Response 1

Nurses cases about Julie Thao and Kimberly Hiatt took me to memory lane when I decided to become a nurse. One of my fears was medication error and nervousness. The lesson I learnt is that health care provider are human but at the same time they are over-burdened and they are expected to perform at their utmost best, even ,heavy duty machines need rest, imagine a nurse worked 16 straight hours and could not get a well-deserved rest before continue a new shift for the next day. As human being our body system deserves rest, health care provider needs to care for themselves like every other human being to seek rest when there is a need to. Fatigue negatively affect physical health, mental health and performance which is relatable in Julie Thao’s case. Also, humans are meant to make errors, but health care providers errors are just too costly because it involves life. Meanwhile, no matter the error committed health care providers still need support and compassion because committing the error is like being in a boiling kettle, while blaming and prosecuting is synonymous to jumping into fire. I quite understand this situation a little bit, although I have not practically been in this situation, but it can be likened to virtual simulation lab I did in adult health class. It was an error with administering naloxone to a post-operative patient after abdominal surgery, I mistakenly gave her double dose of the naloxone which led to the death of the virtual patient. Despite the situation not been real, I couldn’t help but feel guilty, incompetent and failure at being a nurse.

Another lesson learnt is that error should be reported regardless of how grievous it might seem to curtail the damage as soon as possible. No matter the situation nurses or health care provider find themselves, they must use the 5 right of medication to reduce medication error to the barest minimum if not eradicate it.

Nurses are meant to provide optimum care to the public, which is a moral responsibility that is directly liked to their description of job. Nurses must serve the interest of larger role of which it belongs, this makes the principle of beneficence one of the ethics of nursing. “The principle of beneficence is equated with the need to balance benefits, risks, cost to gain the overall result, which also covers the general ideas of benevolence and the specific commitment to positive beneficence requiring agents to provide benefit to others” (Runstein & Bentwich, 2017, p. 100). The nurses never meant harm or cause any bodily harm, nor intentionally cause loss to the patient life there were caring for when they were administering the medication. According to what I read from the internet, the patient was voluntarily working back to back double shift 16 hours in a row, but when she was trying to administer to medication to a 16 years old pregnant patient, the patient was nervous due to the rush of the moment the nurse bypassed the code and did not see the warning label of not administering anesthetic intravenously. This story showed that she was promoting good to her patient.

The preceptor, charge nurse and doctors were helpful to the nurses in terms of providing a shoulder to lean on and helped arrest the situation in due course, although the hospital administrator handled the situation legally and ethically, however, they are to be blamed partially because they knew she was doing back to back double shift which could be detrimental to herself and others around her since fatigue played a devastating role on human performance. I think the hospital administrator should have treated the case as general human error that is caused by fault in system since human are not 100% perfect, except if it is an intentional harm to the patient, and in both cases it was not. In addition to being kind to the nurses, the colleagues exhibited professional relationships to the nurses because they strive to solve systematic problems, support the nurses, and exhibited ethical integrity in the relationship with the nurses in distress and nursing unity and being caring.

The second victim are the nurse who commit the medication errors, obviously they are traumatized with guilt, shame, abandoned, stupid, incompetent and afraid. There is a need to help them heal during this process because it could be frustrating which led of the reason Kimberly committed suicide. The second victim needs some coping strategies that would help them from their guilt because feeling guilt for an action is a good moral virtue that shows an individual is ready to make things better but remaining in shame and depression will not help the grieving process. To err is human, to forgive is divine. As human we should learn to learn form our mistake and move forward. They should strategize to use better modality such as apologizing, seek help from family members, colleagues and therapist and more so pay more attention to details.

References

https://www.truthaboutnursing.org/news/2006/nov/20_captimes.html#gsc.tab=0

Rubinstein, G., & Bentwich, M. E. (2017). The enemy as a patient: What can be learned from the emotional experience of physicians and why does it matter ethically? Developing World Bioethics, 17(2), 100–111. https://doi-org./10.1111/dewb.12125

Response 2

In the cases of Julie Thao and Kimberly Haitt, there were multiple lessons which all healthcare professional and I can learn from it. One similarity that I found between these two cases was that both of the nurses made an unintentional medication error. Even though both nurses mistakes was unintentional, one was due to fatigue from over workload and one was due a miscalculated dosage. According to Gorgich et al. (2016), the most important causes of medication errors in nursing were staff deficiency and fatigue due to high and over workload. This is the reason why we as a human cannot overestimated our body, especially those who working in the healthcare system because one mistake could causes someone else’ life. This is also why some hospitals only allow nurses to work three 12-hours shifts because if the nurse is fatigue, it can lead to poor decision-making, poor judgment, lack of focus (Gorgich et al. 2016). Additionally, these cases shown us that it is important to practice the five rights of medication administration and the three checks before administer the drugs to prevent medication errors.

The principle of beneficence and the virtue of benevolence are both desire to go good for others. In both of these cases, Julie Thao and Kimberly Haitt were good nurses who work in the field for so many years. They both have a good intention as well as the virtue of benevolence because they have satisfied other things and wish to help and protect more patients before this tragic situation happened. They did not wish to killed their patients, then again the hospital administrator only looked at their mistakes but not all of the helps they brought to their patients. This shown that the hospital administrator did not handle the situation legally and ethically. After all those year of satisfaction, I feel like the hospital did not provided enough support and help for both of these nurses when they needed the most. Additionally, I cannot understand how the hospital administration allowed Julie Thao to work 20 hours out of 24 hours and expected no mistake. Yes, it was up to Julie to made that decision but I think the hospital administration known better and should have stop Julie from overworking herself since it could affect not only her, her patient but also the hospital’s reputation.

Furthermore, there were not much their colleagues can do that point, however, I think emotional support would help Thao and Hiatt went through this difficult time. Additionally, I think it is important that nurses work together as a team. In the case of Kimberly Hiatt, she stated that she was distracted when she did her dosage calculation because she was talking to another nurses. I think this is when teamwork would be an effective. For instance, if I was Hiatt’s co-worker, I would stop talking to Haitt and leave her alone for a few minutes so that she could focus on her medication dosage calculation. Then, I would asked her to let me double check her calculation to prevent any miscalculated errors.

Both nurses’ errors teaches us that we are human and we will make mistakes. However, it is important for nurse to keep in mind that if a mistake happen, then take accountable to the mistake and speak up instead of trying to run away and hide it. This is a painful lessons but forgiveness and learn from the lessons is what make us stronger.

References

Gorgich, E. A., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the Causes of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint. Global journal of health science, 8(8), 54448. https://doi.org/10.5539/gjhs.v8n8p220