Home E-Weekly July 15, 2014

Would You Have Fired This Bawdy Nurse?

Published: July 14, 2014

Her colleagues called her a bully and complained about her bawdy language and sexually charged jokes. Her superiors were annoyed by her suggestions for improving the training of nursing students. She complained about working evening hours. Still, the National Labor Relations Board recently ruled that Donna Miller, RN, was a talented surgical nurse whom Inova Fairfax Hospital had no right to fire.

The trouble began in 2005, when the supervisor of the Falls Church, Va.-based hospital's ASC decided to schedule cases after 6 p.m. This upset Ms. Miller and her colleagues, who were accustomed to working regular hours. The friction between management and the OR team escalated in early 2007, when most pediatric procedures, including inpatient cases, were moved to the ASC.

During this time, however, the head of the ASC called Ms. Miller an "excellent clinician" and "fabulous nurse" and noted she was "a tremendous asset" during an annual review conducted in September 2008. A few weeks later, Ms. Miller was promoted and praised for her clinical expertise and dedication.

But then things began to snowball. In December 2008, the ASC supervisor told Ms. Miller she had received complaints about her constant use of inappropriate language. In early 2009, 3 nurses called the health system's compliance hotline to sound off about Ms. Miller's manipulation of the surgical schedule, apparently to punish nurses she didn't like; her failure to follow proper procedures, including the adequate cleaning of instruments; her habit of taking extended breaks; and her use of profanity and sexual innuendo among co-workers. The nurses said Ms. Miller intimidated and bullied the people with whom she worked.

During the ensuing investigation by Inova's HR manager, Ms. Miller authored an e-mail (signed also by 4 colleagues) to the supervisor in charge of training nurses. It requested that they receive notification of which nursing fellows were scheduled for a rotation through the ASC, how long the rotations would last, a list of learning objectives, and a way to adequately evaluate and document the fellows' progress. They also asked for weeklong breaks between rotations. The e-mail ended with, "We are committed to giving these fellows the best possible educational experience with all of our combined experience and guidance!"

The supervisor sent the e-mail to the ASC director, noting that she was "furious" that Ms. Miller acted as spokeswoman for the group and claiming that the group was talking behind her back and ganging up on her. At the time, the HR director found nothing objectionable in the e-mail. Three days later, however, the HR director discussed the e-mail and compliance hotline complaints with the chief of surgery. The chief said he admired Ms. Miller's clinical skills, but found her vindictive and put his full support behind her termination.

Ms. Miller was informed of the accusations and denied all but one: She admitted that, when a surgeon asked her what she'd done on New Year's Eve, she told him she'd been naked in a hot tub with her husband. Ms. Miller was placed on administrative leave and instructed not to discuss the disciplinary action with her colleagues.

Several surgeons offered to speak on her behalf, but were allegedly turned down by the HR director. Ms. Miller was terminated less than a month later for "creating a hostile work environment, excessive sharing of details of her personal life and using inappropriate language," according to the NLRB.

The NLRB ruled that Ms. Miller's initiation of a discussion about how certain aspects of the nursing training program ran, her request for a week's break between rotations and her raising of concerns over the transfer of cases to the ASC were activities protected by labor law and "particularly relevant to the terms and conditions of employment of the ASC nurses."

The NLRB also noted that inappropriate language was apparently part of the culture in the hospital's ORs, and tolerated by the health system for years. According to the ruling, nurses and surgeons often shared off-color jokes, a monthly calendar that hung in the operating room depicted a cartoon penis and posters made by a pediatric surgeon featured images of a nurse's face superimposed on provocative magazine covers. Additionally, the board noted, Ms. Miller's punishment was much more severe than the 3 written warnings given to a surgical tech who shared sexually explicit photos of herself with colleagues.

Ms. Miller will receive lost wages and benefits as restitution. Her attorney, Paul Tyler, says he is pleased the board did its job and that the mistreatment of his client has been rectified. He says she has moved on from the ordeal and has not returned to work for Inova.

As for Inova, however, "Because it is possible we will appeal the decision, we have no comment at this time," says spokesperson Tracy Connell.

Daniel Cook

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