Blowing whistles

Why does being a whistleblower have such a bad connotation? What if there weren’t people out there willing to risk everything to do what they knew was right? There are many famous as well as infamous whistleblower stories; Mark Felt otherwise known as “Deep Throat”, Sherron Watkins the former VP of Enron, former employees of Eli Lilly, a pharmaceutical giant, best known for calling the company out on their fraudulent marketing of the drug Zyprexa, and most recently Anne Mitchell and Vicki Galle two Registered Nurses in the small west Texas town of Kermit. 

The thought, concept, and idea of whistleblowers in healthcare didn’t enter my mind until a few weeks ago.  I now know however, that my lack of knowledge made me very naive on this subject.  A few months ago, I received my copy of the June edition of AJN with Anne and Vicki on the cover.  Their story was also featured on my This American Life podcast Old Boys Network around the same time.  When you start paying attention and doing research it becomes easy to appreciate the serious lack of whistleblower protection legislation in health care.  For the protection of our patients as well as ourselves as patients this needs to change.

The story of these two strong and inspirational patient advocates has been featured in The Texas Observer newspaper.  Their story and what they went through is lengthy and horrific.  What they lost was significant, what was taken from them; their professional future still filled with opportunities to make a difference, and what they suffered through; unimaginable.    Reading their complete story in the newspaper articleor listening to it in a podcast is much more powerful and pays more respect to what they have been through than any amount of retelling I would do here.  However, I will attempt to summarize.  Anne and Vicki lost their jobs and had criminal charges brought against them in retaliation for reporting one physician they worked with to the state medical board for very serious patient safety and practice concerns.  Formal criminal charges were brought against Ann Mitchell and dropped against Vicki Galle.  After an extreme two years of fighting Anne was eventually acquitted by a jury.  The severely corrupt individuals who retaliated against these nurses are each now facing the same criminal charges themselves.  Dr. Arafiles, still in medical practice though with limitations through the Texas Medical Board, Scott Tidwell the county attorney, sheriff Roberts, and Stan Wiley the former CEO of Winkler County Memorial Hospital all were indicted in January.  Stan Wiley pleaded guilty to charges in March and each of the other four will face trial this year. 

The American Nursing Association talks about whistleblower protection on their website.  Whistleblower legislation, all in varying degrees of provisions and protection, exists in 20 states, only 20: Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Maine, Maryland, Michigan, Nevada, New Jersey, New York, Ohio, Oregon, Texas, Utah, Vermont, Virginia, and West Virginia.  What does it take to get legislation in place to protect people who risk everything to speak out against unsafe healthcare practices? I do not understand why every state does not have something like this in place.  Each of us has the potential on any given day to be a patient in a hospital in this country.  I want the nurses and other heath care professionals taking care of me not to hesitate to speak out if something questionable revolving around my care is taking place.  Unethical corporate situations, like ENRON, have implications for all of us; though the scale to which each of us is impacted is different when we are speaking about unsafe or unethical health care practice.

The one thing that should be learned of not having whistleblower protective legislation in place, is risk.  A blood-borne pathogen exposure in Nevada in 2008 risked the health and lives of 62,000 patients.  They were notified of their potential exposure to Hepatitis C after being seen at 2 endoscopy clinics.  115 people were found to be infected from this exposure.  After the exposure was found, the nurses working at the clinics talked about their fears of professional retaliation as a reason for not reporting their concerns.  Because none of them spoke up, 115 people have to live with serious and inexcusable consequences. 

As patients, each of us should feel safe in the care we receive; knowing that staff is empowered to do the best they can in the care they provide.  As nurses we should never be afraid of the consequences to speak up and do what is right.  Maureen Kennedy stated this her editorial in the June issue of AJN

“Being a whistleblower can be costly; but the alternative-silence-could be catastrophic”

It is just so true.  To start we need to make ourselves aware of the legislation that is in place in the states where we practice and then we need to keep talking.  Keep talking about safety, keep talking about the culture of safety and reporting at our places of employment, and make sure to support our fellow coworkers in situations when they stand up and speak out.

To Anne and Vickie- I’m sorry for what you’ve been through and all that you’ve lost.  I need to thank you though for having the integrity to stand-up for what is right.

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