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Topics About 'Lawsuits'.

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  1. According to the AMA’s Division of Economic and Health Policy Research, more than 34% of physicians have had a liability lawsuit filed against them at some point in their careers. Although plaintiffs in the majority of cases don’t win, the average cost for defending a case is more than $30,000 A recent article published on Medscape looked at how physicians are attempting to protect themselves by screening out patients who are more likely to file suits. Not Obligated to Treat Anyone As consumers, we are usually able to pick what physician we see and can change providers if we are not satisfied. What about physicians- are they obligated to treat anyone seeking their services, or do they have a right to self-select patients? According to the American Medical Association’s Economics and the Ethics of Medicine, an office-based physician doesn’t have to treat every patient seeking care. Possible Red Flags Medscape’s article highlights Dr. Marie Bradshaw, a physician practicing internal and emergency medicine over the course of 27 years. What makes Dr. Bradshaw unique? In her long career, she has never been sued as a physician. Dr. Bradshaw interviews potential patients before agreeing to be their primary care doctor and credits this practice for preventing legal problems. Here are other factors Dr. Bradshaw considers before accepting a new patient: How many physicians in that specialty has the patient seen over the past 1-2 years? More than 2 could be a sign of “doctor shopping” Important to ask if they terminated the relationship or did the doctor….and why. Did the patient have problems with other doctors or practices.? Asking the patient if they have ever had “an issue” with another doctor may open the door to learning about a previous lawsuit. What is the patient’s attitude toward the practice’s conditions for treatment? Does the patient complain about or refuse to sign an agreement related to treatment? This could be a red flag the patient will become difficult later in the relationship Compliance with clinical recommendations. Is the patient compliant with health screenings (mammograms, colonoscopies, etc.) and treatment recommendations? Is the patient show consideration for the practice and staff? Impolite behavior and rudeness towards others are a big red flag. Potential for violence should be a deal breaker. Do you communicate well with the patient and have a good rapport? It may be a red flag if intuition is telling you it may be difficult to build a good rapport with the patient. Joseph Scherger, MD, former vice president of primary care and academic affairs at Eisenhower Medical Center, recommends getting the above information while taking the patient’s medical history. Nurses Have Valuable Insight Michael Sacopulos, JD, CEO of the Medical Risk Institute, has sat in on hundreds of malpractice lawsuits over the years and emphasizes the need to pay attention to how a patient treats office staff. He states “I can't tell you how many times I've heard physicians say that when the paperwork arrives, the staff isn't surprised". Patients are more likely to voice concerns or dissatisfaction to nurses and other staff members. Dr. Sacopulos theorizes that staff members are cued in on warning signs quicker because patients tend to be on their best behavior for the doctor. Therefore, it is important for physicians to listen and consider feedback from staff. There Are Risks When it comes to turning away or discharging patients, there are state and federal laws physicians must follow. Noncompliance with these laws may lead to complaints being made to state or federal agencies, resulting in an investigation by the state attorney general’s office. A patient, who was not accepted, could file a complaint with the medical board that they were not treated properly. In this case, the physician would need to demonstrate that a physician-patient relationship never existed. For example, a written letter notifying the patient of nonacceptance may be used as evidence the patient was not under the physician’s care. Taking It to the Extreme What do you think? Does the practice of screening for potentially litigious patients encourage an attitude of “patients are out to sue you”? What ethical pitfalls do you see?
