Second Victims: Caregiver Consequences

Cardiac Intensive Care Nurse Kimberly Hiatt, after a flawless, error-free 24 year career, accidentally overdosed an 8 month old child in her care last Sept. 14th leading to her firing, a state nursing investigation, and finally, her suicide.

As a former ICU nurse, I sympathize with her feelings and understand the horror and guilt one single mistake can cause. I also understand how devastating hurting another when you're doing your very best to help can lead to suicide.

The Critical Care culture where a single mistake is cause for firing, result in the death of a patient, cause many sleepless nights of guilt and anxiety, or at the very least, is cause for verbal lashings from superiors and snotty comments from co-workers, is partly to blame. It is the specialty most likely to "eat their young," new nurses looking to start a critical care career.

One reader summarized the tragedy so well, "As a nurse who has made a medication error (I allowed a patient to be prescribed a medication that she had a documented allergy to because I did not check her list of allergies against the drug order I received from the nurse practitioner), I can tell you that it will never leave your mind, that terror and guilt. I am now acutely aware of allergies and find myself checking the allergy lists of patients who are not even under my care for the day just to make sure that nothing has been missed through incomplete charting.

I was devastated when it came out that the patient had an adverse reaction. There was a lot of sobbing; I thought I was going to lose my job. In the end, my mistake led to better documentation within our practice -- we have allergies listed on the front of all charts, allergy buttons on our electronic charting and cross-checking between patient enrollment forms and allergy lists. My clinic managers were very kind to me. I had to fill out incident forms and received a reprimand, but they know that mistakes happen. I've become a better nurse due to my mistake, and my manager has made my work day easier by allowing me to have my own desk where it is quieter and I'm able to concentrate better on my work.

My heart hurts for this nurse and the family of the baby. I think the family of the patient affected handled this with a lot more grace than the hospital and they should be commended for their kindness in this matter. The nurses and corporate heads at this Seattle hospital need to stop eating their young and realize how much it hurts when you make the mistake. I hope that the nurse's family finds peace."

I am so sad this had to happen to both the family and the nurse, but I'm happy her story has brought to the forefront a long held secret among critical care's finest, who are primarily type A perfectionists, that even one mistake in 24 years is one too much. It's likely few of her long term co-workers comforted her in public. She was left ostracized, fired, feeling the guilt and severe depression of causing a death despite the state's finding that she was not negligent without the hospital's empathy to help her "debrief," a common therapy giving after the loss of any patient.
 I'll pray for the family. I'll pray the nurse and all the nurses who give care knowing how harsh the consequences for a single error can be. I hope you will as well.

I hope this will help you understand how serious and dedicated many great nurses are, learn to appreciate them, and even give them a break sometime. Providers are people too. They just try to hide it during work hours.

For the full article go to:
http://www.msnbc.msn.com/id/43529641/ns/health-health_care/t/nurses-suicide-highlights-twin-tragedies-medical-errors/