In many malpractice cases, doctors are the ones who are looked at when it comes to finding fault. Most people assume that if a medical mistake happened, it was likely the doctor on call who did it. However, there are many times where a nurse could have been the one to make a mistake. Consider how many patients a nurse is dealing with at one time in most scenarios. It is not hard to imagine a nurse giving one patient the medication meant for another. Mistakes happen, but they are not always at the hands of doctors. Nursing malpractice is a real event, and it deserves just as much attention as traditional medical malpractice.
How Malpractice Can Happen With a Nurse
Nurses are held to a different level of care than most other healthcare providers. They are expected to care for a wide range of patients each going through their own medical ailments and having unique needs. The number of patients that a nurse cares for differs depending on what type of unit the nurse works in. For example, if he or she works in a pediatric unit, the number of patients will be different from a nurse who works in the critical care unit of a hospital. The same goes for nurses who work for medical clinics. Each situation requires the nurse to use different skills, remember different orders, and not get anything confused. Unfortunately, nurses are human and occasionally make mistakes.
Since nurses are expected to keep up with a standard level of care, he or she must always be ready for whatever is coming. A nurse that does not do something that should be done in a situation, or does something totally unexpected during a medical situation, could wind up causing an injury. That is when it goes from a mistake to malpractice. Malpractice can also happen if a nurse confuses the needs of two patients and administers the wrong orders to the wrong patient. This could happen during routine examinations or could even be something worse, such as administering a dangerous medication to the wrong patient. That is why there are laws against malpractice, no matter what type of medical staff caused the injury.
What Are the Duties of Most Nurses?
Nurses have many jobs and many of the responsibilities that a nurse has overlap with other medical staff’s responsibilities. Here are some of the most common jobs a nurse has to perform each day:
- Assessing a patient who came in for care
- Taking a medical history
- Writing down a record of what the patient is struggling with, such as symptoms and which treatments have been tried
- Talking with the patient before and after a procedure to assess the person’s pain or understanding of what occurred during the procedure
- Taking vital signsregularly to ensure there are no spikes in heart rate, blood pressure, temperature, or breathing
- Obtaining samples from patients, including blood, tissue, or DNA
- Training student nurses or nurses with lower seniority how to perform specific activities
- Administering medications ordered by the physician for the patient
- Coordinating the care of the patient between different doctors or different procedures the patient requires
- Placing and monitoring IV fluids
- Knowing how to use different pieces of medical equipment in the room
- Organizing which nurse gets which patient based on strengths and weaknesses
- Being supportive and informational to patients as they have specific needs or questions
- Helping explain procedures, problems, and situations to relatives of patients
- Changing bedding when necessary to keep the patient comfortable
- Helping move patients around their hospital room or from room to room
- Assisting the doctor with procedures that can happen in the room
- Supporting doctors during surgery
- Getting height, weight, and other vitals at a doctor’s office prior to the doctor seeing the patient
These are just some of the activities that a nurse takes on during each shift. Their overall goal is to make sure that the patient they are caring for has an advocate on their side who will help them with whatever medical process they are going through. Some places require nurses to take 24-hour shifts, which can lead to exhaustion and possibly increase the chance of malpractice occurring.
Where Are Most Nurses Employed?
A nurse can work in many different locations. While many of them work in hospitals, that is not the only place a nurse can find work. Here are some of the common places for a person to come in contact with a nurse:
- A medical clinic or office building where a doctor practices medicine
- Residential homes for people with physical or mental handicaps
- Asylums or institutions for those with mental illness
- A nursing home or hospice facility for the elderly
- Schools often have a nurse on-site in case children get hurt or become ill
- Prisons need to have a skilled nurse on staff
- Some companies employ nurses for injuries or illnesses within larger companies
- Some fitness facilities employ nurses for patients who need help with weight loss or injury recovery
- Many physical therapy facilities have nurses on staff to help with recovery
- Drugstores with built-in clinics often have a nurse at the location
- In-home nurses also exist, who travel to a patient’s home to help with daily medication, treatment, or therapy
- Many nurses also ride-along with EMTs who go out to different scenes to help when there is a medical emergency
Nurses can be almost anywhere. They are very valuable members of a healthcare team and have many different skills that other staff typically find quite useful. Still, they might make mistakes, no matter what type of environment they work in.
