Nurses and Lawsuits: A Medico-Legal Perspective

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    As nurses initiate their professional obligations, their legal responsibilities also begin. As they start their journey, they also start learning from themselves and from other people. Their license bears out that they are capable and qualified under the law to practice their profession. Their license is the proof that they are now able to give holistic and quality care to their clients as a professional nurse.

    When nurses embark on to practice their profession, they are considered responsible and accountable for the quality of performance of their duties and responsibilities. Nurses who are employed in agencies, institutions, or hospitals are directly conscientious to their immediate supervisors. Private duty nurses, being self-regulating or independent practitioners, are bound to a standard of conduct that is expected of reasonably prudent nurses. The standard is a clearly defined, legal anticipation to which nurses are considered accountable.

    There were times that nurses never worried about medical malpractice lawsuits. They did not have any concern regarding their profession, which involves medico-legal aspects. These days, however, a growing number of professional nurses find themselves involved in litigation (court cases, proceedings), either as part of a permissible action against a facility or, increasingly, as an individual defendant.

    These nurses end up losing their jobs and their licenses, as well as their assets. These things happen though their mistake was unpremeditated. Some nurses thought that they were basically following the physician's orders. But then, in a few recent cases, nurses have found themselves in front of criminal charges and even jail terms due to medication errors that have led to patient death.

    State nursing boards as well as the public expect the nursing practice to be perfect because the field deals with life. We cannot bring dead people back to life. Dead is dead. People anticipate perfection in the nursing practice even as patients get sicker and nurses take more responsibilities. In addition, human error should be tolerated.
    Nursing responsibilities have also developed. This is probably because some busy physicians spend less time at the bedside that they rely more on nurses to be their eyes and ears. This possibly increases pressure on the nurse to account and follow through the changes that occur in the patient.

    In general, lawsuits against hospitals or physicians and nurses involve recuperation of money damages. The defendant is compelled to execute the judgment. Failure to conform will be considered as derision of court and it will result in fine or imprisonment. If the decision is for payment of money, the plaintiff may cause the sheriff to sell so much of the defendant's property as necessary to pay for the costs.

    The following can be utilized by the nurses to reduce the risk of being named in a lawsuit or to seek protection if they are involved in a lawsuit already.

    The significance of medical records is both scientific and legal. As a record of illness and treatment, it saves duplication in future cases and it helps in immediate treatment. There should be a thorough documentation. Documentation of patient care may not be nurses' favorite activity, however, nurses who find themselves involved in lawsuits and have documented thoroughly will thank themselves later. Charting is almost certainly the most essential facet of proving that nurses have met the standards of care. The nurses' notes are aids to medical diagnosis and in understanding the patient's behavior. In addition, it serves as a legal protection for the hospital, doctor, and nurse by reflecting the disease or condition of the patient and its management.

    The patient is the nurses' partner throughout the nursing process. Neither the patient nor the nurse does a hundred percent effort towards attaining the goal which is to achieve the optimum functioning of the client. It should be a fifty effort from the nurse and fifty percent from the patient. The nurse should work hand in hand with the patient (and/or the relatives) in order to achieve the goals set in the nursing care plan. Sharing significant information with the patient can help decrease errors. This is one reason why nurses establish rapport at the beginning of the nurse-patient relationship. The nurse should also extend that rapport to the relatives of the client for they should also know the plan of care for the client. The nurse should explain the procedures that would be done to the client. Explaining the procedures to the client and the relatives enables the client to cooperate well with the nurse. The nurse should also listen to the client's feelings and response. In addition, the nurse should also pay close attention to the concerns of the family members because they also are ones who often notice when a patient's condition has changed. They should also know and understand what is happening to their loved one.
    One vital responsibility of the nurse is to make sure that the equipment used in procedures and treatments is not defective. Such equipment includes wheelchairs, stretchers, suction machines, anesthesia apparatus, x-ray tables, etc. The nurse should see to it that all pieces of equipment are recurrently inspected, maintained, and are functioning suitably. She should also document the times she requested these to show that she was able to anticipate the improper functioning of the equipment, which might cause possible harm or injury to the client. The nurse should be able to recognize system flaws and be able to report them. In addition, this measure enables the nurse to provide the client an error-free environment and accommodation.

    The most common security in a negligent action is when nurses know and conquer that standard of care in rendering their service to the clients and that they have properly documented the care they give in a succinct and accurate manner. However, if the patient's careless conduct takes part to his own injury, the patient cannot bring a law suit against a nurse. On the other hand, if the nurse has deliberately given advanced consent in performing a contractual obligation that involves threat, such as giving care to a psychiatric patient or a patient with a communicable disease, the nurse cannot bring suit against the client if she gets hurt or acquires the disease since upon accepting the case, the nurse concurred to presuppose the risk of harm or infection, in this manner, relieving the client or his relatives from legal obligations.

    Above all, the best way for the nurse to avoid a lawsuit is to be aware of the standards of nursing practice and follow them by heart. Ultimately, to prevent errors, nurses should meet the standards of care. It also implies that a nurse should be aware of the hospital's policies and procedures, the state nursing practice act, and the professional standards of his specialty. Ergo, nurses should exercise their sound verdict and employ standards of nursing care in order to avert lawsuits or to protect themselves.
    Last edit by Joe V on Mar 26, '10 : Reason: formatting for easier reading
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  3. by   Heogog53
    This is an excellent article on the present state of nursing legal issues. I would like to dispute the nurse's complete responsibility in regards to knowing what equipment works, is broken, etc, as in most hospitals there are also others involved in the care of the patient. If those people, such as CNA's, transportation team personnel and others don;t report the problem to the correct departments as well as the charge nurse about an equipment failure, how can the NURSE be the only one who is accountable for such issues?
  4. by   nursenow
    Very nice article but I wonder why it bothers me that the word "she" was used throughout the article when refering to the nurse. Kind of like something out of the 70's?
  5. by   fathertod
    Wooooman Nurses get sued more statistically speaking
  6. by   Heogog53
    Woooman nurses????

    Historically speaking, woooman nurses have been the dominant sex in the field til recently. Now 1 in 10 nurses is male. There would be why wooooman nurses have a higher sue rate than maaaan nurses. When the ratio is 50:50, then let's speak about comparable historical patterns.

    However, since this is the 2000's and men are becoming far more visible, the article should not have used "she" as an exclusive pronoun.

    I am, by the way, a Female nurse or a woman nurse, but never, ever a wooooman nurse.