Hypothetical scenario: What if..?

James Huffman · Oct 2, 2002

Are we talking about willfull damage (i.e., I intended to hurt the patient) or an unintended accident? If the damage is unintended, there's no reason to feel ashamed. Embarrassed, perhaps, saddened, certainly, but everyone makes mistakes, and someone who claims to have none is lying.

What I have found is that nurses are much harder on themselves than any other professional group I've seen. When our physician colleagues make mistakes, they do what they can to rectify any damage, and usually go on and live their lives. Only nurses seem to think there's a scarlet "m" (for "mistake") plastered on their forehead for eternity.

If you make an honest mistake, what's the big deal? Correct what you can, apologize for your error, learn from it, and go on and live your life. People who don't make mistakes never do much of anything.

Jim Huffman, RN

http://www.NetworkforNurses.com

Dr. Kate, BSN, RN · Oct 2, 2002

I have known two people who went through this for different reasons. I know only what a supportive observer sees and knows. One never acknowledged to me that she no longer had a license. The situation that led to her losing her license was pretty clear cut and indisputable. She managed to get positions as an office nurse (which did not require a license, just skill.) The other was caught in a situation that was murky at best, had complicating medical problems, and will remain disabled for the rest of his life. I know the details but I am probably the only one who does.

Both went through a long period of disbelief, depression, despondency, and despair. One wouldn't even tolerate driving by the hospital, the other is a bit better but will not go anywhere where he might run into the people involved.

Both people were the kind who saw being a nurse as central to the core of their being. Therefore, neither in their own mind ever stopped being a nurse. What each eventually found was a way to serve that wasn't nursing but utilized, directly or indirectly, the knowledge and skills of nursing.

The thing Isaw happen in both of these cases was that the person became a pariah among people they once considered friends and colleagues. People being incredible voyeurs wanted to know what's happening with the person and wanted to send their best, but wouldn't reach out personally to be supportive. So, the person lost livelihood and friends. It is a terrible thing to watch someone go through. It's like watching while someone has their soul ripped out and they go chasing after it, trying to catch it and not get trapped in hell. You can run along side of them but there's nothing else you can do but be there as witness to the process. Rather like a death watch.

**canoehead, BSN, RN** · Oct 2, 2002

I think that those that make a mistake and own up to it and take the consequences are to be respected, not shamed. I have a greater respect for a colleague who made a mistake who reports it, tells the family, and works hard to get that pt through their difficulties than I do for the person who says they have never made an error, or who talks about the errors of others. Making the same mistake twice though- that makes me think twice.

I don't think people should be shamed, but many times you don't know whether that person wants to hear from colleagues at work or would rather just move on. It's hard to know what to say.

NicuGal, MSN, RN · Oct 2, 2002

We had one girl that made a huge mistake and she was reprimanded by the state. She sunk so low that she needed therapy. The thing is...she lied about what she did and when the truth came out she was let go. This is a person that always was preaching about telling the truth and how people aren't truthful and that God would punish them. The tables turned and she turned into that person she berated. It was too much for her. She did not return to nursing and has not been employed since.

DiveMedic · Oct 3, 2002

A drug error that lead to a fatality was probably the biggest fear I ever had when I was a practicing nurse. Fortunately for me the drug errors I was responicible for were non fatal.

Two which could have led to serious complications didn't simply because the hospitals I worked in had a policy that "de criminalised" drug errors and so encouraged immediate reporting in order that corrective measures could be implemented if indicated along with close monitoring, one on one if necessary, this created an atmosphere that encouraged honesty.

Yes an Inquiry was held and a full range of sanctions was available to the inquiry board to deal with the errors but only twice was the ultimate sanction of striking off used in both cases the nurse in question was found guilty of gross negligence compounded by failing to report the incident and then of lying in an attempt to cover their errors which unfortunately led to mortalities. In neither case was the individual a particularly "good" nurse and in additon their subsequent efforts to cover their tracks placed them beyond the pale.

In a couple of other cases which unfortunately led to fatalities the nurses reported the errors accepted responsibility and were not treated like "pariahs" because we all knew that "there but for the Grace....."

**canoehead, BSN, RN** · Oct 3, 2002

Damn right, It could be me next time...

prmenrs, RN · Oct 3, 2002

Okay, I used a med error as an example. but here's another one: Several years ago, I extubated a 600 gram baby (on purpose!) to place him on Nasal CPAP. I suctioned out his mouth (at that time, we used those dental "saliva ejectors"-yep, like the ones at the dentist's office)--and got BLOOD!! Not good. So we (an RT was helping) used the light from the laryngoscope to look in the baby's mouth to see why---and found a neonatal tooth!!

I has in tears!--I hadn't done anything wrong, really, but I had caused him pain and bleeding. I made the attending take the tooth to the lab and look at it under a microscope to make sure that's what it was. It really bothered me--who knew to even LOOK for a tooth in a baby that small! Nonetheless, I was really shaken up by that.

I got to thinking about other unintentional errors--what if an OR nurse handed the wrong instrument to the surgeon and something happened to the pt. What if something got messed up on someone's halo? What we do everyday is so scary sometimes, so many different ways we can screw up.

How do or should we handle mistakes? I'm assuming we're honest and so forth. Making a mistake, even little ones, it's like a ding in our self-confidence. I wonder if it starts to snowball--you make a mistake, it shakes you up, then you maybe make more mistakes.

So, how do we patch ourselves back up?

prmenrs, RN · Oct 7, 2002

I thought I'd bump this up and see if anyone else has any ideas? I hope?

Thanks

Mkue · Oct 7, 2002

This is my #1 fear of becoming a Nurse. It could happen to anyone.

donmurray · Oct 8, 2002

I agree with Jim and canoehead, we are all human and subject to error. You learn from it, and move on. You may even help to improve a system error by highlighting a previously unseen problem. Covering up is what should attract prosecution/censure.

jenac · Oct 8, 2002

My biggest fear is that I will screw up and hurt someone. I work in LTC- and we all know how bad a med error can be for an elderly person. I still triple check all my meds-especially narcs. But it's always in the back of my mind...