I recentlly read some articles about this. Most of the articles are about MD’s and how they are effected by serious errors. As is usual there is little written about the subject as it relates to nurses. However the effects of a serious error are pretty much the same for both ans what they need and how they deal with it are pretty much the same.
Serious errors, of course, are something hat no one wants to be a part of. Frequently the result is disastorous for the patient and family. Not always, but frequently it results in death or some other irreversible, major harm to the paient. Then comes the probability of a law suite.
The question that I want to entertain is what happens to the staff. The patient and family are well supported by the hospital administration, but what happens to the doctor or nurse. The facility is quick to deal with them and usually in a harsh disciplinary manner. It may be necessary from their point of view but what about the staff member? There must be an inbetween way of doing so. What about the old belief that one is innocent until proven guilty.
Before we get into any of this, lets look at what this does to the person involved. How would you feel if it was you? Would you be scared? I would imagine so. You would probably be the most frightened that you’ve been in your life. What is going to happen to you? Are you going to have a job? Are you going to lose your license? How will you tell your family. The person feels so, so responsible and guilty. He feels embarrased and humiliated and alone. Suddently there is no one to talk to. Administration does not want to talk to you and in reality you probably should not talk to them without representation and you do not want to talk with the other nurses as they will judge you and blame and condemn you. There is little trust among nurses as it is. Now there is none.
In other articles I have alluded to the fact that nurses believe that they have to live up to high expectations of perfection. Nurses are their own worst enemy. They are harder on themselves than anyone else is because they have been taught from the beginning of their education that they must remain composed and must go on with their practice no matter what happens. They keep all of these feelings to themselves and take the consequences because she is responsible and has to deal with it.
Doctors go through much the same thing. The one major difference is that ususally doctors suupport each other and as stated in another article doctors usually will not go against each other. Not true for nurses. One other thing that they have and nurses don’t is a peer review process which gives them a chance to express what happened and saves MD’s from immediate dismissal. Nurses are disciplined immediately, before any of the details are sorted out.
Now the question that needs to be answered is what does the nurse need at this time. She needs support. She needs social support for one thing. She needs to talk about this with someone that she can trust. She needs to get the feelings out and she needs someone to tell her that she is still worthwhile as a person and a nurse. She needs to be able to cry or scream so she can express the fear, sadness and guilt that she has. Hopefully she has a social support system that will allow her to do this.
Both the doctor and the nurse need 1:1 counseling that is provided for financially by the facility. The counseling needs to be off grounds and by someone that is not associated with this facility. The nurse needs to feel that what she says will remain confidentail and not get recorded or communicated to the facility. Without this the person will no feel confident to express anything except what she things the facility wants to hear. She is so afraid of continued disciplinary action and/or condemnation or mistrust of her as a nurse. Remember the nurse is doing a good job doing all of this. She will be effected by this for a very long time, and maybe forever. She will always fear her decisions and actions as a nurse if she does not work through this. She reaffirmation of her competence and validation of her decision making processes.
To ERR IS HUMAN. Hopefully this never happens to you, but if it does we all need to know that there is support to help us get through this. Facilities need to start to change. We have a nursing shortage as it is, but if things continue as they are it will get worse as nurses leave when they can’t take any more. Lets’s provide the services that nurses need to remain in nursing.