just a nurse

Any illusions of infallibility were quickly dispelled upon joining the profession of nursing. Never have I been more acutely aware of my ability to make mistakes than in my first months in the ICU, and the stakes were high. The seasoning of a nurse takes years and growth follows an often unpredictable pattern as if guided by Brownian Motion. I am forever grateful to all of my colleagues for their patience, mentoring, tough love, and preventing me from killing anyone.

We spend thousands of hours educating ourselves and thousands of dollars obtaining and maintaining various credentials, certifications, and professional memberships. We miss soccer games, recitals, beach days, and Christmas with our families (there are precious few of these). We are subjected to long hours, stress, violence, missed lunch breaks, abuse, medical residents, assault, full bladders, battery, bodily fluids, various forms of excreta, being perceived as someone not smart enough for medical school, infectious disease, surgical residents and many other occupational hazards. We do this for little pay. There is chatter within the ranks, but most of us accept this. Many of us love what we do. We chose nursing.

Imagine spending 12+ hours giving everything you have to save someone's life, drawing on all of your education and experience. Is it possible that while managing the care of an unstable patient and attending to the emotional needs of a distraught family that you make a mistake? Could you forget to chart a critical intervention that you performed. Did you click the wrong box out of the hundreds available in the endless strata of the computerized chart? Did you chart an item in only one of the three places it "needs" to be charted? Did you effectively justify the rapid titration of the 15+ continuous IV infusions? Did you follow protocol when checking the 16 units of PRBCs, 8 FFPs, 10 PLTs, DDAVP and cryoprecipitate? Did you fail to carry out orders or followup on laboratory results in a timely manner? Did you forget to chart a turn, the head of bed > 45 degrees or oral care performed?

You probably did all of this well. You are just a nurse

If a medical malpractice case goes to trial:

1. Inconsequential errors WILL have consequences.
2. You will NOT be held to the standard of your profession.
3. You WILL be held to the standard of public opinion.
4. You will NOT be judged by a jury of your peers.
5. You WILL be judged by a jury with no understanding of the complexity of your role.
6. You WILL be discredited as a person
7. You WILL be discredited as a professional.
8. You WILL have your life turned upside down.
9. You WILL run the risk of losing your job.
10. Your colleagues WILL look at you and treat you differently.

As a group, nurses give every day, in a role that transcends all facets of their lives. Nurses are human and prone to errors in a system that is designed to fail. Most are not grossly negligent. Most do their best. Most are immensely effective and have an amazing opportunity to impact the lives of many. This is a gift I relish and a responsibility I accept. I am just a nurse.

Brian M. Wilson, BSN, RN, CCRN