A War on Nurses?

Recent legislative changes and the future of the nursing profession.

The North Carolina Supreme Court has recently overturned a 90-year-old precedent, now allowing for nurses to be sued for following doctor’s orders when they result in patient harm. (See article: Legal Newsline.) The news of the decision has caused quite an uproar among some in the nursing community, threatening an already beleaguered healthcare system.

Opinions on the matter have been split, but those opposed have listed some of the following reasons:

• “I’m not supposed to know as much as a doctor, hence the pay difference.”
• “I can’t NOT follow the doctor’s order”, that would be insubordination!”
• “They don’t pay me enough to ask these questions”
• “I’m done with nursing. No patient is worth this.”

I don’t understand the mindset that believes that we as nurses should have some sort of blanket shield of liability. Why? Because our jobs are hard and we don’t get paid enough? We are licensed professionals; with that comes a level of responsibility to our patients and the public. It comes with accountability for our actions, and sometimes, for our inactions.

On the one hand, we want physicians to respect us and to consider us their colleagues; we wish for the public to hold us at a certain level of esteem because of our chosen profession; yet on the other, some nurses seem to believe that we aren’t educated enough to be held liable when our failure to intervene leads to patient harm. We can’t have it both ways. Either we are highly skilled, well-educated, healthcare professionals; or we are nothing more than conformist “doctor helpers” and pill passers. Which would you prefer?

I’ve worked in healthcare for 26 years. I spent many years as a clinical medical assistant before eventually returning to school to get that coveted RN behind my name. Even when I was an unlicensed healthcare professional, I understood the need to be knowledgeable in the areas I worked, especially as it related to patient care and safety.

I’ve even seen some comments that stated it isn’t a nurse’s job to know these things. Except that it is. It is literally our job to know these things; our first priority is to provide adequate, competent, and SAFE care to our patients. As nurses, we must understand that before us is an enormous responsibility – WE are their LAST LINE OF DEFENSE. Because of this, we should always be asking questions, we should always be learning, and we should ALWAYS be advocating for our patients.

So while I do feel that there should be accountability, I was recently asked if I believed that there is a war on nurses and if some of these recent legislative changes are a reflection of that; and my answer was yes; I do believe so.

The system, as it is designed, makes it all but impossible to provide this adequate, competent, and safe care. It creates an environment conducive to medical errors and patient harm.

Consider the recent case of former Registered Nurse, RaDonda Vaught – Allowing for a nurse to be charged criminally for medication errors. This set a horrible precedent, in my opinion. That isn’t to say that a nurse should not face consequences of some kind if it is proven that their negligence led to significant patient harm or death, but without intent, a criminal charge is a hard sell for me.

So while I do believe that the system should be shouldering much of the responsibility for its poor outcomes, rather than scapegoating its nurses, I still find the concept of wanting to practice within our profession with zero accountability to be quite frightening.

The system may be largely to blame, but that does not strip the nurse of our duty to protect. This duty of ours is exactly why we should be questioning the science instead of just blindly following it. Yes, I do believe there is a war on nurses and I would call on each of you to engage in the battle; we need to stand up in our own defense, in defense of our patients, and in defense of our once noble and trusted profession.

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