It is Not Just the Error – It is What We Do Next

11 Jan, 2024

In light of the conviction of Nurse RaDonda Vaught and the response from AONL (seen below), I have taken time to reflect on nursing, caring culture, and accountability.

I believe, in response to criminal charges enacted against medical professionals, we should first reference the nursing code of ethics, and public trust for nurses. The nursing profession has been nominated multiple times, for being one of the most trusted professions for a reason. The relationship and nomination should not be a surprise, as it’s one of the few caring sciences in the medical profession. In the nursing code of ethics, the term nonmaleficence, or do no harm, is a nurse’s pledge and commitment to protect all patients from harm.

The unsettling practice of convicting nurses and other healthcare professionals is a very dangerous path. The conviction of caregivers on criminal charges will not set an example but have the opposite effect, causing one to be less likely to report errors due to fear of facing criminal consequences.

In the landmark 1999 IOM report, To Err is Human: there are a few key takeaway strategies that are essential when combatting medical errors. These include recognizing and mitigating doing harm from error through identifying and implementing safety actions to prevent harm. The report also identified that most health care professionals often view medical errors as a sign of being reckless and incompetent, thus less likely to report errors (Donaldson, 2008). In a time when we are facing extreme shortages of nurses and healthcare professionals, we must look towards healthcare research, new nomenclatures of error, and innovative strategies for addressing and preventing errors rather than seeking criminal charges.

As a nurse-led organization, we stand behind the National League of Nursing statement and other nursing organizations across the country, along with supporting safe staffing levels to ensure high-quality patient care and patient safety actions. These recommendations will help overcome human medical errors and support a culture of safety.

Lastly, research reveals that when hospitals and medical facilities experience critical staffing shortages, healthcare organizations are more likely to experience higher rates of medical errors, poor patient outcomes, and increased numbers of nurse and caregiver turnover.

AONL Statement in Response to the Conviction of Nurse RaDonda Vaught

The verdict in this tragic case will have a chilling effect on the culture of safety in health care. The Institute of Medicine’s landmark report To Err Is Human concluded that we cannot punish our way to safer medical practices. We must instead encourage nurses and physicians to report errors so we can identify strategies to make sure they don’t happen again. Criminal prosecutions for unintentional acts are the wrong approach. They discourage health caregivers from coming forward with their mistakes, and will complicate efforts to retain and recruit more people in to nursing and other health care professions that are already understaffed and strained by years of caring for patients during the pandemic.

Robyn Begley, DNP, RN, NEA-BC, FAAN
Chief Executive Officer, AONL
Chief Nursing Officer, SVP Workforce, AHA [x]

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