would have shoved it in my face!
If I ever go before a hearing both the Hospital and EEOC will have to explain the need for all this deliberately deceptive secret evidence. This tactic of demonstrating guilt behind my back where I was denied access, unable to even see the so called "incriminating evidence" and could therefore not challenge the validity of that evidence. should never be allowed at any type of hearing as it is instrumental in perpetrating fraud. This fake "evidence" only worked because my former Hospital was able to present it to EEOC in this clandestine way at a Mediation where this dubious form of deceit was not only allowed there was a promise it would never be referred to again.
The number of Managers who attended my Mediation only further convinced me of their sheer desperation to suppress the truth. Each time I attended a hearing there was a larger contingent of Hospital representatives that I faced virtually alone with just a Union Representative. There were times when even that Union Rep started to buy into their propaganda. I had to elaborate on their inconsistencies, their lack of documentation and their reliance on subterfuge to perpetrate lies to win her around by demonstrating things that didn't make any sense. The Hospital fully expected me to be so intimidated and thoroughly humiliated by their barrage that I would give up. They also expected me to go for the money they offered to silence me; first $5,000, then $8,500. This was contingent upon my writing a letter of resignation, but then damage that prohibited my being hired elsewhere would go away. There was a carefully veiled threat in their offer and I saw it as a sleazy bribe. If I really had acted as they said I would have been guilty of a criminal offence and they should never have offer me a nickel! Think about it, a Manager endures over 50 harassing calls and you reward the harasser with a cash payment? It was not the offer or the amount; it was the fact that under those circumstances, where they had gone behind closed doors to prove a criminal level of harassment had occurred, it was a totally amoral thing for an employer to consider offering any sum of money to the alleged perpetrator!
In retaliation cases those who attempt to victimize you tend to go OTT with their false allegations, but wile it may impress a decision maker at the time it can come back to haunt the abusive Management latter on as it cannot be proven. They never consider the next hearing as they never think that there would be a next hearing. The second I knew that this piece of fabricated "evidence" existed I started requesting it in writing. The Hospital had never counted on my doing this and it became a severe embarrassment to them. By the time we went to Arbitration they were very cautious to avoid mentioning this "evidence" as it had swiftly and very conveniently disappeared. There are pieces of evidence that are so absolutely conclusive and damming that they should have been paraded before the Arbitrator at my Hearing; this phony phone log/office planner was one such item. The record of calls made and complaints that were discussed with the Hospital's Security Department was another key item of conspicuously absent "evidence."
Before the Mediation hearing both parties were asked to swear that nothing either of us revealed that day would go beyond the hearing or be used in court; my former Hospital counted on that assurance to perpetrate fraud. The behind closed doors revelation of incriminating evidence is supposedly a standard EEOC policy according to their response to my letter of complaint. I want to reveal the dangers of this devious tactic so that EEOC and other Public Agencies are forced to make policy changes and future victims are warned ahead of time. If you agree to Mediation go over the terms of how the hearing will be conducted before you start. A behind closed doors meeting with a team of six Hospital representatives can be very persuasive and if you think the Mediator will not be swayed by their ear bashing you are way too naïve. Do not trust EEOC to provide a fair and impartial Mediation. Due to the blatant fraud perpetrated at my EEOC Mediation I no longer feel obligated to abide by my promise of silence as it is not in the public interest to continue endorsing this corrupt policy. If I have broken the law in revealing what happened that day: so be it. I am ruled by my conscience and would risk jail time to prevent future acts of fraud. This fraud helped a Hospital cover up patient negligence and retaliation against a whistleblower: I can no longer in good conscience remain silent.
The important thing here is that it was documented and I did absolutely everything I could do to end the negligent practices; my conscience is clear. It may take a patient death to expose the issues I bought forward, but if and when that happens my documentation of the danger will surface at last. What continues to drive me five years on is that it is not necessary for anyone to die to correct these problems, so I feel compelled to continue speaking out even from exile on the other side of the Atlantic. This is what you must keep in mind: document the danger and do not allow them to silence you, hopefully no one has to die from this negligence before the truth is revealed. It is easy to imagine that if there is no written reply from them it was not very important; be governed by your conscience human life is important. They think that by ignoring your letters of complaint and reports on negligence that the situation will go away and the big bucks from ignored negligent practices, skipped orientation, incompetence and understaffing will keep rolling in. Inadequate training of personnel and understaffing are forms of fraud as they defraud the public by false assurances of safe Hospital care: you are bearing testament to this truth. Do not let their inaction persuade you to abandon this important paper trail of evidence; this is really vital. If something adverse happens in the future it will be hard for them to deny any knowledge of past reported negligence or incompetence when there is a stack of ignored letters of warning from you documenting everything.
Even as I parted with so many personal possessions when I was forced to abandon my Baltimore home I got one file of important paperwork out to be carefully preserved with a trusted friend in the US so it will always be ready for me to present in Court or at a public Hearing. There were so many other treasured items I left behind, but it was my solemn duty to protect that vital file. I hope that one day we may be called upon to testify before an inquiry. I live for that day. I will beg and borrow the money to return to the US to testify with all of my British family and all of my American friends in full support of my stand for justice. That will perhaps be my last duty of US Citizenship.
a minor blunder folks: this last post was meant to be placed on the other thread i was replying to, but it's not like the info is not relevant.
these new grads are being intimidated, used and manipulated while the hospital plays on their insecurity as new recruits. if someone is not comfortable taking on a task they may not be ready for it yet, but that doesn't make them a bad nurse, just a wise and cautious nurse as it's merely a sign of admirable humility and full understanding of one's own limitations. if new grads are reluctant to accept responsibility when lives are at stake because they feel overwhelming then they are putting their patient safety first.
when i began working as an or tech i was very conscious of my own lack of experience and inadequacies; this is normal. my ex-husband reminded me of the serious nature of my new job and said that in the first year i was still a "rookie." he said i should cut myself some slack, have patience and pace myself; i should not expect to be perfect overnight, but allow the more experienced people around me to be supportive as i learned and perfected my practice. no one should be afraid of learning or admitting that they still need to learn; we continue needing to learn for our entire career. the initial period of "orientation" to a new job is just one aspect of our ongoing commitment to training in the healthcare field. beyond orientation there are "in-service presentations;" "continuing education credits," recertification, renewal of cpr, acls etc. no one part of this process can be, or should be, omitted. all of our doctors must follow this process too, plus they have surgical grand rounds, m&ms, conferences to attend and papers to demonstrate their competence is being kept relevant and up to date. there is a good reason why we renew our cpr cards regularly as we cannot allow any skill to lapse as our memory banks get crammed with new knowledge. any medical professional who seeks to avoid orientation and training because they think they don't need it is being arrogant and downright irresponsible towards their patients as well as letting down their coworkers.
