Читать книгу Toxic Nursing, 2nd Ed - Cheryl Dellasega - Страница 52

When things go wrong within a clinical setting, it is important to have established a culture in which the error is reported rapidly and the focus is not on blaming the person who made the error but on exploring why the error occurred and preventing future errors. In this scenario, Carrie has created a culture of blame through her exaggeration of the error made by Liandra.

The focus is now on correcting the misinformation and negative feeling created by this exaggeration. As the manager, it would be important to directly address this issue with Carrie and help her understand how her actions have created an environment that is not only problematic for her colleagues but also shifts the focus from prevention of these errors to seeking blame for an error that anyone could make—again. The manager should work with the staff to create a culture of trust that encourages the staff to report errors quickly and accurately without fear of repercussions from other staff. And when errors like the one in this scenario occur, the approach should be to seek opportunities for new learning at all levels.

–Melissa Snyder

My first concern in this situation would be Liandra’s well-being—assuming, of course, that the patient has been taken care of. I would act quickly to address the situation by reinforcing the process to be followed when mistakes are made, stressing that patient safety comes first. With Liandra, I would try to identify factors that may have contributed to the mistake in case system issues need to be corrected.

Next, I would have a unit-wide discussion on errors. This would provide an opportunity for all ER personnel to discuss how we as professionals address mistakes. It would be helpful if others volunteered ahead of time to share incidents in which they have made errors and how they dealt with both the ethical and emotional aspects. This might be the venue to further examine the damage done when negative talk occurs around a coworker’s performance.

Finally, I would want to check back with Liandra and make sure her professional self-esteem is back on track. If she continues to feel guilty and unsure of herself, the likelihood of future mistakes will increase. Other senior nurses could also be encouraged to be supportive of Liandra and check in with her from time to time.

–Cheryl Dellasega