The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital (52 page)

charging them with “misuse of official information” . . .
Editorial,
The New York Times
, February 10, 2010.

Charges against one of the nurses
See, for example, Betsy Blaney, “Ex-County Lawyer’s License Suspended,”
APNewsBreak
, February 2, 2012.

filed a federal lawsuit . . . won a $750,000 settlement
Ibid.

the sheriff, who lost his license . . . one-hundred days in jail
Ibid.

county attorney, who was sentenced to ten years’ probation
“Retaliation case merits stiff sanction,”
San Antonio Express-News
, February 10, 2012.

Arafiles pleaded guilty . . . five years’ probation
See, for example, Betsy Blaney, “Texas Doctor Pleads Guilty in Retaliation Case,” The Associated Press, November 7, 2011.

As part of his plea agreement, he surrendered his medical license
Texas Medical Board. Public Verification/Physician Profile; Ibid.

charging him with several additional violations of improperly treating patients and intimidating the nurses . . . monitored by another doctor
Mary Ann Roser, “New Texas Law Bans Anonymous Complaints about Docs.” The Associated Press State and Local Wire, September 20, 2011.

Texas Legislature passed a bill . . .
“Justice Doesn’t Always Have Happy Ending.”

and protecting those nurses from criminal liability
. Betsy Blaney, February 2, 2012.

In 2011, another Texas law . . .
“New State Law Bans Anonymous Complaints Against Physicians,”
FierceHealthcare
, September 20, 2011.

An examination of policies and calls
Calls to every state nursing board. Arizona would be a forty-second state, but its policy is hazy. A spokesperson said, “The Arizona Board of Nursing does accept anonymous complaints, but the contact info of the complainant needs to be given to the assigned investigator. The complaint remains anonymous to the nurse.”

a nonpartisan Texas citizen advocacy organization
http://www.texaswatch.org/about
.

“It is shameful that nurses . . .”
Interview with Alex Winslow by Eaves.

“intimidating and disruptive behaviors”
The Joint Commission, “Behaviors That Undermine a Culture of Safety.”

afraid the doctor will yell at them
See, for example, Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety,”
The Joint Commission Journal on Quality and Patient Safety
34, no. 8, August 2008; Interviews.

Nurses have reported . . . confrontation with a physician
Alan Rosenstein and Michelle O’Daniel, “Impact and Implications of Disruptive Behavior in the Perioperative Arena.”

Approximately half of surveyed respondents . . .“intimidation clearly played a role.”
“Unresolved disrespectful behavior in healthcare.”
ISMP Medication Safety Alert
. October 3, 2013;
ISMP Medication Safety Alert:
Intimidation: Practitioners Speak Up About this Unresolved Problem (Part I).” March 11, 2004.

many OR nurses are too intimidated
See David Maxfield et al.

Despite mandatory safety protocols like checklists . . .
See, for example, Julia Edwards, “Nurses Afraid to Speak Up When Doctors Slip Up,”
The National Journal
, March 23, 2011.

more than 80 percent of nurses . . . “and disrespect” at their hospitals
. “New research shows communication breakdowns in hospitals undercut the effectiveness of safety tools and negatively impact patient outcomes,” AORN/Vital Smarts press release, March 22, 2011.

Of the nurses who admitted . . . 83 percent did not report the violation
See David Maxfield et al.

Rhode Island Hospital in 2007. . . which side was correct
Michelle R. Smith, “Brain Surgery Errors Rack Up at Prestigious R.I. Hospital.”
The Virginian-Pilot
, December 15, 2007.

most likely to jeopardize patient safety
Carla Johnson, “Group Calls for Zero Tolerance of Doctor Bullies.” Associated Press Online, July 9, 2008. For more information on these issues, see Shellie Simons, Roland B. Stark, and Rosanna F. DeMarco, “A New, Four-Item Instrument to Measure Workplace Bullying.”
Research in Nursing and Health
34 (2011). See also Arminee Kazanjian, Carolyn Green, Jennifer Wong, and Robert Reid, “Effect of the Hospital Nursing Environment on Patient Mortality: A Systematic Review,”
Journal of Health Services Research and Policy
10, no. 2 (April 2005).

Botched communications
See, for example, Alan H. Rosenstein and Michelle O’Daniel, “Impact and Implications . . .”