when i was at sea i was very reluctant to become a captain and postponed taking this responsibility for many years. the more i learned, the more life threatening the events i experienced at sea, the more i came to understood the level of responsibility i would be taking on by becoming a captain and the more reluctant i became. in my lengthy career at sea i have had multiple very humbling experiences and plenty of opportunities to reflect on the responsibilities of captaincy. at 21 i was the least experienced in a crew of 3 as we were dismasted aboard a 30' sailing yacht in the roaring 40s off the cape of good hope on my second trans-atlantic crossing. i learned the importance of a safety harness during times on that crossing when i was picked up and bodily hurled across the cockpit by a huge sea; it was as if someone had broken a chair over my back! surrounded by armed egyptian soldiers in the red sea i had to contemplate acting alone to escape their guns and sail south to alert the embassy when the owner failed to return. i came on deck as we were nearly run down by a freighter in the gulf of suez. i almost stopped sailing after "red barron" was rolled over north of bermuda; i have never been so terrified before or since as when i stood in that bucket chain bailing water for my life with blood streaming down my face!
sailing with my husband in the 80's we were shot at by drug-running pirates east of the bahamas on a routine delivery run to the caribbean. we fought them off by returning fire with a rugger mini 14, but i felt especially guilt ridden as my brother was sailing with us for the first time. despite the encouragement of many, including my husband, i preferred less responsible roles; i contented myself with excelling in celestial navigation. meanwhile as i proceeded to carefully weigh the consequences of increased responsibility, i was constantly confronted by real rookie sailors who were intoxicated by the heady power of being in command. they were all far too eager to strut their stuff as a yacht captain, but naivety and lack of experience were shielding them from any full understanding of the responsibilities they were taking on. it was bought home to me when it was my responsibility to set of my epirb to call for help after we lost the rudder out of a 30' race boat i was delivering to puerto rico. on the whitbread, i watched my best friend tossed into the southern ocean; we also broke the boom, trashed sails and lost the steering at one point. it was the serious understanding of responsibility that first led me to seek the medical training that resulted in a major career change for me.
after facing so many serious incidents at sea i did not come to healthcare thinking that i would never be confronted by crisis. i try to anticipate the potential for a real crisis and teach myself tactics to safely cope with such situations. in my latter years at sea i often sailed in a teaching capacity with new boat owners. as i noted the look of terror on the face of the owners wife as her husband went up onto the foredeck, i would teach her to think about what she should do if he were swept overboard. confronting the possibility head on, facing the demon fear and thinking through things logically always seemed to help allay their horror filled anticipation of the worst nightmare scenario. i used to have a recurrent dream that one of my crew was swept overboard and i had to get them back. only once did i dream that i was the victim in the water on all other occasions i was the one saddled with responsibility for getting that sailor safely back onboard the boat. strangely enough i did not consider these nocturnal emergency drills nightmares; i would wake up calm and at peace having worked through my worst fear of responsibility for another person's life.
in the medical profession as at sea ongoing training, emergency drills and refreshing of skills is being better prepared to save lives. it is highly unprofessional to avoid this duty. no one should ever shy away from, or be too proud to admit needing help and advice to make the care they provide safer for our patients. when hospitals try to abdicate responsibility for proper training, or when they try to dumb down the workforce, it is for profit driven concerns only. there is no excuse for someone to refuse orientation except arrogance. there was no logical reason for our or techs. not to be required to have cpr training except to maintain the illusion that we were idiots doing idiot work. who might suffer the consequences of such lack of preparedness? less training, lower qualifications and fewer skill requirements, as well as winging it with fewer staff, is not a desirable, safe hospital environment.
this is fraud, as it defrauds the public of safe hospital care!
we must continue to protest this outrage:
fairwinds & followingseas, tsunami kim.
ps: i was writing a book at one point; it was a novel with a strong medical theme that focused of moral and ethical issues. but it's hard to be creative when one is fighting the persecution of retaliation as a whistleblower, so most unfortunately it has remained on hold since the incident where i was wrongfully terminated. i hope to continue my creative writing when i regain some of my self respect and my piece of mind.
before the mediation hearing both parties were asked to swear that nothing either of us revealed that day would go beyond the hearing or be used in court; my former hospital counted on that assurance to perpetrate fraud. the behind closed doors revelation of incriminating evidence is supposedly a standard eeoc policy according to their response to my letter of complaint. i want to reveal the dangers of this devious tactic so that eeoc and other public agencies are forced to make policy changes and future victims are warned ahead of time
tsunamikim.....is that legal?can they mandate that this "what appears to be " a legal proceeding can not be on "record"?see...i have a limited knowledge of how "unions" work...but.....this smells like a rat 2 me.
also...did your hcf stand behind that too....and not discuss it amongst others?bc.....alot of these hcf have very " pretty"...strong well written policies......however......thats all they are.meaningless words on paper.i was wondering ...do you know if jcaho actually makes these hospitals provide proof of any time they have actually enforced their anti retaliation policies?that would be interested to see.....since they are begining to focus more and more on ethics and compliance during their inspections...and also as the public is begining to be more and more informed.it would be interesting to find out if,,,,these hcf's are providing any proof of how they actually have enforced their :redlight: :yeahthat: policies.
Well actually the very existence of a Compliance Line brings with it the assumption of Compliance, just as "Risk Management" implies a conscious effort to reduce risk! It did not take too long before these Hospitals learned how to play the game and manipulate the system to their own benefit. Believe me, there are significant benefits to having a Compliance Line because it allows the opportunity for an investigation to be handled internally where it can be controlled, managed and manipulated: ultimately the desired result is virtually guaranteed. It also helps an employer to identify troublemakers at a very early stage when retaliation can be accomplished swiftly and effectively, before the concerned employee has time to take any action to protect themselves or solidify their case for alleged negligence. In addition it is a neat PR stunt to have a Compliance Line littered with flowery language about patient safety, integrity, honesty and transparency posted on the Internet. It's real downfall has more to do with the tangible danger of having "the Foxes Guarding the Hen House."