So, When Does a Mistake Become Malpractice?
Not all mistakes lead to an injury, so these mistakes may simply be nothing more than a mistake that no one becomes aware of. However, when a mistake leads to someone getting hurt or dying, it then becomes negligence. When someone goes in to see his or her doctor, that person has a reasonable expectation that the issues he or she is experiencing will be diagnosed and treatment will begin. No one expects to go to see the doctor and come home feeling worse, or worse, not come home at all. However, if that reasonable expectation of care is not adhered to, it could become malpractice.
Every member of the medical staff has specific jobs that each person is supposed to do. When those jobs do not get done, in some cases, that is negligence. This includes nurses and all of the responsibilities they have. Sometimes not doing something that a doctor requests means intentionally ignoring to help. However, the times when a nurse does not take proper action are the times when the potential for malpractice should be evaluated.
Examples of Nursing Malpractice
The first duty of a nurse has is to his or her patient. This means if the patient needs something, the nurse should advocate for it. If a nurse does nothing when the patient needs him or her to do more, this can be negligence. The same goes if the nurse says nothing when the patient should be advocated for. A nurse needs to take the right kind of actions to ensure that the patient has his or her needs met medically, as well as comfortably.
Another time when a nurse may be considered negligent is when he or she uses medical equipment the wrong way. When a patient gets injured as a result of not using the equipment the way it should be used, this can become malpractice. Some examples of this include:
- Knocking over equipment into or onto a patient
- Burning the patient with a hot piece of equipment
- Leaving surgical equipment behind in the surgical site once the surgery is complete
- Causing damage while taking vitals
- Injecting the patient without being careful not to cause damage during the blood draw or medication injection
Nurses can also be negligent if they are not careful when administering medication. This can include giving the patient the wrong dose, giving the patient the wrong medication, or not checking to make sure the medication will not counteract what the patient already has in his or her system. Another way a nurse could be negligent with medication is by not informing a doctor who may have given the wrong medication order. For example, if a doctor says to give a medication that the nurse knows the patient is allergic to, he or she needs to advocate for the patient. It is a way of protecting the patient. By not advocating for the patient, it is negligence that could be turned into a malpractice case.
Some routine procedures do not always go as planned. This can be a mistake that is no big deal, or it could be a reason to consider malpractice. If a nurse goes to draw blood or start an IV but does not put the needle in properly, this could be negligence. It could also be negligence if the nurse goes to insert a catheter, and the patient gets injured during the process. Some routines are uncomfortable, but they should not leave the patient in long-term pain. If this is the case, the nurse may have been negligent in his or her duties.
When a nurse does not continue to monitor a patient, he or she could be guilty of negligence. It is the nurse’s job to monitor things like heart and breathing rates, blood pressure, and pain levels. When a nurse does not properly monitor how a patient is doing, and the patient’s condition declines, it could be malpractice. Nurses should be able to notice things like:
- A decline in vitals, like heart rate slowing down or a dangerously low blood pressure
- A patient reaching out to the nurse because they no longer feel good
- Lack of responsiveness in a patient that was alert and talking a short time before
In these situations, the nurse must reach out to the doctor or other staff to help so that the patient’s care or condition does not decline. If the doctor for that patient is unavailable, another doctor can fill in while the original doctor arrives. However, it still shows the nurse being attentive and doing what is in the best interest of his or her patient.