More than two-thirds . . . or patient deaths
See, for example, Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .”

63 percent of cases . . . communications failure
The Joint Commission, “Sentinel Event Data Root Causes by Event Type 2004–2013,” April 15, 2014.

“the most significant factor . . . communication”
Arminee Kazanjian et al.

patients die unnecessarily
Ibid.

the mother of a toddler . . . to follow up with him
. Lisa Rosetta, “Abuse Protection Sought for Healthcare Workers,”
Salt Lake Tribune
, October 21, 2009.

“We tried to stop the doctor . . . an advocate for the patient.”
David Maxfield et al.

“Failure of MD to listen . . . outcome in newborn.”
Alan Rosenstein and Michelle O’Daniel, “Impact and Implications . . .”

“When a nurse reported . . . safety and well-being.”
L. L. Veltman, “Disruptive Behavior in Obstetrics: A Hidden Threat to Patient Safety,”
American Journal of Obstetrics and Gynecology
196 (2007).

attending surgeons are . . . disruptive behavior
. Alan Rosenstein and Michelle O’Daniel, “Impact and Implications . . .”

Doctors and nurses . . . neurologists
. Ibid.

The hospital departments most likely
Ibid.

three-quarters of doctors . . . affects patient care.
Owen MacDonald, “Disruptive Physician Behavior,”
American College of Physician Executives.

“despite the best efforts of many . . .”
Barry Silbaugh.

“I could teach a monkey . . .”
Interview.

Up until the mid-twentieth century . . . wait on him.”
Leonard Stein, “The Doctor-Nurse Game,”
Archives of General Psychiatry
16 (June 1967).

In 1967 . . . penis envy.
Ibid.

“Nurses have spent . . . hate each other?”
Rahul Parikh, “Do Doctors and Nurses Hate Each Other?”
Salon
, May 30, 2011.

“A couple of the nurses . . . got the point.”
Interview.

“Female doctors”
Interview.

Nurses have continued to battle . . . instructors are nurses
. See, for example, Rahul Parikh,
Salon
.

“Nursing school . . . to be a physician.”
Ibid.

Kevin Pho . . . carry that attitude into the workplace.”
Kevin Pho, “Theresa Brown Unfairly Blames Doctors for Hospital Bullying,”
KevinMD.com
(blog), May 7, 2011.

doctor bullies blamed a heavy workload . . .”
ACPE survey; see also “Reader Consult: Does the Culture of Medicine Enable Bad Behavior?”
WSJ Health
(blog), May 25, 2011.

“Surgeons have learned . . . behavior by observation.”
Alan H. Rosenstein and Michelle O’Daniel, “Impact and Implications . . .”

“culture of disrespect among healthcare providers”
“Intimidation: Practitioners Speak up About this Unresolved Problem (Part I),”
ISMP Medication Safety Alert
, March 11, 2004.

In October 2014 . . . Ebola from a patient
See, for example, Alice Par, “Nurses ‘Infuriated’ by Suggestion of Dallas Ebola Protocol Breach,”
Time.com
, October 14, 2014.

“Dr. Thomas Frieden . . . breach in protocol.”
Rebecca Kaplan, “CDC Chief on Second Ebola Case: There Was a Breach in Protocol,”
Face the Nation
,
cbsnews.com
, October 12, 2014.

National Nurses United . . . to an isolation unit
See, for example, “Dallas Nurses Accuse Hospital of Sloppy Ebola Protocols,”
abcnews.com
, October 15, 2014.

protective gear left their necks exposed
See, for example, Saeed Ahmed, “Ebola Outbreak: Get Up to Speed with the Latest Developments,”
CNN Breaking News
, October 14, 2014.

Frieden later said . . . misconstrued.
See, for example, “CDC: Nurse not to blame for breach of protocols in Ebola infection.”
Nurse.com
, Oct. 16, 2014.

“There’s a lot of outrage . . . blame the nurse again.”
Nancy Shute, “Nurses Want to Know How Safe Is Safe Enough with Ebola,”
npr.org
, October 14, 2014.

At Vanderbilt Medical Center in 2013
Kimberly Curth, “Vanderbilt Medical Center to Have Nurses Cleaning Up.” WSMV TV, Nashville, Tennessee, September 6, 2013.

half-and-half
“Will Work for Half-and-Half,”
Emergiblog
(blog), July 14, 2012.

