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.

[sirI, MSN, APRN, NP]

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.

[Oldiebutnewbie]

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

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!!

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.

Timehonored RN said:

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.

[DougMSNRN]

Bimmie...be patient with yourself. It will take months to feel comfortable in your new role. Start each shift with a clear head, ask questions when you are not sure and identify your mentors early on. You can get through this!

Doug

As an RN that "won" a medical malpractice settlement after the death of my husband, (if you want to call it winning after your your husband/best friend dies), I can't agree more on how far a kind word goes. Part of the reason that I did litigation was because of the way I was treated after my husband's heart stopped. Almost no one talked to me, except one nurse and one doc. I was treated with silence from what I had thought was my sisterhood of nurses and healthcare workers. The two healthcare providers that did express condolences did so simply by saying, "I'm sorry." Those two words let me know they were the true healthcare providers among the many who treated him.

The nurses had a chance, as sirI puts it, to question authority, yet no one did.

Edited Aug 18, 2010 by sirI

A nurse told me tonight that she is documenting short staff by "two psych techs on shift". Many patients are strict line of sight on the psych unit and two staff members plus nurse, math don't add up. So she says she covers it through documentation. What do you think?

candlecat said:

A nurse told me tonight that she is documenting short staff by "two psych techs on shift". Many patients are strict line of sight on the psych unit and two staff members plus nurse, math don't add up. So she says she covers it through documentation. What do you think?

She can "document" short staffing all she wants, but the courts and BONs have repeatedly held that short staffing is not an excuse or defense for providing less than adequate and safe care. As the RN, your options are to either refuse the assignment in the first place, if the situation is unsafe in your professional judgment, or do your job adequately/competently regardless of the staffing levels. Your acquaintance is not protecting herself in any way by documenting the staffing level. If anything goes wrong, she will be held to the same standard of care and practice regardless of how many or how few techs she had on that shift (and I guarantee you (and her) that no one from the administration is going to step forward and say, "Oh, it wasn't her fault -- we made her work short-staffed" -- they will leave her to dangle in the wind).

[sirI, MSN, APRN, NP]

elkpark is absolutely correct.

Short-staffing is one major reason for nursing errors, but not a defensible excuse that will hold up in court.

[sirI, MSN, APRN, NP]

Again, reviving an older Article.

Have you ever been named in a lawsuit? If so, did you have Liability Insurance coverage?

What are your thoughts on carrying protection?

[traumaRUs, MSN, APRN, CNS]

I would only practice nursing with my own malpractice insurance. Its nice to know there is someone (lawyer) in your corner. BTW if you are sued and its successful, after all the paperwork is filed, the stamps placed on the legal documents and the gavel comes down, guess what? THEN, it goes to the BON. Ugh!