mtnNurse.

Will probably make people pause when they peel off a warning label that says "PARALYTIC PARALYTIC PARALYTIC PARALYTIC PARALYTIC" Even if she is found guilty I doubt she'll do time. She's either being charged with a class D or E felony. No priors. Normal ordinary person. Tons of folks to vouch for her character. Suspended sentence, probation. I don't understand why you think nurses would be more prone to see a warning label if they knew they could be criminally charged if they don't see it. So are you saying that the criminal charges and verdict will serve as a deterrent to purposely ignoring warning labels? If so, why do you think that would serve as a better deterrent than the horrific possibility of killing a patient would serve as a deterrent? Suppose that prior to RV's accident (again, 'accident' meaning she did not kill on purpose), she had knowledge of criminal charges for nurses' mistakes. Do you really think that would have prevented her accident?

We're both wanting to be polite...sometimes we don't see what the other writes as so polite though. I think I've had more tolerance than some others about things we disagree on. But, I will try to do better. ? I would like to hear more about what good will come of criminal charges for nurses who have accidents. I would like to try to understand why some people think our profession or society will benefit for her to be found guilty and put into prison for many years?

Oh. Then replace my bolded phrase above with "in well-meaning efforts to do their jobs and not hurt anyone". So no, ideal work conditions would not change how I feel about criminal charges. And yes, I feel that way about anybody not just nurses. I think a moral society would opt for remedial rather than penal solutions -- though I feel differently for violent crimes. And I think licensing agencies should handle cases of professional accidents (again, 'accident' meaning she did not kill on purpose, so it was an accident that she killed the patient). Have you ever heard of a hospital that has adequate staffing, light workloads, reasonable work expectations, sufficient breaks in a 12-hr shift, and is conducive in every way to keeping a nurse's brain sharp throughout that LONG work day?

The district attorney has made it very clear why RV is being charged and for whatever reason....you keep ignoring this very important and significant difference. I haven't ignored it...maybe you've ignored my opinions about it. We just disagree. By 'accident', I mean she did not kill on purpose. I can see you prefer penal rather than remedial solutions; that just makes me sad, but I know I won't sway your beliefs. I like your example of what a hospital could do to help prevent accidents such as what happened. Force nurses to give valid reasons for overrides and hold them accountable when they have those high numbers of overrides without valid reasons. That way, no nurse will become so accustomed to performing overrides that it is something she could do on 'auto-pilot'.

What I bolded in your post is one of my points. Nurses have to quit or be willing to be fired in order to 100% adhere to standards of practice at many or even most nursing jobs (but even in ideal conditions they can't guarantee 100% because that would be saying they're perfect and can't ever make a mistake). You did the right thing and quit. So now you're gone and nothing has changed. The unsafe work environment is still there. If one of those co-workers you left behind caused a bad outcome down the road, how would it change the unsafe work environment to fire her and criminally charge her? What good does it do? Your questions using analogies are not consistent with this case. Had the nurse been aware she was risking killing that patient in the moments of the fatal accident, she would have been aware enough to catch her mistakes. I believe she erroneously, fallaciously "KNEW" she had no chance of killing that patient. We'll probably have to agree to disagree on that. I love the idea of hotlines, whistleblower lines, and unions! I also agree people shouldn't just throw their hands up and consent to give substandard care. But there is often more subtlety there then consciously choosing to give substandard care. For example, if an overloaded nurse is going as fast as she can and doing her absolute best to be safe and adhere to all standards of practice and then an accident happens, that is a very different thing than if she instead just throws her hands up and says, "I give up on giving good care".

I highly recommend to those of you who want the board to act differently -- well then get more involved and fix the BON. Because you could say the same thing about the criminal justice system. If they don't deliver the verdict and punishment you deem appropriate, you could then say exactly what you said here: "if the [court] isn't going to do anything somebody else should". Does that mean you'd be calling for the mob to take matters into their own hands to ensure she is punished as you see fit? I doubt you think that. If the BON fails, focus on fixing it; don't instead call for the criminal court to handle cases the BON should handle. So I’m guessing, from this statement, that you’re okay with no charges being filed for mercy killings by healthcare providers. After all there was no malicious intent. That sounds like something I'd be interested in having a conversation about if you want to start a new thread for it and fill me in on what the issue is. If you like attempting to understand others who disagree with you, it doesn't further the conversation to duplicate your posts with reference to 'Ferris Bueller's Day Off' and talk about being irritated of certain people suddenly being silent (though that is a funny movie ?). Consider that whoever you wanted to answer you might've not seen your questions yet. If any of you are not attempting to understand others who disagree with you and just want a venting board to spew out your condemnation of RV...carry on then.

