Nurses’ Mistakes Cause Thousands of Deaths

C H I C A G O, Sept. 10, 2000 -- Poorly trained or overwhelmed nurses areresponsible for thousands of deaths and injuries each year in thenation’s hospitals, according to a Chicago Tribune investigation.

Since 1995, at least 1,720 hospital patients have beenaccidentally killed and 9,548 others injured from mistakes made byregistered nurses across the country, the Tribune’s analysis of 3million state and federal computer records shows.

“I wake up every day and hope I don’t kill someone today,” said registered nurse Kathy Cloninger. “Every day I pray: God protect me. Let me make it out of there with my patients alive.”

Mandatory overtime and 16-hour shifts have led to fewer nurseswho are willing to work at the University of Illinois at ChicagoMedical Center, where she has worked for seven years.

Last year, Cloninger accidentally over-infused an infant withliquid nutrients while rushing to reach another premature newbornin need of care. The baby, who received a 24-hour dose of nutrientsin less than 30 minutes, suffered no permanent injuries.

Nursing Staffs Hurt by Cutbacks

The Tribune’s investigation found cases where patients weregiven overdoses of medication or vital care was delayed, sometimesfor hours. It also found hospitals increasingly use part-timenurses from temporary agencies, who lack patient familiarity andtraining within specialties.

Nursing staffs have been the first target for cutbacks athospitals where profits have been squeezed by managed care programsand falling federal Medicaid reimbursements, said Rick Wade, seniorvice president for communications at the American HospitalAssociation.

The Tribune found that, since 1995, at least 119 patients havebeen killed and 564 others injured by unlicensed, unregulatednurses aides.

Aides, who earn an average of $9 an hour, are used to augmentstaffing but sometimes supplant higher-paid registered nurses.Under a cost-saving program in at least two Chicago hospitals,housekeeping staff assigned to clean rooms are pressed into duty asaides to dispense medicine.

Dangerous Staffing

One of the first lawsuits that targets corporate-level staffingdecisions rather than individual negligence is the case of61-year-old Shirley Keck, whose pleas for help went unnoticed untilit was too late.

In February 1998, Keck was one of 41 critically ill patients onher floor at Wesley Medical Center in Wichita, Kan. When shestarted having trouble breathing, her daughter, 29-year-old BeckyHartman, ran to the nurses station several times for help, but noone was there.

“There was nobody around,” Hartman said. “I was raising my voice and getting angry. I was so frustrated.”

Her lawsuit alleged that lack of monitoring by nurses — causedby short staffing — led directly to the permanent brain damage Kecksuffered.

The hospital agreed to a $2.7 million out-of-court settlement,but maintains that it was safely staffed.

Lack of Necessary Skills

The Tribune also cited several cases in which patients diedafter nurses performed delicate medical procedures without thenecessary training, failed to detect internal bleeding and failedto help patients go to the bathroom.

A November 1999 report by the Institute of Medicine said medicalmistakes kill anywhere from 44,000 to 98,000 hospitalized Americansper year.

That report also attributed the problem to basic flaws in theway hospitals, clinics and pharmacies operate. After the report,President Clinton said hospitals should agree to routine reportingof serious and deadly mistakes.

Later, another group of researchers issued a report that saidthe Institute of Medicine’s conclusions were exaggerated.

However, the Tribune’s findings are no surprise to the nursesthemselves.

In testimony prepared for a national meeting on Monday, theAmerican Nurses Association said there is a critical need forresearch that would explore the relationship of staffing levels andskill mix and the number of medical errors.