IL Supreme Court Rules Only Nurses Can Testify on the Standard of Care for Nurses - page 5

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... Read More

  1. by   WhiteCaps
    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.
  2. by   fergus51
    We actually do read the whole schwack before our shift, including labs, etc.
  3. by   unknown99
    Quote from fergus51
    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.
  4. by   Peeps Mcarthur
    I did the same thing as a respiratory therapist and as a student nurse.
  5. by   tmylen
    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.
  6. by   fergus51
    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....
  7. by   fiestynurse
    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.
    Last edit by fiestynurse on Apr 9, '04
  8. by   Peeps Mcarthur
    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.
  9. by   fiestynurse
    Unless the "semantics" themselves are completely off track. You lost me with your discussions on who has the authority over patient care, territorial rights, medical hierarchy, nurses "blindly gobbling up responsibility," and how we are alienating ourselves further from the medical profession. Who gives a crap! It's as simple as nurses just wanting to speak on our own behalf.

    Is it the fact that the words "nurse" and "expert" appeared in the same sentence that bothered you?
    Last edit by fiestynurse on Apr 9, '04
  10. by   Peeps Mcarthur
    It is the fact that the words "nurse" and "expert" appeared in the same sentence that bothered you?
    Clearly, nurses think patient care and the ability to perform it makes them experts. That makes everyone that passes the licensing an expert in patient care that supercedes a doctor's patient care. Some are better experts than others of course, but experts none the less.

    If this is what you mean then yes, it does bother me. I'm sorry if it makes you angry, but just contemplate it for a minuet. Don't let your anger and resentment of doctors get in the way of the true meaning.

    If you still feel that way, I have nothing else I can say to try to present my point of view in an acceptable way.

    There is no need to respond if you still feel angry. I wouldn't hold it against any of you. I was really just presenting what I thought was a unique perspective.

    I can see why it would be so unique here
  11. by   LilgirlRN
    Both specialties, nursing and medicine are interdependent. They can't do their job without us (for sure), we can't do our job (legally) without them. If someone is to critique my work, my ablilties, then I want the person that knows the most about my profession, that person is not a doctor. I will not be called to testify about a surgeon's capabilites, I might be called to testify to say if he returned calls in a timely manner but I would never be called to say that his technique was superior to another doctor's. This is really preposterous... humans have pets, lets say you have a dog, you've had the same dog for 10 years. But who knows more about being a dog? Do you, or does the dog?
  12. by   fergus51
    Peeps, I don't think you'll ever understand. You seem to see nursing as just a group of poorly educated people who hate doctors and want to steal their jobs or something.

    This ruling doesn't mean that a new grad nurse would testify as an expert, not any more likely than a newly qualified doctor being asked to testify as an expert (though I would say a new nurse still knows more about working as a nurse than any other professional). It just means that a nurse is the one who knows how to be a nurse. When you consider that nurses are judged based on what "a prudent nurse would do," how does it make any sense to ask a doctor? A doctor isn't a prudent nurse. She observes nurses, but never works as one. Why wouldn't a nurse be the one to ask about nursing? If you can explain that to me I'd appreciate it.
    Last edit by fergus51 on Apr 9, '04
  13. by   fiestynurse
    I have no anger and resentment towards doctors. Again, you missed the point. I give up!