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Aug 13, 2006
Hi Care2 Activists,
                                 
         A Heartfelt Thank You to each and every one of you for taking the time to Sign this Patient Safety Advocate’s Whistleblower Petition at:
            
 http://www.thepetitionsite.com/takeaction/938995258   

         I
don’t want to bug those of you who have already signed,  but I urgently need you to keep forwarding this Link on to all of the Care2 Friends in your Network.   I am still actively seeking additional comments from Patient Safety Advocates, Medical Professionals and especially Nurses for inclusion on this really vital Patient Safety Petition that highlights the critical need for much stronger universal Whistleblower protections for US Healthcare workers.  

Kim Sanders-Fisher in Surgery; working as a Medical Volunteer in the OR at Cut Nyak Dhien Hospital in Meulaboh, Aceh Indonesia after the Tsunami.


         Most, if not all, of our Care2 members make a conscious choice to care passionately for animals and to protect our fragile environment; I genuinely applaud this extremely valuable contribution.  Over the past three months I have learned that it is a really tough challenge to muster any significant response for a Petition that does not focus on such issues, but instead targets the current Healthcare crisis.  This is deplorable, as we really must recognize that sick and injured Hospital patients are equally vulnerable to abuse and neglect; they too deserve our attention and protection.   

         We might not want to dwell upon our own human frailty or  physical weeknesses, but the fundamental need for access to Safe Medical treatment is an irrefutable fact of life!  This is about the integrity of YOUR Medical system, so please bear in mind that  inevitably we will all require Medical care at some point in the future.  Don’t let deliberate negligent under-staffing become the nightmare scenario that determines the fate of your vulnerable loved ones when they enter a US Healthcare facility.  Join with those of us who are now Petitioning to demand immediate dramatic changes to America’s increasingly dangerous and dysfunctional “Profits over Patients” Medical  system.      

                                  THANKS TO ALL YOUR HELP  
  WE HAVE REACHED A MILESTONE OF SUCCESS
  
                SURPASSING  1000  SIGNATURES!                
                                                         
                             MORE THAN  1275  HAVE SIGNED SO FAR     
           BUT THE  3000  SIGNATURE GOAL IS A LONG WAY OFF...         
  I STILL NEED YOUR HELP!      

         Although I am sure Healthcare really is one of your priorities, you still might not have got round to signing this important Patient Safety Petition yet. Few people realize what a critically important role strong Whistleblower protections play in the workplace: no where is this more vital than in our Hospitals!  Ignoring the crisis in US Healthcare now, could potentially have devastating consequences for the delivery of safe Medical care in America in the near future.  

       Unfortunately, so called “Managed Care” in the US equals: “too much costly and grossly inefficient Management for too little basic rudimentary Patient Care!” Healthcare dollars are being needlessly squandered by top heavy Management as powerful CEO’s rake in obscene salaries for implementing drastic workforce reductions among the badly beleaguered ranks of those still valiantly trying to deliver quality care. 

         Deliberate negligent under-staffing is already harmfully impacting Hospital practices and jeopardizing our vigilant adherence to safety regulations in all clinical areas of numerous Medical facilities throughout the United States.   Greedy Corporate power mongers deceptively refer to this as necessary “Downsizing.” In reality it is far from “necessary,” and often downright dangerous, leaving the most vulnerable patients neglected or abandoned by unworkable staffing cut backs.  To find out more about why this Petition matters so much to you and your family visit my Care2 Sharebook.

Read about the specific healthcare dangers I was removed for trying to expose,
GO TO:
   
http://www.care2.com/c2c/share/detail/99894
Read the letter of appeal that further elaborates on my personal motivations behind filing this Petition,  
GO TO:  
http://www.care2.com/c2c/share/detail/91853      
or Visit the TEAM Blogspot:
                             Medic Integrity & T.E.A.M.  
   
