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Discussion

Nursing qualities

As a new nurse I have this on my mind. Most likely a new grad will at some point violate one of the patient's five rights. We all hope no harm is done if it does happen. Here is what happens in the hospital as a new grad. A new nurse violates one of those rights and say hangs a discontinued antibiotic. The new nurse tells the preceptor and the preceptor flips out, and tells management. management disciplines new nurse, and tells them to find another job. The gossip flies around to everyone about the stupid new nurse who made a huge mistake and is now without a job. The other new nurses find themselves lucky not to be the ones who screwed up. Until, one passes a PO beta blocker to the wrong patient who is hypotensive. The patient codes and almost dies. The new nurse plays dumb and gets away without reporting the mistake. What is wrong with nursing is that there is no one to fix the problem. By eliminating those who come forward and admit mistakes, management is silencing everyone else and creating more problems. I know I am not the first to recognize this. Is this how you think nursing should be?

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After reading posts on here lately I feel very fortunate to work where I work. I feel like my institution is very transparent with mistakes and instead of disciplining for mistakes they identify the cause of the mistake and put in practices to prevent future mistakes. Of course, if you are a repeated offender or were just plain negligent there are definitely repercussions. At my facility we are definitely encouraged to speak up when we make a mistake and there are incident reports to be filled out that do not result in discipline. I have never seen anyone where I work get fired for admitting to a mistake.

I think that the OP may be new, but has already gained a pretty good understanding of a serious issue in health care today.

There are no quick solutions, but the "Just Culture" movement is the most promising. Here's some info AHRQ Patient Safety Network. This is an approach that began in the airline industry and is being adopted by increasing numbers of health care organizations. Basically, it acknowledges that human beings make errors - perfection is unrealistic. But the response to errors should be based upon the type of error committed. If it was an "honest' unintentional error, the person should be consoled and any contributing factors should be fixed. If the error was due to 'at-risk' behavior... the person either took a calculated risk because they really didn't think anything bad was going to happen or they were taking shortcuts, leaving out steps, etc. to save time ... they should be counseled and provided with re-training as needed. However, if the behavior was 'risky' - knew it was wrong, but did it anyway - they are subject to termination.

So - if you're ever offered a new job with an organization that has adopted the Just Culture model.... grab it!

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