a.salai@setonhill.

edu

April 11, 2022

President Joseph Biden
1600 Pennsylvania Ave NW
Washington, DC 20500

Dear Mr. President,

It is with intent on raising awareness and preventing medical error and malpractice that I
write this letter. As a nursing student I have been in clinicals now for over a year now, and have
seen some great nurses who love their job and follow evidence based practice to perform their
jobs. However, I have also seen nurses who are on the opposite end of the spectrum, and do not
follow EBP to perform their tasks. Again, the intent of this letter is not to be a “tattle-tale”, but
rather to bring to your attention this problem. This issue of “standard of care” when it is not
being met, offends a person's dignity as we are all created in the image of God. This is a Catholic
Social Teaching that is the biggest motivator for me to pursue my future profession in nursing.
In class I have learned that EBP is the only way to perform any medical task. If I am
deciding what to do for my patient I always turn to EBP because that is the standard which will
help patients get the best form of care and have a successful time in the hospital. This is
solidified when Upshaw-Owens writes; “Standardization is a set of principles based on
effectiveness and followed consistently, resulting in a positive patient impact”. EBP is not just
used in nursing schools, but is used by the hospitals, and just as quoted, when this standard is
followed, the patient has the best chance of a successful outcome.
In clinical however, I have seen nurses not follow this standard of EBP. For example, a
patient of mine couldn’t swallow and so he had a PEG tube to get his food and medicines. He
had a long list of medications and because they had to go through his PEG tube each medication
had to be crushed. EBP says to crush each medication individually and flush through his PEG
tube individually. The nurse I was working with knowingly crushed them all together and
flushed them down his PEG tube all together as well. Another example of not following EBP is
just seeing the nurses I work with fail to put gloves on when entering the room to provide care
for the patient, not using hand sanitizer after leaving the room, and not cleaning the computer on
wheels (COW) at the end of their shift.
These examples that I have seen in clinicals put that patient and all the other patients at
risk for infections. As written in my medical surgical book for class; “Microorganisms can gain
direct access to the bloodstream, especially when invasive devices or tubes are used. The
incidence of bloodstream infections (BSIs) continues to increase in hospitals throughout the
United States” (Ignatavicius, D.D., Workman, M.L., & Rebar, C.R. (2018)). The goal of the
nursing profession is to provide excellent, quality, and professional nursing care. This will help
the patient have the best opportunity to have a successful time in the health care system. As I
mentioned in the beginning of this letter; this lack of following the standard of care affects the
patient’s dignity. Their dignity is affected because as humans, we are all made in the image of
God, and by purposely not following the standard of care we run the risk of harming the patient.
This is an issue of utmost importance as hospital infection rates cost the healthcare
system over $9.8 billion USD a year in managing these HAIs (healthypeople.gov 2021). By
taking a stand for making sure that the health care professionals follow the standard of care we
could limit these HAIs and bring the cost down as well. Not only should the money be a
motivator to join this stand, but along the lines of catholic corporal works of mercy, “visiting the
sick” is something we ought to do in taking care of God’s creation, especially those in a
vulnerable position (being in the hospital).
I ask that you join in collaboration with the healthcare system in ensuring that we follow
the standard of care. Perhaps visiting the hospitals and encouraging the healthcare workers. I
believe the governmental body of our system is working, but I think the reason for the
negligence I am seeing is because they feel unappreciated. So with the help of you visiting us, I
think it would show us that you respect us as we respect you, and this could help those who don’t
follow the standard of care to remember that their job is important as well.
I do not know your religious background, but understanding that everyone deserves
dignity, lowering the spending of the health-care system, and visiting the sick in terms of making
sure they are taken care of appropriately are all great motivators to join in this stand for health-
care-justice.

Thank you for your time,

Alexander Salai
114 Sleepy Hollow Lane
Hunker, PA 15639
a.salai@setonhill.edu