Risk to RN license and liability issue of non compliance with California laws

[nicurn001]

I am concerned regarding the risk to my Nursing license

I am employed in California .Recently my employer posted a notice to the effect ,that it complies with all laws relating to missed breaks ( I think this has been prompted by a class action lawsuit [either threatened or active I am not sure ] .

In order to provide Meal and rest breaks ( a total of 1 hour /person/12 hour shift ),they have been using the Charge Nurse , (who already has the usual tasks of a CN , plus ensuring proper staffing the unit ) plus the Resource Nurse ,who has the responsibility to attend all critical deliveries ,aid staff in their admission of infants and other tasks. Both of these positions having been justified to HR and higher management. We are staffed for to have 14 nurses /shift , so without any other tasks, these 2 nurses already are expected to spend 7 hours of there shift covering breaks.

Obviously if there is a crisis ,the bedside nurses know and accept the priority of attending the delivery or helping stabilize the crashing baby , but they are now placed in the position of either forgoing their break or breaking the staffing ratio law ( however you view this law , surely as patient advocates ,we should support any measure that mandates a licensed nurse to be caring for a assignment , as defined by the law at any one time ) .

At present the shift manager is telling the nurse who cannot be relieved to hand off their patients to another nurse to cover her . This is in breach of the Staff ratio law , so by offering this solution (CN)and accepting this solution (bedside RN) ,both these nurses and possibly the Department Manager ( who is allowing this to happen) are risking their Nursing licenses , because as I will show in the scenario below , if anything was to happen to the infant whilst the assigned nurse is at break , they could be held liable :-

Scenario ; courtroom , liability suit being argued because infant choked while assigned nurse was at break .

Plaintiff's Attorney (PA) : Nurse were you assigned to care for infant Doe , the day of this incident.

Assigned Nurse(AN) : Yes I was , but I was at break when the incident occurred .

PA :Was a nurse assigned to cover your break , in compliance with all laws applicable to staffing and breaks .

AN : The Charge nurse told me that ,there was no one available to relieve me , that I should ask the other nurses in my room ,to keep an eye on my patients .Which is what I did .

PA : Nurse you didn't answer my question , but lets go on , Are you aware of the minimum staffing law , which you did not comply with as it states , specifically Title 22 - Section 70217 " Licensed nurse to patient ratios represent the maximum number of patients that shall be assigned to one licensed nurse at any one time"

AN : Our Department Manager , had told us previously that ,it was alright to have other nurses watch our babies when we went for break .

PA : So you relied upon Department Managers incorrect advise and did not check into this yourself . Remember ignorance of a law is not a defense .

Later in the Proceedings

PA : Your employee's have stated it was common practice , to take breaks without being relieved , in compliance with all state laws relating to breaks .

Department Manager (DM): We had through ,the Notice regarding compliance with state laws re .breaks placed upon a designated notice board , informed them of their rights and responsibilities regarding breaks . No one told me or any of my line manager of problems regarding lack of coverage for breaks .If they were taking breaks without being relieved in accordance with the law , they were abandoning their patients without my knowledge.

PA : So you are stating here that you have no responsibility , for the nurse having taken a break without relief , which led up to this infant choking .

DM : That is correct.

Bottom line I feel that we are being placed at risk of losing our RN licenses and being the target of liability lawsuits , by knowingly not complying to all the laws related to breaks. If somebody could show me how my reasoning is incorrect ,or how we can get out of this mess ,I would be grateful.

[Nightcrawler, BSN, RN]

As long as the other nurse that is "watching" your patients for you while you are on break agrees to do so you will be covered with the BRN. You could probably get sued according to the staffing ratios as you covered because of the staffing ratios, but my understanding is that the ratios are separate from the standards of practices in the Nurse Practice Act. By reporting off to the other nurse for the duration of a break, you are not abandoning your patients. Civil liability would be a different matter, so you could lose your house without Liability Insurance, but probably not your ability to pay the settlement

[nicurn001]

Thanks for your reponse ,which is basically ,make sure you have independent Liability Insurance .

While I remain unsure about the abandonment aspect, because I would be aware that the nurse I give report has a full assignment ,as defined by the law,so is in no position legally to accept more patients .I could a)not plead ignorance to the law and b) place the patient in an unsafe assignment .

[wjf00]

If your manager tells you to violate the ratio laws you should file an ADO (assignment despite objection) now the manager assumes the liability.