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In a question of ethics, student suspended over medical scrubs

  • Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012.  Stickley says she  has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."<br/><br/>(SAMANTHA GOREH / Monitor Staff)

    Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012. Stickley says she has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."

    (SAMANTHA GOREH / Monitor Staff)

  • Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012.  Stickley says she  has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."<br/><br/>(SAMANTHA GOREH / Monitor Staff)

    Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012. Stickley says she has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."

    (SAMANTHA GOREH / Monitor Staff)

  • Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012.  Stickley says she  has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."<br/><br/>(SAMANTHA GOREH / Monitor Staff)
  • Heather Stickney poses for a portrait on the NHTI campus where she had gone to nursing school until she received a failing grade in a class because her professor accused her of lying and breaking the code of conduct; December 4, 2012.  Stickley says she  has always wanted to be a nurse, "I have no plan B," she says that she has always been the top of her class and that her, "punishment does not fit the crime."<br/><br/>(SAMANTHA GOREH / Monitor Staff)

All Heather Stickney wants is to be a nurse.

Stickney, 30, has dreamed of working in an operating room as a first assistant to a surgeon since she was a teenager. She’s currently a licensed nurse’s assistant and is a little more than one semester away from finishing a program at NHTI that would qualify her to sit for her licensing exam and become a registered nurse.

But since early last month, her dream has been on hold and may be in doubt.

Two years into the program, Stickney was suspended last month after taking home scrubs she had worn during a rotation at Catholic Medical Center. If her appeals of the suspension are rejected by college administrators, she may not be able to afford to start the year over again in the fall, and doesn’t know when or if she could earn her degree, she said.

Her professor and clinical adviser failed Stickney on the grounds that she had stolen the scrubs and then lied about it. Stickney says it was a misunderstanding, citing an unblemished academic record and testimonials from other students and nurses. Her first appeal to the department chairwoman was denied, but she’s filed for a second with another administrator.

“My clinical skills are exceptional. I have never once made an error,” she said. “My career could be over, all over a pair of scrubs. It just doesn’t make sense to take someone who could be a really great nurse away from patients who I could help.”

Stickney’s path toward a degree has been a long one.

She first decided to become a nurse after seeing the care her father had received when he was diagnosed with cancer 15 years ago.

“Those nurses were there with him when we had to leave. I want to be the person who is there for my patients. Their families can’t always be there, but I can, and I can be an exceptional nurse. They are keeping a great nurse from patients who could benefit from my skills,” she said.

After she graduated from Manchester Central High School in 2001, and after cancer treatments exhausted her parents’ assets, she scraped together money on her own to pay for college applications.

NHTI’s reputation as one of the best nursing schools in the state put it at the top of her list. She spent one semester there before she was overwhelmed trying to work enough hours to pay for tuition and living expenses. She started again a few years ago, completed her general studies requirements and started the nursing program.

Her skills during the clinical rotation were especially good, she said, because it was the second time she’s taken the course. Last fall, not long before the end of the year, she had to stop attending class for a medical leave when doctors found she had a severe endometriosis. She had to pay in full for that semester, even though she didn’t get academic credit because she hadn’t finished.

But at the foundation of her clinical skills is her desire to care for patients, her friends and fellow nurses wrote in letters supporting her appeal.

“I would trust Heather with my life, and my children’s life,” Erica Kowalski wrote.

Another friend left the nursing program after observing nurses who “seemed to be unpleasant people who did not enjoy their jobs.”

“Heather is one of the few people whom I have met who I feel genuinely cares about her patients,” Taury Anderson wrote. “Heather’s enthusiasm for the task of being a nursing student and her impressive capacity for applying her text book knowledge has always astounded me. If anyone was meant to be a nurse, she is.”

NHTI spokesman Alan Blake said student privacy-protection laws prevent him and other administrators from discussing individual cases, but that the college has “a significant chain of appeals process to remove what might become personal biases or unresolvable differences in communication.”

What exactly happened the day Stickney took the scrubs depends on who’s telling the story. During her clinical rotation on Nov. 8, Stickney alerted staff to the deteriorating condition of a patient, who was rushed to emergency surgery. Staff allowed her to borrow a set of operating room scrubs from the hospital linen department and observe the procedure.

