Editorial: Betrayal of trust: Upholding dignity in patient care is paramount

There are few places where people are more vulnerable than in a hospital.

When reaching out for medical care, patients have to be open about things they would tell no one else. They discuss the most embarrassing things that happen in the bathroom or in the bedroom. They come clean about what hurts and what isn’t working the way it should. Visits include stripping down and being inspected in a way that makes it hard to maintain dignity.

According to a 2020 article in the medical journal Preventing Chronic Disease, 26.1% of surveyed individuals said they avoid health care. This builds on a 2015 survey that showed people put off treatment for reasons including cost and inconvenience, but also mistrust and bad experiences.

Women and minorities — and people with some chronic conditions — can feel dismissed, judged or blamed for their own illnesses. The fallout of delayed treatment can be that medical conditions that might have been identified and addressed while easily treated can become dangerous and expensive.

That is what makes the recent charges against two former nurses at Westmoreland Hospital so unsettling. No one wants to hear that their medical provider was arrested for anything, but the charges in this case strike at the fears some patients have about shaming.

Greensburg police charged Peter Castellano, 36, of Pittsburgh and Melissa Tompkins, 36, of Baldwin with disclosing intercepted communications, criminal use of a communication facility, invasion of privacy and harassment.

The charges stem from a group text message thread between the nurses and two techs. It included audio and video recordings and images. Some pictures were of naked or partially clothed patients. Some were manipulated to add co-workers’ faces.

Both Castellano and Tompkins deny the allegations. Independence Health System issued a statement expressing shock and outrage over the conduct, as well as gratitude for the employee who revealed what was happening.

We will not address the charges, as they are ongoing and the defendants deserve their day in court. However, there is a deeper impact than the criminal cases here.

While we tend to focus on the licensing and official government rubber-stamping with medical providers and facilities these days, in the old days, responsibility was vested in the vows taken. Doctors swore to “do no harm” when they took the Hippocratic oath. For nurses, it was the Nightingale pledge.

In this, nurses solemnly promise to “practice faithfully,” to “abstain from whatever is deleterious or mischievous,” to “elevate the standard” of nursing, to “hold in confidence” their patients’ information and to devote themselves “to the welfare of those committed to my care.”

Nurses and other medical professionals have been desperately needed even before the pandemic. It is a stressful and difficult job. But it is incumbent on all medical providers to consider the promises of the Nightingale pledge — and that no one is healed by being bullied.