Whistle-blowers are heroes.  Whistle-blowers do the right thing.  Anne Mitchell is a whistle-blower.   She is a hero.  The way she was treated is a travesty.   Numerous articles and websites have discussed the case of Nurse Mitchell. The NY Times ran this article

Anne Mitchell was indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor was practicing bad medicine.  She was fingerprinted and photographed at the jail last June.  Mrs. Mitchell stood trial in Texas state court for “misuse of official information,” a third-degree felony in Texas.   Legal experts argue that in a civil context, Mrs. Mitchell would seem to be protected by Texas whistle-blower laws.

“It was surreal,” said Mrs. Mitchell, 52, the wife of an oil field mechanic and mother of a teenage son. “I said how can this be? You can’t go to prison for doing the right thing.”

The prosecutor said he would show that Mrs. Mitchell had a history of making “inflammatory” statements about Dr. Rolando G. Arafiles Jr. and intended to damage his reputation when she reported him last April to the Texas Medical Board, which licenses and disciplines doctors.  Mitchell had assumed the letter she wrote was anonymous.

When the medical board notified Dr. Arafiles of the anonymous complaint, he protested to his friend, the Winkler County sheriff, that he was being harassed. The sheriff obtained a search warrant to seize two nurses’ work computers and found the letter.  Mitchell was fired without explanation.  The prosecution has stained her reputations and drained her savings. With felony charges pending, she has been able to find work. 

Of course the prosecution ignores laws to protect whistle-blowers, and ethical requirements that Mrs. Mitchell had including a professional obligation to protect patients from a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.

It was not long after the public hospital hired Dr. Arafiles in 2008 that the nurses said they began to worry. They sounded internal alarms but felt they were not being heeded by administrators.  Frustrated and fearing for patients, they directed the medical board to six cases “of concern” that were identified by file numbers but not by patient names. The letter also mentioned that Dr. Arafiles was sending e-mail messages to patients about an herbal supplement he sold on the side.

Mrs. Mitchell typed the letter and mailed it with a separate complaint signed by a third nurse, who wrote that she had resigned because of similar concerns about Dr. Arafiles. That nurse was not charged.

To convict Mrs. Mitchell, the prosecution must prove that she used her position to disseminate confidential information for a “nongovernmental purpose” with intent to harm Dr. Arafiles.

Mari E. Robinson, executive director of the Texas Medical Board, has warned in a blistering letter to prosecutors that the case will have “a significant chilling effect” on the reporting of malpractice.

Nonetheless, the sheriff, Robert L. Roberts Jr., and the prosecutor, Scott M. Tidwell, had expressed confidence (and arrogance) in their case.  A Texas jury found veteran nurse Anne Mitchell not guilty of harassment. The verdict was announced after the four day prosecution. Jurors took less than an hour to reach a unanimous verdict.  The verdict has a profound effect on whistle-blowers in Texas and nationwide. Arafiles is still practicing medicine at Winkler Memorial Hospital

Texas laws protect a nurse’s right, and duty, to report any health care provider when he or she believes that patients are at risk.  In a surprise inspection last September, state investigators found several violations by Dr. Arafiles and concluded that the hospital had discriminated against the nurses by firing them for “reporting in good faith.”  The hospital administrator, Stan Wiley, admitted that Dr. Arafiles had been reprimanded on several occasions for improprieties in writing prescriptions and performing surgery. Mr. Wiley said he knew when he hired Dr. Arafiles that he had a restriction on his license stemming from his supervision of a weight-loss clinic.  All along, Arafiles said he was the victim in the case, even though he had been reprimanded several times by the hospital.

 

 

Jasmine Hall from Nurse Practitioner Schools sent us a link to an article entitled "100 Reasons to Become a Nurse."  The article explains how becoming a nurse is a great decision for anyone interested in the field of medicine.  There are practical and altruistic reasons to become a nurse as the article cites.  It is a great article for people thinking about a career in nursing.

Daniel Rusu wrote the following blog entry.  Please check out his website.

