As a nursing graduate, my dream was to be a pediatric nurse. I worked nights in urology until I received an offer of an immediate position in pediatrics. The nurse, whose position I would fill was a veteran professional who administered Morphine, instead of Demerol, to a three year old pre-surgical patient. A respiratory arrest followed the injection. An anesthesiologist positioned on the unit (as if a guardian angel) intervened. The child survived without residuals. The nurse, however, lost her job and her professional licensure. Even unintentional errors in nursing carry huge consequences and heavy sanctions.

Pediatrics! I was overwhelmed with the opportunity to realize my dreams, but my excitement was quickly tempered with the thought of how a patient and a nurse’s fate are so closely entwined in a fleeting moment that changes both forever. I renewed my vow to “do no harm”.

In July, 2006 a Wisconsin hospital nurse made a medication error that resulted in the death of her patient, the loss of her decade long job, her license and a felony charge of neglect of a patient causing physical harm. The details of this case will not be discussed within the context of this article, but rather a general look at how the supply of nursing professionals, already at a critical level, will certainly be threatened even further by this nurse facing criminal charges for an unintentional medication error.

As healthcare professionals, we strive for the best possible outcome in all of our services. Our hearts go out to the families we touch and the loved ones we lose. Nurses can never lose sight of “do no harm”. We know that everything we do on a daily basis has consequences and we have accepted the responsibility of those consequences in our professional and private lives. The unprecedented legal action (felony neglect of a patient causing physical harm) against a nurse who made an unintentional medication error, takes healthcare in a direction that will certainly impact the future of our chosen profession.

Through the years, quality care processes have developed, due to the ability of the healthcare professional to report the error, to research the cause and to enact corrective actions. In a recent report, “To Err is Human.” The Institute of Medicine (IOM) observed that, “reporting systems are important part of improving patient safety and should be encouraged. These voluntary reporting system should periodically assess whether additional efforts are needed to address gaps in information to improve patient safety and to encourage health care organizations to participate in reporting, and track the development of new reporting systems.”

If felony charges for an unintentional medical error stand, healthcare workers will certainly be more hesitant to report errors. This impacts not only the outcome of the immediate situation the error has created, but impedes the quality of all healthcare environments thereafter. In error prevention, it is important to emphasize the system and not the individual. Most errors can be prevented if the process is examined. One error researched and corrected within the system will prevent many future errors. If this error is never reported, then the system does not improve and errors will multiply exponentially.

Nurses understand the tragic results of an error and such errors should be avoided at all cost. The daily reality of the hospital is challenged by excessive overtime work, fatigue, poorly designed medication packaging, improperly functioning drug bar coding and insufficient training in new technology. How will facing a felony charge for an unintentional error improve bedside care? Would you encourage your children or grandchildren to enter a profession in which a mistake will not only bring professional sanctions and emotional trauma, but will brand you a felon for the rest of your life? If this case sets the precedence of allowing felony charges for a nurse’s unintentional error, it will most certainly exacerbate the nursing shortage; resulting in even greater numbers of healthcare tragedies.

References

1.  OIM Report, “To Err is Human:  Building a Safer Health System,” 2000.

2.  Sax, Barbara (2006) Med Error Suit May Drive Reporting Underground.  Pharmacy Times.

Retrieved December 13, 2006 from the World Wide Web:

http://www.pharmacytimes.com/articleNewsletter.cfm?ID=4025

3.  (2006) Felony for nurse’s error. Washington Times.  Retrieved December 15, 2006 from the World Wide Web:

http://www.washingtontimes.com/natonal20061207-11444-8105r.htm

4.  Frew, Stephen A, JD (2006) Medlaw.com, Retrieved December 16, 2006 from the World Wide Web:

http://www.medlaw.com/healthlaw/MEDMAL/nurse-charged-with -felony.shmtm

You may remember us introducing Kevin Haynes in Last month's issue of RN MARKET News. Kevin has only been with us a short time but has made a huge difference in our accounting system. If you remember from last months newsletter issue, Kevin has his own racecar that he races on dirt tracks. He does this because it is something he loves and at the time was more of a hobby than anything else. Around the same time we hired him as an accountant, he had sent his resume to some NASCAR racing teams. Because of his experience in racing, Kevin was offered a position on the NASCAR Busch Series with Andy Garcia's crew. This is a dream job for Kevin and we are excite for him. He will be the Car Chief for Andy Garcia's Team. Needless to say, Kevin will be making more money than we can offer him and doing accounting for RN MARKET is hardly a dream job. We're not mad that he's leaving as long as he gets us all tickets. So, good luck to Kevin and his new team. If you're a NASCAR fan, keep an eye out for him. You'll probably see him on television.

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