Running head: LACK OF REPORTING MEDICAL ERRORS IN NURSING 1

Lack of Reporting Medical Errors in Nursing

Samantha R. Wiederkehr

Grand Canyon University: NSG-436

August 9, 2020
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Lack of Reporting Medical Errors in Nursing

Nursing is one of the most rewarding occupations, however with reward comes difficulty.

Nurses are faced with ethical and moral dilemmas constantly, and part of the job is figuring out

how to resolve these issues in order to do what is right and ultimately what is best for the patient.

The difficulty that comes with these dilemmas can become overwhelming but being able to

recognize what they are and what steps to take beforehand can make it much easier. One

prominent ethical dilemma in nursing today is lack of reporting medical errors, and as a nurse

leader one must take the responsibility to recognize this ethical dilemma, develop a plan to

manage it, and lead in a way that influences the decision making process in order to do what is

right.

Analysis of Lack of Reporting Medical Errors

Medical errors may occur for several reasons and consist of many different mistakes;

whether it is not wasting, giving a medication at the wrong time, giving an incorrect dose, or

giving a medication to the wrong patient it is important that it always is reported. However, it is

still a very prevalent issue in fact, “reporting of medical errors by nurses occurs in only 37.4%-

67% of cases” (Vrbnjak, Denieffe, O’Gorman, & Pajnkihar, 2016). These statistics should be

getting nurses attention because as advocates for the patients it is a nurses job to strive to get

these numbers to 100%. Reporting medical errors is not something that was introduced in health

care to punish nurses, it is something that nurses do in order to protect the patients safety and

even the nurse from any future issues as well. I believe that all medical errors should be reported

regardless of how small they are. There are several things that must be considered when a

medication error occurs and what may come from it such as increased occurrences of death,

longer hospital stays, and even increased costs. Medical errors can have serious adverse
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outcomes, yet they are so frequently not reported which is why it is important to address this

ethical dilemma and work to resolve this issue.

Ethical Decision Model and Resolution

Ethical dilemmas lead a nurse to having to make a decision that is most likely difficult for

them. In the case of not reporting a medical error the decision the nurse must make is whether to

report it or not and in many situations the nurse chooses not to. This is why nurse leaders

develop ethical decision models so that all of the pieces to the ethical dilemma can be laid out

and considered in order to resolve the issue. An ethical decision model that could be used to

resolve this issue is the PLUS Ethical Decision-Making Model. In this model PLUS is a

mnemonic used to represent policies and procedures, legal, universal, and self (Ethical Decision

Making Models and 6 Steps of Ethical Decision Making Process, 2020). Each thing that a person

should consider when trying to make an ethical decision. First, one must decide whether or not

the decision they want to make falls in line with the hospitals policy when considering whether

or not to report an error this step should send red flags to the decision maker. Hospital policies

are set for when medical errors occur so that whomever involved is obligated to file an incident

report. Next, the nurse must consider if what they will do violates any laws. This one is big

because a nurse who does not report a medical error could become more punishable later on if it

were ever to come to someone else’s attention. Universal considers the values of the company

and the job that is being done and determining whether or not they will be violated. Nurses have

several ethical values that must be considered in this step. According to the ANA Code of Ethics,

nurses practice with commitment that belongs primarily to the patient, promotes the safety and

rights of the patient, holds accountability for their nursing practice, holds an obligation to

promote health, and maintains an ethical environment in the work setting (Hegge, 2015). Each of
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these values, including some not mentioned, become violated when a nurse chooses not to report

a medical error. Lastly, self leads the nurse to consider their own personal values and what they

believe to be fair. Each nurse must consider this step on their own because no one is exactly

alike, however all nurses do represent a position that prides itself on promoting the health and

safety of others. By using this model and taking into consideration ethical principles such

autonomy, beneficence, nonmaleficience, and justice nurses should be able to lead themselves

towards making the decision to report all medical errors that may be made.

Possible Solution and Leadership Influence

The hardest step when dealing with ethical dilemmas is working towards finding a

solution to the problem. As a leader, one solution that can be implemented is implementing goals

in the workplace that decrease the occurrence of medical errors, lowering the need to report them

and increasing the chance of reporting. Another possible solution is to encourage reporting

through something else such as still penalizing them for their action but gratifying them for

taking responsibility. When individuals are reassured that they have made the right decision, it

increases the chance of them making the right decision again. Another way to influence the

decision is by encouraging staff to use a specific model such as the PLUS model so that they

have something to turn to when they are overwhelmed with a decision. Incorporating the PLUS

model supports the leadership and management skill of needing to set policies and standards of

care in order to hold nurses accountable (Huber, 2018). Many people when frustrated or

confused make impulsive decisions that seem to be right at the time but fail to consider the long-

term outcome. The last, and most effective step to being a leader in decision making is to lead by

example. When people who look up to you see that you hold yourself to the same standards as

them if not more, it encourages them to continue work harder and do the same.
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References

Ethical Decision Making Models and 6 Steps of Ethical Decision Making Process. (2020, April

11). Retrieved August 09, 2020, from https://status.net/articles/ethical-decision-making-

process-model-framework/

Hegge, M. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD:

American Nurses Association.

Huber, D. L. (2018). Leadership and Nursing Care Management. (6th ed.). St. Louis, MO:

Elsevier-Saunders. ISBN-13: 9780323389662

Vrbnjak, D., Denieffe, S., O’Gorman, C., & Pajnkihar, M. (2016). Barriers to reporting

medication errors and near misses among nurses: A systematic review. International

Journal of Nursing Studies, 63, 162-178. doi:10.1016/j.ijnurstu.2016.08.019