I don't know what led RV to fail in the ways she did but can imagine plenty more possible causes than just assuming "only happened because of...". I think she should be held accountable for her failings to the BON rather than criminal court, which is different from saying she's not accountable at all. As I've described more in other posts, I don't think criminal charges should ever be brought against nurses (or other professionals) when malice is absent and they make mistakes or stray from standards of practice in efforts to meet impossible work demands. In such situations, the BON (or other licensing agencies for other professionals) should hold the professional accountable. Criminal court should be reserved for malicious criminals. And I find it hard to believe that RV was being aware of what she was doing and aware that there was a risk of killing her patient in the very moments of her failings. I strongly believe that if she had stopped to think about what she was doing, she would have caught her mistake rather than risk the life of her patient. Again, as people have copied in other threads what reckless homicide means, and by using those definitions, the mindlessness her behavior exhibits is what indicates she is not guilty of reckless homicide. I believe she was in a mindless rush and should be held accountable by BON. Good question about what to do if BON is not serving their purpose...should we somehow hold BON accountable in such cases? Or do we need to trust that BON used their best judgement in determining their actions on this case -- and if we can't trust that, then concerned nurses need to get involved in the BON and work to make a difference, whether it's to get on the board yourself or bring your concerns to the board. It's just like a union or democracy -- if you don't like the judgement used by the leaders within, then you need to either run for office yourself or support those you do trust the judgement of in becoming leaders. What good will come of putting nurses such as RV in prison? I'd like to see people's opinions about this, if you'll please also address my previous post about 'deterrents' and 'accidents', e.g. How would criminal charges be a deterrent if the much scarier deterrent of killing a patient fails? How can you deter someone from making a mistake -- it's a mistake because they did not foresee it coming or intend for it to happen -- What we CAN do is prevent more mistakes by having more safeguards in place to reduce the chances of human error not being caught in time.

Yes! Quit or be willing to be fired rather than work in such a place. That is what we should. Easier said than done for sure, and I don't know what advice to give those who need that job to stay in their house or feed their kids...do you? I haven't seen anyone argue for the nurse to be absolved from her failings -- just that the BON should be the only entity to hold her accountable rather than criminal court.

It makes sense to defend nurses involved in accidents from criminal charges if you think the BON should handle accidents and the criminal court should be reserved for malicious criminals. Of course, you have a right to not think this. If you're truly interested in why some defend her, there are what 3-4 threads now and plenty of well thought out various valid differing opinions. Please don't make yourself sick...just get off the computer before that happens. ?

YES on much greater regulatory oversight of health care facilities being necessary! Just one of endless regulations we could think of to improve safety would be: mandated maximum number of patients to allow nurses to better care for each patient and reduce risk of mistakes! Here's a question for you based on the rest of the comments you made. Let's say we just start throwing in jail everyone involved in medical errors. This will lead to greater safety because...how exactly? How will criminalizing nurses prevent other nurses from having accidents? People will be too afraid of jail to make a mistake? So killing a patient isn't scary enough, but then jail would be, is what you're saying? Jail is a bigger deterrent then KILLING a patient?? And besides, how to you deter someone from having an accident?? Does that question not defy the very definition of 'accident'???

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.

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.

THANK YOU for speaking up about the reality that many nurses are dealing with all over the country, whether it's LTC or hospitals or other facilities that make money the bottom line over patients and employees! I really wish more people would speak up about this. The grab-the-handcuffs, throw-under-the-bus, shame & blame nurses who seem to be getting their message across louder on this entire forum need to hear from more people like you. 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. Let's start looking at the CAUSES of caring, conscientious nurses making mistakes, having accidents, failing to adhere to standards of practice, and taking shortcuts to keep their jobs. Let's start blaming those causes. Let's start trying to understand those nurses when it happens to them; let's listen to them when they tell us what conditions are like and how they came to take shortcuts (it was normalized in the culture of their workplace...they were expected to do it...their boss demanded it); and for god's sake, let's show some solidarity and fix these problems together instead of thinking there's just a bunch of rogue nurses out there who don't care about their patients! Are there "bad people" in every profession? probably. Are there "bad nurses" who really don't care if they harm or kill people? probably (though I believe MOST nurses become nurses because they have a desire to HELP people). But to not even look at the CAUSES and assume these nurses are just "bad" and deserve criminal charges...come on, have you EVER seen these work conditions where nobody would be able to do what's expected of them, and have you ever needed a job to survive? If you want to change things, change the systems...criminalizing as many nurses as you want will NOT fix these systems!!!