NEVER TRUST SOMEONE WHO SAYS: "TRUST ME."
Beyond well managed damage control and PR, there are other more tangible benefits: if they get caught with their hand in the cookie jar they can plead that their institution did everything possible to encourage reporting, by having that Compliance Line. This will earn them a significant reduction in the amount their Hospital will be fined for bending the rules or even breaking the law. That can be a big chunk of change; a very similar incentive is driving the call for Tort Reform: it is all about the money. Reduce accountability, reduce liability and increase profits. I was told that one of the Whistleblower Internet sites had an exposé warning about not turning to Compliance Lines for internal reporting as they were not safe from corruption and did not provide protection from retaliation as the profess to. So much hypocrisy; I only hope that my Petition will help to blow the lid of this scam.
However, while it works great for them, does it protect patients from potential harm or protect those who report negligence and abuse? NO! Quite the opposite as calling a Compliance Line may alert a company of who they need to target for prompt removal. All this is irrelevant and useless if a "Compliance Line" or "Risk Management" refuses to investigate, manipulates a sham investigation to provide damage control or fails to prevent retaliation for those who dare to report negligence. There are serious flaws inherent in an investigation where the investigator has a vested interest in finding "no probable cause." Is it really an independent Compliance Line or do their investigators essentially work for the Hospital? Selective questioning is the real key to a desired outcome. What questions are being asked and how are they being asked? Who documents all of the replies and what is their personal agenda? What part of the reply given was subsequently deemed by them to be unimportant and therefore got discarded? You provide a list of witnesses for them to question, but the focus of their questioning is not to uncover wrongdoing, it is to discredit the reporter. All too often you are horrified that the truth did not emerge, but there is generally no hope that it ever will.
The interviewer implies that the only relevant investigation centers on your credibility, your competence or their personal opinion of a misconduct charge fabricated to oust you. The witnesses are fully aware of the consequences of trying to act as a character witness for a fired coworker and there are ways to reinforce this very real fear. By now your former coworkers have realized that your patient safety concerns are not considered relevant and will not be addressed any time soon, so why suffer the same fate as the ousted employee if there is nothing to be gained? Now the questioning will target subjective (and therefore irrelevant) personal feelings for you as coworker. The investigator will be extremely persistent until they get the exact comments they are looking for to paint your legitimate complaint about negligence as an isolated irrelevant personal opinion or a grudge against the Hospital in response to discipline.
Most people will turn to EEOC trusting them to redress this type of wrong, but at the very least expecting them to behave in a fair and impartial manor. Their literature clearly states that they do not take sides. The concept behind not allowing testimony revealed at Mediation to go beyond Mediation was a good one, but once again it can be badly manipulated to the advantage of a corrupt employer. The reason this is done is so that both parties seriously consider Mediation as an option, because when it works, it saves money, time, frustration and so much more. I went into the Mediation well prepared with notes on what to present and a determination to take the moral high ground and I think I handled my part well despite feeling outgunned. I caught them of guard by asking them all to stand and look at the clock, it was close to !0:00AM. I then described the restrictions of movement, limitations on things that could be touched, the complete dependency of being "scrubbed into Surgery." I stated what my duties entailed and how I had to concentrate on anticipating the Surgeons needs and how many really tiny sutures I might need to load and pass during a liver transplant. I reminded them that the entire Surgical team would leave the room briefly during a lengthy case, but I was trapped without food, water, without even a chance to urinate, standing until !0:00PM that night.
They were unshaken by this demonstration, as if expecting this of an employee was part of the normal job requirement. I continued to focus on just the negligence and patient care issues only latter adding that reporting these issues had cost me my job. I finished by saying that if they refused all fair treatment of me with regard to reinstatement to please assure me that they would at least take my documentation of negligence problems from the Mediation and agree to fix the issues I had raised. I stated that if these problems were taken seriously they might dodge the bullet and not have a patient harmed by the negligence or their family suing for compensation; so in effect it might save them money to just listen to me! I gave them a copy of my idea for the "Kaleidoscope of Innovative Momentum," a concept that was a follow on from the OR Retreat that I had precipitated early on in my employment with them. Despite their persecution of me I would gladly have handed this idea over to them if they had expressed an interest in pursuing it, but they were too busy trying to demonize and discredit me. Of course they didn't heed any of my warnings and then proceeded to spew lies for several hours in order to intimidate and humiliate me into silence: it was obscene!
The part that caught me off guard was the behind closed doors look at their fabricated incriminating evidence, that there was no real possibility to quantify, let alone refute. In combination with the "nothing goes beyond this room" policy it encourages the fabrication of documents that could then disappear as they will never be mentioned again. I have never seen the evidence that left that Mediator so convinced of my guilt. Some might say that this was probably valid evidence and I was just in denial, but this is simply ludicrous. If it had been valid my former Hospital would not have concealed it from me so carefully; instead they would have flaunted it openly and produced it at my Arbitration hearing. Beyond the point where the "private viewing" occurred in a separate room the EEOC Mediation ceased to be fair and impartial; she advocated for me to take the bribe and put a lie in writing by tendering my resignation. Because of the gag order I could only allude to the type of evidence I expected them to produce prior to my Arbitration as: "any documentation of the alleged harassing calls giving the exact times and dates of those calls." I could not refer to what ever was produced as the "the phone log shown to EEOC at Mediation." If there was some form of documentation shown to EEOC it has since disappeared, since I have never seen it I suppose the Mediator could have been bluffing.
