IL Supreme Court Rules Only Nurses Can Testify on the Standard of Care for Nurses

Nurses Activism

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from psna enewsletter:

the american association of nurse attorneys (taana) recently announced that the illinois supreme court responded positively to taana's amicus brief submitted in the case of sullivan v. edward hosp., no. 95409, 2004 wl 228956 (ill. feb. 5, 2004) when the court issued its decision on february 5, 2004. citing extensively to the taana brief and also to the authorities cited by taana, the court ruled that only a nurse is qualified to offer opinion evidence as to the nursing standard of care.

the brief was drafted after almost two years of research by members of the taana litigation section and was written by karen butler, chair of the litigation section. the chicago chapter of taana, particularly, leatrice schmidt, reviewed and submitted the brief. the issue, in brief, was whether a physician, who is not a nurse, should be permitted to offer expert opinion evidence, as to the standard of care for nurses. the taana position is that nurses and only nurses have the authority and responsibility to define the scope and practice of nursing. the illinois trial lawyers also submitted an amicus brief arguing that physicians can do anything a nurse can do and, therefore, a physician can always testify as to the standard of care for nurses. for a copy of the decision, contact the taana national office.http://www.taana.org/

Specializes in Nursing Education.
That's an interesting comment Tmylen. An EMT career doesn't exactly make me out to be an overachiever-type-A personality now does it? :rotfl:

I would not waste time pouring through a legal brief to make observations. I would most definitely not wade through nursing doctrine trying to decipher it. Nursing care itself is not complicated but the words used to describe it can seem like rocket science. In nursing's stuggle to evolve It has been nescesscary to breed contempt towards the medical institution from which it was born. Even the mention of 'hierarchy' raises the hackles.

Contempt towards physicians is understandable considering the pressure nurses are under to perform thier orders and be scrutinized negatively when the procedures are not carried out to thier satisfaction because of circumstances beyond the nurse's control. Once the nurse catches crap from the doctor, she can look forward to catching comparable amounts of crap from the family, her supervisor and eventually the BON.

It's true, nursing is becoming more specialized................but what kind of specialization is it? With no medical training; nurses are setting a precedent for a future with no medical encroachment for decision making. The precedent is set for the BON to just get that scope of practice expanded. If the BON can get this far, it's only a matter of time.

I'll be writting orders some day. You can be assured that I'll be scrutinizing my own expertise and that of the nurses I write orders for.

Congratulations, and good luck

Peeps - what scares me about this post is that, according to you, you will be writing orders someday. The fact is not that you will be writing orders, but that you have such contempt for nurses. I have been following this thread from the start. Many of the nurses on this BB have tried to explain to you the difference between medicine and nursing .... and there is a difference. Yet, throughout each of these posts, your response promotes medicine and denegrates nurses. There can be a world with both medical professionals and nursing professionals. Each can have a seperate scope of pracitce and also work in harmony. I have been a nurse for a long time. Over the last 10 years, I have witnessed wonderful changes taking place between nurses and physicians. We are both needed in today's crazy heath care world to meet the expanding needs of the aging baby boomers as well as the very fragile elderly. I am excited to be a part of such a dynamic work in process. Yes, there are parts of the health care delivery system that still suck. But, day after day, people are working to fix the system and make it better.

Nurses and physicians are an integral part of the framework of making our health care system better. This means that we need and should embrace the advancement of nursing science as well as nursing's evolving role in health care. Putting down the maturation of nursing as a profession is certainly not a way to enter into medicine. I submit that as you go through residency, your best friend and the one who might save your butt will be a nurse. Please remember that.

Now, as to the original topic on this thread, I applaud the judge who made this ruling. Nursing is the only expert about nursing care. There is no other expert.

Peeps, I think this is a case of you reading more into a situation than you should. I get the impression that since you didn't like nursing school you have taken a negative view of everything nursing related, despite the fact that you have never been a nurse. The fact that you think "niceness" is all that differentiates nursing from medicine is evidence of that. I don't understand how you can make a logical argument that a nurse isn't the best person to testify about nursing. Maybe I'm just simple, but it seems like it's better to get it from the horse's mouth than from someone who has never done the job.

I actually get along really well with the vast majority of the docs I work with, even the residents. There are a few jerks, but that's true of the nurses I work with too. I have never had my care scrutinized by a doctor or "caught crap" from one of them, mainly because, unlike you, they are aware that they are not my supervisor and that I am perfectly competent in MY job (and not anymore interested in taking their job than they are in taking mine). If you want to comment on nurses' reactions to the hierarchy, you might want to actually understand what it is in the real world.

