A Medication Error and Legislation Designed to Punish: The American Association of Nurse Attorneys Defends Just Culture in Nursing

• Automatic, mandatory revocation of a nursing license without the opportunity of a hearing and investigation of the facts violates the right of due process.
• Boards of Nursing are enacted by state legislature (and territories) with full authority to enforce their Nurse Practice Act.
• The “Just Culture Model” is the established method of investigating error and seeks to promote a nonpunitive, supportive environment that promotes quality and safety over punishment and blame.
• Nurses must be proactive in educating lawmakers and the public about the importance of patient safety and quality measures including promoting a nonpunitive response to unintentional medical error.

This article was authored by The American Association of Nurse Attorneys (TAANA) in response to a bill proposed by a South Carolina senator that would require revocation of a nurse's license if a medication order was “misread” resulting in an over/undermedication administration. TAANA believes that the proposed law is unconstitutional because it violates dues process, usurps the authority of the board of nursing, and does not comport with the Just Culture Model, which promotes patient safety by encouraging a nonpunitive culture of transparency to address medical errors that occur as a result of unintended human error.