How should medical mistakes be handled?

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Nurse’s Suicide Highlights Twin Tragedies of Medical Error

This article highlights the case of a 25-year experienced RN in a Seattle Children’s Hospital, who accidentally gave a baby too much of a particular drug.  The child died five days later, however her fragile state made it impossible to know if it was the medication error that directly caused her death.  The nurse was fired, almost stripped of her license, and eventually committed suicide.  Although the child’s family did not seek punitive damages against her personally, it was the hospital administration that went under enormous fire over the situation.

Are we safer by slamming down the hammer on healthcare providers after they make mistakes?  Or does that send the message to let mistakes go unreported out of fear of punishment?  What’s the best way to deal with a professional who’s made a mistake?  It’s easy for all of us to admit that we make mistakes all the time, in our jobs, relationships, parenting, and everyday lives, and to encourage each other to give ourselves a break.  It’s only human, right?  But do we have that same compassion for a nurse, or doctor who is taking care of our family member and made a mistake?  They’re only human,…… right?   And who gets to define where the line is between an “accident,” and patterns of negligence or medical malpractice?

In my experience working as a CNA at a hospital, nurses definitely felt that their mistakes would be personally held against them.  I did not necessarily feel that way, however, I never had a situation where I made a mistake that caused a patient harm (to my knowledge!!) and required follow up with management.  Perhaps if I had, I would have felt the same way.  We had a system in which caretakers went through periods of coaching (probably akin to probation) in which they had to work closely with management to improve aspects of their care.  But, termination of your job depended on the severity of your mistake or patterns of mistakes, not much comfort for a caretaker who fears that they will never be hired again if they were to lose their job.  People felt compelled to report mistakes that others had made in order to protect themselves from blame, but uneasiness with reporting their own mistakes.  This made for some tension between staff, fear of punishment, and a sense that at every step you had to cover your own rear because By God some patient was going to try to sue the life out of you and everyone else who walked by their room.  These pressures make it hard to just enjoy the job of taking care of people!

We all want to feel confident when we take a family member to a healthcare facility that they will be cared for by professional, competent, well-prepared individuals that adhere to the highest standards of excellence in medical care.  It’s alarming, however, to read the statistics that most caretakers not only have made mistakes (some severe) themselves, but nearly all admit to seeing colleagues make mistakes as well.  Somehow, we’ve got to find a way to deal with mistakes in a way that doesn’t just shoot our wounded, like the nurse, Kim, who had many years of exemplary service.  We need a system in which a Kim can get appropriate training to prevent a future mistake, and also retain a job or maintain hirability to other facilities.  How on earth do we profit if a good professional is burned at the stake after an accident, and is unable to continue working in the very field that they are qualified and competent to work in?  If our answer is simply that we have a no tolerance policy, then frankly, we are kidding ourselves.

In a culture of cutthroat ambition, overzealous litigation and paranoia, we have got to find a measure of grace.  Grace for each other’s mistakes, and a willingness to acknowledge that human error whether it’s someone who forgot to look in their rear view mirror before changing lanes, or a nurse who accidentally gave too much medication may negatively impact you or a family member.

How much grace would you extend to a nurse or hospital who made a mistake that caused you or a family member harm?  Would you immediately sue?  Would it depend on the mistake or the circumstances?  Would you want that person to be fired and stripped of their license?  How fair is it to extend less grace to a medical worker than you extend to yourself and colleagues in your own field?

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