Nurses Call the Governor of Tennessee

Nurses General Nursing

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You are reading page 35 of Nurses Call the Governor of Tennessee

mtnNurse., BSN

1 Article; 147 Posts

10 hours ago, Susie2310 said:

Nurses are held individually accountable for their practices by their state Boards of Nursing. Nurses are held to legal and professional standards of practice. My state BON doesn't permit me to violate the Nurse Practice Act and accompanying regulations in order to be a "good worker."

I agree with you. But I also don't think we should criminalize those nurses who are attempting to be good workers. We live in a society where our lives depend on money and where the quality of our lives depends on jobs. Hospitals are big, powerful institutions. Maybe nurses who accidentally harm patients are usually inexperienced, I'm not sure, but regardless, for many nurses it is no easy thing to learn to buck the system and forgo their jobs -- or to even realize that they can't trust their bosses to not lead them astray. Yes, nurses must learn this and realize they can't trust any boss telling them "they can handle it", "you don't need experience with this patient population, these are easy patients, don't worry", etc. like we've heard some of the horror stories. But it takes a strong, experienced nurse to know how and when to say no to the boss to adhere to standards of practice. It'd be great if nursing schools could emphasize these vital real-world nursing lessons more.

Wuzzie

5,116 Posts

12 hours ago, Susie2310 said:

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. 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.

Ah yes, the “Brain Fart” defense. Where nobody is held accountable for doing dangerous things because we are so busy and stressed we just forgot how to do things the right way.

mtnNurse., BSN

1 Article; 147 Posts

1 hour ago, TriciaJ said:

Actually, I don't know if anyone believes she should be found guilty, just that it's not necessarily inappropriate that she be charged. At this point we see how it plays out in court. There may be all kinds of extenuating circumstances we aren't yet aware of, and we all come away with sympathy for her. Or it turns out she has a history of egregious practice and has coasted until now. Or something else.

I'll certainly be watching with interest.

Maybe then the poll should have asked "should be charged", "should not be charged", "should be charged & found guilty", "should be charged & found innocent". I would have guessed most people voting for "yes, charge" would also want her to be found guilty, but maybe that isn't the case.

mtnNurse., BSN

1 Article; 147 Posts

1 hour ago, Rose_Queen said:
14 hours ago, mtnNurse. said:

Well, I'm glad no circumstances such as understaffing could cause you to skip the rights of medication administration. I hope we all become as flawless in that way as you are. She wasn't a new grad but still did not have a heck of a lot of experience IMHO.

I never skip the rights of medication administration. Never, not even when I have a patient on the OR table who is struggling to come off bypass. I work with potent medications- I know that one little slip can cause death.

These rights are drilled into nursing students' heads from day 1. It takes mere seconds to check the label of the drug. It takes mere seconds to read the order. It takes mere seconds to verify a patient identity. The fact that you use understaffing as an excuse to skip these is mind-boggling.

Well, I'm glad no circumstances such as understaffing could cause you to skip the rights of medication administration. I hope we all become as flawless in that way as you are, as well as the other person. I know someone thought this sounded snotty, but I actually mean it sincerely when I say I'm glad you are incapable of that type of error and I do hope we all become flawless in that way.

I am NOT using understaffing or anything else as an excuse to purposely skip those safety steps in medication administration -- I'm saying understaffing or other conditions can lead many nurses who are not flawless to accidentally skip some of those steps. We've heard many stories of such.

FineAgain

372 Posts

Specializes in ED; Med Surg.
On 2/10/2019 at 11:40 AM, Wuzzie said:

She did not make a mistake. If she had properly observed the patient for the medication she THOUGHT she gave this patient would not be dead and I would have an entirely different opinion. She slammed 2mg of Versed and walked away. That is the recklessness that takes this way beyond a simple medication error

This right here! Except she slammed 2 mg of vec and walked away. I have been so conflicted about this but keep going back to the basics. Not even the "rights" of medication, but the fact that you should not be giving versed and walking away. I have not worked anywhere that vec was not kept in an RSI kit instead of the Pyxis. I also keep thinking about the poor patient and how she must have suffered. This is not just a simple mistake. With the privilege of our license comes the responsibility of making sure we give medication the right way. If she had monitored a "conscious sedation" (which is what it is) the patient would be alive and this would be not be happening.

