Wall of Silence-Reflective Journal
Assignment Instructions: For this course, you will be reading The Wall of Silence by Gibson and Singh (2003). Please read the book according to the schedule, reflect upon what you have read, and complete the assignment as described. The purpose of this reflective assignment is to provide the approach for connecting The Wall of Silence, the course content, and your personal and professional experiences. You will complete four reflective journal entries, one for each section of the book. Submit each entry by the due date no exceptions. All entries require the use of APA (see rubric). There is no length requirement for any of the entries however, to earn all potential points you must demonstrate that you a) have read the book and required readings, b) applied the course material as necessary as demonstrated through citing/referencing of course materials, and c) reflected on all related components. You should cite and reference the book and all other necessary materials as evidence of your understanding of course materials. Entry #1: Based upon Gibson and Singh Part 1: Breaking the Silence. Gibson and Singh provided alarming statistics based upon the IOM’s 1999 report of 100,000 deaths per year due to medical errors. According to Gibson and Singh, this translates to 275 deaths due to medical errors every day. Based on the number of deaths known, and considering the potential number for unaccounted deaths, reflect on the book and address the following: 1.Describe your level of awareness of the prevalence of medical errors before this course and reading part 1. 2.Part 1 of Gibson and Singh details 10 patient-family accounts and their experience with medical error. Select one of the cases and discuss the following areas: a.Provide an overview of the case. b.Describe in detail your feeling as you read the story and part 1 of the book. c.What type of error occurred in the case? d.What quality and safety initiatives discussed in our course could have prevented the error? e.Why was this case so compelling to you? 3.It is acceptable to use first person in this entry. Support your entry with quotations from the book as needed and with literature and sources from our course. Follow APA format. Entry #2: Based upon Gibson and Singh Part 2: Why do medical mistakes happen? Gibson and Singh provided a detailed overview of why medical mistakes happen and they provided rationales behind the culture of cover-up in the health care environment. The culture of cover-up is contradictory to our professional code of ethics. 1.Discuss our role as nurses in developing a culture of safety interdependent upon a professional code of ethics. 2.Why is it that nurses fail to report errors and what are the consequences to the nurse, patient, facility, and system? 3.How does the nursing shortage affect safety and the potential for errors in the health care system? 4.How frequent and how significant are medication errors in your experience? 5.Describe in detail your experiences in managing, correcting, and documenting medication errors and explain how they affect your practice? 6.Do you believe quality improvement is really needed? Explain. 7.Support your entry with quotations from the book as needed and with literature and sources from our course. Follow APA format. Entry #3: Based upon Gibson and Singh Part 3: Silent white line Gibson and Singh described potential methods of regulation and reporting to better inform patients and consumers about their health care providers. 1.Explain how patients and consumers find valid and reliable information about health care providers and facilities. 2.In your experience, do patients and consumers investigate their providers or facilities before making selections? What about you, your friends, and family? 3.How do quality improvement systems affect regulatory and accreditation reporting and reimbursement? 4.Support your entry with quotations from the book as needed and with literature and sources from our course. Follow APA format. Entry #4: Based upon Gibson and Singh Part 4: Courage to change the things we can 1.Gibson and Singh devoted an entire chapter to the use of technology making health care safer. Examine your own feelings about developing competency in nursing informatics: What issues come to mind when you reflect on the need for all nurses to use information and technology to communicate, manage knowledge, mitigate error, and support decision- making? How does technology support safety at your facility? Explain how health system safety and technology will influence your practice in the next 10 years. 2.Gibson and Singh compared the current health care system to less flawed, safer industries, like aviation. How do you feel about safety and quality in health care when compared to the aviation industry? Support your entry with quotations from the book as needed and with literature and sources from our course. Follow APA format. 3.Open Communication Letter: Overall, this course and associated materials should have enlightened you as to the depth and breadth of issues related to quality and safety in our health care system. You should also have a broader understanding of how the issues you experience at the bedside are related to the overall system. For your Open Communication Letter, refer to the case you described in journal entry one (part 1) or to a specific case that you have knowledge of. Reflecting on that specific case and what you have learned from this course and readings, write a letter to either the patient or family from the perspective of the health care professional who made, discovered, investigated, resolved, or prevented the error. Submit this letter as an Appendix to entry #4. The letter itself does not need to be in APA format; instead, use the format for a professional letter. Required books: Gibson, R., & Singh, J. P. (2003). Wall of Silence: The untold story of the medical mistakes that kill and injure millions of Americans. Washington, DC: Lifeline Press. Textbook: Cowen, P. S., & Moorhead, S. (2011). Current issues in nursing. (8th ed.). St. Louis, MO: Mosby.
Wall of Silence
Name:
Institution;
WALL OF SILENCE
Introduction
Through its comprehensive evidence, Wall of Silence, a book by Gibson and Singh has brought out shocking experiences and stories of individuals that have been affected directly or indirectly by the incompetence tendency of the medical field. They have shared elaborative stories that regard patients that suffered ravaging injuries that emerge after medical mistakes. It is very traumatizing to people that live in disability and pain, loss of livelihood or loved one as well as the unreimbursed and recurring costs of being injured or disabled. The relatives of the individual that did not live to tell the story live in regrets and sorrow of wishing they had taken another step when physicians delayed or failed to communicate with their patients (Gibson & Singh, 2003). These issues that no one ever talked about them or even if they did were not heard, have been voiced in this wonderful masterpiece, which is very significant presently to hinder further cases of such kinds of death.
