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Susie2310

Susie2310

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  1. Susie2310

    Nurse Charged With Homicide

    Medical errors (however caused) have been shown to result in large numbers of patient deaths annually. Many patients are harmed by medical errors annually. It has also been shown that patients frequently experience errors in care. Many errors in care go unreported, even in spite of a non-punitive "just culture." Medical errors that result in patient deaths are not currently reported on patients death certificates. I conclude that the current voluntary system of reporting errors in care is insufficient to protect patients and that much greater regulatory oversight of health care facilities and of health care practitioners is necessary. The argument has been made that if licensed health care practitioners face criminal charges for their actions this will result in reduced voluntary reporting of errors. I consider this more an excuse than a valid reason. It appears that new methods need to be devised to ensure that licensed health care professionals report their errors in care. In my opinion much greater oversight of licensed health care professionals' practice is needed by independent overseers, not by the health care industry. Licensed health care professionals' have a professional and ethical duty to their patients, patients' family members, the public, and to the profession to report errors in care timely especially so that timely action can be taken by health care professionals to reduce the harm/injury to the patients affected; for example by close monitoring of the patient, administration of a reversal agent or other medication or other agent or transfer of the patient to the ICU, etc. When licensed health care professionals choose dishonestly not to report errors in care, there is no possibility to remediate the harm/injury that a patient may experience from the error/s. Some errors in care are due to recklessness on the part of individual licensed health care professionals, and sometimes this can amount to criminal behavior. While we practice as part of a health care system we are always individually responsible for our own safe practice. Also, not all errors in care are due to "systems" errors; some are due to individual practitioner errors. Our number one priority should be to protect patients, not to protect licensed health care professionals who practice unsafely or to protect the health care industry. We have Standards of Care and we are taught medication administration safety procedures (Five/Six or more Rights) in nursing school; this is drilled into us in nursing school. Health care is a complex industry but Standards of Care exist for a good reason, for the protection of our patients. Other professional occupations that have safety responsibilities to the general public are held to industry Standards of Practice and the licensed professionals in these occupations can be charged with criminal negligence when their actions demonstrate that they have violated safety standards and members of the public are harmed or killed as a result. Licensed health care professionals whose licensed professional practice is below the Standard of Care and results in harm/death to patients should not be treated differently or be exempt from criminal charges when after an appropriate investigation it is determined that criminal charges are appropriate.
  2. Medical errors (however caused) have been shown to result in large numbers of patient deaths annually. Many patients are harmed by medical errors annually. It has also been shown that patients frequently experience errors in care. Many errors in care go unreported, even in spite of a non-punitive "just culture." Medical errors that result in patient deaths are not currently reported on patients death certificates. I conclude that the current voluntary system of reporting errors in care is insufficient to protect patients and that much greater regulatory oversight of health care facilities and of health care practitioners is necessary. The argument has been made that if licensed health care practitioners face criminal charges for their actions this will result in reduced voluntary reporting of errors. I consider this more an excuse than a valid reason. It appears that new methods need to be devised to ensure that licensed health care professionals report their errors in care. In my opinion much greater oversight of licensed health care professionals' practice is needed by independent overseers, not by the health care industry. Licensed health care professionals' have a professional and ethical duty to their patients, patients' family members, the public, and to the profession to report errors in care timely especially so that timely action can be taken by health care professionals to reduce the harm/injury to the patients affected; for example by close monitoring of the patient, administration of a reversal agent or other medication or other agent or transfer of the patient to the ICU, etc. When licensed health care professionals choose dishonestly not to report errors in care, there is no possibility to remediate the harm/injury that a patient