Another way a nurse can be negligent is through poor documentation. Writing reports and keeping medical records up to date is a very important part of what nurses do during each shift. If he or she neglects to keep proper records, it could become a problem for the patient. Examples of poor documentation include:
- Forgetting to put updates in a patient’s chart that describe new symptoms or problems, or even side effects of medications that the patient is taking
- Using the wrong words or abbreviations to describe what is going on with a patient’s condition or reactions
- Recording the wrong symptoms, vitals, or side effects, or recording information from another patient on the wrong patient’s chart
Nurses need to maintain medical equipment and could be negligent if this does not occur. It is the job of the nurse to ensure the patient eats whatever is within his or her dietary restrictions. Plus, the nurse needs to maintain records of how much a patient is drinking. This helps the staff in general track the risk a patient has of getting dehydrated. If a nurse fails to track this type of care, it could result in negligence or a patient getting injured. Dehydration carries its own risks, and if a nurse is not monitoring simple things like fluid intake, there may be other issues that the nurse is not taking note of either.
Many of these examples of malpractice can be attributed to a physician, a nurse, or another type of medical staff. However, they also result in the potential for a case of malpractice. This includes:
- Leaving a patient disfigured after a procedure
- Not diagnosing a patient based on obvious symptoms, or not recording those obvious symptoms in a patient’s chart
- Not being there to assist a patient who needed help moving around, especially if the patient called for help and no one responded
- Not passing along symptoms that point to a growing infection to the doctor
- Neglecting to put all information into a patient’s medical history or not asking all of the questions so a proper history could be taken
- Getting poor results from a piece of medical equipment but not verifying the results before treating the patient
- Neglecting to pay attention to fluctuations in vitals that could have helped a physician diagnose the patient
- Not answering questions for the patient that could have helped the patient decide on a different course of care
- Not pointing out if a medication order would contradict what symptoms the patient is experiencing or administering a medication that was the wrong type or dose for the ailment
- Leaving equipment behind following any medical procedure
- Prepping the wrong area for surgery and the surgery being performed on that area instead of where it should have been performed on
- Turning off medical alarms that could have helped save a patient from decline or danger
- Not being there to help with a mother or baby in distress during pregnancy or delivery
Who Becomes Responsible if a Nurse Becomes Negligent?
One of the hardest parts of malpractice claims is determining who should be blamed for the injury. Many people are involved in patient care. Any of those people involved could do something that could lead to an injury. It may be the nurse administering the wrong medication, or it could be a physician’s order for the wrong medication, as an example. This is where a malpractice attorney can help.
In some cases, the hospital policies are that anyone involved in the care of the patient could be included in a mistake investigation. In the general meaning of the law, hospitals hold vicarious liability to anyone working for them. This means the injured party can sue the hospital along with the nurse if they are suing for malpractice. However, for the most part, the person who directly caused the injury is the one that will be named on the lawsuit. Doctors are liable if they order the wrong medication, do not diagnose the patient properly, neglect to fix an obvious error or when similar circumstances occur. If the nurse does not catch the doctor’s error, it could mean that the nurse will not be held liable.
In some instances, the nurse comes into a patient’s home to deliver care. In this case, the nurse could be held responsible, but so could the agency that the nurse worked for at the time of the accident. It all depends on what was done by the nurse at the time of the injury, and whether or not the nurse was the one directly responsible.
In hospital settings, nurses can be held liable for negligence under many different circumstances. This can include a surgical setting, when helping with patient care in a specific unit, in a patient’s room, while moving patients from one part of the hospital to another, and even when helping a patient to his or her vehicle. Again, it all depends on what was going on and if the nurse did anything to make a good situation worse or a bad situation better.
Are Nurses Subject to Joint Liability?
In some instances, a patient can be injured by more than one party. Sometimes more than one party could have done something to help a bad situation and did not take action. In these instances, joint liability may be the route an attorney suggests going. For example, if a nurse in New Jersey did not provide the recognized standard of care, and the doctor ordered the wrong medication, both parties could be jointly charged with malpractice for that patient. However, not all states recognize joint liability when it comes to malpractice cases.
