I haven’t dropped the mission with Amanda.
There have been a few technical problems, though.
Amanda is in the process of creating a timeline of events that have occurred since the incident. I have been piecing together responses from organizations that have responded to the issue and will add those to the timeline. Thus far, I am disappointed in some of the responses from the Arizona Board of Nursing. If you have more information about Amanda’s case, e-mail it to me.
I have also done some research on several of the people involved in the firing and investigation. I can’t post their names here, though.
I have also received multiple documents from several sources that I will also post.
The problem is that I have been asked not to post the material on this blog. There were several reasons for this request, and I agree with the reasons and have agreed not to post the material here as a result. One reason that was raised was that the problems that Amanda is facing do not involve emergency medicine physicians and do not involve emergency medicine in general. This was a problem that occurred with inpatient medicine and surgical informed consent. Emergency Physician’s Monthly magazine has a focus on emergency physicians. I agree with that.
I think that the issues involved in Amanda’s case cut across all aspects of medical care.
If a patient hasn’t received informed consent or doesn’t understand the informed consent, to me, that’s not a “floor medicine” issue, that is an issue that affects patients in every aspect of medical care – including emergency medicine.
If a staff physician had a temper tantrum in front of patients and staff and is otherwise disruptive, to me, that is not just a floor medicine issue. Disruptive physicians affect every aspect of medical care. They make other staff afraid to do their jobs for fear of the next tantrum or … of losing their jobs. If physicians are disruptive on the medical floors, they will be disruptive in the operating rooms and disruptive in the emergency departments as well. Most hospitals have a code of conduct that must be followed. That code must be followed everywhere, including the emergency department. This is a team sport.
If a nurse has gone outside the scope of her nursing license, that isn’t a floor medicine issue, to me, that is another issue that affects every aspect of medical care – including emergency medicine.
If a hospital trumps up charges against a medical provider due to political pressures, that tendency doesn’t stop with floor nursing, with nursing in general, or even with physicians. Inappropriate administrators should be investigated just as much as inappropriate medical staff.
If a state nursing board has to hide its review of a nurse’s actions and has to threaten a nurse’s licensure for disclosing facts about the investigation, to me, that is facially suspect and flirts with constitutional due process violations. The same issues could happen just as easily to an emergency medicine nurse and I have first hand knowledge of similar things happen to emergency medicine physicians.
So, yes, Amanda is a floor nurse and this issue did not happen in the emergency department. However, the underlying procedures involved with this case transcend specialties. When medical professionals stop questioning the process, we lose as a profession, not as a specialty and not as a class or providers. When we stop investigating the potential for nepotism and conflicts of interest to assure that any disciplinary process is fair, everyone loses.
I still don’t have enough information to conclude one way or another whether what Amanda did was correct. But the fact that the parties investigating her actions won’t release any information and have allegedly threatened Amanda in order to prevent her from disclosing the allegations against her and the investigations involved makes me wonder what those parties are hiding.
In order to pursue this issue and to help other bloggers in the process, I am starting another independent blog. I’m not leaving EP Monthly, but I am going to independently publish information on this other blog about Amanda’s case. I’m also going to provide an open platform to other medical bloggers who want to blog – either anonymously or in their own name. We’ll compile our stories and write about random unidentifiable patient scenarios so that there can be no claims of “HIPAA violations” by administrators, lawyers, or anyone else. De-identified information is not and has never been subject to HIPAA laws [see 45 CFR 164.502(d)].
Want to blog? Drop me an e-mail at whitecoatrants (at) Google’s e-mail service dot com and I’ll sign you up.
Medbloggers.org is registered and will soon be live.