“I was on cloud nine,” she said. “It was just the best day.”

She said she wanted to keep the scrubs as a memento, but her clinical advisor Karen Tetreault said she had to return them.

When she went down to the linen department, Stickney told the man she found there about her day, and again asked if she could keep the scrubs. He said yes. She went back to her classmates and Tetreault, who asked her if she still had the scrubs, Stickney said.

She said she thought Tetreault was joking, and that it was obvious that the scrubs were stuffed in her jacket.

Tetreault did not return a phone call for this story, but Stickney provided the Monitor with Tetreault’s own written synopsis of the incident submitted in the first appeal.

It turned out the man Stickney spoke to didn’t work in the linen department, he was just there on his break. He told Tetreault later that he thought Stickney meant she would return the scrubs the next day.

Tetreault said in her report the scrubs were hidden and it wasn’t until she went to the linen department that she knew Stickney still had them. Six days later, she gave Stickney an administrative failure in her evaluation, which suspended her from the class, and the nursing program.

“I briefly discussed the event with the student and informed her that she would be receiving a clinical warning at the very least,” Tetreault wrote. “I also questioned that if she chose to lie about scrubs would she also lie about a med error or other patient incident.”

That’s the line all nursing educators and supervisors walk, wondering when a mistake is a mistake – or a character flaw that could put patients at risk.

Character matters

Sometimes, conversations about ethical dilemmas are explicit in nursing classes. Gene Harkless has been teaching nursing at UNH for 27 years and is the department chairwoman. When her class discussed the recent accusations of drug diversion at Exeter Hospital, they talked about how and when a nurse should report a colleague suspected of diverting medications, or a supervisor who made a judgment they disagreed with.

Every case is judged on its own merits, especially against the concerns about whether patient safety is at risk, but “basic dishonesty and stealing are generally accepted in our community as something you don’t do,” Harkless said.

“When you understand the work of nurses, you understand we work at the direct interface of care with patients, at their most vulnerable moments,” she said. “We work in individuals’ homes, we have access to addictive substances. We’re there to enact and follow and adapt plans of care. We are the fulcrum of care. We must be trusted, we must have our actions align with our voice. We cannot have a mistrust in the nursing realm.”

Kathleen Polley-Payne, associate dean of nursing and chief nurse administrator at Southern New Hampshire University, agreed that the standards can seem high and the discipline inflexible, but it’s for a reason.

“We tend to err on the side of caution because we worry that nurses care for patients when they are at an extremely vulnerable time. We have to know your character is unimpeached,” she said.

“We all make errors, but will you come right out and tell somebody? The most important thing is how do we fix the error for the patient.”

In her 32-year career as a nurse and nursing supervisor, she said no one incident has led to a nurse or student’s suspension unless that person did something egregious like bringing a weapon to work or striking a patient.

“It would be so much easier if it were all clear, that if you do this, this will happen, but just like every patient is unique, every circumstance is unique,” she said.

“Nursing as an industry struggles with this, but the fear is really that patient who cannot speak for themselves, cannot advocate for themselves and the thought that a nurse could do something wrong and not tell the truth about it.”

An annual poll of which profession Americans trust the most was released on Monday, with nurses earning top marks for the 10th straight year.

“Nurses are very aware of the Gallup poll, and we are all very proud of the public’s trust in us,” Polley-Payne said. “That is just another reason we are so protective of our patients.”

Stickney said patient care is the reason she wants to get back to class and keep working for her degree. As a licensed nurse’s assistant, she can check patients’ vital signs and dressings on wounds, but she can’t administer medication or oversee any procedures.

“It’s just out of line with my skills now. I can do so much more and I may never be able to, because of a misunderstanding about a pair of scrubs,” she said. “The punishment just doesn’t fit the crime.”

If her latest appeal is not granted, she’s not sure if she can afford to start over next year, she said.

Even if she does prevail, she’s in an uncertain position, trying to catch up on the course work she’s missed, including a test and several lectures. She’s still studying for the final exam on Wednesday, just in case.