may experience from the error/s. Some errors in care are due to recklessness on the part of individual licensed health care professionals, and sometimes this can amount to criminal behavior. While we practice as part of a health care system we are always individually responsible for our own safe practice. Also, not all errors in care are due to "systems" errors; some are due to individual practitioner errors. Our number one priority should be to protect patients, not to protect licensed health care professionals who practice unsafely or to protect the health care industry. We have Standards of Care and we are taught medication administration safety procedures (Five/Six or more Rights) in nursing school; this is drilled into us in nursing school. Health care is a complex industry but Standards of Care exist for a good reason, for the protection of our patients. Other professional occupations that have safety responsibilities to the general public are held to industry Standards of Practice and the licensed professionals in these occupations can be charged with criminal negligence when their actions demonstrate that they have violated safety standards and members of the public are harmed or killed as a result. Licensed health care professionals whose licensed professional practice is below the Standard of Care and results in harm/death to patients should not be treated differently or be exempt from criminal charges when after an appropriate investigation it is determined that criminal charges are appropriate.
  3. I have seen a state Medical Board not revoke a physician's license until the physician was physically in jail facing serious charges. The physician had a significant previous disciplinary record with the Medical Board.
  4. I posted the following comment to mtnNurse on two other threads. To further the discussion I thought it appropriate to post it again: "You keep making the point that nurses brains are subject to failure because we are humans. By your logic all workers in all types of occupations should never be charged with any crime due to their negligence unless they deliberately intended to cause harm to the public. Following your logic airline pilots brains are subject to failure at any moment during an 11 hour flight, and the plane could crash if the pilot gets overwhelmed or distracted. Think of all the many, many flights that take place all over the world, just in the course of one day, yet planes aren't crashing all over the place every day. Should we conclude that airline pilots brains function better than nurses brains? Or do airline pilots practice to higher professional standards? Nursing isn't the only profession with a lot of stressors, distractions, and responsibility/accountability. I just had a licensed electrician work perform some work for me. Should I assume that he/she may be under extraordinary stressors and be unable to perform safely? I never thought that he/she might actually have been incompetent is his/her practice or might make a mistake that would lead to him/her ignoring basic electrical safety procedures. That perhaps he/she might be negligent to the point that I will get electrocuted. Oh, well, I guess I will just put it down to brain failure on his/her part. In which case, what is the point of professional licensure? If a licensed electrician can't perform their job safely why should I bother using his/her services? Why bother to have any professional standards for any professions at all? Why bother with licensure? If the public can't trust that a licensed professional will be able to perform to industry standards of safety, why should they bother using the services of a licensed professional? Then we don't have professions, because everyone does the job equally incompetently/unsafely. If you believe that nursing is a unique profession with extraordinary stressors such that nurses are unable to concentrate on their licensed activities to the point that they are unable to perform safely and must excuse themselves due to brain failure when they inadvertently harm or kill patients due to not being able to perform safely, why should anyone have any confidence in nurses ability to perform safe care? Why should the public go to hospitals? 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. I ask you a question in return, why should the public have confidence in licensed professionals? Why should I receive nursing care from you? Do you see where this goes? If the general public loses confidence that they will receive safe nursing care, do you think you can take for granted that they will continue to come to the facility you work at for their care? Do you think you might lose your job? Licensed professions rely on the confidence of the general public. The reason licensed professionals get paid is that the general public trust in the standards of the professions and place their trust in the licensed professionals. If you can't provide safe nursing care why should I come to the facility you work at for my care? If a licensed airline pilot can't fly a plane safely, meeting industry safety standards, why should I fly with that airline? If the problem is endemic to the airline industry, why should I fly at all?"
  5. Susie2310

