Weber: Education over punishment when dealing with medical mistakes

By Madison Weber ’23, Staff Writer and Social Media Editor

Photo by Hush Naidoo Jade Photography on Unsplash

Radonda Vaught, a former registered nurse from Tennessee, was recently found legally guilty for a fatal drug error in 2017. Vaught was charged with gross neglect of an impaired adult, and negligent homicide. While her sentencing is not until May 13, Vaught is facing three to six years in prison for neglect, and an additional one to two for homicide.

As a nursing student myself, watching the situation unfold has been nothing short of both scary and deeply uncomfortable as I prepare to go into the same field. Nursing Professor, Marcie McMahon, teaches about nursing ethics in both her leadership and advanced research writing classes; “so much of what we do has to be guided by ethical principles, and we’re faced with dilemmas large and small throughout our careers in caring for people.”

To preface, I think what happened was horrible and I feel for the family of the patient who became collateral victims of Vaught. As a result of her actions, Vaught lost her nursing license and won’t be able to practice in healthcare again – which is incredibly reasonable. However, this verdict sets a dangerous precedent that is already making nurses uncomfortable. McMahon is concerned by the case as well; “It has people rattled. The fact that precedent has been set is very concerning to people, and the impact that it could have.”

In healthcare and nursing specifically, there are things called “never events” that you learn about in school. Medical errors are one of these events. McMahon said that “Historically, this idea of criminal charges for unintentional error is pretty much unheard of.” She worries about the impact this will have on an already stressed field, and a nurse’s willingness to report errors.

As a nurse, we are constantly drilled with the idea that we are the patients last line of defense. In my time in healthcare, whether it be through clinicals or working as a technician in hospitals, I’ve seen providers order drugs to the wrong patients, prescribe things that patients are allergic to, and order the wrong dosage.

I won’t go as far as to say that it happens everyday, or even close to that, but it does happen and it is a reality in healthcare. In these situations, it’s the nurses who catch the error and advocate for the patient.

But, these nurses are human. And many nurses across the country are working in situations unlike any that we’ve ever seen. Celebrity nurse, Nurse Blake Lynch, is current in the middle of a petition for safe staffing ratios to protect both nurses and patients.

But, these never events exist for one overarching reason: patient safety. Patient safety is and has been the ultimate goal in healthcare and in nursing especially.

In the past, honest mistakes by healthcare professionals have often resulted in focused financial penalization against the hospital itself– as it was likely the result of a system error. Far less rare has been legal action against individual nurses beyond the extent of losing a license.

Now that this precedent has been set, it will be hard to get away from. I believe this will result in nurses who are more afraid to advocate for patient safety if it incriminates themselves. Vaught followed all the proper channels after realizing her error and accepted all the consequences– something she would have probably been less likely to do if she had known jail time may be a consequence.

It’s been shown that punitive measures increase the cover up of medical errors, rather than actually protecting the patient as intended. In studies, nurses report feeling stressed out rather than on alert or more watchful. Nurses and other medical professionals are educated and trained individuals – and many medication errors are a result of bad systems in place. Not necessarily bad people.

I’ve been working in hospitals since before the pandemic, and everything changed when COVID-19 hit. With overworked and underappreciated staff, various vaccine mandates, sick staff, and the ever growing nursing shortage – things haven’t exactly been on the upward swing.

It seems the situation has never been more dire, and after the Vaught case, the stakes have never been higher. The field of nursing is always stretched incredibly thin – and I worry that this will be enough to rip the very fabric of the profession.

We  worked through the pandemic, hospitals  tried to cap our salaries, and now the judicial system wants to send us to jail for medical errors. If some nurses decide the reward of nursing is no longer worth the risk, it will send the healthcare system into further decline.

There is already a nursing shortage — and especially a bedside nursing shortage as many have found that working through the pandemic was too much – from unplanned retirements and leaving direct patient care.

So yes, Vaught deserved punishment to a degree. But so does the healthcare system at large, and finding Vaught guilty in the court of law is toing a dangerous line.

The key to fixing medical errors is likely not in punitive punishment, but rather reform and education. Having no nurses will lead to the same problem as having bad nurses.

McMahon urges all nurses to have their own malpractice insurance, know their scope of practice, not assume the organizations they work in will protect them, and to constantly be cautious and work to protect oneself. According to McMahon, the Wegmans School of Nursing promotes evidence-based practice heavily in order to help protect their students and future nurses; “Following “the science,” so to speak, is a way to justify your actions and protect your practice/ nursing license.”

 

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