New exclusions on renewal of NSO liability insurance.

[anonymurse]

Anyone check out CNA's G-147292-A rider that applies to renewals?

There are new exclusions here, Silica, Mold and Asbestos. Seemed innocuous enough, all related to environmental liability.

But this (under mold) caught my eye: "...it is necessary to exclude, or in some states restrict, coverage for mold, fungi, or microbe related losses. Accordingly, the exclusion or limitation that may be applied to your policy will specify the absence (or extent) of coverage for mold/fungi/microbe related losses."

And you know the first thing that came to mind was nosocomial (or HA if you prefer) infections, because I've been told HA infections are presumed to be, as are decubiti (and their infections) nursing's fault, and because one of my first experiences in a hospital was walking into a room where an outside sitter had fallen asleep and the confused THR patient had clawed off her dressing and was scratching away at her thankfully-stapled incision, with blood all over her hand.

Now when I called NSO, they said it was about the environment, but first off I don't see how I can get sued for what's in the environment that's not under my control, and second I don't see anything in the above that says it's about the environment. So I can imagine a suit alleging nursing negligence in the case of molds, fungi, or microbes getting into the patient.

Then I looked at the silica. Excluded is "'bodily injury' which arises out of the respiration or ingestion of 'silica'," which could be broken glass, like a piece of an ampule, since they say "'Silica' means the chemical compound silicon dioxide (SiO2) in any form, including dust which contains 'silica'."

And asbestos looks safe, but then it says "excludes coverage for Bodily Injury, Property Damage, Personal Injury and Advertising Injury arising out of the actual, alleged or threatened exposure to asbestos...." And whereas I'm not smart enough to imagine what that might mean, I figure at least I know this exclusion isn't in my liability policy for mere show.

So will someone who's smarter than I am either reassure me or scare the heck out of me by telling me what all this really means? 'Cause as it is, I'm left standing here glazed, dazed and amazed.

Thanks in advance!

[Medic/Nurse, BSN, RN]

Wow. You make some good points - but, I think you are "overthinking" this just a little. Sure, there may be some way to connect this dot to that dot and then ... well, you have an obvious straight line.

Legal Gobelygook. Necessary? Maybe, but really inhaled glass from broken ampoules - I'd worry more about inhaled micro-dermabrasion crystals from those rare addicts that lurk in medi-spas everywhere! :)

But, before you cross that line - I think that perspective may be in order. If I wanted to think about ANYTHING and EVERYTHING that I could be sued for -

I KNOW that I would never sleep again - I'd become psychotic from the insomnia, then have a car wreck on the way to work - all the while hitting a lady pushing one of those strollers for triplets (that all happen to be baby genius offspring - with projected lifetime earnings in excess of 50 millions each - oh, and they all die horrific deaths) and then total a rare Ferrari, hit a Jag in the gas tank (and it would burn) and then the smoke blurs my vision and I cross the median to hit a tanker of Tri-Ethyl-Deathyl that will kill lots of innocent people at once (think India in the 80's) and then leave a forever scar on the environment that will force the relocation of thousands of families (think Chernobyl) and leave lasting marks on generations of genetically damaged offspring from that crazy chick that caused that wreck on the way to work.

Whew...that hurt.

I think that it is OK to be cautious. I think insurance is good - if it makes you sleep better at night. But, (and this is big) I know that:

• I do the absolute best that I can for every patient every day.

• I take great pride in doing a good job. I stay current and follow EBP.

• I document well.

• I am practical, deliberate and through - but, I have to be efficient.

And I do make mistakes. I do wish I could do things better/different/faster at times. I also know:

THAT I CANNOT PREVENT ANYONE FROM SUING ME FOR ANYTHING!

and then I just do my job as well as possible. Please don't obsess over this - I'm not saying that there is no liability - I am saying that THERE IS NO PLACE THAT IS SAFE FROM A PLANE FALLING FROM THE SKY (or A HELICOPTER FROM FALLING OUT OF THE SKY!).

Then I get up.

Get ready.

And go save lives (or something like that!).

It is really difficult to place ANY liability on a nurse that practices within accepted scope and standards. Nurses are generally the good guys.

Just do a good job. Always work to be a better clinician. Practice in a manner that is prudent, practical and deliberate. Be good to your patients and yourself.

Good Luck

Practice SAFE!

[anonymurse]

Yeah, I overthink exclusions, because an entire office full of lawyers overthought them before they threw them at me.

And nobody's gonna inhale an ampule top, but I sure could see one ending up in a pt's linen.

I believe if you're a cautious person, it ain't the things you think of that'll get ya. It's the stuff you'd never dream would get ya.