Medication errors can have potentially serious consequences for patients and healthcare workers. For patients, they can lead to serious injuries, disability, and even death (Hashemi, 2007). For healthcare workers, they can lead to withdrawal of practicing licenses and other disciplinary actions. The indictment of three registered nurses for negligent homicide following the death of a newborn occasioned by a medication error in 1997 ushered in a chilling novel level of disciplinary action: criminal prosecution. This paper will discuss emerging issues related to an instance of medication error that resulted in criminal charges against the nurses who were involved. The incident involved three nurses and led to the administration of an overdose of penicillin to a newborn baby who subsequently died. It occurred at the Centura St. Antony Hospital outside of Denver Colorado.
The above Colorado Board of Nursing case evokes the emotions of sadness and outrage. Sadness is related to the fact that the life of an innocent baby was lost due to a potentially preventable medical error. The death of the baby must have brought undue suffering to the parents and staffs involved. Outrage is evoked by the charges of criminally negligent homicide leveled at the nurses and their subsequent indictment on the same. The noble intentions of the nurses to minimize the pain inflicted on the baby did not deserve the disciplinary action meted. The courts should have taken into consideration the fact that the medication error occurred because the nurses wanted to avoid causing undue suffering to the baby. This is because the nurse’s considerations of the patient’s pain experience were ethically correct. Their decision to avoid causing unnecessary pain to the baby may have been informed by the ethical principle of beneficence. This principle requires nurses to do good (Smeltzer, Bare, Hinkle, & Cheever, 2009). The harm that occurred to the patient in this case was unintentional. They also adhered to the professional code of conduct that requires nurses to act in the best interest of the patient with respect to the pain issue.
Other than nursing, numerous other occupations are faced with the same legal threat with reference to the consequences of unintentional errors. For instance, in the shipping industries, unintentional errors that lead to the loss of life of passengers in a cruise ship lead to charges of criminal negligence being leveled against the crew of such a ship. Other occupations with similar problems include aviation professionals like pilots, building contractors, military personnel, and police officers.
The nursing profession should respond to this new threat by coming up with a common unified approach to the issue. Firstly, nurses should carry out research to identify causes of medication errors and strategies for reducing them (Nichols et al., 2008). Secondly, they should consult with legal experts on the issue. Thirdly, they should lobby legislators and other policy makers to make suitable adjustments to the law. Thirdly, more nurses should become nurse lawyers as a way of enhancing the influence of nurses on legal matters. This is essential because evidence suggests that medical errors mostly occur due to system factors as opposed to the shortcomings of individual staffs (Hashemi, 2007). The law may, however, not appreciate the influence of these factors in the occurrence of medication errors.
The nurses in the St. Antony Hospital case violated the standards of nursing practice section of the Colorado State Nursing Act. This section identifies the responsibilities of nurses in healthcare settings. According to the section, all nurses are responsible and accountable for the quality of care accorded to patients under their charge. This responsibility is not voided by accepting orders from another person (Washington State Nurses Association, n. d.). In this case, the nurses had a responsibility to confirm the dosage of the drug before administering it to the baby. The fact that the pharmacist had prepared the drug was, therefore, no reason for them to administer the wrong dosage of the drug.
In summary, the medication error that led to the death of the baby at the Centura St. Anthony Hospital evokes emotions of sadness and outrage. The courts should have considered the intent of the nurses in administering the medication via the IV route. A host of other occupations like building contractors also face serious legal consequences for unintentional errors. The nursing profession should respond to this new legal threat by strictly observing standards of practice and increasing their participation in the making of related policies and legislations. The nurses in the above case violated the standards of practice section of the Colorado State Nursing Act.
References
Calfee, B. E, & Plum, S. D. (1997). Nurses indicted: Three Denver nurses face prison in a case that bodes ill for the profession. Retrieved from http://business. highbeam.com/4397/article-1G1-19588498/nurses-indicted-three-denver-nurses-face- prison-case.
Hashemi, F. (2007). Response ethics to nursing errors. J Med Ethic Hist., 4, 31–46.
Nichols, P., Copeland, T., Craib, I. A., Hopkins, P., & Bruce, D. G. (2008). Learning from error: Identifying contributory causes of medication errors in an Australian hospital. MJA, 276- 279.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2009). Brunner and Suddarth’s textbook of medical surgical nursing (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Washington State Nurses Association (n. d.). Your nurse practice act and the disciplinary process: A handbook for nurses (2nd ed.). Retrieved from http://www.wsna.org/practice/publications/documents/Disciplinary%20Process%20Book let%20v11-1.4.pdf.
