Ever have one of your patients threaten to sue? Scared!

barbyann · May 12, 2006

You can't rewrite your documentation but you can certainly place an OOS (out of sequence) note in the record. If you feel there are details that were not placed on the record go ahead and write more. Just be sure to date and time it when you actually write it and label it OOS so it will be clearly labeled.

beautifulb · May 12, 2006

I feel that sometimes pt's will throw that "S" word in for a control issue. I used to be nervous each time I heard that word. In the past I would be searching the mail looking for a letter from some attorney's office saying I would be named in a lawsuit. Each time 7 yrs go by I take a deep breath! But honestly, document what you do and the pt's response.

I wouldn't worry too much.

**canoehead, BSN, RN** · May 13, 2006

Just reply "That is your right, sir." and go on with whatever you were doing. Ask them if they would like to write out a complaint form. People don't write very coherently when they are angry, so it will probably do more for you than for him if her takes it further.

Or, for the REALLY obnoxious ones, say " I would welcome the chance to talk about this entire situation in court." Say it like you really mean it, for best effect.

Jo Dirt · May 13, 2006

About 3% of attempted lawsuits ever make it to settlement/courtroom.

So, I am 97% certain you have nothing to worry about.

NephroBSN, BSN, RN · May 13, 2006

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Ruby Vee, BSN · May 13, 2006

unfortunately, threatening to sue is a very commonly used control tactic. usually the ones who do end up suing don't throw that word around lightly. i wouldn't worry about this guy . . . just shrug it off as best you can. document, document, document and try to maintain a good relationship with all your patients and families. people are less inclined to sue someone they like.

i once had a lawyer threaten to sue me because i wouldn't get him a big glass of ice water. (npo.) i just laughed at him and told him to grow up. he ended up liking me. go figure!

911fltrn · May 13, 2006

I have heard this statement hundreds of times. It is almost always from some drunk idiot whos out of his mind. I inform them that it is always their right to sue, but im sober and at work, your drunk and acting foolish. Who do you think will win.

I work e.r. I have had one pt. begin the process of sueing. Once the plantiffs attorney read my nurses note, the litigation stopped. The power of the pen is indeed mighty at times.

PamUK · May 13, 2006

In order for calims to be successful the patient (plaintiff) has to prove the following THREE issues:

1. that you had a duty of care to them (easy to prove)

2. that your actions fell below or deviated from the standard of care expected of a reasonable person (in your case a reasonable nurse)

3. that your actions caused FORESEABLE harm

So go through point 2 & 3 and answer the questions. Chances are that you did nothing wrong and this patient was just being a total pain. It is very difficult to prove point 3

In the UK, I think patients only have 3 years to complain or sue. I'll check that one out

Hope that helps... and stop beating yourself up... PLEASE

bluestar · May 13, 2006

Carry your own liability insurance, do your job to the best of your ability.

I agree with this.

grinnurse, RN · May 13, 2006

If I had $5 for every family member that has muttered those words...I'm getting/talking to my lawyer...I'd be rich and retired.
Unless you know something is really, really wrong don't fret it unless you hear from risk management. In health care, you will hear this more times than you ever thought you would.

Ditto. The first time a family member said that to me, which I had approximately been a new nurse for roughly 2 months, freaked me out!! Now, I am like, don't let the door hit you in the a** on the way out of the hospital to the lawyers office. Usually the ones that threaten are the ones who are drug seekers in my case that is what I have seen anyway. And as long as you have charted properly and been with in your scope of safe nursing practice, your good.

grouchy · May 13, 2006

I'm so glad I read this thread! Many of you have come up with excellent verbal replies to defuse or counter the situation. The kind of stuff I wish I'd been smart enough to think of myself.

I would just add that it is my understanding that not only does someone have to prove that you deviated from the standard of care, but they have to prove that you actually caused harm - not a potential to harm. This gets rid of alot of garbage lawsuits.

I'm pretty neurotic, and I still tend to get pretty worked up about the risk of being sued, even when I've done my best, and no threats have been made. Working in understaffed, dysfunctional situations means that even my best may not be enough to truly meet the standard of care. To calm myself down, I try to think about the situation in the following terms- stuff I've garnered from my reading.

First, I've read that even when harm is done, many lawyers will not take a case unless it is a big money case. They feel it's not worth their time. Second, even though a lawyer may take a case on contingency, that only applies to their fees, not any costs associated with discovery, subpoenas, etc. Very few people have the financial means to front the money for the costs associated with a case, especially as it may take years to wend its way through the courts. Third, people are going to go where the money is - which means they are going to target the hospital first, the doctor second, and you third, assuming that you have not grossly neglected or abused a pt.

I carry my own malpractice insurance, because hospital-supplied malpractice insurance will do nothing for you if the hospital argues that the blame falls on you because you failed to follow their protocols - even if it was impossible to do so because of lack of staff, equipment, etc. Never assume that the hospital's lawyers will protect you - they are there to protect the hospital, and the easiest way to do that is to pick on someone like you.

I chart the stuff that I think actually could apply to failing to meet the standard of care. For example, when there have been repeated problems getting stat labs drawn in a timely manner, I chart when I called phlebotomy. Charting to protect myself sometimes wins me little talks from my manager, but I'm not charting for him or her - I'm charting to convey information accurately to other members of the health care team, and for the jury that might be reading these charts someday. If confronted, I don't say this - I just play dumb.

These kind of threats are very upsetting, and will really keep you up at night. It's tough when you're new, and you're nervous about doing an adequate job anyway. Nobody prepares you for this, or talks about this in nursing school. Nor do you get the impression from TV that unfounded threats happen. I think it's something that none of us ever expected, and we feel truly hurt, as we have usually been giving 110% in unimaginable situations, going without meals and bathroom breaks to try to keep our patients safe. Even when we know that the situation is beyond our control, we go home at night blaming ourselves, thinking that maybe we could have somehow managed to give 120%. It's even worse when you're new. I think everybody feels like a bad nurse for the first year or so. We need to realize that the first year of nursing is kind of like being an intern after medical school. Try to remember that most of the anger that fuels these remarks comes from people's experiences with the health care system overall, not something you did. It also reflects what I think of as the "Jerry-Springer-ization" of social norms. These situations will happen to even the best professionals, given the cutbacks in Medicare and Medicaid, and other financial pressures affecting hospitals. All you can do in an imperfect world is to do the best you can do and "leave the rest in God's hands", to put it in religious terms. Meaning, don't beat yourself up for situations beyond your control.

My advice is intended to help you feel less anxious - not to take the place of other advice offered on this thread. Many of the comments, such as talking with your manager and risk management, are excellent, and are also part of what I do in this kind of situation.

Antikigirl, ASN, RN · May 13, 2006

The statue of limitations in most states is 3 years. Unless it's baby.

Over the past four years working mostly Assisted Living and elder care, the trend of certain suits (not sure which ones) have been extended in our state to 7 years, use to be 5 (my facility management went to a BON class for management in regards to lawsuits due to a significant rise in our state and what patient/facility rights are...and this was mentioned to show how bad things are getting)So I think that goes pretty much for elders...so I just use that as the worse case scenero guide to charting!

Heck, just documenting well enough to be able to know exactly what you did a year from the day is good enough...if you can read it a year from then...it is good to go for more .