Nursing practice has always been associated with making various decisions within a limited period of time. The recent demographic shifts have led to a shortage of nursing staff, which results in nurses’ work overload and a high turnover rate. Nurses overwhelmed with numerous tasks, long working hours, and numerous consecutive shifts tend to make mistakes that can lead to negative patient outcomes. Healthcare-related organizations try to manage such situations in many ways, creating various initiatives. This paper dwells upon possible strategies to address a case, involving a medical error, and ensure nurses’ ethical behavior and accountability.
The case in question concerned with an error made by a nurse who, most likely, due to fatigue, forgot to document the administration of an opioid to a patient. The following day, the nurse found out that the patient had an arrest, but he was stabilized soon and felt well. It turned out that the nurse’s relief thought that the patient did not receive the necessary medication and administered the drug, which led to the arrest. The nurse had to make a decision regarding the situation and her response.
This case is not uncommon, so hospitals need to develop effective measures to prevent such cases or, at least, address them properly. One of the primary steps to undertake is launching a training program aiming at enhancing nurses’ accountability, ethical behavior, and performance. Nester (2016) noted that training provided to interdisciplinary teams has a positive effect on the working environment and the performance of the personnel. It is stated that communication is one of the most serious challenges nurses, as well as other healthcare professional have to face (Nester, 2016). Therefore, training programs should contain a sufficient number of activities aimed at improving communication skills. In the case under analysis, communication also plays an important role. Nurses should be trained to report such errors without being afraid of potential outcomes. The choice of the right words and the form of reporting can be instrumental in making nurses more accountable.
Training activities should also include the discussion of such cases and the most effective responses. Nurses should reflect on their own reactions in case they find themselves in a similar situation. These practitioners should relate their personal philosophies and ethical codes to the case mentioned above. They should also share their ideas regarding the matter and discuss the most ethical, correct, and effective decisions to be made. Such conversations and reflections can motivate nurses to remain accountable and report rather than conceal such critical data as medical error or the violation of some protocols.
In addition to training, medical organizations should have specific protocols regulating the provision of reports related to cases that did not result in severe adverse outcomes. Nurses should be encouraged to report because it will improve the quality of provided care. These protocols may include rewarding and punishment, depending on certain factors. For instance, if no harmful effects followed, but the nurse reports some medical error, this professional can be rewarded. Appreciation or promotion, as well as other benefits, can be utilized. Rewarding is an appropriate reaction as the nurse decided to report although she could conceal her error. Such responsible behavior should be encouraged, so rewards could be used.
If mild adverse effects occurred (such as patients’ arrest and the quick normalization of the patient’s state), the case can be analyzed by a specific group. This group of nurses (approximately three professionals) can consider all the aspects of the situation and decide whether any punishment should be imposed. In the current case, it is obvious that overload with tasks led, at least, to a certain extent, to the error. At that, the nurse is experienced and is known as a diligent and responsible professional. Therefore, no punishment is needed, although a nurse leader can have a conversation with the nurse to make sure that no such errors will take place in the future.
Nevertheless, if an error leads to more serious consequences or some factors are present, punishment can be the necessary measure. For instance, if a nurse is not diligent and there have been cases of other violations and misconduct, the group can decide to punish the violator. No bonuses or even some fines can be employed, or the nurse can be fired under certain circumstances. It is also necessary to develop a policy of reporting and whistleblowing, which can help to prevent concealing important information.
In conclusion, it is necessary to state that the development of protocols and the provision of training are possible strategies to avoid underreporting and nurses’ unethical behavior. The protocols will regulate professionals’ actions and guide them in difficult situations. Rewards or punishments can be utilized as a potential response, and a group of peers will analyze each case. The accountability of nursing personnel can also be enhanced by training, so the corresponding programs should be developed. The key elements of these training incentives should be reflection and discussions. Nurses should feel that ethical behavior is beneficial for all the involved stakeholders.
References
Nester, J. (2016). The importance of interprofessional practice and education in the era of accountable care. North Carolina Medical Journal, 77(2), 128-132. Web.