Should I Carry Nursing Malpractice (Liability) Insurance?

[sirI]

This question comes up frequently and is asked of me quite often, "should I carry malpractice protection?"

What is Malpractice?

Simply put, it is a failure to adhere to a standard of care or conduct by a professional such as a Physician, Nurse, Attorney, etc. Malpractice occurs when it can be proven that the professional had a duty to provide a standard of care/conduct, breached that duty, an injury or damage resulted, and the injury/damage was caused by the breach.

No matter how educated, confident, and careful the Nurse is, unintentional mistakes can and will happen. Accidents will occur. And, unfortunately, willful neglect can be an issue. Injury and death very often are the results of mistakes, accidents, and neglect. Families want to know what happened. Even in the best scenario, the Nurse feels embarrassed and ultimately fears what the damage could do to a perfect professional reputation. Nurses must have the option of protecting their professional reputations and personal assets. Having individual Liability Insurance is a smart solution.

Nurses will often make the following statement

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My employer covers me so I don't need my own malpractice/liability policy.

Yes, your employer's policy may cover you, but only up to a point. Remember: Your employer's policy is created to fit their specific needs and protects them first. You may even be told (by your employer HR) that you do not need your own policy. What they do not tell you is that they want you to be represented by their attorneys. They do not want "outside" representation for they know that their best interests will not be first and foremost.

All malpractice liability insurance policies have limits of liability. If you are only covered by your employer's insurance, other defendants employed at your entity may and probably do share your liability limits under the same policy. If you, as well as others, are named in a suit, your legal costs, including any settlement, could exceed your employer's shared liability limits. This would mean out-of-pocket expenses for you.

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What type of policy and how much coverage do I need as a Nurse?

These are questions that are very important when considering a policy.

Two Popular Policies

• Occurrence-based - any covered incident occurring while the policy is in effect even if the policy is now canceled and/or you have retired
• Claims-made - any covered incident only while the policy is in effect

The cost of a policy is economical and reasonable. For example, the annual premium could cover the first hour billed by Attorney. $1,000,000/$6,000,000 coverage premiums are approximate $100/year in most states for the Registered Nurse (RN) as well as for the Licensed Practical/Vocational Nurse (LPN/LVN).

Links of Interest

• CM&F Nursing Medical Malpractice Program
• American Nurses Association
• Nurses Service Organization

One major benefit of an individual policy that is often overlooked or taken for granted when considering coverage is license protection. Nurses need to be aware that this will extend beyond their employer's coverage and includes discipline issues that can be brought up by the individual Nurse's Board of Nursing (BON). Many Nurses do not have the financial ability to go against the BON, therefore, license protection is a must.

Another all-important beneficial consideration is that policies normally will include coverage regarding libel, slander and patient confidentiality, including HIPAA issues. These issues can be troublesome and include a great cost for the Nurse.

Finally, a common statement that is incorrect and based on myth ...

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Malpractice liability insurance will make me a target and I'll be named in a lawsuit.

When being named in a lawsuit, no one knows you have your own personal policy unless you have revealed this information. Only after a lawsuit is filed and only during the period of the discovery phase is this information available.

So, do you carry your own individual malpractice/liability insurance? In the end, the question of whether or not the Nurse should carry malpractice/liability insurance is a personal one and should be seriously considered.

The peace of mind knowing that you are covered is overwhelming.

The peace of overwhelming reassurance.

[elkpark]

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OK...to clarify this for all of us. Do you mean that if we have functioned outside of our scope of practice or we have violated of SOC's or the hospitals policies then the nurse can be named and not covered under the hospitals malpractice coverage? Does that mean the hospital cant be held legally responsible financially for any negligent actions of the nurse/md/ etc etc etc? bc....if that is so then a lot of the hospitals could not be held legally accountable for the malpractice actions of the nurse.

And that isn't right either. I mean....if my child suffered an anoxic brain injury d/t a nurses negligence...or a doctors negligence that violated SOC's then that lets the hospital off scot free....or does it? See this is where a lot of nurses get confused. Because we always kinda think that all malpractice litigation has no factual premise. But in reality according to all kinds of studies like "to err is human ", and others,....the reality is that there are so many people each day that die d/t a medical or nursing error....and that very very few of those deaths / disabilities result in any type of legal action.

