IS IT TRUE THERE IS A CULTURE OF FEAR & RETALIATION @ UVA HEALTH?
We are Concerned Citizens of Charlottesville and Patients of UVA Health who are troubled by what we have heard from many UVA Health professionals over the past year.
These professionals are not only our doctors and nurses but also our friends, family and neighbors. They are not willing to use their names yet out of fear of retaliation by UVA Health senior leaders. We believe our community should value and protect its healthcare providers who have dedicated their lives to helping UVA patients.
We have witnessed and heard additional accounts of doctors and nurses being reduced to tears because of their stress and mental anguish caused by current UVA Health senior leaders.
Many of these UVA Health doctors and nurses have followed the required and recommended reporting protocols within UVA Health—only to be admonished and in some instances retaliated against and punished for doing so.
Several have sought legal counsel and been informed they have valid cases against UVA Health and senior leaders. They have also been advised if they bring forth evidence of their mistreatment, senior leaders could attempt to damage their reputations and career prospects inside and outside of UVA Health.
We have been advised by counsel that merely asking these questions could result in UVA Health senior leaders taking the following actions against their patients and concerned members of their community:
Send threatening cease and desist letters in an attempt to silence these questions.
Retaliate against the UVA Health professionals who are speaking out.
Deny the validity of any of this.
We’re dismayed by all of this. We do not take it lightly when we ask you:
1. What changed at UVA Health the last four years to create this climate?
2. Is it true that in January 2024, the UVA School of Medicine Faculty Senate delivered a Resolution to the UVA Provost that included the following?
WHEREAS, it is the understanding of the SOM Faculty Senate that UVA Health senior leaders have followed up with some Department Chairs and other leaders so that they may caution faculty who have already expressed their views to stand down and discourage faculty from raising concerns at open forums on a variety of topics of late, especially OTUA. This, along with confidential reports from current and former faculty regarding specific responses and behavior from SOM leadership has created a Culture of Fear and Retribution amongst many faculty members. The SOM is governed by a Code of Conduct requiring all faculty, including UVA Health senior leaders, to commit to avoiding all forms of harassment, threats, intimidation, and bullying. Central to that commitment is the principle of treating each UVA SOM community member with respect;
3. What specific incidents caused the peer-elected UVA School of Medicine Faculty Senate Representatives to write those words?
4. Is it true that UVA Health professionals have been silenced, discredited and retaliated against by UVA Health senior leaders for reporting patient safety concerns?
5. Is it true that accomplished and respected doctors and nurses have left UVA Health due to the actions of UVA Health senior leaders?
Can you help us understand if any of this is true and if so…
What is going on at UVA Health?
A Parrhesiastes is someone who speaks the truth in a clear and honest way…
It's about the courage to speak one’s mind even when it's difficult or unpopular…to prioritize truth over social niceties or personal gain...
But speaking the truth can be dangerous. A Parrhesiastes understands this risk and is willing to face the consequences, from social disapproval to vindictive employers or even violence...
Because ultimately Parrhesiastes act out of a sense of duty. They believe speaking the truth is necessary for the greater good and to protect the people and institution they love.
The following message about witnessing retaliation was sent by someone more comfortable DM’ing us anonymously vs posting the comment themselves. They gave us permission to post it here:
"I have personally witnessed retaliation at UVA.
Multiple colleagues have been threatened with blocked promotions. Some have even had their promotions officially blocked, despite lack of cause and no track record of poor performance.
Professional Titles have been taken away without cause. Colleagues have been pushed out of their clinical specialty; recruitment to replace physicians in good academic and professional standing happens out in the open and without regard to loyalty or good will.
The culture of collaboration and mutual support has been replaced by fear, retribution and intimidation. There is no trust in health system leadership, whatsoever. New department chairs are running clinical programs in the ground and running off established, tenured leaders in the health system.
Something has to give. As things stand, the situation is unsustainable. Everyone is tense and uncertain, just waiting for the shoe to drop."
