Her Name was Kimberly Hiatt - And She Was A Good Nurse

6/28 Author's Update:  After sleeping on it, this post has been edited several times through the course of the morning, and slightly expounded upon.  As I've re-read and played with the text - adding links as the whim arose, I realize that it sounds incredibly bitter.

And I just don't care.

A nursing colleague of mine pointed me to this story on MSNBC today - about a Seattle Pediatric Critical Care nurse who was fired after making a medication mistake that may (or may not) have contributed to the death of a medically-fragile baby.  She accidentally gave a cardiac patient ten times the normal dose of calcium chloride, and the infant died five days later.

The nurse reported her mistake immediately.  She cooperated with hospital and state investigators.  By all accounts, she was a stellar employee/nurse with glowing reviews, and this was her fist major mistake after over two decades of nursing.

The child's prognosis (the baby apparently suffered from a complex congenital heart defect) was poor to start with.  The attending cardiologist was very quick to throw the nurse under the bus (uber predictable), but it's not clear the overdose had any direct causal relationship to the baby's death.

The child's parents said they "didn't want anyone's head cut off" over the mistake.

That's real grace.

But despite that sentiment . . . as well as current JCAHO guidelines for handling medical mistakes, and what the eggheads-in-the-ivory-towers call "Just Culture" . . . the hospital still fired the nurse (using the gutless/snivelling reputation-killer that hospitals commonly hide behind - telling the world that there was “more behind her case than can be made public” - because of personnel and privacy policies).

The "Just Culture" business is a wholesale joke to me.  For thirteen years ago (before the days of blogs and friending on Facebook), when I defied the threats of a couple of CLUELESS practice executives in Asheboro, North Carolina, and did the right thing by a very sick patient-not-even-my-own (while in public service no less), I got no fair review, no due process.

Nope.  I had to be SILENCED.

A couple of carpet-bagging MBA's decided that I did not fit in.  To my own hometown.  It was news to my horrified parents and dumbfounded friends.  My patients/their parents were deliberately lied-to and kept in the dark.  They were supposed to think I abandoned them.

That was about money - and the hosptial keeping "the business" for itself.

And/so, I was destined to become medical roadkill for intervening to STOP malpractice and then reporting what happened via proper channels.

(Call me entitled, but employment law in North Carolina pretty much equates doctors and nurses with the guy/gal who scrubs toilets at one of Commerce Secretary Keith Crisco's mills - and it just aint' right.)

Those who actually did the wrong have never been held accountable.  In fact, the doctor who screwed up was eventually promoted to Chief-of-Staff.

I don't know what kind of "culture" it is, but it for sure wasn't "just".

And President Obama's hallowed healthcare "reform" (our resident genius-in-the-White-House threw even more money at the National Health Service Corps - and put the IRS in charge of oversight) hasn't fixed any of it.

As it happens, on the state level, I was pleading my case to convicted & soon-to-be-convicted (if God is just) felons (does anyone else want to slap the oily smiles off of John Edwards and his fat-cat lawyers's faces as they smugly stroll to various Federal courthouses?).

OBTW, the nurse in Seattle was a lesbian.  (Insert sarcasm) I'm sure that had nothing to do with what her hospital did to her.

Regular readers know that Asheboro's mill-town thugs-in-suits thought I was a lesbian (those "small town values" require a man - and children - to justify a woman's existence).  The thugs were wrong.  But the truth has never EVER mattered to the scheming Neanderthals running Asheboro and Randolph Hospital.  Rumor and innuendo and snickering behind people's backs are their stock and trade.

I guess dumping on the faux-lesbian was a better story to tell and snicker about than the one about the OB who aborted his own child at home (24 hours to think it over wouldn't have done any good).

Randolph Hospital bigwigs ignored what the OB did (acting like a back-alley baby-butcher) until they couldn't anymore (he was a surgeon and a big money-maker for them).  But they fired the Pediatrician who answered the phone in the middle-of-the-night and came in to save a baby's life.

They couldn't have anyone on the inside saying anything bad about their hospital - even if it was TRUE.

Much later on, when I stopped cooperating with a gag order negotiated on a pile of lies and in bad faith, I became "crazy".  Still, no one in a position of oversight (don't even get me started on the local "journalists") could pose a coherent question to the over-paid MBA's who hid their dirty deeds behind confidentiality and privacy - and used the law as a vicious weapon against a good doctor on the tax-payer's dime.

Make no mistake, my life was not supposed to be only about taking care of other women's children.  I wanted kids of my own.  But after my stint in Hillary's "village", I just never had the time to settle down with someone worthy-of-being-a-Father to have them.  I was too busy fighting off liars and thieves - and just trying to survive.

I know.  I should just "get over it".  And "move on". Surgical scars and all.

Moving on along in this very-sad-story-that-I-cannot-help-but-justapose-against-my-own, the nurse in Seattle fought to keep her license in the resulting firestorm of negative publicity (after the media black-out of my case, I'm kinda wondering how the story got out - I guess privacy and confidentiality only go so far).  She was ultimately fined, sentenced to "CME" (continuing medical education) and put on probation.

The next hurdle became getting hired anywhere else - so she could pay the fine and the lawyers.

Enter the Washington State Nurses Association - whose leadership thought Seattle Childrens' actions against the nurse were overly harsh, and intervened to help her legally - negotiating a confidential settlement with the hospital on her behalf.  But the damage was already done.

