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Litigious Areas of Nursing and the Nurse's Liability



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Sep 29, 2008 04:23 PM

Litigious Areas of Nursing and the Nurse's Liability

by sirI Staff
Updated Jul 04, 2009 at 11:21 AM by sirI

The 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)
  • Inexperience
  • Ignorance
  • Inadequate patient monitoring
  • Poor nursing judgment/critical thinking
  • Hesitation
  • Faulty communication
  • Ignoring patient complaints
  • Fatigue
  • 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.


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6 Comments
No. 1
from BimmieBear
Old Feb 10, 2009, 02:28 PM

Default Re: Litigious Areas of Nursing and the Nurse's Liability
Thank 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.
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No. 2
from sirI
Old Feb 10, 2009, 03:04 PM

Default Re: Litigious Areas of Nursing and the Nurse's Liability
Hi, BimmieBear. Good to hear from you.

Yes, the newness of the nursing career and all new territory as you orient can be very overwhelming sometimes.

Hope you have taken out liability insurance. Great peace of mind for very little each year.
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No. 3
Old Feb 14, 2009, 04:40 PM

Entertainment Re: Litigious Areas of Nursing and the Nurse's Liability
Great advice for everyone, especially about kind words. People don't care about your degree(s) and certification(s). They do care about your kindness and honest concern.

Nurse Pam
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No. 4
from CrispRN
Old Feb 19, 2009, 08:04 PM

Gavel Re: Litigious Areas of Nursing and the Nurse's Liability
I 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!!
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No. 5
Old Mar 09, 2009, 04:51 AM

Default Re: Litigious Areas of Nursing and the Nurse's Liability
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.
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No. 6
Old May 15, 2009, 09:24 PM

Default Re: Litigious Areas of Nursing and the Nurse's Liability
Originally Posted by Timehonored RN View Post
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.
That wouldnt make sense to any layperson in society , mustless a healthcare member.
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