Safety Culture In Nursing

Safety Culture in Nursing; Individual, practice and system causes of errors

Patient safety culture in healthcare is referred to by Balamurugan and Flower (2015) as being the overall behaviour of both organisations and individuals based on a shared set of values and beliefs that work towards decreasing the risks for patient harm. It is viewed by many as a performance shaping factor that acts as a guide to encourage healthcare workers to view safety culture as their priority in the workplace (Nieva and Sorra 2003). When positive patient safety culture exists, it enhances the standards of patient safety which includes the ability and readiness of the healthcare staff to report any major or minor incidences or errors associated with routine tasks

On this particular day, the guidance from my preceptor was non-existent. In total on our side we had seven patients, a mixture of both surgical and medical, within two four-bedded units. After receiving handover from the night staff, I began doing all the safety checks and regular checks that are completed at the beginning of each shift for every patient. It started off as a normal day, the nurse was giving me certain jobs for certain patients which I successfully completed, as the day went on I was doing more and more work eventually caring for the whole seven patients by myself with no help from my preceptor. I was no longer under the guidance of anyone, I was discussing patients with the doctors, I was ringing up the psychology team to review my anorexic patient, I was involved with all members of the multidisciplinary team. I asked for help at one stage with getting a post- operative appendectomy patient out of the bed and my preceptor had told me she would be down to help in a few minutes. As time passed she was nowhere to be seen which meant the post-operative patient remained in the bed. It was pivotal that this patient was mobilising by that afternoon to distinguish whether he was being discharged or

I felt swallowed up in all the work I had to do within such a short space of time. I panicked when thinking about the caseload I had to manage, I was asking myself questions like ‘how will I manage this?’, ‘is this possible?’. When asking for help at the beginning I felt intimidated by the senior staff and my preceptor as I had not been working alongside her for many days before this. This feeling of intimidation slowly decreased throughout the day as I knew I deserved help so I persistently asked but nothing changed. I felt very vulnerable during the day as I was only supernumerary and I had a huge patient caseload to myself with barely any assistance.

This incident was very unfair towards the patient’s and their families due to the fact that nurse patient contact was very limited therefore family and child centred care did not exist. I felt neglected on this day by my preceptor and subsequently felt l was neglecting my patients. The situation was hugely unfair on me as a student, this was clearly not the appropriate way for me to learn and the unacceptable pressure placed on me was not beneficial to myself or my patients which ultimately led to the safety of my patient’s being