Donald Trump said that there is nothing worse than disloyalty. He said that disloyal people are no good, never will be any good and all you can do is get rid of them. So it's not as though healthcare is alone in enforcing the importance it places on loyalty. The choice for healthcare workers is between being loyal to colleagues or protecting patients - another of the conflicts of interest between providers and patients. The fact that healthcare workers are the least likely of all people to report crimes committed against patients tells you who they protect.

Reporting is not tolerated in medicine.
See Silencing.

Consider this example. At the Jones Memorial Hospital in Wellsville, New York, Gary Ogden, M.D. was drinking the equivalent of 20 shots a day. He had been doing this for years and everyone knew about it. The nurses had talked among themselves and decided to say nothing. Not only did everyone know about it, but they had discussed it. They had arrived at a decision. They had decided to remain silent.

Finally, a baby died. One nurse, Rose Mary Vossler, couldn't live with it any longer. She didn't think it was her responsibility to say anything (so much for nurses being patients' advocates), but to the appropriate person she said that she had smelled alcohol on his breath. She had hoped to keep her action secret, but people figured out who had talked. They bullied her and bullied her until she quit without even having another job lined up.

For one of the reasons for why things are this way, click nurse training

After she had told me about this, I asked her if she thought there that there might be a wall of silence in medicine. She said she had never thought about that before but supposed that there must be one because otherwise how could Dr. Ogden have gone on the way that he did for as long as he did with everyone knowing about it but no one doing anything about it.

This is a typical level of awareness in medicine. When asked about a wall of silence, her own did not cross her mind. She had said that the nurses had talked among themselves and decided to remain silent. It had been discussed. It had been agreed upon. When that is not recognized as a wall of silence, even by a hero who sacrificed her career and social standing in a small community to protect patients, consider how far from consciousness it is for everyone else in medicine.

"The nurses had agreed to remain silent"

This disconnect between belief and reality is pandemic in medicine. They insist that their perspective is the only true, objective one when really it is inaccurate, self-serving and dangerous for patients.

She said another doctor in the hospital had the authority and the responsibility to do something but he said that he couldn’t because he was Ogden’s friend. Whether it is the result of friendship, loyalty, consensus or automatic, unthinking routines it still is a wall of silence. Problems will not be corrected and patients will die, and even be murdered, because of how silence enables that.

Years of alcoholism without anyone reporting it? It is usual for an OR nurse to assist on as many as 2000 operations per year. How many thousands of patients were operated on by the inebriated surgeon without one of the other people involved in reporting it? The one who finally did was mobbed and bullied and, in the end, excommunicated for it. There should be a patient safety initiative that runs to the aid of people like her, and people like Anne Mitchell, RN and Vicki Galle, RN.

I asked her other questions from my survey of nurses as well. She has never filed an incident report with a state board or agency, not even about this problem, and wouldn’t step forward again if confronted with another situation like this. "It’s not worth it," she said. So another of the heroes of patient safety has been silenced.

Eliminating or silencing those who speak is an evolution that leaves a dangerous brew

Gary Ogden still is her friend and is not bitter, but her former coworkers are bitter and are not her friends. She no longer can work in healthcare.

Mobbing and bullying like this is status quo in nursing. Australia and the United Kingdom have laws against it. In the USA there isn't even awareness of it. In other countries there are support groups and websites about it. A search on the words mobbing bullying nurse will provide a list of sites and references. Clicking on mobbing and bullying opens a page on this site with a bit more about it.

By the way, an injured patient in England asked me to mention that even though there are laws against it in England, those laws never are enforced. We would have been surprised if they had been, but we still would like to see at least an acknowledgement of the problem made by some kind of official sanction against it in the USA.

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