Exploring the experience of nurse practitioners who have committed medical errors: A phenomenological approach

J Am Assoc Nurse Pract. 2017 Jul;29(7):403-409. doi: 10.1002/2327-6924.12468. Epub 2017 Apr 27.

Abstract

Background and purpose: To explore the experience of committing medical error from the perspective of nurse practitioners (NPs). Overall, the purpose of the study is to discern NPs' behaviors, perceptions, and coping mechanisms in response to having made a medical error.

Methods: Qualitative research based on two face-to-face audio-recorded semistructured interviews with 10 NPs who had made medical errors in practice. The analysis was guided by concepts in phenomenology.

Conclusions: During iterative analyses, four overarching themes were identified: (a) The paradox of error victimization, (b) primacy of responsibility and mindfulness, (c) yearning for forgiveness and a supportive other, and (d) coping with a new reality is context dependent. The narratives strongly suggest that NPs who err experience "second victim" phenomena.

Implications for practice: Reminiscing about the experience of living through an error, NPs shared meaningful insights into their need for a safe environment in which they could candidly share feelings, reflect on the experience, and ascertain the etiology of the mistake. Debriefing in a formal manner might prevent the development of permanent psychological injuries. Hence, inherent to the care of "second victims" is the notion of co-workers' fairness, compassion, and recognition of appropriate caring responses that contribute to effective coping and healing.

Keywords: Medical errors; advanced practice nurse; medical mistakes; nurse practitioner; phenomenology; qualitative research; “second victim”.

MeSH terms

  • Adaptation, Psychological*
  • Crime Victims
  • Fear
  • Female
  • Humans
  • Life Change Events
  • Male
  • Medical Errors / nursing
  • Medical Errors / psychology*
  • Nurse Practitioners / psychology*
  • Nurse Practitioners / standards
  • Perception*
  • Qualitative Research
  • Social Responsibility