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Health System Lays Off Nurse During Surgery

Keri Mucci, April 22, 2009

A Dean Health System physician made an incision during a recent routine surgery, but it's a manager's cut during the procedure that is making waves.

Healthcare professionals are now questioning why the manager laid off a nurse during the surgical procedure.

Paul Pitas, director of corporate communications at the Madison, WI-based facility, confirmed the incident followed an announcement on April 8 that the health system would lay off 90 employees "immediately."

The facility released a statement in which Pitas declared "the absence of an RN goes against established patient care procedure" and that the act was "clearly . . . an error in judgment on the part of the manager conducting the layoff." Pitas declined to release the manager's name, who he stated has more than 30 years of nursing experience in the Wisconsin State Journal.

The timing of the layoff—during a surgery—is what has upset many nursing advocates.

"Layoffs may occur in these economic times, but there are correct methods for doing them," says Polly Gerber Zimmermann, RN, MS, MBA, CEN, FAEN, assistant professor at Harry S. Truman College in Chicago, and former ED nurse director. "The employee should be told at the end of the day, after care responsibilities have concluded. Healthcare workers are traditionally known for their caring approach; it is important that the same consideration is given to them in this type of situation."

Neither the name of the dismissed nurse nor the type of procedure he or she was assisting in were released. According to Pitas, the layoff didn't endanger the patient because other clinical staff, including a physician, were present during the remainder of the surgery.

But regardless of the surgery's severity, the nurse is there to advocate and care for the patient, while the operating physician focuses on the procedural aspect, says Zimmerman. "One nurse does not leave a procedure without being replaced," she says. "If the same nurse left on his or her own initiative, they could have been charged with patient abandonment."

Pitas stated in the Wisconsin State Journal that the nurse manager is "very upset" and "extremely remorseful" over the incident. He added that the layoffs created "extraordinary circumstances."

No one can deny that the pressures are mounting for healthcare leaders in today's economic climate, but Beth Kessler RN, BC, director of patient care services at Lehigh Valley Muhlenberg Hospital in Bethlehem, PA, questions whether the manager could have delayed the layoff until the procedure was completed or if it was just a bad decision on his or her part.

"I cannot judge the actions of the manager without knowing the circumstances that he or she faced," Kessler says. "We in the healthcare industry are not escaping the effects of the economy. But we, as a profession, must unite and recognize the need to be efficient while still providing safe patient care."


Keri Mucci is an editorial assistant in the nursing market at HCPro, Inc. She edits the journal Strategies for Nurse Managers, maintains StrategiesforNurseManagers.com and StressedOutNurses.com, and writes articles within the industry. She can be reached at mucci@hcpro.com.

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