One year ago, as an RN working in Psych, I received an unjust disciplinary measure regarding the fall of a Pt. Although the fall related to my shift resulted in no injury to the Pt., a subsequent fall in the morning resulted in a fracture and Sentinel Event. I received a three day suspension without pay, loss of PTO. None of the other staff members received similar discipline. I fought this through my union & received my benefits back, with discipline reduced to a written warning. The tone of the “concession” letter from management was very negative, without apology, and basically was a “better watch your back” type of tone. Since that time, I have had the feeling they are watching my back, and in fact, have had staff tell me verbally to “watch out”, “they are looking for something to pin on you”. I did not realize what a toll this had taken on me, until recently. My co-workers are hostile, my team members are insuboordinate, the “in group” “out group” mentality is rampant. Recently, I had an incident with my Program Director which has “put me over the edge”. I have had to see a mental health counselor, see a medical doctor, start medication, have been unable to work, and it is unknown if I will lose my home due to financial loss. I will add that the Unit’s Practice Standards are abhorrent. The standards for patient care are very sub standard, and cause me a great deal of stress. There are unethical issues, poor management issues, borderline, if not outright legal issues. How do I trust the leadership in my corporation, who were ready to hang me from the highest limb? I recently did submit my concerns to a person in leadership there, but the reply from the leadership was to “meet with my directors”-the very people who had caused much of this grief! I am willing to do what is necessary for myself as well as the Pt’s, who I have a duty to protect. I am well aware that this may cost me my job, my income, my home. Integrity, moral & ethical right come at a high cost.

- Dee, MN

I worked as a Public Health Nurse for an Indian Tribe for 18 years. We all experienced “unusual” working conditions that were not found “outside” the tribal employment community but still had to to perform within our legal nursing scope of practice. As a mandated reporter I filed many Child Protective Service reports over the years. Last fall I was approached by one of my long-term clients who reported allegations of abuse and medical neglect by her mother. Family members substantiated her statements. I took them to the tribal CPS office for further assistance. She continued to contact me and said she’d been placed with one of her mother’s friends who was a licensed foster care provider. Six days after our initial contact she reported her mother had come to the “foster home” and shoved her around trying to find a cell phone that she’d given back to her uncle earlier that day. She again asked me for help as she hadn’t seen anyone from CPS. After consulting with my co-workers there was consensus that another report was needed. I completed a formal report with copies to my boss, the Tribal CPS supervisor, our clinical director, and our local county CPS office with a request to involve the Indian Outreach Worker. I was later sent to the tribal CPS supervisor who yelled at me for “making her look bad” by filing a copy of the report “downtown.” She accused me of gross misconduct, negligence, and a host of other inflammatory charges. My boss never discussed any of this with me but fired me anyway. My former co-workers are now (understandably) hesitant to report suspected abuse and neglect for fear of losing their jobs. I remain unemployed.

Kathleen, [State withheld for anonymity]