Are Nurses Like Canaries in the Coal Mine?

By Jordie Papa

Image courtesy PxHere

If you’re a nurse, your efforts undoubtedly come under scrutiny on a daily basis.  That’s because your job is quite literally the first line of defense against injury or infection.  This puts the onus on you to perform your assigned tasks diligently.  While doctors can bury their mistakes, nurses get buried by theirs.  Whether you’re tasked with treating patients who are infected with communicable diseases, or you work in a hospital where Staph and MRSA are present, the chances of passing a pathogen onto another patient is significant.  Read a chart wrong or improperly administer an IV and you could find yourself being written up before the Board of Nursing.  While nobody is perfect, the sad fact is that patients can and sometimes do wind up being injured by the very people who are treating them. 

The Big HAC Attack

It’s a fact that Hospital Acquired Conditions otherwise known as HACs have risen during the past decade.  In January 2019, the Agency forHealthcare Research and Quality stated that hospitals reported more than two and a half million hospital-acquired conditions in 2017.    Preventing HACs not only saves patients time and money, it also saves lives. While the current trend of hospital acquired conditions and infections have been on a downswing for the past three years, that doesn’t mean they’re likely to go away any time soon, if ever.  The three most prevalent ways that patients wind up being HACked are:

1.      Having germs pass from healthcare professional to patient via direct contact.

2.      Acquiring a Catheter-Related Blood Stream Infection.  (CRBSI)

3.      Being administered either the wrong drug or the wrong dosage of the correct drug.

Any time a nurse comes in contact with an infected patient or even enters the room of an infected patient there is a 70% chance of picking up a pathogen on the caregiver’s clothing.    A 2014 study conducted at New York Hospital Medical Center even identified neckties as being a hotbed for pathogens.

Image courtesy flickr

New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.

The secret to stemming the spread of germs when it comes to medical uniforms is to handle them with care.  If your scrubs come into contact with an infected patient or wind up being contaminated with biological material, they need to be changed as soon as possible. 

CRBSIs are another matter, since blood-borne infections can lead to potentially life-threatening conditions.  While a number of different solutions have been proposed for the prevention of CRBSI, what seems to work best is to disinfect the patient’s skin with chlorhexidine alcohol before inserting an IV.  While this sounds like a simple enough solution, studies have shown that it can substantially reduce the risk of CRBSI.

Highway to the Danger Zone

One of the quickest ways to endanger a patient is by inappropriately administering a medication.  While no nurse would purposely give a patient the wrong drug, unfortunately it occurs far too often.  According to the US Food and DrugAdministration, “The FDA receives more than 100,000 U.S. reports each year associated with a suspected medication error. The reports come from drug manufacturers, healthcare professionals and consumers through MedWatch, the agency's safety information and adverse event reporting program.” 

Administering the wrong drug or the wrong dose of the right drug can have catastrophic effects, including disability, birth defects, hospitalization, life threatening injuries and even death.  Since many medications look alike or have similar names, the FDA encourages healthcare practitioners to use barcode scanners to make certain that they are administering the right drug in the correct dosage. 

The Canaries in the Coal Mine

When President Obama signed the Affordable Healthcare Act into law in 2012, Democratic lawmakers hailed it as “a victory for people all over this country whose lives will be more secure.” Yet seven years later, many citizens feel that the American healthcare system is in crisis. 

Dr. Steffie Woolhandler told CNN, “Unless you’re a Warren Buffet or Bill Gates, you’re one illness away from financial ruin in this country.” 

Image courtesy Uniform Destination

According to author DavisLiu, MD, “The fundamental challenge facing this country is to deliver healthcare while balancing the cost of care, access to care, and the quality of care provided. Currently we are failing at all three of these goals.” 

While nurses can affect neither the cost nor the availability of healthcare, they most certainly have in their power the ability to improve the quality of care seen in hospitals, clinics and private practices.  They can also urge their supervisors to provide sufficient time and training to deal with patients in their care.  This will lessen the incidence of errors and omissions.  Like canaries in the coal mine, it's up to those in the front lines of healthcare to keep the system from becoming more of a hindrance than a help to all those who rely on it to stay healthy.

Jordie Papa owns and operates Uniform Destination in Jacksonville, Orange Park and St. Augustine, Florida.  For more information on her locations go to https://www.uniformdestination.com/