I hope this is not the latest trend to be putting nurses in jail.
(CNN)Current and former employees of an Ohio nursing facility are accused of mistreating two patients in their care, including one who died as a result of the nurses' actions, Attorney General Dave Yost said Thursday.
A Franklin County grand jury indicted seven people who worked as nurses in 2017 at Whetstone Gardens and Care Center in Columbus, Yost said in a news conference.
The defendants face 34 charges, including involuntary manslaughter and patient neglect, Yost's office said.
One patient "literally rotted to death" as a direct result of the nurses' neglect, Yost said, adding that another suffered physical harm because nurses falsified her medical records and forged signatures.
"This is gut-wrenching for anyone who has entrusted a care facility with the well-being and safety of a loved one," Yost said.
The accused include six current and former employees.
I posted the following comment to mtnNurse on three other threads. To further the discussion I thought it appropriate to post it again:
"You keep making the point that nurses brains are subject to failure because we are humans. By your logic all workers in all types of occupations should never be charged with any crime due to their negligence unless they deliberately intended to cause harm to the public.
I've wanted to stick to just talking about nursing rather than including other occupations because I don't know how well other jobs compare to nursing jobs, regarding how in many (most?) nursing jobs, the nurse would have to quit or be willing to be fired to keep her license in integrity. But your valid questions in your post made me think about other occupations. Ok, so here is what I think. If a well-meaning worker in any occupation who is doing their best to do their job, who does not maliciously set out to harm anyone, makes an honest mistake in the course of doing their job or accidentally acts in a negligent way (i.e. is negligent not by choice but due to being overworked, considering one person only has one set of eyes and hands, can only be in one place at a time, and only has so much brain-power to actively think about a limited amount of cases simultaneously), then the licensing agency should decide how to hold the worker accountable rather than criminal court. Such a worker is not a criminal and it doesn't do a lick of good in our society to criminalize these workers. If we look at the causes in those situations, and find that the employer asked the worker to meet impossible demands, with an impossible work load...we need to hold the employer accountable rather than the worker. Why? Because if we hold the workers accountable, that does not fix the place of employment, and just leads to the next round of workers falling into the trap. If we hold the place of employment accountable instead, and the employer is prevented from understaffing / overworking, then lo and behold those same workers are suddenly able to adhere to all standards of practice while doing their jobs.
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Following your logic airline pilots brains are subject to failure at any moment during an 11 hour flight, and the plane could crash if the pilot gets overwhelmed or distracted. Think of all the many, many flights that take place all over the world, just in the course of one day, yet planes aren't crashing all over the place every day. Should we conclude that airline pilots brains function better than nurses brains? Or do airline pilots practice to higher professional standards? Nursing isn't the only profession with a lot of stressors, distractions, and responsibility/accountability.
From this analogy, I would conclude that the system of safeguards in which airline pilots do their jobs is a better system than that which nurses have to work within. I totally agree that nursing is not the only profession with stress, distractions, and accountability, and in fact I think there are worse. I consider a doctor's profession to be far worse regarding stress and distractions and higher responsibility; but doctors perhaps have a better understanding of the risk of harm and the risk of human error and are less likely to be criminally charged for accidents because they probably understand that accidents and unintentional negligence are not a matter of criminality but rather an issue for the medical board.
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I just had a licensed electrician work perform some work for me. Should I assume that he/she may be under extraordinary stressors and be unable to perform safely? I never thought that he/she might actually have been incompetent is his/her practice or might make a mistake that would lead to him/her ignoring basic electrical safety procedures. That perhaps he/she might be negligent to the point that I will get electrocuted. Oh, well, I guess I will just put it down to brain failure on his/her part. In which case, what is the point of professional licensure? If a licensed electrician can't perform their job safely why should I bother using his/her services?
