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Nurses Call the Governor of Tennessee

Nurses   (15,479 Views 422 Comments)
by Nurse Beth Nurse Beth, MSN (Advice Column) Writer Innovator Expert

Nurse Beth has 30 years experience as a MSN and works as a Nursing Professional Development Specialist.

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You are reading page 24 of Nurses Call the Governor of Tennessee. If you want to start from the beginning Go to First Page.

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47 minutes ago, Horseshoe said:

Where *I* would draw the line would be in intent and malice. Just because you are not put in prison does not mean you cannot be penalized very severely. But Tennessee clearly doesn't make that distinction; it's not up to me. 

Criminal sentences are intended to act as a deterrent to others who would commit a similar offense.  The purpose of a criminal sentence is not just punishment for the offender; it is also to protect the general public and to deter others from committing a similar act.  Intention to harm is not necessary.  A serious departure from the Standard of Care (practicing below the Standard of Care) can be enough.

Edited by Susie2310

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1 minute ago, Susie2310 said:

Criminal sentences are intended to act as a deterrent to others who would commit a similar offense.  The purpose of a criminal sentence is not just punishment for the offender; it is also to protect the general public and to deter others from committing a similar act. 

I've addressed the deterrence factor a couple of times already.

 

Seriously have to go. I always feel it's rude not to respond to people's posts when they quote me, but at some point I have to call it quits. 

 

Happy debating everyone.

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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13 minutes ago, Susie2310 said:

Criminal sentences are intended to act as a deterrent to others who would commit a similar offense.

It hasn't "deterred" criminals who commit future crimes. That's because a criminal mind is different than people who are like you and I or maybe Nurse RV.

13 minutes ago, Susie2310 said:

The purpose of a criminal sentence is not just punishment for the offender; it is also to protect the general public and to deter others from committing a similar act. 

The BON upholds the standards of the nursing profession and protects the public from unsafe nursing practices. Government regulations and voluntary safety nursing practices in our healthcare institutions deter others from "committing a similar act". She ignored those safety practices and she must face trial for it, in my opinion, within our own system of checks and balance, not in criminal court.

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HomeBound has 20 years experience.

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1 minute ago, juan de la cruz said:

It hasn't "deterred" criminals who commit future crimes. That's because a criminal mind is different than people who are like you and I or maybe Nurse RV.

The BON upholds the standards of the nursing profession and protects the public from unsafe nursing practices. Government regulations and voluntary safety nursing practices in our healthcare institutions deter others from "committing a similar act". She ignored those safety practices and she must face trial for it, in my opinion, within our own system of checks and balance, not in criminal court.

Why would a nurse be exempt from the rules that society has put in place? What makes us special cases? Doctors have the AMA--and they are sanctioned all the time for their behavior, some losing licenses and such---however, when there are the three elements of criminal act in place,

Mens rea:  Others may require proof the act was committed with such mental elements such as "knowingly" or "willfulness" or "recklessness". This is not to be confused with "motive". The law does not take into account "motive" when the basic elements of a criminal act is being deliberated.

In general, guilt can be attributed to an individual who acts "purposely," "knowingly," "recklessly," or "negligently." Together or in combination, these four attributes seem basically effective in dealing with most of the common mens rea issues.

actus reus:

All crimes require actus reus. That is, a criminal act or an unlawful omission of an act, must have occurred. A person cannot be punished for thinking criminal thoughts. This element is based on the problem of standards of proof. How can another person's thoughts be determined and how can criminal thoughts be differentiated from idle thoughts? Further, the law's purview is not to punish criminal ideas but to punish those who act upon those ideas voluntarily. [5]

Unlike thoughts, words can be considered acts in criminal law. For example, threats, perjury, conspiracy, and solicitation are offenses in which words can constitute the element of actus reus.

The omission of an act can also constitute the basis for criminal liability.

concurrence: the act and the mental state must occur at the same time

causation:

A causal relationship between conduct and result is demonstrated if the act would not have happened without direct participation of the offender.[5]

Causation is complex to prove. The act may be a "necessary but not sufficient" cause of the criminal harm. Intervening events may have occurred in between the act and the result. Therefore, the cause of the act and the forbidden result must be "proximate", or near in time.

 

These are the rules that civil society has agreed upon that constitute the basis for a criminal act. Extenuating circumstances occur--which is why there are levels of charges, such as "involuntary homicide" or "Aggravated assault". The law is not black and white, as some here are proposing it is---ergo, RV CANNOT and SHOULD NOT be charged.

She meets the criteria for the standard of behavior for citizens of this country. She is a nurse. The two are not mutually exclusive.

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17 minutes ago, juan de la cruz said:

The BON upholds the standards of the nursing profession and protects the public from unsafe nursing practices. Government regulations and voluntary safety nursing practices in our healthcare institutions deter others from "committing a similar act". She ignored those safety practices and she must face trial for it, in my opinion, within our own system of checks and balance, not in criminal court.

The BON has the power to discipline or revoke a nurse's license.  But in some cases, as I mentioned earlier, where an investigation has taken place and charges appear to be indicated, it can be appropriate for a person to face criminal charges, not just to be prevented from practicing their profession.  

You admitted in an earlier post on this thread to feeling "Solidarity for the profession" and I told you I understand this as feelings of self interest.

I disagree with you that Government regulations and voluntary safety nursing practices in our institutions are sufficient to deter others from practicing below the Standard of Care.  In many cases they are not.  The fact that Medical errors have been shown to cause significant numbers of patient deaths annually in my opinion shows clearly that voluntary practices and existing regulations are not sufficient to protect patients.

