Hospice Patients Alliance: Consumer Advocacy


Although the public invests much trust in the nurses, doctors and social workers who provide health care services, some of them betray that trust by keeping silent when accurate information is needed. Why such a betrayal might occur is easily explained by financial concerns: keeping one's job or power or prestige in the agency.

It is well-known that cover-ups can occur when something goes wrong, in surgery, in the emergency room, in health care in general. Do all doctors readily admit their responsibility if they ordered the wrong medication or the wrong dosage for the patient who died unexpectedly? Do all nurses volunteer the information that they gave the wrong dose or medication to the patient? And when a social worker learns that a patient did not receive certain services which he or she should have, does the social worker (employed by the agency) immediately tell the patient that the agency made a mistake or exploited him??? ...or does the social worker look the other way and keep quiet?

While there are so many dedicated and honest health care workers, who do speak up and advocate to protect their patients... who do admit wrong if appropriate, there are also many who keep quiet when things are not done according to the standard. Those who honestly admit their mistakes may be looked upon as fools by those who cheat every day, and keep their jobs. Day after day we can read in the newspaper of terrible errors made in health care with resulting lawsuits. When the errors first occur, do the patients or families get full information from the agency? Rarely.

Do the hospitals refuse to allow certain doctors to admit patients when the hospital knows that the doctor is not fully competent. Not usually. Only when insurance companies threaten to raise the hospital's premiums would a hospital normally revoke a physician's admitting privileges. Why? Because the physician is a source of income to the hospital. By referring patients, the physician brings cases to the hospital and keeps things running smoothly, at least financially that is. As long as patients keep coming in, the hospital will keep quiet. When nurses complain about a surgeon whose death rate on the table is two times the other surgeons', does the hospital revoke the privilege of the physician? Not usually. Does that nurse who complained suffer from retaliation or get blackballed? Yes.

The reason there are so-called Whistle-Blower protection laws is that employers routinely harass, intimidate or terminate employees who honestly complain about problems. Some employees are even physically harmed. Putting the whistle-blower protection laws on the books does not assure protection for employees who make complaints about their employers. Employers have clever, tricky ways of getting around the law, harassing employees in ways that are difficult to document. Annoying them till they resign voluntarily and leave. The employer gets rid of an honest employee who the employer considers a troublemaker, but who is really a servant of the public and honest. Other employees see the retaliation that occurs and decide not to get involved...to keep silent.

How many nurses or other staff will risk losing their job, simply to speak the truth? Unfortunately, not that many. Many dedicated health care workers have left the field because of the lack of integrity and responsiveness in agency administrators. These health care workers who are leaving care, and because they care, they feel that they can no longer work in the field in good conscience, knowing what goes on.

While many leave the field, there are also many who remain dedicated to their tasks. They often pay a high price from the stressful environment. Nurses and nursing assistants have the highest rate of back injuries among all professions, and when a nurse injures her back seriously, her career is often finished. But complain about the lack of help (due to understaffing ) in transferring patients, and you could get labelled a troublemaker. So injuries continue to occur. While disabled and injured police officers are supported by community fund drives, injured nurses are discarded by the agencies and forgotten. And then if the injury is work-related, the agency plays games to avoid paying workers' compensation benefits. The nurse may end up destitute or completely disabled.

This is not the picture which public relations experts will paint in the media, but it is the hidden side of health care...hospice included. Health care workers keep silent and simply hope to survive.

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