Mandated Whistleblowers

by Sam Beardsley, RN 11/27/15

I’ve been pondering this essay for a week now. I’ve been an RN for 35 years. Have absolutely loved the profession, but I also love challenges… even though I’ve been tested, I wouldn’t have had it any other way.

I’ve watched, and continue to watch the profession itself and those outside of the profession, both colleagues and clients, as they try to define what a “good RN” is. I’ve never heard a perfect answer. It seems to be like the story of the blind men as they define an elephant.

Personally, I think of Chief Justice Stuart Potter, who in the early ‘60’s, during the Supreme Court’s efforts to define pornography, frustratingly uttered the now famous line “I shall not today attempt further to define (pornography), and perhaps I could never succeed in intelligibly doing so. But I know it when I see it.” All of us who have been in nursing, even for a short time, appreciate this sentiment. We know it when we see it!

On to my point. One of the attributes to admire in a good nurse is that of being able to “think outside the box,” i.e. challenging ‘”tradition” or “common knowledge.” I thought of this as I kept passing over the word “whistleblower.” The word is such a trigger-word. In this culture it certainly has a negative connotation, especially in the corporate arena.

Pondering the word and my profession I couldn’t get away from the idea that one of the larger aspects of the normal part of my job is that of whistleblower. I’m supposed to always be watching out for variances in the way care is being delivered to my patient(s). My state actually mandates my being a whistleblower if I find a non-patient child or an elderly person being mistreated. I can lose my license and be held criminally liable if I’m not a whistleblower!

We’re good at many areas of our practice because we had good role models and mentors showing us how to do it and supporting our actions. We need equally good leaders in our professional organizations supporting us when we try to expose a practice that’s not in the best interest of our patients or the profession.

It’s a serious blow to the profession of nursing when the exposure has to come from the popular press because our members have found only silent and scared “leaders.” I hope that when any of us is called a whistleblower we can smile and say thank you!

Advertisements

Simmering Discontent?

By John Kauchick, RN BSN

(EDITOR’S COMMENT: Is our discontent merely simmering, as an elite member of our profession writes below, or is it boiling over? You decide! Let us know your thoughts in the comments section below.

Here is the story of one nurse’s attempt to bring the subject of wrongful termination and employer accountability for same to the awareness of major nursing organizations in the United States.)
________________________________________

This past year has been called “the year of ethics.” I decided to see how serious various professional nursing organizations and ethics institutes were going to put words into action.

From August of 2014 through May of 2015 I wrote to the elite experts within and outside these organizations. None responded. The common thread to not getting responses seemed to be my mention of wrongful termination.

A few weeks ago, I tried writing again with the preface that, considering the paper trail of unanswered emails, the recipients failing to to respond will be subject to answering questions as to why they didn’t respond. Finally, one top nursing ethics expert responded:

“Thanks for your information. Wrongful termination is a legal concept. Some of what you express is ethical behavior that perhaps underlies these issues. — continues to move forward and look at ethical climate where nurses work. This was a focus of —.

Our — addresses many of these issues and I encourage you to work to incorporate the — into the evaluation processes at your hospital.

We will continue to discuss the ethical environment where nurses work, but although you express a simmering discontent very little of that discontent ends in legal action.

I hope you will continue to dialog with us and others … as we continue to work toward a more ethical climate in nursing.”

Since it appeared I was invited to “continue the dialogue,” I responded. Those emails were never answered!

In my emails, I raised concerns that the cancer of wrongful termination had spread to the nursing schools and, furthermore, that it was having a devastating effect on future nurse/patient advocates.

I asked why national nursing organizations not supporting the spread of the Safe Harbor law to states other than Texas.

I said there was a lack of courageous leadership. I asked for defamation and wrongful termination to be added to the agenda at future conferences or national nursing organizations.

I asked that they send a strong signal to hospitals that there will be no tolerance for defamation and wrongful termination. I asked that it be clear that offenders would be subject to accountability.

Let none of us be fooled! The purveyors of injustice and misconduct are protected by inaction and silence.

“Those who stand for nothing, fall for anything.” ——Alexander Hamilton 1778

_________________________________________________

GuerrillaNurse is Morphing!

 

Melissa Brown, RN

When I first published my GuerrillaNurse website on August 1, 2015, my intent was to bring attention to the manner in which nurses are treated locally with regard to safety and security. I wanted to tell the truth about my prior employer as I experienced it. That was the extent of my plan.

