Winkler County nurse 'not guilty' after reporting former Victoria physician
Chilling Effect?: Local medical professionals talk about future of reporting patient care concerns
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NURSE CASE
To see how the Winkler County nurses' case progressed, visit www.texasnurses.org.
Victoria nurse Katrin McDonough has closely watched the case of two nurses charged with doing what they were trained to do - watch out for the patient.
In June, two West Texas registered nurses anonymously reported a former Victoria doctor to the Texas Medical Board because of concerns over the physician's standard of care in Kermit.
Anne Mitchell and Vicki Galle were indicted on charges of misuse of official information with intent to harm Dr. Rolando Arafiles.
Arafiles filed a harassment complaint with the Winkler County sheriff and he conducted an investigation to find out who had written the report.
Ultimately, Galle was dismissed Feb. 1 and a jury found Mitchell not guilty on Feb. 11.
That nearly nine-month roller coaster ride was enough to keep nurses on their toes, said McDonough, a Citizens Medical Center registered nurse.
"No nurse, if this is her bread and butter, is going to want to risk her license," she said. "We're all fired up."
THE CHILLING EFFECT
Both nurses worked at the Winkler County Memorial Hospital with Arafiles, who also worked at the Winkler County Rural Health Clinic in Kermit.
Between 1998 and 2002, Arafiles had a family practice and worked in Victoria, said David Brown, Citizens Medical Center CEO.
Though McDonough did not know Arafiles, the case hit home both as a nurse and Victoria resident.
"We hear all the time about doctors not policing themselves. Nurses have the right to refuse if they think it's going to be harmful. We are taught that in nursing school," she said.
Mitchell and Galle had concerns over Arafiles' use of non-therapeutic treatments and prescriptions.
Arafiles had adopted some therapies that were less well known by most of medicine, Brown said.
"He was not a physician that we would include in the mainstream of physicians in Victoria," Brown said. "He did very little hospital work and mostly did outpatient things, and probably explored the perimeter."
It would be a problem if patients were guided to alternative medicines rather than what is traditionally followed, Brown added.
"My instincts told me the nurses did the right thing," he said.
The case was chilling for the medical community to follow, but this is why the Texas Whistleblower Act is in place, he said.
For McDonough, the real chill effect is what the nurses went through to show the system worked.
"Nurses are not going do something if you've got a DA out there that's going to press charges against you for doing what they are suppose to do," she said. "I'm glad it worked out in their favor."
THE EMPOWERING EFFECT
The conclusion of the trial is enough to restore Lisa Campbell's faith in the system.
The Victoria registered nurse is in the process of receiving her doctorate in nursing practice and was also fired up when she first heard how far the case was going.
"It (the jury's decision) sends a clear message to the public that nurses will continue to perform their duty and protect them," she said.
That is the exact message being sent out to nurses nationwide, said Jim Willmann, general counsel for the Texas Nurses Association.
It just took two veteran nurses to prove that.
"I think nurses should be reassured by the fact that the jury clearly recognized the nurses' duty to advocate for their patients," he said.
The ethic of patient safety and advocacy is, and will always be, the basis of what is taught in nursing school, said Kathryn Tart, founding dean and professor at the University of Houston-Victoria School of Nursing.
Undergraduate and graduate students have followed the case in their classes to see a Whistle Blower case in action, she said.
"Nurses should be proud of this profession," she said.
If Mitchell had been found guilty, years of building a strong ethical foundation would be called to question, she said.
Instead, a nurse's role has been made very clear.
"It's not chilling at all," she said. "I think it's empowering."
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saw216 what does what you typed have to do with anything other than the fact that they are nurses and not doctors? I mean stating the obvious or just nothing else to do?
February 20, 2010 at 9:26 a.m.To Flier
Thanks for your comments.
Something is very wrong in America when nurses can be criminally prosecuted for what these two nurses did. It is an outrage.
The silence of all of organized medicine (except for the nursing associations) tells me that this prosecution did not offend organized medicine enough for it to take action.
