MEDICAL ERRORS: Impaired Nurses Rarely Disciplined
The final part of the Chicago Tribune's three-part series on nurse medical errors addresses drug addiction among nursing staff and its consequences on patient care. Blaming a lack of disciplinary action and "a shoddy system of reporting medical errors" on permitting "negligent, incompetent and impaired registered nurses to return to work in Illinois even after committing deadly errors," the Tribune describes incidences of heroin and cocaine addiction and prescription drug theft that injured patients through nurse neglect and inattention. Nurses are "the primary guardians of hospital care," responsible for monitoring patients and alerting staff when conditions decline. However, due to understaffing and longer shifts, nurses make most of the country's medical errors, according to state and federal healthcare records. Illinois and 36 other states do not require health care institutions to report cases of nursing errors or misconduct, even in the event of injury or death, but rather "embrace a second-chance philosophy based on a belief that registered nurses are a treasured resource to be saved no matter the risk." According to Vicki Sheets, director of policy and credentialing for the National Boards of Nursing, "If there is any chance [at] all, state licensing boards will always lean towards remediation. A nurse is a valuable resource." Through an examination of Illinois Department of Professional Regulation records, the Tribune discovered a "pattern of leniency" toward nurses and insufficient resources to ascertain the danger posed by specific individuals. Other findings include the following:
- DPR understaffing sometimes leads to cases being closed without medical record examination and determination of patient harm;
- In at least 43 cases in the last six years, DPR did not refer nurses suspected of felonies to the state's attorney office for investigation;
- When lawsuit settlements raise concerns of negligence, nurses are not disciplined or investigated;
- Seventy-five percent of the 924 case files on nurses closed since 1995 have been "stripped" of basic information;
- DPR's system for identifying problem nurses depends on hospital cooperation, but state laws only require a hospital to notify regulatory authorities if a nurse is fired;
- State licensing laws to regulate professions and protect the public are decades old.
Not Just Illinois
Federal regulatory oversight is also to blame for the medical errors committed in hospitals by all staff members, a second article in the Chicago Tribune reports. Despite care controls and tracking administered by the FDA, the Joint Commission on Accreditation of Healthcare Organizations, and the National Practitioner Data Bank, voluntary hospital reporting, ineffective monitoring and records restricted from public release make it nearly impossible to detect which facilities have the worst records. Earlier in the year, President Clinton proposed a mandatory reporting system to be created by 2004, but the American Hospital Association and the American Medical Association have spent millions of dollars in advertising and lobbying efforts to thwart such a federally controlled system, claiming it would "unfairly open the door to medical malpractice lawsuits," and lead to "chilling" legal liabilities (Berens, 9/12).