For Immediate Release
May 12, 2022
ANAMASS Stands with American Nurses Association and Tennessee Nurses Association in opposition to the criminalization of medical errors.
“Freedom is not worth having if it does not include the freedom to make mistakes.” ~Mahatma Gandhi
Just as nurses are seeing the light at the end of the COVID tunnel, a new professional concern has emerged: the criminalization of a medication error.
The American Nurses Association Massachusetts (ANAMASS) concurs with The American Nurses Association and Tennessee Nurses Association March 25, 2022 statement that “the conviction of a former Vanderbilt University Medical Center nurse because of a fatal medication error made in 2017 sets a dangerous precedent,” and “that the criminalization of medical errors could have a chilling effect on reporting and process improvement.”[1]
In Massachusetts, many nurses recall the case of Betsy Lehman, who died in 1994 due to an inadvertent overdose of chemotherapy while receiving treatment for breast cancer at the Dana-Farber Cancer Institute. Her death catalyzed a movement to recognize that patient harm is not always caused by an individual clinician’s negligence. Rather, preventable medical harm can be viewed as a consequence of institutional systems and culture that has not kept pace with the complexities of modern health care. A more collaborative and less punitive approach, which emphasizes the identification of root causes of adverse events, development of corrective action plans, and open communication about the error, results in less emotional harm to patients and prevention of the recurrence of medical harm.[2]
Nurses are the number one trusted profession for a reason. As professionals, nurses take accountability for our own practice just as RaDonda Vaught did. No nurse goes to work with the intention to cause harm. Inadvertent harm, unfortunately, happens as made evident in IOM’s To Err is Human[3] Report.
“Punishing one nurse does not ensure that a similar tragedy won’t occur in a different hospital on a different day….Ms. Vaught’s case must be viewed as a story not just about individual responsibility but also about the failure of multiple systems and safeguards. That is a harder narrative to accept, but it is a necessary one, without which medicine will never change. And that, too, would be a tragic error but one that is still in our power to prevent.” [4]
What can we do moving forward? Continue to encourage reporting of errors, create and promote “just cultures,” continuously improving the systems in which we work in with the goal to improve safety and reduce the potential for errors to reach our patients. Most of all, we must be supportive of our nursing colleagues for we will only move patient safety forward if we all move together as a profession.
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The American Nurses Association Massachusetts is a constituent member association of the American Nurses Association, the association representing the interests of the nation’s 4 million registered nurses. We advance the nursing profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. All registered nurses are eligible to join ANA Massachusetts. Reflective of the profession, our membership is inclusive of many roles, including direct care nurses and advanced practice registered nurses, who work in a wide range of settings such as acute care hospitals, clinics, long-term care, schools and other settings. Approximately 50 percent of ANA’s members who hold membership at the state and national level are direct care, staff nurses. For more information, visit www.anamass.org.
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