Most states allow for joint liability. Meaning, if more than one person is responsible for the injury a patient sustained, they can both be part of the malpractice lawsuit. The court will have to figure out what percentage of the fault each party is responsible for. When the compensation is decided, each party will then pay the percentage of their responsibility. If the nurse was 25 percent liable, but the hospital was 75 percent liable, then the nurse would need to cover one-quarter of the compensation awarded, and the hospital would need to cover the other three-quarters of the amount. Since most nurses do not carry malpractice insurance, this could result in the nurse having to pay his or her portion of the compensation out of pocket.
Who Else Can Be Brought Into a Case of Malpractice?
When a nurse is negligent in his or her actions, and an injury occurs, a case of malpractice can be filed. However, in many cases, more than just the nurse can be named in the suit. For example, if the injury occurred at a hospital, there may be culpability to the hospital. For the hospital to have any part of the suit, the nurse would need to meet these criteria:
- He or she worked for the hospital directly
- He or she was on the job at the time of the accident
- Someone outside of the hospital’s staff was not directing what the nurse did at the time of the accident
If the nurse worked at a medical clinic and injured someone, then the clinic could be held accountable if the same applied to the relationship between the nurse and the clinic.
In some cases, the attending doctor may also have some culpability for the injury caused by a nurse. For a doctor to be put on the lawsuit as well, the criteria become:
- The nurse must have been acting out a directive from the doctor for the patient
- The doctor must have been present or otherwise held accountable in their absence
- The doctor might not be held accountable if he or she did not make a mistake. If the doctor also made a mistake on top of whatever the nurse did, such as ordering the wrong medication, the nurse may only be partly to blame because it was also the doctor’s mistake
For a doctor not to have any culpability, the nurse must have been acting on his or her own or have made a mistake that did not come from the doctor. This can be difficult to prove but is worth the effort to do so if the mistake was grievous or death occurred
What Does the Court Want to Be Proven for Malpractice Cases?
For nursing malpractice cases, the court wants to see the same basic proof that it wants for traditional malpractice claims. First, the court will want to be sure that the patient and the nurse in question had a working relationship. This proves that the nurse should have been doing what was in the patient’s best interest at the time the injury took place.
Next, the court will also want to understand what level of reasonable care the patient should be able to expect under the circumstances. This establishes what should have been done, no matter what medical professional was in the room at the time. Each person who was caring for the patient at the time had specific duties they should have been carrying out. This includes the nurse specifically.
From there, the court will want to be able to see how the care the patient received fell below the established level of care and how this directly caused the patient’s injury. This could be through action, such as hurting a patient while performing some tests, or through inaction, such as not reacting to a monitor showing too high of blood pressure. This establishes that the reasonable care the patient should have expected was breached and that led to the injury itself.
Finally, the court needs to see the direct relationship between the nurse and the injury. Establishing that there was a breach in care is a good start, but if no connection between the accused and the injury can be established, then the case will not move forward. Each of these things must be established with some form of proof that the court can hear or see directly. That is how a malpractice suit progresses toward damages for the injured party.
Damages a Plaintiff Can Go After for Nursing Negligence
When a patient gets injured or dies due to something a medical professional did or neglected to do, damages can be requested to cover the cost of expenses related to that circumstance. There are punitive damages, which cover expenses related to the injury. Plus, there are non-economic damages, which cover the emotional side of what happened as a result of the injury. Some examples of monetary damages include:
- Income lost during the time of the injury and recovery
- Money to pay off any bills for care since the injury
- Compensation for necessary prescriptions used to help in the healing process
- The cost of any medical equipment the plaintiff requires as a result of his or her injury
- Future medical procedures that will need to take place to restore normalcy to the injured person’s life
- Costs to cover any type of therapy the plaintiff will now need to try and restore comfort, function, or independence to his or her life
- Future income that is lost should the injured party no longer be able to work in the same capacity or in the result of the injured party’s death
Non-economic damages are a little bit different. They try to put a monetary amount on how a person felt going through the injury. This can include things like:
- The pain or the suffering of the patient from the injury itself
- Any type of trauma that the patient went through during or as a result of the injury. This can also include any type of trauma that may happen in the future, such as if there was permanent disfigurement to the plaintiff.
