If you are the patient's advocate, can you sue the MD?

  1. I am curious to find the answer to this question. I know that most anyone at anytime can sue another individual in America. But if you see outlandish medicine practiced at your facility, can you sue the MD for malpractice as the nurse representing this client at the bedside? Anyone know of any historic events that mirror this concern?

    Or for that matter visa versa, can an MD sue you the nurse for not providing the best of care to a patient???!
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  2. 32 Comments

  3. by   fergus51
    Quote from TeleRNer
    I am curious to find the answer to this question. I know that most anyone at anytime can sue another individual in America. But if you see outlandish medicine practiced at your facility, can you sue the MD for malpractice as the nurse representing this client at the bedside? Anyone know of any historic events that mirror this concern?

    Or for that matter visa versa, can an MD sue you the nurse for not providing the best of care to a patient???!

    No. Patient confidentiality would prevent you from even discussing it with a lawyer, let alone taking it to court.
  4. by   James Huffman
    The short answer is no. Filing such a suit would involve "standing" to sue, and -- as their nurse -- we have no such standing. Nor does the MD have standing to sue us.

    I disagree that nurses are somehow a patient's "advocate" The easiest way to realize this is to ask 5 random patients, "Am I your advocate?" and 99.9% of the time, the patient will either stare blankly back at you, or respond (correctly), "No." (The .01% who respond positively are professors of nursing. Count on it).

    If a nurse's patients don't know that the nurse is their "advocate" on what grounds is the nurse taking this role? In the US, an "advocate" is a synonym for "attorney." I am not an attorney. I suspect that most people reading this aren't, either.

    The idea that a nurse is a patient's advocate is founded on a particular theory of nursing practice, one by no means universally accepted in theory and practice. Obviously, I disagree entirely with that theory.

    Nurses who want to be patient advocates are welcome to do so. But they should explain very clearly to the patient that this is how they will be operating, and should have the patient's informed consent for the nurse to operate as their advocate. To operate in this manner without the patient's consent is, frankly, bordering on malpractice.
    Last edit by James Huffman on Sep 26, '07
  5. by   Jolie
    The previous posters are correct that a nurse providing bedside care for a patient has no standing to sue a physician on behalf of a patient who receives inappropriate medical treatment.

    But that does not mean that you lack options in addressing concerns regarding inappropriate medical care. Is the physician prescribing treatment that falls outside the norm of accepted medical practice? Is he ordering care that violates hospital policies and procedures? Do his patients indicate a desire to refuse the care he orders?

    Any of these situations require action on your part, including notifying the physician of your (or the patient's) concerns regarding his plan of care, and asking him/her to clarify it. If that doesn't yield satisfactory results, you need to let the physician know that you will be withholding care while you go up your chain of command to your charge nurse/manager/supervisor/risk manager for guidance. If need be, it is the supervisor's responsibility to contact the chief of medicine to resolve the issue.
  6. by   Ms.RN
    no, because the facility will stand behind physicians instead of nurses and they will back up physicians.( this is what my nursing instructor told us). the only thing you can do is go up the chain of command and file your complaints.
  7. by   cmo421
    Quote from TeleRNer
    I am curious to find the answer to this question. I know that most anyone at anytime can sue another individual in America. But if you see outlandish medicine practiced at your facility, can you sue the MD for malpractice as the nurse representing this client at the bedside? Anyone know of any historic events that mirror this concern?

    Or for that matter visa versa, can an MD sue you the nurse for not providing the best of care to a patient???!

    No I agree that you can not. But if you feel so strongly in your opinion of the MD practice and behavior,why not ask for a meeting and discuss it. If you have a supportive supervisor,they will assist you in facillitating this. If the treatment is really bad, you have the chain of command to go up and also the State Medical Board.
    No doc worth a grain of salt would dare try and sue a nurse, they would have the world down on them in a sec,,,lol.(plus most doc are not sue prone due to their knowledge of how vulnerable they are)
  8. by   classicdame
    This is why we have chain of command.

    Also, the MD does not owe you a duty so you do not have a gripe.
  9. by   caliotter3
    Even if one were to find an attorney to pursue such a case, it never would be a wise action to take. The nurse doing so would be committing career and reputation suicide. Never bring a lawsuit against an MD unless it is for your own problems. Even then, you have to be prepared for the consequences. Remember, you are part of a community that bands together to cover the MD and the corporation above all else. Nurses are expendable.
  10. by   elkpark
    Quote from caliotter3
    Never bring a lawsuit against an MD unless it is for your own problems. Even then, you have to be prepared for the consequences.
    The other posters are correct -- you can't bring a civil suit against an MD unless it is "for your own problems," or you are the authorized legal representative/guardian of someone who has suffered an injury that meets the other legal requirements to constitute malpractice, and you are bringing suit on that person's behalf.

    However, there is the chain of command within your institution, there is the Medical Staff of your institution, and there is the state medical board.
  11. by   jjjoy
    Quote from James Huffman
    I disagree that nurses are somehow a patient's "advocate" ... The idea that a nurse is a patient's advocate is founded on a particular theory of nursing practice, one by no means universally accepted in theory and practice. Obviously, I disagree entirely with that theory.
    Interesting. I, too, have reservations about the strong push to say that one of the nurse's major role is to a be a "patient advocate." Did you discuss your disagreement with this with your instructors? I bet they'd love that (not!).

    To me the concept of "advocate" means that you can't have any other roles that might conflict with advocating. But nurses do have many other roles such as administering treatments, monitoring physiological status, etc. Of course, nurses need to stand up for what they believe to be best for the their patients... but that has to do with patient safety and respecting the patient's wishes... and all health care personnel should be encouraged to do that. I don't see that as an "advocate" role though. Again, as I've usually seen it in practice, an advocate comes in as an otherwise uninvolved party to ensure that the patient's wishes and needs are being met.

    I imagine the concept of nurses being "an advocate" developed to counter the idea that nurses just blindly follow orders and to encourage nurses to speak up if they saw problems with how the MD was handling the case. I wouldn't call it "advocating" though. I'd call it informing the MD of extenuating circumstances or further information that he/she may not have considered in making their decisions and following the chain of command if the MD is making decisions that aren't in the patient's best interest.

    Back to the OPs initial question... I'm curious, TeleRNer, if there was some specific incident or observation that led you to wonder about the possibility of an advocate bringing a lawsuit against someone.
  12. by   CaLLaCoDe
    Quote from jjjoy
    Back to the OPs initial question... I'm curious, TeleRNer, if there was some specific incident or observation that led you to wonder about the possibility of an advocate bringing a lawsuit against someone.
    No, no such specific incident. Just curiosity.
  13. by   RNsRWe
    I frequently do advocate for my patients. This does not, however, make me their actual (legal) advocate.

    I advocate for them by asking their MD for more effective pain meds when I see what's ordered isn't working. I advocate for them by not letting them wallow in nausea, but instead getting orders for antiemetics.

    I advocate for them by giving them resources in the community for help they may need. I am not their 'advocate' in that I do not then contact those resources myself on their behalf. I use my own place in the hospital to my patients' best advantage.

    None of this, however, includes going to an attorney as some kind of position of authority on behalf of that patient. I HAVE no such authority, and neither do you, as their nurse.
  14. by   leslymill
    You might be able to address your concerns to the AMA, but I don't know if that would be the best route. I suppose it would depend on how gross the misconduct. Sueing is not an option though.

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