My blogs have moved to www.nursingattorney/b. I have not posted in a while because we were busy setting up the new blog site. I hope that putting the blogs on my website will help readers navigate the blogs and the articles. Let me know what you think.

Tort Reform's unexpected impact on nurses

The National Council of State Boards of Nursing met August 12th – 14th in Philadelphia. Approximately 300 Boards of Nursing executives and member delegates as well as interested organizations were present. During a discussion of Discipline Texas reported that since the state tort reform caps on punitive damages was passed in 2003, aggrieved consumers are turning to the licensing boards to seek redress and licensee sanctions. This is particularly troubling, given the varying burdens of proof between a court of law and an administrative proceeding. (Thanks to Rosemary for this update).

What this means is that previously when patients were unhappy with their care, they would sue in court but now they are reporting the health care professionals to their licensing boards because it is too difficult to sue for malpractice now. But do not think that this means that you do not need malpractice insurance--remember that malpractice insurance covers more that lawsuits and one of the major reasons to have coverage is for legal representation before the Board of Nursing.

Just a Thought

Whenever I feel blue, I start breathing again.

I know...nurse humor!!

Additional Information about the Fired Nurses

This information was received from the Texas Nurses Association (where a legal defense fund has been set up): "A brief summary of the facts is:



1. Vicki and Anne had concerns about whether a physician was practicing at an acceptable standard of care. They tried to raise those concerns at the facility level and with medical staff but got nowhere.

2. They were accused of anonymously reporting the physician to Texas Medical Board (TMB). That report included the medical record case numbers of six patients but no patient names. They did not sign the letter, stating they feared for their jobs, but that they would speak with an investigator at the appropriate time if an investigation by TMB was determined to be warranted. In the report, one of the nurses described herself as being a female over 50 years old and employed at the facility since the 1980s, etc.

3. The hospital apparently has a policy of “Self-Review” which prohibits the reporting of any concerns to any Board/Agency without the hospital being notified of the intent to report.

4. When the TMB notified the physician that a complaint had been filed against him, the physician filed a complaint for harassment with the county sheriff’s department against the unknown persons making the report.

5. The sheriff interviewed all of the patients whose medical record case numbers were listed in the report. Apparently, either TMB or the sheriff used the case numbers to obtain the patients’ names from the hospital to determine who filed the complaint. The sheriff also asked the hospital to identify who would have had access to the patient records in question. At some point, the sheriff obtained a copy of the anonymous complaint from TMB and used the description of a female over 50 to narrow the potential complainants to Vicki and Anne. He then got a search warrant to seize their work computers and found a copy of the letter to TMB on one of them.

6. The nurses have been indicted and arrested under Texas Penal Code Sec. 39.06 for misuse of official information a, third degree felony, which carries potential penalties of two-to-ten years’ imprisonment and up to a $10,000 fine.

7. Both had to retain legal counsel and post a $5,000 bond to defend these criminal charges.

8. Both have been fired by the hospital."

What Are They Thinking?!?!?!

The American Nurses Association and the Texas Nurses Association issued a press release on July 16, 2009 and here is part of it: "Winkler County Memorial Hospital nurses Anne Mitchell, RN and Vicki Galle, RN, were charged with violating the law by sending an anonymous letter to the Texas Medical Board that expressed concern about a physician at the hospital. After receiving a complaint of harassment from the physician, the Winkler County Sheriff’s Department initiated an investigation that resulted in criminal charges against both nurses.

Because the two nurses worked for a county hospital – and included medical record numbers of the patients in their reporting (no patient names were disclosed) – the County Attorney’s office indicted them on misuse of official information – a third-degree felony that carries potential penalties of two-to-ten years’ imprisonment and a maximum fine of $10,000. Mitchell and Galle, both long-time nurses at the hospital, were fired from their positions."

I will have to assume that since the Medical Board, ANA and TNA all are in support of the nurses that there is validity to the complaints. There have been malicious reporting to the Boards to "get back" at practitioners, but we have to be careful not to sway into discouraging a way to have nurses advocate for patients. That said and assuming that there are standard of care issues, I find it incredible that nurses are being vilified for advocating for patients. Nurses have a duty to advocate for patients. Too often a complaint to the Medical Board is the only way to protect patients because hospitals refuse to recognize dangerous physicians because the physicians are revenue resources for the hospital (and often in small towns for the town). To say that these nurses misused official information appears to be a ridiculous stretch and it causes one to question the real reason behind the actions against these nurses.

If you want to vocalize your opinions the contact information for the Winkler County Attorney's office which was obtained online is:

COUNTY ATTORNEY, Scott Tidwell,
COUNTY ATTORNEY, Belle Armendariz
100 EAST WINKLER, SECOND FLOOR COURT HOUSE,
KERMIT, TX 79745 OR
CO. ATTORNEY, P.O. BOX 1015, WINKLER COUNTY,
KERMIT, TX 79745

(432) 586-2596 (432) 586-3535