Huh?

  1. Listened to a talk by risk managment nurse today. I was really impressed with her professionalism. There was a couple of things she had to say that made me go "HUH?. Want to see what you guys think. 1. Not necessary or advisable to carry your own malpractice insurance. 2. Never copy anything at work and keep for your own records not even an incident report. 3. Never keep a journal about work or make notations in a journal that pertain to work. (You are not supposed to do 2 or 3 because a lawyer could subpoena private records if they found out about them.) 4. There is no reason why you could not fill in the proceedure section of OR consent form for a physician. (I argued about this last one, just ain't gona do it.)
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  2. 8 Comments

  3. by   P_RN
    Im not a risk manager but I disagree. First it's only to YOUR best interest to keep malpractice insurance.

    I don't think you should make copies of patient records, but as long as occurrence reports are written in ink there is definitely the opportunity to "amend them." I prefer being able to PROVE what I wrote. It wouldn't be the first time management tried to "clarify" issues.

    In your journal, would you write anything but the truth? I will say my attorney didn't like it when I presented him a typewritten paper of my injury during my workers comp meetings. He said that as long as I gave it to him first, it was OK. All the same it was nothing BUT the truth.

    Now as far as the procedure on the consent.....I don't mind writing it in the blank BUT I won't witness unless the patient has been seen by the doctor and the doctor has filled out HIS teaching part. That seemed the only way to avoid chicken scratch abbreviations.

    We have a JD on here...Fiesty? What do you say?
  4. by   dawngloves
    I think the argument about malpractice insurance is that if a lawyer finds out you have it, it increases your chance of being named individually and sued.
    I'd rather risk it and have my own . CYA!
  5. by   KellyandtheBoys
    Here's my understanding on malpractice insurance:

    The lawyers go for the "deep pockets".
    1) Dr.'s who aren't employeed by the hospital, but, contracted to work in the hospital. Therefor they carry their own insurance.

    2) th hospital which as a for profit organization will have some money.

    As en enployee OF the hospital you won't be independently sued.
    There just isn't enough gain.

    However, if you have your own malpractice insurance you can be sued independt of the hospital. Because you have the big insurance company behind you, you now have more "worth" financially.

    If you are independently named it will be primarily your (and your insurance company) responsibility to defend you. You may or may not get much assistance from the hospital lawyers.

    And I have heard of cases ( not sure weather it is true) where the hospital turns around and sues for their expences.

    If the insurance company defends you, you may still be liable for a certain amount of expences. And, there for loose the very things you are trying to protect.

    So, for these reasons I don't carry my own insurance.
  6. by   nicola
    I always have carried my own insurance because I occ. do volunteer nursing for my church during health fairs etc. If some one should decide to sue me based on something I said/did during such an event, I would want insurance. When I'm at work I'm covered by the agency's ins. too.
  7. by   CATHYW
    Kelly and the boys-for a long time I agreed with your line of thought. Then I heard that you could be sued, no matter whether you are insured or not, and that they could take any of your assets, including your house!
    That scared the bejeepers out of me, so now I have my own insurance. I am not considered an independent practioner, but since I am the only healthcare provider in my facility, and see, triage, and treat/refer most all cases, just wanted to be covered.

    A cardiologist that I once worked with (in a private group practice) said that he did not have malpractice insurance, and that EVERYTHING he owned was in the names of his wife and children, whom he felt could not be included in a lawsuit.
  8. by   thisnurse
    i think you will get sued whether or not you have your own insurance. they will sue EVERYONE involved and see who has the most to offer. its not going to be us but you never know what the hospital is going to do when all is said and done.
    not worth the risk to me.

    im sorry but the not keeping copies things sounds like thats more for their benefit than yours.
    as stated above i wouldnt copy pt records (parts of my charting if necessary) but i sure would keep cover my butt copies.
    thing is WHO IS GOING TO KNOW YOU HAVE THEM?
    unless of course you go around the unit telling everyone...lol
  9. by   Jenny P
    I carry my own malpractice insurance because I once knew of a nurse who did lose her house when she was sued and the hospital did not support her. The hospital got off (they could afford the big buck lawyers- she did not have malpractice insurance and didn't think she needed her own lawyer), but she lost the lawsuit. I don't remember the circumstances, but it really shocked us to realize it could happen to any of us.

    I used to keep my worksheets when I worked charge in a special file because of fear of liability, but I no longer do that as they have pt. names on them and I became concerned about confidentiality with the law changes a couple years ago. So that is long gone. If I'm journalling, I'm usually writing about what affects me mentally, emotionally, and physically. Sometimes it may be work, most often it is other things. My biggest problem with that is I fell out of the habit of journalling about the time I started writing here (LOL!!).

    I think making your own copy of the incident report and deleting the name, address, and etc. of the patient involved may be prudent at times. I've never done it, though.

    My hospital has the nurse copy down the name of the O.R. procedure from an order in the chart. That order could be either written or verbal, but I never co-sign as a witness to the patient's signature unless I have talked with the patient and am fully satisfied with the patients' response to my questions.
  10. by   psnurse
    My two cents...

    Having your own insurance is a good idea. You don't have to wear a sign or anything. I think you are more likely to be sued because of the climate of healthcare than because you have your own insurance. Make sure you are covered for legal fees for the suit as well as any licensure hearings that may result.

    Copying things is not a good idea. They can be demanded by opposing counsel if they are discovered. This may protect the facility, but it may also protect you. What it does is gives you the ability to say you don't remember and have it be the truth. Sometimes the absence of memory is a good thing.

    With regard to consents, this is a point of much confusion. When you witness a consent you are merely witnessing that is was the actual patient in question that signed the consent. Obtaining informed consent is the responsibility of the physician. It would behoove the physician to fill in the procedure because if it is filled in incorrectly it would be a liability for him/her. But it is not necessary for him to fill it in. Also, it is the responsibility of the physician to inform the patient about the procedure, although it is not necessary for this information to be on the actual consent form. It can be in the progress notes or wherever.

    I see the issue of signing consent as an advocacy issue. I do ask if the patient has had an opportunity to ask questions of his/her physician about the procedure. Then I have them give me a quick run down on the procedure. If I am not satisfied that the patient is informed, then I call the MD and tell them that they will have to come back. Pisses them off, but TOO BAD!

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