 

Many times, when a senior goes to the hospital for an overnight surgical procedure, or some other procedure that requires them to stay for an extended period of time, they are left alone for some time. If a family member drove them, they might leave the patient alone to go back to work, or to sleep comfortably at home instead of at the hospital. If a hired caregiver drove them, the caregiver often times needs to leave to take care of other assignments. This is a dangerous mistake that can potentially bring a lot of harm to the senior. We recommend a family member or hired caregiver stay with the senior at all times for three reasons.

 

The first reason someone must stay with them at all time is to be an advocate for them. An advocate is someone who represents the best interest of their client. In this case, the caregiver or family member would be representing the best interest of the senior patient. Often times during surgery, the patient is sedated and is not able to communicate their wishes. Because of this, it is important to have someone there who can communicate with the doctors and other staff so everything goes to plan.

 

The second reason is to observe what takes place. Malpractice is a possibility for any patient. In fact, malpractice cases are on the rise and growing each year. For that reason, it is important to have someone there to observe the surgical procedure and the general care of the patient. If malpractice occurs, the observer becomes a valuable witness.

 

The third and final reason is to be there for them when they need help. Often times nurses and other staff at a hospital are assigned too great a number of patients to properly take care of each one’s needs. A patient can wait for hours at a time before being assisted to the restroom or brought a comforting item such as a drink or the newspaper.

 

There are many reasons why a senior should not be left alone at the hospital. Other reasons include moral support. Having someone there beside them when they wake up is always a comfort. To read more tips on caring for the elderly, be sure to visit my site Adult Family Home.
 

This guest post is contributed by Kitty Holman, who writes on the topics of Nursing Degrees . She welcomes your comments at her email Id: kitty.holman20@gmail.com.

The New York Times had an article about the process of choosing a nursing home for your loved one. This can be a long and difficult process for people, and there are certain things to remember as you work to find a home that fits your needs.

1. Collect the data. The Centers for Medicare and Medicaid Services collect data annually on nursing homes across the country, assembling information about everything from health inspection rankings to staffing reports on more than 15,000 institutions. A great way to get started in this is by using the Nursing Home Compare tool at Medicare.gov.  However, it’s important to remember that federally issued rankings of nursing homes only reflect the home’s performance during a very brief period, so the quality might have changed since the report was issued. Additionally, Medicare’s grading system stipulates that only 10 percent of a state’s nursing homes can receive the top rating of five stars, so a high-quality home might get four stars for no reason other than that it missed the arbitrary cutoff point.

2. Visit repeatedly. It’s impossible to get a sense of what a nursing home is like from just one visit. In order to better understand life at a particular home, it pays to visit several times, over different days and at different times of the day. This way, you can get an overall feel for the place. Medicare.gov also provides a helpful PDF checklist  you can take on visits to record what you see, hear, and smell. For instance, are staff and residents busy interacting, or is the place quiet and reserved? Does it smell like food, or cleaning supplies? Are there noticeable stains or broken fixtures? This is also your chance to talk directly with the nursing home’s management, including the head physicians. If they can’t make time to speak with you, it might be a good idea to move on and look at another home.

3. Ask the right questions. If you’re placing a loved one in a nursing home, make sure to ask the facility’s staff about "person-centered care" and "consistent assignment." The former is a term that means residents will be able to set their own schedules, including meal times and when they wake up. The latter means that the same team of physicians and assistants will deal with the same patients in each shift. This provides a feeling of continuity for residents and allows them to develop relationships with their caregivers.

4. Check their reputation. Every state in the country has a federally funded ombudsman overseeing long-term care who works as an advocate for nursing home patients. Your state’s ombudsman will be able to help you find out more about nursing homes in your area and whether there is additional survey information on the facility in question. They can also tell you if any complaints have been filed against the nursing home. The National Long-Term Care Ombudsman Resource Center can help you learn more about your local ombudsman.

 

The Daily Comet ran a story about how a wheelchair-bound 93-year-old nursing-home resident got outside on a frigid night.  Man’s family doubts he left nursing home on his own. His family maintains that nursing-home employees erred by not noticing his room was empty.   Two employees at Lafourche Home for the Aged and Infirm were fired in the aftermath of a Jan. 10 incident in which authorities found resident Etienne Adams outside in sub-freezing temperatures.  Adams was outside for several hours. He has not fully recovered and has been moved to another facility.

