WASHINGTON, DC- Due to added responsibilities, the role of the registered nurse has changed dramatically over the last decade. But what also has changed, says Donna Lee Guarriello, a registered nurse and attorney in New Jersey, is the idea that nurses now can be held liable for negligence.
In an article in a recent issue of Trial, the national legal newsmagazine of the Association of Trial Lawyers of America (ATLA), Guarriello adds that liability for negligence can include just the nurse, or can jointly involve the nurse and other health care providers.
She says that trial attorneys, when deciding liability, look at several possible errors that a "reasonably prudent" nurse might have made. Mistakes in administering medication are common areas of nursing error and can result in injury or death, says Guarriello. Errors involving dosage, time, and routing of medications or involving incorrect medications occur when the medications have similar names or the doctor's handwriting is read incorrectly.
A nurse's inability to exercise good judgment also can result in serious harm to the patient. Knowing when to stop or continue medication, or the appropriate manner in which it should be administered, should be well-understood by the nurse, without specific instructions from the attending doctor.
In collecting more patient data and monitoring more sophisticated equipment, today's nurse also is responsible for utilizing good judgment in deciding when to communicate the results. Abnormal blood pressure readings, for example, should be reported to the physician right away so that necessary treatment may be provided, she said.
"Injuries can occur to patients not only through improper use of equipment, but also through the utilization of damaged or defective equipment," the author states. Negligence for burn injuries can be proven if the equipment was not inspected carefully prior to use.
The author cautions that liability can result even if a nurse follows the doctor's exact orders. "When a physician issues an order that is obviously erroneous, it is negligence if the nurse carries out that order," Guariello says. Although the physician also can be held negligent, "the nurse is concurrently responsible, having not only the last chance, but also the duty to prevent that negligent conduct."
Further errors in nursing practice leading to liability include failing to act properly in an emergency situation. Changes detected in a patient's particular heart rhythm, if left untreated, can be fatal. The nurse is considered negligent if it is proved that the resulting injury could have been prevented.
In conclusion, Guarriello warns that "as physicians depend more heavily on skilled nursing judgment, specialization becomes more pronounced, and independent nurse practioners become more widely utilized, the awareness of nursing malpractice will greatly increase."