I think one study said the number of pt deaths d/t medical and nsg error is the equivalent to a loaded /packed jumbo jet full of people crashing every day or every few days. and that is reality. So a lot of healthcare personnel are fearful of attaining malpractice insurance for fear that they will not be covered under their facilities malpractice insurance.

So....to clarify are you saying if they violated the SOC's or P/P's for that facility that the nurse/md is not covered under the facilities umbrella malpractice policy...or does it just potentially give rise to the possibility they could legally hang the nurse out to dry for their actions?

As soon as any incident occurs that might end up being a lawsuit, the hospital's attorneys start looking for ways to reduce the hospital's liability (I'm not saying this means they're evil, or anything -- that's their job), and one of the ways they can argue in court that the hospital is less responsible is if they can identify someone else and blame that person/persons. I have seen this happen many times, myself, in real life (I've seen it happen to other people, that is). the hospital doesn't have to cover you under their insurance if they are making the argument that you acted improperly and that's the cause of the incident/negative outcome, and they will look very hard for any reason to say that this is someone else's fault.. how sure are you that you always, 100%, follow every detail of your hospital's policy, exactly the way it's written in the manual, for every procedure you do??? Can you prove it, if the hospital chooses to claim that you didn't??

And, keep in mind that, if you choose to take your chances with the hospital (relying on their liability coverage), the lawyers advising you on what to do and how to testify in court will be the same lawyers who are looking to protect the hospital ... do you really trust that they are also looking out for your best interests??

It's not that the hospitals "get off Scott free," it's that they will argue in court that they're not completely responsible, and the problem is mostly someone else's responsibility. Obviously, if the hospital has decided to blame you and argue in court that the incident was your fault, their attorneys cannot then turn around and defend you, so the hospital will cut you loose. and, as we've said earlier, if that happens, it's too late for you to get your own coverage, and you will have to pay for any necessary legal representation out of your own pocket.

To me, what it boils down to is, are you prepared to stake your entire future career (and future economic status) on your employer protecting your interests? I know that I am not. Again, I don't mean to imply that means they're evil or anything -- it's just simple reality that, if something bad happens, the hospital/facility management and attorneys will do whatever they need to do to protect the facility, and, if that means throwing you under the bus, rest assured they won't hesitate to throw you under the bus.

[Keysnurse2008]

Hmmm...this is actually very eye opening. I mean that is usually the whole premise of litigation. That the nurse/ MD etc violated a standard of care or the hospitals policy thus the injury occurred. I cant help but wonder HOW successful the hospitals are at arguing this?BC ...at the end of the day is the hospital hadnt employed that nurse/MD then the pt wouldnt have been exposed to the injury in the first place. So...out of curiousity.....how successful has this legal tactic been?

[elkpark]

tnnurse said:

Hmmm...this is actually very eye opening. I mean that is usually the whole premise of litigation. That the nurse/ MD etc violated a standard of care or the hospitals policy thus the injury occurred. I cant help but wonder HOW successful the hospitals are at arguing this?BC ...at the end of the day is the hospital hadn't employed that nurse/MD then the pt wouldn't have been exposed to the injury in the first place. So...out of curiosity.....how successful has this legal tactic been?

I don't have any statistics about the outcome of cases, but I can explain to you rationale the hospital uses -- when they first hired the nurse, they verified her/his licensure, checked her/his background to make sure there were no problems or concerns in the nurse's past practice, they put the nurse through an orientation program to verify that s/he was competent and introduce the nurse to how the hospital wants things done, and they provided a policy/procedure manual that spells out in detail exactly how they want the nurse to carry out each and every procedure performed in the course of the nurse's duties. They have done everything they could do to ensure that the nurse would be safe and competent to practice in their facility, short of assigning someone to follow her/him around all day, every day, and watch her/him at work, so how can they be blamed if the individual nurse suddenly decided one day to do something weird and dangerous? They've done everything they could reasonably do to ensure that that was unlikely to happen, and there is no way they could have forseen or prevented the nurse's action in this incident.

You've got to admit, that's a pretty compelling argument -- what else could the hospital have done? Also, keep in mind that, in civil suits, the standards are not "innocent until proven guilty" and "beyond a reasonable doubt" -- each plaintiff involved gets a chance to try to prove that the injury, whatever it was, wasn't its/her/his fault, and the standard the jury uses to arrive at a decision is "a preponderance of the evidence" (that is, >50% ...)