Thank you for posting this to further the discussion of a case for which there is much to be learned. It should be the BON's job and not the DA's or criminal court's to determine how RV should be held accountable for failing in all the ways she did to adhere to professional standards of practice. If anyone should sanction RV, it should be the BON rather than the criminal court. Not caring and accidentally not thinking are two very different things. Ever heard of the possibility of good people not paying attention when they should have? It happens to all of us at one time or another, and as far as I know it is humanly impossible to never enter into "auto-pilot" at some point in time in your life, even when you are doing something for which the risk requires full attention. I do agree bad nurses might be "liked" and good nurses "disliked" by patients and coworkers. But I reckon if people had said about her that she was always hateful and mean it might make people wonder if she'd done it on purpose (which nobody so far has thought) -- so knowing how people felt can help influence whether people conclude she made an honest mistake(s) or not. I'm glad you are aware all hospitals are flawed; I don't know that, but it is very much my strong suspicion that is true because I've never seen or heard of a perfect one. Because I strongly believe that, I don't doubt there is plenty that happened in RV's working environment and circumstances leading up to the accident which contributed to the accident through no fault of her own. I agree she erred in ways where she should also be held accountable and not solely the hospital. But it's the BON's job to hold nurses accountable when they make mistakes or stray from standards of practice in the course of attempting to do their jobs in a well-meaning way. RV is not a criminal for her accident. Nurses and all caregivers deserve better than to be criminalized for accidents; their jobs entail risking their own lives and the lives of their patients in efforts to heal and save their patients.

I told you that I posted that with the best intentions. It was beginning to sound like maybe you were having a terrible experience with staffing issues at your job. I never said you can't post your opinions. There is no need to get testy. I have been nothing but polite to you. Well, thank you then for your best intentions. I would like to be polite to you too and from what I've seen you post before, you are intelligent and also an experienced and good nurse. I do get annoyed with posts I've seen among recent threads (not necessarily yours) that imply that someone who defends a nurse from criminality must have self-interest involved. I thankfully removed myself from working in a hospital that demanded to give staff too many patients and every nurse there felt it was unsafe. And I most likely will not put myself back into a situation like that again. As one person put it "I'd rather dumpster dive". So I have no self-interest involved when I seek to defend nurses from criminality. I do think all of us who disagree are ultimately on "the same side". We are all nurses. We all care about people. We all want our patients to be safe. We all want good working environments, reasonable work expectations, safe nurse-to-patient ratios. We all want a good job and nice work-life balance. I think that most or all of us know that most nursing jobs do not give us these things that we deserve as nurses, as workers. I hope we can all work to change that.

You continue to make this flawed emotional argument throughout this forum. No profession is above the law. You are saying that nursing professionals should be above the law; that criminal charges should not apply to nurses where the evidence indicates that they have committed criminal offenses in the course of their employment. Criminal laws apply to everyone. Well, I could reply that you continue to make a flawed emotional argument about why we should criminalize our fellow nurses when they stray from standards of practice in attempts to keep jobs which make impossible demands of them. But I don't claim your argument is flawed; I just disagree. We both have the right to our opinions and I'm interested in others' opinions, even when they disagree. I believe the BON should handle accidents and negligence. A nurse's job, and doctor's, and other caregivers, comes with inherent risks to harm and kill while they are attempting to heal and save. Licensing agencies should handle the caregivers' accidents, negligence, and their straying from standards of practice when the caregivers were just trying to do their job. Criminal charges should be reserved for the true criminals; those with intent to commit a crime; those with malice and intent. If what I'm saying "puts nurses above the law", then it's past time to change the law! Our caregivers deserve better than to be hauled away in handcuffs when they were well-meaning and trying to do their jobs. If their places of work betrayed them by making impossible demands, and that leads to the nurses having an accident or overlooking something or straying from standards of practice in an effort to do their jobs -- then that is something for licensing agencies to handle, not the criminal justice system.

