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yardwork

(62,061 posts)
3. Sepsis that was overlooked over a weekend. Classic example of systems failure.
Sun Aug 27, 2023, 11:24 AM
Aug 2023

The nurses were aware but the institution's culture prevented them from escalating, and the physicians in charge weren't on top of it, partly because it was a weekend.

This is not the parents' fault. It's the fault of the institution. Lower level employees are typically blamed in these situations, but they weren't the main cause, either. The leadership needs to do a complete overhaul of the institution's policies and culture.

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