March 16, 2016 Kim Krisberg 0Comment

At Vox, Sarah Kliff writes about the side of medical errors we rarely hear about — the doctors and nurses who make such errors and the mental health toll of living with that responsibility. In an article that explores whether health care workers are getting the support they need to deal with such experiences, Kliff begins with the story of nurse Kim Hiatt:

Kim Hiatt had worked as a nurse for 24 years when she made her first medical error: She gave a frail infant 10 times the recommended dosage of a medication. The baby died five days later.

Hiatt’s mistake was an unnecessary tragedy. But what happened next was an unnecessary tragedy, too: Seven months after the error, Hiatt killed herself.

“She fell apart,” her mother, Sharon Crum, says. “I suppose it would be the same thing you felt, if you felt at fault for a child’s death.”

This is a story about Hiatt, the mistake she made, how she struggled with that tragedy, and how the institutions that had previously supported her ultimately shut her out.

It is also a story about an open secret in American medicine. Medical errors kill more people each year than plane crashes, terrorist attacks, and drug overdoses combined. And there’s collateral damage that often goes unnoticed: Every day, our healers quietly live with those they have wounded or even killed. Their ghosts creep into exam rooms, their cries haunt dreams, and seeing new patients can reopen old wounds.

Kliff reports that researchers have found three basic facts on the relationship between health care providers and their mistakes: medical errors are common; in the aftermath of an error, many providers experience significant mental and physical duress; and most providers don’t think their colleagues are experiencing similar duress, which means they often try to cope in isolation.

While providers often face harsh punishments for medical errors, some health systems are looking for tools to help providers better cope with their mistakes, such as peer support hotlines. Kliff reports:

(K)nowing that our health care system depends on human beings who are fallible — and knowing that most providers will berate themselves internally, sometimes experiencing depression or suicidal urges — some hospitals have begun to think about a different approach.

Sue Scott is a patient safety expert at the University of Missouri, where she runs a 24/7 peer support service for health providers who’ve experienced traumatic events. She remembers when her first patient died. There was no mistake — the location of a gunshot wound appeared to guarantee the patient’s death — but she still struggled with the gravity of his death.

“There can be a mindset among some clinicians like, ‘Welcome to health care, this is what you signed up for,'” Scott says. “When I had my first experience [where a patient died] like this, I said something to the nurse I was working with like, ‘I don’t know if my heart can take this.’ Her response was, ‘Welcome to nursing. You better buck up.'”

Scott runs all patient safety efforts in her hospital system, and about a decade ago she gathered staff to talk about how they handled similar traumatic incidents — and whether they felt they needed help.

The answer was a resounding yes.

Read Kliff’s full story at Vox.

In other news:

Reveal: In response to a documentary about female janitors and sexual assault on the night shift, California Assemblywoman Lorena Gonzalez is now working on a bill that would improve protections for such workers. Christina Jewett reports that Gonzalez, who made the announcement at a rally outside the state Capitol, is considering rules that would require women work in pairs, mandate sexual harassment training and educate women about their rights. Jewett writes: “Sandra Diaz, policy director for the Service Employees International Union, also spoke at the rally. She said that after the film aired, a janitor told her that her supervisor had raped her twice. But she had to keep working to provide for her daughter. ‘I’m so proud to be in the company of such courageous women who aren’t afraid to lift up their voices and say the time for change is now,’ Diaz said.”

CBS News: Protestors and farmworkers led by the Coalition of Immokalee Workers demonstrated near the home of Wendy’s Chairman Nelson Peltz last weekend, calling on the fast food chain to join its Fair Food Program. Companies that participate in the program agree to pay an extra penny-per-pound to tomato growers to improve the wages of farmworkers. Fellow fast food giants, such as Burger King, Taco Bell and Subway, have already joined the program. The article notes: “Tomato harvesters make an average of about $10,000 during the six-month season, earning 50 cents for every 32-pound basket they fill. The coalition says the program can add $20 to $150 to their weekly checks.”

The Nation: Dave Zirin reports that NFL team owner Stan Kroenke, who recently decided to move the Rams team from St. Louis to California, attempted to have his players remain employed under Missouri’s workers’ compensation laws. Fortunately, the NFL Players Association realized what was happening, brought it to light, and Kroenke has agreed to classify players as workers under California labor law. Zirin quoted DeMaurice Smith, executive director of the players association: “With the NFL lately, we seem to be adversaries every day…. Workers’ compensation is a right of every American worker and is not just for athletes. When the owners of professional sports teams actively try to circumvent this right, or try to rewrite legislation that carves out athletes from this right, our union will always fight back.”

Washington Post: Joe Davidson writes about the long and slow hiring practices at the Customs and Border Protection agency — a process that workers say is resulting in involuntary overtime and long stints away from home. The issue was the topic of a congressional hearing earlier this month. Davidson quoted Jorge Llanos, a customs officer and president of the San Diego chapter of the National Treasury Employees Union: “’Our employees at the San Ysidro and Otay Mesa ports of entry work 16-hour shifts almost on a daily basis.’ Thinking about his two boys, LLanos recalled missing ‘the majority of their birthdays [and] one of their graduations.’”

ABC News: The Associated Press reports that a judge has ruled in favor of a former Chipotle employee who was fired after tweeting about low wages and circulating a petition about worker rest breaks. The judge ruled that Chipotle’s social media rules — which ban disparaging or false statements about the fast food chain — violated labor laws. The case was one of many that the National Labor Relations Board has considered in regard to the social media rights of fast food workers who are organizing for better wages and working conditions.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.

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