Letters to the Editor is a periodic function. We welcome all comments and will publish a range. We edit for size and readability and require full names.

Nursing on Trial

It’s about time that nurses are held accountable for his or her jobs (“As a Nurse Faces Prison for a Deadly Error, Her Colleagues Worry: Could I Be Next?” March 22). A number of measures, coaching, and laptop techniques are already in place to attempt to make sure that nurses don’t make medicine errors. However they only ignore them or manually override the pc. Medicine errors had been rampant at my final hospital job. Each hospital has an nameless system the place any worker can report these sorts of errors. I reported a number of medicine errors, and nothing was ever completed about it. No conferences, no emails, no “right here is an instance and we have to do higher.” So I gave up reporting them on the system.

A number of days earlier than I retired, I used to be telling the evening nurse a couple of med error I prevented on a brand new affected person admitted the evening earlier than. Seems she was the one who made the error! Her response was, “Shouldn’t pharmacy have caught that?” She took no duty for not clarifying the order. And he or she had been a nurse for over twenty years. And the med error was near an overdose quantity, in line with the pharmacy.

My expertise was that there’s little or no accountability in nursing except a supervisor doesn’t such as you. It has nothing to do with the power to do the job or affected person security.

— Phyllis Mitchell, Laguna Woods, California

— Tom Wriggins, Naples, Florida

I’ve been a registered nurse for 2 years and was a licensed sensible nurse for 10 years. What RaDonda Vaught did is abysmally fallacious on so many ranges. I can not imagine the variety of licensed professionals attempting to defend pure malpractice and negligence (“Reaction to the RaDonda Vaught Verdict: KHN Wants to Hear From Nurses,” March 30).

This isn’t a “system downside,” it’s a RaDonda downside. You’re telling me she must be exonerated after blowing previous 10 enormous pink flags?! They stated “Cease what you’re doing and ensure that it’s appropriate. It is a PARALYTIC drug.”

No extra system checks would have made a distinction as a result of she ignored each single one which got here up.  Medical professionals rely method an excessive amount of on know-how. Blaming know-how and “the system” are poor excuses for what occurred.

If I used to be consuming, then determined to drive my automobile at 80 mph by a neighborhood, blast by cease indicators and pink lights and kill a baby, ought to I be forgiven with a slap on the wrist?

Pure and easy negligence. These individuals attempting to defend Vaught are all about skilled duty, and need RNs to be revered, however assume that is OK? The RN is knowledgeable, licensed nurse and is the underside line towards errors that slip by the system. If she would have taken two seconds to consider the 5 rights, this by no means would have occurred, no matter whether or not there have been issues with the automated medication-dispensing system. That is fundamental Nursing 101.

This case actually upsets me. The very fact nurses are attempting to shift blame away from her is alarming. And in the event that they’re nervous it might occur to them, then possibly they shouldn’t be working towards.

— Paul Dziejman, Depew, New York

this trial that resulted within the criminalization of medical errors additionally revealed systemic points within the hospital setting. if unaddressed, the priority of this ruling could have unfavourable impacts on the nursing occupation. #RaDondaVaught #PM760https://t.co/KKFOyEPtKv

— Katie Wee (@wee_insun) March 29, 2022

— Katie Wee, Boston

One necessary explanation for potential nursing errors not talked about within the article is understaffing. My RN sister’s intensive care unit expects as many as six nurses gone quickly, from her shift alone. And the more severe circumstances are, the much less possible even company nurses will settle for a place. Do devoted RNs keep for the sufferers’ sake, or go away to guard themselves? You may assist each sufferers and nurses by supporting secure staffing laws in your state.

