AJN, American Journal of Nursing:
We must support nurses who come forward as whistleblowers.
AJN Editor-in-Chief E-mail: email@example.com
Gracing this month's cover are Anne Mitchell and Vicki Galle, two Texas nurses who were arrested after they reported a physician to the state medical board for unsafe practices. (See "Texas Nurses Under Fire for Whistleblowing," In the News, October 2009.) Exoneration came only after they'd endured nearly two nightmarish years in which they were fired from their jobs and charged with misuse of official information, a felony; Mitchell also faced criminal prosecution. Last January and February, those who'd brought the charges against the nurses were themselves indicted on charges that included retaliation, misuse of official information, and official oppression. Mitchell and Galle reportedly received a $750,000 financial settlement in a civil suit they brought against the county for wrongful arrest and prosecution.
This isn't a case of "all's well that ends well"—both nurses have endured personal and professional repercussions because they came forward. Recently I interviewed Mitchell and Galle, along with their colleague Naomi Warren, an NP who wrote a letter supporting their claims against the physician. Mitchell told me, "Our futures were changed forever." (To hear the two-part interview, visit www.ajnonline.com; click on Podcasts, then on Conversations.) In the rural area where these nurses live, there are few health care employers and no other hospital where they might work. They've lost the ability to contribute to retirement and social security funds. Warren now drives 80 miles round-trip to her current job. Being a whistleblower can be costly; but the alternative—silence—could be catastrophic.
Perhaps the largest nosocomial patient exposure to a bloodborne pathogen on record in this country occurred in 2008: the Las Vegas–area hepatitis C outbreak. It occurred in part because nurses at two endoscopy clinics failed to report unsafe practices, although many knew such practices violated accepted infection control standards. Over 62,000 patients were notified that they might have been exposed to hepatitis C; 115 patients were found to be infected. In the ensuing investigation, many nurses said they'd feared retaliation, including being fired, if they complained about or reported the unsafe practices.
As a result, the Nevada Nurses Association (NNA) appealed to the state legislature to enact whistleblower protection for nurses. But the legislature needed more data. To that end, the NNA commissioned Lisa M. Black to survey Nevada nurses about their experiences as patient advocates; Black reports the results in this issue (see "Tragedy into Policy: A Quantitative Study of Nurses' Attitudes Toward Patient Advocacy Activities"). Black found that 34% of respondents reported being aware of, but not reporting, a patient care condition that could have caused harm; of these, 44% cited fear of workplace retaliation as the main reason for not reporting. The study results were instrumental in the NNA's successful effort to achieve whistleblower protections for nurses.
But, as the Mitchell and Galle case demonstrates, whistleblower protection laws aren't guarantees against criminal prosecution. AJN contributing editor, nurse, and attorney Edie Brous explains: "The whistleblower laws are intended to protect employees from employer retaliation in the workplace; these are labor or employment issues in civil law. No one anticipated that employees would be prosecuted in the criminal system and would need protection from district attorneys; the whistleblower laws don't address that." She notes that since the Winkler County case, "some statutes are being amended or new bills [are] pending to prevent such egregious abuse of process."
If ever there was an issue around which all nursing organizations should rally, it's this one. I asked Mitchell, Galle, and Warren whether, knowing how much whistleblowing would cost them, they would have pursued the same course of action. Without hesitation they said, "Absolutely." We must support changing the laws to protect nurses who are acting as patient advocates from criminal prosecution. It's the least we can do to repay those who stand up for patients and for nursing.