- Any loss of happiness for life that occurred as a result of the injury or recovery process
- Depression that resulted from the injury can be compensated for, especially if it made any of the healing process more difficult
- Loss of consortium is another type of compensation, and it refers to an injured party’s inability to provide the same things to the family that he or she once did, such as companionship, love, and assisting with taking care of the household. However, without a severe injury or death, this is not awarded in the majority of states
Each state has its own limits on the damages that can be awarded for different categories. Some states have a limit on all damages, while others limit a specific category, like pain and suffering. It is important to reach out to an experienced malpractice attorney when trying to find out what type of damages an injured party could be awarded with. Their skills and experience give them the unique ability to estimate what type of settlement the plaintiff could be looking at. While it may not be wholly accurate, it can give the plaintiff a good idea of what he or she could expect from the court process.
Ways Nurses Could Prevent Malpractice Problems
Nurses have very intense jobs where they are constantly being pulled in various directions. There is no downtime, and exhaustion is prevalent among nurses, just like it is among all medical staff. Unfortunately, there is no way to eliminate malpractice entirely. However, the chances of it happening can be decreased. In order to take steps to limit issues with malpractice, nurses need to set themselves up to be attentive to what each patient may require. Here are some steps nurses can take to avoid having higher chances of facing malpractice charges:
- Taking the time to think critically before attending each patient. This allows for greater focus.
- Keeping lines of communication open with patients and consistently asking for feedback about what is going on and how the patient is doing. This also helps the patient feel comfortable asking questions about their care and their prognosis.
- Focusing on one patient at a time until tasks are complete
- Assessing only one patient at a time until the process is complete, then promptly document what the assessment returned
- Implement safety measures where people are coming back behind each other to make sure nothing is missed
Some measures can also be taken to reduce medication errors. This is considered the 5 Rs. They are as follows:
- Right Drug: Did the nurse double-check to make sure this is the drug the doctor ordered and that there is nothing in the patient’s system that could conflict with this drug?
- Right Patient: Did the nurse verify the patient this drug is supposed to be administered to?
- Right Dose: Is this dose appropriate for the height and weight of the patient, not too much, or not enough?
- Right Route: Is the way this drug is being given appropriate for the patient?
- Right Time: Is the drug being administered at the right time according to this patient’s medical records? If it is given too early, it could cause harm, and too late, could mean it was not able to be as effective for the patient.
By following these simple guidelines, it can help avoid issues with medication errors.
The Evidence Required to Get Into Court
When going to court becomes inevitable, that means there needs to be a lot of evidence gathered. Having an attorney gather the evidence during an investigation means that no time is being wasted and the process can move forward as efficiently as possible. Each state is specific as to what should be submitted and what is not necessary, but basically, every state wants some of the same evidence to get started. This includes:
- All medical records that the plaintiff can come up with. Having them from both before and after the accident can help the court visualize how the injury affected the life of the plaintiff.
- Witness statements from anyone that was around when the injury took place.
- Digital evidence from around when the accident took place. This can include photographs taken of the injury at the time of the accident, videos of the injury itself, surveillance videos that could have been taken in the hospital or medical clinic, and more. Some floors of hospitals have more surveillance than others, such as labor and delivery, and intensive care. These are great places to have surveillance pulled, which could help prove the plaintiff’s case in court.
- Reports showing maintenance of the equipment in question, if that was the error.
- Statements from any physician or medical staff that saw the plaintiff since the injury. That way, the effects of the injury, treatment, and total recovery are all well documented by professionals whom the court can speak with if necessary.