— Gloria Kohut, Grand Rapids, Michigan

— Sunny Ro, Philadelphia

The Fallout of Prosecuting Medical Errors

Within the article “Nurse Convicted of Neglect and Negligent Homicide for Fatal Drug Error” (March 25), I discovered myself reflecting on my future nursing profession. Though it’s clear RaDonda Vaught was responsible of a medicine error that led to the loss of life of a affected person, I can sympathize. The hateful public ridicule she has been given and the defaming feedback from the prosecutors concerning her nursing character being “uncaring … and abandoning her affected person” are alarming. It creates an alternate narrative of what has taken place, and that’s that Vaught deliberately harmed a affected person, not unintentionally. Reporting any sort of medical error whether or not it’s small or massive is essential in figuring out issues of safety in nursing care and, with the dealing with of the Vaught case, some nurses could really feel that admitting to a mistake can price them their job and/or their life. To construct progress towards bettering well being care supply, the dealing with of medical errors must be judged pretty, and with out shaming nurses who’ve devoted their lives to defending and therapeutic sufferers. As acknowledged within the article, “Well being care simply modified endlessly,” and this creates an atmosphere of concern and distrust, and an unsupportive system for nurses to return.

— Katarina Velardez, San Francisco

Be frightened. For these of you concerned in making medical care safer and extra dependable, a latest prosecution of a nurse for a medical error could set our efforts for “Simply Tradition” again a number of a long time. We study, not blame. @AAPneonatal @D8Neonatal https://t.co/NpWqS5gfBh

— james barry (@skideepowder) April 1, 2022

— James Barry, Denver

I’m saddened that with all of the efforts made to advance affected person security that RaDonda Vaught was prosecuted versus Vanderbilt College Medical Heart and/or the drug-dispensing vendor.

We all know that medicine errors happen on daily basis and we have to repeatedly work to reengineer issues to make it onerous to make an error. Having been a nurse for a few years, I’m appalled on the manipulation of calling nurses who work in difficult circumstances heroes till one thing goes fallacious.

This error was fully comprehensible and predictable. To start with, after a long time, why are these techniques nonetheless not programmed to acknowledge each generic and model names? That alone would have prevented this medicine error.

Secondly, as with all damaged techniques, when there have been identified meting out points with the drug-dispensing system, why wasn’t Vanderbilt proactive? If nurses wanted to override the system routinely, why didn’t a patient-safety skilled conduct an FMEA (failure mode occasion evaluation) and take away all high-risk medication from the drug-dispensing machine?

Vanderbilt has failed sufferers and nurses and ought to step up. With out specializing in investigating what went fallacious and sharing the findings with different organizations, well being care can not study. Distributors for these techniques are additionally failing sufferers and nurses. Shouldn’t there be necessities by now for all searches on these techniques to incorporate each model and generic drug names?

Now we have created a distraction with this trial to mistakenly assist People really feel secure. We eliminated this “unhealthy” nurse, so we’re secure now. The reality is sufferers at the moment are much less secure than earlier than this verdict. Nurses all the time reside in concern of creating a mistake and inflicting hurt. We wrestle to proceed to work in environments the place our voices for affected person security usually are not heard and are silenced.

It is a step backward for all of American well being care wherein medicine errors stay the No. 1 sort of error. Now we have uncared for to be clear and discover ways to stop one other nurse from making the identical mistake. This has reaffirmed for me and different nurses that you may be requested to work your self to exhaustion, give all of your psychological and bodily power and be known as a hero as long as it advantages a company or society, however when one thing goes fallacious you may be unsympathetically discarded and made a villain. How unhappy.

— Carole Cassidy, Newtown Sq., Pennsylvania

She made a crucial mistake, however is she deserving of serving time in jail?

Nurse Convicted of Neglect and Negligent Homicide for Deadly Drug Error https://t.co/8DjvYVrolr by way of @khnews