I had also felt ganged up on by the number of representatives from the Hospital; I think it was six on that occasion. There is no indication ahead of time that you will face so many detractors. I do not know who else could have come into my Mediation Hearing under the rules, but I think they would have barred anyone not associated with the Hospital. A lawyer that I could not possibly afford? A few of my former coworkers who could not be expected to risk retaliation? So that left just me and a Union Rep! The Mediators are not Lawyers and the one I encountered had less idea of a legal concept of fairness than I did. Things like hearsay and second hand adapted heavily manipulated evidence were all fair game. Her suspicions were not aroused by my former Hospital's secrecy and I still did not get one single direct quote from the so called "letters of outrage" coaxed out of employees. I doubt she bothered to read these letters as they were singularly unconvincing, very obviously solicited letters referring to normal actions with one nonsensical subjective comment tagged on the end. I could tell that she had no concept of "due process," as she failed to recognize the total unfairness of the Mediation process that day. Employees need to understand how the odds will be heavily stacked against them at a so called "fair and impartial" EEOC Mediation. I would never consider this option again and would strongly discourage any other employee from seeking this form of redress. Unless the rules governing how EEOC Mediations are drastically changed these hearings will remain anything but fair.
When the crew I had sailed with from South Africa to the Seychelles followed us to go up the Red Sea they ran aground off the coast of Somalia. Once we knew that they were being held I worked with the British Foreign Office, the UK and RSA press to try and secure their release from jail in Mogadishu. This increased my interest in Human Rights issues. Because of this incident and through my subsequent involvement with Amnesty International I have a better understanding of what constitutes Human Rights abuse than most ordinary citizens without any legal training. We are encouraged to write letters on behalf of prisoners of conscience around the globe. There is a special format for diplomatically appealing without provoking a harmful response or escalating the potential for harm to be inflicted upon a prisoner. I have also attended asylum hearings in Miami and have a good understanding of the rights of asylum seekers. That is why I have such a firm understanding of how the abuse perpetrated by my former Hospital violated Human Rights statutes as defined by the Geneva Convention for the treatment of working POW. Freedom of speech is also very important to me and my freedom of speech rights under the US constitution were violated too.
As a Unitarian I am very open minded and non-judgmental in my beliefs; I do believe in the Buddhist concept of "Karma." My handling of the EEOC Mediation was governed by a strong belief that by doing evil things to others we invite pain and suffering into our lives: even the quest for revenge brings bad Karma. Any vindictive satisfaction in seeing a Manager disciplined is unnecessary as I know that at some point the pain they have caused me will catch up with them and it is out of my hands. I do not therefore seek any form of revenge as I believe that: "success is my best revenge." Having said this however, the OR Managers who deliberately victimized me must loose their jobs because this will be necessary to provide parity in disciplinary consequences. Without this action regular employees easily recognize the unfairness of the immunity shown to Managers and it causes disrespect and decent among the workforce. If at some point a full investigation proves that certain Managers are guilty of victimization and retaliation then they must face exactly the same level of discipline as all other employees at their Hospital, but this is out of my hands.
I always try to consider options that are fair to everyone concerned. Unfortunately, while I took the moral high ground on the day of my Mediation, my former Hospital crawled in thru the moral sewer. It was yet another deeply humiliating and painful experience. Perhaps a combination of guilt, public embarrassment and bad press will force my former Hospital to finally act with honesty, integrity and real transparency at last, but I'm not holding my breadth. Let's keep the pressure up on all of these toxic Managers at abusive profit driven Hospitals, I'm not giving up yet.
You know....I am pretty much "past" expecting my old HCF to do the correct ethical thing. They have lost every shred of trust pretty much I had in them by their inconsistencies/misrepresentations.I mean....like I have said-Bite me once-shame on you Bite me twice-shame on me. Everything is now at my attorneys discretion as far as I am concerned.What I was saying though is beyond a "compliance line".
JCAHO is an accrediting agency that sets safety "standards" for hospitals.Each year/so they have to pass a JCAHO inspection. I am just wondering "what" proof they have to present to JCAHO that they are maintaining an environment that is condusive to "reporting/whistleblowing" on unsafe pratices/events. I mean...other than their well written meaningless policies. Do you think they have ever had to show any...any....instance of where they have actually enforced these very eloquent policies?I am just curious...if...on these inspections....they have ever had to actually show how they have ever enforced these policies?I am just curious if there is any way to find this out without actually having to list the HCF in question.Bc...I wouldnt do that.I didnt start this whole thing in that "spirit" and I just wouldnt do that. I cant control their ethical standards(or lack of)...but I can mine. But out of curiousity.....do you know if they have to provide any actual proof that they enforce these type policies?
JCAHO were an easy con: my Hospital conned them every time they paid us a visit. The OR at my former Hospital was completely transformed for JCAHO's meticulously choreographed scheduled visits. The filthy overflowing trash dumpsters disappeared from the OR corridors into the hopper room. Is that where they belonged? Wow! So why didn't we keep our dumpsters in the Hopper room? There was an antiquated layout with just one really long corridor connecting the ORs, but these minor logistical problems were far from insurmountable. When it comes right down to it we broke regulation out of sheer arrogance; that was the way it was done at my former Hospital and no one ever questioned it. When this arrogant, blatant non-compliance was reported to JCAHO they said that they couldn't do an unscheduled inspection of the facility even in response to reports of ongoing non-compliance. I was shocked by this revelation, but I am sure that the public doesn't know that this is their regular policy or that even reports of serious repeated abuses might be ignored! I recently discovered that JCAHO are now going to change their standard policy to start conducting unscheduled visits in the future. The public should question why this was never considered necessary until now, even after a legitimate complaint was filed, and why the first unscheduled visits might not start until 2007?
In 2002 a perfectly healthy Lab. Technician was killed in an Asthma study due to negligent Research practices that failed to properly review the toxic side affects of the substance being tested on this human subject. The "powers that be" closed down all their Human trials Research programs for at least one week. My former Hospital was genuinely shocked by this censorship of their practices and totally outraged over what they perceived as a radical response to their gross negligence. How their callously indignant public proclamations must have hurt the victim's family as they the stacked their unimpeachable record of excellence up against just one most unfortunate, regrettably unnecessary death! There are a few other alarming examples of their less than ethical practices with regard to various research projects, both in the US and in their affiliated research facilities overseas. However, at such a prestigious institution they fully expected to function beyond the range of prying external review and occasionally beyond the law as well.
