Last October, the discipline committee of the Saskatchewan Registered Nurses' Association found Carolyn Strom guilty of "professional misconduct" for a post she made on Facebook, venting about her grandfather's "subpar care."
Now, the SRNA has determined the penalty: a $1,000 fine, $25,000 to cover costs of the disciplinary proceedings, a reprimand, and a requirement that Ms. Strom write a "self-reflective essay" and complete an online ethics course. If she fails to complete any of these, her nursing license will be suspended.
This is preposterous. It does nothing but add insult to injury.
It's bad for nursing and it's bad for patients.
Let's look at the facts of this case.
On Feb. 25, 2015, a month after her grandfather's death at St. Joseph's Health Facility in Macklin, Sask., Ms. Strom posted the following comments on Facebook:
"My grandfather spent a week in palliative care before he died and after hearing about his and my family's experience there, it is evident that not everyone is 'up to speed' on how to approach end of life care or how to help maintain an aging senior's dignity.
"I challenge the people involved in decision making with that facility to please get all your staff a refresher on this topic and more. Don't get me wrong, 'some' people have provided excellent care so I thank you so very much for your efforts, but to those who made Grandpa's last years less than desirable, please do better next time."
Some nurses at St. Joseph's were, understandably, upset at being taken to task and they filed a complaint with the SRNA.
The discipline committee charged that Ms. Strom had committed five professional and ethical breaches: not respecting patient confidentiality by identifying her grandfather (that charge was dropped); failure to follow proper channels in making a complaint; making comments that have a negative impact on the reputation of staff and a facility; failure to first obtain all the facts; and using her status of registered nurse for personal purposes.
Let's be clear: Calling out your colleagues on Facebook is not very nice. It would have been more professional to write a letter to St. Joseph's management expressing her concerns. Ms. Strom admits that.
But who among us has not been upset by the care of a loved one at some point? Who among us has not said something ill-advised – especially on social media?
Ms. Strom should have received a slap on the wrist, apologized to the nurses she insulted, and that's that.
But, in the hands of the SRNA disciplinarians, the response to a relatively innocuous Facebook post took a Kafkaesque turn. There were god-knows-how-many meetings and hearings and legal negotiations and media stories.
According to the "penalty decision," the whole process cost $150,000. The SRNA patted itself on the back for demanding Ms. Strom pay "only" one-sixth of the costs.
But she shouldn't have to pay a red cent. Ms. Strom and her lawyer made every effort to reach a settlement – one that focused on the educational component of the penalty.
Yet, the SRNA insisted on a monetary penalty because "deterrence is an important consideration."
Here's some perspective from a previous case: In 2011, Ontario nurse Margaret Kaufman allowed her husband to access the personal health records of her clients, billed the province for a patient visit she didn't make, posted personal information about a client, and badmouthed that client on a publicly accessible website. Pretty egregious stuff, yet she received a four month suspension, some mandatory education, but no financial penalty. A basic principle of justice is that the punishment must fit the crime. The precedent is for members of self-regulating professions to pay the costs of their hearings, but it has to be reasonable. Ontario doctors, for example, pay $4,460 for costs, regardless of their offence.
Slapping Ms. Strom with a $25,000 in costs, in addition to a $1,000 fine, is a perverse injustice.
The only thing it's going to deter is nurses speaking up about sub-par patient care. We should be encouraging, not dissuading, those on the front lines from doing so.
Ideally, whistle blowing or venting shouldn't be done in a Facebook post and that's perhaps the one useful take-away from this debacle. But, at the very least, we could cut a grieving granddaughter and nurse with an unblemished 13-year record a little slack.
The only reputation truly harmed here is that of nurses. By viciously turning on one of their own, they look petty and vindictive and, in many ways, unworthy of the privilege of self-regulation.