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Old 02-05-2008, 05:45 PM
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Question Accountability

Today in the UK an inquest has taken place. Shortly after giving birth in 2004 Mayra Cabrera died having been given the wrong drug. In court the midwife who was accused of giving the drug denied she had been responsible.

I do not like apportioning individual blame. Often in these cases there is a system failure and in this case the hospital accepts this was the case.

But as nurses and midwives who are registered to practice we are also personally accountable and as such if we make a mistake then we have to admit as much.

I have blogged about this here, I'd value other peoples thoughts and comments.
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Old 02-05-2008, 07:46 PM
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Originally Posted by Julie View Post

I do not like apportioning individual blame. Often in these cases there is a system failure and in this case the hospital accepts this was the case.

But as nurses and midwives who are registered to practice we are also personally accountable and as such if we make a mistake then we have to admit as much.
I agree that there was some form of failure in the system, whether the drug was not clearly labeled or whatever. However there has to have been some human error involved.

Someone had to have ordered the drug to be given, someone had to have mixed it, and someone had to administer it. Was the order not clear? Was it labeled? Did the midwife who gave the drug do a proper check prior to giving the drug (those darn "5 R's" we learn in school). Is she denying that she hung the drug at all? If so, then who may have? If she hung the drug, then she should at least admit that, and her role in the mistake.

Mistakes happen, we all make them from time to time. This one unfortunately had a terrible result. No matter what the result, we should have the backbone to fess up to what happened. How else will we learn?

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Old 02-05-2008, 09:29 PM
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It's tragic when these things happen, and, unfortunately, it's the nurse who is usually held liable. Julie, do nurses in your country carry malpractice insurance

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Old 02-05-2008, 11:09 PM
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Case in Australia, reported in Coronial communique in November 2006. "At 15:30hrs she was ordered more pethidine. The ampoule was double checked out of the locked cupboard by two registered nurses but only one of them took the drawn up pethidine to the bedside. The syringe was put into a green kidney dish beside a blue kidney dish containing a syringe of syntometrine."

The syntametrine was given instead of the pethadine, the nurse notified the doctor immediately and an emergency C-section was arranged, however another doctor could not be found. "The doctor decided to deliver the baby vaginally. The baby’s Apgar Scores
were 5 and 5 at one and five minutes respectively. He died four days later."

On a nursing basis it was found that the syringe of syntometrine represented a casual link to the demise, as a result:
"Coronial Recommendations
The coroner recommended that drugs not be drawn up until they were needed and that different drugs should be placed in separate dishes and that the ampoule should be re-checked by the administrator and an independent practitioner before being administered."
-------------------------------------
In Australia we do not have malpractice insurance for nurses. We are covered by our place of employment as well as our registration board. We can also have union membership who will also support us. The support that we receive from these three agencies is based on the fact that we have not knowingly caused harm and are working within the prescribed scope of practice for our level of training.
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Old 02-06-2008, 12:04 AM
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I've always carried my own malpractice insurance because I don't believe that my employer would really back me up if I ever ended up in court. I've been told many times by employers that I don't need insurance, but I'm not stupid. A hospital will sellout their nursing staff to save their own skin.

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Old 02-06-2008, 02:55 AM
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Quote:
It's tragic when these things happen, and, unfortunately, it's the nurse who is usually held liable. Julie, do nurses in your country carry malpractice insurance
We are covered two ways. We are encouraged to join a professional organisation / union like the royal college of nursing which gives us indemnity and some smaller organisations particularly private companies insist on it. Secondly if we work for NHS trusts we are covered through vicarious liability. People then would tend to sue the organisation rather than any individual since you can get a larger payout that way.
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Old 02-25-2008, 09:45 AM
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Wooooah there Tiger!
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Originally Posted by P/J View Post
In Australia we do not have malpractice insurance for nurses. We are covered by our place of employment as well as our registration board. We can also have union membership who will also support us. The support that we receive from these three agencies is based on the fact that we have not knowingly caused harm and are working within the prescribed scope of practice for our level of training.
I agree we don't generally carry malpractice insurance, but where on earth do you get this notion that the organisation, or nursing rego or, for that fact, the union will cover your mistakes?
Even when you had no intention of causing harm; if you breach an organisational protocol, rest assured they will hang you out like a pair of old knickers - never to be brought back in again. The nursing rego will only pass judgment on your clinical practice - they will not bail you out of criminal or civil matters. As for the union - they do have some supportive measures - but if a private negligence case was brought against you for a clinical error - who of these do you think will pay out for you?

If, heaven forbid, it ever happens to you, I hope they realise as julie says;
People then would tend to sue the organisation rather than any individual since you can get a larger payout that way.
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