Nursing failure


International Nursing Day today. Nursing was one of the first domains I cited in my original post on Embracing Failure. It is also one of the areas where the press is quick to pounce on tragic mistakes. I think nursing errors are enticing news because, like airline crashes, they are situations where many people feel vulnerable and scared already and so stories that highlight what could go wrong touch that nerve.

The key is to embrace failures in the system before they turn into headline tragedies. Prof. Amy Edmonson, possibly the foremost academic authority on failure, has turned to the medical arena for a number of her studies (including the one cited in my original post) as well as in the HBR “Failure Issue”. She delves further into the subject with the piece with Anita Tucker in her piece “Why hospitals don’t learn from failures” (thanks, Kent)

  • “Seventy percent of the nurses we interviewed commented that they believed their manager expected them to work through the daily disruptions on their own. Speaking up about a problem or asking for help was likely to be seen as a sign of incompetence.”

The topic of embracing failure in hospitals has moved into the mainstream media of late well…

  • “Brigham leaders started the publication [of a monthly online newsletter] to encourage staff to talk openly about their mistakes and propose solutions, and help make sure errors are not repeated. While many hospitals post information on their websites about patient infections and falls, they rarely provide details of medical errors or candidly discuss with their entire staff how medical mistakes harmed patients. Executives fear the public will find out, sparking lawsuits and scaring off patients. This reluctance, patient safety advocates warn, may be hampering the push to reduce medical errors because there is not wide discussion of how mistakes happen and how they can be prevented. ‘Open-faced transparency is really valuable to staff at an institution because it causes them to know themselves better,’ said Paul O’Neill, a member of the Lucian Leape Institute at the National Patient Safety Foundation.” – Brigham and Women’s airing medical mistakes” (paywalled)
  • ·Medical mistakes are now estimated to kill up to 440,000 people in U.S. hospitals each year, making preventable errors the third leading cause of death in America behind heart disease and cancer. Wrong doses of drugs, undetected tumors, objects left behind in patients’ bodies: Such errors — and many more — are an “everyday occurrence,” experts say. But eliminating errors has proven difficult, especially in a health care culture where doctors and other providers are reluctant not only to admit their own lapses — but also to report when others mess up as well. New guidelines issued today are aimed at tackling that problem, and helping ease the thorny dilemma of whether, when — and how — doctors should disclose their colleagues’ mistakes.” – When docs make mistakes, should colleagues tell? Yes, report says