Linda A. Treiber

Devastatingly Human: An Analysis of Registered Nurses’ Medication Error Accounts

Despite many safeguards, nurses make the majority of medication administration errors. The purpose of our research was to investigate the perceived causes for such errors and to better understand how nurses deal with them. We performed an interpretive analysis of 158 accounts by nurses who made self-identified medication errors. We found common themes among these accounts. First, although nurses admitted responsibility for errors, they simultaneously identified a variety of external contributing factors. Second, nurses’ accounts were often framed in terms of “being new,” with the underlying background expectancy of inexperience. Third, emotionally devastating visceral responses to errors were common and often incongruent with error severity. Fourth, nurses had to deal with fear. Fifth, nurses voiced frustrations with technologies and regulations. Sixth, embedded within many of the accounts was a “lessons learned” theme, through which nurses developed “personal rules” as a result of an error. We conclude with suggestions for additional research.

The role of ‘workplace family’ support on worker health, exhaustion and pain

The goal of this study was to improve understanding of the potential health benefits of social support at work. We utilized 2002 GSS data to examine the relative influence of workplace support on self-reported health, exhaustion and experience of persistent pain in a sample of 1602 workers. Building on previous Demand-Control-Support models, we examined co-worker, supervisor, and organizational safety support (conceptualized as ‘workplace family’) in concert with job demands, job control and work-family conflict as predictors of worker health measures. We further tested the extent to which work-family conflict acted as a mediator between family and work characteristics and worker health outcomes. We found that increased co-worker support in the workplace was associated with better worker self-reported health, lower exhaustion and less pain. In addition, higher levels of perceived organizational safety support were associated with better self-reported health and lowered exhaustion. There is little evidence that work-family conflict mediates between work and family characteristics and worker health, and work-family conflict does not mediate the relationship between workplace family measures and worker health. We discuss results in light of workers’ changing and expanding definitions of family, with implications for changes in the organization of the workplace to improve workers’ health.

Dual, Yet Dueling Illnesses Multiple Chronic Illness Experience at Midlife

The prevalence of multiple chronic illnesses is increasing dramatically, especially among those in middle adulthood, yet much prior research has focused on the experience of multiple morbidity among older adults. We examined the online illness narratives (blogs) of 10 men and women aged 36 to 59 to better understand the experience of living with multiple chronic illnesses at midlife. Multiple morbidity presents distinct challenges to those at midlife: (a) diagnosis and management of multiple illnesses, (b) need for information, (c) identity dilemmas and threats to self-image, and (d) stigma and social rejection. Relinquishing the work identity was especially difficult for participants because it threatened to foreshorten middle adulthood and push them prematurely into late adulthood. Participants used their blogs to revise their identities, alleviate isolation, and inform and guide others.

The care/cure dichotomy: nursing's struggle with dualism

A care/cure dichotomy exists between nursing and medicine. Consistent with the nature of most dichotomies, where one part dominates, medicine has emerged as the more valued and prestigious half of the dichotomy. Nursing has steadfastly adhered to the science of caring which, in many ways, impedes the ability to move beyond the dualism of care/cure. This analysis examines the origins and endurance of the care/cure dichotomy in nursing as both externally and internally imposed.

More Than 1 Million Potential Second Victims: How Many Could Nursing Education Prevent?

Any error made in health care can cause the health care provider to become a second victim. There are many initiatives, tools, and instruments designed to support second victims after an error has been made. The role that nursing education can play in preventing nurses from becoming second victims has not been well explored. This article presents a study designed to investigate perceptions of recent BSN graduates about preparation for medication administration, medication error, and their personal experience with error making and second victimhood.

Safety or Control? Workplace Organization and Occupational Health

Using labor process theory and epidemiologic models as a framework, this study analyzed relationships between task exposures, worker labor process control, perceived safety climate, and three dependent measures of adverse occupational health: workplace injury, exhaustion, and health status among a national sample of employed adults (n = 1,607). Multivariate analyses confirmed that task demands of heavy labor were associated with workplace injury above baseline individual and job characteristics. Consistent with previous research, results indicated worker control was associated with increased health. Reliable co-workers were associated with less exhaustion, and working fast was associated with greater exhaustion. My results implied that increased safety climate was associated with fewer injuries, less exhaustion, and increased health. Safety climate did not account for associations between task exposures, labor process control, and work place injury or exhaustion. Results suggested that part of the influence between labor process control and health status occurs through improvement in safety climate.

After the Medication Error: Recent Nursing Graduates' Reflections on Adequacy of Education

BACKGROUND The purpose of this study was to better understand individual- and system-level factors surrounding making a medication error from the perspective of recent Bachelor of Science in Nursing graduates. METHOD Online survey mixed-methods items included perceptions of adequacy of preparatory nursing education, contributory variables, emotional responses, and treatment by employer following the error. RESULTS Of the 168 respondents, 55% had made a medication error. Errors resulted from inexperience, rushing, technology, staffing, and patient acuity. Twenty-four percent did not report their errors. Key themes for improving education included more practice in varied clinical areas, intensive pharmacological preparation, practical instruction in functioning within the health care environment, and coping after making medication errors. CONCLUSION Errors generally caused emotional distress in the error maker. Overall, perceived treatment after the error reflected supportive environments, where nurses were generally treated with respect, fair treatment, and understanding. Opportunities for nursing education include second victim awareness and reinforcing professional practice standards. [J Nurs Educ. 2018;57(5):275-280.].

Cascading Losses A Case Study of Suffering From AIDS and Head and Neck Cancer

In this case study, we analyzed an online illness narrative written by a middle-aged man living with HIV/AIDS who received a diagnosis of squamous cell cancer of the tongue. We found that the onset of a second illness initiated a series of cascading losses that became increasingly problematic, severe, and interconnected. In response to these losses, the author developed several coping strategies, including sharing his story with others and engaging in magical thinking. The findings of this case study broaden our understanding of what it means to live with a complex and unusual combination of illnesses. We conclude with implications for practitioners and scholars engaged in the sociology of loss.

McJobs and Pieces of Flair Linking McDonaldization to Alienating Work

This article offers strategies for teaching about rationality, bureaucracy, and social change using George Ritzer’s The McDonaldization of Society and its ideas about efficiency, predictability, calculability, and control. Student learning is facilitated using a series of strategies: making the familiar strange, explaining McDonaldization, self-investigation and discovery, and exploring and implementing alternatives. Through assignments, class exercises, and films, students contextualize modernity and its unintended negative consequences by viewing McDonaldization though the lenses of work and jobs. These strategies provide a framework to help students understand key concepts, critique McDonaldization, and formulate positive ways to cope with Weber’s iron cage.