● Whether the nurse accepted the patient assignment, which established a nurse-patient relationship. ● Whether the nurse provided reasonable notice when severing the nurse-patient relationship. ● Whether reasonable arrangements were made for the continuation of nursing care by others when proper notification was given. Some examples of patient abandonment include the following: ● A nurse assigned to provide resident care in a nursing home walks off duty in the middle of the shift without telling anyone and does not return, seriously impairing the delivery of nursing care to the residents. ● A circulating nurse leaves the operating room during a surgical procedure without transferring responsibility for nursing care to another qualified healthcare practitioner, seriously impairing the delivery of surgical care. ● A private RN suddenly stops providing nursing care to a home-bound patient without notifying anyone and without making any arrangements to ensure that the patient will continue to receive needed care. ● A nurse who works on a hospital pediatric unit informs the unit clerk that she must leave work immediately. The nurse immediately leaves the hospital for the day without telling anyone else, even though some of the nurse’s patients require immediate nursing care. Since the nurse failed to transfer her responsibility for the nursing care for her patients to another qualified healthcare practitioner by reporting on her patients, other hospital staff were unaware of the immediate care needs of the nurse’s patients. The following situations are not usually considered to be patient abandonment: ● A nurse promptly refuses her supervisor’s request to float to an unfamiliar hospital unit because she lacks the experience to competently carry out the assignment. The hospital did not provide the nurse with any training or orientation to the hospital unit and does not modify the nursing assignment (so that the nurse who must float provides only services the nurse is competent to perform). ● An LPN immediately refuses their supervisor’s request to float to a hospital Emergency Room to perform triage (which is outside the legal scope of practice of an LPN). ● In a non-emergency situation, a nurse promptly refuses their supervisor’s request to accept an assignment to work additional hours beyond the posted work schedule (i.e., a double shift). ● In a non-emergency situation, a nurse completes their assigned shift at a nursing home and then notifies their employer that they are quitting, effective immediately. ● The nurse fails to return to work at a nursing home after a scheduled leave of absence and the nursing home is not experiencing staff shortages (NYSED, n.d.). ● A nurse agrees to work 4 hours longer than their scheduled shift because of an emergency. After working overtime, the nurse refuses the supervisor’s request to work additional hours because the nurse is too exhausted to continue to practice safely and informs their supervisor that they are too exhausted to work safely. Contributory negligence Contributory negligence refers to the patient’s acts or omissions that contribute to their claimed injury. Forms of contributory negligence include the patient’s failure to take reasonable care or to follow physician or discharge orders to prevent injury. A finding of contributory negligence may prevent the injured party from recovering damages in a lawsuit. An example of contributory negligence includes the patient’s right to refuse care (Wacko Guido, 2020). False imprisonment False imprisonment means holding a person against their will with an unjustifiable reason (Wacko Guido, 2020). An example
of this would be restraining a competent patient against their wishes. Foreseeability A concept that certain events may be expected to cause specific results (Wacko Guido, 2020). For example, not providing a patient their insulin foreseeably results in high glucose levels. Negligence Negligence is an omission or commission of an act that is a deviation from a standard of care, also equated with carelessness (Wacker Guido, 2020). Malpractice is professional misconduct or negligence, improper discharge of professional duties, or failure to meet the standard of care of a professional that results in emotional, physical, or monetary harm to another in their care Under respondeat superior, or “let the master answer,” the employer is held responsible for the legal consequences of the acts of a nurse or other employee acting within the scope of employment. The basic idea behind this theory comes from the concept that the employer has the right to control the acts of the employee. In other words, the hospital is held responsible for the actions of the nurse, which in turn encourages employers to ensure competencies of their employees. Likewise, the nursing supervisor can be held responsible for staff nurses’ actions. Typically, a plaintiff files suit against both the nurse and the institution. The institution is usually named as a defendant because it usually has adequate assets to cover a judgment Nurses may be sued personally for matters not involving medical malpractice under ordinary negligence. Under this scenario, the allegedly negligent conduct is compared with the conduct of a reasonably prudent layperson, not a reasonably prudent nurse. Ordinary negligence is conduct that involves undue risk of harm to someone. For example, if an orderly observes water on the floor but fails to clean it, resulting in a patient fall, the orderly may be held responsible for damages suffered by the patient. Professional negligence is different from ordinary negligence because professionals are held to professional standards of care (Wacker Guido, 2020). Malpractice or professional negligence Nurses are held liable for malpractice or professional negligence (Wacker Guido, 2020). Respondeat superior (Wacker Guido, 2020). Ordinary negligence in most settings. Nurses’ increased responsibilities and the increased number of nurses carrying personal malpractice insurance makes them financially attractive to plaintiffs. However, a plaintiff’s attorney usually does not inquire into the insurance status of a nurse before filing suit. Accordingly, carrying a personal policy does not increase the risk of involvement in a lawsuit. Malpractice law enforces the moral value to do no harm to the patient. The law represents the minimum standard of nursing practice. The standards of good nursing practice include assessment, planning, implementation, and evaluation. In nursing, negligence is the failure to meet accepted standards for nursing competence and nursing scope of practice (Wacker Guido, 2020). Spoliation Spoliation is a term used to describe any action, including destruction, alteration, or concealment of records, that deprives the court or patients of evidence. Failure to preserve, or inability to produce, evidence, including medical records, can lead to severe consequences. Although state laws differ, some laws require the court to order an adverse presumption against the party unable to produce the records – that is, the records would have been harmful to the party. Moreover, defending a case is difficult, if not impossible, without the pertinent medical records. If the jury learns of the absence of the records, they may assume that the records contained damaging information that led the healthcare provider to destroy the records (Jun, J. & Ihm, R., 2021).
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Book Code: ANCCUS2423
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