    NTI 2019 - ABCDEF Bundle - Some Questions and Answers

    Thank you for this very useful and informative article. I also clicked on the link you provided and watched the You Tube video/s where former ICU patients described the severe difficulties they experienced after discharge. I found it very helpful to hear patients tell of their experiences. I hope that more ICU's will implement the ABCDEF care bundle which includes open visitation in adult ICU's and has been shown to improve patient outcomes and to be beneficial to patients and their families. Open visitation for patients has been demonstrated separately to improve patient outcomes and to be beneficial for patients and their family members. I also did an internet search for "ICU ABCDEF Care Bundle" and found some studies that focused on it's implementation in various ICU's. It was interesting to read about the medical/nursing staff's perceived barriers to implementation.
  6. Susie2310

    Nurse Charged With Homicide

    I posted the comment below yesterday on the "Nurses Call the Governor of Tennessee" thread in reply to another poster: "You keep making the point that nurses brains are subject to failure because we are humans. By your logic all workers in all types of occupations should never be charged with any crime due to their negligence unless they deliberately intended to cause harm to the public. Following your logic airline pilots brains are subject to failure at any moment during an 11 hour flight, and the plane could crash if the pilot gets overwhelmed or distracted. Think of all the many, many flights that take place all over the world, just in the course of one day, yet planes aren't crashing all over the place every day. Should we conclude that airline pilots brains function better than nurses brains? Or do airline pilots practice to higher professional standards? Nursing isn't the only profession with a lot of stressors, distractions, and responsibility/accountability. I just had a licensed electrician work perform some work for me. Should I assume that he/she may be under extraordinary stressors and be unable to perform safely? I never thought that he/she might actually have been incompetent is his/her practice or might make a mistake that would lead to him/her ignoring basic electrical safety procedures. That perhaps he/she might be negligent to the point that I will get electrocuted. Oh, well, I guess I will just put it down to brain failure on his/her part. In which case, what is the point of professional licensure? If a licensed electrician can't perform their job safely why should I bother using his/her services? Why bother to have any professional standards for any professions at all? Why bother with licensure? If the public can't trust that a licensed professional will be able to perform to industry standards of safety, why should they bother using the services of a licensed professional? Then we don't have professions, because everyone does the job equally incompetently/unsafely. If you believe that nursing is a unique profession with extraordinary stressors such that nurses are unable to concentrate on their licensed activities to the point that they are unable to perform safely and must excuse themselves due to brain failure when they inadvertently harm or kill patients due to not being able to perform safely, why should anyone have any confidence in nurses ability to perform safe care? Why should the public go to hospitals? 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. I ask you a question in return, why should the public have confidence in licensed professionals? Why should I receive nursing care from you? Do you see where this goes? If the general public loses confidence that they will receive safe nursing care, do you think you can take for granted that they will continue to come to the facility you work at for their care? Do you think you might lose your job? Licensed professions rely on the confidence of the general public. The reason licensed professionals get paid is that the general public trust in the standards of the professions and place their trust in the licensed professionals. If you can't provide safe nursing care why should I come to the facility you work at for my care? If a licensed airline pilot can't fly a plane safely, meeting industry safety standards, why should I fly with that airline? If the problem is endemic to the airline industry, why should I fly at all?"
  7. Susie2310

    Nurses Call the Governor of Tennessee

    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."
  8. Susie2310

    Nurses Call the Governor of Tennessee

    You keep making the point that nurses brains are subject to failure because we are humans. By your logic all workers in all types of occupations should never be charged with any crime due to their negligence unless they deliberately intended to cause harm to the public. Following your logic airline pilots brains are subject to failure at any moment during an 11 hour flight, and the plane could crash if the pilot gets overwhelmed or distracted. Think of all the many, many flights that take place all over the world, just in the course of one day, yet planes aren't crashing all over the place every day. Should we conclude that airline pilots brains function better than nurses brains? Or do airline pilots practice to higher professional standards? Nursing isn't the only profession with a lot of stressors, distractions, and responsibility/accountability. I just had a licensed electrician work perform some work for me. Should I assume that he/she may be under extraordinary stressors and be unable to perform safely? I never thought that he/she might actually have been incompetent is his/her practice or might make a mistake that would lead to him/her ignoring basic electrical safety procedures. That perhaps he/she might be negligent to the point that I will get electrocuted. Oh, well, I guess I will just put it down to brain failure on his/her part. In which case, what is the point of professional licensure? If a licensed electrician can't perform their job safely why should I bother using his/her services? Why bother to have any professional standards for any professions at all? Why bother with licensure? If the public can't trust that a licensed professional will be able to perform to industry standards of safety, why should they bother using the services of a licensed professional? Then we don't have professions, because everyone does the job equally incompetently/unsafely. If you believe that nursing is a unique profession with extraordinary stressors such that nurses are unable to concentrate on their licensed activities to the point that they are unable to perform safely and must excuse themselves due to brain failure when they inadvertently harm or kill patients due to not being able to perform safely, why should anyone have any confidence in nurses ability to perform safe care? Why should the public go to hospitals? 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. I ask you a question in return, why should the public have confidence in licensed professionals? Why should I receive nursing care from you? Do you see where this goes? If the general public loses confidence that they will receive safe nursing care, do you think you can take for granted that they will continue to come to the facility you work at for their care? Do you think you might lose your job? Licensed professions rely on the confidence of the general public. The reason licensed professionals get paid is that the general public trust in the standards of the professions and place their trust in the licensed professionals. If you can't provide safe nursing care why should I come to the facility you work at for my care? If a licensed airline pilot can't fly a plane safely, meeting industry safety standards, why should I fly with that airline? If the problem is endemic to the airline industry, why should I fly at all?
  9. Susie2310

