Should Nurses Blow the Whistle?

[Willow Moonsidhe]

Should Nurses Blow the Whistle?

Jennifer LeClaire

With the various corporate scandals of recent years, we've seen plenty of headlines about whistleblowers in the business world. Now, the nursing industry is bringing us its own front-page cases that could see more medical watchdogs come to the fore.

Legal experts say the number of whistleblower cases in the healthcare field has been on the rise since 1999, when the Institute of Medicine of the National Academies reported that medical errors are the nation's leading cause of death and injury.

"Nurses are becoming more vocal about concerns that healthcare organizations are using unlicensed assistant personnel and not employing enough nurses on a shift," says attorney LaTonia Denise Wright, RN, of the Healthcare Risk Aversion Group in Cincinnati. "This is a real concern, because these practices lead to medical errors."

Nurses Speak Out

Nurses are also blowing the whistle on questionable practices. Cindy Moore, RN, got vocal about the way Florida's Duval County Health Department diagnosed people with sexually transmitted diseases. She complained that health officials were not notifying infected people in a timely manner and was subsequently fired for her accusations.

Likewise, Stephanie Hohman, RN, blew the whistle on the University of Texas Medical Branch (UTMB) emergency room when she became concerned about patients' rights and possible abuse. Hohman was also fired. And psychiatric nurse Stacie Neldaughter, RN, was fired after reporting alleged misuse of shock therapy treatment at a Wisconsin hospital.

Despite the career risks, healthcare attorneys say nurses have a responsibility to blow the whistle on such activity.

"Everyone has a moral obligation to blow the whistle on unsafe practices," says attorney Joanne Sheehan of Friedman, Newman, Levy, Sheehan and Carolan in Fairfield, Connecticut. "A nurse may be disciplined by the state licensing board for participating in unsafe practices that can harm patients."

Employer Retaliation

While this is certainly true, Wright advises nurses to understand the potential backlash before speaking out.

"You could be terminated, and even if you decide to file suit, it could be years before you get your job back-if you get your job back," she says. "The statutes are normally very narrowly worded, and they vary from state to state. It's not a decision that you should make lightly."

More than 50 percent of workers who flagged incidents of unlawful conduct in 2002 were fired, according to a study by the National Whistleblower Center, a nonprofit educational advocacy organization dedicated to supporting employee whistleblowers. Many others said they faced unfair discipline.

The protections are limited even where a whistleblower statute is applicable, since statutes of limitation often force employees to learn of their rights and file a complaint within 30 days of being fired or disciplined.

Steve Lee, RN, says his career nose-dived after he blew the whistle on alleged unsafe practices at a Texas hospital. He has since launched Nurseprotect, a grassroots effort to support nurses who face retaliation for whistleblowing.

"Don't blow the whistle unless you are willing to give up your career for it," says Lee. "Whistleblower laws are symbolic and largely ineffective."

While many agree with Lee, more nurses are finding protections and remedies under new state whistleblower laws, say experts, especially since the Health Insurance Portability and Accountability Act came on the scene with federal provisions built in.

Mixed Outcomes

In August 2003, a jury decided that the Duval County Health Department fired Moore in retaliation for making accusations about unsafe departmental procedures. The two sides settled and Moore got her job back.

Hohman won her four-year battle against UTMB when a jury ruled that the facility retaliated against her for whistleblowing. The jury also awarded her wages and damages totaling $500,000.

But in Neldaughter's case, even though the Wisconsin Coalition for Advocacy found that her hospital's procedures for obtaining informed consent for shock therapy were coercive, she did not get her job back after taking court action.

"If you are thinking about blowing the whistle, then you need to make sure you are protected by whistleblower statutes," advises Wright. "If not, then address it through your management or through your union. Court battles could take years to resolve and winning is not automatic."

This article was originally published on Monster.com.

http://nursinglink.monster.com/benefits/articles/6515-should-nurses-blow-the-whistle?page=3&utm_content=nl_c1_20110419_whistleblower&utm_source=nlet

[classicdame, MSN, EdD]

Texas passed a Whistleblower protection act for nurses not too long ago. The first case to try the law was when 2 APN's wrote to the Medical Asso. about an MD. Not only did the AMA, ANA, BON and Texas Nurses Asso. support these nurses, the MD and the Sheriff ended up on the wrong side of the law. Go to www. Texasnurses.org to read the court transcript and the update. Interesting!! I do not know if the nurses are working, but they do have their licenses and may not need to work now due to out of court settlement.

