Liability issues in Nursing

Liability Issues in Nursing Case Study Essay

Introduction

            Patients are at the core of professional nursing practice and all practitioners are accountable for them across all healthcare settings. However, across all areas of the nursing profession, litigation instances can occur when the nurses are not alert to the legal aspects that relate to their practice, despite the best efforts or care provided. As such, the aim of this paper is to answer the questions that relate to the pulmonary embolism death case in chapter 9, offer my opinion regarding to how I would have gone about the case to make a decision as a judge, locate the various provisions provided and answer the insurance company case in chapter 10.(Liability Issues in Nursing Case Study Essay)

Chapter 9 Case Study

            Documentation is a vital entity in all nursing assessments as it influences the ultimate outcomes of all patient cases. According to Guido (2014) the practice of nurses accurately documenting all process is crucial and shows their credibility or consistency of their care actions as per the professional standards that ensure delivery of quality and safe patient care. Documentation is fundamental for communicating the health whereabouts of the patient to the health facility management team. In regard to the case study (Guido, 2014; 185-186) the nurse’s failure to admit the documentation of the patient assessment was crucial in the court jury’s decision about the complications which led to the patient’s death. Despite the efforts by the doctors and nurses, not documenting the data relating to progress of the patients health especially in the chart created a difficult scenario of no evidence to support the affirmed claims in the proceedings.(Liability Issues in Nursing Case Study Essay)

            Negligence was evident and it resulted in the death of the patient. Nurse are required to see the changes and communicate them to the necessary physician after keen assessment and monitoring. The accuracy of the nurse and her timely reports of the changes in the patients or vital aspects mean the difference between death and life. Nurses ought to maintain competence in their specialty areas of practice. Sohn (2013) describes negligence in healthcare as a process where nurses fail to comply with all the standards and rules which relate to delivery of patient care. The lack of or failure to complete the documentation of all the procedures as per the healthcare standards insinuated a higher level of negligence (Guido, 2014). This scenario of the entire team relates to the risks which shows a lack of patient advocacy.  Bono & Hipskind (2019) note that negligence is depicted by failure in documentation, communication, and carry out assessment, monitor and failure to act as a patient’s advocate. The nurse mentions that she attempted to contact the physician’s office but none of the claims was documented immediately until the following day. Besides the truth in the claim, the nurse ought to have done more than just calling the physician or leaving him or her messages, but also act as the patient’s advocate and ensure the patient receives immediate attention (Guido, 2014). The habit of the patient scribbling handwritten notes when on her shift they typing the progress notes on the computer the following day is not acceptable based on healthcare standards, and regulations, and also opens up a gap to dispute the documentation. Inexcusable negligence is also depicted in the lack of documentation of the patient’s vital signs which is not based on the healthcare regulations, and standards.(Liability Issues in Nursing Case Study Essay)

            The nurse in charge of the patient did not follow several standards of care as she was supposed to by the regulations. The nurse must have contacted the physician in a prompt way upon observing the patient’s rise in respirations to 50 per minute (Guido, 2014). The nurse mentioned she contacted the office of the physician. She was supposed to done more than just calling the physician or leaving him or her messages. The habit of the patient noting handwritten notes when on her shift they typing the progress notes on the computer the following day is not acceptable. Instead, the nurse should have documented the patient’s health status in the last hours to denote an increase in rate of respirations and his death. The nurse should have responded differently to the wife’s complaint about his husband’s heavy breathing before she left the health facility. Conducting a comprehensive assessment is the process that should have been taken by the nurse to show concern and care to the family member of the patient (Brickley, Lu, & Wedig, 2017). The health status information ought to have been documented in the chart assigned to the patient. Regulations should have been followed by the physician to show concern to the patient and not ignoring the critical signs.(Liability Issues in Nursing Case Study Essay)

            As a judge in this case, the decision I would have upheld that the nurse and the physician’s office for negligence. Based on the standards of care, failing to notify the physician or advocate available at the time of the medical emergency, is an act of negligence and also against the code of acting as the patient’s advocate. Failure to document the nursing care impedes the defense of the nurse (Guido, 2014). In this case, documentation could have verified the claims of the nurse and avert any negligence accusations.(Liability Issues in Nursing Case Study Essay)

Insurance policy

The declarations that should be included are: the name of policyholder, the profession, address, the nurse and the covered time duration.

Policy limits: $100000 per claim/ $600000 per aggregate(Liability Issues in Nursing Case Study Essay)

The declarations that should be included are: the name of policyholder, the profession, address, the nurse and the covered time duration.

