Regulatory justice following gross negligence manslaughter verdicts: Nurse/doctor differences.

Two professionals who treated Jack Adcock before his death were convicted of gross negligence manslaughter, receiving 24-month suspended sentences. His nurse, Isabel Amaro, was erased from the nursing register; but after reviews in the High Court and Court of Appeal, his doctor, Hadiza Bawa-Garba, was merely suspended. This article explores the proposition that nurses are at greater risk of erasure than doctors after gross negligence manslaughter through a close reading of the guidance for medical and nursing tribunals informed by analysis from the High Court and Court of Appeal in the Bawa-Garba cases. Examination of the relevant sections of the guidance for medical and nursing tribunals reveals no significant differences. An outline of the conduct that amounted to breach of duty of care by Amaro and Bawa-Garba shows that their conduct could satisfy the thresholds for erasure given in their professions' respective guidelines for tribunals. Both presented similar mitigating evidence, although this cannot be weighed heavily in a professional tribunal setting. Thus, Amaro was treated more harshly than Bawa-Garba without a simple explanation. However, I suggest that the Nursing and Midwifery Council's Conduct and Competence Committee made a mistaken 'presumption of erasure' for gross negligence manslaughter and misinterpreted the sway that sentencing remarks should hold over tribunals. Both of these types of error were criticised by the Court of Appeal in Bawa-Garba. Furthermore, the Conduct and Competence Committee did not flesh out its analysis of 'public confidence' or acknowledge Lord Hoffmann's caution against ending 'useful' careers for the sake of public confidence, but Bawa-Garba's legal team ensured these arguments were taken into account by the Medical Professional Tribunal. The Conduct and Competence Committee's failures are not inherent to Nursing and Midwifery Council procedure or policy. Rather Amaro's self-representation appears to have impaired her access to justice. Tribunals must accept their right, and responsibility, to reach their own conclusions.

Regulación de la Enfermería Española: incorporación a la profesión sanitaria (1850-1950) / Regulation of Spanish Nursing: incorporation into the health profession (1850-1950) / Regulation of Spanish Nursing: incorporation into the health profession (1850-1950)

RESUMEN OBJETIVO Conocer la evolución de la formación académica de la enfermería española (1850-1950), describiendo los cambios que la transformaron en profesión sanitaria. MÉTODO Investigación histórica en la modalidad exploratoria-descriptiva, con análisis e interpretación de información obtenida en bases de datos electrónicas, archivos nacionales, provinciales y municipales, Boletines Oficiales y Bibliotecas. RESULTADOS En 1850 coexistían diferentes categorías sanitarias, sin embargo, el título de enfermera no surgió hasta 1915. Con el auge que alcanzó la Salud Comunitaria durante esa época, en 1924, se funda la Escuela Nacional de Sanidad, creándose en 1932 las especialidades de Enfermero Psiquiátrico, Enfermeras Pediátricas y Enfermeras Visitadoras. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Entre 1915 y 1950 los profesionales de enfermería poseían formación universitaria, por tanto, a través del conocimiento científico estos sanitarios adquirieron una identidad propia dentro de las profesiones de la salud. Se logró proporcionar una asistencia especializada para el cuidado de personas.

ABSTRACT OBJECTIVE To know the evolution of the academic formation of the Spanish infirmary (1850-1950), describing the changes that transformed it into sanitary profession. METHOD Historical research in the exploratory-descriptive modality, with analysis and interpretation of information obtained from electronic databases, national, provincial and municipal archives, official gazettes and libraries. RESULTS In 1850 different health categories coexisted, however, the title of nurse did not emerge until 1915. With the boom that Community Health reached during that time, in 1924, the National School of Health was founded, creating in 1932 the specialties of Psychiatric Nurse, Pediatric Nurse and Visiting Nurse of Mental Hygiene. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Between 1915 and 1950 all nursing professionals had university training, therefore, through scientific knowledge these health professionals acquired their own identity within the health professions and they were able to provide specialized assistance for the care of people.

ABSTRACT OBJECTIVE To know the evolution of the academic formation of the Spanish infirmary (1850-1950), describing the changes that transformed it into sanitary profession. METHOD Historical research in the exploratory-descriptive modality, with analysis and interpretation of information obtained from electronic databases, national, provincial and municipal archives, official gazettes and libraries. RESULTS In 1850 different health categories coexisted, however, the title of nurse did not emerge until 1915. With the boom that Community Health reached during that time, in 1924, the National School of Health was founded, creating in 1932 the specialties of Psychiatric Nurse, Pediatric Nurse and Visiting Nurse of Mental Hygiene. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Between 1915 and 1950 all nursing professionals had university training, therefore, through scientific knowledge these health professionals acquired their own identity within the health professions and they were able to provide specialized assistance for the care of people.

Epidemiology of medico-legal litigations and related medical errors in Central and Northern Saudi Arabia. A retrospective prevalence study.

