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Nurse Whistleblower Case Sets Dangerous Precedent

Rebecca Hendren, for HealthLeaders Media, February 9, 2010

I love movies like Erin Brockovich, where an ordinary person comes across something wrong and courageously decides to take action. I realize I am unlikely to uncover a nefarious plot to secretly dump toxic waste. If I did though, I'd hope to have the courage and fortitude to do something about it.

Most of us encounter the small, everyday acts of wrongdoing, such as the teenager bullying another child on the way home from school, or the coworker spreading malicious gossip. In such cases, it takes courage to step in and say something.

Some of us encounter issues that are much more troubling, particularly in healthcare when they concern patient care or someone else's competence, and ethics demands we do something about it. The American Nurses Association's Code of Ethics requires nurses to advocate for and protect the health, safety, and rights of patients. Which is what Anne Mitchell, RN, a former compliance officer at Winkler County Memorial Hospital, TX, says she was doing when she sent a letter to the Texas Medical Board last year.

Mitchell's side of the story is that she observed physician Rolando G. Arafiles Jr. displaying serious lapses in competence and judgment that put patients at risk. When she felt her hospital wasn't taking action, she reported the physician to the Texas Medical Board.

Arafiles alleges Mitchell filed the complaint to spitefully destroy his reputation and he asked the sheriff to investigate. Mitchell was charged with misuse of official information, a third-degree felony in Texas, because patient medical record numbers were included in the letter, although no patient names were used. Charges against a second nurse who helped write the letter to the Medical Board have been dropped.

The case has caused uproar in the small Texas town and has come to national prominence. Everything I know about this is based on media reports and press releases. So, for all I know, Mitchell's claims are completely unfounded and Arafiles has done no wrong. I would like the Texas Medical Board to come to that conclusion, however, not the local sheriff.

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