Fourth-Place Winner of Constantine Cannon’s Fifth Whistleblower Essay Contest: Victoria Wiggin

By the Constantine Cannon Whistleblower Team

The Constantine Cannon whistleblower team is pleased to announce the Fourth-Place Winner of the firm’s Fifth Law School Scholarship Essay Contest. That award (and the $300 prize) goes to Victoria Wiggin.

About Victoria

Victoria was born and raised in Virginia Beach, VA. She has been a cardiac ICU nurse since 2018 and worked in ICUs all over the country—particularly during the pandemic. Currently a first-year law student at Regent Law School, Victoria plans to go into healthcare law to attempt to improve the healthcare system in the United States. Victoria’s winning essay shares a personal account of speaking up after repeatedly witnessing one of her healthcare colleagues cause patient harm. According to Victoria: “Many of my coworkers were shocked that I would say something, but unethical behavior has no place in healthcare.”

Victoria’s Winning Essay

It was 2100–my shift was really just getting started–and my patient was experiencing the normal anxiety one feels when he knows his chest is getting cracked open the next morning. I was a nurse working nightshift in a cardiac intensive care unit.

Nurses in intensive care units (ICUs) tend to have a pretty close relationship to and good rapport with the doctors and midlevel providers. Plainly put: we have each other’s backs. However, for the last several weeks, I had been noticing one midlevel provider, a physician’s assistant, performing an increasing number of procedures on patients that may or may not have been necessary. It was beginning to seem like he just liked to intubate patients and place central lines for the thrill of doing “emergency interventions.” I had often given this PA pushback on certain clinical decisions he made regarding my patients, but nothing to the point of reporting him. In my mind, all the lines he had previously crossed were convincingly blurry. This night was different.

Without boring the reader by overexplaining the patient’s clinical picture, the patient had a computed tomography (CT) scan ordered by the cardiothoracic surgeons (CTS). In order for one to have a CT done, he must be able to lay flat for a period of time. Due to the patient’s anxiety and constant use of the wall suction (he had just had a breathing tube removed and his throat was sore, leading to him constantly clearing his throat and spitting), he was apprehensive about laying flat. Without trying anything less invasive, a common and often required practice, the PA decided that we needed to intubate the patient in order to get the CT. When questioning the PA about his decision, I was told that the patient definitely needed to be intubated and it would all be fine as long as he was extubated (have the breathing tube removed) before CTS rounded at 0500 to make sure he was still fit for surgery. CTS would not operate on him if he were intubated when they rounded.

The patient was intubated, I took him for the CT, and we got back to the room with few to no hiccups. However, we were unable to extubate him before the CTS team rounded in the morning. This postponed the patient’s surgery. When the doctors rounded on the patient and saw that he was back on the ventilator, they went to the PA to ask what happened. He told CTS that the patient had been having oxygenation issues that were worsening throughout the night. Intubation was his only option. However, the patient’s oxygen requirements had not been going up throughout the night and the patient had not had an arterial blood gas (ABG) drawn for several days. An ABG is the gold standard for determining how well one is oxygenating and perfusing his organs. The PA lied. I was furious.

Tired of watching my superior cause harm to patients, I asked my charge nurse who the chain of command is for the midlevel providers. I got the phone number for the head of his department and gave him a call. I ended up filing a long report detailing the extent to which I have witnessed this provider mistreat patients. I ended up speaking with multiple administrators over the course of a week or so. The PA was subsequently disciplined and put under strict supervision.

Many of my coworkers were shocked that I would say something, but unethical behavior has no place in healthcare. Patients have to trust the decisions of strangers while they are not only confronting their own mortality on what is often the worst day of their lives, but they are intermittently stripped naked in the process. That reality is not to be crass but to paint a realistic picture of the relationship between staff and patients. The faith and trust that our patients place in healthcare workers is unlike any other profession. Rightfully so, we should be held to the highest standard. It is difficult to know where the line is in healthcare; a lot of people assume things are black and white and that is just not the reality. While some things are grey, this instance was black and white.

More Whistleblower Essays

Constantine Cannon congratulates Victoria on her outstanding essay, and invites readers to peruse our other winning essays. And to all those law students looking to follow in Victoria’s footsteps with their own winning essay, we just launched our Sixth Whistleblower Essay Contest. Throw your hat in the ring! We look forward to reading what you have to say about whistleblowers or your own whistleblower experience.

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