What I didn’t expect was the reception GuerrillaNurse would receive. I didn’t expect to receive hits and support from nurses and others all over the USA, Canada and even the UK. For about two months I had no clue what I was going to do with my site. I felt compelled to build on the site’s foundation, but I couldn’t articulate a goal. I couldn’t conceive of what it was I wanted to accomplish.

In October, I started a Facebook community page affiliated with the page, GuerrillaNurse. Based on personal experience starting FB groups such as Just One Nurse , I expected to have about 25 nurses join the group within six months (if I was lucky.) One month later, we have 165 members on our community page. Not a lot, but not too shabby, either. And many more than I expected!

Then, on November 6, 2015, we had some success sharing an article written by a The New England RN, a nurse who prefers to remain anonymous. James Ledbetter, the author of the original story to which The New England RN responded in her article, responded to us via Twitter. We were heard!

The gauntlet had been thrown at my feet. What now? What was next for GuerrillaNurse?

I plan for GuerrillaNurse to become the go-to place on the ‘net for nurses who want to publish their own stories, opinions, poems, articles and more. This site is no longer for or about only me — it’s for and about all nurses, everywhere.

If you have a story to tell, allow me to be your conduit, your muse. Put your story down in writing, and email the rough draft to me here: guerrillanurse@cox.net

Together, our truths will be told.

Melissa Brown RN
Pensacola, Florida

My Story

Hello!

I am Melissa Brown, otherwise known as the Guerrilla Nurse. I am a former RN, now happily retired, living in Pensacola, Florida.

For 37 years, I practiced as an RN is multiple clinical settings including emergency nursing, flight nursing, all critical care units except neonatal and, from 2002 until 2013, as an RN in psychiatric and substance abuse settings.

The Guerrilla Nurse was born when Alene Nitzky RN PhD asked me to write a blog post for her new website, Fighting Dinosaurs

The first post was written just in time for Nurses’ Week in 2015. My second post was written about two weeks later.

Guerrilla Nurse: Part One
Guerrilla Nurse: Part Two

In May of 2013, I was fired from my position as an RN at Lakeview ASU in Pensacola, Florida. With the help and support of my husband, I was able to do what most nurses can’t do: I sued my prior employer.

And what an adventure it has been!

After my deposition on April 9, 2015, I learned I wouldn’t be able to obtain a copy due to the price: nearly $600.00! However, another nurse for whom I have the greatest respect, Donna Carol Maheady RN APRN EdD of Exceptional Nurse, suggested I start a gofundeme page in order to request donations so I could purchase my deposition. I didn’t think it would work, but within two weeks, I raised the funds from special nurses and other friends who believed in what I was trying to do.

I promised I would post the deposition online if and when I could buy it. Here it is: My Deposition

It is long — 225 pages! I had to redact, of course, all of the information that could identify patients or patient situations. In addition, after considerable thought, I decided to redact the names of all the nurses, psych techs and others with whom I worked while I was at ASU.

Several of the people whose names were brought up in my deposition still work at ASU. As they will see in my deposition, I tried my best to protect them. Yes, I was asked in my deposition to name those with whom I spoke or interacted after i was fired. The only thing I can do at this point is redact their names.

However, I did NOT redact the names of those in management who were responsible for my termination and ultimate suit against Lakeview ASU. Those names, as well as their actions, need to be exposed. I understand the risk. It is a risk I am willing to take.

I will leave it to my old coworkers to read this deposition. All of you need to know what you are up against should you decide to sue one of the largest health care corporations in town.

I also edited out one specific situation that was addressed in the deposition. To leave it as it stood could affect another nurse. I won’t do that.

Welcome to the GuerrillaNurse website!

This page debuted on August 1, 2015 as a means by which I could tell my story. Since then, other nurses have come forward with their own stories to tell.

This website is now serving as a platform for nurses who wish to tell their stories.

If you are a nurse, and have an article or opinion piece to share, please contact me at guerrillanurse1@cox.net

Together, our truths will be told.

Melissa Brown RN

 

There is NO nursing shortage!

a1a4dog

There is NO Nursing Shortage – An Open Letter to The New Yorker Magazine

by The New England RN (who prefers to remain anonymous)

November 5, 2015 – James Ledbetter touched on some good points in his recent article, “Why Is The U.S. Perpetually Short On Nurses?”