OBJECTIVE: To study medico-legal litigations and related medical errors in Central (Al-Qassim), and Northern (Hael) districts in the Kingdom of Saudi Arabia (KSA), and to identify types and causes of errors to reduce medical errors and patient harm. METHODS: This retrospective prevalence study was carried out between May 2010 and December 2011 to analyze medico-legal litigations in Al-Qassim and Hael districts that were investigated by the Al-Qassim Medico-Legal Committee, Al-Qassim, KSA. Final verdicts issued between 1992 and 2009 included 293 cases. RESULTS: The patient`s mean age was 29.5 years. Fifty-seven percent of the patients were females, and 92% were Saudis. The Obstetric and Gynecology department was involved in 29.7% of litigations followed by General Surgery, and Pediatrics (11.3% each). Of the 635 defendants, 90% were physicians, and 7.6% were nurses. Investigations showed no error in 47.1% of cases, error but no harm in 11.9%, and error resulted in harm in 39.6%. Errors were negligence (45.8%), wrong diagnosis (14.2%), surgical error (10.3%), and administrative error (5.2%). The average total duration of litigations was 13.9 months. Type of harm was the most significant predictor to determine a guilty decision (p<0.001). CONCLUSION: Obstetric practice in Al-Qassim and Hael districts and provider negligence contribute to a large portion of medico-legal litigations, and therefore this has to be further studied to recognize the specific causes and possible interventions. A systematic review of the medico-legal committee is needed to shorten the long duration of litigation.

Mulher, maternidade e trabalho acadêmico / Women, maternity and academic work / Mujer, maternidad y trabajo académico

Objetivo. Descrever a vivência do trabalho acadêmico e da maternidadedas professoras universitárias. Metodologia. A investigação se realizou de dezembro de 2003 a dezembro de 2005 e se coletou informação das histórias de vida e das entrevistasreflexivas a cinco professoras de uma universidade pública de São Paulo (Brasil). Resultados. A análise dos dados compreendeu dois eixos: a história de cada “uma” e a história de todas “elas”, que levou às categorias empíricas: maternidade, relaçõesde gênero e trabalho acadêmico. Os resultados assinalaram que o trabalho proporciona a realização profissional, ao afirmar-se como profissional e ao poder prover a manutenção da família, mas essa afirmação poderia ser secundária ao universo familiar e relacional que apóia as realizações individuais. Conclusão. A maternidade foi o elemento desencadeador de questionamentos do caráter mítico de mulher “realizada”, o que levou a reflexionar sobre si mesmas, o trabalho e sua relação com os filhos e esposo.

Objetivo. Describir la vivencia del trabajo académico y de la maternidad de las profesoras universitarias. Metodología. La investigación se realizó de diciembre de 2003 a diciembre de 2005 y se recolectó información de las historias de vida y de las entrevistas reflexivas a cinco profesoras de una universidad pública de São Paulo (Brasil). Resultados. El análisis de los datos comprendió dos ejes: la historia de “cada una” y la historia de “todas ellas”, que llevó a las categorías empíricas: maternidad, relaciones de género y trabajo académico. Los resultados señalaron que el trabajo proporciona la realización profesional, al afirmarse como profesional y al poder proveer la manutención de la familia, pero esa afirmación podría ser secundaria al universo familiar y relacional que apoya las realizaciones individuales. Conclusión. La maternidad fue el elemento desencadenador de cuestionamientos del carácter mítico de “mujer realizada”, lo que llevó a reflexionar sobre sí mismas, el trabajo y su relación con los hijos y esposo.

Objective. Describe the experience of academic work and motherhood of university professors. Methodology. The study was conducted from December 2003 to December 2005 and collected information on the life stories and thoughtful interviews with five teachers at a public university in São Paulo (Brazil). Results. The data analysis included two axes: the story of "each" and the story of "all", which led to empirical categories: Motherhood, gender relations and academic work. The results indicated that the work provides a professional performance, to assert itself as a professional and to provide family support, but that statement could be secondary to family and relational universe that supports individual accomplishments. Conclusion. Motherhood was questioning the trigger element of the mythical character of "woman made", which led to reflect on themselves, the work and its relationship with the children and husband.

Nursing culpability: a proposal for change in nursing regulation.

Nurses make mistakes. They work in a complex environment which can sometimes be a contributory factor to a mistake being made. At present, Nurses' Boards in Australia have no mandate to investigate the circumstances in which a mistake is made. Their jurisdiction is limited to investigation of the individual nurse. This article sets out the argument for change in nursing legislation to allow for a broadening of the role of Nurses' Boards. It argues that an extension of their jurisdiction explicitly to allow them to investigate inadequacies in the health system would be a constructive development.

[Forensic medical evaluation of flaws in medical care rendered at public health institutions in the Russian Federation]. / Sudebno-meditsinskaia otsenka defektov okazaniia meditsinskoi pomoshchi v uchrezhdeniiakh zdravookhraneniia Rossiiskoi Federatsii.

The authors analyze the flaws in medical care rendered at various public health institutions by the results of 2436 expert committee conclusions, verified at bureaus of forensic medical expert evaluations. The essence and causes of these defects at the hospital and prehospital stages of medical care, rendered by physicians of different specializations and nurses, are analyzed.