Again, I don't mean anything negative about employers when I say that, no matter how many times you're told "we're all family here," or whatever saccharine and meaningless cliché a facility chooses to use, your employer is not your friend. It's your employer -- that's just reality. If you trust your employer to protect your interests and professional future, you're in for disappointment, small or large, at some point in your career. Small disappointment is disappointing. Big disappointment might ruin your career and your future ...

[UpinArms]

sirI said:

Excellent, Sue. Wise decision.

Yes you should, becouse here in okla a lpn can do what every they want to and ge away with it and the Okla Nursing Board wont do anything about it, yes nurses can do things wrong like file false reports to the hospital and file patient record under Jane Doe O and by the way the Jane Doe was his 12 yr old daughter that hurt her arm at his house on his weekend visit and would not take her to see a Dr about it and hegot fired from tht hospital and do other things and yet the board wont do anything about it and yes I did file with the board and 5 months later nothing has been done and no witness have been contacted and when I call the Okla Nursing Board they wont tell me anything, why why why?????

[MaritesaRN]

UpinArms said:

Yes you should, becouse here in okla a lpn can do what every they want to and ge away with it and the Okla Nursing Board wont do anything about it, yes nurses can do things wrong like file false reports to the hospital and file patient record under Jane Doe O and by the way the Jane Doe was his 12 yr old daughter that hurt her arm at his house on his weekend visit and would not take her to see a Dr about it and hegot fired from tht hospital and do other things and yet the board wont do anything about it and yes I did file with the board and 5 months later nothing has been done and no witness have been contacted and when I call the Okla Nursing Board they wont tell me anything, why why why?????

My opinion is that if you work in a clinical area, you must since the lawsuit in this area are higher thatn a nurse that works in a insurance or office job.

[lamazeteacher]

When I was working in California early in my nursing career, an inservice about malpractise insurance/legal liabilities was given. Upon finding out that the hospital lawyers wouldn't necessarily defend me too, in a lawsuit, I also filled out the card in the front of RN magazine (in the early '70s), and carried it throughout my career!

However, I've never heard how the service was, when it was needed. Has anyone needed to put it to the test?

[bayes]

I have been actively in nursing for 39 years and have never had malpractice insurance.

[elkpark]

bayes said:

I have been actively in nursing for 39 years and have never had malpractice insurance.

I've never had to use my homeowner's insurance in the 25 years I've owned my house, but I still purchase it each year ...

[shiccy]

cjcsoon2brn said:

That's really interesting, I honestly haven't put much thought into that. So sirI at what point would you recommend that we look into malpractice insurance? I am still a student but I want to be prepared for these kind of things ahead of time.

!Chris

I reside and went to school in Ohio. I was informed that the college *I* went to had an excellent malpractice insurance they take out for all of their students. I was then told, "If you don't get insurance after your done with school, you're an idiot.

Just having the peace of mind if the chance came up is enough for me to pay the $90/year fee. I don't care if I don't use it in my entire career - I do my job as best as I can and with as much care as I can pull out of my soul ... the saying **** happens is true, and it's just like driving the car. You never know what can happen... You can be driving along, minding your own business, and *POP!* your tire falls off and you're in oncoming traffic.

[lamazeteacher]

VACRNA said:

Not sure if this has been covered but it you stay within your Standard of Practice you are OK without an individual policy. Another reason is usually you have much deeper pockets standing in front of you. A malpractice lawyer is more apt to sue the doctor or medical institution where you practice

I'd like to know the source of your information. If it was a doctor crying in his/her "beer", forget that!

When malpractise litigators file their cases, they grab everyone within eye or " ear shot" of the happening. What's in a nurse's pockets may not seem like much to the "heavy hitters", but whatever you have will be taken anyway - which for you, will be a lot! :paw:

I sure hope that in your line of nursing, you have the highest insurance for malpractise that you can get....... and lots of other resources for income.

[Blessedx3]

sirI

I am half way through NP school--and have some questions I would like to ask you via email. Would you be willing to share that? Thanks so much.....

[sirI, MSN, APRN, NP]

Sent you a pm, BlessedX3