Do current healthcare systems effectively encourage nurses to stick to protocol?
When you drive on the motorway, do you stick to the speed limit? I don’t. If the car I’m driving doesn’t shudder and break I drive at a comfortable 75 mph and 80 if I’m feeling annoyed or reckless, or if I’m pushed for time. They’re not great reasons, but they’re true.
So what pressures can encourage you as a nurse to break the rules? Are the reasons the same? Are you less likely to follow hand hygiene protocol if you’re pushed for time, you feel you’re not likely to get caught or if you have more of a natural propensity to take risks?
An interesting talk at this week’s Patient Safety Congress 2011 by John Pickles, associate medical director for patient safety, Luton and Dunstable Hospital NHS Foundation Trust, discussed human behaviour and risk taking in healthcare.
He said that driving on a motorway can be compared to working in healthcare. Factors that influence a nurse’s behaviour at work may be their pressure to hit targets, good or bad interaction with technology and increase in patient demand - just as you might start pushing 80 if you’re running late.
But the real question isn’t why do some nurses break the rules, as pointed out above – everyone does. But more important than that is the question – do the healthcare systems currently in place effectively encourage a culture of protocol compliance?
John emphasised that we need a culture of openness between staff at different levels that will encourage people to admit their mistakes and discuss what’s going well and what’s not – without the fear of being blamed and reprimanded.
Not that he encouraged a totally blame-free culture, but a culture where nurses and other staff communicate openly. “Is it working?” “No.” Well then let’s change things.
Will healthcare settings ever be able to be fully open – and will this really encourage professionals to stick to the speed limit?