Monday, March 3, 2008

Overview - Nurses have legal responsibilities and guidelines that, if adhered to, can prevent a lawsuit from happening. Such legal responsibilities include patient care documentation. When it comes to the law, nurses abide by a Standard of Care, which is a legal approach to defining the proper guidelines a nurse should follow. The specifics vary depending on location, and most medical lawsuits occur when there is a breach in a Standard of Care.

The Legal System - Before looking at legal responsibilities, it is helpful to understand exactly how the law can affect nurses nowadays. A physician is no longer responsible for making every decision for every patient; nurses practice autonomy and thus can be held responsible for their own behavior or action while on the job. The two breaches of law commonly associated with nurses are negligence and civil cases of medical malpractice (Scott, 2007). Civil lawsuits are different from criminal lawsuits, in the sense that a dispute can normally be resolved through compensation. If involved in a civil lawsuit, the nurse may or may not have medical insurance or a lawyer. Each is a viable option if necessary.

Child Abuse - One responsibility shared by all medical providers is the duty of reporting instances of child abuse when there is a reason to suspect it. There are guidelines when it
comes to this as well, in which nurses must consult with other nurses or physicians in order to confirm their suspicions before addressing the situation. Although a child may not want a report filed and may plead to a nurse to maintain secrecy, it is the duty of the nurse to report abuse. Failure to act on such legal duties may lead to charges against the nurse for failing to act (Saliba, Garbin, Garbin, & Dossi, 2007). In addition, nurses are legally bound to the Standard of Care and must report any other worker who does not uphold these standards.

Documentation - Because so many of the cases involved with nurses claim an instance of negligence, a nurse should be able to provide clear evidence if it ever becomes necessary. Evidence is
usually provided in the form of patient documentation. Documentation itself must be precise, including the patient care plan and all times and details of information usually exchanged between the nurse and the physician. These exchanges can also include nurse-patient or nurse-third party communications. If a patient's chart is to be used for medical evidence in a courtroom, it must be precise and clearly written. Ideally, all charts should be this way, though realistically nurses must deal with many patients and may rush through the process of documentation (Pyrek, 2007). It is crucial to avoid common mistakes often associated with documentation.

Conclusion - In sum, nurses have legal obligations of which they must be conscious in order to avoid lawsuits. These responsibilities are an everyday part of nursing as a profession, as they relate to patient documentation and Standards of Care. Dealing with lawsuits can put a strain on nurses' everyday lives and may jeapordize a nurse's career. The stress that nurses encounter can be reduced if the legal responsibilities are well-known and adhered to, since avoiding a lawsuit is something all nurses should strive to do in their careers.

Additional Links -
Nurses Service Organization (NSO) - Professional Liability Insurance

Related Student Blogs on Nursing as a Profession -

References -
Burkhardt, M.A., & Nathaniel, A.K. (2008). Ethics and issues in contemporary nursing. Clifton Park, New York: Thomson Delmar Learning.
Pyrek, K. (2008). Documentation is crucial to the medico-legal process. Medi-smart. Retrieved 10, January, 2008, from
Saliba, O., Garbin, C.A., Garbin, A.J., & Dossi, A.P. (2007). Responsibility of health providers in domestic violence reporting. Revista de Saude Publica, 41(3): 472-477.
Scott, S. (2007). Your license may depend on proper documentation. Medi-smart. Retrieved 27, November, 2007, from