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Safety: Patient rights

By Rukhsana yasmin

The practice of professional nursing has its roots in ethical tradition of service. These nursing services can promote and restore the health of patient. While providing care the nurses promote an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. On the other hand nurses feel uncomfortable with a situation in which nurses’ witness’s incompetent, negligent or abusive practices by health professionals but can be can not figure out. This type of issues makes the nurses to think that she should tell in order to protect the patient or not. According to Husted (1991) “A patient whose well being is threatened by a nurse has a right to blow a whistle on the nurse” (p. 32) all health professionals including nurses are ethically obliged to speak out to protect the patient from harm; this is an aspect of beneficence. According to American Nurses Association Code for nurses (1990) “the nurse act to safeguard the client and the public when health care and safety are affected by incompetent, unethical or illegal practice by the person” (p.64) Allah also says in Holy Quran if any one saved a life, it would be as if he has saved the life of the whole mankind” Though in the past health professionals had this concept that do not tell to any one just keep quite on error. Moreover, nurses were punished for their mistakes but this solution did not prevent errors, on the contrary it gives heightened awareness of their weakness for making additional errors.

As I reflect back when I was working in the bed side area at Faisalabad I have seen many nurses, doctors and other health professionals were doing many mistakes but no one wanted to report to the management. If any nurse wanted to advocate for patients, she had to face many barriers which refrain the nurse to speak out in addressing the rights, choices, or welfare of their patient. So in this way there was always the possibility that attempts to advocate for a patient could fail. although, still it has least importance among health professionals and it is controversial issue that nurses should whistle blow or not means that nurses should speak up or not.. That is way my contention to say the nurse should whistle blow to eliminate the medical errors, to improve the quality of the patient care and for job satisfaction.

It has been claimed that many medical errors occur during prescribing, preparing, dispensing and administering of the medication and these errors result in serious harm, such as death, disability or prolong treatment. Further more patients can be harmed psychologically, socially, and economically. According to Smith (2005), “Medical errors are responsible for more deaths each year than care accidents, breast cancer, diabetes, pneumonia, renal disease or AIDS.” It could be argued that nurse is a first person who is very close to the patient and recognize the situations which are not in the best for patient interest. She can report these situations to persons who can effect change. Further more, it is said that hospital should have any system and policy that encourage the nurses to speak out whenever, nurse sees any health professionals engaging in a wrongful act that affects a patient. In this way all health professionals more vigilant and care full because they think that we are being monitor and they will not do more error. However; it is unrealistic to believe that errors can not be completely eliminated because mistakes are part of human nature but on the other hand errors could be enhanced by disclosure discussion which is result of regret for unexpected outcome. According to Konishis (2007), “whistle blowing as an act of advocacy specially means that if nurses have the ethical responsibility to protect patient from harm, then at times they must report the incompetent or ethical actions engaged in by colleagues.”

It might be contended that nurses should speak up for job satisfactions because nurse who has made mistake they might suffer from guilt, regret, loss of self esteem and loss of integrity as well as poor patient care. It is indirect but strong threat on patient care. On the other hand nurses do not feel safe to discuss the incidents or their response to that mistake with other. According to Meek (2007), “Making mistakes and unhealthy way of handling mistakes might contribute to some nurses professional dissatisfaction, burn out, or other negative attitudes and responses”, so if nurses will not speak out then how can they provide proper care and satisfied themselves while working. On the contrary many nurses do not want to speak out on issue because they have a fear of ostracism by the other team members and the fear of being labeled as a troublemaker which could impede her own career prospects. As fare as our culture also prevents whistle blowing because nurses think that doctors should not be challenged so that nurses frightened to come forward and expose wrongdoing. However nurses have taken pledge after joining the nursing then at any rate nurse has to protect the patient from harm. According to Florence Nightingale pledge “I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug”, however, nurses who are involved in making mistakes might need a personal support from institutional managers and from colleagues to resolve feeling of guilt, shame or other negative response. It might be claimed that handling mistake should be in healthy manner so that it bring healing and positive growth to the nurses, patients and families. Furthermore, health facilities should have self reporting system which is use for educational purposes for nurses who made a mistake as well as for other health professional.

Moreover, it has been claimed that Nurses are an invaluable and crucial component of providing quality care and nurse are the principal caregivers in any health care system, directly and intensely. So that if she will speak out in this way quality of care will be improve because a health personal who did mistake they will learn proper way of providing skills and they will not do same mistake again because it is fact that to error is human and person will learn by mistake.

To conclude that nurses should whistle blow. However, it is recommended that such issues should be part of nursing curriculum. So that the nurses would be able to blow the whistle on wrong practice and there should be strong system of protection for whistle blower. In this way nurses will speak put and provide appropriate direction and help to individual and family in health related issues. It should be part of hospital policy to conduct workshops and refresher courses to update nurse’s knowledge. Finally, I must say that it is challenging task for nurses to whistle blow on wrong doing practices for protecting the patient. Every hospital must have proper system and policy for communication and it is necessary for the nurse to work collaboratively with other health professionals and try to involve them in providing proper care. In this way it would ultimately improve the quality care and learn how to blow the whistle on wrong practices.