Electricians get to focus on one job at hand at a time. Nurses in many (or most?) places of work are given unsafe obscene numbers of patients to guarantee safety for. I would trust a licensed electrician, but understand also that electricians are human so licensed or not, of course they could make a mistake. Making a mistake does not mean the person was incompetent -- that is WHY it's a mistake! The electrician perhaps had decades of fine-tuned skills to do something, then suddenly "whoops", did NOT mean to do that!
Ok, so what is the point of licensure -- I'd like for someone to answer that too! Because if I were a conspiracy theorist (which I'm not), I'd say it's so we can blame workers rather than employers when workers make mistakes in places of employment where they are set up to fail to save money! I don't believe that's the purpose of licensure (hope not). Isn't its purpose to protect the public from the worker as someone has said? --Then let the licensure agencies serve their purpose by holding workers accountable, and if the agencies aren't doing so, let the agencies be held accountable. Regarding why you should trust licensed professionals knowing they are human and might err and knowing they are held accountable to their licensing agencies...well, find out more about their employer -- if the licensed worker is given too much work, then common sense would tell us they aren't as likely to be able to do as well of a job. So as consumers, don't go to businesses who overwork or otherwise mistreat their employees if you can help it.
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Why bother to have any professional standards for any professions at all? Why bother with licensure? If the public can't trust that a licensed professional will be able to perform to industry standards of safety, why should they bother using the services of a licensed professional? Then we don't have professions, because everyone does the job equally incompetently/unsafely.
Licensure alone cannot guarantee safe work. This seems like common sense to me because of work conditions I've seen. If a licensed worker is in a job requiring a work load so excessive that the worker cannot perform safely...then the licensed worker is supposed to quit or be willing to be fired in order to adhere to the standards of practice. So then we are faced with the conflict of interest between a worker wanting to adhere to the standards of practice and be a good nurse / electrician / pilot / etc. but who ALSO wants to be a good worker and who also understandably wants a good job to have a good quality of life in this country. So what do we do? If we criminalize the worker when they inevitably fail when faced with impossible work demands, that does NOTHING to prevent the next worker from failing. Regarding nursing, that does NOTHING to keep patients safe. On the other hand, if we change the work environment and expectations and whatever CAUSED a conscientious worker to fail, then we allow future conscientious workers to succeed in simultaneously being a good worker AND a good professional.
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If you believe that nursing is a unique profession with extraordinary stressors such that nurses are unable to concentrate on their licensed activities to the point that they are unable to perform safely and must excuse themselves due to brain failure when they inadvertently harm or kill patients due to not being able to perform safely, why should anyone have any confidence in nurses ability to perform safe care? Why should the public go to hospitals?
Good question! The public should not have any confidence in a hospital to guarantee their safety if at that hospital there is an unsafe working environment, staff are given impossible work loads, there is not enough staff for the number of patients, staff are working 12 hour shifts without being able to take breaks, and other common assaults on the physical and mental limitations of human beings. That said, I do believe most nurses CARE and are giving it their absolute best to care in spite of horrid work conditions. I do believe somehow, against the odds, seemingly super-human nurses pull it off. Sometimes they don't. But we'll never hear about the times they don't when it's not reported, or if it's not fatal and no one even notices. I think the way ample articles and videos explain that "swiss cheese" model of how mistakes happen is a very good explanation of how things go wrong all the time but it's when a crucial sequence of the wrong things align that we get a bad enough outcome to notice.
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You are saying something quite terrible, that perhaps you don't realize you are saying, and that is that the public shouldn't expect to rely on licensed professionals to meet industry safety standards.
