Say it isn’t so: Eradicating the fear of retaliation
First, let me commend you and your staff on this excellent publication. The July 2013 issue was particularly interesting and I read it in its entirety in one sitting.
Your [Pamela Cipriano] editorial (“Say it isn’t so”) was thought provoking and sobering and prompts me to reply with a bit of a sigh. The anecdote about your colleague whose relative had a negative experience with nursing care and feared retaliation represents the most ordinary of complaints I investigated during my 4+ years as an executive director in nursing regulation. Not every complaint was validated, but significant numbers of horrific incidents were uncovered. Some of the incidents we investigated and adjudicated caused me extreme mental anguish as I came to terms with the reality that some of my fellow registered nurses engaged in the most atrocious types of abuse, retaliation, and negligence for their own personal gain. As is true in other service-oriented “caring” professions (e.g., clergy, medicine, mental health), the nursing profession includes members with psychopathology or substance use disorder; those who are perpetrators of sexual violence and abuse; thieves, liars, and a few who are just disengaged from moral and ethical codes of behavior. Yes, it is so, and until our educators and leaders acknowledge that we are no different than the rest of the society we hail from, we will continue to express shock and horror when these issues come to light. More importantly, we will have done nothing to protect the public from bad nursing care and fear of retaliation if they speak up.
We need to come down from the high horse of self-righteousness and stop perpetuating the notion that nurses are “special”, “the one true caring profession.” This belief set hails directly from Florence Nightingale-era roots. Just as we have evolved into the 21st century as a highly educated and diverse profession, we are also products of a society plagued with conflicting values that fall short of a strict code of moral behavior. Nurse leaders would do well to acknowledge that many seek to enter our profession for economic and practical realities, not altruistic values. The promise of scholarships, financial aid, and a “quick” path to solid income holds appeal to a much more diverse group; some of these individuals have significant criminal backgrounds, mental health problems, and socioeconomic struggles that influence the critical thinking ability we value so highly. Nurse practice acts and the ability of nursing regulators to act are highly dependent on the political climate and agenda of the individual states. As an educator, I tend to believe that education is our best weapon. Educate all stakeholders with crystal-clear standards of professional behavior and enforce them with appropriate regulations. Our society has progressed in civil rights, racial and sexual equality, and a multitude of other areas on the same basic platform. Our colleagues in mental health have made great strides in this area that we would do well to emulate.
— Mary Kay Goetter, PhD, RN, NEA-BC
Nurse Scientist, Senior Researcher
Joint Combat Casualty Research Team
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