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by sirI

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Posted: Oct 12, 2007 10:06 AM

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Received 3,272 "Thank You" From 2,454 Posts

The areas of nursing most vulnerable today are anesthesia and midwifery. RNs in OB (L and D), those working solely in monitoring capacities (fetal heart, telemetry, etc.), and medication administration are also included in highly litigious areas.

Of course, the Advanced Practice Nurse (APN) other than CRNA and CNM are subject to increased litigation, but the latter two more so.

And, nurses in general can be and often are, at risk.

Major reasons why more lawsuits are being made against nurses:

• Our responsibilities have increased in complexity
• Higher levels of Standards of Care (SOC)
• Increased patient expectations
• Pressure to increase productivity and increased patient load
• Society has become highly litigious

Most common issues:

1. Failure to follow the SOC
2. Failure to document, including lack of documentation, altered documentation, missing or "lost" documentation, incomplete documentation
3. Failure to recognize change in patient condition
4. Failure to appreciate the change in patient condition
5. Failure to report change in patient condition
6. Failure to communicate across the healthcare provider spectrum
7. Failure to monitor
8. Failure to act as patient advocate
9. Failure to provide a safe environment

We all need to know our individual Nurse Practice Act (NPA), adhere diligently within our SOP, know the SOC for our specialty area(s), question authority, educate ourselves, and make sound, safe, and practical nursing judgments for all our patients.

And, I realize that we all strive to provide the best possible care for our patients.

Finally, a kind word and non-defensive attitude with a patient turns away many a lawsuit.

Oct 15, 2007 07:47 PM - Excellent advice, sirI, from which we all can benefit. I will refer my nursing students to this post.

Oct 15, 2007 09:28 PM - Thank you for this post, Siri. In my job, I have to deal with these issues on a daily basis because I'm responsible for ensuring safe medication administration practices in my ALF. Sometimes it's good to be reminded of just how much is at stake when I go to work in the morning!

Oct 19, 2007 08:06 PM - I was involved in a legal investigation after a patient died. A piece of documentation that I had completed had gone missing. But for some reason, I had documented the information in another area, which normally I would never do. Once I pointed this out, I was covered (and the information was not even specifically related to the case). But it was scary...

Oct 22, 2007 05:49 PM - Excellent outline! I am an attorney and an advanced practice RN; I deal with litigation re: nurses 24/7. I liked your succinct characterization of the most important points!

Nov 19, 2007 02:50 AM - SirI - one more reason you may be named in a lawsuit: Simply being staff on the floor when the incident occurs. Even if you have no role in the care of this patient and your name is nowhere in their chart, you will need to prove that you were otherwise involved when the incident took place (with documentation) in order to be dropped from the suit.
The voice of experience.

Nov 19, 2007 07:45 AM - That's a mathematical certainty, bagladyrn. But, not a reason why more nurses are being named in lawsuits. That is just standard procedure.

Nov 19, 2007 08:08 AM - I understand what you are saying. My point was that sometimes there is no reason - just being a nurse is enough.

Nov 19, 2007 08:13 AM - I see what you are saying, too.

Thanks for your feedback.

Dec 13, 2007 12:17 AM - Enjoyed your article,what concerns me this maybe the reason why there maybe a nursing shortage.