Eeyore’s Gloomy Little Instruction Book contains this sage advice: “No matter how good your friends are, and no matter how right you are, they may not stand behind you in a work-related confrontation, and you have to forgive them for that…”
A great deal of both pain and wisdom are captured in that one sentence! Moreover, no one can protect you from all the retaliation. Yes, legislation has been passed, and courts have often find in favor of the whislteblower, and the whistleblower may even get compensation—but he or she will still pay a price, which, when all is said and done, is why it is so very hard to “blow the whistle” even when you know to the very core of your being that what is happening is wrong, and that reporting it is right.
Take, for example, a recent Texas case in which a nurse anonymously reported a physician to the Texas Board of Medicine for unethical conduct. Needless to say, the physician became aware of her complaint when the Texas Board of Medicine followed up on it. This physician not only sought retaliation, he filed a harrassment complaint with the county sheriff who arrested the nurse for “misuse of official information.” Although a jury promptly acquitted the nurse, Alex Winslow, executive director of Texas Watch, a patient advocacy group, noted, “Whether Ms. Mitchell was convicted or exonerated, was largely irrelevant to the long-term impact her prosecution will have on Texas patients. The very fact that she was prosecuted will make individuals who have information that could save lives will think twice before speaking up, putting Texas patients at risk.”
And here’s a real kicker: the Texas Nurse Practice Act requires nurses to report harm, or even potential harm, done to patients, so the nurse would be in violation of the Nurse Practice Act if she did not report the physician! Although both the Texas Board of Medicine and the Texas Nurses’Association expressed relief that she was exaonerated, the nurse (and one of her colleagues) was fired even before the case went to trial. Presumably she is now reinstated, but why do we punish Whistleblowers? The answer is complex: The power of the elite versus the conscience of an individual. The desire of both institutions and people in general to distance themselves from unpleasantness. Group pressure to conform, the pull off team affiliation, the “all or nothing” attitude of group think leads otherwise moral people into—at the very least—the complicity of silence.
Had this physician not filed a criminal complaint, he most likely would have suceeded in punishing the nurse. However, his desire for vengeance was so great that he went outside the healthcare community…he tried to make a criminal case out of it…and the justice system worked just fine…this time!
Jury foreman Harley Tyler, Sr. put it this way, “…Nurses are the eyes for the patient.” The nurse, Ann Mitchell, despite the fact that she would have faced up to10 years in prison if convicted, said, “I still have to do those things for patients. My duty has never changed.” She’s absolutely right; she’s probably she’s back to work…and almost inevitably, she’ll have to find another job soon.
Dr. Leah Curtin, RN, ScD (h), FAAN, is Executive Editor, Professional Outreach, American Nurse Today. An internationally recognized nurse leader, ethicist, speaker, and consultant, she is a strong advocate for both the nursing profession and high-quality patient care. Currently she is Clinical Professor of Nursing at the University of Cincinnati College of Nursing and Health. For over 20 years, she was the Editor-in-Chief of Nursing Management. In 2007, she was appointed to the Standards and Appeals Board of DNV Healthcare, a new Medicare accrediting authority. Dr. Curtin can be reached at
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