Protect yourself, Protect your license, and most of all Protect your patient

by madwife2002 Asst. Admin

11,290 Views | 26 Comments

Many of us believe we are providing the best possible care for our patients, many of us believe we are practicing the best way possible, many of us believe we are safe practitioners. We are! but in a court of law, unless we are following the policy and procedures laid down in the policy and procedures hand book of the facility we work at, then we may be at risk of being sued or fired!

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    Protect yourself, Protect your license, and most of all Protect your patient

    Did you know that the only way to protect yourself in a court of law is to follow your companyís policies and procedures, to the letter!

    If it is in the Policy and Procedure (P & P) manual, then it is written in stone for your workplace. If you chose to not follow the P & P and something goes wrong then you are not covered by the facility where you work.

    P & P are available to support, guide, and protect your practice. They are also there to protect the hospital or facility you work at from being sued. If you do not follow the P & P then they can fire you immediately and if a patient is harmed or dies then the buck stops at you!

    Reading the P & P is up to you. I strongly suggest you find out where it is located and familiarize yourself with the contents.

    If you had poor nursing training, mentors, and or preceptors then you can bet your bottom dollar half of them donít follow the policy and procedures provided by your facility.

    I suggest that you familiarize yourself with your company's current P & P. Most health care facilities have a committee who update these on a regular basis and often they will change. You will be informed of the changes either by email or in a staff meeting.

    Some Managers will review changes with you - making sure you understand them. Even if they send you these changes via email, read them because when these policies are sent out they have a Ďreadí receipt which confirms it was delivered and you read it. This will indicate that you have accepted the email and confirmed that you know about the policy changes.

    If you are anything like me, it is all dry boring stuff and you havenít got the time to read it. You have to make the time - trust me

    You have to respect these P & P because they are important and they do matter. I force myself to read them to check if I need to change my practice.

    P & P are normally in place because something went wrong in the past somewhere and there was a need to formalize practice; and, to make sure we are all doing the same thing.

    Often we worked and trained at different schools, hospitals. Not one of us practices the same, yet we all believe what what we are doing is safe and hat we are safe.

    What you need to keep in mind is that we need to make sure we are practicing safely according to our company's policies. Under normal circumstances, it is a small change in our daily routines to comply to policy changes.

    Can you imagine a defense in the court room of "Well I heard about it on a web site, so it must be true?" Or, "Well she does it that way so I did it."

    It's not a good defense, trust me!

    You have to follow your P & P and do it the way it is outlined in your P & P! Your internet friends could be correct in their practice but it is only correct if they are following their companies guidelines (ther own P & P).

    I do not know about you but I have worked with a lot of healthcare professionals who practice is less than desirable. How do you know that the advice you are receiving via the internet is not from one of those less than desirable professionals?

    You don't!

    If you are concerned about your practice and you want to practice safely then you know what to do!

    Protect yourself, protect your license, and most of all protect your patient.

    Go find that manual!

    Oh, and by the way, when you signed all that paperwork when you started your job, you probably signed to say you would follow the P & P of that facility.

    Remember your company will be protecting themselves, now you need to protect yourself.
    Last edit by Joe V on Nov 20, '12
    Meriwhen, Retired APRN, teeniebert, and 13 others like this.
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  3. About madwife2002

    madwife2002 joined Jan '05 - from 'Ohio'. madwife2002 has '24' year(s) of experience and specializes in 'RN, RM, BSN'. Posts: 9,451 Likes: 5,176; Learn more about madwife2002 by visiting their allnursesPage


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    26 Comments so far...

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    Well, I know my fellow nurses are going to dislike me for saying this, but is part of their P & P to constantly put us in unsafe situations putting our license and patients lives at risk? Yes, should we should always follow their P&P, but what do you do when you are simply overwhelmed all the time? I say in addition, get your own liability insurance. You can't always trust what these facilities say. Sorry just my 2 cents.
    prnqday, CountyRat, kf15, and 2 others like this.
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    Thanks for a very true, informative, and alerting dissertation.

    If only we could say on the stand, "My facility constantly places me in dangerous situations!" I know too well they would say, "And could you tell the jury, loud and audibly, did you accept that assignment?"

    I totally feel your angst and resentment at unsafe Nursing Practice Environments, and I know refusing a report is difficult- could even lead to firing. But, I would rather explain my resignation for unsafe conditions, than my termination for the medical error that severely injured a patient. The Policy and Procedure is what we will be judged by in nursing practice, documentation, and Admission/Discharging- and if I even have a twinge in my gut- I pull that big monster binder down.
    Wise Woman RN likes this.
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    It is so frustrating isn't it, that we cannot protect ourselves against the unsafe working practices we are all put in during our nursing career.

