EP 111: Nurse Liability

In this episode, we will be talking about nurse liability. Talking about the legalities of nursing and medicine are not the most exciting things but it is something every nurse should be aware of.

What exactly are nurses liable for, what is liability insurance, and should you buy liability insurance.

An analysis of 60,000 medical professional liability cases, from 2007-2016 indicated that nurses account for less than three percent of the 104,000 defendants associated with those cases.

When nurses are identified as the primarily responsible service for cases, individual nurses represent less than 15 % of defendants (regardless of the injury severity).

More often than not, the liability in such cases falls on the organization where the nurses practice, or to the physicians who were also involved in the patient’s care.

Nurse Liability and Malpractice

Nursing is consistently voted the most trusted of all professions. One that involves providing medical and personal care for individuals at their most vulnerable.

So, why should nurses consider carrying nursing liability insurance to protect themselves from litigation?

Because we live in an increasingly litigious society. Nurses are human, and, unfortunately, they can make mistakes. 

What is Nurse Negligence?

In order to be found legally liable, it is generally necessary to show that the nurse acted negligently, or acted in the way they shouldn’t have, which can occur even when a nurse has good intentions.

A nurse can be found to be negligent if these three standards are present:

• The nurse owed a ‘duty of care’ to the patient, or was obligated to care for the patient
  • The nurse was supposed to do something and didn’t
• The nurse ‘breached’ that duty of care, or failed to properly care for the patient
  • Did the incorrect thing
• The breach resulted in ‘measurable damage’, injury, or harm to the patient
  • The action resulted in harm to the patient

When determining whether or not a nurse owed a ‘duty of care’, and whether or not that duty was breached, the court will consider the standard of care appropriate for a nurse with similar education, training, and experience when encountering the same or a similar situation.

A nurse in her first weeks of work will not be held to the same standard as one with years of experience.

Also, a nurse will not be held to the same standard of care as a surgeon who worked on the same patient [1].

Nursing Malpractice

Nurse liability laws also apply to malpractice, which is when a nurse fails to perform his/her medical duties, that failure harms the patient.

A great example of this is private nurses performing care in a personal residence or at a nursing home.

Malpractice in the form of abandonment may occur if the nurse suddenly stops providing patient care without notifying the supervising doctor or nurse. 

To prove medical malpractice, the attorney must be able to pinpoint when the medical professional chose to act against your best interests [2].

Common Examples of Malpractice in Nursing

• Failing to monitor a patient – It is your nursing duty to monitor the patient, keep track of vitals/condition and inform the attending physician of all changes. If a nurse fails to assess a patient’s condition, that can result in harm or injury.
  • Missing changes in vital signs
  • Failure to respond to a patient 
  • Not following up with a doctor when necessary
• Errors in Medication – Nursing administration is always your responsibility. Careful also to check allergies and drug compatibility. 
  • 5 medication rights
    • Right patient
    • The right drug
    • Right dosage
    • The right route
    • Right time
• Documentation Mistakes – Nursing responsibilities is to record accurate documentation of the patient’s condition (vitals, medication, dosage, reactions, progress)
  • Inaccurately charting
  • Using incorrect verbiage or abbreviations
  • Failing to update changes in progress

21 Century Cures ACT

As of December 2016, as a part of the 21st Century Cures Act, patients have the ability to access their clinicians’ notes from their electronic health records.

This is a new form of transparency in the medical field as a move in the right direction. 

Implementing the final rule, promotes patient access to their electronic health information, supports provider needs, advances innovation, and addresses industry-wide information blocking practices.

The notes that must now be open to patients include the following:

• Consultation notes.
• Discharge and summary notes.
• History and physical.
• Imaging narratives.
• Laboratory report narratives.
• Pathology report narratives.
• Procedure notes.
• Progress notes.

Malpractice Insurance for Nurses

Malpractice insurance costs anywhere from $100 – $200 annually. There’s a range of coverage options from $500,000 per claim/$1 million aggregate to $2 million per claim/$6 million aggregate. 

What is nurse negligence and how can you avoid it? Watch the full episode here 👇👇👇

TIMESTAMPS:

00:00 Intro
00:22 Our longest shifts
01:23 Today’s topic
01:57 Statistics of liability cases
03:12 Importance of always charting
05:26 More transparency in nursing today
07:50 Live access to charting
08:38 Nursing negligence
10:15 Examples of malpractice in nursing
12:58 Failing to monitor your patient
14:35 Charting
18:45 Summary of documentation mistakes
21:23 Five administration rights
23:57 Malpractice insurance for nurses
26:50 Wrapping up the episode
27:15 We’ve been busy
30:53 Taking a step back
31:00 End of show