— Garry Klein (@GarryfromIowa) April 6, 2022

— Garry Klein, Iowa Metropolis, Iowa

A Household Caregiver’s Plea

One other important a part of household caregivers must be a requirement for medical data to have the ability to be accessed by the household (“To Families’ Dismay, Biden Nursing Home Reform Doesn’t View Them as Essential Caregivers,” March 22). I’m the authorized guardian of my sister-in-law and don’t have any entry to her medical data. She shouldn’t be able to answering my questions precisely. I want to have the ability to see these data to observe her medicines and observe what care is being offered. It isn’t as in the event that they don’t use computer systems. It might require no further work on the employees’s half. And we should always have additionally entry to the identical data the employees sees. As a result of I’ve no entry to her data, it made no sense for me to proceed to take her to her personal physician or psychiatrist as a result of I can not reply the questions they ask about her exercise and her well being and consuming. I go to twice per week and do a few of the little issues that the employees misses. There are occasions I think a missed dose of medicine or a medicine change, however there isn’t a option to know for positive. I’m contemplating transferring her to a unique facility for that reason. I simply assume this can be a important a part of together with household, particularly if they’ve guardianship.

— Theresa Smith, St. Joseph, Missouri

Actually? There may be nothing “casual” about household caregiving. Household/shut pals are probably the most trusted allies & care coordinators for residents of LTC services. They’re important to the well-being of susceptible older adults. https://t.co/TI60SRGrmR by way of @khnews

— Lynn Friss Feinberg (@FeinbergLynn) March 22, 2022

— Lynn Friss Feinberg, Washington, D.C.

Issues About an Autism Remedy

I’m involved in regards to the article “Delays for Autism Diagnosis and Treatment Grew Even Longer During the Pandemic” (March 30) as a result of it doesn’t embody any enter from an really autistic grownup and it helps ABA [applied behavioral analysis] remedy because the gold normal for autism remedy, a idea dethroned by a number of latest research. I used to be just lately identified as autistic as an grownup and have completed hundreds of hours of analysis on what’s the greatest remedy for myself and an underage member of the family underneath my care.

ABA is extraordinarily costly and time-consuming and not proved efficient, in line with a recent study by the Department of Defense, and could be actively harmful to youngsters receiving the remedy.

As well as, the remedy follow is ethically questionable, because it was based by Ole Ivar Lovaas — sure, the identical man who based homosexual conversion remedy. And forcing an autistic child to “convert” to trying “regular” is equally dangerous.

Therapies that must be really useful for just lately identified youngsters must be occupational remedy, to find out sensory points and a sensory routine to help these wants; speech remedy (if wanted); and coaching within the collaborative problem-solving methodology by Dr. Ross Greene.

For extra skilled data than mine on the harms of ABA, see the work of the Therapist Neurodiversity Collective. Thanks on your consideration.

— Andrea Hebert, Nashville, Tennessee

You realize whats extra heartbreaking for fogeys who’ve youngsters with autism? Nothing will likely be completed to assist them in any respect. They had been deserted, and CNN article is a pretend concern contemplating they incited lockdowns and covid hysteria.https://t.co/QcgoA9rZhA

— Ndee -Jkid- Okeh (@Jkid4) March 29, 2022

— Ndubuisi Okeh, Capitol Heights, Maryland

Extra on Vaccines and Covid Transmission

As one in all your readers, I worth your general mission. I’m writing with concern in regards to the article by Aaron Bolton, known as “Patients With Vulnerable Immune Systems Worry Vaccine Exemptions May Put Them in Peril” (March 22). The premise of the article is that unvaccinated well being care employees are placing sufferers in danger, ignoring the broadly acknowledged indisputable fact that vaccination doesn’t stop, and even cut back, transmission. I’d count on better diligence in demanding objectivity out of your featured authors, reasonably than perpetuating fear-based claims that unfairly goal these front-line employees who’ve been working extra time for the well being of the general public.

This article presents info on the transmission of covid-19 which will assist inform which items you select to run sooner or later.

— Hannah Miller, Missoula, Montana

— Barbara Katz-Chobert, Philadelphia

Eradicating the Stigma of Miscarriage

I’m a scholar nurse at California State College-East Bay and am writing concerning the article “After Miscarriages, Workers Have Few Guarantees for Time off or Job-Based Help” (Jan. 26). I want to begin off by merely saying thanks. You mentioned a subject that has gone ignored for thus lengthy. It’s disheartening to learn that not even half of our nation has enacted legal guidelines that present paid sick go away for miscarriages. My hope is that articles like yours will enable us to have deeper, significant, and destigmatized discussions about miscarriages — and, extra so, to acknowledge the emotional, psychological, and bodily affect on anybody who could have skilled such loss.