According to commentary on various nursing boards across the net, it’s clear the article has also triggered some interesting dialogue.

Nurses across the U.S. would like to invite an adventurous journalist to look with a deeper perspective into what is actually happening in the nursing arena!

There is so much more happening alongside the rewarding aspects of being in the Nursing profession.  I underscore that it would take a journalist who is adventurous because to cover the terrain of the actual full spectrum truth within nursing will take some courage and stamina.

As an adventurous journalist, you’ll need somewhere in the vicinity of the fortitude required for a nurse to consistently run 8-12 hours on foot, often at a pace of let’s say, running for a bus. Combine this with having to mentally override your bodily functions. There are no pit stops to eat or use a rest room.  Instead, add a steady diet of mind numbing bombardment of stimuli from patients, family, machines and phones calling out in constant need. Be sure to keep all those important life saving facts on the top of your gray matter to ensure positive patient outcomes.

Next, you discover there are not enough resources in the way of adequate staffing. By the very nature of the health care construct, adversarial push back from managerial or administration demands often exists.

Last, you would have to be able to be the type of journalist who is able to tolerate having your days garnished with the fear factor (and not the fun entertaining kind) such as all the reasons you need liability insurance, the pervasive hostile incivility and bullying from just about anyone in your environment, the loss of trust with those who vowed to do no harm but found themselves abandoning that idea with the push for profits, physical and emotional violence from patients who strike out, whether intentionally or because of a dementia-ridden mind.

Keep on the top of your brain now that you always have to be “Johnny on the spot” while being in judgment from peers, regulatory agencies and compliance police.

Now, let’s say you’re a pretty savvy and seasoned journalist who has ventured into some war torn areas to cover a story. You are a person who is experienced with life and death up close and are acutely aware of the mortality all around you. With your experience, you’re likely ready to look at some of the environments in which nurses are trying to execute this once sacred profession.

Allow me to demystify a few points for the sake of getting the conversation started.  I say a few points because there is an overload, a back breaking mother load of scenarios that still have not been brought to light or resolution. For every nurse, there are stories that would fill volumes more than the size of a few hardcover Physician Desk References (PDR). Presently, there is a general consensus that conveys that nurses love nursing for what it once was, how it was taught and mentored to them and what it could be, but not for what it has become.

So, in order to prevent the piano that I am going to toss out the window from landing on your head, let’s start with only a few points, just as fair warning.

1)   THERE IS NO NURSING SHORTAGE 

There hasn’t been one for a very long time.  Just about the mid 1980’s, “someone said somewhere” that there is an impending nursing shortage.  So why, oh why, wouldn’t it be true? You read about it in magazines and saw it on the news…all those trajectory graphs.  “It’s been the song that never ends…it goes on and on my friend…”  .

Suffice to say, the colleges and universities clearly got this song stuck in their heads and started recruiting from high school shindigs to hospital awareness chats.  Students come wielding their tuition and a new sense of purpose and meaning. How can their bright, rose colored futures go wrong? They have been told they will have recession-proof jobs with huge financial rewards in environments full of humanity. So in exchange for their blood, sweat, tears, empty bank account and first born…they launch into their career of ………(crickets)

The reality is, new graduates suffer huge disappointment and confusion by having to explain to everyone from hill to dale why there is difficulty getting a job in nursing.  This adds to the confusion of the people to whom they are explaining. After all, there is nursing shortage, right?

The New Hampshire and Massachusetts Boards of Nursing concur.  There is NO nursing shortage.

The current trend now is that a new Nurse will have to earn stripes in a proving ground environment, such as a Long Term Care Facility (LTCF) aka Skilled Nursing Facility (SNF) for about a year before being considered for a position in an acute care setting…that’s fancy talk for a hospital. Outside of those who are able to land a position in Long Term care, there are many other nurses scrambling for ‘something…anything…do you know anyone who can get me in?’ Ask any hospital Human Resource department how many applications from Nurses they get in daily. Luckily, only 50 percent of nurses work in hospitals, so there’s still hope yet.