TRANSPARENCY for EQUAL ACCOUNTABILITY in MEDICINE
                                  
Visit the new "Blogspot;" 
GO TO:  
http://medicintegrity-team.blogspot.com/   


         Americans
must pay dearly for their Medical insurance in order to access quality care touted as the absolute “finest available anywhere in the world.”  When we or one of our loved ones is sick or injured, we really deserve to know that they will receive the very best and safest standard of Medical care.  However, although we might rightfully expect safe Medical treatment and are truly horrified when someone close to us becomes the victim of negligence, abandonment or abuse, Healthcare is being severely compromised and accountability is seriously diminishing.  This disquieting trend is being documented right now by numerous signatories to my Petition who have experienced negligent care or harmful medical errors.  You too can add your comments regarding the sharp decline in the quality of US Healthcare.  

         The fact is that greedy Corporate profiteering in Healthcare is getting steadily worse.   The dangerous "Profits over Patients" agenda has aggressively implemented drastic staff reductions.  This created such intolerable working conditions for Medical professionals that it precipitated a full scale “Nursing Exodus.” Those who are unable to change this unworkable system and have consistently refused to be responsible for the horific consequences of unsafe care have left the Medical field altogether!  

         Abuse and neglect of vulnerable Hospital patients is rampant due to the stress and unreasonable demands on fatigued, overstretched, Medical professionals.  Our inability to cope with the severe limitations of minimal staffing is creating major problems.  Basic safeguards are being ignored or eroded and Medical Errors are on the increase.  It does not have to be this way, but we must demand a reversal of the current negligent "Profits over Patients” Medical system.  

         The really Good News is that the majority of former Nurses still diligently maintain their Nursing licenses.   Many of these highly qualified and experienced professionals are eager to return to direct bedside Nursing.  If and when staffing is safely regulated, and the current unworkable conditions change so that Medical staff can advocate and care for their patients properly once more, they will return to their chosen career.  We can confidently anticipate that increasing the number of tenure Nurses will help make the US Medical system safe again.   

         A few conscientious outspoken Medical practitioners are battling to insure that your Medical care remains safe, despite the current appalling working conditions.  Some have courageously chosen to jeopardize their entire career to vocally advocate for the safety of patients entrusted to their care.  This heroic sacrifice should never be necessary.  However, Whistleblower protections for Healthcare workers are almost non-existent in most States and this situation urgently needs to change.  The Safety of Medical care remains far from guaranteed while Medical staff are still totally helpless to advocate on behalf of their patients without fear of significant reprisal or complete career sabotage. 

To sign this Patient Safety Advocate’s Petition;
GO TO:
 
http://www.thepetitionsite.com/takeaction/938995258    

         Please
take immediate action right now to Demand Safe Patient Care by insisting that conscientious Medical practitioners, who want to advocate on your behalf, are protected from retaliation.   It will be far too late to protest when your ultimate survival or the life of someone close to you hangs in the balance, and is dependant upon the compassion, knowledge and experience of a competent Medical team.  Please do not hesitate to contact my with your questions, comments or to request a “Friends” link connection as I would really appreciate having you on board,    

                                         Thank you, for your critically needed support,   

                                                                Kim L. Sanders-Fisher.
   

PS:    Although this Petition is now gaining more signatures than most other submissions in the "Health" section it is still not listed at the top among the "Most Popular Petitions" on the “Health” page.  I have repeatedly appealed to the Petition Site to update their ranking of the ten "Most Popular Health Petitions" which even now still lists one Petition that has been closed to signing for well over a month!  Please help persuade them to revamp their list to reflect recent changing trends in importance and focus.  Urge them to do this so that active Petitions, like mine and others that are still actively seeking public support, can become more visible.   Your Signatures could then put this vital Patient Safety Petition in the “Most Popular Petition” spot at
last.
                                                                                               

Imported from external blog

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Posted: Aug 13, 2006 11:54am
Jun 21, 2006
Focus: Health
Action Request: Petition
Location: United States
ATTN.:  ALL PATIENT SAFETY ACTIVISTS & FRIENDS,
              Please sign this especially important Patient Safety Petition & then forward it to as many activist friends as possible; GO TO: 

 http://www.thepetitionsite.com/takeaction/938995258 

      I REALLY NEED YOUR HELP!         
 With a 3000 Signature Goalthere is still a very long way to go 

                                                                   
                  Many thanks to all who have signed & forwarded the Petition; Please keep forwarding this on to conscientious friends!   Once again,  Many Thanks for your support,     Kim Sanders-Fisher.

