Nurses Need to Turn Errors Into Positives

Nurses need good resilience to learn from errors at work. Constructive-work environment is needed, which comes from good relationships among them. Nurses Announcements Archive Article

Nurses Need to Turn Errors Into Positives

Nurses are hard at work to protect the lives of patients as everybody knows. As every business has a silver lining, so does the nursing world. This author who experienced nursing duty both in United States and Japan as a registered nurse focuses on a side of nursing work. Making errors is one of the stressful events. If making errors can be fatal to a patient's life, it is no wonder that the nurse must be serious not to allow it to happen again. Thus, how to address those mistakes is important. Yet, seemingly even minor errors that don't affect their patients can be a serious one in Japan. It is a phenomenon that the nurses in Japan do not have much tolerance for and are rather too much sensitive about it. What makes them act in this way?

I realize that the nurses in Japan have less independence than in USA in my experience. The dependence makes the nurses ask other nurses before intervention to their patients. Then, the dependent relation among the nurses lets them be too empathetic to each other. Hence, they are always too sensitive to others performance because the nurse feels responsible for the intervention and the nurse who is asked also feels responsibility for what he or she says. Upon being afraid of making errors, the tendency shows up as their intolerance to even minor mistakes. No mistakes at work is ideal but we are all human who do make mistakes. This tendency turns to a negative environment at work in Japan. I wonder if it is good for nurses in Japan?

Openly talking each other at work regardless of age, sex, or any other difference is healthy and helpful because we need to know if something new comes up. However, a casual circumstance at work to establish an answer in Japan is not always easy. For instance, new nurses are very afraid of asking senior nurses questions. At the same time, they are blamed for doing things without the seniors' permissions. Japan tends to be a vertical society including nursing in where younger nurses must listen to seniors without making any opinions to show complete respect and obey. It might be similar to a military situation where top-down command is must. They go to the seniors to receive directions because interventions without directions from them mean disrespect. The situation does not develop their independence as a result. In USA, nurses regardless of their position or being older, they talk to each other more casually and openly. There are more opportunities for nurses to use their own judgement to develop their independence.

Another possible explanation why they are sensitive to each other is a Japanese term called Murahachibu. It is a punishment in villages in traditional Japan for those who violate rules or orders. They are shut out of any communication until the punishment works. It represents traditional Japanese society that likes collectivism rather than individualism. (Wikipedia, 2016) If they see someone who is so different in appearance, thoughts, behaviors, or anything else, they develop dislike rather than acceptance. It can be applied to the nurses' work in Japan. If a nurse doesn't like another nurse, Murahachibu may start. The fear for the punishment may dominate the nurses. As a result, many choose loyalty and obedience rather than opening their mouths to confront. In this circumstance, a nurse who uses others' mistakes for oppressing opportunities become a powerfully prominent person at work in Japan. He or she is almost free to abuse other nurses because most of the nurses choose peaceful observation upon the fear from the oppressive nurse. This situation doesn't help the establishment of independence for the nurses.

It is totally wrong that this tendency is applied for all nurses in Japan. Many nurses in Japan are very independent and have opinions at work. This depiction is, however, typical describing the nurses in Japan. The nurses who uses others' mistakes for their advantage corresponds to liking and disliking their co-workers. In USA, most nurses are open enough to accept any nurses as a partner. Most of them have enough ability, tolerance, or acceptance such as sociability regardless of their personal preferences of other nurses. This type of maturity is important on how to develop a constructive-work environment among nurses because it makes the nurses more open to others. A constructive-work environment means that a mistake is a next step for a nurse rather than a chance for punishment. Of course, we are all human who sometime shows our evil side with blaming someone unreasonably. However, it becomes too stressful for the nurses if the blame escalates or continues in an unconstructive way. If the work environment is constructive, such furious attitude or behavior from a nurse to another nurse becomes a foolish action to nothing. A nurse needs to be mature enough to realize how important it is to establish a real relationship among nurses. It ends up with a healthy-working condition and develops their independence and a good work environment

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hay913tets

About hay913tets

Tetsuya Hayashi, RN, MSN

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I just finished some exchange credits from the University of Beijing and got an international certificate in Chinese culture. I know there are some differences from Japan, but it's the same overall "collectivist" top-down social hierarchy that you describe. I will say first that there are certainly some aspects of the social structure that I admire, particularly the monumental importance that is placed on relationships. However, it didn't occur to me how this rigid hierarchy might play out in a hospital setting where it's critical that younger nurses can ask questions in order to expand their understanding, even if it's asking the senior nurses to explain why something may or may not be the best practice, etc.

Specializes in Nephrology, Cardiology, ER, ICU.

I was stationed in Japan when I was in USN and yes agree that there are drastic differences in culture. This points to being culturally aware for those of us in the US too as we come in contact with many patients and families from cultures different from our own.

Thank you for this article.

Unfortunately mistakes do happen, and whether or not you're a nurse in Japan or US, the culture must be to learn from your mistakes. Otherwise you are doomed to failure and will repeat these mistakes.Talk to a respected charge nurse of nurse manager, to see about setting up a culture of safety at your facility, rather than a culture of blame.No one learns from a culture of blame, and this can be extremely harmful for the patients, if the nurse is more worried about making a mistake, than doing the right thing.

Specializes in GENERAL.

Wait a minute. I'm seriously having trouble with undertanding from which dimension of planet bizzaro the prior posters are channeling from.

The culture of blame is so inculcated into Western society that it defies reason and experience to think otherwise.

Whenever I hear someone someone say "you have to own your mistakes" I'm reminded of the legions of ne'er-do-wells who have pleaded the 5th to escape the serious consequences of adhering to this noble but tiring bromide.

In fact, with all the hipocracy I have seen down through the years, taking resonsibility has always been best left up to the other guy naive enough to want to take the rap sans legal counsel.

While I'm not advocating for lies and deceit to rule, I do admire the accepted custom in medieval, feudal Japan where the true mischief makers in society would do the right thing and commit Seppuku and leave the rest of us alone.