I think that is great!!!! :balloons:

I think it's quite a stretch to say that I'm putting nurses down in some way. I don't feel that i'm being contemptable towards nursing. That would certainly be silly since I'm posting on a nursing board now wouldn't it?

Now, what I DID intend was to say that nursing is blindly gobbling up responsibility just for the sake of having more responsibility and in so doing is setting a precedent that could have consequences not yet considered by the whole.

I was well aware that my opinnion would draw out the people that think because I don't support everything nursing, then I must hate them. That is fine as long as you quote an example. It seems that it would be quite easy to find a passage in something I've written since I have such contempt.

I even gave congratulations for the victory........maybe I didn't have any :balloons: . Is that the problem?? It is a win for nursing and I do not intend to make it a backbiting contest. I would love to make a point about some good comments but it will not come out the way everybody wants. I can't backpeddle on what I said. If you appreciate nothing else, at least appreciate that I am not wishy-washy.

I may be playing devil's advocate rather than the actual devil.

Not to insult anyone here but I had an interesting talk with a doc one day in which I learned that he thought we hospital floor nurses knew more about our pt's than we do!

He expected we had actually read all the pt's H&P's, lab & test results, etc before caring for the pt's. He, had known his pt's for years, from seeing them in the office etc.

What he didn't realize was that I had a 10-15minute report on my group of pt's then am expected to be out there immediately giving care, meds, treatments, answering lights etc.

So, I can only conclude that if he had to give expert testimony as to what a nurse should have known or done, well, he might just over-estimate the expectations!

I'm not saying we don't do a great job, we do! But it's another aspect to look at.

We actually do read the whole schwack before our shift, including labs, etc.

Specializes in Inpatient Acute Rehab.
We actually do read the whole schwack before our shift, including labs, etc.

The other nurses that I work with and myself always read the H&P, labs, careplans, orders, Mars, and 24hr nurses notes prior to starting our shift.

It is a tremendous help and we wouldn't have it any other way.

I did the same thing as a respiratory therapist and as a student nurse.

Well, I didn't and don't read everything word for word. I focus in on problem areas and scan the rest. I read the doc's plan, look at labs related to the diagnosis, lytes and CBC, the first part of the H&P to make sure I have all the co-morbid diagnoses, verify that the meds I am going to give have current/active orders, and check for new orders/nows and such. Then I'm off to do my assessments. I constantly refer back to the chart as necessary. Invariably, I find orders undone, meds not delivered, etc. That's what takes up to much time. Sometimes I think we could handle more patients if the ancillary services kept up with the pace. But one patient having problems can chew up a lot of time.

We only have 2 patients and their histories are always less than 6 months since they are babies.... Usually in report I can honestly say I have looked at their history from birth to present:) It is important because the docs can be looking after 15 and often miss or forget little details like Hgbs of 76....

I have been reluctant to jump in here, because Peeps has gotten this debate so of course. But here it goes.

Courts describe the standard of care as follows: Nurses are expected to conduct themselves professionally according to a generally accepted reasonable practice of nursing care, and their performance will be compared to the performance of other nurses in the same specialty. In a malpractice action the adequacy of a nurse's performance will be based on a professional standard and tested with reference to the performance of other nurses.

So, if the issue of laboratory values comes up in court. The expert nurse would testify that the standard of care is for the nurse to look at the labs at some time during her shift. the attorney might say "Would there ever be a time when a nurse would not look at the labs?" The nurse expert would give a variety of reasons why, such as short staffing and lack of time to review the labs.

Being an expert witness on the legal standard of care has nothing to do with who knows more, the doctor or the nurse. You are testifying, as the nurse expert, as to what the average nurse would do in a certain circumstance.

Why would a doctor know what a nurse does on a day to day basis?

Nurses are being named personally in lawsuits more and more. And I have seen nurses scapegoated too many times. In a malpractice situation, hospitals and doctors point fingers at nurses and blame nurses for everything that goes wrong to divert the attention away from them. This is why I would rather have a nurse expert testifying on my behalf, rather than someone else, who has no idea what it is like to be a nurse. That is why this Illinois Supreme Court decision is so important.

That seems reasonable.

Testifying as to whether the labs were checked rather than the biochemistry behind the values.

I think such semantics are important to discuss and I don't see how it's off track to do so.

A reasonable thoughtful post almost always follows another.

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