Linda Boly, RN

As a pre-admitting nurse in the outpatient surgery unit at Legacy Good Samaritan Medical Center in Portland, Ore., Linda Boly, RN, was an unwilling contestant in a game of Beat the Clock. As part of the hospital's productivity quota, she was expected to make 8 to 10 pre-op patient phone calls in an 8-hour shift. Making this game even more challenging: Most of her calls were to elderly cataract patients who didn't always speak fluent English or who had complicated medical histories.

"They might have 30 medicines that I need to record in an electronic health record. That alone can take 20 to 30 minutes, typing at a fairly fast clip," says Ms. Boly.

She couldn't always keep up with the patient-per-hour pace, sometimes completing only 6 patient charts in a shift. Rather than hit the numbers, she'd rather spend more time with a patient who needed it than the quota allowed.

"These are not numbers," she says. "These are patients. If you're rushed, you might miss telling them what they need to do to prepare for surgery."

From December 2012 to June 2013, Ms. Boly was written up 3 times for failing to meet productivity quotas and for "working off of the clock" by completing chart work at the end of the day.

Despite having a stellar track record during her 34-year career at the hospital, Ms. Boly was fired in June 2013 for low productivity and poor professionalism. She filed a grievance, then a wrongful termination suit. A jury awarded Ms. Boly, 59, more than $3 million: $916,000 for lost wages based on a retirement age of 67, $625,000 for emotional distress, $1.5 million in punitive damages and $880,000 for legal fees. Legacy Health has appealed the jury's decision. "We continue to disagree with the verdict and will be pursuing all avenues available to us to appeal the matter," says Brian Terrett, a spokesman for the heath system.

Not only was she the highest paid nurse in her unit with $88,000 in annual wages, but she was never one to shy away from controversy or questioning authority. Ms. Boly complained that the pre-op phone call quotas were arbitrary. She also contends that she was singled out for her rebellious past. She worked to pass Oregon's Nurse Staffing Law, which was designed to give nurses more influence over decisions that might affect patient care. She testified before the Oregon Legislature about her concerns that Legacy's time standard caused nurses to rush and compromise patient safety. And she also joined a group of nurses that tried, unsuccessfully, to organize a union at Legacy hospitals.

The appeals process could take another 2 years. She's working as a per diem nurse without benefits. With 2 children still in school and a disabled husband, she's the breadwinner. She's also an unsung hero to nurses everywhere who refuse to compromise on patient care. "Most of us are scared to death of speaking out and getting punished," she says, "but you're talking about peoples' lives." OSM