'It sends the message: Be quiet.' Was nursing manager demoted for revealing failures in patient care?

'It sends the message: Be quiet.' Was nursing manager demoted for revealing failures in patient care?

CHARLOTTE, NC (Fred Clasen-Kelly/The Charlotte Observer) - Two Mecklenburg County commissioners are raising questions about whether Health Director Marcus Plescia demoted a top nursing manager for helping report problems with notifying patients of their Pap test results.

Nursing Director Jacqueline Glenn in January ordered staff members to notify the county's risk management and human resources offices that nearly 200 women had not been told about abnormal test results and their risks for cervical cancer, according to five current and former employees.

[READ MORE: How widespread are problems at the Mecklenburg County Health Department?]

The five employees have direct knowledge of the department's operations and management. Emails obtained by the Observer and a county report support their account.

Plescia removed Glenn from the department's executive team last month, according to emails exchanged between Plescia and Glenn.

County Commissioners Jim Puckett and Pat Cotham said the timing of the action suggests it was retribution for her role in reporting embarrassing information.

The county's human resources department conducted an investigation and concluded in March that the Health Department's management showed a "lack of leadership" and failed to respond to concerns raised by employees.

Puckett said it appears that Glenn was the first health department employee who acted immediately to rectify the situation. Her demotion sends a disturbing message to other workers, Puckett said.

"It sends the message: Be quiet," Puckett said. "That's what it looks like on the surface."

Cotham said she has also heard complaints about the demotion.

Asked if she believed Glenn was demoted for her role in reporting a problem, Cotham said it appears "that he got mad and rapped her on the hands."

Mecklenburg County did not make Plescia or other officials available for interviews. Glenn did not return phone calls seeking comment.

In an email Plescia sent to Glenn on April 18, he wrote that he removed her from the executive leadership team to restructure management of two publicly-run health clinics where patients receive Pap smears. That means Glenn no longer reports directly to Plescia.

"Please understand this was not intended as a punitive action," Plescia wrote to Glenn before alluding to the Pap test lapses. "It was important to make changes in leadership structure to handle this crisis."

Clashing personalities?

No one else was removed from the department's executive team. It remains unclear why Plescia acted before a consultant the county hired made recommendations on how to restructure the agency's management.

Glenn, who makes about $106,000 a year, kept her job title, but the change is widely seen by county employees as a demotion.

The executive team, now comprised of six officials, sets broad policies and goals for the agency. Members wield influence because they have direct communication with the health director.

Current and former employees spoke on the condition that their names not be used because they are not authorized to speak publicly on their concerns and they fear reprisals from management.

They called Glenn outspoken and someone who operates by the letter of the law. They said her willingness to take stands sometimes clashed with Plescia.

Commissioner Puckett said Glenn's actions in reporting the Pap smear lapses show that she should have remained on the executive team.

"If you're going to take the voice of about half your employees and drop them down a level, you have to question whether it was retribution," Puckett said, noting the agency employs about 300 nurses.

Defending his record

The Health Department provides a wide range of services, helping to prevent epidemics and the spread of illnesses. It runs clinics on Billingsley Road in southeast Charlotte and Beatties Ford Road in West Charlotte.

Some employees say that patients at the clinics have unacceptably long waits for appointments, sometimes receive inaccurate results from tests for pregnancy and STDs and do not get needed follow up after treatment.

But Plescia has been unwilling or unable to adequately address the problems and dismisses employees who raise concerns, the employees said. They said what happened to Glenn is an example of why workers are hesitant to deliver unwelcome news to top executives.

The move has angered some employees, particularly nurses and African-American workers concerned with representation at the executive level. Glenn is African American.

Of the remaining executive team members, two are African American.

Plescia has said the quality of patient care and his management style have been mischaracterized.

At a commissioners' committee meeting Tuesday, Plescia said an on-going state review of the agency has found no major deficiencies so far. The county has already implemented most of the state's recommendations, he said.

"During my tenure here, I have also sought to address assertions of previous bullying and discrimination by taking steps to change the executive leadership team and by seeking diversity," he wrote in a May 9 email to staff to address media coverage of the department. "The executive leadership team is now comprised of two white males and four females, two of whom are African American."

"These and other changes have made a difference. The Department employee survey results have improved significantly over the last three years and now exceed county averages on most indicators."