Occasionally something happens to cause a public embarrassment. One of the residents at my former Hospital blew the whistle on their violations of the working hours set by ACGME and they were forced into compliance. In a quote he reiterated to AP what he was told by the Hospital: "Hey we're "xxxxxxx," we're going to do anything we want!" It was this pervasive attitude of believing that regulations were made for lesser institutions that bothered me so much. I am sure this young man was tormented by his decision to come forward, but what are the alternatives when what is being regulated is a safe standard of patient care? He became overtired one night and nearly made a critical mistake with the care of a patient. That was the "event" that prompted him to report violations, but in many cases it takes more than a near miss, it takes actual harm before negligent practices are investigated. The harsh reality is that more of us need to have the courage to report potential problems before harm is done to a patient. It will never be an easy decision to make and the consequences can be personally devastating, but it is the right decision to take from a moral standpoint.
There are some minor examples, visible to the public via the web, where external investigators have looked into one area of their operation and demanded that measures must be taken to insure public safety. The letter ordering them to tighten controls over their blood bank supply is one such example, but did they fix problems or fain action with their haughty arrogance? They use their internal Compliance Line to fob off more intrusive external investigations as they did when the Board of Healthcare Quality confronted them with my allegations; when the Hospital told them everything was "OK" it was just left it at that. They probably relied on information supplied by the Compliance Line, but if there are latter revelations of negligence the existence of that Compliance Line will help to modify and fines. Genuine oversight and accountability is key to insuring that adequate standards are met and regulations are adhered to by all healthcare facilities. There is a significant danger to the public when any institution is given "Iconic Immunity" from censure.
On most occasions they can remain completely untouchable while they continue to hide behind that famous name. When something really terrible happens there is a flurry of press coverage, but even the press have learned that they should help to excuse rather than give voice to the public's shock. When a young child died at the Hospital from totally preventable negligence they enlisted the parent's help in creating a new patient safety program. Publicly the horror over the tragedy was obscured by the triumph of their bold new safety program; but was this program just good damage control with a great PR spin or was it a genuine commitment to make significant positive changes? I hope, for the traumatized parent's sake, that it was the latter. The Doctor in charge of heading up this impressive program lost his own father to a medical error so he certainly should be a patient safety zealot. I wrote to him, but he shuffled my letter sideways to the same HR people who had corruptly engineered my wrongful termination. I informed him of this in a subsequent letter, but since then all of my letters have been ignored, so go figure? My Petition will put pressure on this good Doctor and the Hospital's Dean to at last provide the genuine transparency that they proudly boast on the Internet and to finally do the right thing by demanding a proper, thorough investigation through their Compliance Line.
I am sure my former Hospital was not alone in claiming special immunity privileges by virtue of their iconic status, but this does not protect the public from harm. All Hospitals must abide by the same set of rules, comply with public agency inspections or investigations and accept the consequences of non-compliance. While internal reporting to Risk Management and supposedly "independent" Compliance Lines do potentially offer a way forward they too will need to be monitored and supervised carefully as corruption has already crept into their MO. I hope that my Petition will expose the corruption of the Compliance Line that refused to protect me from retaliation and insist that they dramatically change their policies. When someone reports to them that retaliation is being used to try and silence complaints made to Managers up the chain of command there should be immediate action taken. The Compliance Line should have insured that there really was a just cause for firing me and even if it was for a legitimate reason they should have continued to stringently monitor the dismissal process for fairness throughout, but they failed to do this.
The only thing they did was a very cursory investigation into the negligence issues I had presented. I had expected them to get back to me stating their findings are informing me of what measures had been taken to correct all of the negligence issues I raised, but there was never anything in writing. I doubt they would have bothered to do any follow up with me at all, but when I called they gave feeble irrelevant excuses on behalf of the Hospital Management and it was obvious that their supposedly impartial investigation was just a sham. I was ment to feel satisfied with a casual phone comment from their Chief Investigator: "we have decided to just keep an eye on things!" This was the same Chief Investigator who had informed me that the Compliance line could not look into the retaliation issue until I had exhausted all other remedies first a complete contradiction of what is posted on their Internet site. Worse still, after being told by him that only after all else failed could this long postponed Compliance Line investigation proceed, he was too spineless to even tell me that he had just lied hopping I would never return to demand accountability.
The Chief Investigator that I dealt with, who made the above totally spineless statement and comments to me, was the person originally responsible for establishing the Hospital's Compliance Line back in 1998. On the Internet I found a stellar presentation on "Assessing the Effectiveness of your Program," (Compliance Line), that he had delivered at a conference on Hospital Compliance. In a press release announcing his latest promotion within the same Corporation it detailed the job he had held from 1994 before being asked to create the Hospital Compliance Line in 98. He was recently rewarded late in 2003 with a new post as Senior Vice President of one of their satellite Hospitals. This was very obviously a long term employee who fulfilled a steady progression of important assignments within the institution. Would you consider him an unbiased "independent" investigator with no special interest agenda? Congratulations must go to that "Independent Investigator," who earned the eternal gratitude of my former Hospital for creating the right kind of Compliance Line to limit liability by provide perfect damage control, ignoring or condoning the targeting of informant "troublemakers" and providing terrific PR! What a job, you've just gotta love that guy.
Are all Compliance Lines equally "independent" and "unbiased?" Who is reviewing the set up of these supposedly independent Compliance Lines? Which Agency is monitoring the potential for conflict of interest that might cloud their "independent Investigator's" judgment in providing unbiased Compliance and lead to a dangerous lack of oversight? The shocking truth is that I am unaware of any regulatory body acting in the public's best interests to review the practices of these Compliance Line Investigators to insure the safety of Hospital patients. If there was some level of oversight how come my former Hospital was able to set up their Compliance Line under the guise of independence while assigning its creation to an internal Hospital appointee? Why are they permitted to fool the public, and gullible, vulnerable, employees, into thinking that this internal appointee will not be acting in the Hospital's best interests at all times by removing threats to their impeccable reputation? The evidence of self-interest is openly displayed on the Internet for Public Agencies to observe and question, but not knowing the Investigators name the public does not know of the deception. Portraying the Hospital's Compliance Line as "independent" implies the credibility of unbiased investigation and protection from internal retaliation which is not the case. No one cares that this is blatant hypocrisy!
The public needs to know just how crude this inadequate protection offered by Risk Management and "independent" Compliance Lines really is and Public Agencies like JCAHO need to demand a higher level of access for oversight and accountability. In for profit Hospitals the motivation is money, but a Compliance Line limits liability, helps with PR and does rudimentary damage control by supporting retaliation to remove those who report negligence. I hope that my Petition will expose this problem and put safeguards in place to control the "Foxes" before all the "Hens" are eaten alive! We cannot afford to complacently wait until negligence harms patients or takes lives before significant changes are made. As yet there does not appear to be any proper oversight to insure that internal reporting departments like Risk Management or so called "independent" Compliance lines are really doing a thorough job of protecting Hospital patients from harm.
