Sunday, May 1, 2005 School nurse who helped girl get birth control sues over firing By GREGORY D. KESICH, Portland Press Herald Writer Copyright © 2005 Blethen Maine Newspapers Inc. A veteran school nurse who was fired after taking a teenager to an off-campus clinic where she got a pregnancy test and a "morning after" birth-control pill is suing the superintendent in federal court. Lola Charette said she was unfairly fired from her job at Fort Kent Community High School because she followed the law and protected a student's right to confidentiality. But officials at School Administrative District 27 say she was terminated for violating an unwritten policy that prohibits students from leaving the school without parental permission. The case, which shows what can happen when a health-care provider's legal responsibilities clash with the community's sensitivity about teenage sex and birth control, is moving forward in U.S. District Court in Bangor after surviving a motion to dismiss. Charette wants to regain her job with back pay and is seeking money damages from the district, said her lawyer, David Webbert of Augusta. School officials put her in an impossible position, Webbert said. "She is a sacrificial lamb. She follows the law, which she has no control over, and gets fired in the middle of a school year," Webbert said. Central to Charette's case is Maine's confidentiality law, which prohibits a health-care provider from divulging medical information without the patient's consent, even when the patient is a minor. Charette asserts that she would have violated that law if she had followed Superintendent Sandra Bernstein's order to inform the student's parents about her visit to the clinic. According to notes taken at Charette's dismissal meeting that were quoted in Charette's complaint, Bernstein said the nurse had violated "community norms" and said, "If it was my daughter, I would want to know." Bernstein could not be reached for comment, but the lawyer representing her and the school district said Charette was fired for breaking school rules - not for protecting a student's constitutional rights. "Confidentiality was never an issue at all," said Melissa Hewey. "She was terminated for taking a student off grounds without a parent's permission. It doesn't matter if it was for birth control or to get a tattoo." Charette had worked as the K-12 school nurse in SAD 27 since August 1982. On Jan. 22, 2003, she was approached by a female student who said she thought she might be pregnant. The girl said she was anxious and could not concentrate in school or study for her exams. Charette helped her make an appointment with a local clinic for a pregnancy test. Charette said she tried to convince the girl to tell her parents and family doctor about the appointment, but the girl refused. She also would not give Charette permission to talk to her parents. School nurses, like other health-care professionals, are bound by confidentiality laws even when the patient is a minor, said Wanda Miller, executive director of the National School Nurse Association in Castle Rock, Colo. Miller said most state legislatures created the protections in the 1980s in response to concerns that children with sexually transmitted diseases were not seeking medical help because they didn't want their parents to know they were sexually active. As a result, diseases were spread, and treatable conditions went untreated. "It's also an issue in pregnancy," Miller said. "You don't want a pregnancy to go on for five months without any health care, because there can be consequences for the fetus." A school nurse who violates state confidentiality laws could be sued by the patient and could lose his or her nursing license, Miller said. The Fort Kent student told Charette that she needed a ride to the appointment. Charette borrowed a school vehicle and took the girl to the clinic. While there, in addition to the pregnancy test, the girl received a dose of a "morning after" contraceptive, which can allow women to avoid pregnancy if taken shortly after intercourse. The next morning, the girl asked Charette for a ride to a follow-up appointment. She had another girl with her, who also had an appointment. Charette again borrowed a school vehicle, signed the girls out and took them to the clinic. When she got back to the school office, the principal's secretary told Charette that one of the girls had thrown away a cardboard package for "Plan-B," a brand name for the contraceptive. Charette was called in for a meeting with Bernstein three days later. According to notes of the meeting quoted in court documents, Bernstein told Charette she had informed the girls' parents. "We don't tell any student that anything is confidential," Bernstein is reported to have said during the meeting. "Can you imagine how the parents feel?" According to Charette's suit, Bernstein said Charette's actions violated "community norms." Charette was fired the next day. According to a letter dated March 3, 2003, Bernstein wrote that she was terminated for "exercising poor judgment" in assisting students in obtaining "medical services without notifying the parents or the administration." This, Bernstein wrote, "resulted in the District losing confidence in her performance and judgment." Hewey, the district's lawyer, insists that Charette's misjudgment was leaving school grounds without permission, not the controversial nature of the trip. She acknowledged the school had no written policy about off-campus medical appointments but said it was a well-established rule. Webbert said that argument is implausible. "Oh, sure. You fire someone after 20 years over a policy that is so unimportant nobody ever bothered to write it down?" Webbert said. The real issue, Webbert said, is whether Bernstein had a right to fire Charette for helping students get contraceptives and protecting their privacy. Even if you have strong feelings about teen sex and birth control, Webbert said, "You can't fire someone for doing her job." http://pressherald.mainetoday.com/news/state/050501schoolnurse.shtml |