It’s been a weighty week. As we were putting the finishing touches on this email, news broke that former nurse RaDonda Vaught had received a diverted sentence of three years probation following her March conviction of criminally negligent homicide in the death of her patient Charlene Murphey.
In reviewing early coverage of the sentencing, Judge Jennifer Smith’s words quoted by The Tennessean stand out:
“This was a terrible, terrible mistake,’ Smith said. ‘And there have been consequences to the defendant.'”
We agree. It was a set of significant mistakes that led to Murphey’s death, and it was a mistake that Vaught faced criminal charges. And there certainly are consequences…for Vaught and for our workforce-challenged industry.
The judge’s words read like those of someone seeking to deescalate a bad situation, without overturning the conviction or diminishing what happened. It was an impressive decision, actually. One that likely most – including us – hoped for. And it was also an impressive example of a leader communicating simply and elegantly amidst an emotionally charged and complex situation.
Two things can be simultaneously true. First, that Vaught made a horrible error. And second, that she should not have been pursued as a criminal. The threat of a criminal conviction on top of professional excommunication could have negative effects on patient safety (are nurses more or less likely to report an error now?) and further stress a besieged and exhausted workforce (add the risk of being charged with murder to your rounding).
As your nurses sit with the news and consider what comes next, all that we wrote in March holds true. Keep listening, keep bringing everyone to the table, keep showing your nurses how you support them.
While Judge Smith’s decision is the best news possible under the circumstances, there is still a lot to process.
Theresa Collins, a travel nurse from Georgia who closely followed the trial, is quoted in Kaiser Health News as saying, “When you criminalize what health care workers do, it changes the whole ballgame.”
“…More than a dozen brands that have previously taken positions on other issues either declined to comment on the draft opinion or didn’t respond to requests for comment. A variety of factors is likely at play, including fear of alienating consumers or other constituencies and the fact that the Supreme Court hasn’t yet ruled on the case…”
What It Means for Healthcare Providers
“No comment” won’t suffice for providers of care. Laying low isn’t an option. Because you’re in the direct line of this story.
That said, speaking up on Roe won’t be easy. Your organization may see the reproductive services protected by Roe as a fundamental healthcare right. A nuanced take can be a challenge; there is little shading in the politicized, black-and-white national conversations on the topic. No matter what you say or what position you take, a notable percentage of your workforce and community will think differently about it and the differences can be sharp and sharply felt.
Consider that 75 percent of the healthcare workforce and nearly 90 percent of nurses are women. Consider that you serve diverse communities. You may be in a blue city in a red state. Or a red town in a blue region. You may be leading a hospital that’s part of a publicly-traded system. Or guiding a Catholic organization. You may have multiple facilities in multiple states, each with unique cultures, politics and personalities.
There’s no smooth path through this. But that’s not a reason to stay quiet.
And while, in light of the leak, it’s tempting to scenario plan and run through all the what-ifs, avoid this behavior. The potential reversal of Roe v. Wade is a huge issue, but still up in the air. So for the moment, work with what’s known.
Here’s our advice for healthcare providers who are being asked now to respond. Step one: Assemble your executive, legal, clinical and communications teams and consider these 10 points:
- Expect inquiries from staff, patients, media and your community. If you haven’t received the call yet, it will come as a decision nears or as Congress or your state legislatures take anticipatory action. Again, “no comment” won’t cut it.
- Know and communicate your position. You must be able to articulate your organization’s unique position on providing abortion services. So, based on who you are, be prepared to describe how the position was determined and how it is rooted in your mission, clinical philosophy or legal structure. (Of course, if your organization does not have a position on this divisive issue, develop one internally before external forces create it for you.)
- Align your team. Talk to your board, administration and clinical leaders; remind them of your organization’s position and how to answer the questions as they come.
- Know how this will land with employees. Assume your organization’s position on abortion services will become common knowledge soon. If not already well known, anticipate how it will play among your workforce. Prepare a thoughtful response that reflects the nuances and unique characteristics of your organization, your employees and your community. Then communicate accordingly, carefully.
- Know your policies and record on abortion services. If your organization provides abortion services, what are they, where do they take place and how many do your clinicians perform? What are the criteria or guidelines surrounding these services? Is this information public record?
- If you do not perform abortions… What is your guidance and/or referral policy for patients seeking these services?
- Find the right public messenger. It’s critical to have a spokesperson who best reflects and can articulate your organization’s position, how it was reached and who owns it. Is that your board, member of the executive team or a clinician? Even in prepared statements, the generic corporate voice won’t suffice – every message must have a person behind it.
- Know your employee benefits related to reproductive health and abortion services. Do your benefits match your policies? What about the morning after pill? What about IUDs and other reproductive health services?
- Anticipate the response of your state government. Your legislature and governor will shape abortion service guidelines if Roe v. Wade is struck down. You may have a good idea of which way they’ll go, but work with your GR team to get a read on the details. Additionally, consider whether your organization will want to advocate for a particular result.
- Be responsively proactive. Unless you are advocating for a specific policy, there is little reason to answer the question publicly until it is asked. But when asked, you need to be ready with a clear and defensible position.
Bonus: Remember that no secret is actually secret. If one of the most staid, structured and protective organizations in the country – one whose function depends on keeping things quiet until the right moment – could experience a leak like this…it could happen anywhere. And of course, leaks don’t happen for everyday issues. The point of a leak is to create pressure toward the outcome desired by the person responsible. So if it happens, it’ll be on an issue of importance.
A last thought for healthcare leaders: This issue may be a test of your organization’s mission and values. Broadly, do the words on your website, your marketing and internal communications support your mission and serve as a foundation for your position – on this topic and any other that matters for patients? If not, take time now to choose your words. Because while words are not enough, people are watching and listening and will be comparing who you say you are to what they experience when they turn to you.