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

Legacy Comments23

I'm a nursing student and I found this while researching for my Ethics class, specifically concerning workplace theft. When we take items of little value it's called pilfering, but it's still stealing. In my research I’ve found that pilfering of items such as scrubs, bandages, etc... causes significant yearly loss for hospitals/clinics. We tell ourselves it's not that bad to do, but add up dozens or even hundreds of employees, it really is that bad. It's also an example of cognitive dissonance – we know taking something not ours is stealing, but in some situations we find ways to rationalize. It's a defense mechanism everyone has but nurses must be very self-aware of our decision-making process. Every decision made in our job reflects how we uphold our professional ethics. Heather's decision and even desire to take the scrubs regardless of permission from a hospital employee, shows cognitive dissonance and flawed decision making. That she did so even after her instructor said no reflects doubly negative on her decision-making process. As nurses we are required to make choices about patient's lives. Our self-awareness of how we make those decisions is extremely important. The letter Heather posted to her instructor does show a misunderstanding, but not the one she believes. Unfortunately, her misunderstanding is not realizing why what she did was wrong and why her internal rationalization had no effect on real-world consequences. Her letter primarily addresses her own positive qualities but the truth is all the good qualities in the world don't change the reality of a bad decision. We all make them, but as nurses we have to demonstrate understanding of why the decision was wrong and what in our thought process needs to change. On the other hand, personally, I don't think she was intentionally dishonest or deceitful, or even fully aware of why the decision was bad. If this was truly an isolated incident, her instructors should have put more effort into teaching her to assess and alter her decision-making process rather than punish her in such a way that the needed lesson wasn't learned. She was a student and, as my instructors tell me, we need to make our mistakes while we're students and learn from them so we don't repeat them later in our jobs when it really matters. I truly hope Heather finds resolution to this situation. Good luck.

For those who question the student's responsibility for her actions: How many Banking CEOs go to jail after causing the thousands of citizens retirements to be wiped out? How many executives go to jail after pouring tons of oil into the Gulf of Mexico? How many political leaders resign after four deaths of their own subordinates on their watch? This is an example of how rules of honesty and right conduct are dealt out to those who are politically and financially powerless. The hypocrisy of those in power is once again on display here!

There are so many wrongs here. As a student nurse, my first instinct is to sympathize with Ms. Stickney, I understand all the hard work that nursing school entails (on top of the financial drain) and to see it go down the drain for a pair of scrubs is heartbreaking. I have an instructor who are genuinely vindictive and malicious. She will make your experience miserable and she treats students as if they're 5 yr olds in elementary school. My first reaction was to equate her instructor with our instructor, who is even referred to as "Satan's spawn" on ratemyprofessors.com. However, after reading some of the comments, I am inclined to go with the school. The point here are not the scrubs, but the PRINCIPLE. As nurses, we have to be accountable for our actions, we cannot just give a medicine if we know we shouldn't just because "the Dr. ordered" it, or perform random interventions just because we feel like it. I have an instructor with whom I get along famously, she also has a rather sarcastic sense of humor, but I know when she's playing and when she's not. If Heather was told more than once to RETURN the scrubs, she should have done so, period. I too had a chance to go into the OR, and I too wanted to keep the scrubs as a memento, but I was told I needed to return them, so I kept the googles, which were going to be discarded anyway. Is the punishment unusually hard? Maybe. Unfortunately it seems that the school is sending out a message with Heather's harsh punishment, but it is a message that needs to be sent out.

I also am a 2012 graduate of NHTI and this story disgusts me, but for an entirely different reason. Based upon Ms. Stickney's accounts, she was under the impression that she and Professor Tetreault were engaging in friendly joking banter, as they had been, all clincial. I absolutely agree that Professor T is a fantastic instructor, but anyone who has had her also knows that she deals in sarcastic humor and "eye rolling." As nursing students we were taught to assess the entire situation from a wholistic view. This clearly was NOT an act of deceipt. NHTI allows students who have made errors a chance to redeem themselves. Why was this an instant expulsion, not a clinical warning with a chance to redeem herself? It makes me sad to see the lack of compassion for what was a slight error in judgement, not a blatant act of deceipt or a patient safety concern.

thank you.

