The Pathology of Patient Safety

Antique Steam Engine (It Still Works) photo: jparadisi

The other day I said something I regretted while giving a medication during a procedure. Before giving the med, I verified the dose, and patient’s name against the signed and dated physician’s order and the medication label. I checked the volume and rate of administration. Then I said something stupid: I apologized for my “perfectionism” to the patient and the physician, demonstrated by performing The Five Rights of Medication Administration:

  1. The Right Patient
  2. The Right Medication
  3. The Right Dose
  4. The Right Route
  5. The Right Time

My apology struck me as handmaiden-like behavior.  So, I said out loud what I was thinking: “When did doing something the right way become “perfectionism”? Shouldn’t performing safety procedure be the bare minimum standard of health care?” The physician gave quick and sincere agreement in answer to my question. He wasn’t annoyed by the small delay; he appreciated it. So did our patient.

So why did I apologize in the first place? I am offended when I hear nurses label coworkers as “perfectionists” or even “OC,” for taking the time to insure the five rights of medication administration or follow any safety policy governing patient care. It is the perception of these nurses that this behavior slows down the flow of patient care. When did looking up and following safety policies become pathology, the behavior of a disease? David says it occurred when “Right Now” was added to the Five Rights of medication administration.


  1. I am going to have to repeat this to my gf who always says she is OC at work…you have a great point here… why do we have to apologise for doing something ALL nurses SHOULD be doing…


  2. David is exactly right. When did ALL of the care we provide become urgent and treated like an ongoing emergency? And when did this “emergency” start to overshadow safety for the patient.. and the nurse?


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