Real world nursing isn’t just what you were taught in nursing school. As you learn to work with patients in your clinicals, your instructors teach you the “ideal” method for every procedure and every situation. Once you get into the real world, with license in hand, you begin to see that “ideal” doesn’t exist in healthcare.
As you go through your day, learning the skills and procedures you need to use in your practice, you will probably see things that make you think “that’s not right.” You may see colleagues taking chances that could endanger their patients. You might see an overstated bill that will end up costing the insurance company or patient more than necessary. Most of the time these mistakes are just random “oops” moments, with no real pattern or ill intent. But what if you see a dangerous practice again and again, or if a fraudulent billing method is standard operating procedure? What do you do?
First, talk to your immediate supervisor. Many times the practice will end when it’s brought to a manager’s attention. If the supervisor is not receptive to your report, try taking it to the next level. You should employ as many remedies as are at your disposal before taking the issue to a more serious level.
If you reach a point where you think blowing the whistle is the only remedy left, consider the following before you make any calls:
– Are you prepared to lose your job over the issue? This often occurs in cases of whistleblowing. Your employer may view you as a threat. Your colleagues may not want to work with you. How will you pay your bills if faced with job loss?
– What are your motives? Are you protecting patients or calling attention to fraudulent billing practices involving Medicare or Medicaid (federal offenses)? Is a situation simply less than ideal and it needs to be stopped?
– How high a priority is this issue in your own life? If you don’t report it, will you simply have trouble sleeping or could you lose your license?
– Do others view the issue in the same manner? Have they also tried reporting it? If you are the only one that feels strongly about the situation, perhaps it isn’t as critical of an issue as you believe.
– What evidence do you have? Documentation is the key to proving a case. Dates and times of occurrences are important, and any notes you make of conversations or actions you witnessed are also helpful.
– What could this cost you apart from your job? Think about your reputation. Will you make a credible witness if called? Do you have issues from your past that could be brought to light?
Also consider talking to professionals from your state board of nursing before taking any action. Practice specialists at the state level can answer questions and make recommendations. You can talk to them anonymously if you wish.
If you have assessed the situation and decide to become a whistleblower, you’ll need to contact an attorney experienced in healthcare law. The attorney will develop a plan of action with you and try to minimize negative consequences to you, professionally and personally. Your attorney will counsel you as to probable outcomes should you decide to pursue the matter, and whether or not your case strong enough to go forward.