I agree it is terrible that licensed professionals are often not able to adhere to their professional standards of practice because often the jobs available to them (recalling most of us need jobs to survive) make impossible work demands that cannot be met while adhering to those standards of practice. The public can't ever rely on a human to never make a mistake anyhow; that is why a good place of work would have many layers of safety catches in place. In the case of nurses who absolutely must have a sharp state of mind to work safely, I would say there are many failings of those needed safety catches, e.g. lack of sufficient breaks in a 12-hr work shift (and SO MANY MORE, just go see for yourself...). And YES it is terrible that the public cannot rely on any businesses to do anything with safety as a priority because most any business in this country has money, not safety, as its bottom line! That is unregulated capitalism at its worst -- create a system where the incentive is to be unsafe in order to make more money (yay for the USA!). I would very much like to continue discussion on how to improve the NURSING profession and don't want to get too political here but would talk more in depth politically on a different thread if you want to start one, if that's even permitted talk in these parts (without being shot ?).
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You are saying that licensed professionals shouldn't be held criminally liable for failing to meet industry safety standards; that as long as they did not deliberately intend harm they should not face criminal charges and that their lapse of judgement/unsafe performance however caused should not result in criminal charges.
Agreed -- if it wasn't deliberate, then the licensing agency should deal with it not criminal court. Isn't that the point of the BON and parallel licensing agencies in other professions?? Save the criminal court for actual malicious criminals.
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I ask you a question in return, why should the public have confidence in licensed professionals? Why should I receive nursing care from you? Do you see where this goes? If the general public loses confidence that they will receive safe nursing care, do you think you can take for granted that they will continue to come to the facility you work at for their care? Do you think you might lose your job?
I think the public should lose confidence and should not go to the facilities in which staff is not given the environment to be able to perform safely, EXCEPT for the fact that medicine ALWAYS has risks vs. benefits. So if someone is having a heart attack, they're most likely better off going to a hospital than seeing what happens at home. What's the statistic, that hospitals are the third leading cause of death in this country or something like that? I'd recommend to the public to go to the hospital as a last resort. And to vote for people who care about changing our god-awful health care system. Facilities have financial incentive to employ fewer staff than the number needed to guarantee safe high quality care to every single patient every single day...this is our reality of most (or all?) places we work as nurses. I don't understand your last question about losing your job...if what, if we aren't hauled off to prison for a mistake then people won't trust us? We could still lose our jobs for a mistake...the BON could take away our licenses. Leave it in their hands to decide if the mistake or stray from standards of practice was just a rogue nurse being bad or because of the system or some of both, and how much to hold the nurse accountable -- but it's not an issue for criminality. Streets will not be safer to have conscientious, overworked nurses behind bars for their "crime" of doing their best to keep their jobs.
YOU are not a criminal if you worked at a place that demanded you take shortcuts in order to keep your job. You did the best you could. You likely did not have time to check for wounds on a ridiculous number of patients if you were hauling a cart as fast as you could up and down hallways to get people their medicine.
That's not entirely true. But where these nurses really screwed up, they forged signatures on doctor's orders. And documented care that they never provided. Both of those are illegal under criminal law.
It's also illegal to require unsafe shortcuts. It's even more illegal to punish any worker for straying outside of the law.
There's absolutely no excuse. You have a legal responsibility to refuse. If it means your boss has to get out from behind a desk and go pass meds, then that's what it means.
Unless your state has specific exceptions, you absolutely do not take on more patients than your states nurse:patient ratio limits. If you get fired, you have a huge lawsuit. But you won't get fired, because you'll be smart enough to call your BON and whatever agency oversees your facility.
Specializes in OR, Nursing Professional Development.
27 minutes ago, tonyl1234 said:
Unless your state has specific exceptions, you absolutely do not take on more patients than your states nurse:patient ratio limits. If you get fired, you have a huge lawsuit. But you won't get fired, because you'll be smart enough to call your BON and whatever agency oversees your facility.
You do realize that CA is the only state with a ratio law for all hospital units, right? It doesn't even touch long term care facilities.
Specializes in Psych, Addictions, SOL (Student of Life).
On 2/20/2019 at 3:54 PM, Persephone Paige said:
This was my point too. These places should not exist. But, it's an industry. The insurances are in on it, the owners. They KNOW these patients don't get good care, but they keep cashing the checks. And hiring minimal staff... God forbid they hire more nurses, might cut into their profits.
