I attended a meeting last week in which we discussed the criminalization of nursing errors, and I have to admit, it was one of the highlights of the meeting. Punitive and finite steps (this may be one of the most tragic examples) are often the response by institutions, which may result in a culture of silence in the face of mistakes, rather than promoting solutions to avoid repeating them.
So I liked seeing that Medscape published an article summary, When ‘to Err’ Is a Crime, from Nayna Phillipsen’s “The Criminalization of Mistakes in Nursing”. The article was published last month in the Journal for Nurse Practitioners (you can see the abstract here). In her article, the author refers to the Just Culture model (PDF) as a way to promote positive systems change and a culture of patient safety, and this is certainly something I think we should be promoting, as well. What we know, though, is that criminal charges aren’t just occurring in the wake of nursing errors; we spent some time on this site talking about last year’s debacle about the Texas nurses who were charged with felonies in the wake of reporting the unsafe practice of a physician with whom they worked.
…An issue worth monitoring, for sure.
2 replies on “The Criminalization of Nursing Mistakes”
Thanks very much for this post. I work as a civil investigator for the MA Department of Mental Health and a psychiatric triage clinician in a local ED; I shared the post with my peers in both settings.
Though I agree with the application of the Just Culture model in most circumstances, I’ve also seen the extrapolation of that model shield nurses and counselors whose interactions with patients are rude, if not abusive, from disciplinary action. The fact is just because a person has chosen the field of nursing, etc, doesn’t mean s/he is suited to be a professional caretaker.
It seems the real question is about how to hold nurses (and other caretaking staff) truly responsible with possible real and appropriate consequences but without meting out excessive punishments that effectively persecute them as sacrifices to assuage public perception.
Comments welcom.
Thanks for your comment, Kerry, and for sharing the post with colleagues. Your perspective is a good one. I have not worked in any system where Just Culture was implemented (as I tend to not work in hospital settings). I can definitely see where the pendulum could end up swinging all the way to the other end of the spectrum.