Entry 1: Breaking the silence
In my earlier years of living and ignorance, one observation has been clear, that physicians and all those people in the medical profession are more competent in their work. At least, that is what most people believe, until they get involved in a medical error. It could be due to ignorance or overreliance and trust of the people that view doctors like some small gods. However, this perspective has changed with time, as several complains of medical errors have been made in my hearing and worse still seeing the aftermath of the same. One of the first medical errors that I witnessed was very painful and even though it left no serious effects on me created fear of the qualifications of physicians (Gibson & Singh, 2003). This is because it happened to me that the physician had made several holes on my arm while looking for a vein, before getting it right. This was a moment of ailment where several prescriptions including injections are made. Such an incident can be disturbing and an individual starts to lose trust with such physicians. The other incident that I heard about was death of a young man who was involved in an accident but the doctors delayed to take him to theatre on time for operation. Moreover, a woman died when giving birth because the nurses left her saying that she was overreacting. The death that really disturbed me was that of friend’s wife who died in a cesarean section when she was delivering a baby, after she immediately started bleeding after she was sealed. The doctor who operated on her regretfully admitted that he had cut a vein while operating on her. Even after the knowledge of these cases, little did I know that cases of medical error could rise to a great plague, resulting to massive deaths. In fact the recorded number of deaths that happen as a result of the medical error may be quite less if the actual number is to be revealed. This could happen because of people that avoid publicity and continuous trauma if they voiced their concerns.
On the other hand, some victims and relatives to the victims decide to stand up for their rights and voice their pains and ordeal of such incidents. For instance, one of the stories in the book “Wall of Silence” contains groaning parents that lost their son at a very tender age, due to medical error made by the physicians. George and Ilene were the parents of Michael, a child whose enthusiasm brought hope and joy into the family that wished he would have lived to be a perfect and a great son. But this was cut short by short common illness whose practice of medication was questionable, leading to his early and grieving death. Michael had suffered the consequences of a medical error which turned a procedure of surgical routine into his death knell at the age of three years. The child is said to have undergone surgery after doctor’s recommendation that the tonsils and adenoids should be removed because they had started getting large as he grew. After the surgeon’s instructions of what the parents should look for when taking care of him they went home and much later Michael started bleeding. The first problem was bleeding was fixed when the surgeon cauterized the leaking blood but after persistence in the bleeding, the response offered by the nurses was not pleasing. The response from the medical side was too slow such that even after Ilene took her own son to hospital, she did not receive any help and instead was dismissed. The final visit to the hospital after more fear led Ilene and her son to being attended by an allergist that just gave them more instructions. After signs of recovery, Ilene reported back to work only to come back to her baby seater’s house after she received the news that he had vomited blood once again, marking the end of her son’s life.
This story brings a lot of sympathy to the parents of the deceased and stirs up great concern mixed with anger for lack of the sense of responsibilities that medical experts have. The young son should not have died because of ignorance and undiscerning tendency of the physicians. In addition, the kind of medical center described in the story reflects on professionals abandoning their duties and service to the public that they should be answerable to. This is evidenced by the two visits that Ilene made and missing both the surgeon and the doctor, inclining her to receive treatment and instructions from an allergist. The nurses involved in this case were also ignorant of their duties like reporting to the surgeon about Michael’s revisit to the hospital while he was absent. The main error noted in this case was the fact that the doctors did not enquire or make tests of the amount of blood that Michael was losing every time he bled. They failed to be keen on the matter and assumed that it was just a routine surgery that the parent is complicating. The administration of the medical center also failed to ensure that all the employees were responsible in their duties. This error could have been avoided in the first instance when the surgeon received the boy for excess bleeding, since he would have run some tests on him that would measure the amount of blood that he was losing. The institution should have also developed and adopted safe procedures and protocols for reducing operation and surgical errors. Technology would have also helped to conduct faster tests and detect any abnormalities of treatment that were reflected in the child. This case caught my attention because it involves an innocent soul, young and whose life was very promising. In the story, it is indicated that not only the parents of Michael were affected but the grandparents and other extended families, including the neighbors as well as the policemen that had responded to the emergency call. This implies that he was a jovial young boy who made every person happy. It was great life that was cut short by the ignorance of experts in the line of duty. In addition, I believe in justice and thus the case even contains the evidence from the final doctor’s report on the cause of the boy’s death, where he also mentions that an unusual and significant postoperative history had been ignored. The physician also stated that there was failure of determination of finding out the amount of blood lost, which resulted fatality in bleeding every time it happened.
Entry 2: why do medical mistakes happen?
As nurses we have vital roles in line of our duties and we should be committed towards ensuring that those roles have been satisfactorily met. This would be perfect in developing a safe culture that is interdependent upon professional code of ethics. All the nurses including the ones involved in administration, patient care, research as well as education should take up the best of behaviors in their work. We are always supposed to remember the standards of conduct which we know contain duties to maintain confidentiality, maintaining competence as well as safeguarding patients from unprincipled practice of other people. In all our professional practices, we should exercise respect and compassion for the inherent worth, dignity as well as exceptionality of every person. This should happen regardless of the people’s economic or social status, personal traits, or the kinds of health problems. As nurses, we are supposed to look forward to serving the community, group, family or individual, as our patient and this should be our primary commitment. In addition, we should always strive to advocate for, promote and strive to guard the safety, health, as well as rights of our patients. Nurses may fail to report the errors made because they are afraid that they would be blamed for their actions. They are not aware that once a mistake or error is done the best way to fix it ethically is by admitting that it existed. Thus, their failure to report the medical errors deteriorate their own career and those that are regretful may be affected by the damage they caused or witnessed from other physicians. On the other hand, they may develop into merciless beings that wouldn’t care about destroying someone’s life, which endangers the lives of people who are put under their care, especially in places like retiring homes (Gibson & Singh, 2003). In such a circumstance, a nurse’s code of ethics is questionable and may lead to the end of their career if this behavior persists, since there would be a likelihood of being sacked from work if the medical secto...