The Internet site for my former Hospital's Compliance Line is filled with flowery language that certainly implies great honesty, integrity and accountability. They talk of a transparency that I certainly never encountered and promise protections from retaliation that I was never afforded. However, the site is reassuringly impressive and I am sure that the public as well as some very vulnerable employees are totally fooled by their elaborate hype. But, it is just Hype! Compliance Lines and Risk Management have created the façade of self-policing, but our cases of denied access to reporting accountability and zero protection from retaliation prove that they are unreliable, purely self-interest driven, PR scams, who's gross inadequacy promotes only a dangerous façade of protection. Courageous, conscientious healthcare professionals, Nurses, must keep speaking out until genuine protections are finally established to end the lunacy of uncontrolled abuse and negligence. The more staff expose the truth the more likely we are to accomplish a tangible result with better protections for patients. While the problems may seem almost insurmountable, the challenges daunting, the personal sacrifices made and the price we must pay close to intolerable, with no possible hope of any reward or recognition: WE MUST STILL KEEP BEARING WITNESS TO THE TRUTH.We owe this as a commitment to our patients and our own professionalism, Stay Strong,
i recently discovered that jcaho are now going to change their standard policy to start conducting unscheduled visits in the future. the public should question why this was never considered necessary until now, even after a legitimate complaint was filed, and why the first unscheduled visits might not start until 2007?
in 2002 a perfectly healthy lab. technician was killed in an asthma study due to negligent research practices that failed to properly review the toxic side affects of the substance being tested on this human subject. the "powers that be" closed down all their human trials research programs for at least one week. my former hospital was genuinely shocked by this censorship of their practices and totally outraged over what they perceived as a radical response to their gross negligence. how their callously indignant public proclamations must have hurt the victim's family as they the stacked their unimpeachable record of excellence up against just one most unfortunate, regrettably unnecessary death! there are a few other alarming examples of their less than ethical practices with regard to various research projects, both in the us and in their affiliated research facilities overseas. however, at such a prestigious institution they fully expected to function beyond the range of prying external review and occasionally beyond the law as well.
omg....when am i going to stop being shocked?i mean ...i "thought" all research studies involvong meds txs etc had to be conducted on like mice for x # of months..and then begun with like maybe 2-3 humans.i can at least say i am very proud of whatever institutional governing body that did shut down all their human research studies pending a full investigation. i mean,,,how many times are these nurses, physicians and hct members going to have to say it? when are they going to realize these are people? with thoughts , memories, personalities,things that have made them so special to the ones who know and love them. did you ever hear the results of the investigation? poor family.poor...family.
as far as their "public indignation" goes...these hcf better wake up.these new laws that are being passed to ensure the publics safety are coming to the forefront ...and making it thru all these senators etc etc bc....instances like this are being brought into the limelight. families are getting a "clue".they are asking questions...and when they dig enough and get the truth....are absolutely outraged as to what did./did not occur.any institution that treats patients...accepts money from them or their insurance provider...has their doors open ...should have pt safety as the #1 priority.
again...this shows how incredibly niave i am.i had no idea that jcaho did not do "spontaneous" non announced inspections.that.....is outrageous....so much for them having the publics interest at heart. again....these new laws are coming about for a reason...and i suspect that is one reason that jcaho is going to unnannounced visits.
The real shocker is that not only do JCAHO not do spontaneous inspection visits as yet, but that when you contact them and report that your Hospital is an ongoing flagrant violator of the regulations they state that they cannot respond by doing an unannounced check on the facility! I was mistaken over the start date for their new policy and I am glad to say that according to a SEIU Union report the visits will start as soon as this January. Look on the SEIU web site to see their report of this triumph. The Union has been pushing for this for some time and I think it is an important change. Hospital staff do not want to support institutions that are in constant violation and they do welcome these unscheduled inspections. However, from my own appalling experience I know that the very few courageous employees who dare to risk retaliation and job loss to report to JCAHO are not taken seriously. As with all Public Agencies that I contacted I was made to feel as if my credibility was on the line and I was under scrutiny to firmly establish this credibility firs; this premise does not protect patients from potential harm. The wrongful termination allowed the Hospital to debunk everything that I said.
We cannot afford to discount any reported negligence and all allegations must be investigated without the credibility of who has reported ever being raised as a relevant issue. All Public Agencies need to start acting in the public's best interest by treating every single report as a potentially legitimate complaint that requires a proper thorough investigation regardless of the iconic status of the institution. They may just be shocked and appalled when they start seeing Hospital facilities as they really are most of the time minus the deceptive transformations that are deliberately done to fool their gullible inspectors. This is a really positive thing for patient safety that should have been in place years ago; now we want real accountability at Healthcare facilities throughout the US. With the Maryland Board of Nursing at first it appeared that my reports on the negligent policy decisions and subsequent retaliation suffered under four Nurse Managers was being taken seriously. In good faith I believed that these Nurse Managers had crossed the line and that they required some form of censor to curb their negligent decision making that was harmful to patients. In addition the serious abuse of power used to target and victimize a subordinate in retaliation for daring to question their poor judgment and trying to expose the negligence was unacceptable and grossly unprofessional. However following the first interview it was soon apparent that by showing false documentation behind my back they had managed to persuade the investigator that I was the most serious transgressor.