2)   NURSING GLUT BRINGS LOWER PAY RATES 

So where are the big bucks that all of the nurses have been told are out there waiting for them?  The pay rates have lowered or have frozen over the past 20 years.  With a nursing glut comes lower wages.  There is always someone willing to do it for less.  So, good bye to nurses of longevity with invaluable skill sets and higher pay rates and hello to new grads who are compelled to take lower paying jobs in order to work in the profession they so rigorously trained for. So who is happy here? Happy are those corporate entities that get to keep more for a very long list of things that don’t include compensating nurses adequately.  I think dealing with secretions alone, warrants significantly more than $24/hour.  That is what one nurse reported this week as earning in Ohio in an Intensive Care Unit (ICU). To put this in perspective, I was earning $3 more an hour than this as lower-degreed nurse in 1997.

3)   THERE ARE AN ABUNDANCE OF NURSES WHO ARE UNWILLING TO WORK WITH UNSAFE NURSE/PATIENT RATIOS 

Many things constitute an unsafe environment for both the nurse and patient.  It all starts with the basics of available hands to perform the safe, competent care. Lack of staffing is not due to the lack nurses in the U.S. It has to do with keeping costs down for the corporation.  There are unsafe nurse/patient ratios everywhere, not just the hospital setting.  I have given up working in  Long Term Care/Skilled Nursing Facilities where nurses are expected to pass medications, execute wound treatments, breathing treatments, maintain oxygen, prevent falls and other emergencies and much more for an average of 35 patients on day and evening shifts.  Once the night shift hits; you are saddled with anywhere from 40-60 patients. But, what about the Certified Nurse Aides that help, you say?  They are great if there are any.  The last place I worked in gave me a unit 40 patients and a singular CNA who didn’t feel like working that night. Where is the safety or humanity in that?

FEEL THERE ARE QUESTIONABLE ETHICS

Nurses love people. Caring for you is a calling. We really do want to take care of you the way we would want to be cared for.  But the corporate structures only understand numbers and profits. They will talk a good game about the rest. All of the suits will be on the heels of the uniforms to this end. The real end result is that it prevents most nurses from providing care in the manner that feels good and rewarding.

It is simply humanly impossible to cover all of the demands. Nurses feel bad when they have to shave off everything but the highest priorities, work off the clock, not take that mandatory half- hour break that you have to say you took because ‘it’s the law” and your employer knowingly docks you for that time. The last place I worked in had a financial incentive for administration to keep costs down.  How they decided to do this was what I call “play with the schedule.”  The schedule would go up for all to see that all the shifts were covered by so-and-so regular staff and so-and-so agency staff. It’s not before long you realize these agency staff do not exist.  So when Jane Doe from the agency doesn’t show up for work; the regular staff has to work short-handed and the corporation keeps those funds. The financial incentives for administration are what keeps this and other creative behaviors continuing. Meanwhile, a lot of smoke and mirrors are held up to the public eye. There are a slew of ways nurses are finding themselves in conflict with ethics and integrity.

WHERE BULLYING, INCIVILITY AND THREATENING EXIST

An employer does not value its nurses if they allow bullying to thrive. It has become the rule rather than the exception to experience bad behavior from other healthcare staff at all levels. It’s a complex issue with those entrusted to keep an even keel are often willing participants. I know, hard to believe.

But some facts and realities, although painful, need to be looked at before it can heal. 1 in 3 nurses are leaving the profession because of bullying according to Claudia Sanborn, RN, author of “Yellow Sick Road.”

Melissa Brown, RN, founder and facilitator of GuerrillaNurse on Facebook (https://www.facebook.com/GuerrillaNurse) was put on probation by her hospital employer two weeks after pressing assault and battery charges against a patient who battered her. Less than three months later, she was fired. The American Nurses Association (ANA) has come out with a statement recognizing this as a real problem that needs serious attention. http://www.nursingworld.org/Bullying-Workplace-Violence

Yes, something has gone horribly awry in our heart centered, caring profession. For anyone experiencing this, consider contacting the go-to guru Renee Thompson: https://rtconnections.com/.  She is an expert on this topic from top to bottom and will guide you with her light.

My observations and experience over the past 30 years as well as experiences compiled from others nurses who are either still in the trenches, on the ledge or have run from the profession like their head was on fire tells me it is time. It is time to look deeper at where the system has broken without debate but with a focus on solutions and healing.  Nurses were made for this.

Accurate journalism will help.  I know there are many amazing Nurses working to facilitate the healing of the wounds within the profession.  Please support these efforts. Join initiatives that give support and groups premised on the Golden Rule. Share what brings the best out as we navigate the broken systems. Keep with your heart centered goals in Nursing.  No matter what profession you have committed to, please remember to bring compassion, integrity and caring in all that you do.