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July 22, 2006

Medication errors harming millions?

It's a funny thing, you know, medication errors. But probably not how you're thinking it. In a retail setting, a pharmacist makes an error, and depending on what part of the country s/he lives in, and who he works for, it can be all over the news. Basically, it's a publicity circus.

On the other hand, you've got hospitals where errors occur almost daily. In fact, these errors occur more often than you'd think:

Mistakes in giving drugs are so prevalent in hospitals that, on average, a patient will be subjected to a medication error each day he or she occupies a hospital bed, the report by a panel of experts said.

You don't hear about these errors on the news, though. Probably because it's prohibitively costly to figure out who is actually at fault, and they're just so common. This news about the alarming number of errors you'll find in institutional settings is nothing new to healthcare professionals — we've all known about it for a while. The problem is fixing it.

As the article says, there are changes that could and should be made. No single change, of course, is a panacea. Incremental change is what will bring about real results, and it will happen in time. There are lots of great suggestions that the article mentions: e-prescribing — though I don't think bad handwriting is as much of a problem as it once was — barcoding patients, etc.

But they all miss one key problem.

Caring. The problem is that it's not the doctors administering medications to the patient. They simply don't have time. Nor is it the pharmacist. It falls to the nurses and nurses' aides to handle this responsibility. And for some of these people, their job is just that: a job. It's not a profession. It's not something to necessarily take pride in. I read this editorial the other week, and it scratched an itch I've been having for a little while now: the fact that many people lower on the medical profession's totem pole just don't give a damn.

And that bothers me. I think if we could get everyone on the caring and pride bandwagon, we'd see the number of medication errors decrease. As it stands now, dispensing "all these meds" is just something to be gotten out of the way. And I think it's sad, but an unfortunate occurrence because of the "cheaper, faster, more" mantra that the healthcare profession has slowly taken on over the last 10-15 years. It's not all bad, of course, but if we could get everyone to actually care and respect the people that they administer medications to as real, living, breathing human beings, developments like barcoding patients would only result in minor improvements because there wouldn't be a systemic problem to begin with.

Unfortunately, there is no easy solution to the above problem that I can come up with.

(Incidentally, when I speak of nurses, I use the term in a broad sense of the word to include nurses aides, etc. I should clarify that most of the negative things I've said above don't apply to RN's with a four-year degree and NPs. And I'm not saying that you need a 4-year degree or better to be good at what you do and take pride in it and not make mistakes. In general, someone who "hand-picked" their profession tends to take take more pride in the quality of their work than someone over who fell into it as a means to pay the bills. This means that those who went to school for it generally have a tendency to care more because they've invested themselves in whatever it is they're doing. This compared to someone who got a six-week certificate and goes to their 10-6 wondering how they're going to make that payment on their brand new Expedition with 24" rims, *and* afford rent on their 2-room ghetto apartment in between text-messaging their girlfriends. An extreme stereotype, sure, but I think you know the type of people I'm referring to…)

[tags]Medicine, pharmacy, nursing, medication errors, personal responsibility[/tags]

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