Well, shoot, I just replied in another thread called 'I hope this is not the latest trend' -- can we please just pick one thread when it's a long post and if you want to comment in another thread, re-write your points in a new way so at least it's not the identical post to respond to? Sadly, I will follow your suit here to copy & paste my response -- I don't like doing so for the sake of people reading all threads, but I don't want your post to go unanswered if people are only reading this thread. You ask valid questions here and I give valid answers!
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.
