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 Texas : Features : Columns : "The Girl Detective's Theory of Everything"

Damned if You Do,
Damned if You Don’t

by Elizabeth Bussey Sowdal
Elizabeth Bussey Sowdal

I was fascinated and horrified by an article written by Amy McGuire in "Advance for Nurses" regarding the bizarre case of two Texas nurses, Vickie Galle, RN and Anne Mitchell, RN. These nurses, formerly employed by Winkler County Memorial Hospital in Kermit, Texas have been charged with a third degree felony for the "misuse of official information" and – get this – using patient records to "harass or annoy" one Rolando Arafiles, MD. Nurses Galle and Mitchell were arrested, imprisoned and have since been released on $5,000 bonds for reporting the estimable Dr. Arafiles to the Texas Medical Board for selling herbal remedies to his hospital and clinic patients. These nurses are facing a jury trial, scheduled for Sept. 29, and 2-10 years imprisonment and a $10,000 fine.

First of all nurses, have you ever heard of a doctor selling anything at all to a patient in or out of the hospital? Ever? I never have. Secondly, are we not mandated by our licenses to protect and advocate for our patients? I believe we are. I am sure of it. Thirdly, did you ever imagine that if a nurse – you, me, any nurse – had a serious concern and reported it to a governing board that nurse could be prosecuted in a court of law and imprisoned? In the United States of America? It sounds like a joke. A bad joke.

Nurses Galle and Mitchell included in their report to the Texas Medical Board the records, including identifying information, of ten hospital patients and this is the branch they are being hung upon. The county attorney’s office indicted Galle and Mitchell on "misuse of official information" because they included this information in their report without the permission of the patients or the hospital.

According to the Texas Medical Board in a letter to the Winkler County district attorneys, the nurses’ complaint was allowed under both state and federal law and because the complaints were confidential and not subject to subpoena, any information given to the Texas Medical Board, "is exempt from HIPAA requirements."

Both the Texas Nurses Association and the American Nurses Association are standing firmly in support of the two accused criminals. Just to firm it up in your mind, the two criminals whose crime was attempting to protect patients from harm and unethical practice. Those two criminals. Attorney Brian Carney, who represents the nurses, filed several separate motions to suppress and dismiss the case, all of which were denied by District Judge James L. Rex, a man who must not be afraid of a fight.

And a fight may be just what Winkler County will have on it’s hands as the attention of the nation is turned upon this case. It is no longer just about nurses Galle and Mitchell, but about every nurse and the role of nurses as patient advocates. It is interesting timing, perhaps unfortunate timing for Winkler County, as both the federal government and the citizens of our country are giving the state of healthcare in this country such a lot of scrutiny. If nurses are to be prosecuted for attempting to protecting the public, then who will be the public’s advocate? The Winkler County district attorney? Dr. Arafiles? The article didn’t say what type of herbal remedies the good doctor sells, but I doubt it’s anything strong enough to cure the headache he faces now.

Winkler County Memorial Hospital administration deserves a bit of attention as well. They fired the two nurses, both long-time employees, although the "Advance" reporter was not able to learn why. Jim Willman, director of government affairs and general counsel for the Texas Nurses Association cited a 1983 Texas case (Lunsford v. Board of Nurse Examiners, 648 S.W.2d 391, 395 Tex. Civ. App. 1983) where the court ruled that a "license to provide medical services is a covenant to serve the people" and that "nurses have a duty to act in the best interest of their patients, and this duty is not superseded by hospital policies." Of course. If this were not the case then there would be nothing to prevent hospitals from doing anything in the world to patients and then claiming that it was hospital policy, so there!

There has got to be accountability in healthcare. In a perfect world there would never be any question of substandard care or medical ethics. This is not a perfect world. And since it is not, and since nurses are mandated to protect the rights of and advocate for their patients, nurses bear the responsibility, the legal, moral and ethical responsibility, to report deficits in care when they happen. No matter what the policies of their hospital might be.

Every nurse in the United States should be interested in the outcome of this case, because it has the potential to affect any of us. "There but for the grace of God, go I." As they say. Should you care to show your support of nurses Galle and Mitchell the Texas Nurses Association has established a legal defense fund. They plan to match every dollar contributed by individual nurses up to $5,000 and have raised more that $20,000 already. More information can be found at www.texasnurses.org.

© Elizabeth Bussey Sowdal
"The Girl Detective's Theory of Everything"

September 4, 2009 Column

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