— Catherine Zelidon-Sarcos, Pittsburg, California

Wonderful essay on how we will honor girls within the office. If we would like extra children, then we have now to worth girls at work.

After Miscarriages, Employees Have Few Ensures for Time Off or Job-Based mostly Assist | Kaiser Well being Information https://t.co/5oaNdqqAFR

— dacortright (@david_cort7) March 22, 2022

— David Cortright, Austin, Texas

Countering the ‘Abortifacients’ Argument

The morning-after tablet and IUDs work by stopping conception, not by stopping implantation (HealthBent: “As Red States Push Strident Abortion Bans, Other Restrictions Suddenly Look Less Extreme,” March 30). The hormonal IUDs create a mucus plug that forestalls the passage of sperm. Copper IUDs create a sterile inflammatory response that basically neutralizes the power of the sperm to penetrate the egg. Emergency contraception capsules stop ovulation. By perpetuating the anti-choice narrative that these strategies work by stopping implantation, you’re discouraging and stigmatizing their use.

— Amy O’Meara, Kamuela, Hawaii

You can not fully ban abortion, as a result of the far-right can’t even agree on what an abortion is. 18 weeks, 6 weeks, conception, contraception, masturbation, IVF. Each new restriction opens the door to an much more draconian regulation. https://t.co/0BUiRIC9xQ

— Trojan Horse Information (@realTHNews) March 30, 2022

— Kate Woods, Atlanta

The Value of Treating Troubled Youngsters

The $400-plus-a-day common reimbursement per youngster equates to nearly $148,000 a yr. That looks like lots to accommodate one in all these youngsters (“Montana Is Sending Troubled Kids to Out-of-State Programs That Have Been Accused of Abuse,” March 25). I additionally assume the story glosses over the challenges that these youngsters current to the faculties.

— Mike Morgan, Bozeman, Montana

— Ian O’Neil, Boston

Earlier than you write an article about out-of-state abuse and quote somebody …

“Transport these children out of state for remedy for behavioral and substance use issues comes with a excessive price ticket, and usually the youngsters’s points usually are not resolved or are even worse, stated Michael Chavers, CEO of Yellowstone Boys and Women Ranch. ‘Once they return to us, they return with worse outcomes and for increased price,’ Chavers told Montana lawmakers final fall.”

… you would possibly need to have a look at the background of the Yellowstone Boys and Women Ranch, because it had to pay out $300,000 in a boy’s sexual abuse case in 2018. Let’s clear up our yard first. Perform a little research earlier than throwing stones. The writer of the article ought to have completed higher analysis on the enterprise or individuals they had been utilizing as “consultants.” Disgrace on YBGR and Chavers for making feedback as if they’re with out issues.

— Kim Hover, Stevensville, Montana

Embracing Customized Drugs

Within the article “Big Pharma Is Betting on Bigger Political Ambitions From Sen. Tim Scott” (March 28), KHN describes the Customized Drugs Coalition and its work inaccurately for a second time (see additionally “A Senator From Arizona Emerges As a Pharma Favorite,” Might 29, 2020). PMC, a 501(c)(3) nonprofit group comprising 14 distinct stakeholder teams inside well being care, with the most important phase made up of “analysis, schooling, and scientific care establishments,” shouldn’t be a commerce affiliation and doesn’t symbolize any single trade or enterprise mannequin.

Furthermore, your implication that customized or precision medication jacks up the prices of pharmaceutical merchandise misses the mark. Its purpose, along with promising higher outcomes for sufferers, is to decrease systemic prices for well being care by making it extra environment friendly.

