I do think that nurses should be held responsible for medical errors, especially ones that are made out of stupidity or ignorance. And on the subject of ignorance, this flows into my favorite peeve–forcibly floating nurses to work in areas where they have no experience, are uncomfortable, and can’t function as they should. That is inviting disaster, and nurses should refuse to do it. There’s a nursing shortage, right? Well, no better time than now to stand up for yourself.

But back to errors…most are unintentional, and are an endpoint of a system that is badly damaged. Too many patients, overwork, not enough help, and not enough time to doublecheck everything that comes from pharmacy. Plus, there may be nothing wrong with the drug or dose, but someone (and not necessarily the nurse) failed to note that the patient is allergic to the drug. Or the drug dose is correct for someone with normal kidney function, but this patient is going into renal failure–only the physician failed to take note of that, the pharmacist didn’t know, and it’s hardly expected that the nurse to going to read the physician’s notes and study lab values from the previous day before giving an ordinary drug.

There is an interesting on Nurse.com discussing the rise in criminal charges against nurses who make unintentional errors. Considering that most physicians are never charged with criminal intent, even if they amputate the wrong leg or remove the brain by mistake, it seems a little excessive to charge your average nurse. True, killing someone because of a medical error is tragic–but then, most drunk drivers who kill people tend to go free or with a piddly sentence. People who have been involved in traffic accidents because they were text messaging while driving don’t seem to be charged with criminal offense either. So why nurses?

In late 2006, the Wisconsin Department of Justice charged obstetric nurse Julie Thao with a felony for making a medical error that caused the death of a patient.

Although Thao pled no contest to two lesser misdemeanor counts for the role she played in the death of a patient at St. Mary’s Hospital in Madison, Wis., the direction society is moving by prosecuting nurses who err unintentionally is scary indeed, says Gina Dennik-Champion RN, MSN, MSHA, executive director of the Wisconsin Nurses Association.

There are nurses who are criminally negligent, and who should not be practicing. But as this article points out, many of the errors that nurses make are part of the larger broken system, as I mentioned earlier.

“It has become commonplace and accepted among administrators and their peers to mandate that nurses work overtime,” says Stephanie Bloomingdale, director of public policy for the Wisconsin Federation of Nurses and Health Professionals. “The way we see it is that currently we have employers out there who are absolutely irresponsible in forcing nurses to work mandatory overtime.

“When nurses work prolonged hours and are forced to work beyond the end of a shift, they are often fatigued —- and we know that fatigued nurses are more likely to make mistakes,” Bloomingdale says.

The nurse in this article, who had criminal charges filed against her, made her lethal error while working a shift separated by only seven hours from a double 16-hour shift the day before, according to published reports. Hospitals have to realize that they can’t work their staff to death and escape lawsuits; nurses have to stand up for themselves (and their patients) and just say no to mandatory overtime; and while many nurses like the overtime pay, they have to realize their limits.

It seems to be a growing trend, however, that criminal charges are being filed against healthcare workers. This is all the more reason for nurses to take stock of a situation and know that they could end up in prison for making a lethal medical error. And like most things, it is always so easy to blame only the nurse, when in fact, the medical error may have likely been the result of a chain of events that begins at the top–like the facility refusing to staff adequately.

At the same time, whenever a medical error occurs, the roles of other healthcare providers need to be evaluated.

“If the supervisor, the director of nursing, or the hospital CEO breached his or her responsibilities and could be charged with a criminal action and was not, well, shame on the state’s attorney,” Brent says. “It’s not fair if a nurse gets charged with a crime and others do not.”