                   Medic Integrity & T.E.A.M. 
TRANSPARENCY for EQUAL ACCOUNTABILITY in MEDICINE
                           Visit the new "Blogspot;" 

To read more about the Patient Safety issue that precipitated my dismissal: how deliberate negligent under-staffing leaves OR team members stranded in Surgery for unsafe periods without relief, 
 GO TO http://www.care2.com/c2c/share/detail/99894   
Also read my letter of appeal regarding enlisting the support of influential Doctors empowered to introduce regulatory changes to hopefully bring an end to such dangerous occurrences;  
 GO TO:   
http://www.care2.com/c2c/share/detail/91853 
Alternatively, please explore the numerous informative Links in this Petition or visit discussion threads that I have either started or contributed to on the
 
allnurses.com   Website,  
  GO TO: 
 http://allnurses.com/forums/members/105717.html   
Read my comments posted under the name:   Tsunami Kim. 

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Posted: Jun 21, 2006 2:08am
May 24, 2006
Focus: Health
Action Request: Petition
Location: United States
PLEASE SIGN THE PETITION; GO TOhttp://www.thepetitionsite.com/takeaction/938995258
How Long is Too Long for a Vital Member of the Sterile OR Team to Remain Continuously Scrubbed into Surgery Without a Break?        
         Although the general public might not understand that medical professionals, including the Surgeon, must leave the OR briefly during a lengthy Surgery, most conscientious practitioners realize that this is a normal safety measure necessary to combat fatigue. I am still trying to get a consensus of feedback, from those who must routinely face this dilemma in the OR, as to what time frame is universally accepted as the maximum period that any member of the sterile team should ever be expected to safely function while scrubbed into Surgery without a break?  

         Protocol refinements are urgently needed to prevent OR personnel being left stranded in Surgery for dangerously long periods without any relief.  In signing this Petition, please join me in my quest to convince Johns Hopkins Hospital and the Center for Innovation in Quality Patient Care that this important patient safety priority requires their most immediate action.

         I am now enrolled in the National Institute of First Assists, “NIFA,” training program to become a First Surgical Assistant, but even as a Surgical Technologist, performing the “Scrub” role, I had to concentrate on anticipating the Surgeons needs during a case.  After how long would you consider that Scrub role jeopardized by fatigue to the point where I might have lost concentration and focus on the operation? Is 6hours of metilulous attention to the demands of a Surgeon and maintaining the sterile field still within the bounds of safe patient care?  But, after 8hours of continuous duty standing in Surgery has this demanding OR task become a torturous and dangerously unacceptable ordeal? 

         Can we really afford to take such risks and blithely talk of the increased incidence of medical errors as if these issues were completely unrelated?

         While a Surgeon can, and should, demand that the person assisting them in Surgery is relieved briefly during a lengthy case, Nurses and Surgical Technicians fall under the control of OR Management.  This leaves them vulnerable to the vagaries of inappropriate OR coverage as determined by the Hospital. As a consequence of Hospital “downsizing” to cut costs, "redundancy of personnel" has been severely limited. This has reached the point where during the off-shifts, especially at night and on weekends, there are no free staff to break people out of Surgery for even a quick run to the bathroom!  

