Physician: nurses key to reducing hospital errors

December 20, 2003 -- Today's Baltimore Sun included reader letters about its December 14-15 story on efforts to reduce hospital errors after the dehydration death of Josie King at Johns Hopkins Hospital, including an astonishing letter by Dr. John F. Irwin of Catonsville arguing that "the answer to eliminating medical errors lies right in our midst--nurses."

Dr. Irwin, who we assume is a physician, asserts that nurses are "under attack" in the managed care system: "underpaid, under-appreciated, and overworked." However, as he notes, nurses are "the patient's best advocate during a hospital stay," serving as a check on "patient orders from doctors and pharmacies." He also explains that a "well-supported nurse" could have "realized that Josie King was dehydrated and alerted the physicians." Of course, because of the physician-centric nature of the original Sun piece, it isn't clear just how much support Josie King's nurses had, or what role that may have played in her death. And nurses do far more than check physicians' work and alert them to patient problems; they often initiate solutions to such problems, using their own skills and training. But Dr. Irwin's appreciation of the real nursing role is truly rare in the medical community. He concludes that "too many corners have been cut" in the current health care system, but that "[n]urses can lead us out of this mess if we let them. These are some of the points the Center itself made in analyzing the Josie King article.

The Center salutes Dr. Irwin, not because nursing depends on physician recognition, but for doing something we have not seen from many of his physician colleagues: making a serious effort to understand the importance of nursing, and offering nursing his public support. We can only hope that other physicians follow his fine example.

To see Dr. Irwin's letter to the editor click here and scroll about 5/8ths of the way down the page.