- Anon
Former RN, retired after 33 years and then worked part-time at a job I loved. I was pushed out after I had been writing “be safe” reports. I was told by my manager to “stop writing incident reports!” I stood up for myself and said that the reports that I had submitted were systems issues. She wasn’t happy with that because she told me that these report would land on her desk and she would have to write a reply. All of the things I had reported had to do with patient care, most of the errors were found in patient charts. Things that were missing or missed. Whenever I had found a problem, I usually offered a solution. No one wanted to hear any suggestions.
I am among several excellent nurses who were given the boot for being vocal or trying to implement change. Often we would go around our managers in order to get things done. Even the physician staff did not have authorization to make changes without the approval of administration, regardless if it was the right thing to do. This has been “the UVA way” for over 20 years.
A great example of how the administration works to save money is the story of the demise of the Chest Pain Center in the ED. The CPC was a unit dedicated to taking care of acute cardiac patients. Quick action by the staff to “save myocardium” was the goal. The CPC was staffed by nurses who specialized in cardiology. These nurses created protocols for actions to be taken based on the patients’s condition. These protocols were backed by research. The staff’s protocols and statistics allowed the unit to be given national certification as a center for acute cardiac care. The unit was equipped with monitors that were specialized to detect ST elevation or depression, which would indicate cardiac ischemia. The nurses were trained to read EKG’s and were able to get a “STEMI” patient from door to catch lab in 5 minutes. This unit was a well oiled machine until a new manager hired by the administration decided that “a nurse was a nurse,” and that all the ER nurses should rotate to different areas of the Emergency Department (ED), including the Chest Pain Center (CPC)nurses. This manager also bullied many of the staff, and had sexually harassed one CPC nurse. When the announcement was made that the CPC nurses had to rotate out to the main ED and the ED nurses had to rotate in, there was a mass exodus. The nurses who worked out in the main ED knew how to take care of trauma patients. They were not trained in the use of the ST segment monitoring, nor could they read EKG’s. There was no mention of training for these nurses, since “a nurse was a nurse,” they all should have the same knowledge base and be able to do the same work.
The medical director of the CPC had no control of this action. Because these nurses loved what they did and excelled in their knowledge of the care of these patients,all but two of these nurses left. One member went to MHJ, several members went back to work in cardiology units, and a few remained to work in the pediatric ED. The attending cardiologists, who were dependent on the skill of the nurses in the CPC to get these patients treated properly and expediently, were also powerless prevent this from happening.
UVA administration also has an affinity for going through Directors of Nursing. If the administration had treated their nursing staff with respect and stopped cutting the budgets (for equipment, training, sending the nurses to conferences, and networking,) they would have saved themselves lots of money. Now the hospital has as many traveling nurses as their regular staff. Travels are much more expensive, need to be trained continually, and are not loyal or dedicated to UVA.
In the mid 1990’s administration decided to get rid of the senior nurse clinicians, who were the nurses on each unit that did continuing education and trained new staff. Senior Clinicians took a great burden off the floor nurses who were expected to train new staff while taking care of patients at the same time. Another way to save money.
After the senior clinicians were done away with, the clinical ladder was instituted. This was good and bad. The nurses now had to write essays and put together portfolios to show proof that they were professionals practicing at a level that they were being paid for. The managers were given a gift in this respect because the onus was no longer on them to evaluate their work. Now nurses were having to spend time learning creative writing, instead of learning new and better methods of patient care. The nurses were also picking up the slack for other staff as the administration decided to cut the I.V. Team, respiratory therapy, physical therapy and staff education.
There used to be a Bed and Bath Team who would bath and weight patients. There was a Lift Team who would get patients out of bed. Patient Transportation was cut. All these ancillary people who made a difference in the care they received had been shown the door. Patients are given towels now that are warmed up in the microwave and told to clean themselves. No one is available to help brush teeth, wash hair, or get a patient in and out of a shower. The patients are left to themselves to read their discharge instructions since the nurses don’t have time to go over these documents because they are giving out medications, charting, answering the phone, answering call lights, and reading over doctors orders. Nursing has gone from the bedside to the door side computer. When housekeeping isn’t available, the nurses are cleaning beds and wiping down equipment. The nurses pick up the slack in order to move the patients through.
Years ago, Jean-Sorrell Jones, who was then the Director of Nursing, gave all her Clinician 4’s a copy of “Leadership is an Art.” She should have also given copies to the hospital administrators.