Hospital Impact—Utah nurse's arrest is a teachable moment for healthcare organizations

Emergency-Room-Sign
Because of the occasional violence that can occur in the emergency department, one health system has come to depend on law enforcement for its staff's safety—necessitating a strong working relationship between providers and police.
Barry Ronan headshot
Barry Ronan

Over the last few days, I have been reading with great interest the story about Alex Wubbels, the emergency department nurse in Utah who was arrested for refusing to draw blood from an unconscious patient. News articles have detailed how she was right to stand her ground and follow both hospital policy and the law.

The reason her story got my attention is that we had to deal with a somewhat similar situation a few years ago at my health system. There were threats of arrest for obstruction of justice because staff would not share patient information with law enforcement; fortunately, the arrests were never carried out. 

Unfortunately, relationships between our staff and law enforcement began to deteriorate after a few such incidents. At that time, we asked for a meeting with law enforcement. Our general counsel, our compliance officer and I met with the city's chief of police, the sheriff, the local state police commander and the state’s attorney. 

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During the meeting, we shared the permissible disclosures under HIPAA and stressed that we want to work with law enforcement, but that in doing so, we have to obey the law. The meeting was a constructive exchange of information and ideas. Both sides also agreed that we needed to share information the right way, or else it may not be admissible in court. The state’s attorney now has access to our compliance officer 24 hours per day, seven days per week. That process continues to work well in that we have had no incidents with law enforcement since that meeting.

As a result of the recent story about nurse Wubbels, I reached out to my executives and asked them to use it as a learning opportunity. I wanted to make sure that there have truly been no incidents and that our relationship with law enforcement continues to be a positive one. 

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I also wanted to be sure that our security officers understood that hospital policy and the law took precedence over what a police officer may be demanding. Our security officers work more closely with law enforcement and I didn't want those relationships to take precedence over our staff should such a dispute arise. 

We are especially fortunate since our newly hired director of safety and security is a former city police captain who has an excellent working relationship with our staff and the region's law enforcement. Our new director suggested that he follow up with law enforcement to again review the permissible disclosures under HIPAA and to make himself available to discuss the incident in Utah as well as any other related issues.

Having a good working relationship with law enforcement is critical with the issues that we face every day. At my health system, we deal with many issues related to the heroin crisis, especially in the ED. Because of the occasional violence that can accompany this crisis, we have come to depend on law enforcement in many instances for our staff's safety.

I would encourage other hospitals and health systems to also use the Utah ED incident as a learning opportunity and to work with law enforcement before situations escalate.

Barry Ronan is the president and CEO of Western Maryland Health System in Cumberland, Maryland.

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