Nursing Negligence: Guidelines for Care
Video Title: Nursing Negligence: Guidelines for Care
Originally Published: 2007
Publication Date: Mar. 20, 2020
Publishing Company: Medcom Inc.
City: United States
© Medcom Inc., 2007
NARRATOR: Today, there are tremendous pressures on the time of everyone in health care, particularly on nurses. As a result of cost-cutting efforts made in all areas of health care, the delegation of some traditional nursing tasks is occurring. However, this should be done carefully so that legal issues, such as negligence, do not arise.
NARRATOR [continued]: While damage caps in some states have reduced negligence suits against nurses and limited the amount of some awards for nursing negligence, nurses are at risk for negligence lawsuits, and more than 400 judgments are made against nurses every year. Any act of negligence can have serious consequences
NARRATOR [continued]: for patients, for the reputations and licenses of the health care professionals involved, and for the accreditation and reputation of the whole institution.
HEALTH CARE PROVIDER: Emily is bleeding. I think she’s abrupted. Her water has broken.
HEALTH CARE PROVIDER: I think she’s crashing.
HEALTH CARE PROVIDER: OK.
NARRATOR: In this program, we will discuss the legal elements of negligence and how delegation of tasks to unlicensed assistive personnel, such as Certified Nursing Assistants, or CNAs, and others, affects your liability. We will also discuss some of the most common types
NARRATOR [continued]: of nursing negligence. Daniel Giroux is an attorney specializing in medical law. He has been involved in thousands of medical-malpractice lawsuits. Nikki Lind is a practicing registered nurse. She has been a registered nurse for eight years.
DANIEL GIROUX: I’ve been practicing for close to 20 years, and currently, my specialty is medical malpractice. So I represent individuals who’ve been harmed through medical neglect. So I go after either hospitals, health care providers, nurses, nurse practitioners, mid-levels, anybody in the health care
DANIEL GIROUX [continued]: field. The biggest thing, as it relates to nurses, I think, that I can say is that nurses are the patient advocate. I mean, they are the ears, the eyes of the patients, and they’re the ones who have got to bring to the attention of a physician or a mid-level, problems, or changes, or deviations from a patient’s current status.
DANIEL GIROUX [continued]: I think the biggest places where we see harm is that when there’s not contemporaneous notes made. There’s not accurate charting that is done. There not being an advocate for the patient. Even when they know that a physician’s not doing what they’re supposed to do, there’s things that they can do, like implement what’s known as the “chain of command.” I think, from my standpoint, in my career,
DANIEL GIROUX [continued]: those are the things where we see nurses get in trouble.
NARRATOR: In its simplest terms, “negligence” can be defined as a “failure to exercise the degree of care that a reasonable nurse would exercise under the same or similar circumstances.” But there’s more to it than that. Legally, negligence consists of four elements which must be proven.
NARRATOR [continued]: First, it must be proven that you owe a duty to the patient– that is that a nurse-patient relationship exists. This relationship can be established in a number of ways. If you are assigned to care for the patient, or if you observe any unattended patient who obviously needs help, you, as a nurse, owe that patient a duty to provide help.
SAGE © Medcom Inc., 2007
Page 2 of 9 Nursing Negligence: Guidelines for Care
NARRATOR [continued]: If you are in a clinical setting, and you give nursing advice to someone who asks for it, in the eyes of the law, you have established a nurse-patient relationship. Even if another caregiver is present, if you observe a patient receiving inferior care, you have a duty to take action, either to help with the care
NARRATOR [continued]: yourself or summon help.
HEALTH CARE PROVIDER: All right, let’s see if that works.
DANIEL GIROUX: I’ve had a case against a facility here in the Midwest where a nurse was required to follow standard postpartum orders. Within an hour after any type of delivery, that is when a mother is more likely to have a hemorrhage. And in that particular case, for the first 20 minutes,
DANIEL GIROUX [continued]: every five minutes, you’re checking vitals, and every 10 minutes, and every 15 minutes. And it’s pretty standard throughout the United States what they’re supposed to do. But in this particular case, the nurse wasn’t checking vitals for an hour. And ultimately, what happened when she finally decided to check the vitals, unfortunately, the patient was very hypotensive.
DANIEL GIROUX [continued]: Her blood pressure was 80 over 40. She had a heart rate of 140. And she was in a late-stage hemorrhage. And ultimately, she required an emergent hysterectomy. That’s the way they control the bleeding. She had a, pretty much, complete blood-volume resuscitation,
DANIEL GIROUX [continued]: and she ended up passing away.
HEALTH CARE PROVIDER: Her temperature is 99.
HEALTH CARE PROVIDER: And her pulse?
HEALTH CARE PROVIDER: Is 60.
NARRATOR: Your duty is to provide care that meets the legal standard of care. This is the care that a reasonable and prudent nurse would be expected to provide. Many sources help define the legal standards of care. These can include your state’s board of nursing; federal statutes, such as the patient’s bill of rights;
NARRATOR [continued]: state statutes, such as Nurse Practice Act; and other laws setting standards of care. Other sources of the legal standard of care are guidelines and policies for nursing-care delivery issued by organizations, such as the Joint Commission; professional nursing organizations,