Connie Donahue fought not just for patients at Duke, but for nurses' rights. Did that help kill her? Brandeis University researcher Dana Beth Weinberg talks about some of the problems in nursing in a new book called Code Green: Money Driven Hospitals and the Dismantling of Nursing. In an interview in the Massachusetts Nursing Association newsletter of September 2003, Weinberg was quoted as saying that: "The nurses in this study did not actively try to change hospital practices, for example by going public with problems or bringing in a union. Indeed they adopted work practices that promised the fast track to burnout, sacrificing themselves to save patient care."
In the spring and fall of 2000, several dedicated and experienced RNs at Duke University Medical Center did try to start a union there for the sake of nurses and patients. We even called ourselves NUPA: "Nurses United for Patient Advocacy." None of us wanted a union so that we could be lazy. All of us wanted to be able to give better care to our patients, to make our profession more attractive so more people would enter it, and to have a more powerful voice concerning our working conditions. None of us wanted these things more than Connie Donahue did.
Unfortunately, Connie died of a heart attack on Oct. 6 at only 49 years of age. As her obituary says, she "Édevoted her life to caring for her patients and their families lovinglyÉ compassionatelyÉ was a true patient advocate, and loved her profession" for all the 28 years she worked in it. In what was at times a very stressful union campaign, we never saw or heard any words from her that would have indicated otherwise. She did a lot of work on the NUPA website. Someone called her our "Web Diva." She asserted she'd rather be a goddess than a diva; after that we called her our "Web Goddess." She was caring, intelligent, professional, dedicated, and fun.
In spite of all these good qualities, in July 2002 Duke fired her after 17 years in the surgical intensive care unit. Duke certainly didn't cause her death, but it did make her last 17 months difficult for her. In our opinion, Connie Donahue did not deserve the treatment she got from Duke. She was ostensibly fired for jeopardizing a patient's safety by leaving that patient for 11 minutes, although there was a respiratory therapist present and two physicians nearby, and she had first checked and adjusted the patient's medications. Her nursing judgment was sound. The patient's condition was unchanged before she left, while she was gone, and when she got back.
No one should be fired without some kind of orderly disciplinary process--verbal warning, written warning, and final written warning, especially not an employee of 17 years, especially not when there is a nursing shortage, and especially not when there was no patient harm. That is usually Duke's procedure. Sometimes those orderly steps are bypassed (falsifying records, working under the influence). They certainly were bypassed in Connie's case. We know what Connie would say about all this: "If we had a union, with union representatives to attend disciplinary hearings with accused RNs, then I might still have a job."
Even admitting the possibility that Connie did make a mistake, worse things have certainly happened at Duke (and every other hospital) without anyone losing jobs over them. Nor should they. All medical professionals are human. All humans made mistakes. Connie may have made a mistake. Nurturing work environments help staff learn and grow from mistakes. All Connie Donahue wanted was a better environment for nurses at Duke. No one will ever convince those of us who worked, knew and loved Connie that she was not fired so summarily for any reason other than her unionization activities. She was one of the leaders on the NUPA movement in 2000. She had contacted the United American Nurses (the union arm of the American Nursing Association) in May 2002. In that same month, Dr. William Fulkerson, chief medical officer at Duke, called her into his office. After the meeting, Connie said she felt his chief purpose in meeting with her was to attempt to avoid another union campaign. Then, in June 2002, the incident happened for which she was fired in July 2002. This timing seems very coincidental.
We can't help feeling that, if Duke's nurses had a union, Connie would never have been fired. We are heartsick at losing Connie. We are even more heartsick that the N.C. Board of Nursing considered suspending Connie's license. Not only had she lost her job at Duke, but she was also faced with losing the profession she had known and loved for 28 years. We hope the N.C. Board of Nursing will consider reinstating her license posthumously. We are angry that the last 17 months of her life had to be so emotionally painful. Some of us wish we'd had the courage to resign en masse when Duke fired Connie. But, we needed our jobs, our health insurance, our pensions. Employers count on that. Connie was the bravest of us all.
A study by the Journal of the American Medical Association, also quoted in the Massachusetts Nursing Association newsletter of September 2003, found "each additional patient above 4 that an RN is assigned to care for produced a 7% increase in injury or death, a 23% increase in nurse burnout, and a 15% increase in job dissatisfaction." Connie knew this. One of the goals of NUPA was better staffing and lower patient ratios. Connie was a leader of that union effort. Nursing has lost a terrific advocate. We will miss you, Web Goddess.
Violette Blumenthal, Dorcas Butler and Marge Dooley are registered nurses at Duke University Medical Center.