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For two decades, nurses have been considered the most trustworthy professionals in the country, above physicians. Yet the rigid hierarchy within hospitals and health systems places physicians at the top, creating a fraught power dynamic and a double standard when it comes to discipline.

Case in point: RaDonda Vaught. She’s a former nurse who was criminally prosecuted this spring after accidentally ordering the wrong drug for a patient, who later died. She’ll serve three years of supervised probation, while a former physician named William Husel was acquitted after purposefully ordering deadly doses of fentanyl for 14 patients who then died under his care.

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This week on the “First Opinion Podcast,” nurses and educators Michelle Collins and Cherie Burke discuss this double standard and how hospital systems need to create more supportive, respectful atmospheres to keep clinicians and patients safe.

“If you hold up one slice of Swiss cheese, you can see through it. If you hold up a whole half-pound of Swiss cheese, you can rarely see through all the holes,” Burke said. “The holes all aligned here — Vaught went through the holes and an error occurred. So we need to build better systems to ensure our safety.”

This conversation was an extension of their First Opinion essay, “The case of RaDonda Vaught highlights a double standard for nurses and physicians.” Collins is the dean of the College of Nursing and Health at Loyola University New Orleans, where Burke is director of the School of Nursing.

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