If had to guess whatever she got did not begin to cover the damage.  Hospital CEO's don't think nurses - or doctors - are worth very much.

Still juxtaposing, when I asked the North Carolina Medical Society for help, they waived my dues for a year (secondary to financial hardship) but otherwise continued to play footsies with the North Carolina Hospital Association on peer review reform and whistle-blower protection . . . looking the other way as the hospital dons made the CEO who orchestrated my misery an officer in their organization.

I don't belong to the North Carolina Medical Society anymore - or the Pediatric Society - or the American Medical Association.  It was by choice.  For if they "don't do individual advocacy", then it seems to me that individual dues are wasted on these organizations.  Doctors should pull out and stop throwing their money away.

Meanwhile, the North Carolina Medical Board, whose ethical canons and position statements REQUIRED me to do what I did, hasn't come in out of the rain in all of the thirteen years I've been sending them letters.  When challenged about what they should be doing to protect those in their ranks crucified for actually not screwing up, all you'll get is a blank stare and, "What . . . who us?".

For years, JCAHO has been all over the very convenient (for hospitals) theory of the "disruptive physician" (blaming everything on doctors solves so many problems for the suits), but told me TWICE that they had no mechanisms in place to discipline executives behaving badly.

They still don't.

JCAHO Accreditation is just a dog and pony show and the game is fixed to favor the hospitals that pay for the party.  Doctors are the source of all evil at a hospital, don'tchaknow.  And "non-profits" always act for the public good (that was sarcasm - the Wall Street goons who bankrupted this country have NOTHING on the non-profiteers - who can hide behind charity - and whose slick lawyers can style their lies as "agressive representation" and "legal conclusions" without the N.C. State Bar batting an eye).

It all speaks volumes about accountability and transaparency when it comes to patient safety in North Carolina.  The recently-vetoed medical malpractice reform bill had no provisions for peer review reform or better whistle-blower protection for doctors and nurses.  So I'm not crying over the veto.  It wasn't even close to being what we need.

This time it just doesn't hurt for Bev Perdue to pander to her base.

But I am crying over this:  Riddled with guilt and drowning in despair (doubting she'd ever be able to work again), the Pediatric critical care nurse in Seattle committed suicide several months after making her one and only major mistake.

Outsiders looking in say she ran out of coping skills.  And that's just a cop-out.  Lame-to-the-nth-degree.

She died of a broken heart.

The system did not work for her.

Just as it did not work for me.

I'm actually surprised that an American news outlet published the story sympathetically - much less at all.  Doctors and nurses these days are much easier to cast as public enemy number one.  Our President certainly has had no problem doing it.

(Speaking of styling doctors as demons, the New York Times reported this week that the While House plans to conduct a "stealth spy" campaign against rural doctors - in an effort to "prove" that they are screening out Medicare and Medicaid patients - as opposed to being over-burdened and grossly underpaid for their work.)

I cried when I had time to sit down and read the MSNBC article.  That picture of the nurse - in happier days - broke my heart.  For although I was fired for very different reasons (in my story the baby lives and her  grateful parents send me a Christmas card every year), I know EXACTLY how this woman felt.

I KNOW that kind of darkness - and that depth of despair - the sensation of being utterly abandoned and isolated/alone.  Unjustly humiliated.  The object of ridicule.  It took a Herculean effort to keep fighting the good fight . . . and to keep working/doing what I love and trained for decades to do.

Some in this blogosphere found my pain and vulnerability amusing - and reason to pummel some more.  It gave them some kind of sick, warped charge to try and finish "breaking" the doctor.

Despicable.  Unforgivable.  There are not words to express how contemptible and pathetic I find those actions.  And I'm pretty good with words.

If I'd gone off the deep end and done myself in, these high-minded, enlightened progressive types in the Greensboro, North Carolina blogosphere would have thrown a party (Steve Schmidly and Bob Morrison would bring the beer).  For doing myself in would have proven that they were right about Dr. Mary being a "wack job" . . . and in their twisted games of partisan oneupmanship, that's really all that matters.

I took a summer break from Housecalls in part because I'm really struggling with the relevancy of blogging.  The Ed Cones and John Robinsons of this world have nearly killed me.  I'm wondering why I ever took them at their word - or gave a rat's tail about what they thought.

The message in all of this for doctors and nurses is that if you make a mistake - or see medical badness - just keep your head down and your mouth shut, lest you be crucified . . . lest you be cast off and stripped bare to walk the medical-yellow-brick-road-from-Hell . . . to a land where fake wizards behind curtains - who have no clue as to what they're doing - can rip your heart out and destroy your dreams.

A Pediatric critical-care nurse in Seattle would probably still be employed and alive (albeit very troubled) if she hadn't opened her mouth.  And I would probably still be in Asheboro cleaning up other people's messes.

I'd like to think I would not have kept putting up with it . . . that I would not have become like the "colleagues" I once trusted and called "friend" . . . the ones who looked the other way and let the businessmen/lawyers do their dirty work . . . but you just don't know. 

I wanted so badly for Asheboro to work. For it not to be what it was.  What it is. 

I don't feel like tackling this subject in greater detail tonight - but I may pick up this post later on.

In the meantime, the nurse's name was Kimberly Hiatt.  She was a good nurse.  And I know in my bones she is someone I would have been proud to call friend.