Guilt After Nursing Errors

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The guilt nurses experience after completing a medical error is an important concept that needs to be evaluated. Many nurses and advanced providers will commit a medical error during their careers. A medical error is defined as the failure of a planned action to be completed as intended or use of a wrong plan to achieve an aim (Grober & Bohnen, 2005, p. 42). Medical errors can be an unintended act of omission or commission or one that does not achieve its intended outcome.

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Medical errors may or may not cause patient harm (Grober & Bohnen, 2005, p. 42). Hospital medical errors are now the third leading cause of death in the United States (U.S.). There are 35,416,020 hospitalizations per year with a death rate of 251, 454 due to medical errors. This is almost ten percent of all hospitalizations (“Study suggests”, 2016).

Patients are not the only persons effected by medical errors. The physicians, nurses, pharmacists, or others involved in the patient’s care are the second victims of medical errors (Quallivan et.

al, 2016, p. 376)). Experiencing patient harm and loss is an inevitable reality in the medical profession. Health care providers (HCPs) are affected in a traumatizing way when patient harm occurs due to medical errors or negligence (Quallivan et. al, 2016, p. 376). Medical errors impact the providers personal lives, interaction with colleagues, and social lives (Grissinger, 2014, p. 594). Healthcare providers are victimized by the event and suffer consequences to their well-being such as anger, anxiety, fear, sadness, and guilt (Quallivan et. al, 2016, p. 378).

According to provision 3.4 in the Nursing Code of Ethics nurses must lead in the development of promoting patient health and safety, reduce errors, and create a culture of excellence.

Nurses are held personally accountable for errors and mistakes and it is their responsibility to disclose any error that has occurred (“ANA Code of Ethics”, 2015). Nurses primary commitment is the patient and the nurse should advocate, promote and protect the health, rights, and safety of the patient (Ramsey, 2005, p. 20). Nurses have a commitment to their patients. This can prompt the feelings of guilt that occurs with errors while caring for patients (Ramset, 2005, p. 21).

Given the impact that medical errors have on nurses and nurse practitioners, it is important to gain an understanding of what guilt means to this population. Further clarity is needed on this concept and how guilt relates to nurses when applied in the context of medical errors. A new definition of guilt as it pertains to nurses and or nurse practitioners who have caused or committed a medical error will be provided.

According the Merriam-Webster Online Dictionary guilt has several meanings: “the fact of having committed a breach of conduct especially violating law and involving a penalty”, “the state of one who has committed an offense especially consciously”, “feelings of deserving blame especially for imagined offenses or from a sense of inadequacy, self-reproach”, “a feeling of deserving blame for offenses”, “responsibility for a crime or for doing something bad or wrong”, and “a bad feeling caused by knowing or thinking that you have done something bad or wrong” (Guilt, 2018).

The term guilt when speaking from an emotional context can be defined as a dysphoric feeling that occurs when people recognize they have committed a wrongdoing, mistake, or transgression, like harming another person. Often self-blame and a sense of responsibility evokes the tendencies for actions to occur to repair the wrong doing. Guilts is often treated interchangeably with shame but should not, as shame is associated with the feelings a person has when exposed. Shame is associated with a negative view of the self, whereas guilt is associated with an evaluation of a behavior.

A negative evaluation of the behavior or action in question promotes feelings of guilt. Guilt is a reaction to one’s violation to what society or themselves view as the norm and is associated with the recognition that one has violated the moral or social standard. The individuals’ perceptions of flawed behavior may lead to feelings of guilt, but the person may still view themselves as a well-intentioned person (Halmburger et. al. 2014; Wietzer & Buysse, 2012, Tigner & Colven, 2018, McGaffin, 2013, Lock et. al., 2015).