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Nurse Whistleblower Case Sets Dangerous Precedent

 |  By rhendren@healthleadersmedia.com  
   February 09, 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.

Both the ANA and the Texas Nurses Association have vigorously protested the prosecution and have been raising money for the nurse's legal defense. The ANA reports the Texas Medical Board has also protested the prosecution, complaining that it is improper to criminally prosecute someone for raising complaints with the board; that the complaints were confidential and not subject to subpoena; and that under federal law the Texas Medical Board is exempt from HIPAA.

The case sets a dangerous precedent for future whistleblowers. Now they'll risk their jobs and even prison time if they speak out. And it's a warning for healthcare leadership about handling complaints about physician or nurses. Caregivers must feel they can bring concerns to the appropriate people in their own organizations, and that cases will be investigated thoroughly and fairly. In light of the incident in Texas, hospitals should examine their policies to ensure concerns are properly addressed internally.

Meanwhile, Mitchell is being threatened with 10 years in prison for doing what she felt was right.


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Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits www.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.


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