I had said that the documentation of which staff were on duty during off shifts was documented in a rather ordinary looking note book kept at the main desk. My former Hospital must have been furious at having to hand over copies of all the pages of these books so that the BON investigator could evaluate my claim of critically deficient staffing. While she remarked on how shocked she was by the unintelligible entries that made it almost impossible to determine the qualifications and experience of those supposedly noted as on duty, she shrugged off this poor documentation in favor of assuming that there must have been adequate staff to cover cases. In other words, if your documentation is unreadable the BON will just assume that what you say is documented, is correct? If they had been able to or only bothered to decipher the scrawling in that book they would have discovered that on multiple occasions when cases were started there was no longer a Nurse available to stand by for Trauma which was in violation of the COMAR requirements for OR staffing of a Level One Trauma Center. Instead they could readily assume that the room turnover cleaning crew were available to insure that an existing Surgical patient was not abandoned when a Trauma case came to the OR: the distinction between Nursing and non-Nursing staff was unclear in the note book. This was the flawed Managerial policy that provided zero redundancy of personnel to relieve staff for breaks or remain on stand by as required. But it was financially motivated and had already save the Hospital a great deal of money. I was told that in the January, just one month after I was ousted, they started calling in their call teams to stand by for Trauma as required by MEIMSS. They must have become nervous about their policy of patient abandonment in view of the fact it was likely to be exposed.
Although I signed a waiver to permit the BON to get hold of my short distance phone records they did not mention these records during my interview. I have to presume that because they couldn't possibly have provided the type of incriminating evidence they were so obviously seeking by this point, they were not even mentioned by the investigator. I was informed of the existence of some documents that I had no previous knowledge of before the BON interview, but I was still barred from seeing them. Can you imagine sitting opposite an examiner and she states that she has this incriminating document that has proved to her that you have behaved in such a way that she probably viewed you as a criminal. The sheer volume of false harassment charges claimed by the Hospital would have been sufficient to warrant a serious criminal indictment! But she will not show you this compelling "evidence" and there is no legitimate reason given for this secrecy. No all evidence used to persecute you must be deliberately hidden from you and once again there are no direct quotes allowed either! How do you manage to refute the validity of a document you aren't allowed to see? It was like the phone log/office planner shown to EEOC; did it even exist? Did the EEOC Mediator actually see it or was she convinced by the Hospital Managers that it existed? She said: "it would be very hard to fabricate something like that," but she didn't explain why? If I had seen it there would have been dates of alleged harassing phone calls at times where I could have produced an iron tight alibi that would have precluded making any type of call; so they kept it from me.
Then there was a letter from a Nurse who said that I had contacted her and allegedly harassed her after being fired. This letter was placed in my file as a complaint subsequent to my removal: we call that a "Witch Hunt" in the UK! I was very upset by that letter as it was written by a Nurse I had counted as a very close friend since buying my Baltimore home from her. She was an extremely credible, conscientious rather outspoken patient advocate, with a track record for excellence as a Nurse; I had learned a lot from her and I genuinely admired her. I had even invited her to spend Christmas with our family in England one year so I felt deeply betrayed by her actions and fail to see her motivation. She had contacted me after I was fired and requested to stay in touch; she sent me a Christmas card that documents this request. However she did not agree with my decision not to take the Hospital's bribe and she severed all contact at that point. She reneged on her commitment to write me a reference and placed some piece of poison into my personal file to help support the Hospital's phony harassment charges. I do not know why her allegiance shifted so radically, but I suspect that she had casually mentioned staying in touch with me and my former OR Manager seized the opportunity to manipulate her as another "witness." This Nurse had moved to the float pool and would have been highly susceptible to veiled threats if she failed to produce the letter documentation our ongoing contact as unwelcome harassment. Although she had been outspoken herself regarding the issues I felt so strongly about she must have known that the Hospital might go to great lengths to retaliate if she chose to defend my stand. I am sorry she did not have the courage to defy them as I thought she was a stronger person than that and a more loyal friend. This incident and her callous betrayal have made it very difficult for me to genuinely trust anyone again.
Documents were deliberately kept from me on the explicit instructions of my former Hospital, yes, the "BestHospital in America," that proudly touts their "honesty, integrity and transparency?" Great transparency! Give them a prize for their "transparency." Oops, they just received a patient safety prize sighting their "transparency" as a major reason for the award! I want to expose the seamy reality of their "transparent" dealings with wrongfully terminated Whistle Blowers as it is truly abhorrent and shameful. Their great PR juggernaut is just filled with shallow hypocritical garbage! What is so appalling is that they have got away with this con trick for so long completely unquestioned. If any employee has transgressed and it requires disciplinary action to secure their removal fine, this is a legitimate necessity in some cases. However, all the secrecy and the ongoing insertions into my file should strongly suggest a cover-up of dubious practices and a witch-hunt to silence the real truth! This is what their Compliance Line should have investigated and refused to even look at.
The former friend who betrayed me with her poison letter referred to a phone call made a full 8months after I was fired; the Hospital had to be really desperate to show that to the BON. There were two Minor Rule Violations that the BON investigator may or may not have been shown as I do not know when they were fabricated and placed in my file. However both violations referred to incidents that had allegedly taken place in the months prior to my being fired, but were entered into my personnel records at a latter date. They were never mentioned at my dismissal or Grievance hearing which is highly suspicious and easily provable as their was a written transcript of the Grievance Hearing. These two alleged charges are also not documented as prior incidents on the Major Rule Violation used to fire me. This is the strongest indicator that they were fabricated after the fact as there is no legitimate reason for this omission. Of course neither document was signed by me, but I was told that for the "counseling," which I defiantly did not receive, there did not have to be a signature. How very convenient. I had signed my first Major Rule Violation as I was told I had to sign so these two Minor's would have been signed be me for the same reason, but they were not. My second Major Violation I did not sign as I was told I could not be made to sign and I wanted to protest the corrupt nature of the charges, but there were witnesses to my being there. If the Compliance Line had just monitored the dismissal process then it would not have been possible for my Managers to keep inventing documents after the fact and inserting them into my personnel file to beef up their case.
So far no one has questioned any of these serious flaws and discrepancies and the same bankrupt process can be used to silence another conscientious patient advocate in the future.