Adams’ granddaughter, Jeri Lynn Fields, said that the two employees who worked the shift before he was discovered, should be fired, because Adams went missing while they were working.

Authorities are investigating the incident, but have not released their findings. Police estimate Adams, discovered at 1 a.m., had been outdoors for up to four hours based on his body temperature. He could have been outdoors as early as 9 p.m., they said.

The facility claims that Adams wheeled himself out of his room, down the hall and outside withoout being noticed by staff.   His family maintains that he’s physically incapable of doing so. The nursing home now locks its front and back doors at 8 p.m. and reopens them at 7 each morning.

 

FOX6Now.com had an article about a greedy nursing home owner who has pleaded guilty to tax evasion.   Karen Mason took more than $1 million from Havenwood Nursing and Rehabilitation Center to pay for personal expenses for herself, her then-husband, her friends, her children and their friends. The 57-year-old is accused of not reporting it as income.

Mason is accused of spending it on jewelry, furniture, carpeting, vehicles, tickets to concerts and sporting events and a wedding and honeymoon of one of her children. The nursing home has since closed.

She could face up to 5 years in prison and a $250,000 fine when she is sentenced on May 21.  It is doubtful she will serve time.

 

IQ Nursing Homes is pleased to offer comprehensive nursing home abuse statistics, reports, articles and information on its website. Nursing home abuse is a serious problem throughout the country, and it often goes unreported because the victims cannot communicate that they are being mistreated. By reviewing the resources available at IQNursingHomes.com, friends and family members of nursing home residents can educate themselves about this issue and act as advocates to protect their loved ones.

Nursing home abuse can take many forms, including physical abuse, sexual abuse, financial abuse, and emotional abuse. When nursing homes are understaffed or caretakers fail to receive proper training and supervision on the job, seniors may not get the level of care that they need and deserve. The effects of nursing home abuse can range in severity from discomfort to serious injury, and even wrongful death. Bed sores, broken bones from falls, dehydration, and malnutrition are just a few of the life threatening conditions that can result from neglect and abuse in nursing homes.

IQ Nursing Homes includes detailed articles and videos that provide an overview of the types of nursing home abuse, as well as a list of warning signs that may indicate that abuse is taking place. It is important to note that nursing home abuse and neglect can be difficult to detect and may be missed if a concerned family member is not watching out for their elder relative. In some situations, a nursing home resident may be afraid to seek help because of threats made by the abusive staff member. In other cases, the victim may be physically or mentally unable to communicate that he or she is suffering from nursing home abuse.

Visit today to learn more about nursing home abuse. A national nursing home directory, a database of nursing home and elder care facility ratings, and a guide to choosing the right nursing home are also available to help you ensure that the facility you trust your loved one’s care to is reputable and safe.

If you suspect that a loved one is the victim of nursing home abuse or neglect, you may want to consider speaking to a nursing home abuse lawyer about how to protect your loved one’s rights. IQ Nursing Homes offers a Free Case Evaluation for those interested in pursuing a potential nursing home abuse lawsuit.

About IQ Nursing Homes

IQ Nursing Homes has partnered with nursing home abuse lawyers and nursing home neglect law firms throughout the country with the goal of putting a stop to the victimization of the elderly. By holding negligent staff members accountable for their actions and making it financially devastating for nursing homes to allow abuse to occur, it is our hope that this pattern of nursing home abuse can be put to an end. Visit to review articles, videos, and legal resources related to nursing home abuse and neglect and receive a Free Case Evaluation.

KnoxNews.com had an article about a lawsuit filed against Ashbury Place for failing to protect Katheryn Hill from a known sexual predator living at the nursing home.  The Hill family wants to know why she shared a floor at the nursing home with a convicted sex offender, James Charles Strickland

"They let him roam the floor with everybody else," said David Boyd, the family’s lawyer. "He had free rein to assault her."

