Guest Columns

What it's like to be a nurse whistleblower

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Pam McNally
Pam McNally

Following a McKnight's column on whistleblowers, I wanted to write my response. I am one of the nurses who blew the whistle on unethical practices in my place of employment.  

I worked in a hospital acute care setting.  As nurses, or any licensed professional in the healthcare field, we are required by law to report unlawful or unethical conduct that we witness in the workplace, according to the uniform credentialing act. Failure to report violations may result in licensure discipline by the department of health and human services.  

In Nebraska, the Department of Health and Human Services has a website and forms to fill out online for healthcare workers reporting a colleague. The website stated that reports are confidential. This assured me that the narrative in my complaint would not be shared with my employer. That was not the case.  

The department of investigations within HHS sent my complaint, with intent to investigate, to me at my employer's address. I received the correspondence opened. I spoke with the postmaster, as I believed it was illegal to open another person's mail. It was not, since HHS sent the letter to my employer's address, not to my home address, which was on the form that I submitted to them.  

My second complaint was sent in its entirety to the very person whom the complaint was about, which was my boss. Both HHS employees were nurses. It is inconceivable to me that nurses would throw other nurses under the bus in this way, but that is exactly what happened.  Both of my complaints were Class 1 safety violations regarding improper use of narcotics.

I began experiencing retaliation, including but not limited to relational aggression, better known as bullying. According to the Nebraska Equal Opportunity Commission website, whistleblower retaliation falls within a protected class. After filing a complaint with EOC, I later discovered that whistleblowing in my case was not federally protected since I was not a federal employee.  State law in Nebraska was intended for state employees. Furthermore the EOC investigators are not medically trained and my testimony was very technical. It was clear that we, as medical professionals, needed additional legislation.  

State Sen. Brett Lindstrom heard our call and wrote a bill that would offer protection to nurses and other medical personnel for reporting unethical conduct or safety violations. The law passed, and in the state it replaces old verbiage in the Uniform Credentialing Act, and now makes clear that identities of reporters will not be released.  Although we have better protection against retaliation with the new whistleblower law, a nurse still must do their part to show that retaliation occurred.   

I am not an attorney and cannot offer legal advice but my tips to nurses include:  

  1. Document, document and document. Keep a diary if you start experiencing retaliation after whistleblowing. Often, in a case that is being investigated, it turns into a “he said/she said” scenario.   The human resource manager's No. 1 job is to protect the employer from litigation. They know exactly what to do and how to document to their advantage should litigation ensue.  
  2. Save emails and correspondence.  If you are dismissed from your place of employment, an attorney will need evidence to win the case. As in many states, Nebraska is an at-will state, meaning you can be fired for just about any reason. However, you cannot be fired for whistleblowing.   
  3. Remember what you say can and will be used against you, so it is wise to keep silent and not get into discussions with coworkers.  Always, state clearly to your HR manager that you feel you are being retaliated against and follow it through with an email. Emails must be saved by your employer for several years by law. Request that the retaliation stop and identify in writing the actions taken by your supervisor that showed retaliation. Include dates, times and witnesses. Write the incident as it happened, not your interpretation of the incident.  
  4. Always follow the chain of command. If this fails, you can file a complaint with EOC and ask for mediation. They may be able to intervene and help you remain employed.   
If you are an employer, there are steps to help diffuse a bad situation. In my case, I wanted the bullying and retaliation to stop. I had many discussions with Human Resources where a manager could have diffused the situation and turned conflict into connection.  

Here are some tips:

  1. A simple admission and apology often works at the beginning.  Acknowledging an employee's feelings goes a long way to produce conflict resolution.    

  2. Have a whistleblower policy and follow it. Offer mediation. It may save you time and money.  

  3. Have an ethics hotline that is manned by an outside agency that allows a person to report without fear of retaliation. In my place of employment, the hotline was internal, and allowed my employer to use it as a tool for retaliation. There was a 3.5 month long internal investigation into the complaint I made against my boss for practicing out of the scope of an RN.  Anonymous calls to the hotline started 1 day after the internal investigation concluded, all portraying me as an angry, disgruntled bully, supposedly by coworkers who should not have known the details of when the investigation concluded.   

In my case, I learned that none of the anonymous calls could be substantiated as they had no dates, times, witnesses or any identifying information that would allow a real investigation into the nature of the claims against me. I was placed under investigation by the CEO, harassed and threatened in the presence of HR.

I resigned, as my work life was intolerable, and it was clear that I was about to get fired. The EOC investigated my claims. The costs in employee hours and attorney fees, plus fines for violations can be astronomical. Had the situation been handled differently by the Human Resource department, the outcome may have been much different.

It is time for employers to stop blaming and discrediting professionals who simply follow the law and advocate for themselves and their patients.  It is unethical and ruins lives.  The simple rule of “do unto others” is a good place to start.

If you are a nurse, read the work of Cheryl Dellasega, NP, Ph.D., on the toxic culture in nursing.  As employers, a good understanding of the dynamics of what causes a nurse to blow the whistle can provide solutions and hopefully prevent negative outcomes. Mistakes happen, and taking accountability for them is essential. Taking time to educate your managerial staff and employees will lead to better interpersonal relationships and a higher rating of job satisfaction.   

When nurses are happy they work hard. They are loyal and seek out constructive ways to help their organization deal with conflict. In long-term care, Medicare and Medicaid cuts mean money needs to be saved now more than ever. Keeping a business viable includes mitigating the need for attorneys and dealing with nurse turnover.  

Pam McNally, RN, was a nurse in Nebraska who advocated for a state bill that protects nurse whistleblowers.

Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.