This Is Why Nurses Leave the Profession

Incidents like this remind me of why I left the hospital bedside. Granted, we’re told there’s more to the story in this particular case of a nurse who was punished by management for bringing an AWOL patient back to the institution without following some asinine protocol. Perhaps, if management were more forthcoming, I might have a clearer picture of Ms. Diasparra’s alleged transgression and feel differently about the outcome, but I doubt it.

Nurse Joyce Diasparra was on her way home from work when she noticed an escaped patient wandering along a dark road. She didn’t have a cell phone to call for help. Fearing for her safety confronting a potentially unstable and violent patient on her own, she did what any prudent nurse or reasonably sane person would do. She went back to her place of work to summon help. Not only did she enlist the help of the security guard, but she went with him in her vehicle back to the scene, retrieved the patient, and escorted him back to the institution. She could just as easily have passed by the patient without notifying anyone, and she certainly didn’t have to retrieve him herself. This is where we witness the dedication of a 15-year employee and the compassion of a true Good Samaritan.

Apparently, management had other ideas about Diasparra’s behavior. According to them, she broke a cardinal nursing rule of never leaving a patient in an unsafe situation. So, we should expect this lone nurse to coax a potentially dangerous patient into her vehicle, subdue him if necessary, and transport him back to the institution without incident. Does this sound like a safe scenario to anyone? Maybe, she should have just tailed him along the road, flashing her lights and shouting frantically at passer-bys to call 911, until he got agitated enough to run for cover, or maybe even into a line of traffic! Yeah, that makes a lot more sense, since, technically, she would never have left his side and broken the pesky rule.

And, playing devil’s advocate, so she may have pissed the patient off earlier in the day as management contends, and based on his interaction with her (we don’t know), the patient decided to make a run for it. This is all the more reason for her to have left him on the side of the road and kept mum. Trust me, nurses don’t relish caring for—how to put this delicately—“difficult” patients. I’m sure if the two of them butted heads, Diasparra most likely wouldn’t have been jonesing to care for him on her next shift. The bottom line is she upheld her duty to care for the patient when she could have looked the other way, and no one would have been the wiser. Her behavior was reasonable and brave, but since it didn’t conform to a hypothetical ideal, she was punished for it.

Sadly, incidents like this are all too common, especially in healthcare institutional settings where the top brass forgets that nurses are humans who care for other humans under extraordinarily stressful and unpredictable circumstances. Nurses have to assess the situation at hand and make the best decision for the well-being of everyone involved often on a moment’s notice. This means some rules are going to be broken, but when the best interests of the patient are served (as they appear to be in this case), we should all have enough common sense not to penalize people for doing what is right in a society where so many think nothing of doing wrong as long as the wrong hurts someone else.

Administrators, educators, and politicians yammer on about the nursing shortage and how to increase enrollment, recruitment, and retention, but they fail to recognize that this maltreatment of dedicated clinicians leads to sinking morale and burnout that ultimately results in nurses leaving the profession. I respect the need for general policies and procedures, but I want respect for my critical thinking skills and my ethical actions that won’t always fall within the confines of policy. Management needs to pull its hypothetical head out of its bureaucratic ass and demonstrate some common sense in these situations, or risk getting left on the side of the road, at least the next time I pass through.