Nearly 40 percent of doctors
ACPE study. The Joint Commission’s Sentinel Event Alert, July 9, 2008.

As of 2015 . . . to earn a doctorate.
See, for example, Gardiner Harris, “Calling More Nurses ‘Doctor,’ A Title Physicians Begrudge,”
The New York Times,
October 2, 2011.

Nurse leaders say . . . respect in the medical field
. Ibid.

physicians have turned the debate . . . endangers patients
. See, for example, Cindy Borgmeyer, “AMA Delegates Oppose DNPs as Medical Team Leaders,”
AAFP News Now,
June 25, 2008; Amy Lynn Sorrel, “AMA Meeting: Physician Supervision of Nurses Sought in all Practice Agreements,” June 29, 2009.

They argue that . . . confuse patients
See, for example, “American College of Physicians Response to the Institute of Medicine’s Report,”
Journal of the American College of Physicians,
November 1, 2010; Jeremy Olson, “U Program Turns out ‘Doctor Nurses’ but the Name Ruffles Some Doctors,”
St. Paul Pioneer Press,
June 21, 2008.

an attempt to equate . . . medical training
. See, for example, Cindy Borgmeyer, “AMA Delegates Oppose DNPs as Medical Team Leaders,”
AAFP News Now,
June 25, 2008.

loudly protested the DNP . . . dentists, and podiatrists.
“ANA Letter to AMA on HOD Resolution 303 (A-08) Protection of Titles ‘Doctor,’ ‘Resident,’ and ‘Residency.’” Targeted News Service, June 11, 2008. Interview with AMA spokesperson. See also Resolution 232, AMA Resolutions, June 2008.

Eventually . . . physician
Interview with AMA spokesperson. See also Resolution 232, AMA Resolutions, June 2008.

Nurse practitioners say . . . the field
. See, for example, Mary Anne Dumas, president, National Organization of Nurse Practitioner Faculties, “Letter to the Editor,”
American Medical News,
August 18, 2008.

more time to spend with patients and charge less for their services
. “28 States Consider Expanding Nurse Practitioners’ Duties,”
American Health Line,
April 14, 2010.

“essentially the same” health
See, for example, Carla K. Johnson,
The Virginian-Pilot
(Norfolk, VA), April 18, 2010. See also “Research from Drs. Linda Aiken, Carole Estabrooks, and Others Have Established a Clear Link Between Higher Levels of Nursing Education and Better Patient Outcomes.” Doctor of Nursing Practice (DNP) Talking Points. American Association of Colleges of Nursing, October 2009.

nineteen states and the District of Columbia
Interview with AANP spokesperson. In these areas, NPs can “evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the state board of nursing,” according to the American Association of Nurse Practitioners. Other states require oversight of NPs.

Nurse-owned practices . . . expected to grow.
Peter McMenamin, “In 2011 in Every State Thousands of Medicare F-F-S Beneficiaries Were Treated by an APRN,”
ANA NurseSpace,
January 2, 2013.

looming physician shortage in the United States by 2020
See, for example, Chen May Yee, “A Doctor and a Nurse, All in One Package,”
Star Tribune
(Minneapolis), April 27, 2008. See also Samuel Weigley et al. “Doctor shortage could take turn for the worse.”
24/7 Wall St.
usatoday.com
, October 20, 2012.

“The medical profession . . . in the United States.”
Interview.

“code of conduct” . . . managing those behaviors
. The Joint Commission
Sentinel Event Alert
40.

“moderate improvement”
Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .” See also Julia Edwards.

In 2005 . . . quarter of these nurses
. David Maxfield et al. “The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives.” VitalSmarts, AORN Journal, and AACN.

only 41 percent . . . “greatest negative impact.”
Ibid.

TJC continues to receive
“Workplace Bullies Can Undermine Safety,”
Occupational Health Management
, March 1, 2010.

“there are still large, disconcerting”
Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .”

“Tempo!”
“Workplace bullies can undermine safety.”

red phones at each nurses station
Interview.

Nurses in a New Brunswick, Canada, hospital . . . in support.
“Needed: Happy Endings in Workplace Bullying Cases,”
The Times & Transcript
(New Brunswick), May 13, 2010. Code Pink in many hospitals refers to infant or pediatric abduction.