Deductibles: the amount deducted by insurance for the nurse’s legal defense $200,000.                                                                                                                                                               Exclusions: are not included in the insurance cover. For example all actions that relate to the nurse’s violation of the healthcare practices.(Liability Issues in Nursing Case Study Essay)

Reservation of rights: These are rights reserved by the insurance company to deny coverage upon knowing the negligence process and lack of documentation of the nurse as a crime, an action that violate the healthcare practices, and a restricted activity. The nurse must pay all expenses from her pocket.(Liability Issues in Nursing Case Study Essay)

Coverage injuries: these outline the multiple injuries that can be paid by insurance including body injuries, mental challenges, damage of property, privacy invasion and other monetary charges.(Liability Issues in Nursing Case Study Essay)

Defense costs: these costs include all the necessary and reasonable costs used during investigation, negotiation and defense process of the covered lawsuits.  These costs will cost up to $1200 as per the policy period.(Liability Issues in Nursing Case Study Essay)

Covered conditions: are the duties of the nurse to the insurance carriers when a lawsuit is filed, a policy is cancelled and rights are subrogated.(Liability Issues in Nursing Case Study Essay)

Supplementary payments:  these are payments or provisions for more cash to the party that is insured or the nurse.

            After going through the policy of liability, I found out that it is not easy. It is evident that the limits of coverage are on the low side close to $100,000 and $600,000. In my opinion, I would not choose the policy given in the book due to challenges with the reservation of rights. With regard to the limits of reliability, the total cost required is $4000 (Guido, 2014).(Liability Issues in Nursing Case Study Essay)

Chapter 10 Case Study

            The provisions that I would consider in this case relate to professional liability insurance. For the insurance company to pay for the claim, I would look at the two distinct ways of classifying the insurance including the claims policies and occurrence based policies (Brous, 2017). I would specifically consider the claims made policies that relate to provision of coverage only when the claim of injuries is filed with the court and active during an active policy period (Guido, 2014). The limit of legal liability is that the insurance carriers do not cover the cost of the moral obligations that the healthcare party owes the injured party. Another limit is that the company can pay up to the lower limit for a single claim and up to the upper limit during the policy period (Guido, 2014).(Liability Issues in Nursing Case Study Essay)  

            The nursing home insurance company is correct to say that it was a professional judgement issue and as such, has exclusions and insured licensure. The insurance covers the employees and entire business from work mistakes, failure to deliver, negligence, inaccurate advice and misrepresentation (Diana, & Grant, 2017). The insurance company should pay for judgements against the business for the lawsuits and legal defense. What the nursing home should do is look at the declarations of the policy if it is still in effect (Diana, & Grant, 2017. The administrator’s insurance should pay the court ordered judgment. As the judge in this case, I would decide that both the administrator’s and nursing home’s insurance share the fine and be held responsible for the wrongful death.(Liability Issues in Nursing Case Study Essay)

Conclusion

            Nurses and physicians are have the duty of upholding ethical standards and healthcare regulations to ensure quality care is provided to patients. The medical practitioners ought to be careful. For this reason, the objective of this paper has been to analyze the liability issues in healthcare by answering the questions that relate to the pulmonary embolism death case in chapter 9, offer my opinion regarding to how I would have gone about the case to make a decision as a judge, locate the various provisions provided and answer the insurance company case in chapter 10.(Liability Issues in Nursing Case Study Essay)

References

Guido, G. W. (2014). Legal and ethical issues in nursing (6th Ed.). Upper Saddle River: Pearson.

Sohn D. H. (2013). Negligence, genuine error, and litigation. International journal of general medicine, 6, 49–56. https://doi.org/10.2147/IJGM.S24256(Liability Issues in Nursing Case Study Essay)

Bono MJ, & Hipskind, J.E, (2019). Medical Malpractice. [Updated 2019 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470573/

Brous, E. (2017). Professional liability insurance: What all nurses should know? Journal of Radiology Nursing, 36(4), 236-237.

Brickley, J. A., Lu, S. F., & Wedig, G. J. (2017). Malpractice laws and incentives to shield assets: evidence from nursing homes. Journal of Empirical Legal Studies, 14(2), 301-332.(Liability Issues in Nursing Case Study Essay)

Diana, J. D., MBA, R., JD, P. D. B. M., & Grant, R. N. (2017). Law for Nurse Leaders. Springer Publishing Company.(Liability Issues in Nursing Case Study Essay)