One thing will always turn a bad situation into something much worse: lying about the bad situation. As humans, we're all capable of making mistakes and errors in judgment. Because none of us is immune, most people can ultimately move forward and chalk up an event as a learning or growth opportunity. But when the person involved doesn't demonstrate integrity in owning the mistake, an entirely different set of potentially serious and long-ranging consequences may follow.
Integrity is the foundation of our judicial system and a core expectation of professional nursing practice. It's intrinsically connected to personal ethics and manifested through accountability for one's actions. Integrity requires the courage to be honest no matter what the situation. I've come to believe that although nursing skills and knowledge can be taught, integrity stems from deeper lessons learned about morality that originate in a person's upbringing and character development.
Patient safety depends on professional integrity. When an error involving a patient is recognized, it must be immediately reported and addressed to protect the patient. It also must be disclosed to the patient or the patient's family and sometimes even to regulatory bodies, such as The Joint Commission, according to institutional policies and procedures. These aren't easy conversations to have, but they're essential to preserve trust, to intervene effectively, and to objectively discern preventive actions to avoid future occurrences.
But if someone attempts to alter the facts and that breach of integrity is discovered, a whole host of negative consequences are likely, including significant damage to one's reputation, possible termination of employment, and perhaps even sanctioning by the professional regulatory board. Clearly, there are personal, professional, and employment repercussions to any attempt at a cover-up.
Practicing with integrity is a conscious choice. No matter how scary or difficult the situation, honesty is always the best policy. As a leader, I think we need to proactively talk about this subject a lot more on nursing units and within healthcare teams. Being honest won't always protect a nurse from having to face consequences, but it will serve as the best way to protect the nurse's professional reputation and moral character as well as the patients in his or her care.
Until next time,
Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM
Editor-in-Chief, Nursing2015 Vice President: Emergency & Trauma Services Christiana Care Health System, Wilmington, Del.