It was during WWII that the idiom, “loose lips, sink ships” became popular. This statement warns against unguarded talk that might hurt the war effort. “Even the walls have ears” is another phrase that restates the same thought. We may never know who is listening to our conversation and just exactly what that person can do to hurt the person, plan, or institution. An individual who is reckless in their conversation can create harm. “Do no harm” references more than a surgical error or a misdiagnosis that alters the life of a person in the care of a medical professional or nursing professional. Those three important words are a warning to all of us that our words have the ability to change lives, to harm people and to discredit a situation. An interesting analogy is found in an epistle written by James in the New Testament in the first century. To paraphrase, he mentions putting bits in the mouths of horses so that they may obey us. He admonishes his audience to look at the ships of the sea. A wind may blow them, but they are guided by a small rudder as the pilot directs. “So, the tongue is a little member and boasts of great things.” How great a forest is set ablaze by a small fire.
If someone walks up to you and tells you that “loose lips sink ships,” they’re telling you to stop talking because you’re giving away information to a third party that you should keep secret. The phrase applies to social and professional settings. The “ships” in the phrase refer to plans, your reputation, or anything you’re trying to keep secret in a patient’s medical record. Where and when can these events surface in our daily lives as professionals? I wish to mention just about a half dozen situations, but failure to listen and hear can represent one of your largest professional errors and can cause litigation, disillusionment, loss of your employment and even more importantly, your reputation.
Let’s look at the most common and easiest mistake to be witnessed by others, elevator talk. If we are employed in a hospital or other medical facility, we no doubt have an elevator system. When we are on this elevator with a friend or co-worker, we may be tempted to discuss or ask a question about our patient. It is not necessarily mentioning them by name, but their cascade of complaints and symptoms may be a giveaway to a visitor or family member who is present. Patients and their families can be paranoid or are under the assumption that this constellation of signs and symptoms are related to them, even if they were not mentioned. All facilities warn their medical and nursing staff of this. The same is to be said of the nursing desk. It is not unusual for other hospital staff to be gathered there as well as visitors and patients and families. The nursing desk is not a location where we can forget the hazards of unguarded speech and its sequalae.
Places where we consume our food are also offenders to the rules of professional sensitivity to guarded information. Often PAs, NPs, residents, and nurses are accustomed to getting “curbside consultations” in the cafeteria or while with friends or partners in an upscale, trendy restaurant. Our work is exciting, and our spouses and significant others are only too eager to lend an ear and help you decompress from your busy day. Who may be sitting near your table, with the capacity to hear and take recourse if this is about someone they know or if this is an administrator totally unknown to you? Lawyers like to spend lunch hours with a colleague at just such an establishment near your hospital. Their purpose? To listen to the conversations and plan a strategy.
I have walked into a surgeon’s locker room at the end of my day in surgery to hear some of my less than respected surgeons laughing about very sensitive outcomes which often made me cringe and, forever, indelibly imprinted my mind with their unprofessional banter.
Another dangerous situation is communicating with friends in your facility about your section chief, your director, other surgeons or nurses or administrators. Your colleague friend only holds that title now, but people change and, with it, their aspirations to climb another step up the ladder. Your comment can be incriminating and cost you your employment. Life in the trenches is not about waiting out the storms hoping that they will pass suddenly; it’s about dancing in the rain. But your best dance cannot equal your ability to utilize an umbrella and protect us from the rain. In other words, if we learn to control our tongue, we will not be liable for dire consequences. Old mottos are always nice to bury in our souls, such as “Remember the Alamo,” or for this article, “What happens in Vegas, stays in Vegas.” The most important thing to remember on this subject is that both your reputation and legal culpability are at stake.
In closing, failure to heed my warnings can create a loss of employment as well as litigation for unprofessional conduct and violation of your patent’s privacy and their trust. Yes, you can be sued for these breaches, and you will need a great personal liability insurance because, if you are guilty of infractions against your facility, I would not relinquish my defense to their insurance carrier. Now is the time for you to invest in a AA Best rated personal liability policy and the best mode would be an Occurrence Policy. I have always used an AA Best Superior for my malpractice needs; this is not the time to search for the most inexpensive policy. An old warning to the pioneers and the cavalry in the early days of our country was to keep your ammo dry. A flintlock rifle or pistol cannot work if it is wet. Cheap malpractice coverage will not give you adequate insulation if you are challenged with litigation. Hopefully, these free flowing thoughts will register in your mind and you will become determined to care for your personal needs, and that of your family.
Written For CM&F By: Robert M. Blumm, PA, DFAAPA, PA-C Emeritus
CM&F Clinical Advisor
