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Accountants do it when they crunch numbers on their relatives' tax returns at no cost. Lawyers do it when they handle a friend's legal advice for free. Car mechanics do it when they perform a valve job on a girlfriend's car, no charge.
When it comes to doctors and nurses helping each other through their latest health needs, however, professional courtesy can get sticky in a hurry. Just ask Deborah Nigh, an operating-room nurse at Platte Valley Medical Center in Brighton.
Make that a nurse formerly employed by the hospital. Nigh was fired recently when the hospital discovered that she had assisted several physicians performing an operation on a colleague for free in one of Platte Valley's operating rooms.
Nigh's story is more than just a case of alleged insubordination, though. It speaks volumes about how concerned hospitals have become lately over issues of health-care costs and legal liability. It is also a story about the still stark difference between the relative worth a hospital--particularly a rural one--puts on its doctors, who are difficult to come by, and its nurses, who are not.
"I wish we could share more information with you," says Daryl Meyers, director of community relations for Platte Valley Medical Center, a nonprofit, 58-bed facility that is owned by Rocky Mountain Adventist Health Care. "All I can tell you right now is that a surgery was done, the records are missing, the hospital board is doing an internal investigation and a nurse was fired."
Reached by phone at her house, Nigh describes the incident as "bizarre" and "absurd." Beyond that, however, she declined to discuss the case on the advice of her attorney. She says she is considering suing Platte Valley Medical Center and doesn't want to prejudice her case.
According to documents obtained by Westword, Nigh was in charge of the hospital's operating room on a day shift in April when two physicians, Drs. Olivia Morris and Jerry Sisk, agreed to perform surgery--believed to have been a knee operation--on another physician, Elizabeth Benyi.
Benyi had only recently graduated from her residency, during which time she trained as a doctor of osteopathic medicine and joined a practice in Brighton (state records show she was licensed in Colorado in August 1993). For reasons that remain unclear--Benyi declines comment to Westword--she still did not have health insurance at the time her colleagues decided to perform the operation for free.
The plan was to conduct the procedure on Benyi as an unregistered patient--a practice called professional courtesy that goes on all the time between physicians, although mostly in their private offices. In this case it meant that Benyi could bypass the administrative and paperwork channels that normally result in a large bill from the hospital for supplies, labor and overhead costs. Consequently, the operation was performed off the books, and the hospital's records and billing departments were not informed.
The operation apparently came off without a hitch. But soon after, administrators discovered--Platte Valley's Meyers declines to say how--that its facilities had been used without its permission. The hospital quickly called in its attorney.
Meyers will speak only generally about the hospital's concerns with the under-the-table procedure. But he says that Platte Valley was worried about being held liable for an operation it knew nothing about. And, of course, about losing money on the job. "We are a business, just like other businesses," he says. "If you're not properly reimbursed, there's a good possibility that you won't be in business for very long."
As a result, the hospital reportedly has threatened to charge the doctors with attempting to defraud Platte Valley Medical Center. It also hinted that it was drawing up a report of the incident for submission to the Colorado Board of Medical Examiners.
In response, Sisk and Morris (neither of whom returned phone calls) have contended that the procedure cost Platte Valley virtually nothing and that they had no intention of stealing anything from the hospital. They have argued that they simply were extending some well-intentioned help to a colleague who was experiencing some thin financial times and that their time and most of the medical equipment necessary for the procedure was donated.
As of the end of July, the physicians' fates remained unresolved: The Brighton police department says no charges have been filed against the doctors, and Tom Beckett, executive director of the state medical examiners board, says he has received no report of the incident from the hospital.
Nigh has not been so fortunate.
Although hospitals have changed some, nurses very much remain subordinate to physicians. At the very least, they need to preserve a good working relationship with doctors. In Benyi's case, the operation could not have been performed without the assistance of the operating-room nurses. So when the physicians asked several nurses--including Nigh, who oversaw the operating room--to help, they agreed.
After being put on leave without pay, Nigh was fired last month from Platte Valley Medical Center. According to state records, she has worked as a registered nurse in Colorado since 1971 without any disciplinary action having been taken against her.