A Just Culture in Health Care

Response to Peer

Hello. Great insight! I think it’s the nature of people to want to protect themselves first before assessing a situation deemed dangerous or uncertain. A person will naturally tend to blame others before accepting any responsibility on their part when things go wrong. Children, for example, when caught doing something wrong, will automatically point the finger at someone or something else in an effort to exonerate themselves from any wrongdoing. Adults are the same; for example, when a marriage goes wrong and perhaps ends in divorce, one party will blame the other rather than look at what they, as individuals, did wrong and contributed to the failure of the marriage. It’s the same with healthcare; the Just Culture has done very little, as I mentioned earlier, to eliminate the blame culture (Edwards, 2018). Who wants to put their job on the line? Worse still, who wants to be known as the whistleblower or ‘goody two shoes’ every time things get messed up? In an effort to work in harmony, collaborating to achieve their goals, and basically watching each others’ backs, nurses will choose not to report when errors occur in their line of duty. As you rightly said, we live in a blame culture, which has bled into our professional lives. As you have also cited, nurses will tend to blame the nurse managers, and the reverse is also true (British Journal of Nursing, 1999). I believe that more needs to be done to incentivize healthcare workers to report errors. The packaging of the Just Culture should lean more on incentives rather than learning from mistakes. I say this because once a mistake occurs, the staff involved in that particular scenario can learn from their mistake and choose to sweep the matter under the rug, promising/deciding not to repeat it or report it again.

References

British Journal of Nursing (1999). Why is there a blame culture in nursing? Retrieved from https://search-ebscohost-com.ezproxy.ccu.edu/login.aspx?direct=true&db=ccm&AN=107208741&site=eds-live

Edwards, M. T. (2018). An assessment of the impact of just culture on quality and safety in US hospitals. American Journal of Medical Quality, 33(5), 502-508.

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A Just Culture in Health Care

I need help to respond to fellow student’s response. Thank you

Peer Response:

RE: A Just Culture In Health Care

A Just Culture in Health Care

Hi! It is unfortunate that the Just Culture has not been truly actualized by healthcare organizations. You state how one potential situation might be that employees are not trusting and may fear for their jobs if they report errors made on their part. I do agree that this would hinder reporting. Do you think that despite the Just Culture’s implementation, that people still have these fears because our society truly exists in a blame culture? This is certainly still the case in some healthcare organizations. For example, according to The British Journal of Nursing, many nurses blame nurse managers when things go awry, because it is the managers who are overseeing the system, while the nurse managers feel the demands made on them are unrealistic (1999). Here we see a shifting a blame on both sides. Do you think this is insidious, and exists in our society’s culture as a whole, ultimately bleeding into our professional lives?

References

Why is there a blame culture in nursing? (1999) British Journal of Nursing, 8(2), 72. Retrieved from https://search-ebscohost-com.ezproxy.ccu.edu/login.aspx?direct=true&db=ccm&AN=107208741&site=eds-live