IMO opinion, after reading the story and the post below from Heather Stickney, I believe that Ms. Tetreault is not only inflexible but appears to be vindictive. Life is far too short to be ruled by these kinds of folks on a power trip. Ms. Stickney is worried, rightfully so about how this will affect her future. Ms. Tetreault has already determined that and now that it is out in the public, the damage is done. This story is a prime example of small thinking, negative leadership and something so simple as allowing her to keep her scrubs or attempting to do so has accelerated this into such a negative situation. If Tetreault was an effective leader, she would be catching her folks doing things right. I think inquiring at the hospital as to if she could keep the scrubs would have been positive for Ms. Stickney, motivated her and bought some increased respect for Ms. Tetreault. Unfortunately, there are good leaders and poor leaders.

I couldn't agree with you more! In fact she tells her students of her "sarcastic nature and her rolling eyes are not to be taken seriously, and she is not one who "pats you on the back", so her student's aren't to look for a "good job" from her.

It was Ms. Stickney herself who brought this to the paper. NHTI did not. She didn't get the answer she wanted about keeping the scrubs, so she went to somebody else. She didn't like the due process at NHTI so she went to the paper. Because of this, when prospective employers, for LNA or RN, google her, they will certainly think twice about hiring her.

Ms. Stickney has a job, a job that her Professor helped her get. To which she still has, with full support.

I am a 2012 RN graduate of NHTI and disgusted by this story…First off I have had professor Tetreault in clinical and in lecture and she is one of the most AMAZING professors and people I have ever come in contact with, and I speak this way of NHTI as well. This is not about a pair of $20 scrubs, this is about dishonesty and speaks directly to her character. Heather intentionally, after her professor said NO, placed the scrubs under her jacket and left…. If she didn’t do anything wrong why stuff them under your jacket? Nurses are held to a higher standard, if she’s going to lie about this what else will she lie about! She was not awarded these scrubs for her supposed lifesaving event, is she going to take something as a memento every time she thinks she does a good deed? This type of dishonestly could possibly lead to major medical and medication errors without ownership and who know what else, scary! It’s too bad NHTI can’t comment on this because I’m sure there is more that they are weighing about her character to make this decision……Good job NHTI!

Based on the published account, describing Ms. Stickney's long and determined journey to become an R.N., and her excellent clinical skills and devotion to patients' well-being, she deserves a second chance. It seems a pity this wasn't handled differently by the clinical advisor. I hope the 2nd hearing has a better outcome for her. Keep us posted, CM.

Is this even a common practice? To me, she asked her supervisor and was told no, and that should have been the end of it. Once the situation started to get out of control, she should have apologized and returned them immediately. I'm not questioning her dedication, but once a boss says no, you don't keep asking around until you get the answer you want.

