caduca

Vette, undoubtedly your insurance provider will subscribe to your need to have insurance. For a neutral opinion, I suggest calling a medical defense attorney (and not the one assigned to defend your hospital- but someone completely neutral). Example: A patient dies due to a medication error. Who are they going to sue- the physician, the hospital, the pharmacist, or the nurse? They want to get the biggest $$ amount they can get. Hospitals carry about a 3 million dollar policy (usually). Wouldn't it be more advantageous for them to prove that the hosptial's policy and procedures were not substantial enough to protect the patient from undue harm, than to prove you are a bad nurse? Actually, if they prove you are a bad nurse and that you as an individual caused the problem, then that would make finding fault with the hospital harder. Why would they want to do that (unless your house, car, clothes, or insurance policy, etc are worth 3 million)? Sometimes, multiple persons are sued- but as I demonstrated above the nurse's involvement is usually stated as the hospital's neglect. The physician is almost always sued as well, rather he/she were present or not. You are also correct in assuming the hospital's insurance does nothing for you personally- after all, if the hospital is going to try to prove they did everything right- then perhaps you are a bad nurse- and a nice nursing insurance policy may make that a more convincing case to the party bringing the suit. The absolute best thing a nurse can do to prevent being sued- smile, be polite, and admit when there has been a mistake to the patient. I appreciate your reply- thanks.

I remember when I was in nursing school that we were taught to always have nursing insurance. However, when I went back to school for my healthcare administration degree- my Legal course actually advised against it. The exact quote was, "Do you know what you call healthcare providers with personal insurance? Defendants." The theory is that fault of an incident must be traced to a source of substantial monetary value (physician/malpractice insurance, hospital, agency, etc.) Of course, the agency has truckloads of insurance- as does the hospital. I feel fairly confident that our insurance would not offset the personal expense for a lawyer in the case described here, but we have in other cases that potentially involved the agency- hence the reason for the insurance. Incidentally, the cost of this insurance is one of the primary causes for small (usually nurse owned) agencies to fail.

I work with AAS as a client. In one city, they provided a great service to the community by stabilizing the ridiculous bill rates that some of the agencies were charging (while still paying low to the agency nurse). We partnered with them and are their largest provider of nurses. Very few nurses joined their agency though for a multitude of reasons- primarily the loss of independence due to forced cross-training and "being pulled" to less desirable areas (that also paid less). In another city, I am not as impressed with the operation. Overall, there are "evils" to this industry that AAS can manage with good use of their leverage as HCA representation- but as an agency I feel they too often take nurses out of their own HCA hospitals to redistribute at higher cost to their own entity. I overheard an Administrator call the use of internal agencies a transfer of $$ from one set of accounting books to another in the same company.

Ultimately, the nurse has the responsibility to choose the best agency for themselves and (hopefully) the nursing industry. No agency can be a success without nurses. Essentially, the agency with the most nurses wins in the market. Some good questions to ask when selecting an agency are: 1) What % profit do you expect for your services? 2) How are you competitively pricing in the market to ensure availability of work for the nurse? 3) What hospitals can supply you references to both your quality and partnership? 4) How long have you been a staffing firm? 5) What do you bring to the table that warrants a nurse's employment with you? Hope this helps. I am currently in the business of decreasing profit margins for staffing agencies. I bill the hospitals less than my competitors. I pay the nurse more than my competitors, and my regulatory compliance and quality are the best. This volume pricing has led to recruitment attempts from competitors, but unfortunately not to embrace the low-margin/high volume concept- instead just to remove me as competition. It has only fueled my mission. NURSES- BE AWARE of your agency. We are all in this together- which brings me to one last question to ask- 6) Does this agency have a nurse manager and when was the last time he/she touched a patient? As for me- I cover 7 states, hundreds of hospitals, and thousands of nurses. Out of touch? Hardly- I pull my third shift this month on Saturday.

I can share a similiar incident that occurred with one of our nurses. As the nurse manager of the agency, I received a call from a hospital rep that one of our nurses was no longer allowed back to the facility. After some questioning, I discovered that someone told this hospital rep that the agency nurse had stolen some drugs at another hospital and quit before it was discovered. As a nurse manager, I was concerned and discussed it with the agency nurse who was furious and denied it completely. He also conceded to a drug test. I typed a report for him to utilize as he wished with the information- he took it straight to a lawyer and served the hospital with a cease and desist (sp?) order. Subsequently, the hospital was much more careful in the future with barring a nurse the right to work in their facility. Many benefited from his investment of time and money. Additionally, I would not let the amount of time passed make you complacent about the event. It could be months before the Board contacted you about the event, if anyone reported it. Rarely, is the agency contacted except to request a copy of the personnel file.