Lessons From Winning Cases

Two Nurses Who Spoke Up, Lost Their Jobs, and Sued

Carolyn Buppert, MSN, JD

Disclosures

April 08, 2016

In This Article

Lessons Learned

Suggestions for Hospitals

Hospitals and facilities can learn from these cases. Hospitals across the country are attempting to save on labor costs, and nursing is a hospital's highest labor cost. But efforts to reduce costs should be wary of targeting older nurses and those who speak up for patient safety. Costs of litigation and damage awards can erase any savings on salaries. Certainly, there is value to having both experienced nurses and nurses who are patient advocates, and it is damaging to staff morale when colleagues must resort to suing their employers over patient safety issues or discrimination.

Here are some suggestions for hospitals: Most nurses just want to continue to work, while feeling free to express concerns about the healthcare process. Listen to nurses who identify patient safety problems. Correct the problem, rather than ignoring it or covering it up. Don't fire the messenger. And don't alter or make up records after the fact. Landin's attorney Allweil says to employers, "The cover-up is worse than the mistake. Patients and families generally understand that mistakes happen. Deal with mistakes through insurance, not cover-up."

If supervisors are going to cite nurses for infractions to develop a paper trail so that there is basis for termination, hand out the citations to all nurses who commit the infraction. Otherwise, the fired nurse may have basis for challenging the termination. Reduction in staff is legal, as long as it doesn't focus on one age, gender, or racial group or on nurses who speak up about dangerous situations.

Suggestions for Nurses

In a perfect world, a nurse wouldn't need to consult an attorney before reporting a patient safety issue. However, given the ins and outs of state laws on public health, nursing, and employment, it would be prudent to consult with a local attorney before reporting a patient safety issue. Certainly, nurses who are fired after reporting a patient safety issue should consider consulting a local attorney. At minimum, research a nurse's responsibility to report patient safety issues in your state (start with the nurse practice act), any applicable national standards, the state's whistleblower law, the state public health code on standards of care, and the state public health code on reporting violations of the code. Usually, a nurse would begin by reporting a patient safety problem internally, but whistleblower laws may require a report to an outside agency. A nurse who reports a problem will want to protect his or her legal options if an employer retaliates, so knowledge of the law is important.

Nurse performance evaluations are important to the nurse's future career, and are integral to supporting a claim for retaliation. Take performance evaluations seriously, strive for great evaluations, and keep copies of the paperwork. If evaluations aren't good, strive to improve them. The nurse who has bad evaluations and also reports a patient safety problem won't have a strong basis for a retaliation suit.

These two cases are not the only cases nurses have won, but they are remarkable for the size of the damage award and the lack of regard of the employers for both the employees and for patient well-being. Ideally, facility managers and administrators, in their efforts to save money, will learn from these cases, and consider the unintended consequences of cost-cutting measures.

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