Professor Tetreault, I am desperate to speak with you about this incident. Since I have not been able to meet with you yet and right now my career and life goals hang in the balance, I am resorting to writing to you. I misread all the cues I thought I was getting from you on that night. I felt that we had reached a point in our student-teacher relationship where there was a certain amount of comfort and that there was room for humor. I have come to feel that you have confidence in my abilities and that I was a competent and safe student. With this assumption, I took the liberty of engaging in what I thought was a humorous exchange with you. I felt our back-and-forth joking about the scrubs was light-hearted and fun. I held no devious intent when I returned the scrubs, and I was elated when the man who seemed to be in charge gave me permission to keep them. When I came back to the floor, I was so sure that you were still joking with me that instead of telling you that the gentleman in linens had told me to keep the scrubs, I continued in the vein that I felt you and I had been earlier. I was certain that it was apparent to you that I was bringing the scrubs home and that you found it to be a small and certainly amusing quirk. I was completely wrong. I overstepped my bounds as a student, misread the situation and did something that must seem to be deviant and deceitful. Please hear me when I say that this is a miscommunication between you and I and not an ethical issue. In nursing school and in all matters in life I hold myself to an extremely high code of conduct with people I love as well as those who I work with. The fact that you have understood the incident on the 9th as deceit on my part crushes me for more reasons than I think I can convey. On the top of my list is remorse that you now find me to be untrustworthy and have deemed me unethical. I am aware that there is no way to guarantee that your renewed trust in me would be well placed. I am defending my misunderstanding of the situation, I was wrong. I made a gross mistake. I understand that you may feel that I had bad judgment in this case. I do not understand why you would insist on having it cost my career. I have been in two clinical rotations with you. I have brought several incidents to your attention that were overlooked by the hospital staff. The patient is and always has been my first priority above all else. I love being a nursing student and I know that I will love being a nurse even more. I pay attention to small details with my patients. In several instances in clinical, I have shown to have good instincts concerning patient conditions. I love this career. I want to take care of people, and I feel that I will do a good job. I feel that you know this as well. If you uphold your decision to fail me for this misunderstanding about the scrubs, you are guaranteeing that I will not become a nurse. Yes, I will continue to be an LNA, and I will be a good one, but you know first hand that I can be so much more than just a good LNA. Please reconsider you decision. The punishment does not fit the crime. I erred. I know I have erred greatly. But, please understand me when I say that there was no intended deceit. No ill intent. I misread the situation. I have always respected your authority and experience in the clinical field. I would never have intentionally deceived you. This is a simple misunderstanding on my part. Please do not make me pay for it for the rest of my life.

This was my letter to Karen Tetreault days after the event occurred. It's important that the readers know that I took FULL responsibility and made many apologies for the misunderstanding.

Taking responsibility means not using the word "misunderstanding". I see excuses, not taking responsibility.

so taking responsibility means "expulsion"???? $25,061.00 in JUST tuition, not to mention 5 years of hard work and dedication??? Is that taking responsibility?? Maybe she got caught up in a moment, a moment for a student that is pretty amazing. She took responsibility. She apologized for a misunderstanding.... DEFINE taking responsibility!! I'm pretty sure that its viewed in MANY different ways!

Have we come some far now that we take dishonesty and put it in order of what was taken? There are some things in this world that cannot be justified or watered down. Stealing and lying comes to mind. And we also seem to not want to hold folks accountable for their character. I have witnessed folks who are in home care services rip of relatives. Turns out these folks always have things in their past that points to poor character. Everybody gets a pass these days. And we wonder why our kids cheat, steal and lie. When did we lower our standards so much?

agree Jim but would you want a person with these ethics to handle your mothers rings, jewelry, valuables etc while under care? Tough call.

I would have supported NHTI if they had found this woman guilty of taking medicines or instruments or even letterhead. She was offered, and accepted, a pair of scrubs. Read the article - a nursing student assisted in a life-threatening situation!. A pair of cheapy thin scrubs is the least of her take-aways from that day. If she ran for public office, she could do so with a felony conviction; but Heaven help the young lady who took home a pair of scrubs during her clinical training. Fight the fight, Heather! Behind you 100%

This isn't really about a pair of scrubs. It's about dishonesty. If you really want to be able to move forward, you should apologize to your instructor and acknowledge that you made a mistake. This has been an unfortunate lesson for you and the first step to putting this behind you is to accept that you made a mistake and take responsibility.

Great story, Sarah Palermo! She didn't take supplies, medicines, or money - this was something offered to her by hospital staff. We ELECTED a person in Nashua who was convicted of felony credit card fraud, but we'll deny a hard-working gal her future over a pair of scrubs. NHTI (and our State) do not have their priorities in order nor do they have their customers (the students) in their best interests. Fight the fight, Heather - I'm behind you 100%

Rules are rules but this is really ridiculous. It is more about a professors power trip than much else. By the way, you can buy scrubs just about anywhere or $20....whoopeeeee! This poor woman........bullied by elitists.

Darn lucky we don’t hold politicians or anyone else to those standards. Unemployment rate would be 99%....... Ever notice at the start of the school year all the pencils, pens, rulers, staplers, etc… start disappearing from work!!!

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