At Every Corner There's a Bias

The article “Nurse to Stand Trial for Reporting” in the New York times was fascinating. The different types of relationships and the communication within them are very evident throughout the entire story. Reading this article once through, you become outraged and immediately want to fight on the side of the nurses. You want to say the whole thing is unfair, charges should be dropped, Dr. Arafiles appropriately reprimanded, and that that is the only correct outcome in this situation. But before jumping on this bandwagon one should layout separately all aspects of the story.

Kermit, TX sounds like an incredibly small town where “everybody knows your name”. Being unbiased would be especially hard because there are so many relationships between everyone that objectivity, whether intentionally or not, goes out the window. And small towns also seem to have a mindset of hierarchically social classes. Of course a Sheriff and Doctor are going to have a lot of weight and be friends in such a community, look at their professions.
Second of all, let's look at the hierarchically system within the hospital. Doctors are above nurses, plain and simply. Even if the nurse is an administrative nurse. It also seems that when healthcare providers, especially nursing homes, have troubles the answer is to get rid of current administration and hire new ones. It should be of little surprise that the administrative nurse is the only one still be charged.

Because whistle blowing is a problem but necessity of ethical working conditions, laws are put in place to protect these people. Many, however, still feel the negative repercussions of trying to do the right thing. The fact that the nurses knew they would probably get fired for their jobs for writing the letter shows they understood risk of what they were doing but felt action needed to be taken despite the consequences.

Finally, let's not forget that Dr. Arafiles was from the Philippines and did some training there. Foreign doctors automatically have a prejudice against them when they start practicing in the states, no matter how qualified they may or may not be.

So what do I think? Well after my initial rolling of the eyes accompanied with a “that's typical” under my breath I reread the article. I think that for a case like this the investigation and punishments of the parties should have been handled by an objective third party from out of town. I also think its pretty fishy to have a nurse quit because of a doctors practices, have another complain internally about the problems, and then finally a letter being written to outside authorities and all on a doctor who was hired with restrictions on his license and it was known had done procedures that were not considered appropriate for those types of injuries. Its not like these complaints from the nurses would be the first questionable items to appear associated with Dr. Arafiles name.

I also think that Mr. Wiley may have been dragging his feet about handling the internal complaints. No one had died or been further seriously injured so no lawsuit to the hospital seemed to be on the horizon. Also I would assume Mr. Wiley would find it much easier to hire another nurse rather than find a new doctor in such a location as Kermit, TX. And its possible it would seem like just another administrative complaint from the grunt workers about the gods of the hospital.

By the end of my third read through I wondered why it is that so much invesitgation is being done on the nurse. Why isn't more investigation being done on the doctor. Wouldn't investigation on Dr. Arafiles tell you whether or not the nurses complaints against the doctor were legitimate and carried a credible threat to the patients? If the nurses complaints came up false or of an inappropriate magnitude, well yes, than they should be punished appropriately. But if an investigation shows Dr. Arafiles indeed is not correctly practicing medicine that he should be the one appropriately punished. Why is all the focus, positive and negative on what the nurses doing before any attention is paid to what Dr. Arafiles is doing?