         At an inner city Level One Trauma Center these off-peak time periods are covered by a minimal compliment of essential, highly experienced medical staff, who must frequently deal with critical trauma cases, emergency returns to the OR and major Transplant Surgery.  This was my regular OR shift assignment at my former Hospital for the last 2years of my 5year tenure. With just one Nurse and two OR Techs on duty after 11:30 PM on a Saturday night, this challenging shift already required knowledgeable, highly adaptable and versatile staff. However, inhumane levels of endurance plus the ability to tolerate severe deprivation should not represent an essential component of any normal job assignment!  
                                     
         The real question is, can critical OR personnel fully maintain concentration during complex cases under such radical extremes as 12hours continuously scrubbed into Surgery?  The current lack of redundancy among Nursing personnel is harmfully impacting ICU’s and other critical care units of many US Hospitals, but the physical limitations are severest in the OR. To determine if a similar problem exists in NHS Hospitals in the UK should the British also now consider reviewing their "Operating Theatre" regulations and protocols?
  
         Calling in call team people just to provide OR relief breaks is considered an unnecessary expense, despite the fact that there is a clearly established link between staff fatigue and medical errors.  The sterile team scrubbed into Surgery must remain trapped without food or water until they are relieved which, after 8hours, represents an unacceptable deprivation strain on the body. For those who are unaware, no food or beverage is allowed into an OR, although it's extremely difficult to consume anything during Surgery, totally "hands free” while wearing a surgical mask! The inability to urinate when necessary is very unhealthy too and may predispose repeatedly abandoned staff to a UTI or other significant medical problem.

         To simply “break scrub” and leave the OR without handing over to an assigned relief Scrub and completing the necessary “counts” is considered "patient abandonment."    However, there are currently no real safeguards within the existing US employment laws or OCHA standards to insure that critical Hospital workers, including those in the OR, are not left for hours of continuous, and dangerous, practice without a break.   Under employment laws in most US States:
breaks are at the discretion of the employer.”  

         I was left stranded at the field without relief for 8, 10 and on the worst occasion 12 hours straight during a Liver Transplant case while my patient was on bypass!    I regularly covered all their irrefutably least desirable off-shifts in the OR of a busy downtown Hospital famous for its active transplant program. We saw more penetrating Trauma than any other facility in Baltimore, a city with a homicide rate that averaged well over 300 a year.

         These unsafe abandonment situations impacted my ability to concentrate as my blood sugar plummeted.   Each time I reported becoming sick, dizzy and faint, to the point of nearly passing out. My Nurse Manager wanted me evaluated for a “sugar problem,” and I was asked, “who needs to eat at night anyway?”  When I dared to complain that my condition in response to this hardship presented a danger to my Surgical patients I was targeted for removal, forced to take unpaid leave and then fired. 

         Incidents where any member of the OR team is forced to remain on task for that long should be documented in an “Incident Report,” as an extreme of this magnitude presents an unacceptable, and in most cases unnecessary,  danger to the patient.  How many normal human beings are expected to go for 12 hours without water, food or urination? The Geneva Convention strictly prohibits such inhumane treatment of working POWs!  Why is this acceptable for critical Hospital staff?  

         I offered this mandatory Incident Report requirement suggestion to my former Hospital via their Compliance Line, only to be ignored as a terminated and vilified unreliable informant. I then presented the same information a suggested remedy to the Maryland Board of Nursing only to face a similar incomprehensible rejection. Healthcare facilities know all too well that the most effective way to deal with legitimate patient safety concerns and negligent under-staffing complaints like this to just: shoot the messenger!” 

         Compliance Lines were established in the late 1990s to allow employees to report negligence, fraud and abuse without any fear of retaliation. But, have these Hospital appointed Compliance officers now become another valuable layer of defense from rigid external scrutiny?  No current legislation exists to fully protect Healthcare Whistleblowers. Clearly Hospital Compliance Lines cannot always be trusted with rigorous, impartial, internal investigations when their own facility comes under fire. Knowing there is no potential possibility of independent oversight why should they bother to investigate?

         The campaign of silencing a dissenter goes on long after they have been ousted in disgrace.  I contacted JACHO and several other Accreditation Agencies besides the Maryland Board of Nursing, but my dire warnings were easily discredited by my untimely, deliberatly conspicious, removal from my job.  