Well, yes, but I think you, specifically, need to find a new job. This just sounds like it's hitting too close to home for you. I'm saying that with the best intentions. I hope you know that. ??? I thought you were prone to more intelligent discussions rather than getting personal, so I'm surprised by your response and would very much like this thread and others to stay on point and not get personal. No, I have my dream nursing job actually, and love it. I am very lucky. I'm passionate about the rights of working class people, I'm passionate about caregivers, and I would love to live in a country where we take care of our caregivers. I'd love to live in a country where we don't criminalize our caregivers when they were just trying to meet impossible work demands. I will keep discussing it because this is a public forum and where others have the right to call for handcuffs on their fellow nurses, I have the right to state my opinions of why they shouldn't be criminalized.

I'm beginning to think you need to find a new job. I agree, that is good advice to tell nurses to be willing to quit or be fired rather than continue to work with unsafe work loads or to be willing to cut corners to meet impossible work demands. That is what we most have in our power to do..."vote with our feet" as they say. But is that all the solutions we have for nurses in today's work environments?

Wow. I know you don't think you are a super nurse, but if you can pass all meds, check for wounds, and do all other care and charting for that many patients then in my book you are not just super-nurse, you are super human! If I could watch a video of how someone gets it all done in such circumstances, I'm sure I would learn a lot. I don't know how it's physically or mentally possible. So how many patients or how much work would be too much for you to be able to get it done? And if you were given too much, I highly commend that you would not take shortcuts -- I'm guessing the advice would be tell bosses it's impossible if it is and be willing to quit or be fired if demanded to do an unsafe work load. That's good advice. Any advice for those who say leaving a needed job is easier said than done? Here's where we might hit our dead-end of useful back and forth, because I understand you think we should criminalize those nurses...and I don't think so. BON should handle mistakes and negligence; leave criminal laws for criminals.

What I see as the top priority solution regarding my third question is this: Mandated maximum number of patients! -- for Nurses, CNAs, Doctors, NPs, PAs, ALL HEALTH CARE PROVIDERS! I don't know how much this has been discussed on this forum, but as big a deal as it seems to me, I'm surprised by looking at allnurses homepage, then at the 'What's Happening' side column, and at the 'What's New' top tab, there is no screaming message on this topic...no message at all on this extremely important and urgent topic. Isn't this a HUGE DEADLY problem all over the country right now? Why isn't someone screaming about it every single day? Everyone might have been and just taking a break for all I know. So anyhow, I'm going to scream about it here. We cannot scream about this too much! If I had the money, I would fill the message on billboards all around the country! What is the point in ANY safety protocol or warning signs or beeping alerts, etc. if there is not enough staff to attend to patients and keep them safe?!?! Patients will not be safe if there is not enough staff!!! You wonder why a doctor's urgent order was overlooked? Why a pressure ulcer developed? Why a total-care patient went hungry for dinner? Why patients fall out of bed attempting to get to the bathroom because their call light wasn't answered? Why sepsis wasn't identified soon enough to prevent death? Why medication administration errors are made? Why a life-threatening arrhythmia wasn't noticed on the telemetry monitor? Why patients are angry because nobody is telling them what's going on and they don't even know who their nurse is for the day? Why post-op patients are crying for overdue pain medicine? Why patients lie in feces for hours? Why patients are dying from failure to rescue? Most nurses became nurses because they want a job where they can help people. MOST of the time, the reason horrible things occur in health care is because there is not enough staff, and most of the time there is not enough staff because money is the bottom line in most health care facilities! I would go along with the following recommended nurse to patient ratios being safe IF AND ONLY IF there are ALSO enough CNAs for those patients, and those CNAs ALSO have reasonable safe CNA-to-patient ratios and IF AND ONLY IF there is not HIGH acuity for every single patient. If there aren't enough CNAs or if acuity is high for every patient, those ratios would need to come down accordingly. I am a nurse with only three years of Medical-Surgical experience writing how I feel about safe nurse to patient ratios. If some of you more experienced nurses can safely handle more, fine. But understand that it is NOT SAFE for MANY new grads as well as less experienced nurses to handle more. Patients will continue to be harmed or die UNTIL WE FIX THIS!!! Thank you to whoever made this image I am posting here and to whoever is working to pass such legislation!!! (image in next post) What I suggest could be safe, given my "IF AND ONLY IFs above" is no more than this number of patients: 1-2 patients ICU 3-4 patients MedSurg 4-5 patients SNF Disclaimer: No, I do not have evidence that understaffing is the reason horrible things occur in health care most of the time. If you have time to do the research and come up with evidence to support or contradict this belief of mine, I welcome your input.