So if LTC and SNF facilities should not exist what do you propose we do with the people who end up in them? Sorry to say but I have been on both sides of this. I worked LTC for a year with a max load of 40 patients and while there were things I couldn't always get done in a day - I always practiced ethical nursing care.
The definition of negligence is: failure to take proper care in doing something. When that failure leads to someone's death it becomes criminal negligence.
When a nurse purposely does something like falsifies documentation that is no longer negligence - it becomes malfeasance which is also a criminal act.
But what was I supposed to do with my mother who had Alzhiemers? she couldn't be left alone a home lest we face elder neglect charges as well as the fact that she almost burned the house down twice. Took the car and crashed it into a police cruiser etc. Is euthanasia the answer?
mtnNurse., BSN
1 Article; 147 Posts
I've wanted to stick to just talking about nursing rather than including other occupations because I don't know how well other jobs compare to nursing jobs, regarding how in many (most?) nursing jobs, the nurse would have to quit or be willing to be fired to keep her license in integrity. But your valid questions in your post made me think about other occupations. Ok, so here is what I think. If a well-meaning worker in any occupation who is doing their best to do their job, who does not maliciously set out to harm anyone, makes an honest mistake in the course of doing their job or accidentally acts in a negligent way (i.e. is negligent not by choice but due to being overworked, considering one person only has one set of eyes and hands, can only be in one place at a time, and only has so much brain-power to actively think about a limited amount of cases simultaneously), then the licensing agency should decide how to hold the worker accountable rather than criminal court. Such a worker is not a criminal and it doesn't do a lick of good in our society to criminalize these workers. If we look at the causes in those situations, and find that the employer asked the worker to meet impossible demands, with an impossible work load...we need to hold the employer accountable rather than the worker. Why? Because if we hold the workers accountable, that does not fix the place of employment, and just leads to the next round of workers falling into the trap. If we hold the place of employment accountable instead, and the employer is prevented from understaffing / overworking, then lo and behold those same workers are suddenly able to adhere to all standards of practice while doing their jobs.
From this analogy, I would conclude that the system of safeguards in which airline pilots do their jobs is a better system than that which nurses have to work within. I totally agree that nursing is not the only profession with stress, distractions, and accountability, and in fact I think there are worse. I consider a doctor's profession to be far worse regarding stress and distractions and higher responsibility; but doctors perhaps have a better understanding of the risk of harm and the risk of human error and are less likely to be criminally charged for accidents because they probably understand that accidents and unintentional negligence are not a matter of criminality but rather an issue for the medical board.
Electricians get to focus on one job at hand at a time. Nurses in many (or most?) places of work are given unsafe obscene numbers of patients to guarantee safety for. I would trust a licensed electrician, but understand also that electricians are human so licensed or not, of course they could make a mistake. Making a mistake does not mean the person was incompetent -- that is WHY it's a mistake! The electrician perhaps had decades of fine-tuned skills to do something, then suddenly "whoops", did NOT mean to do that!
Ok, so what is the point of licensure -- I'd like for someone to answer that too! Because if I were a conspiracy theorist (which I'm not), I'd say it's so we can blame workers rather than employers when workers make mistakes in places of employment where they are set up to fail to save money! I don't believe that's the purpose of licensure (hope not). Isn't its purpose to protect the public from the worker as someone has said? --Then let the licensure agencies serve their purpose by holding workers accountable, and if the agencies aren't doing so, let the agencies be held accountable. Regarding why you should trust licensed professionals knowing they are human and might err and knowing they are held accountable to their licensing agencies...well, find out more about their employer -- if the licensed worker is given too much work, then common sense would tell us they aren't as likely to be able to do as well of a job. So as consumers, don't go to businesses who overwork or otherwise mistreat their employees if you can help it.