Hill was living at Asbury Place when Strickland came to her room March 13, 2009, and tried to rape her. Hill called for help, and a worker pulled Strickland off her.  No information about how he was able to get in the room unnoticed by the staff.  Strickland had been previously convicted of rape and incest. 

Federal guidelines require that any nursing homes accepting such patients be able to protect the other patients.  Asbury Place staff knew about Strickland’s convictions but did nothing to separate him from other residents or keep an eye on him.  He died about four months later without being charged by police.  Hill’s daughter pulled her from the home after the assault and has cared for her at home since then.

 "They moved him immediately after this incident and notified police," Boyd said. "But our beef with Asbury is that they didn’t have anything in place to tell the families about him being there or any plan to watch him."

State law bars sex offenders from living near schools or being around children. No such bans exist for nursing homes, said Andrea Turner, spokeswoman for the Tennessee Department of Health.

 

 

 

The Las Vegas Sun had an article about a nursing home that was cited and fined $5,100 by the state for repeated health and safety violations and ordered not to accept new residents.  These violations are incredible.  The bureau said an “immediate jeopardy situation” was declared due to missing resident medications, failure to have criminal background checks, an ongoing cockroach infestation, a lack of a functioning auditory alarm system, poor care on a resident with a colostomy, tuberculosis testing and medication administration.

Eight of the deficiencies were repeats from previous inspections. The state Bureau of Health Care Quality and Compliance said there have been repeated violations dating back to February of 2007 at Best Care Facility which was fined $600 last year.  Surveys in 2007, 2008, 2009 and in February this year showed multiple violations. The bureau said the home was inspected Feb. 2 this year and received the grade of D when 30 violations were found.

“It has been determined that residents are not safe at this facility due to chronic, repeated non-compliance and that the facility is engaging in practices detrimental to the health and safety of the residents,” the bureau said.

A person named “Danny” at the nursing home answered the telephone. He said he would return a call later but he declined to give his last name.

 

 

 

Ashley M Jones wrote on the Pharmacy Technician Certification blog the following article on the 12 most common medical errors and how to prevent them.  Many of these errors occur in nursing homes every day.

According to the National Academy of Sciences, medical errors injure millions of people each year and cost billions of dollars annually in increased health costs. And this does not take into account lost wages or productivity costs. If that isn’t frightening enough, the Institute for Healthcare Improvement estimates that more than 238,000 hospital deaths among Medicare patients between 2004 and 2006 were due to medical errors that could have been prevented.

With healthcare reform front and center in political discussions, but little coming from it, patients are left to rely on their overworked physicians and other caregivers for reliable services. To best avoid becoming part of the statistics, become part of the solutions by knowing the 12 most common medical errors and how to prevent them.

1. Medication Errors : The most common of medical errors, luckily it can be one of the most preventable. Errors include assigning a medication due to improper information such as allergies, other medications taken, previous diagnosis, and others. A medication error can also include lack of up to date warning or miscommunication due to poor handwriting. There is also confusion among drugs with similar names or dosage, and this effects all drugs including prescription, over the counter, vaccines, etc. The best way to avoid this medical error is to know what you’re taking, how much, and what you can’t take. If unable to remember, bring all of your medications to the doctor or hospital with you.

2. Bad Communication :  Have you been going to the same doctor for years? That doesn’t mean that he or she knows or will remember everything about you. The second most common medical error results from poor doctor/patient communication. With loads of tests and labs, doctors will not always remember every test you have, so it is up to you. The Agency for Healthcare Research and Quality lists the ten questions every patient should ask their doctor, along with many other useful tips. You can even go there to build your own personalized question list.

3. Infection : They may seem clean, but hospitals are one of the most likely places to receive an infection. Given the high incidence of people with infections, workers who can become contaminated, and the fact that many patients enter the hospital with weakened immune systems, infection can be a serious problem. If staying at a hospital, be sure to avoid a doctor’s tie, ask him or her if they have washed their hands since visiting the last patient, and be sure to wash your own often. This article reports on the incidence of high IV infection rates. If you receive one, be sure to monitor for signs of infection and ask for a new one if suspicious.

