May 30, 2015
HSM 320
Professor Lori Janello
Application Paper
Professional Liability

Medical malpractice has been an issue of concern in the provision of health care for thousands of years (Young, C. C., & Williams, D. R. 2011). There may be a perception that doctors are held responsible for the majority of medical malpractice lawsuits, the reality is that nurses are often finding themselves defending the care they provide to patients. “Negligence, which is often an unintentional action, occurs when a person either performs or fails to perform an action that a reasonable professional person would or would not have performed in a similar situation.” (Fremgen, 2012). Since I work in a hospital and have the privilege of working closely with nurses on daily bases, I decided to discuss ways nurses can be held liable for negligence. Nursing malpractice occurs when a nurse fails to skillfully perform her/his medical duties and that failure brings harm to a patient.
There are different ways that a nurse can harm a patient, from failing to inform a doctor when something is really wrong with a patient to administering the wrong medication. Like malpractice involving physicians, nursing malpractice happens when a nurse does not fulfill his/her duties in a way that a skilled colleague in another location would do in the similar situation, and that negligence injures the patient. In nurses malpractice cases, often the key issue is who is liable for the nurse’s illegal action the physician or the facility he/she works at, such as doctor’s office, hospital, nursing home, or a health center. Whoever is liable will be held responsible for compensating the patient for the nurse’s error, keeping in mind that sometimes unfortunate incident could happen to a patient. Like when a healthcare professional performs a procedure that would have normally be advantageous to a patient, but the outcome goes wrong since every patient will react to a treatment in a different way from other patient. In such cases a court would determine if the nurse had acted within his/her scope of practice and in compliance with both the standard of care and the policy of the healthcare facility, then they (the court) would determine if negligence happened at all or not.
According to our text book, nursing malpractice can happen in a variety of circumstances, such as doing or saying nothing when action is required, wrong administration of medication, or harming a patient with equipment. It is the duty of the patient to prove that the healthcare professional’s action was negligence, by showing that;
• Duty- the patient must prove that a relationship had been established. The nurse, patient relationship starts in the minute the patient arrives on the nursing unit. From that moment there is an obligation, or legal duty, to care for that patient.
• Dereliction or Neglect of duty- is a nurse failure to act as any ordinary and prudent peer nurse would act in a similar situation, the patient would have to prove that the nurse’s performance did not comply with the acceptable standard of care.
• Direct or proximate cause- the patient would have to prove that the nurse’s dereliction of duty was a direct cause for the injury, and that the injury was proximately or closely related to the nurse’s negligence.
• Damages- if the patient does not receive any injury, then there is no negligence case, for the patient to seek compensation he/she must prove that the nurse caused the injury, there are many forms of injuries a patient can seek compensations for, such as ;
• Personal injury
• Permanent physical or mental disability
• Loss of enjoyment of life
• Pain and suffering
• Past and future loss of earning
• Medical expenses (Fremgen, 2012)
One of the scenarios that a nurse can be held liable for negligence is when dealing with a patient who is hostile and agitated. The behavior of such a patient can put the patient and sometimes the nurse in danger, nurses often find themselves forced to obtain a physician’s order for four points restrains after exhausting all options of calming down the patient. Every facility has different protocols to follow when applying restrains, some of the restrains procedures is to perform a check of the patient’s person for contraband, assigning the patient to a quiet private room where there would be less stimulating environment and where he/she could calm down and sleep, the nurse must perform patient monitoring and assessment checks every 15 minutes, and the nurse must document her monitoring and assessment findings at each of the completed checks in the patient record. The nurse will be facing the risk of malpractice lawsuit if the patient sustain an injury related to the application of the restraints. I have personally witnessed a situations in the hospital where I work about a middle aged man who was admitted because he was so drunk and violent. The physician prescribed a restrain for him as a result of his aggressiveness. The man was so agitated and disoriented, that he started to pull off the restraints to free himself. The more he tried without successfully freeing himself, the more and harder he tried to free himself of the hand restrains, it got to the point that the restrains became so tight and he was able to interfere with the site of the IV on his forearm. Fluids started to penetrate and caused a swelling on his wrist, in this particular scenario the nurse was able to act quickly and correct the situation fast by calling the IV team to relocate the IV site away from the hand restrain.
If the nurse was not observant, the patient would have been at risk of permanent injury and might also lose his hand due to restricting the circulation on his arm caused by the fluid buildup under his skin and from the tightness of the restrains. This nurse was able to prevent malpractice and negligence by acting quickly and taking the right decision at the right time.
Malpractice lawsuit can both be professionally and emotionally overwhelming to a nurse. Each nurse can take steps to protect their selves and help reduce potential liability by using caution and wisdom and by maintaining competence within their specialty area of practice. Healthcare facilities can also help reduce the risk of malpractice claims by increasing the number of nurses and decreasing their workload so that they can have a positive impact on quality of patient care, fewer medical errors and decreased adverse of patient’s outcome.
Nurses are being held accountable to the public for their professional judgment, actions, and outcomes these days. So to help decrease liability, nurses must render safe and competent nursing care, recognize potential problems, identify potential risks in their practice care arena, and remain competent in technology and evidence-based practices (Watson, 2014).

References

Watson, E. (2014). Nursing Malpractice: Costs, Trends, and Issues. Journal of Legal Nurse Consulting, 25(1), 26-31. Retrieved May 30, 2015 from http://library.devry.edu.
Fremgen, Bonnie F. Medical Law and Ethics 4th Edition. Pearson Education, Inc., Upper Saddle River, New Jersey.
Young, C. C., & Williams, D. R. (2011). INFLUENCES OF HOSPITAL STRUCTURE ON MEDICAL MALPRACTICE CLAIM COSTS. Academy Of Health Care Management Journal, 7(1), 1-14. Retrieved May 30, 2015 from http://library.devry.edu