Licensure alone cannot guarantee safe work. This seems like common sense to me because of work conditions I've seen. If a licensed worker is in a job requiring a work load so excessive that the worker cannot perform safely...then the licensed worker is supposed to quit or be willing to be fired in order to adhere to the standards of practice. So then we are faced with the conflict of interest between a worker wanting to adhere to the standards of practice and be a good nurse / electrician / pilot / etc. but who ALSO wants to be a good worker and who also understandably wants a good job to have a good quality of life in this country. So what do we do? If we criminalize the worker when they inevitably fail when faced with impossible work demands, that does NOTHING to prevent the next worker from failing. Regarding nursing, that does NOTHING to keep patients safe. On the other hand, if we change the work environment and expectations and whatever CAUSED a conscientious worker to fail, then we allow future conscientious workers to succeed in simultaneously being a good worker AND a good professional.
Good question! The public should not have any confidence in a hospital to guarantee their safety if at that hospital there is an unsafe working environment, staff are given impossible work loads, there is not enough staff for the number of patients, staff are working 12 hour shifts without being able to take breaks, and other common assaults on the physical and mental limitations of human beings. That said, I do believe most nurses CARE and are giving it their absolute best to care in spite of horrid work conditions. I do believe somehow, against the odds, seemingly super-human nurses pull it off. Sometimes they don't. But we'll never hear about the times they don't when it's not reported, or if it's not fatal and no one even notices. I think the way ample articles and videos explain that "swiss cheese" model of how mistakes happen is a very good explanation of how things go wrong all the time but it's when a crucial sequence of the wrong things align that we get a bad enough outcome to notice.
I agree it is terrible that licensed professionals are often not able to adhere to their professional standards of practice because often the jobs available to them (recalling most of us need jobs to survive) make impossible work demands that cannot be met while adhering to those standards of practice. The public can't ever rely on a human to never make a mistake anyhow; that is why a good place of work would have many layers of safety catches in place. In the case of nurses who absolutely must have a sharp state of mind to work safely, I would say there are many failings of those needed safety catches, e.g. lack of sufficient breaks in a 12-hr work shift (and SO MANY MORE, just go see for yourself...). And YES it is terrible that the public cannot rely on any businesses to do anything with safety as a priority because most any business in this country has money, not safety, as its bottom line! That is unregulated capitalism at its worst -- create a system where the incentive is to be unsafe in order to make more money (yay for the USA!). I would very much like to continue discussion on how to improve the NURSING profession and don't want to get too political here but would talk more in depth politically on a different thread if you want to start one, if that's even permitted talk in these parts (without being shot ?).
Agreed -- if it wasn't deliberate, then the licensing agency should deal with it not criminal court. Isn't that the point of the BON and parallel licensing agencies in other professions?? Save the criminal court for actual malicious criminals.
I think the public should lose confidence and should not go to the facilities in which staff is not given the environment to be able to perform safely, EXCEPT for the fact that medicine ALWAYS has risks vs. benefits. So if someone is having a heart attack, they're most likely better off going to a hospital than seeing what happens at home. What's the statistic, that hospitals are the third leading cause of death in this country or something like that? I'd recommend to the public to go to the hospital as a last resort. And to vote for people who care about changing our god-awful health care system. Facilities have financial incentive to employ fewer staff than the number needed to guarantee safe high quality care to every single patient every single day...this is our reality of most (or all?) places we work as nurses. I don't understand your last question about losing your job...if what, if we aren't hauled off to prison for a mistake then people won't trust us? We could still lose our jobs for a mistake...the BON could take away our licenses. Leave it in their hands to decide if the mistake or stray from standards of practice was just a rogue nurse being bad or because of the system or some of both, and how much to hold the nurse accountable -- but it's not an issue for criminality. Streets will not be safer to have conscientious, overworked nurses behind bars for their "crime" of doing their best to keep their jobs.