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. Nurses Announcements Archive Article

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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.

I 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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Do you have any suggestions as to where one could take a course in nursing and the law? It appears the laws would be according to one's state, unless there's a general course you recommend such as "business law" that is provided in a business degree curriculum.

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Specializes in School Nursing, Public Health Nurse.

So awesome to read this! I just brought nursing insurance today from NSO. I just started as a school nurse and I feel the need to protect myself due to a situation at the district. Not that I don't think the school district will fight for me and leave me high and dry, but I need that sure self-protection. I like to be prepared and this is the best thing I can do for myself and hopefully I will never need it :D I know there's a School Nursing and the Law text out there and I'm going to order it on payday!

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Specializes in I/DD.

Most people threaten to sue for circumstances that are beyond the healthcare professional's control. Example: "I'm going to sue because my vascular bypass didn't work, even though when I went home after surgery I continue to smoke 2ppd and ate McDonald's every day."

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
bookbunny said:
Do you have any suggestions as to where one could take a course in nursing and the law? It appears the laws would be according to one's state, unless there's a general course you recommend such as "business law" that is provided in a business degree curriculum.

Do a Google.com search of the term "Legal Issues in Nursing" and a whole slew of results will show up. Some of the results give information about courses offered at community colleges and state universities, while many of the other results lead to online courses regarding nursing and the law. Many opportunities exist to take CEU courses on legal issues in nursing, too. So there are a variety of ways a nurse can learn about the legalities surrounding their livelihoods.

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Just wondering if this will cover it...

I attend the University of South Florida. Part of our curriculum includes "Ethical/Legal Aspects of Nursing". The course descrpition is "Introduction to contemporary bioethical and legal issues confronting health care providers in a variety of settings. Focuses on identification of legal and ethical principles underlying the decision- making process in nursing and health care."

Is this the type of class that would be a good idea or should I look for an additional class?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
PalmHarborMom said:
Is this the type of class that would be a good idea or should I look for an additional class?

Purely based on the description provided, this type of class seems like a great idea to learn more about legal issues that impact nursing practice.

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TheCommuter said:
Purely based on the description provided, this type of class seems like a great idea to learn more about legal issues that impact nursing practice.

Thanks for the reply! The description that I gave is directly from the course catalog. I see tremendous value in learning about the legal aspects of nursing and feel fortunate that my university has included it in our curriculum.

Thanks again!

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Specializes in Med/Surg., Geriatrics, Pediatrics..

The treat of a lawsuit is real and it's out there in nursing, so buckle up and enjoy the ride. Like we don't have enough to worry about, right?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
nurse4sale said:
The treat of a lawsuit is real and it's out there in nursing, so buckle up and enjoy the ride. Like we don't have enough to worry about, right?

Yes, nurses can be sued. Nurses have been individually named in lawsuits, especially if the outcome was horrible or unexpectedly poor.

But as I've mentioned previously, the patient would need to be either dead or irreparably injured in order for a medical malpractice attorney to even see if there's money to be made. When I talk about irreparable injury, I'm thinking of a patient who falls out of a high bed at the hospital and suffers a permanent spinal cord injury. I'm thinking of the elderly patient who suffers from second degree burns over 90 percent of her body after being scalded by extremely hot water in the shower.

Malpractice suits are risky and costly for attorneys, so they typically do not take the case unless they know they have a case where a huge award looms. There must be a clear cause of action, preferably irreparable harm or death.

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Omg. That is ridiculous!

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Specializes in General Surgery.

Fantastic article, a topic that I think needs to be addressed more often! Good points well made and definitely puts me at ease as I hopefully start my first year as an RN!

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