  2. Nursing students are faced with many challenges when acclimating to the clinical environment – apply what they have learned in a hands-on setting, interact with patients, assume some responsibility for patient care. However, while exciting, with this transition comes new challenges and potential mistakes that can make this next step risky for nursing students’ future careers. Don’t get enough ZZZs Sleep deprivation is common ground for students across all disciplines; they bond about “pulling an all-nighter” or “running on energy drinks.” However, for a nursing student working in a clinical environment, sleep deprivation can impair their care for patients. New data from Ball State University and Western Governors University researchers proves it: their data shows that 83 percent of nursing students aren’t getting an adequate amount of sleep, resulting in a negative impact for quality and safety. And numerous additional studies have shown that cognitive abilities, reaction time, and decision-making are all negatively impacted by lack of sleep and 12-hour shifts. As a result of sleep deprivation, students combat their fatigue with caffeine and stimulants to stay alert, then use sleeping aids at night to help them go to bed. This repeated cycle is not a sustainable, healthy lifestyle and can have negative impacts on the student’s health far beyond when student clinicals end. Cross the line on social media A misstep (or even the allegation of misdoing) on social media – such as sharing patient information or posting inappropriate photos – can be damaging to a nursing student’s budding career and future prospects. As a nursing student enters the clinical world, part of their new responsibilities is maintaining patient confidentiality and conducting themselves in a professional manner. Social media is ridden with people posting photos of their day-to-day activities, complaining about their jobs, and telling funny stories about work. However, nurses have legal obligations of confidentiality as mandated by the Department of Health & Human Services’ HIPAA provisions and have more liabilities that accompany their profession than most, such as facing severe disciplinary action from their Board of Nursing. Nurses need to be increasingly aware of the risks associated with disclosing too much information on their social media platforms. Fail to speak up For practicing nurses, insecurity or hesitancy to speak up can have extreme repercussions – failure to report a patient’s condition change or not asking a question could result in a negative patient outcome or even an allegation of malpractice, according to the Nurses Service Organization (NSO) 2015 Professional Liability Claim Report. Nursing students and new nurses must understand that they are their patients’ advocate – they must ensure their patients receive safe and appropriate care when needed. Advocacy means that nurses have a duty to utilize the nursing and medical staff chains of command in cases where a practitioner is not responding to calls for assistance, or fails to appreciate or respond to the seriousness of a situation. . New nurses may feel hesitant to speak up and ask questions, especially to older and more experienced providers. However, hesitation and insecurity can lead to legal trouble, medical errors, or professional misconduct, asserts the NSO Claim Report. It is imperative that nurses proactively address communication issues, speak up confidently, and use their voice and their power to do their job effectively. Building awareness of these common mistakes can help nursing students succeed in the clinical environment. Unlike a typical desk-job, the nursing profession has an extra level of responsibility and liability; therefore, nursing inherently has risk. To navigate these risks, students must seek out educational resources, be aware of the ways they can advocate for themselves and avoid these mistakes as they make the transition from classroom to bedside.
  3. The first year of nursing is, in countless cases, also one of the most challenging years of a nurse's career because many different events are taking place. First of all, a significant number of newer nurses are acquiring the procedural skills that they did not fully cover in their nursing school clinical rotations, especially if one is immediately transitioning into a highly specialized area as a first healthcare job. Secondly, aspects of the 'real world' of nursing may clash with the idealized 'textbook version' of nursing. Third, it simply takes time for a newer nurse with less than one year of experience to find one's groove in the workplace and develop a comfort zone. Finally, untold numbers of new nurses have been pumped with the often paralyzing fear of the consequences that might result from mistakes. The fear of causing profound harm to a patient comes to mind. Also, the fear of action being taken against one's nursing license is frequently mentioned as a source of worry. "I'm afraid of losing my license" is an immensely common phrase. Moreover, some nurses live with the fear of someone personally filing a lawsuit against them. For instance, several years ago a new grad administered a deep intramuscular injection of promethazine (Phenergan) to the left arm when the patient had requested for the medication to be injected into the right arm. Later on during the shift the nurse was asking, "Can I get sued for giving it in the wrong arm?" In instances like the aforementioned scenario, knowledge is power. A little knowledge about legal issues in nursing can go a long way to alleviate many worries. As a general rule of thumb, unless the patient is irreparably injured or dead as a result of something the nurse has done (or failed to do), it is highly unlikely that the event is lawsuit material. Patients and families sometimes say the words "I'm going to sue you" to nurses as an intimidation tactic, and they do have the right to pursue legal action. However, they would first need to find a medical malpractice attorney who would be willing to take the case. And, as long as the proper injection technique was used and no harm resulted, most lawyers in existence would not waste the time on a case that involved giving an injection to the supposedly 'wrong' arm. I advise all nurses to take a course in nursing and the law to become reassured regarding the types of events that patients and families can and cannot sue for. A patient or family member must have a cause of action in order to sue you. And if you have not been found guilty of a tort (civil wrong), then any action to sue you would most likely be dismissed if it was filed. Generally, personal injury suits are extremely risky and very expensive for medical malpractice attorneys, so they typically do not take the case unless there is a clear cause of action (read: irreparable harm or death) and a large amount of monetary recovery is likely. In this litigious day and age, nurses can be individually named in lawsuits. However, physicians pay tens of thousands of dollars in premiums for medical malpractice policies, while nurses usually pay in the range of $100 yearly. The physician pays more because (s)he is more likely to be sued than the nurse. What is the point of all of this? Take a deep breath, practice safely, consider the ethical implications of everything you do, stay within your scope, ask for help when needed, don't allow anyone to intimidate you, and keep on learning about the wonderful art and science of nursing. Sometimes the words "I am going to sue" might be an everyday part of a person's vocabulary, even if he knows little about the process of suing.