Edited by Susie2310

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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8 minutes ago, Susie2310 said:

You admitted in an earlier post on this thread to feeling "Solidarity for the profession" and I told you I understand this as feelings of self interest.

I disagree, I have no reason to worry about the risk in my practice any more than I already did before I learned about the case. I certainly strive to practice safely as I'm sure you do as well. I don't see myself in a situation that is remotely similar to Nurse RV's actions. When I said "solidarity" that means future criminal prosecutions of nurses at the bedside like her. It's such a gray area, you yourself said that other patients have died from similar errors, where are the courts prosecuting them?

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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16 minutes ago, HomeBound said:

Why would a nurse be exempt from the rules that society has put in place? What makes us special cases? Doctors have the AMA--and they are sanctioned all the time for their behavior, some losing licenses and such---however, when there are the three elements of criminal act in place,

Mens rea:  Others may require proof the act was committed with such mental elements such as "knowingly" or "willfulness" or "recklessness". This is not to be confused with "motive". The law does not take into account "motive" when the basic elements of a criminal act is being deliberated.

In general, guilt can be attributed to an individual who acts "purposely," "knowingly," "recklessly," or "negligently." Together or in combination, these four attributes seem basically effective in dealing with most of the common mens rea issues.

actus reus:

All crimes require actus reus. That is, a criminal act or an unlawful omission of an act, must have occurred. A person cannot be punished for thinking criminal thoughts. This element is based on the problem of standards of proof. How can another person's thoughts be determined and how can criminal thoughts be differentiated from idle thoughts? Further, the law's purview is not to punish criminal ideas but to punish those who act upon those ideas voluntarily. [5]

Unlike thoughts, words can be considered acts in criminal law. For example, threats, perjury, conspiracy, and solicitation are offenses in which words can constitute the element of actus reus.

The omission of an act can also constitute the basis for criminal liability.

concurrence: the act and the mental state must occur at the same time

causation:

A causal relationship between conduct and result is demonstrated if the act would not have happened without direct participation of the offender.[5]

Causation is complex to prove. The act may be a "necessary but not sufficient" cause of the criminal harm. Intervening events may have occurred in between the act and the result. Therefore, the cause of the act and the forbidden result must be "proximate", or near in time.

 

These are the rules that civil society has agreed upon that constitute the basis for a criminal act. Extenuating circumstances occur--which is why there are levels of charges, such as "involuntary homicide" or "Aggravated assault". The law is not black and white, as some here are proposing it is---ergo, RV CANNOT and SHOULD NOT be charged.

She meets the criteria for the standard of behavior for citizens of this country. She is a nurse. The two are not mutually exclusive.

Then whatever you said must be applied equally...there should be more criminal prosecutions and it hasn't happened. Is Nurse RV's case a breaking point? maybe. It is a slippery slope and we have to make a decision to either apply the law to all or not do that at all.

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1 minute ago, juan de la cruz said:

I disagree, I have no reason to worry about the risk in my practice any more than I already did before I learned about the case. I don't see myself in a situation that is remotely similar to Nurse RV's actions. When I said "solidarity" that means future criminal prosecutions of nurses at the bedside like her. It's such a gray area, you yourself said that other patients have died from similar errors, where are the courts prosecuting them?

I believe you are misquoting me.  Please provide the exact quote where I said that other patients have died from similar errors.  I don't recall using these words.

 

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6 minutes ago, juan de la cruz said:

I disagree, I have no reason to worry about the risk in my practice any more than I already did before I learned about the case. I don't see myself in a situation that is remotely similar to Nurse RV's actions. When I said "solidarity" that means future criminal prosecutions of nurses at the bedside like her. It's such a gray area, you yourself said that other patients have died from similar errors, where are the courts prosecuting them?

Yes, I think you have made it clear that you don't want nurses to face criminal charges if they provide care that meets the criteria for criminal charges.

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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1 minute ago, Susie2310 said:

I believe you are misquoting me.  Please provide the exact quote where I said that other patients have died from similar errors.  I don't recall using these words.

 

I was going by this statement:

 

14 minutes ago, Susie2310 said:

The fact that Medical errors have been shown to cause significant numbers of patient deaths annually in my opinion shows clearly that voluntary practices and existing regulations are not sufficient to protect patients.

Shouldn't they all be prosecuted criminally?

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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1 minute ago, Susie2310 said:

Yes, I think you have made it clear that you don't want nurses to face criminal charges if they provide care that meets the criteria for criminal charges.

Now you're the one twisting my words.

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HomeBound has 20 years experience.

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2 minutes ago, juan de la cruz said:

Then whatever you said must be applied equally...there should be more criminal prosecutions and it hasn't happened. Is Nurse RV's case a breaking point? maybe. It is a slippery slope and we have to make a decision to either apply the law to all or not do that at all.

Absolutely agreed 100%. It has to happen.

I was reading up on "nurses who kill"--yes, they are serial killer psychopath types---but the fact still remains that these people were either shuttled off by quietly firing them, or they drift from job to job---and there is suspicion. If everything is "handled from within"---because the BON has absolutely no authority to really penalize someone who has criminality in mind--people died in these cases because of "nursing shorages" or they "don't want to alarm the public about healthcare workers".

Those aren't good reasons. Having the most trustworthy image and perception in the world comes with a responsibility. Transparency and the willingness to accept what society would find "negligent" or "reckless"---particularly in the death of a human, be they elderly or infant---is important.

The minute we believe we are to be "exclusive" and "closeted" ---only judged by other nurses, held only to "our own law"---the situation is ripe for abuse.

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