Nurses are once again fighting the Covid-19/SARS-COV-2 war. This will be the fourth time nurses have bore the traumatic and heavy burden of Covid-19. This time it is the Delta variant. A variant that is 1000 times more transmissable than previous Corona virus strains.
Nurses are again seeing things they can’t unsee. This time children, even neonates are presenting in respiratory failure, in need of rapid intubation. Hospitals are again in crisis mode as they reach capacity. This time however, it is not PPE that is in short supply. Instead, in this fourth surge, there are not enough nurses to care for all the ill.
Nurses are laboring under critical staffing levels. There is not a large pool of agency nurses from which to pull. Too many nurses have left the bedside because of maltreatment from administration, Covid-19 PTSD or simply because they have nothing left to give. After fighting three surges many nurses left their once loved profession. This fourth surge was avoidable. It is a self inflicted, gapping, wound.
When there are not sufficient nurses to provide safe care then bad outcomes and errors are predictable. Patients suffer because inadequate staffing threatens patient well being. Yet, short staffing and overwhelming high acuity, are all too often what nurses expect when they report for work. They know their license may be jeopardized. They fear for their patients as they struggle to keep up with critical staffing levels. Yet, when things do go wrong and there are bad patient outcomes, it will be the nurse who is reported to the Board of Nursing.
Board of Nursing disciplinary actions have not only continued but have increased during the pandemic. Nursing Boards do not consider being short staffed as mitigating conditions that excuse an adverse event. Boards of Nursing do not, frankly care if the nurse was barely keeping their head above water, when a bad outcome or failure to rescue occurred. In reality, Boards of Nursing only care that there was a complaint received and the nurse did it. It matters not if the nurse was in a no win situation overwhelmed with too many and too sick SARS-COV-2 patients. Though nurses are heroes and have done a heroic job for more than a year now, all Boards of Nursing care about is, did the nurse violate their Nurse Practice Act.
In some states there was law passed that nurses during the pandemic could not be held civilly accountable for bad patient outcomes. That protection however, only protects the nurse if a medical malpractice suit was filed during Covid-19 surges. The law provides no protection to nurses from being reported to the Board and subjected to Board of Nursing discipline.
If you are in a state that has such as Safe Harbor law then use this protection. Safe Harbor does nothing to address the immediate unsafe conditions that nurses may encounter. What it does do is provide documentation of the unsafe conditions that existed. This documentation should invoke an internal peer review. Peer review must occur before a healthcare facility reports a nurse to the Board of Nursing. Nurses should never be reported by their employer without first having the right to peer review. A peer review allows for some responsibility to be placed on the employer for system errors or short staffing. Peer reviews conclude with a decesion as to whether or not a nurse should be reported. The moral of this story is always request a peer review if you find yourself being blamed for a bad patient outcome.
You also satisfy having accessed your chain of command when you utilize Safe Harbor, or any similar reporting mechanism. It places the employer and administration on notice. The protection provided the nurse is slim, it is however, always in the nurse’s best interest to invoke such as Safe Harbor.