4. Falls : Because on so many new drugs, patients cannot predict how they will react to them, causing a fall, which is another leading common medical error. In fact, ten percent of falls for the elderly occur in hospitals. Patients who have other mobility issues like a broken leg, walker, or cane, can also find the clean hospital floors more slippery than those at home. If you think you need assistance standing and walking, contact the nursing staff. Be sure and allow 10-20 minutes for a response, as they may be busy assisting others stand and walk.

5. Surgical Errors : Because surgery is scary enough when everything goes right, it is vital to prevent errors before, during, and after. These can include wrong site, wrong procedure, and even wrong patient surgeries. Although there are new procedures in place to reduce these common medical errors, you can still do your part. Speak to your surgeon about the procedure you are having, why you are having it, and what the surgeon will be doing during the surgery. Also know the rules in place to avoid surgical errors: 1. The surgeon must sign the incision site with the patient awake. 2. Use only a signature and not a confusing “X.” 3. The entire surgery team must stop and perform a checklist before beginning the procedure.

6. Pharmacy Errors : You don’t have to be in a hospital to be a victim of a common medical errors. With dozens of patients each day, pharmacies can also make errors on your medication. In fact, according to this article from CNN, 30 million Americans are the victim of outpatient medication errors each year. Although some are minor and can be caught easily by most patients, others are not. To best prevent medical errors of this sort, know what your doctor prescribed and how much when going to the pharmacy. Also, be sure to be honest with the pharmacist about other medications and drugs you are taking to ensure that there is no harmful interaction.

7. Lab Errors : Another facility with many patients and tests in one spot, common medical errors can occur here as well. These can also be truly devastating by leading to wrong diagnosis and wrong treatment, while the initial disease continues. Types of common errors can include MRI or CT taken incorrectly, samples taken incorrectly, or results misinterpreted. If you feel your lab results are misleading, you are within your rights to ask for another lab test to confirm.

8. Treatment Errors : If you feel your diagnosis was reached correctly, a common medical error can still happen during treatment. Because many doctors have been practicing for decades, it is not unusual for them to be using outdated procedures. Be sure to ask why you are having the treatment, how long the doctor has been doing them, and if there are any alternatives. This website is full of guidelines for treating many common illnesses.

9. Follow Up Care : When discharged from the hospital or clinic, be sure and know what your follow up care is and what to expect from it. If you are given a specific amount of medication and told to take it all, take it all. Just because you feel better halfway through, doesn’t mean you are better. Ask the facility who to contact if you have follow up questions on your at home care. This link also has more on what to do.

10. Birth Injuries : It may be the most joyous time in your life, but birthing a child can also lead to medical errors. The most common can result in serious injuries such as cerebral palsy and paralysis. Women who are most at risk include those with large babies, prematurity, prolonged labor, and more. To best avoid these injuries, do research on the place you would like to have your baby in. Check several hospitals in and outside of your area. See the incidence of birth injury and, if possible, read reviews by other mothers who gave birth there.

11. Bring Family : This is vital to avoiding common medical errors. If you are too ill to answer or too tired to protest, an informed family member is your best bet to sidestepping a common medical error. They can answer questions about medications, do reviews of your current and future care, and lift spirits. Make sure they also read these 12 most common medical errors and how to prevent them. Click on this link to get more rules for family members visiting at a hospital.

12. Don’t Wait Until It’s Too Late : With healthcare costs on the rise, many patients believe they can save money by putting off the doctor’s visit. However, this can actually have the opposite effect as the worse a disease gets, the harder and more expensive it is to treat. This decision can also be deadly with the wrong disease going undiagnosed or treated. If you have no insurance, find a Take Care Clinic. Visits start at $65, which is far cheaper than many primary care visits out of pocket. They are also doing free blood glucose testing for the month of February.

If you have any questions regarding the above 12 most common medical errors and how to prevent them, ask your physician. The best way to not become lost in a system like so many million before you is to be your own best advocate. Know your rights both as a patient and an insurance holder. If you don’t have insurance, there are still many resources for you, along with many useful tips for those who do have it.