Litigious Areas of Nursing and the Nurse's Liability
by sirI Admin
- 23 Published Sep 29, '08the 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 (including long term care) 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, the neonatal nurse practitioner (nnp) seems to be at high risk secondary to "pain and suffering" issues.
but, 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:
- failure to abide by the nurse practice act
- failure to follow the soc
- failure to adhere to policy/protocol/procedure
- failure to document, including lack of documentation, altered documentation, missing or "lost" documentation, incomplete documentation
- failure to recognize change in patient condition
- failure to appreciate the change in patient condition
- failure to report change in patient condition
- failure to follow up change in patient condition
- failure to communicate across the healthcare provider spectrum
- failure to monitor
- failure to act as patient advocate
- failure to provide a safe environment
common reasons for errors:
- job overload (poor nurse-patient ratio)
- inadequate patient monitoring
- poor nursing judgment/critical thinking
- faulty communication
- ignoring patient complaints
- breaks in concentration
- flaws in the system
- inadequate staff training
- the nursing shortage
ways to ensure safe practice and avoid litigation:
- be familiar with our individual nurse practice act (npa)
- adhere diligently within our scope of practice (sop)
- know the soc for our specialty area(s)
- question authority
- educate ourselves regarding evidenced-based practice
- stay abreast of changing trends in nursing through continuing education
- educate ourselves regarding medical-legal issues
- make sound, safe, and practical nursing judgments for all our patients
finally, a kind word and non-defensive attitude with a patient turns away many a lawsuit.Last edit by sirI on Jul 4, '09
sirI joined Jun '05 - from 'allnurses.com'. sirI has 'many' year(s) of experience and specializes in 'APRN, LNC, Forensics, OB, ED, Education'. Posts: 85,851 Likes: 21,667; Learn more about sirI by visiting their allnursesPage
17,703 Views1Feb 10, '09 by BimmieBearThank you sirI for posting...I'm a new graduated nurse. Currently in my 1 month and 1 week of ED orientation. I came to realize how vulnerable I am as new nurse--that feeling sucks. The only thing that keeps me going and learning is through prayers.3Feb 19, '09 by CrispRNI think this is an excellent blog. Too many of our peers are caught up in "just doing their job" that they forget the legal ramifications of "just doing their job."
I work in a cardiac cath lab and currently am dealing with having our nursing assignments made by a non-nurse who is a RCIS and called a "Team Leader". It bothers me that she is making a nursing judgement in making our assignments because she makes the decision of who works where within the department e.g., circulating cases, pre-case assessment, post-case recovery, angiography, et cetera. There are 9 nurses in our department and I question her ability to know what nurses are capable of and our responsibilities. She makes the decision of who is doing the patient assessments, giving conscious sedation, and watching the monitors. My question is...how will a judge, jury and plantiff's attorney react to the nurse if something happens because this "Team Leader" assigned someone to an area which he or she is incompetent? Is this "Team Leader" practicing nursing without a license??
I'm very upset and outdone because I have worked very hard to get a college education, pass boards, obtain certifications and further my education when I'm taking directives from a person that was on the job trained and doesn't even have college degree!!0May 15, '09 by Keysnurse2008Quote from Timehonored RNThat wouldnt make sense to any layperson in society , mustless a healthcare member.You're right to be concerned. As a Legal Nurse Consultant I can tell you that's something I'd be all over in litigation.
Letting non licensed people do jobs that require clinical judgement is foolish.
Your hospital should consult with a CLNC regarding this.0Aug 14, '10 by msn10Interesting post. Can you tell me where I can find the research for this? I think everyone has always known that OB is a high risk area whether you are a physician, APN, or staff RN, but anesthesia is different. I did not realize that CRNA practices were so vulnerable for litigation. Anesthesiologists actually have on of the lower malpractice rates (at least in our state) so it surprises me that CRNA's are high. Any article titles would be appreciated.
Thanks.0Aug 17, '10 by awsmfunAs an RN that "won" a medical malpractice settlement after the death of my husband, (if you want to call it winning after your your husband/best friend dies), I can't agree more on how far a kind word goes. Part of the reason that I did litigation was because of the way I was treated after my husband's heart stopped. Almost no one talked to me, except one nurse and one doc. I was treated with silence from what I had thought was my sisterhood of nurses and healthcare workers. The two healthcare providers that did express condolences did so simply by saying, "I'm sorry." Those two words let me know they were the true healthcare providers among the many who treated him.
The nurses had a chance, as sirI puts it, to question authority, yet no one did.Last edit by sirI on Aug 18, '10