Customized medication has been proven to avoid wasting well being techniques cash whereas bettering affected person care. The Academics’ Retirement System of the state of Kentucky, for instance, has found that integrating genetic testing into prescribing selections saved the system $5,176 per enrolled member by focusing on therapies to solely these sufferers who will profit, sparing bills and uncomfortable side effects for individuals who is not going to. For most cancers sufferers, Intermountain Healthcare has also found that genomic testing can lengthen progression-free survival charges with out growing prices.

Sen. Scott could or could not have his eye on increased workplace, however he’s appropriate that we might do lots worse than embrace customized medication.

— Edward Abrahams, president of the Customized Drugs Coalition, Washington, D.C.

The Lengthy Arm of Huge Pharma

I simply realized about your web site, because of a latest each day present occasions evaluation completed by American historical past professor Heather Cox Richardson, which cited a hyperlink to the amazing webpage offering perception into Huge Pharma’s deep-pocket attain into Congress. I’ve nothing however admiration and appreciation for the work that went into making such a web page.

And I say that regardless of the unlucky private shock and bummer it was to see my congressman listed prominently because the “Freshman Favourite,” Rep. Frank J. Mrvan. Dwelling right here in Indiana means Eli Lilly has all the time had an outsize affect on societal affairs. So the truth that it’s on the very high of his listing of pharma donors is no surprise. However then there have been all the opposite pharma corporations beneath Eli Lilly — an eyebrow-soaring quantity, really.

As a result of the dates return to 2007, I had been hoping to match his repute towards his predecessor for this district, Pete Visclosky. The person was extremely esteemed and as such remained incumbent right here since I can keep in mind, at the very least since I used to be in highschool in 2000.

I hope your challenge can fill in knowledge on predecessor representatives. It might assist people like me contextualize simply how a lot pharma donations could have already been an issue. The underlying actuality is that every particular person receiving donations does so on behalf of a selected workplace — due to this fact, my pursuits as a citizen are aggressively purchased out.

I’d wish to know if my say with my earlier congressional consultant was diluted in any respect. Notably with regards to sure private elements of the pharmaceutical trade, just like the $16,000-a-month medicine that saved my mom alive for some time longer in her years-long struggle towards most cancers, which she maintained till at some point she couldn’t anymore. (With out the Inexpensive Care Act’s insurance coverage having “arrived in time” for her discovering a lump and being identified, our capacity to afford such a remedy would have been nonexistent.)

In different phrases: I’d very a lot recognize the chance to understand how offended and resentful, and due to this fact politically energetic, I must be with regards to the donation-driven affect pharma has had on this small little bit of democracy assigned to me, my household, my pals, and my house neighborhood by and massive. Thanks once more for the excellent work. It is rather, very appreciated!

— Tomas Feher, Chesterton, Indiana

— Dr. George Monks, Tulsa, Oklahoma

Combating Congenital Syphilis

It’s heartbreaking, but unsurprising, that the charges of congenital syphilis are growing within the U.S. (“Babies Die as Congenital Syphilis Continues a Decade-Long Surge Across the US,” April 12). Public well being departments are underfunded and reproductive rights have been underneath assault for a few years, particularly since Donald Trump’s presidency. The defunding of clinics, like Deliberate Parenthood, resulting from anti-abortion laws throughout the nation, additionally implies that many individuals looking for STD screening and remedy are dropping locations to take action. As a beginning employee in Los Angeles, I witnessed firsthand how lack of entry to well being care impacts communities of coloration by structural racism.

It’s unacceptable that infants are dying from a very treatable sickness, resulting from a scarcity of employees and sources to assist pregnant individuals with syphilis obtain the prognosis and remedy they want. Simply as we needed to get inventive through the pandemic, this well being downside requires inventive options, partnership, and know-how. How nice wouldn’t it be if a affected person might obtain their STD outcomes and directories of locations to choose up medicines to get remedy, simply as they will with covid-19. An answer should be discovered shortly. The well being and well-being of infants, particularly infants of coloration who’re being affected at increased charges, will depend on it.

— Sweet Ramirez-Hale, Oakland, California