For more than 10 years, Ms. P, a 40-year-old nurse practitioner, enjoyed a stable and prosperous job in general practice. She had worked her way to a supervisory role at a small practice consisting of one physician, and she was well respected. Two years ago, Ms. P was forced to move on as the physician running the practice retired.

She took a new job at an area nursing home that was associated with a large medical facility. Within a short span of time Ms. P found herself unhappy with the work environment. She was used to being in charge and accustomed to working independently and was irritated at the level of supervision, amount of paperwork and general work environment. As a result, there was a good deal of conflict between Ms. P and her direct supervisor, Ms. S, as well as with other coworkers.

During the course of her employment, Ms. P was reprimanded on several occasions. First, she was pulled aside when she accidentally gave a patient medication that had been prescribed to another patient. Ms. P defended herself by saying that the physician orders here were unclear.

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The second instance occurred when a fellow employee reported Ms. P for having caused undue trauma to a patient during a catheter removal. Ms. P felt that she was being treated unfairly, and complained to Ms. S, the nursing supervisor, about the nurse who had reported the incident. The supervisor dismissed Ms. P’s complaints.

Ms. P also complained about another coworker who she felt was rude and condescending to her. On several occasions she reported this nurse’s actions or comments, but Ms. S did not follow up nor discipline the other nurse. Ms. P wrote a letter to Ms. S complaining about her failure to respond to the issues with the other employee, but Ms. S still did not act.

The final incident between the two happened after Ms. P wrote in a patient’s file that the doctor had ordered that the patient be transferred to the hospital. This was not, in fact, the case. Ms. P had been extremely concerned about the patient, and felt that the physician wasn’t attentive enough and that the patient needed an immediate transfer to the hospital, so she took it upon herself to write in the chart that the physician had been notified and ordered the hospital transfer.

When it was discovered that the physician had not ordered the hospital transfer, Ms. P was terminated from her employment.

Ms. P became convinced that her firing — and her supervisor’s treatment of her — was racially motivated. Ms. P was white, and after ruminating on events she came to the conclusion that Ms. S, who was black, was ignoring her complaints and disciplining her based on her race.

Ms. P filed a lawsuit against the nursing home, alleging race discrimination in violation of the Civil Rights Act.

The discovery process began and the nursing home produced its records, which included Ms. P’s letter complaining that Ms. S was not paying attention to her complaints about her coworker. The disciplinary records regarding the three events for which Ms. P was reprimanded were also brought forward. Depositions began and each side had the opportunity to question potential witnesses.

After the discovery process, but prior to trial, the nursing home attorneys filed a motion to dismiss the lawsuit, claiming that no discrimination had taken place and that Ms. P had been fired for cause. The court looked at all three incidents in order to determine whether any racial animus had been shown.

In the first incident, the court held that giving a patient the wrong medication was a clear violation of policy and procedure. In the second incident, involving the catheter removal, the court found no evidence of any racial bias regarding this incident. The final issue — writing orders for hospital transfer in a patient’s chart — was also a clear violation of nursing home policy, the court said. The resulting action, the termination of Ms. P, contained no overtones of racial animus, the court found.

Legal background

Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex or national origin. In the simplest terms, Title VII prohibits employers from making employment-related decisions when the decision is motivated by a person’s protected trait.

In order to establish a discrimination claim, the employee must show that there was unfair treatment based on protected traits. In Ms. P’s case, her employer had clear and valid reasons for terminating her employment, which had nothing to do with race.

Protecting yourself

Ms. P made several serious errors while working. Giving a patient the wrong medication was certainly grounds for discipline, even if the patient was not injured by the medicine. But the most egregious error that Ms. P made was to write physician orders in a patient’s chart when the physician had not ordered the action.  By any standards, this clearly crossed the boundary from “mistake” to “intentional action.”

Ms. P was terminated from her job because of what she did, not because of her race. Her perception that her supervisor was harder on her because they were of different races was a mischaracterization of the events, and a reflection of Ms. P’s unwillingness to take responsibility for her own actions.

Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.