When, in good faith, I made my sworn testimony to the Maryland Trauma agency MEIMSS regarding not calling in call team staff to stand by for Trauma I genuinely believed that it was a dangerous practice and a policy that directly violated the COMAR requirements for a level One Trauma Center. I stated that my concern was that without tightening the language there was a distinct possibility that all four Baltimore Trauma Centers were misinterpreting COMAR to save money on staffing. What if that is still true to this day and a plane crashes at BWI overwhelming all of these Trauma facilities? How will they explain their casual comment to me over the phone concerning this abandonment issue: "it doesn't specifically endanger Trauma patients?" If a transplant patient died after the Circulating Nurse in his surgery abandoned him to go open up a trauma room, how would MEIMSS explain that this non Trauma patient didn't fall under their remit of protection? How would the Maryland BON explain that in the past the Hospitals records documenting the number of staff on duty, and their qualification/skill level was so completely indecipherable that they decided to give the Hospital the benefit of the doubt and just "assume" that OR Managers had called in their call team Nursing staff. Does extremely sloppy documentation provide an acceptably valid excuse for this negligent practice of patient abandonment? How would JCAHO explain their indifference to my complaints and the refusal to do an unscheduled visit of the OR if an Ortho patient lost his leg due to gross infection when a C-Arm that had been stored next to an overflowing trash dumpster had been used during his surgery? How will the Board of Healthcare Quality justify accepting that an internal investigation thought that everything was OK so they had failed to inquire any further?
I do not want to hear that a patient has died due to Public Agencies ignoring the copious, well documented warnings I have been so persistent in repeatedly giving. I still fervently hope that my Petition will generate further investigation from a powerful Government Agency and possibly the press as well. I will gladly fly back to the US to testify if this finally produces results. However, will the Hospital still receive the benefit of a significant reduction in any applicable fines for negligence if a Government Inquiry finds that their so called "independent Compliance Line" passed over all of these warnings with unbelievably feeble excuses and the decision to "just keep an eye on things?" Does the very existence of a Compliance Lines automatically confer a certain level of immunity by crediting the Hospital with providing better patient safety through encouraging the reporting of complaints even after demonstrating a totally inadequate and cursory response to such complaints? Would a Government Inquiry then excuse their total failure and refusal to comply with the basic mandate of protection from retaliation as clearly stated in writing on their Internet site? I hope not as this would send a very dangerous message to other Hospitals. I think that both Hospitals and other businesses have learned to manipulate the Compliance Line system to their own benefit and this corruption desperately needs to be exposed to the Government and the public. Even after being betrayed by my former country of residence, being forced to abandon my home and move back to the UK; I still consider it my public duty as a US Citizen to expose this corruption. I will keep fighting to expose the truth!
i wonder what was the primary factor in making jcaho decide to start doing unscheduled inspections?do you believe it was d/t possibly the nurses/md's contacting them re: issues such as yours?
i truly think the worst thing a nurse can do...is do nothing when there are issues that are placing patients at risk.it is just sad when the one reporting these type of safety violations are terminated in a blind attempt to discredit them.unless...that nurse is in my type of position they would have no way to prove retaliation/whistleblower violations.i have a paper trail a mile long of emails etc etc , high performer evals,letters of recommendation from my nm stating things like "excellent exampe of leadership" ,you are such a great
"strongpt. advocate"thank you for bringing this to our attention - your solution will save lives!", and an email "thanking me for my dedication to the nsg staff-(my old coworkers) only days/hours before i was fired.".then i voice some serious safety issues with a coworker who is best friends with the nm....and i am fired.the nm cant even get her "lie" that she and her friend fabricated to illegally terminate me straight.on one account she says her fabricated event took place on like a friday and on another account she wrote it "alledgedly" occurred on a monday.i cant go into details ...but lets just say that my audiotape recorder has been utilized alot.so many "versions" have been given....it is almost comical.but...i am not laughing. i did the right thing. i followed their bylaws, i followed the nurse pratice act and i was fired.
my family....they lost their health insurance. i am my families primary source of income. i lost my short and long term disability.i lost my retirement.i lost benefits that i had worked years to accrue that would have benefited not only me but ..also my children.i was accussed of something i did not do.i was fired for a "trumped up/false/untruthful " documentation error .i have the nm on tape admitting she knew this nurse had not only removed part of this medical record but also had altered it...and then that same nm fired me for "mysteriously strange" vitals that "appeared" on that medical record .she also admits on audiotape that not only did her friend make alterations on the medical record but that it had no patient info on it...no medical record #, no dob, no room #,nada.it was a blank document.can anyone else smell a rat?
i worked very hard at my job.i thoroughly enjoyed my coworkers. i liked caring for the pt population i was assigned . i did a great job and got raise after raise , & compliment after compliment on my job performance.in the apx 4 years i worked there i went from a base salary of 18$ an hr to over 30$ an hr + shift diff that made me push 40$ an hr.as the sole source of income for my family...when they fired me it impacted all of them.health insurance -gone, dental ins-gone, long term disabilty ins-gone, short term disability-gone, sick days-gone, seniority-gone,retirement-gone,education benefits-gone,life insurance-gone,my professional reputation-tarnished by a lie...my income to support my family-gone.
even...after all this i still was so loyal to that hcf that i actually thought that they would do a valid investigation .i am...still awaiting their final findings of the "investigation"...but my faith in that hcf is quite justifiably gone.i have been incredibly niave bc all this was done to me so fast...it made my head spin....and i think i was still in shock weeks later from it.the public is begining to demand more protection for nurses like me who do the ethically correct thing and report things that could endanger patients.the laws are being strengthened each year...but we as nurses have to get involved,you have a duty....to become more active in your state nsg association.bc...if you think this cant happen to you.....you are wrong.stronger legislation is the answer.
after suffering for 20+ years in several toxic or environments, i realized that the only change over which i had control was - myself. i fought the good fights only to be made the enemy. i witnessed friends of mine be devoured by the political machine that was supposed to be a hospital only to lose their jobs in the end and be run out on a rail. i finally healed myself of the sick co-dependent illness that was my association with surgery, changed area of expertise, got my bsn, and become certified in my area of expertise. i feel whole again but even more important; i feel appreciated. know when and how to pick your battles but also know when the system is erasing you and your importance in nursing.
after suffering for 20+ years in several toxic or environments, i realized that the only change over which i had control was - myself. i fought the good fights only to be made the enemy. i witnessed friends of mine be devoured by the political machine that was supposed to be a hospital only to lose their jobs in the end and be run out on a rail. i finally healed myself of the sick co-dependent illness that was my association with surgery, changed area of expertise, got my bsn, and become certified in my area of expertise. i feel whole again but even more important; i feel appreciated. know when and how to pick your battles but also know when the system is erasing you and your importance in nursing. [/if you are now part of the solution; then you are part of the problem.]
Cute_CNA, CNA
475 Posts
If only administration would realize that the reason there is a nursing shortage is because of the way nurses are treated!