Nurse Responsibility and Patient Safety in Overdose Incidents

Guaranteeing patient safety is a primary concern in the healthcare industry, and nurses play a crucial role in achieving this. However, when a doctor mistakenly writes an order for an overdose, the question arises: who is responsible if the nurse administers it?

Role of the Nurse as a Patient Advocate

As patient advocates, nurses have a duty to ensure that every patient receives the care they need and that no harm comes to them. This is why it is imperative for nurses to meticulously review any medication orders before administration. Even if the order is one that the nurse sees frequently, it is still crucial to verify its accuracy and appropriateness for the patient.

'Nurses wear many hats,' and one of their primary responsibilities is to question any order that seems questionable or inappropriate. Romania writes, 'Some you’ll give so many times it will become old hat. Others will make you scratch your head then too you’re not alone. Check with the pharmacist or your charge nurse. Don’t ever not question an order because you are afraid.' This sentiment is widely echoed in the nursing community, emphasizing the importance of vigilance and teamwork.

Shared Responsibility in Healthcare

Healthcare is a collaborative effort, and while the ultimate responsibility falls on the person with the highest degree of authority—often referred to as the 'Captain of the Ship' under the legal concept of Respondeat Superior—there is a shared responsibility among all parties involved in patient care. In the case of a medication error, it is not just the nurse or the doctor who is at fault. Each professional has a role to play in ensuring patient safety.

In the state where Romania practices, the prescribing doctor is usually deemed responsible, as the doctor is in charge of devising and writing the treatment plan. However, the pharmacist may also be held accountable if the error is due to incorrect medication, and the nurse may face consequences if the error is a medication that is routinely administered and the nurse did not question it. It is important to note that nursing practices can vary by state and legal interpretation, and the culpability of each party may depend on the specific circumstances and their level of negligence.

Nursing Schools and Professional Training

Nursing schools emphasize the importance of catching errors, and this responsibility is instilled in students from the very beginning of their education. As Romania notes, 'At least here in the US, they drummed that into us at the nursing school I went to.' This training prepares nurses to become the gatekeepers of patient safety, ensuring that no oversight goes undetected and no patient is harmed.

However, this responsibility can be daunting, especially for new nurses. They may feel the pressure of being the sole protector against medical errors, a responsibility that Romanian nurses are particularly sensitive to due to their different healthcare background. In systems like the one in the United States, where doctors often only visit the hospital on a regular basis, nurses are the primary facilitators of care, and they must be prepared to handle and prevent errors.

Conclusion

The responsibility of preventing medical errors lies with everyone involved in patient care, but nurses bear a significant responsibility in safeguarding patient safety. By questioning orders and verifying medications, nurses can prevent incidents such as overdoses from occurring. Romania's perspective highlights the collective responsibility in healthcare and the importance of a collaborative approach to patient safety.

For those in the nursing profession, it is crucial to remain vigilant and prioritize patient safety over adherence to orders. Nursing schools play a vital role in preparing future nurses for these responsibilities, and it is essential that this training is reinforced in practice.