  4. Nursing Responsibilities When nurses embark on to practice their profession, they are considered responsible and accountable for the quality of performance of their duties and responsibilities. Nurses who are employed in agencies, institutions, or hospitals are directly conscientious to their immediate supervisors. Private duty nurses, being self-regulating or independent practitioners, are bound to a standard of conduct that is expected of reasonably prudent nurses. The standard is a clearly defined, legal anticipation to which nurses are considered accountable. There were times that nurses never worried about medical malpractice lawsuits. They did not have any concern regarding their profession, which involves medico-legal aspects. These days, however, a growing number of professional nurses find themselves involved in litigation (court cases, proceedings), either as part of a permissible action against a facility or, increasingly, as an individual defendant. These nurses end up losing their jobs and their licenses, as well as their assets. These things happen through their mistake was unpremeditated. Some nurses thought that they were basically following the physician's orders. But then, in a few recent cases, nurses have found themselves in front of criminal charges and even jail terms due to medication errors that have led to patient death. State nursing boards, as well as the public, expect the nursing practice to be perfect because the field deals with life. We cannot bring dead people back to life. Dead is dead. People anticipate perfection in the nursing practice even as patients get sicker and nurses take more responsibilities. In addition, human error should be tolerated. Nursing responsibilities have also developed. Nursing responsibilities probably developed because some busy physicians spend less time at the bedside that they rely more on nurses to be their eyes and ears. This possibly increases pressure on the nurse to account and follow through the changes that occur in the patient. In general, lawsuits against hospitals or physicians and nurses involve recuperation of money damages. The defendant is compelled to execute the judgment. Failure to conform will be considered as derision of court and it will result in fine or imprisonment. If the decision is for payment of money, the plaintiff may cause the sheriff to sell so much of the defendant's property as necessary to pay for the costs. The following can be utilized by the nurses to reduce the risk of being named in a lawsuit or to seek protection if they are involved in a lawsuit already. The significance of medical records is both scientific and legal. As a record of illness and treatment, it saves duplication in future cases and it helps in immediate treatment. There should be thorough documentation. Documentation of patient care may not be nurses' favorite activity, however, nurses who find themselves involved in lawsuits and have documented thoroughly will thank themselves later. Charting is almost certainly the most essential facet of proving that nurses have met the standards of care. The nurses' notes are aids to medical diagnosis and in understanding the patient's behavior. In addition, it serves as legal protection for the hospital, doctor, and nurse by reflecting the disease or condition of the patient and its management. The patient is the nurses' partner throughout the nursing process. Neither the patient nor the nurse does a hundred percent effort towards attaining the goal which is to achieve the optimum functioning of the client. It should be a fifty effort from the nurse and fifty percent from the patient. The nurse should work hand in hand with the patient (and/or relatives) in order to achieve the goals set in the nursing care plan. Sharing significant information with the patient can help decrease errors. This is one reason why nurses establish rapport at the beginning of the nurse-patient relationship. The nurse should also extend that rapport to the relatives of the client for they should also know the plan of care for the client. The nurse should explain the procedures that would be done to the client. Explaining the procedures to the client and the relatives enable the client to cooperate well with the nurse. The nurse should also listen to the client's feelings and response. In addition, the nurse should also pay close attention to the concerns of the family members because they also are ones who often notice when a patient's condition has changed. They should also know and understand what is happening to their loved one. One vital responsibility of the nurse is to make sure that the equipment used in procedures and treatments is not defective. Such equipment includes wheelchairs, stretchers, suction machines, anesthesia apparatus, x-ray tables, etc. The nurse should see to it that all pieces of equipment are recurrently inspected, maintained, and are functioning suitably. She should also document the times she requested these to show that she was able to anticipate the improper functioning of the equipment, which might cause possible harm or injury to the client. The nurse should be able to recognize system flaws and be able to report them. In addition, this measure enables the nurse to provide the client with an error-free environment and accommodation. The most common security in a negligent action is when nurses know and conquer that standard of care in rendering their service to the clients and that they have properly documented the care they give in a succinct and accurate manner. However, if the patient's careless conduct takes part to his own injury, the patient cannot bring a lawsuit against a nurse. On the other hand, if the nurse has deliberately given advanced consent in performing a contractual obligation that involves threat, such as giving care to a psychiatric patient or a patient with a communicable disease, the nurse cannot bring suit against the client if she gets hurt or acquires the disease since upon accepting the case, the nurse concurred to presuppose the risk of harm or infection, in this manner, relieving the client or his relatives from legal obligations. Above all, the best way for the nurse to avoid a lawsuit is to be aware of the standards of nursing practice and follow them by heart. Ultimately, to prevent errors, nurses should meet the standards of care. It also implies that a nurse should be aware of the hospital's policies and procedures, the state nursing practice act, and the professional standards of his specialty. Ergo, nurses should exercise their sound verdict and employ standards of nursing care in order to avert lawsuits or to protect themselves.
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