THANK YOU for your honest post showing compassion for fellow nurses who work in horrible conditions!!! If you are a nurse who has been blessed enough to never have had to work in such conditions, or never have experienced the desperation of needing a job to survive, find it in yourself to imagine what that would be like, find your compassion for these people, and ask yourself if the world is better that they are criminalized. Please.

THANK YOU for your honest post, and I repeat your questions to every nurse who thinks they could've done better: "How in the hell is it humanely possible to care for 40 people? Even if you were so inclined to be a good, conscientious nurse, how would you accomplish it?" If your answer is to quit the job, I agree with you -- but what do we advise people who say they NEED THE JOB? Calling all nurses who could've done better: answer the question in bold keeping in mind you have 30-40 patients. Oh, blondnurse12, don't forget that people are enraged but they are indeed doing something to fix it: just arrest all the nurses who wanted to do what was required to keep their job because they needed a job but who couldn't possibly meet the impossible demands of the job...won't that fix it, just put the nurses in jail? ? Attention fellow nurses who are fed up with all those bad, bad nurses doing the best they can at jobs that set them up to fail: If one day it finally occurs to you that we can put as many nurses in jail as you want and that doesn't fix the tragic problems that will keep occurring at understaffed facilities -- then consider channeling your anger, passion, time, and energy to improving the work conditions that cause subpar nursing care.

Dear KalipsoRed21, I appreciate your post very much and think it is extremely useful for people who think about becoming a nurse. Not necessarily to discourage them from doing so as the last poster said (the world surely needs more nurses), but to allow them to understand what the reality of some nursing jobs are like so they can go into their new profession with eyes wide open. It's heart-wrenching to me that nurses, who usually are people who want to have a good job that also allows them to help people, are too often so over-worked and underpaid. Nurses deserve a good job. Many or most nursing jobs are not good, and too often are horrific. For christ's sake, the job is hard enough in ideal conditions but then to have to work in unthinkable conditions! That said, unless you think you'd enjoy laying bricks as someone suggested (sounds like a good job except for maybe back-breaking), I recommend hanging in there and keep searching for a better nursing job. I thought I'd quit nursing after my experience, but then lo and behold I did find a dream job. There are a lot of options out there and though you have done various things, you haven't exhausted your options to work as a nurse. I understand if you feel like you've definitely had enough and will never go back. But if you need a job and start looking, you might find that nursing is still your best option. If that happens, look every day until you find the job that has none of the most distasteful traits of your previous jobs. e.g. understaffing. But whether you find a nursing job you can tolerate or a non-nursing job, you'll have to accept that medicine is a business in this country and in most non-nursing jobs as well, money is always the bottom line. Whether money is valued above people or above the environment, it's the bottom line. Do we need to align our values with our laws and lifestyles? Absolutely. But do we need jobs to survive? Yes. So we need idealistic people desperately, but you also have to do what you need to in order to survive. Do the best you can in whatever job you take; care for people as best you're able; but know you can't fix all the system's problems alone. If you have it in you to channel your feelings into starting a union or otherwise fighting for better working conditions and pay, we'd praise you to do it; if not, do what you have to in order to get by, so long as you care for the patients to your best ability.

Hi again, I'm surfin' this awesome forum of posts from heroes and just read this thread about one nurse's perspective on her career choice that I also recommend to you to read (click for link). Again, this is NOT to discourage you from your career choice, but rather to help you go into it with eyes wide open, i.e. knowing the reality of nursing jobs. Here's a quote from the thread I linked, which I understand and agree with (though I have mixed feelings on regret and currently in my life, I am grateful I became a nurse): In many if not most nursing jobs, this is a sad example (and there are much more tragic examples) of the priority calls we have to make due to understaffing. Start preparing now by developing a "tough skin". A nurse is only one person and can only be in one place at a time. Start learning how to speak up, how to be assertive, how to stick up for yourself and for your patients, how to say no to authority, how to protect your nursing license, how to brush it off when patients' family gets mad at you when you have to prioritize another patient's urgent needs over their loved one's, how to not take things personally, how to keep caring despite all pressures to not care, how to cope, how to hang in there, how to stay positive and keep putting one foot forward, or how to know when to do something different instead. Nursing school will partially prepare you for a minimum of these things, but really your first job at a hospital will make or break you. Again, all of this to say, good luck and go in with eyes wide open.