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Would you report an error?

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We as nurses have been told time and time again there should be no fear of reporting medical errors. We are told in our hospital orientations as well as during all of our years of nursing education that there is no retaliation to reporting a medical error. Reporting an error increases patient safety, we all know that. I believe we all agree with that premise, but do you really think your professional career is not at risk if you are the one submitting the report. Is there really no report retaliation?

I’m asking a hypothetical question here. I’m not disputing, arguing, defending or defaming any particular facility or individual. I’m simply curious as to what is the nursing community’s consensus on reporting medical errors? Are you really free of fear?

I’m referring to any type of error. Is there really such thing as a ‘small’ error when it refers to patient safety? Who are we to decide when an error or mistake is allowable.

It’s quite the clash isn’t it? Here you are as a professional doing your best to ‘do no harm’. It’s our job to advocate for the patient, for all patients. We are given the responsibility to ‘speak’ for the patient, especially when the patient cannot speak for themselves. It’s the ultimate burden for those that don’t practice this skill.

On the other side of the coin is self-preservation. We love our job (most of us). We love practicing as a nurse. We love making the difference. We of course *AHEM*.. love to be employed too. We do enjoy paying our bills and having a steady income, especially in this tough economy!

So what if you had to choose? Patient advocacy or your job? Now, remember this is purely hypothetical. Because we have all been taught, trained and tirelessly educated on the ‘no report retaliation’ concept. It’s our job to report the errors- and we won’t lose out jobs for reporting.

I may be embellishing a little here, I admit it. But what if?

While we’re being honest here, lets not forget that there are other health care professionals out there that have lost their jobs for doing this very thing (see the link articles referenced below).

This fear of retaliation is very real. And whether we or any other health care professional will openly or publicly admit to it, this fear motivates our decision making skills, hypothetical or not.

Articles of interest:

Nurse Perceptions of Medication Errors: What We Need to Know for Patient Safety

Medical Error Self-Reporting Stifled by Fears of Retaliation

Northwestern U. Dismisses Medical Professor Who Questioned Cardiac-Surgery Chief’s Safety Record

Cardiologist Who Accused Famed Surgeon of Misconduct Is Fired by Northwestern University

AHRQ: Patient Safety & Medical Errors

FDA: Medication Errors

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Sean Dent

Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing. After five years practicing as an RN, Sean pursued and attained his Masters of Science in Nursing. Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital. He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).
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2 Responses to Would you report an error?

  1. Nurse Rene RN

    Generally I do not report errors SO LONG AS A PATIENT IS NOT HURT. This is because of the punitive record keeping practice which management seems to practice these days. I have no desire to see a good nurse fired and reputation trashed over something that could happen to any of us.
    There was one occasion when an MD ordered an infusion of a particular pre-mixed drug and the wrong bag was pulled from the Pyxis by the night RN. When I found it the next morning I told the MD and had the pharmacy remove the drug from our unit as we had no need to keep it around. Never did put anything down on paper as the MD was not particularly interested in the med. error ‘incident’.

  2. Holly Spots RN

    Hypothetical ? You know there are cases where the reporting nurse was set up. I was one of them. I was set up on the charge nurse’s fear that I would report her. She was doing things totally unprofessional and I asked her to ‘take a break,’ and to evaluate what she was doing. She repeated her behavior several times. Patients heard her. I politedly asked her to quit and was sworn at ….at the Nurse’s Station. Two days later, the charge nurse pulled me into the office with a witness and told me that if I reported her to Administration, she would make sure I got fired off the PCU unit and fired from any other department. She said she would track me down in the city when I got a job at any other medical facility and make sure I was fired from there. She said ” don’t think I don’t have friends and can’t do this.” Well, she kept her word. She planted 2 drugs in my locker (blood pressure & Percocet – which I told my Dr. makes me nauseated & to never give me). My locker was stupidly unlocked. She got the Manager involved, who called Security.
    The Board of Nursing would not look at both sides of the information. I gave them rebuttal information and they never talked to my witnesses or references. They never pulled out the documents that would have helped me. The Board did a complete history check going back more than 10 years. What can I say, I was not the perfect nurse and had a few minor infractions but nothing serious, no harm done. The Board only looked at what supervisors stated.
    I didn’t have the money to go through the whole smear of a Hearing. My attorney said it would cost over $20,000. I thought the Board of Nursing would be objective. They were not. They spent 2 years on my case because I fought them. They said they didn’t have the $ money to do a complete investigation like I wanted. However, they had no hard evidence of what was stated. Instead of loosing my license, I was put on probation and have to take drug screens even though I did not go through a drug rehab program since I didn’t and don’t use drugs.
    The PCU unit was so dysfunctional, there were 3 deaths on the unit that should not have occurred … in a big hospital. After I left, there were 1 nurse revoked over the death & I was pulled into the attorney’s office ….as I had followed her mistake and tried to save the man. Also after I left 8 nurses were either fired or removed from that unit.

    I have not been able to get a job as a nurse because even though my DON and Manager nurse friends sent the “hire” paperwork, it was not approved higher up. Many places simply don’t want a nurse on probation. I am working in a retail store years later. I still miss nursing and would like to work as a nurse again.

    So, no I do not think reporting is “safe” for career and I should have recorded what was going on and gone HIGH up. If I had a recording of the threat made to me, I would have been safe. Who knew I would be threatened by other nurses, the charge nurse, and relief charge nurse, at that. I am sorry I ever tried to correct her.
    I am in limbo.