My Pet Peeve

[canoehead, BSN, RN]

Listen folks, I am about to spout off.

I really hate it when in my facility, and yes, on this board, the first question in a situation is " what's our liability in this situation?"

I think it shows disrespect for our patients and a disregard for their lives- puts our concerns ahead of theirs when we should be focusing on their needs. Why do we insist on talking liability as if patients were adversaries?

Our first and usually the only concern should be for a healthy outcome. We should be using the proper technique, doing timely monitering etc because the patient needs it and "what if they suddenly went bad and we didn't catch it?" We should be paying attention to timely and thorough documentation because the full picture needs to be available to coworkers, and to the nurses that come after us and " what if I don't chart it and the next person doesn't realize it's a problem?"

I think if we take care of our patients the liability will take care of itself. I am tired of hearing patients referred to as enemies. Let's start a movement to conciously change the way we think, and change the way we speak to coworkers, and do everything to promote a rapid and healthy outcome. Leave out the fear of a suit and I think we'll be happier at our jobs and provide better care.

[KellyandtheBoys]

I can understand what youare writing. However, I don't totally agree. I think we live in a very legal world right now. I can't tell you the number of times I've had people threaten to "call my lawyer" for simple issues. These issues include test delay, family members not being able to SIT in a CAT scan room, N.P.O. status(for a test) and on and on. Of course, the vast majority of time these folks are scared and letting off steem. But, one never knows.

I think it is rather niave to think that if you do your best you will avoid the legal system. Unfortunately, it just isn't that simple. People expect the impossible from the medical professionals. For instance, we had a 60 yr. old woman with a100+ yr. smoking history. She had metastatic small cell (lung) cancer when she saught help. She died quite quickly and thankfully peacefully.

However, her family was very upset that she died and sued the hospital and Dr.'s. It doesn't mean the WON. But, it was a pain for all involved.

Most lawyers involved in these kinds of suites know that the hospital and Dr. will usually settle out of court even if there is no real issue to sue over.

This is what frightens me and makes the nursing profession not so much fun.

[canoehead, BSN, RN]

You have a good point, however I think that by conciously changing the focus from the lawyers to the patient needs I've been able to have a constructive conversation with cranky families in the past, and ended up being able to meet their need (to be listened to) without either of us feeling like we are on the defensive. Usually I say something like "and that's your right" (sueing), and then review the situation and what we have done and what the plan is now, and what else we are doing to make the patient comfortable. I ask what else they think could help- given the situation, and go from there.

By focusing on patient needs instead of liability don't you think we would end up doing all the same things intervention wise as we do when we are trying to treat defensively. BUT, we would be doing them for a more positive reason, and feeling better about our jobs.

The approach has averted some ugly situations for me as a supervisor. Sometimes I wonder if the whole hospital stopped thinking liability would it help improve communication, and up everyones satisfaction.