Finding an Attorney Who Truly Understands Nursing Negligence
Many attorneys have experience with medical malpractice in general, but not all have experience with problems with nursing care in specific. It is very important that an injured party work with someone that understands how to get compensation for someone that was directly injured by a nurse instead of the more traditional physician. The expectations in court are different, as are the options that an injured person can go after when a nurse is involved. Finding a lawyer or law firm to help file all types of medical malpractice claims means finding a person that the plaintiff feels a connection with. Here are some of the best questions to ask during an initial consultation with the lawyer to see how comfortable the injured party feels with the attorney:
- Does the attorney have the ability to understand the nuances of what happened to the injured party?
- Can the attorney line up an expert witness or two to explain what happened to the judge and jury in a way that they will be able to understand?
- How open is the attorney’s schedule?
- How long does the attorney estimate the case will take from filing to completion?
- When does the attorney get paid, upfront or only if the case is won in court?
- Are there any fees the injured party should expect before filing the case in court?
- How many paralegals and assistants does the attorney have to help with the grunt-work of the case, or will the attorney be taking it all on him or herself?
- How will the investigation into the injury go? What will all be looked into, and whom will the attorney need to speak with that the plaintiff could line up to speed up the process?
- What types of evidence does the attorney think will be required to go into court?
- Does the attorney believe he or she will need a statement from any medical expert that could help the case?
- Does the attorney believe there is a case after hearing the preliminary details? If so, what type of settlement does the attorney estimate would be assigned to the victory? Expecting a generic ballpark for this is best, as the attorney is only guessing based on past experience.
- Who will be communicating with the injured party about the updates to the case? How often should those updates occur?
What Benefits Does a Malpractice Attorney Bring to the Case?
Having the help of an attorney when going to court helps tremendously in such cases. This is because the attorney allows the plaintiff to get much farther in court without the stress or anxiety that can come with trying to go into court alone. In fact, going into court alone could cause additional issues with the plaintiff’s health and further delay healing.
Talking to an attorney and allowing one to assist with the case allows for much better chances of having a favorable outcome. This is because attorneys have skills laypeople simply do not. This includes things like:
- The ability to communicate with the plaintiff, defendant, and anyone else associated with the case while getting depositions
- The ability to communicate with the insurance company to see what kind of settlement could be offered as a result of the injury
- A full understanding of what the court expects in terms of documents, time limits, damage caps, and expert testimony
- Someone who can go through and compile the entire case for the plaintiff, including investigating what happened
- Some attorneys have the option of helping to cover medical care that is required prior to the completion of the case, and they will go back after the accused for whatever they cover
- The ability to negotiate with all parties to figure out what type of settlement is enough to cover what happened
- Someone who can go into court and stand-in for the plaintiff in many instances, so the plaintiff only has to go into court when necessary
- The knowledge of what to say to the judge and what to avoid saying so that the judge continues to listen instead of getting upset
- Being objective when the plaintiff has questions, while still being able to advocate for what the plaintiff needs
- Keeping the stress off the plaintiff by putting all of the documents into court on his or her behalf and keeping the lines of communication open
- The ability to break down the complexities in the case to a simpler level when speaking with the plaintiff so that he or she can understand what is going on
- The ability to get the highest possible amount of damages. Going into court without a lawyer often nets the plaintiff a much smaller reward, if any, so having a lawyer allows people to get a better result than trying to go it alone
Through the use of these skills, an attorney can help the plaintiff get the financial compensation he or she needs, without adding any extra drama, chaos, or confusion into his or her life. This means that the injured party can focus on healing and allow his or her body to take the right amount of time to feel better.
No matter who caused a medical injury, it is something that the injured party should have a professional look into. Nurses can be just as culpable as doctors when it comes to making mistakes, if not more so. People rarely go out of their way to cause any type of damage to others. Instead, they make mistakes that sometimes lead to an injury or death. In the event of either of those results, compensation can be a way to make the recovery process a little bit easier. Always go to court with someone that has the wherewithal to make the process as pain-free as possible. The goal is to help the injured party recover and allow enough money to cover the time that takes to happen fully. For anyone that may have suffered an injury at the hands of a nurse or other medical staff, the best way of being able to ensure that does not happen again is to take the problem to court and let a judge sort it out.