Punitive Consequences in Nursing
It is human nature to make mistakes. From a young age, I was taught that mistakes are a part of growth and are only errors if no attempt is made to fix them.
In medicine, however, there is an incredible responsibility that is instilled in all healthcare providers. The health and, oftentimes, the life of an individual is entrusted in your judgement. A mistake is no longer a simple error, but rather a malpractice that has the potential for catastrophic consequences. Clinicians are simply and rightfully held to a high standard.
As a result, the way that we handle physician mistakes is very gray. In the past, punitive consequences were the norm. According to a patient who used to work as a nurse, “The trend is changing in some care facilities, but for many years, hospitals have been known to pursue punitive consequences.”
She continued, “Whenever I made an error, I filled out an accident report. But, I know that there are a lot of nurses who were afraid to do that because it created the possibility of being fired, even if the accident did not result in harm to the patient.
I feel that it is important to not look at the error by a specific nurse or healthcare provider but to instead look at the system. Perhaps a nurse was juggling more patients than they should because there is not proper staffing, which resulted in that nurse messing up which medication went to which patient. By doing away with punitive consequences, clinicians feel free to report their mistakes. These mistakes can then be evaluated and avoided in the future, allowing for a positive change in how things operate. This is called root-cause analysis, and it’s so much better for preventing errors as opposed to just scapegoating someone.”
This patient also brought up the RaDonda Vaught Case, when Tennessee nurse RaDonda Vaught was convicted of “criminally negligent homicide and gross neglect of an impaired adult” (The Vanderbilt Hustler). This is a particularly polarizing case as significant errors were made both on the nurse’s and the system’s behalf. As The Vanderbilt Hustler assessed, Vaught failed to see the caution labels on the anesthetic she accidentally drew from the electronic dispenser, but the dispenser also labeled the anesthetic very similarly to the brand name of the drug she was intending to retrieve (it was actually labeled by its generic name). Thus, this case’s ruling has created much discourse over the proper manner to handle clinical errors.