[katielac]

As a nurse, it is my duty to advocate for my patient. If this means I am considered a "whistle blower" if I report safety violations or wrong-doings, then yes, it is our job. I would rather lose my job fighting for what is right and just, than to keep working knowing that patients safety is being jeopardized. I really hope that in the near-future, whistle blowing will be encouraged and protected with the intention of reducing injury, harm, and/or injustice to patients and the personnel that take care of them.

[imintrouble, BSN, RN]

Without a doubt nurses have an ethical and moral responsibility to report unsafe or illegal practices at their places of employment. I'm not sure what the Nurse Practice Act says about legal obligations.

Having said that, whistleblowers never win. After blowing the whistle myself ten years ago, I can attest to the fact that the ordeal was beyond painful, and cost me my job. I only found another job when I didn't list the facility that fired me on my resume. Telling the truth about what I went through to prospective employers meant weeks without work and a paycheck.

I knew the facility that fired me was an ethical minefield one DAY after I started. I felt morally obligated to try and change the way they operated. When I couldn't change anything, I reported them to the state.

Would I do it again? Probably. At that facility. Now I would simply quit after the first day, instead of trying to make changes that may cost me everything.

I am older and alot more realistic about my ability to fight the good fight against numbers that I can't possibly beat.

It's easy to be a crusader righteous and outraged, when faced with abuse and neglect if you've never been fired unjustly. It's hard when you have to weigh the welfare of your family over that of your patient.

I'll probably get blasted here as we nurses usually have twice the morality as the general population. It's just I've been down the high road of moral and ethical superiority. Nothing changed at the facilitly I reported. I was the only one fired. Conditions did not improve.

[Willow Moonsidhe]

I blew the whistle on that job I quit after one night. In truth though I have seen more unethical things than I ever would have dreamed of since I came back as a Registered Nurse from disability. Nurses charting crap they did not do and things they did not teach. It is awful but I know why it happens. There is not enough hours in the day to do the things expected of them. It is such a different world with so many different expectations of workers. The reason I blew the whistle on the nursing home is that it was totally unsafe. LPNs came in from the other floors and did the skilled charting, but they did not even go in the rooms and look at the patients.

~Willow

[tainted1972, ASN, RN]

Isnt there a way to report things anonymously? If there isnt, then there should be. I think that more nurses would "blow the whistle" if they could do so without giving their personal information.

[Willow Moonsidhe]

Yes I did it anonymously at http://oig.hhs.gov/fraud/hotline/ This is CMS fraud page.

[Blackcat99]

I gave my 2 weeks notice and picked up my final paycheck. After I picked up my check, I called the state and made an "anonymous call". I told the state that elderly people were being tied up in restraints at a small private home like facility for the elderly. I told the state to arrive at the facility at 9pm and they would see it for themselves. Instead the state told me that they went around at 8pm and that the home care aide admitted that some of the patients were tied up. However, when I asked the state if they actually went into the patients rooms they said no. The state said they didn't turn on the lights because they didn't want to wake up the patients!!!!!!!:eek::mad:. Wouldn't it not had made their case stronger if the state would have walked in to the patients room and examined the patient in restraints themselves!!!!!! Anyway, I later heard that they got a small fine and a warning. The owner of the home accused one of the home care aides of calling the state. This happened years ago.

[abundance56]

I just reported my hospital, using "anonymous". I made sure to only include things that a parent (I work on kids unit) would know. I am known for being a "loud mouth" and talking to people inside the hospital, to try to change things. I am hoping this will protect me. But it was too much: I work for a private hospital, and it is always about the bottom line (money) and not about the nursing safety.

I guess what this tells me, is that I need to start looking for another job, whether or not: they figure out it is me. I have enjoyed the job, but it has finally just gotten to be too much. And too many staffing abuses, and issues that impact patient outcome and safety. I am so pro-patient that it hurts! I wish I didn't care so much!