Temple nurses favor new approach to dealing with staffers’ mistakes

Nurses at Temple University Hospital say there’s a better workplace atmosphere at the hospital along with a new approach to dealing with staffers after a medical mistake.

 

When Temple nurses returned from a bitter strike in 2010, tensions between management and workers lingered. Nurses union leader Maureen May says for three years the workplace environment was “punitive.”

“Ugly. It was not a cooperative, collaborative relationship,” May said. “They were still very angry with us.”

Mistakes are a fact of life in health care, but May says the discipline that Temple managers meted out sometimes did not distinguish errors caused by negligence from mistakes linked to staffing problems or system issues.

After the strike, May said, Temple fired or suspended an unprecedented number of health workers because of medical mistakes.

“I’ve been at Temple for 16 years. In the first 13 years I was here, we had less discipline, than we had in the last three years,” May said.

As example, May offered the case of a nurse — distracted from her duties — who lost her job when she gave a patient the wrong medicine.

“She had self-reported, she had notified the charge nurse. She had even come into meetings to try to correct and make a better workplace with management and they still terminated her,” May said.

Fear of firing forces nurses to hide their mistakes, May said.

Temple responded to the claim of a “punitive” work environment in a written statement, saying the hospital would not engage in “rhetoric in the media or comment on inaccurate or misguided impressions of hospital policy.”

A change

Last month, management and the union brokered a new contract, and both sides characterized those negotiations as respectful. At that time, the Temple branch of the Pennsylvania Association of Staff Nurses and Allied Professionals union cheered the hospital’s plan to adopt a new set of guidelines to manage discipline after a medical mistake.

The hospital’s statement to WHYY/NewsWorks this week also acknowledged a change—”industry-standard algorithms as a framework for decision-making” — will be “formalized” in coming months.

“We continue to emphasize personal accountability and evidence-based protocols in the provision of safe patient care,” the statement said.

Union leader and registered nurse Francine Fregghi said she’s already witnessed the new approach result in counseling and coaching, instead of job-threatening punishment.

“When you walk through it,” she said. “You get a light bulb. ‘Ah, that’s where I went wrong.’ That’s more productive for the patient and the environment at Temple,” Fregghi said.

What’s still not clear is whether Temple will adopt a branded management tool called the “Just Culture” community model which has been used in the airline — and other high-stakes industries — or if the hospital will use some of its tenets.