Injured patients who want to help and be heard,
click here.
Thomas Jefferson said that given the choice between
government without newspapers and newspapers without government, he would choose
newspapers.
In medicine we have government without newspapers. Patients
cannot find out what they need to know to make informed choices. No one in
medicine records or reports the information patients need to know the most. So
patients will have to do it.
Loyalty
Donald Trump said that there is nothing worse than disloyalty. He said that disloyal people are no good, never will be any good and all you can do is get rid of them. So it's not as though healthcare is alone in
enforcing the importance it places on loyalty.
The choice for healthcare workers is between being loyal to colleagues or
protecting patients - another of the conflicts of interest between providers and
patients. The fact that healthcare workers are the least likely of all
people to report crimes committed against patients tells you who they protect.
Patients need someone
who is loyal to them. A community that won't even report crimes
committed against patients cannot make a legitimate claim for the well being of
patients being their first priority. They repeat and believe that it is, but the
statistics reveal that that is a self-serving delusion. Their desire to protect
their careers and their colleagues and their businesses trumps the well-being of
their patients virtually every time. They don't report crimes. They don't report
errors. They don't report incompetence. They don't report colleagues with
substance abuse problems. And they don't recognize the fact that they don't.
While covering things up, they do not see themselves as doing what they are
doing.
Reporting is not tolerated in medicine.
For instance, see Silencing.
Consider this example. At the Jones Memorial Hospital in Wellsville, New York, Gary
Ogden, M.D. was drinking the equivalent of 20 shots a day. He had been doing
this for years and everyone knew about it. The nurses had talked among themselves and
decided to say nothing. Not only did everyone know about it, but they had discussed
it. They had arrived at a decision. They had decided to remain silent.
Finally, a baby died. One nurse, Rose Mary Vossler,
couldn't live with it any longer. She didn't think it was her responsibility to
say anything (so much for nurses being patients' advocates), but to the
appropriate person she said that she had smelled alcohol on his breath. She had
hoped to keep her action secret, but people figured out who had talked. They
bullied her and bullied her until she quit without even having
another job lined up.
For one of the reasons for why things are this way, click
nurse training
After she had told me about this, I asked her if she thought there that there might be a wall of silence in medicine. She
said she had never thought about that before but supposed that there must be one because otherwise how could Dr. Ogden have gone on the way that he did for as long as he did with everyone knowing about it but
no one doing anything about it.
This is a typical level of awareness in medicine. When asked about a wall of silence, her own did not cross her mind. She had said that the nurses had talked among themselves and decided to remain silent. It had been discussed. It had been agreed upon. When that is not recognized as a
wall of silence, even by a hero who sacrificed her career and social standing in a small community to protect
patients, consider how far from consciousness it is for everyone else in medicine.
"The nurses had agreed to remain silent"
". . . had talked among themselves and decided to say nothing."
That is the intentional erection of a white wall of silence. Yet the people who erected it do not believe there is a wall of silence.
This disconnect between belief and reality is pandemic in medicine. They insist that their perspective is the only true, objective one
when really it is inaccurate, self-serving and dangerous for patients.
She said another doctor in the hospital had the authority and
the responsibility to do something but he said that he couldn’t because he was
Ogden’s friend. Whether it is the result of friendship, loyalty, consensus or
automatic, unthinking routines it still is a wall of silence. Problems will not
be corrected and patients will die, and even be murdered, because of how silence
enables that. Years of alcoholism without anyone reporting it? It is usual for
an OR nurse to assist on as many as 2000 operations per year. How many thousands
of patients were operated on by the inebriated surgeon without one of the other
people involved in reporting it? The one who finally did was mobbed and bullied
and, in the end, excommunicated for it. There should be a patient safety
initiative that runs to the aid of people like her, and like
Anne Mitchell, RN and Vicki Galle, RN.
By and large, journalists learn about medicine by
interviewing healthcare professionals, not injured patients,
and healthcare professionals do not report things like walls of silence.
I asked her other questions from my survey of nurses as well. She has never filed an incident report with a state board or
agency, not even about this problem, and wouldn’t step forward again if
confronted with another situation like this. "It’s not worth it," she said. So
another of the heroes of patient safety has been silenced.
Eliminating or silencing those who speak
is an evolution that
leaves a dangerous brew
Gary Ogden still is her friend and is not bitter, but her
former coworkers are bitter and are not her friends. She no longer can work in healthcare.
Mobbing and bullying like this is status quo in nursing. Australia and the United Kingdom have laws against it. In the USA there isn't
even awareness of it.
In other countries there are support groups and websites about it. A search on
the words mobbing bullying nurse will
provide a list of sites and references. Clicking on
mobbing and bullying or the "next page"
button below opens a page on this site with a bit more about it.
By the way, an injured patient in England asked me to mention that even though
there are laws against it in England, those laws never are enforced. We would
have been surprised if they had been, but we still would like to see at least an
acknowledgement of the problem made by some kind of official sanction against
it.
If you want to say something about any of my
sites, my phone number is on almost every page. So is my
email address. There even
are Feedback Forms where you can communicate
anonymously. I am listening. I will be sensitive to what you say.