Legal Food For Thought During the First Year of Nursing (and Beyond)
In this litigious day and age, nurses can be individually named in lawsuits. Also, patients and family members sometimes utter the words "I am suing you" as an intimidation measure. However, a little knowledge regarding legal issues in nursing can go a long way in alleviating a nurse's fears.
The first year of nursing is, in countless cases, also one of the most challenging years of a nurse's career because many different events are taking place.
First of all, a significant number of newer nurses are acquiring the procedural skills that they did not fully cover in their nursing school clinical rotations, especially if one is immediately transitioning into a highly specialized area as a first healthcare job. Secondly, aspects of the 'real world' of nursing may clash with the idealized 'textbook version' of nursing. Third, it simply takes time for a newer nurse with less than one year of experience to find one's groove in the workplace and develop a comfort zone.
Finally, untold numbers of new nurses have been pumped with the often paralyzing fear of the consequences that might result from mistakes. The fear of causing profound harm to a patient comes to mind. Also, the fear of action being taken against one's nursing license is frequently mentioned as a source of worry. "I'm afraid of losing my license" is an immensely common phrase.
Moreover, some nurses live with the fear of someone personally filing a lawsuit against them. For instance, several years ago a new grad administered a deep intramuscular injection of promethazine (Phenergan) to the left arm when the patient had requested for the medication to be injected into the right arm. Later on during the shift the nurse was asking, "Can I get sued for giving it in the wrong arm?"
In instances like the aforementioned scenario, knowledge is power. A little knowledge about legal issues in nursing can go a long way to alleviate many worries. As a general rule of thumb, unless the patient is irreparably injured or dead as a result of something the nurse has done (or failed to do), it is highly unlikely that the event is lawsuit material. Patients and families sometimes say the words "I'm going to sue you" to nurses as an intimidation tactic, and they do have the right to pursue legal action.
However, they would first need to find a medical malpractice attorney who would be willing to take the case. And, as long as the proper injection technique was used and no harm resulted, most lawyers in existence would not waste the time on a case that involved giving an injection to the supposedly 'wrong' arm.
I advise all nurses to take a course in nursing and the law to become reassured regarding the types of events that patients and families can and cannot sue for. A patient or family member must have a cause of action in order to sue you. And if you have not been found guilty of a tort (civil wrong), then any action to sue you would most likely be dismissed if it was filed. Generally, personal injury suits are extremely risky and very expensive for medical malpractice attorneys, so they typically do not take the case unless there is a clear cause of action (read: irreparable harm or death) and a large amount of monetary recovery is likely.
In this litigious day and age, nurses can be individually named in lawsuits. However, physicians pay tens of thousands of dollars in premiums for medical malpractice policies, while nurses usually pay in the range of $100 yearly. The physician pays more because (s)he is more likely to be sued than the nurse.
What is the point of all of this? Take a deep breath, practice safely, consider the ethical implications of everything you do, stay within your scope, ask for help when needed, don't allow anyone to intimidate you, and keep on learning about the wonderful art and science of nursing. Sometimes the words "I am going to sue" might be an everyday part of a person's vocabulary, even if he knows little about the process of suing.Last edit by TheCommuter on Mar 4, '13
About TheCommuter, BSN, RN Senior Moderator
TheCommuter is a moderator of allnurses.com and has varied workplace experiences upon which to draw for her articles. She was an LPN/LVN for four years prior to becoming a registered nurse.
TheCommuter has '11' year(s) of experience and specializes in 'Case mgmt., rehab, (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 36 Years Old; Joined Feb '05; Posts: 38,050; Likes: 68,969.Mar 4, '13Very informative Commuter, thank you. One time when working in the ED I accidently let the rail down on the patients' leg. It barely touched him, he yelped and said " I'm gonna sue you". It took all I had to bite my tongue. I could't beleive how ignorant he was.... I simply ignored him and carried on with my day.Mar 4, '13Wow. That is truly food for thought, Commuter. Something to think about as I get ready to take the nursing classes!Mar 4, '13Thanks for sharing this valuable knowledge. It's an add on piece of mind to calm my nerve down more while I'm practicing.Mar 4, '13Thank You Commuter!!! I was JUST musing about this in another post...
This negative mantra MUST go away, along with another "mantra" involved with eating people or something like that....Mar 4, '13As a student who will be graduating soon it's a comfort knowing that the big bad world of nursing isn't so big and isn't so bad. Thank you for the articleMar 4, '13Seems interesting sometimes the one's who say they will sue you , are the ones who least likely would be able to afford an attorney....Mar 4, '13That is a great post, thank you very much Commuter for putting it up. Having personal experience with malpractice lawsuits (not as a nurse, but as the SNF's social worker), being blamed for negligence in such a procedure is very devastating and personally stressful. It is an important reminder that there are so many things we worry about that we are sometimes scared to relax and enjoy the job. Families and patients can be very pushy and intimidating. But by arming oneself with information, that stress can disappear to background noise.Mar 4, '13Thanks for this. I'm a CNA and in our CNA classes they told us that anyone could call the state at any time for any reason to report a wrong-doing on our part, and even if we were innocent, that would go on our permanent record and we would never be able to find work as a CNA or nurse again. If this is indeed true, then the rules should be changed. Many people with dementia in long-term care think something has been stolen when it's actually just been misplaced or never existed in the first place. If a family member doesn't realize this, a theft could be reported against a CNA with no basis whatsoever.Mar 4, '13I went to a conference recently. One of our speakers was a physician who went to law school. (S)He practices law primarily but also practices medicine some (it sounds like they work per diem). It was interesting the discussion we had about medical malpractice, lawsuits and other legal issues - and a better way for me to gain more understanding about the laws in my current state. VERY informative!
The biggest take aways - things nurses get sued for, what the laws in our state say, and why practicing according to facility policy and within the state nurse practice act is paramount. Obviously, for good reason, one should not be practicing outside their scope of practice and training/competencies. One of the other things that was discussed was that claims are much more likely to be made verses the hospital/corporation or physician - because the potential rewards are higher. That being said, nurses can and do get singled out (depends on the situation, and on what happened, the severity or scope if you will). Statistically speaking though...it is somewhat (okay, I lied, very) comforting food for thought. My facility is self-insured (as are our physician practices), which, mostly, helps us as staff. But. To protect itself, our company is very adamant that our policies and procedures exist for reasons and failure to comply will cause the facility to drop you from the group representation.
Also, one of the things to consider about - many programs for nurses include state board representation. It was explained that most carriers allow nurses to choose and retain private counsel, and once the matter is settled the representation bills the insurance company. (Again, you have to check with your carried/policy specifics).
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