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The Cost of Saving a Life

What makes someone jump in a lake to save a drowning person? In the YouTube video “A drowning man, a selfless act, a life saved in Portland,” the urgency of knowing a life hung in the balance compelled a stranger to risk their own life to save another.1 Many of us in healthcare are trained for CPR and other emergency responses, but a layperson without experience has only adrenaline and compassion. For them, there is no other choice: do what it takes to save a life. What are the differentiating skills? First, assess the situation within seconds, and then immediately push through whatever the physical, mental, or emotional barriers are to provide the help that is required right now.

The man in the video didn’t have a lot of time to think about the fact that this was his first time attempting to save a drowning man, or that he wasn’t a very good swimmer. He was sitting on a bench, taking a break from a bike ride with his girlfriend when he saw the man struggling in the water. What makes some people willing to put their own life, job, and reputation on the line in order to do the right thing? What would we think of someone who watched a person drown and did absolutely nothing? Why do so many healthcare workers let fear of loss hold them back from doing what is right when a patient-safety issue arises? 

The significance of the problem
According to a recent news publication referencing a Johns Hopkins Medicine study, medical errors are the “third-leading cause of death in the U.S.” ranging upwards of 440,000 deaths per year. The article further states that, “Too often, the health-care system silences people around a problem.”2 As a category of medical errors, healthcare-associated infections account for 75,000 of that number in annual deaths, of which surgical site infections are over one-third.3

We see the numbers and they are so staggering. It’s hard to wrap our minds around it all because the problem seems too big. We have a saying in our society that one life lost is a tragedy but millions of lives lost are a statistic. That mindset helps us to detach from the atrocities of disaster, but it also leaves us desensitized to do anything meaningful about it. The internal conflict that each of us faces when encountering a significant safety issue must be resolved either by minimizing it through fear, or choosing to speak up and bring an issue forward.

There are two types of barriers when it comes to a hesitancy to speak up for patient safety: individual and structural. Individual barriers are within our control, while structural barriers require buy-in of the organization for sustainable change. Here are some questions to consider: If organizational barriers exist, how does one establish the skills necessary to advocate, regardless of personal risk? Is the cost (i.e., injury, suffering, or death of the patient) worth the risk (loss of job, how peers perceive you, etc.) if you don’t intervene?

Hesitancy to speak up
The hesitancy to speak up is rooted in the fear of personal loss. According to “Speaking up for patient safety by hospital-based health care professionals: a literature review,” several factors contribute to a reluctance to voice concerns about patient safety issues, and I have associated them with a related fear.4

Society expects all public servants, especially first responders and healthcare workers, to use their knowledge to do everything within their ability to help protect them. Many of us were drawn to work in healthcare because we genuinely want to help alleviate suffering, provide hope, and preserve life. It is for this same reason that firefighters are willing to go into the most dangerous situations and pull people from flames, even when a building is collapsing around them. It is also why paramedics, who are the first ones to a scene and encounter some of the most horrific accidents, still rush in to stabilize a person on the very edge of life and get them to a hospital.

Our communities depend on us to bring the best of ourselves to help them no matter what kind of day we are having. We enter the field of healthcare knowing that it is our duty and honor to serve. We are trained professionals. And we expect no less from public servants when we ourselves or someone we love is in need. Therefore, we really have to ask ourselves in all honesty, how much is a life worth? Is there anything we value more than life? Is our job really worth the sacrifice if our silence causes someone to die? Are these fair questions? If it was your life or someone you loved, would these questions run through your mind?

When other people are depending on us to provide for them, such as our children, the fear of loss is significant. It is true that losing a job could very well mean that we and our families may endure hardships and experience personal sacrifices, but if that is the worst thing that could happen to us, we still have resources to bounce back. Looking at the worst-case scenario, any circumstance we may go through as a result of advocating for a patient would be temporary, but a family can never replace a loved one that died from a preventable medical error. If we lose our job, we can get another one, but a person who dies of a medical error is gone forever. Mistakes will happen and we won’t always know in advance that we could have stopped the line, but we can build greater awareness to see opportunities when they arise. For the moments when we know there is a problem and we hesitate long enough to think about the cost before we speak, I hope this message empowers you to take a stand and speak up because it just might save a life.   

References

  1. Tomlinson, Stuart. “A drowning man, a selfless act, a life saved in Portland.” YouTube video, March 6, 2012https://youtu.be/Rn17NSxFyXo
  2. Sipherd, Ray. “The third-leading cause of death in US most doctors don’t want you to know about.” CNBC, February 22, 2018.https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html#:~:text=A%20recent%20Johns%20Hopkins%20study,after%20heart%20disease%20and%20cancer
  3. gov. “Health Care-Associated Infections.” Accessed March 19, 2021. https://health.gov/hcq/prevent-hai.asp
  4. Okuyama, Ayako; Wagner, Cordula; and Bijnen, Bart. “Speaking up for patient safety by hospital-based health care professionals: a literature review.” BMC Health Services Research, 2014. https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-61

Lisa M. McKown (Wakeman), MBA, CRCST, CIS, CHL, MBTI, is a manager of research and development for Beyond Clean. She graduated with a Bachelor of Science degree in Integrative Leadership and an MBA from Anderson University. Lisa is a doctoral student in the Richard Fairbanks School of Public Health: Global Health Leadership program through IUPUI in Indianapolis, IN. She also holds a certification as a Meyers-Briggs Practitioner, specializing in interpersonal communication. Lisa contributes as an SME volunteer for standards development and other industry-related projects that promote the sterile processing profession, including writing workshops focused on creating and revising questions for the IAHCSMM certification exams. As a healthcare professional driven to influence positive change for patient safety initiatives, Lisa is a catalyst for the advancement of infection prevention within sterile processing. Her passion is education and she is energized when she can use her experience to develop people.

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