    I wrote this article because I worry about my fellow nurses, and how easily we can be thrown under the bus!
    Kashia, Susie2310, DesireeRN2011, and 1 other like this.
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    I work in an ER with very few written protocols.
    There is nothing written anywhere that allows me to start o2, iv, labs, let alone meds I might give without an order, including glucose, ntg, or ativan.


    In a perfect world, there would be a set of protocols for most foreseeable situations. I don't work in that perfect world. In the event of an emergency, I would really like for the doc to be there. They know more than me, and have the education, knowledge and authority to make better decisions than me. But- sometimes all the docs are tied up. At night, the one doc could be in the middle of a lumbar puncture, or an intubation. Or taking a poop.

    Where I work, a nurse who followed the P&P would be considered useless. I have worked in severa ERs, and this is not all that unusual
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    You can practice anyway you want but you need to be aware that In order to protect yourself , you need to know the policies and procedures of the unit where you work.
    If your place of work has none, then I would worry that they have them and you just haven't been told where they live.
    BrnEyedGirl and cienurse like this.
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    Quote from hherrn
    I work in an ER with very few written protocols.
    There is nothing written anywhere that allows me to start o2, iv, labs, let alone meds I might give without an order, including glucose, ntg, or ativan.


    In a perfect world, there would be a set of protocols for most foreseeable situations. I don't work in that perfect world. In the event of an emergency, I would really like for the doc to be there. They know more than me, and have the education, knowledge and authority to make better decisions than me. But- sometimes all the docs are tied up. At night, the one doc could be in the middle of a lumbar puncture, or an intubation. Or taking a poop.

    Where I work, a nurse who followed the P&P would be considered useless. I have worked in severa ERs, and this is not all that unusual
    If nurses in your care environment are expected to initiate medical orders outside of physician contact, you should petition the docs and the department for standing orders so that your butt is covered.
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    Im glad someone started this thread. Since I am a new grad this is a topic that I have spent a lot of time thinking about. When I started I was told that there would always be another Nurse to ask questions if I needed to. Latley I have noticed that I have not been getting much support on that front. It seems like other Nurses are afraid to give advice or sometimes are not sure what to do themselves. I work second shift and weekends when there is no managment. I had a client fall for the first time on me the other night. One of the other Nurses saw them on the floor in their room and she stood outside the door and asked a CNA to run and get me. I was on my own, no advice offered, nothing. I had to go find the paperwork and try to do it myself hoping that I was doing everything correctly. When I gave change of shift report I asked the oncoming Nurse where to put all the paperwork. I was just waiting to get a call today that I screwed something up. I would love if I could take the policies and procedures home because there is not 1 minute on my shift to go through that book because its all I can do to get all my work done. There was never a day of training where I was instructed on policy and procedure, it was just following another Nurse around and a checklist of things they were supposed to tell me.
    elprup, JulieL, WanderingSagehen, and 4 others like this.
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    OP thank you for writing this. The only thing I would add is that there is a difference between policy and procedure. Where I work they are not used interchangeably. The policy is why I go by, not the procedure. The procedure can be formal or informal and tells you how to implement a policy. However, a policy stands on its' own and following policy is ALWAYS the best way to go.
    One day I had questioned something and was ready to take on the clinical specialist, after all I had proof: I had a printed of the "procedure". After I handed her the procedure she directed me to the policy which was slightly different. However, it was that small detail in the policy that changed my whole view on the situation.
    As nurses we have to be proactive about this.
    [COLOR=#004000]DEFINITIONS[/COLOR].

    Policy:
    The formal guidance needed to coordinate and execute activity throughout the institution. When effectively deployed, policy statements help focus attention and resources on high priority issues - aligning and merging efforts to achieve the institutional vision. Policy provides the operational framework within which the institution functions.
    Procedures: The operational processes required to implement institutional policy. Operating practices can be formal or informal, specific to a department or applicable across the entire institution. If policy is "what" the institution does operationally, then its procedures are "how" it intends to carry out those operating policy expressions.
    madwife2002 likes this.
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    What bothers me most is that the P&P's are in 3 huge binders! Not to mention all of the new ones that come out daily. It is very overwhelming and next to impossible to find the time to actually look one up when you need it. I took a one day course over the summer and got some really good advice; look at one policy each day you work and eventually you will get through the books. I've been meaning to start.....
    Rodoon, elprup, sharpeimom, and 4 others like this.


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