Fear, egos, and medical errors

[NurseLauraM]

I have seen a lot of interesting and concerning (and some downright hilarious) posts about errors in healthcare on here lately. Two particularly concerning trends are the posts about RNs who are afraid to question a provider, and providers who believe "RNs should just keep their mouths shut" instead of making suggestions providers. These trends are nothing new, and the latter obviously contributes to the former. However, as someone who has worked as an FNP, outpatient RN, substitute school nurse, EMT, and medical receptionist, I think it is important to point out that mistakes and near-misses occur across all levels off healthcare.

Here are some examples:

- As a receptionist, I prevented a colleague from making an egregious HIPAA violation

- An an RN, I have seen colleagues send incorrect labs, and make dangerous med errors (haven't we all witnessed that?)

- As an RN, I gave a wrong dose after taking a verbal order (still makes me cringe). The physician caught it in my documentation... unfortunately after I gave the dose.

- As an NP, I have seen a well-respected physician colleague with 30 years of experience order STAT labs on the wrong patient. A nurse caught the error.

- As an NP, I have seen another physician colleague send order to an RN for the wrong medication when her dictation software recorded "methotrexate" as "metoprolol" (which I am still pretty shocked by... darn technology!). A nurse caught the error.

- As an NP, I recently learned, through mistake, that prescribing cyclobenzaprine to a patient on tramadol is a huge no-no, thanks to a very vigilant pharmacist.

It's embarrassing to be caught making a mistake. Yet, we all know how deep and widespread the damage from a medical error can be. So, next time you question a provider or colleague's order, don't feel guilty; though they don't show it, most are actually thankful to have their butts saved. And for those who are too smug to admit being wrong, say thank you to your butt-saving colleagues every once in a while!

That's all, sorry for the rant.

[Ruby Vee, BSN]

I have seen a lot of interesting and concerning (and some downright hilarious) posts about errors in healthcare on here lately. Two particularly concerning trends are the posts about RNs who are afraid to question a provider, and providers who believe "RNs should just keep their mouths shut" instead of making suggestions providers. These trends are nothing new, and the latter obviously contributes to the former. However, as someone who has worked as an FNP, outpatient RN, substitute school nurse, EMT, and medical receptionist, I think it is important to point out that mistakes and near-misses occur across all levels off healthcare.

Here are some examples:

- As a receptionist, I prevented a colleague from making an egregious HIPAA violation

- An an RN, I have seen colleagues send incorrect labs, and make dangerous med errors (haven't we all witnessed that?)

- As an RN, I gave a wrong dose after taking a verbal order (still makes me cringe). The physician caught it in my documentation... unfortunately after I gave the dose.

- As an NP, I have seen a well-respected physician colleague with 30 years of experience order STAT labs on the wrong patient. A nurse caught the error.

- As an NP, I have seen another physician colleague send order to an RN for the wrong medication when her dictation software recorded "methotrexate" as "metoprolol" (which I am still pretty shocked by... darn technology!). A nurse caught the error.

- As an NP, I recently learned, through mistake, that prescribing cyclobenzaprine to a patient on tramadol is a huge no-no, thanks to a very vigilant pharmacist.

It's embarrassing to be caught making a mistake. Yet, we all know how deep and widespread the damage from a medical error can be. So, next time you question a provider or colleague's order, don't feel guilty; though they don't show it, most are actually thankful to have their butts saved. And for those who are too smug to admit being wrong, say thank you to your butt-saving colleagues every once in a while!

That's all, sorry for the rant.

I'm a fan of those threads detailing hilarious errors, misunderstandings and orders. However, it is a serious topic. When I started forty years ago, many of the older nurses were reluctant to question providers and providers weren't used to nurses who DID question them. That trend has changed significantly during my career. I hope we're not backsliding here. I make sure all of my orientees know when and how to question an order or make a suggestion.