Wuzzie

5,116 Posts

3 minutes ago, mtnNurse. said:

I am NOT using understaffing or anything else as an excuse to purposely skip those safety steps in medication administration -- I'm saying understaffing or other conditions can lead many nurses who are not flawless to accidentally skip some of those steps. We've heard many stories of such.

No, we’ve heard stories of people missing one step in the process. We haven’t heard one story of someone missing EIGHT PLUS steps/warning signs or anyone not properly assessing a patient. That is the difference in this case. This wasn’t a simple med error that ended badly. This was sloppy nursing that I expect finally caught up to this particular nurse in a spectacularly awful way.

mtmkjr, BSN

453 Posts

12 hours ago, mtnNurse. said:

I'm opposed to criminal charges and would support your stated legislation when the nurse is not proven to have intent to harm and when the nurse is attempting to be a good worker at a facility that makes "good worker" synonymous with "good nurse".

Well then I suppose you are against the whole category of criminal offenses that fall under reckless homicide or negligent homicide? Your reasoning that there was no intent should also apply to any citizen who is charged.

TriciaJ, RN

4,328 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, mtnNurse. said:

Maybe then the poll should have asked "should be charged", "should not be charged", "should be charged & found guilty", "should be charged & found innocent". I would have guessed most people voting for "yes, charge" would also want her to be found guilty, but maybe that isn't the case.

I don't know how I want her to be found, because I don't know all the facts of the case. The CMS report shows what looks like really reckless practice - far below even the most basic standards of nursing. That's pretty damning. That's why she needs her day in court if there's a rest of the story that needs to be told.

mtnNurse., BSN

1 Article; 147 Posts

7 hours ago, Wuzzie said:
7 hours ago, mtnNurse. said:

I am NOT using understaffing or anything else as an excuse to purposely skip those safety steps in medication administration -- I'm saying understaffing or other conditions can lead many nurses who are not flawless to accidentally skip some of those steps. We've heard many stories of such.

No, we’ve heard stories of people missing one step in the process. We haven’t heard one story of someone missing EIGHT PLUS steps/warning signs or anyone not properly assessing a patient. That is the difference in this case. This wasn’t a simple med error that ended badly. This was sloppy nursing that I expect finally caught up to this particular nurse in a spectacularly awful way.

I understand that you think this case is different because of the multiple steps skipped. But I was replying to the quote in which she said I was using understaffing as an excuse to skip. By the way, I replied in the other thread about why I think of the charged nurse's failings as one big horrific mistake rather than a long, drawn-out series of eight separate choices to skip safety checks.

So then, understaffing can be an excuse to miss one step but not eight? How 'bout two? How 'bout not at all as above writer said. My point is that we all know what we should always do without fail. We know that. Yet sometimes, through no fault of our own and in a very unexpected way, we fail.

mtnNurse., BSN

1 Article; 147 Posts

5 hours ago, mtmkjr said:

Well then I suppose you are against the whole category of criminal offenses that fall under reckless homicide or negligent homicide? Your reasoning that there was no intent should also apply to any citizen who is charged.

I described where to draw the line in other posts, including if it were a truck driver...let me know if you want me to copy & paste.

JadedCPN, BSN, RN

1,476 Posts

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
20 hours ago, mtnNurse. said:

Maybe then the poll should have asked "should be charged", "should not be charged", "should be charged & found guilty", "should be charged & found innocent". I would have guessed most people voting for "yes, charge" would also want her to be found guilty, but maybe that isn't the case.

I think that was a big assumption on your behalf. As someone who voted that she should be charged, that does not mean I think she should be charged and found guilty. It just means that her behavior warrants being charged with a crime and then getting her day in court to defend it, just like would happen to every single other non-nurse citizen who made a comparable “mistake” that resulted in a death. Nurses are not above the law, even if they’re working in horrible conditions. Which many people automatically assume she was, though I disagree with that and of course we don’t know.

On 2/17/2019 at 1:51 AM, mtnNurse. said:

I'm opposed to criminal charges and would support your stated legislation when the nurse is not proven to have intent to harm and when the nurse is attempting to be a good worker at a facility that makes "good worker" synonymous with "good nurse".

Well, good news for you!

Intent is not a legal requirement for reckless homicide.

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