BUSI 344 Week 7 Discussion Board Forum 7 Example

Discussion Board Forum 7: Employee Relations, Discipline and Just Culture

BUSI 344 Human Resource Management in Healthcare Administration, Discussion Board Forum 7

Thread by [Student Name]

The hospital, the error and the classmates are composites; the textbook, Scripture and the peer-reviewed articles cited are real.

Last month, a nurse on our cardiac unit programmed an infusion pump with a tenfold dose of a heart medication. A second nurse, checking the pump during rounds, caught the error within twenty minutes, and the patient recovered, but the unit manager's first instinct was to suspend the nurse and place her on a final warning. Human resources was asked to process it. Niles (2013) describes progressive discipline as a sequence of steps, from coaching to warnings to termination, applied consistently and with respect for employees' rights, including the right to know the reason and to respond. Discipline is meant to correct behavior, but not every error is a behavior problem, and treating system failures as personal failings teaches staff to hide mistakes.

A just culture approach separates three kinds of events: honest human error, which calls for support and system fixes; at-risk choices, such as skipping a double check, which call for coaching; and reckless disregard for safety, which may warrant discipline. Our review found that the pump's drug library had not been updated and the nurse was covering two extra patients, which made this an honest error in a weak system.

The consequences of getting this wrong are real. Xu et al. (2025) surveyed 572 nurses and found that the distress of being a second victim of an error was positively associated with intention to leave. Martínez (2026) contends that safety practices succeed when colleagues hold one another to shared standards, and that blame-based accountability from above undermines it.

Our human resources plan adopts a written decision guide based on the three categories, requires a review by a manager and a safety officer before any discipline for an error and offers every involved employee counseling and a peer supporter. The nurse in this case received coaching and support, the pump library was fixed and the unit's staffing on nights was reviewed. She stayed, and three weeks later she was the one who caught a similar error on another unit. Paul instructed that anyone caught in a transgression should be restored in a spirit of gentleness (English Standard Version Bible, 2001/2016, Galatians 6:1). Punishing honest errors does not make care safer; it only makes errors harder to see.

Reply to Brianna

Brianna, your hospital has a zero-tolerance rule that any medication error leads to a written warning. I understand the wish to show that safety matters, and patients deserve that seriousness, but research suggests such rules may reduce reporting, because nurses who expect a warning have a reason to stay quiet about near misses. A review of dozens of studies on whether health workers voice concerns concluded that the surrounding culture largely decides it (Lainidi et al., 2023). Xu et al. (2025) linked the distress of error involvement to nurses' intention to leave, so automatic warnings may cost both safety and staff. Niles (2013) emphasizes that discipline should be consistent and fair, which is different from automatic. Micah calls God's people to do justice and to love mercy (English Standard Version Bible, 2001/2016, Micah 6:8). Could your hospital track whether error and near-miss reports fell after the rule took effect? A drop in reports would likely mean fewer errors seen, not fewer errors made.

Reply to Tyler

Tyler, you proposed a peer support program for staff involved in serious errors, staffed by trained volunteers from each department. The evidence suggests it addresses a real need that most hospitals overlook, since the patient's recovery usually ends the organization's attention to the event. Xu et al. (2025) found that second victim distress was associated with stronger intention to leave, and that posttraumatic growth partly offset that effect, which suggests support can help people recover. In addition, Heller and Souter (2024) note that training and institutional programs help clinicians handle the aftermath of adverse events, including disclosure to patients. The textbook treats staff well-being as part of the human resource mandate (Niles, 2013), so your proposal fits squarely within the department's work. Paul urged believers to comfort one another and build one another up (English Standard Version Bible, 2001/2016, 1 Thessalonians 5:11). Who would recruit and train the peer supporters, how would staff request one quickly after an event and how would the program protect the confidentiality of those conversations?

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Heller, K. O., & Souter, K. J. (2024). Disclosure of adverse events and medical errors: A framework for anesthesiologists. Anesthesiology Clinics, 42(3), 529-538. https://doi.org/10.1016/j.anclin.2023.12.003

Lainidi, O., Jendeby, M. K., Montgomery, A., Mouratidis, C., Paitaridou, K., Cook, C., Johnson, J., & Karakasidou, E. (2023). An integrative systematic review of employee silence and voice in healthcare: What are we really measuring? Frontiers in Psychiatry, 14, 1111579. https://doi.org/10.3389/fpsyt.2023.1111579

Martínez, M. (2026). Peer accountability in patient safety: An under-examined determinant of team performance. International Journal for Quality in Health Care, 38(3), mzag134. https://doi.org/10.1093/intqhc/mzag134

Niles, N. J. (2013). Basic concepts of health care human resource management. Jones & Bartlett Learning.

Xu, Y., Jin, Q., Zhou, Q., Zhang, R., & Ding, W. (2025). Relationship between second victim experience and turnover intention in Chinese nurses: Assessing the mediating role of posttraumatic growth using structural equation modeling. Journal of Nursing Management, 2025, 7327139. https://doi.org/10.1155/jonm/7327139