    Nurse Charged With Homicide

    You posted the following on Jan 25 on another thread: "A family member was in an ED and was subsequently admitted to a Tele Unit. As the family member present at the bedside, I have detected quite a few things that should not have happened and fortunately pointed it out to the nurses who were there to provide care. Examples such as double doing on anticoagulation medications, delay for hours of rate controlling medications for an arrhythmia, etc were all possibly attributable to being overworked but I was also careful not to embarrass or make the nurses involved feel intimidated." Fortunately you, a NP, were at your family member's bedside and were able to catch the mistakes in time so your family member didn't suffer any harm. I think we are all familiar with the harm that can result to a patient from receiving a double dose of anticoagulants i.e. bleeding, intracranial hemorrhage, and to the harm that can result from multiple hour delays to receiving rate controlling medications for an arrhythmia e.g. heart failure, cardiac arrest. Fortunately your family member didn't suffer any harm because you were there by their side to advocate for them. Many patients (and their family members) are not as fortunate. You can keep downplaying errors in care as much as you like. Perhaps if your family member had suffered a hemorrhagic stroke as a result of being overdosed with anticoagulants, or went into cardiac arrest or heart failure due to delays in receiving rate control medications, you would feel differently.
  10. Susie2310

    Nurses Call the Governor of Tennessee

    I don't understand feelings of solidarity for the profession when licensed professionals are charged with a criminal offense after an investigation has taken place. I understand this as feelings of self interest; nurses obviously are concerned about the implications for their own practices and for the health care industry. Much time and resources go into the investigation before cases come to trial, and while the BON is able to handle cases from the point of view of disciplining or revoking a nurse's license I believe this is beside the point. Some situations justify criminal charges. This is necessary in order to protect the general public who have the right to be protected from practitioners whose practice when below the standard of care causes or contributes to patient injuries or deaths.
  11. Susie2310

    Nurse Charged With Homicide

    Why are you using such hyperbole? To my knowledge no-one has been convicted yet, let alone thrown in jail. You seem desperate to influence people.
  12. Susie2310

    Nurses Call the Governor of Tennessee

    People keep bringing this up, as though it is an actuality and is insurmountable. The answer in my opinion is that new methods need to be employed to prevent licensed health care practitioners from dishonestly choosing not to report their errors. As things stand currently, many errors in care, however caused, are not reported.
  13. Susie2310

    Nurse Charged With Homicide

    In regard to your first paragraph above, new methods need to be employed to protect against licensed practitioners dishonestly failing to report medication errors. Many errors in care are not currently reported, 'just culture' or not. The general public have the most power in my opinion, not the health care industry. The health care industry relies on the confidence of the general public. If as a result of this the general public become more politically active in advocating for safe care I believe that could yield significant improvements in patient safety. I have known since nursing school that nurses can face criminal charges for providing care that is below the standard of care when patients suffer harm/death. I find your second paragraph self-serving, as I do many of the replies here. Of course we know that nurses don't like to think of themselves being criminally charged in similar circumstances. Also, being charged with a criminal offense is not the same as being found guilty of a criminal offense. The general public has the right to be protected from licensed health professionals who practice below the standard of care and cause or contribute to patient injuries/deaths.
  14. Susie2310

    Nurses Call the Governor of Tennessee

    Perhaps some airline captains of passenger aircraft will join in the discussion to explain their job description and stressors/distractions they face while doing their jobs. Airline captains have responsibility for the aircraft, passengers, and crew. Airline captains take radio calls from Air Traffic Control. No, they don't have to serve coffee to passengers but they have numerous other stressors and distractions.
  15. Susie2310

    Nurses Call the Governor of Tennessee

    Add to that mechanical problems at 30,000 feet, air traffic control issues, unruly passengers, passengers experiencing emergency medical problems, severe turbulence, ice storms, other air traffic in the sky around one, crew members becoming sick during the flight, delays on the ground; the list goes on and on, just as it does for other industries besides nursing. I just watched a video about the airline captain who landed a passenger aircraft on the Hudson River after a flock of geese flew into the engines just after take off. With all respect to Nurse Beth, I think it's quite naive to think that other industries don't deal with critical problems and distractions also. Airline pilots are making decisions constantly.
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