The failure of any groups of doctors or hospitals to stand up for these nurses and stop this absurd prosecution is disturbing. How can we believe that any part of organized medicine really cares about the public health or justice?
I am not suggesting that every doctor stop treating patients to issue a press release. But shouldn't we have expected a few hundred to speak up?
If they will not speak up about this case, when will they? Does organized medicine only speak up when its income is at stake?
How can we avoid that conclusion?
Lee Tilson
rethinkingpatientsafety@gmail.com
www.rehtinkingpatientsafety.com
February 19, 2010 at 4:13 p.m.I sincerely hope the Winkler County DA has someone running against him in the upcoming elections. This is a case that NEVER should have gone to trial and the good citizens of Winkler County need better representation in the DA's office.
February 19, 2010 at 12:15 p.m.Lee
February 19, 2010 at 9:53 a.m.I would like to address your comments. From what I understand the Board of Medical Examiners contacted Winkler Co. regarding the nurses and said they had a right to report the doctor. In other words they did nothing wrong in their actions! They reported him anonymously. It is our duty to report substandard or dangerous care. I am not sure if the TMA made public comment or not, yes the head of AMA is actually a graduate of UTMB Galveston and very progressive. The nurses are herons for protecting patients from substandard care. This doctor had stipulations on his medical license, had to leave New York related to stipulations. Yet the hospital in Kermit, Texas hired him because there was no one else! That is a crime in my opinion.
There are barriers to doctors policing their own. One is substandard doctors in my opinion are like bullies or thieves, and they threaten to sue if they get reported. Worse yet they retaliate against those they suspect report them. As is the case with these nurses! Nurses have always policed their own; maybe that is why we are the most trusted group of health professionals in the United States. We do not want to be doctors, but we are all smart enough to recognize substandard and dangerous care! Thanks
BOTTOM LINE!!!! YOU ARE NURSES AND NOT DOCTORS!!!! IF YOU WANT TO BE A DOCTOR THEN GO TO MEDICAL SCHOOL!!! IF YOU ARE KNOW SO MUCH THEN WHY DON'T YOU HAVE MD BEHIND YOUR NAME INSTEAD OF RN?????????????????
February 18, 2010 at 9:29 p.m.The prosecution of these brave nurses was a complete tragedy. I applaud them. I admire them. I appreciate them.
As the nursing associations staunchly supported these women, the rest of organized medicine abandoned them. What we heard from the other groups, the doctors and professionals charged with policing our healthcare system was silence. Deadly silence. The silence that allows bad doctors to practice. The silence that looks away when the eyes see bad medical care. The silence that allowed this doctor to continue practicing a bizarre pattern of medicine.
We know this silence. Evil needs silence to continue. That the only people who were unwilling to remain silent tell me more than I wish I knew.
We all hear a lot about tort reform. How about this tort reform: ending the silence. Could we ask that physicians learn from these nurses?
The greater tragedy is that in our enormous country, with all the state medical associations, professional associations and many thousands of hospitals, not a single one stood up for these nurses. Not one. Not one organization said: "If we want to keep patients safe, we need to ensure that observers of unsafe care who are willing to report it, can report it."
If I am mistaken, I ask that you let me know so that I can correct the following statement, I cannot find a single organization of medical professionals other than nursing associations that supported these nurses. Is it any wonder that there is so much malpractice?
Isn't the current president of the AMA from Texas? Did he not know about this?
The loudest and most disturbing message in this case came from those non-nursing medical organizations. The content of the message was:
We don't even care enough to say anything.
By failing to stand up for patient safety by supporting these nurses, organized medicine told all of us the patients that while they may about us, they do not care enough to speak up. They do not care enough to even give one "attaboy" or "you go girl" to the nurses who risked everything for our safety.
This is a big salute to the Kermit, Texas, nurses Vicki Galle and Anne Mitchell. Thank you for having more guts and more integrity than all the rest of organized medicine. You have set an example for everyone else.
Lee Tilson
February 18, 2010 at 8:33 p.m.Detroit
rethinkingpatientsafety@gmail.com
http://www.rethinkingpatientsafety.com