         A minor protocol change must be enacted immediately to prevent future incidents like this from becoming even more commonplace exposing OR patients to potential harm through preventable negligent under-staffing.  
Despite the still unproven transgressions that supposedly put my own professional credibility into question, I cannot understand why so many US Government agencies have remained so complacent in adamantly refusing to review this under-staffing situation rationally and in the best interests of public safety.

         There is a lot of talk about medical errors right now, but far less mention of the current toxic work environment that is increasingly encouraging mistakes.  This situation is getting steadily worse.   While “At Will” employment laws silence those who dare to speak out, mandated overtime and lack of a humane break policy condones driving Hospital staff until they drop. 

         Is it such a big shock that fatal or debilitating medical errors and “sentinel events” are on the increase?   Is it any wonder that a sponge or an instrument is inadvertently left inside the patient when the Scrub is almost comatose after a stressful 12hour ordeal in Surgery?  All the rigorous cross checks and elaborate safeguards are completely irrelevant if the Hospital staff are trying to function while they are so severely fatigued, hypovolemic or hypoglycemic that they are at the point of either falling asleep or passing out.  Even a genuinely delinquent OR Tech. could attest to this painfully obvious fact.  

         When will the Nursing Boards and the various Patient Safety Advocacy Groups in the US finally address this very real problem and insist on proper protective legislation?  There have been advances recently with limiting the Residents working hours and trying to stop mandated overtime for Nurses.  But, much more emphasis must be placed on eliminating unnecessary fatigue among all of our Medical staff.  

         Unit Managers must be held responsible for providing adequate personnel to cover all of their shifts, including a safe redundancy of staff to relieve OR teams during Surgery and in other critical areas.    
If a Manager’s failure to provide relief was documented on a routine basis this shameful practice would no longer be an acceptable form of staffing coverage!   Such incidents would become the rare exception, confined as they should be, to genuine emergency situations where there is absolutely no other alternative. 

No one is more important than the patient unconscious on the OR table.”      
         This was the statement that I gave to Hospital Lawyers at an Arbitration Hearing to determine my reinstatement.  For this well respected Maryland Hospital the “Nursing Shortage” was a very convenient excuse to justify unconscionable Managerial abuse that seriously endangered my patient in the OR. They claimed that the ER was busy and I had not asked for a break! The ER is an unrelated clinical area and just try begging for relief on a phone you cannot even touch!   Doctors, Nurses, Technicians and other Medical personnel face severe discipline when mistakes occur, but why isn’t an abusive Manager, implementing a negligent Hospital policy that condones drastic staffing cut backs ever recognized as the real culprit?  

         In some cases misguided administration policies even offer financial bonuses to further encourage self-serving Managers to implement grossly inadequate staff coverage: greed works!  Then, after clear indications demonstrate that deliberate under-staffing is continually putting patients at serious risk, they fail to hold repeatedly abusive Managers accountable as they drive dedicated staff until they drop.  

         This dangerous Managerial policy is focused purely on drastically reducing vital staffing costs to save money at the expense of creating a safe patient care environment that saves lives.  We must put proper safeguards in place to curb this negligent profiteering strategy before more Surgical patients are put at unnecessary risk of serious harm.  Medical staff in other clinical care areas deserve equally humane treatment and consideration of their basic needs so that they can focus all of their valuable attention on providing safe patient care.

         Additionally, when any Healthcare employee is courageous enough to come forward and expose a pattern of ongoing negligent under-staffing practices, or other significant dangers to patient safety, they must be protected from retaliatory Managerial misconduct that threatens their job.   If a Hospital’s internal Compliance Hot Line fails in their crucial self-policing obligation by refusing to investigate negligence or provide protection from retaliation they must be held fully accountable for this refusal to cooperate.

         Whistleblowers should not face the third degree from our US Government Agencies who are all too easily fobbed off with fictitious excuses implying that an informant might be just some “disgruntled former employee intent on revenge.”   In reality, few will risk jail time to “seek revenge” by making sworn statements under oath to a States Attorney! 

