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I think I was let go from my position at a hemodialysis center because I pointed out errors in patient care. What can I do about it?

Monday December 17, 2012
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Question:

Dear Nancy,

Shortly after beginning a new job at a hemodialysis center, I noticed while auditing charts that one of the patients was positive for the hepatitis C virus. This is very common in hemodialysis units. What troubled me was the fact that none of the policies and procedures regarding the care of a patient with hepatitis C had been implemented.

Anyone testing positive for these bloodborne pathogens should be isolated or at least have a dedicated machine for his or her use only. Patients who test positive for hepatitis should be excluded from the reuse procedure. Reuse is a process in which a patientís artificial kidney is cleaned using special equipment and disinfectants, and then reused again. If a patient with a bloodborne pathogen were to participate in this process, there is a significant potential for exposure, for all patients using reprocessed artificial kidneys. This patient with hepatitis C had been participating in the reuse program for months.

I checked the patientís medication administration record and, to my surprise, treatment for his status had not been initiated or ordered. I immediately phoned the medical director of the clinic to tell him my findings. He was just as surprised.

Before this incident I was praised for my work ethics. Shortly after this incident, I received a pink slip. When I asked the reason for my dismissal, I was told, ďItís just not working out." I also was told that, at the end of a probationary period, an employer didn't have to give a reason for not wanting to continue a working relationship. What just happened here? I am struggling with which way to turn. Do I have any options?

Julia



Nancy Brent replies:

Dear Julia,

You need to contact a nurse attorney or attorney in your state who works in employment law and who can analyze your termination in light of your bringing the issue described to the attention of the medical director and the facility. It is not known whose decision it was to terminate you, but it is quite interesting that it took place after you revealed the situation to the administration in the facility.

Despite the fact that you were at the end of your 90-day probationary period, your state may have a statute that protects an employee who brings an issue of patient care to the attention of administration. Your termination may have been in retaliation (hence, a "retaliatory discharge") for sharing what you discovered with the administration. Such state statutes vary, so your attorney will need to advise you of what your options are.

A second issue the attorney may want to explore with you is whether this "oversight" (concerning the patient's blood status and the lack of follow-up) is something that can be reported to, as an example, the state agency that licenses hemodialysis centers. The procedures that were in place, but not followed, need to be addressed, as well as whether the policies are consistent with practice standards meant to protect other patients who use this facility's services.

In preparation for your meeting with the attorney, write out the timeline of your discovery, what you remember seeing and whom you contacted, so the attorney can advise you with the most factual and current information in mind. Also, if you have a contract of employment, an employment letter, a job description or an employee handbook, take those documents with you when you meet with the attorney.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.