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The ANA Guidelines on Reporting Incompetent, Unethical or Illegal Practices and the ANA Code for Nurses stipulate that a nurse who is aware of inappropriate or questionable practice in the provision of health care should express concern to the person carrying out the practice or to the responsible administrator. This is sometimes called "whistleblowing," particularly when the reported action violates law or statute. ANA began monitoring whistleblower legislation in 1997. At that time, 6 states had introduced legislation but had none passed it. In 1998, 9 states introduced legislation and one (KY) passed it. An area of growing interest and support by the SNAs, a record 26 states have introduced whistleblower protections in 1999 and 10 have passed it. AR's new law permits any person who submits a complaint regarding a resident or facility or who testifies in any judicial proceeding, to have immunity. Similarly, in CA and CO immunity was also granted in complaints related to the conduct of a nurse. CT provides penalties against one who interferes with investigations or retaliates against whistleblowers. FL defines as unfair competition retaliatory actions by HMOs against contract providers who reveal treatment options. IL prohibits retaliation and encourages providers to advocate for appropriate patient care. ND prohibits insurance companies from penalizing or retaliating against a provider who reports jeopardizing a patient. TX prohibits retaliation by one provider against another in assisted living facilities. UT made some statutory modifications in the definition of damages and costs for whistleblower cases. Also, KY's statutory language prohibits a facility from threatening an employee who reports a quality or safety problem. NM's bill, vetoed by the Governor, would have allowed health care professionals to report improper quality of patient care and would have prohibited retaliatory action by employers. The majority of other bills considered (but not enacted) in 1999 prohibit either health care facilities or health care plans (including managed care organizations) from retaliating or discriminating against an employee or enrollee as a result of a complaint: AL, AZ, IL, MA, MO, MS, NV, NY, OR, SD, WI, and WV. An MO bill was specific to discrimination against nurses. HI's bill was premised on violations of professional code of ethics. MT would have protected all state employees. OH's bill was specific to nurse reporting, and outlined an internal process that must be followed before external reporting proceeds. VA specifies immunity for reporting. WV bills would protect employees of Medicaid providers and would prohibit hospitals from discriminating against reporters under threat of license revocation. HI would have created a confidential telephone hotline for reporting dangerous patient care situations.

1999 State Legislative Trends main page