         The primary duty of accreditation agencies is to protect public safety.  They cannot therefore, afford to ignore information or evidence based on self-serving opinions: all complaints and allegations must be taken seriously.   No medical institution, no matter how iconic, prestigious, or powerful should be immune from rigorous scrutiny, as this lack of oversight simply encourages bending of the rules, ignoring regulations and cost-cutting that is harmful to safe patient care.  

         Relentlessly abusive Managers are a remarkably valuable tool in generating increased revenue by facilitating staff downsizing without obvious layoffs. I call this the spineless approach to cost-cutting, but it makes our Hospital working environment extremely dangerous for the patients.  The current so called, “Nursing crisis” has come about through a deliberate and calculated policy of dangerous downsizing to target Nursing staff, but particularly the most experienced Nurses who are higher paid.  Minimally trained assistive personnel are plugging the gaps, working under the direction of overwhelmed new Nurse Graduates who are being forced to take on responsibility they are ill-prepared to face. 

         The creation of a toxic work environment is driving Nurses to leave their chosen profession in droves.  When these Nurses are powerless to change under-staffing, and then powerless to report negligent practices, the only way to refuse to participate or condone the dangerous policy of keep taking unnecessary risks with patient care is to leave: hence the Exodus.  

The US does not have a “Nursing Shortage” it has a “Nursing Exodus!”  

         The US healthcare industry is still consistently expecting all of our medical professionals to take bigger risks by making do with unsafe staffing practices. This vital patient safety issue desperately needs to be addressed immediately.

         Please join me in appealing to Johns Hopkins and the Center for Innovation in Quality Patient Care for their help.   The Dean/CEO of Johns Hopkins, Dr. Edward D. Miller, may be contacted at: (410)955-3180 or via e-mail:
emiller@jhmi.edu and the Medical Director for the Center for Innovation in Quality Patient Care, Dr. Peter J. Pronovost may be contacted at: (410)955-8032 or ppronovo@jhmi.edu  (These are all publicly available contacts.)  In addition please draw their attention to this important issue by signing the Petition and posting your comments on this subject directly into the Petition itself.

TO ACCESS THE PETITION DIRECTLY FOR SIGNING AND COMMENTARY; GO TOhttp://www.thepetitionsite.com/takeaction/938995258

.        The author is still struggling to overcome the severe damage that wrongful termination as a Whistleblower has inflicted on her professional reputation.  She has recently returned from Tsunami ravaged Aceh Province, Indonesia where she worked as an unpaid NGO Medical Volunteer in Surgery at Cut Nyak Dhien Hospital in Meulaboh. Above, and on the Petition itself Kim is pictured wearing a flimsy ER cover gown over her scrubs in Surgery at this minimally equipped disaster zone Hospital. She is pictured with Indonesian Medical Volunteers, Dr Adityo, and Tre an NGO translator, calling home from  PACTEC at the UN Compound in Meulaboh in her recent Care2Share explanatory letter of appeal.  
To Access this, GO TO. http://www.care2.com/c2c/share/detail/91853 
         This conscientious and dedicated Medical professional is now urgently calling for your help in the hopes that her Petition will at last precipitate meaningful debate on important issue like Under-staffing, Compliance and Whistleblower protections for all US Healthcare employees; eventually becoming a catalyst for new legislation of vital regulatory safeguards.  While this will be gratifying, just to make a tangible difference, personal vindication might remove the remaining barriers that still prevent her from reestablishing a worthwhile career as an NGO Medical Volunteer overseas. The author is also in the process of writing a book called: “ICONIC IMMUNITY,” detailing her experiences and the lessons learned.   Please feel free to e-mail your comments to her at:               
Kim L. Sanders-Fisher    -  MedicIntegrity@Care2.com   
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Posted: May 24, 2006 4:50am

 

 
 
Content and comments expressed here are the opinions of Care2 users and not necessarily that of Care2.com or its affiliates.

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Kim Sanders-Fisher
female , divorced
Hastings, AA, United Kingdom
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