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Was nurse with MS fit to work? VA said no

ST. PETERSBURG — Patricia A. Price's supervisors said they watched in sadness as multiple sclerosis eroded the registered nurse's job performance.

Lapses in memory. Mistakes. Confusion.

Price disputed that, insisting she was just fatigued and could still do her job at the Bay Pines VA Medical Center.

When Bay Pines disagreed, Price filed a complaint with the U.S. Equal Employment Opportunity Commission. Two weeks ago, a judge ruled against her claim of discrimination.

"I really can't believe they're doing this to me," said Price, 50.

What came to pass during 2007 in one of the nation's busiest veterans hospitals is the complicated story of one nurse's fight to save her career and the hospital that says her disease endangered patient safety.

The case is documented in the dry language of employment law and the Byzantine rules of the Department of Veterans Affairs.

But like any workplace dispute, the truth is never as straightforward as a lawyer's brief. It's wrapped in emotion. It can emerge without obvious villains.

And often, it pleases no one.

• • •

The VA hired Price to work at Bay Pines in January 2005 after she spent over 13 years in the Army. She worked in the Congestive Heart Failure Clinic.

She loved the work. And the enthusiasm showed in her performance evaluations. Her supervisors praised her. On Jan. 31, 2007, her boss rated her "high satisfactory," the second-highest rating on an evaluation scale.

Within months, Price became concerned by persistent fatigue and weight loss. She visited a doctor. The news stunned her.

She suffered from MS.

MS is a neurological disease whose symptoms vary greatly. It's incurable, though those who suffer from it typically live normal life spans.

It can cause fatigue, muscle spasms, speech problems, difficulty with balance, pain and restrictions in movement.

And in up to 60 percent of MS cases, cognitive problems of varying degree occur, from memory issues to the processing speed of the brain.

Legions of Americans function normally with MS; many of their co-workers are unaware they suffer from the disease. Others aren't so lucky.

Price said she told her supervisors at Bay Pines that she had MS.

"Bay Pines was okay about it," Price said. "It was as if I were telling friends. They offered support."

In the spring of 2007, Price said that changed.

Price didn't want to "float," or move around the hospital, treating patients. A doctor had told her to avoid infection, which might worsen her MS. Moving around the hospital would expose her to more germs than necessary, she said.

"Ms. Price needs reasonable accommodation to prevent exacerbation of her MS," said a doctor's note Price gave to her boss.

Federal law requires employers to make accommodations to eligible workers unless doing so puts others at risk or poses an undue economic burden.

Bay Pines rejected an accommodation for Price.

A nurse supervisor wrote in a memo that Price's request that she not float "is not acceptable to me as all my staff float as needed to assure timely and safe patient care."

The supervisor said in her opinion Price did not meet the definition of a "qualified individual with a disability" because her problems were "cognitive in nature" and make her unable to work as an RN.

A note in Price's personnel file concluded that a transfer to another nursing position wasn't possible "due to the severity" of Price's MS.

Price was furious. She acknowledged that her MS caused her depression and mental lapses at its worst. But MS is typified by periods of remission when the disease's symptoms lessen.

And she insisted that her MS didn't cause her cognitive problems. "I was fully capable of performing my duties," she said.

Her medical records in this same time frame show that Price complained to her doctors about fatigue and difficulty concentrating. A July 2007 physician's note said, Price "is having difficulty accepting her medical condition and its limitations."

Price, however, said she was under stress from supervisors concerned about her MS, something that worsened her concentration.

Price's supervisors, meantime, told her she had made several mistakes in the job and they were concerned. They ultimately pulled her from having any contact with patients.

Once an accommodation was refused, Price filed a complaint with the Equal Employment Opportunity Commission.

That, said Price, angered the VA and resulted in things really falling apart with her job.

Not long afterward, Bay Pines insisted that Price be given a "fit-for-duty" physical. A neurologist examined her and said she could not perform all the essential duties of a nurse.

"I was just wanting them to leave me alone," Price said. "I wanted them to let me do my job."

Price said she had investigated a disability retirement and filled out paperwork for one. But she said she stopped the process, deciding she would fight to save her job.

For a time, Bay Pines allowed her to work at jobs that would accommodate her condition.

But Bay Pines, she said, finally forced her to accept the disability retirement in early November 2007. It provides her up to $20,000 annually, or 40 percent of her full salary.

Price, a single mother of three whose son is in the Army and was recently sent to Iraq, said she can barely subsist on the money.

John Pickens, a regional spokesman for the VA, denied that the agency forced her to retire and said others at Bay Pines with less-severe MS work at the hospital.

"We basically watched this disease take over her," Lawrence Diehl, chief nurse of primary care at Bay Pines, testified as part of Price's discrimination case. "And it's been very tough to watch. ... Nurses can't be cognitively impaired and take care of patients."

Diehl didn't think Price had come to terms with her MS.

"I don't believe she fully accepted her diagnosis," he said. "And I think she's had a real tough time. We're just hoping for the best for her."

Price said her bosses are exaggerating her problems and just tried to get rid of someone making waves. She still hoped to work as an RN.

"They have no compassion," Price said. "They don't care. I know I can't get my job back. But I don't want them to do this to somebody else. This isn't fair."

William R. Levesque can be reached at (813) 269-5306 or levesque@sptimes.com.

Was nurse with MS fit to work? VA said no 12/21/08 [Last modified: Thursday, December 25, 2008 10:36pm]
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