CriminalizationNew position against nurse criminalization
Legal cases criminalizing nurses for unintentional errors resulting in patient harm continue to make national headlines.
In March, ten registered nurses working in Sentosa, N.Y., were indicted on charges of endangering their patients after resigning their positions. Another notable case caught the public's attention in 2006 when the Wisconsin attorney general charged a registered nurse with criminal negligence after the wrong medication was administered to a 16-year-old who died after the incident.
Taking a strong position against such cases of nurse criminalization for unintentional errors, AORN created a Position Statement regarding Criminalization of Human Errors in the Perioperative Setting, which was passed in April by the association's 2008 House of Delegates.
The position statement includes a definition of error, "the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim," and differentiates between unintentional and intentional harm to patients.
"This official position statement on nurse criminalization is the natural corollary of AORN's patient safety focus. It will also serve as a resource in future legislation and litigation for those groups addressing unintentional nursing error," said Ellen Murphy, RN, MS, JD, FAAN, a former AORN president and emeritus professor of nursing from Milwaukee, Wis. who followed the Wisconsin case and helped draft the AORN position statement.
Murphy says "criminalizing nurses is antithetical to AORN's safety and just culture initiatives because the possibility of criminal charges interferes with the disclosure needed to produce safety systems and a just culture." A just culture is one in which staff members are comfortable reporting errors or "near misses" and taking on professional accountability for their actions.
Following this "just culture" paradigm, AORN's Position Statement regarding Criminalization of Human Errors in the Perioperative Setting outlines a systems approach to addressing patient harm, because "any such attempts to criminalize unintentional nursing errors will provide the ultimate fear of reprisal, hampering future error reduction efforts." Furthermore, as noted in the position statement, "AORN believes that all perioperative nurses and healthcare organizations must strive to create a culture of patient safety that provides an atmosphere where perioperative team members can openly discuss errors, process improvements or systems issues without fear of reprisal."
The new Position Statement regarding Criminalization of Human Errors in the Perioperative Setting was created in response to a motion made by members of AORN's 2007 House of Delegates and a subsequent charge set forth by AORN's 2007-2008 AORN President Mary Jo Steiert, RN, BSN, CNOR. Read the statement.