Nurses can take steps to reduce risk of litigation
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Key takeaways:
- Pristine records do not preclude a nurse from being sued by a patient for malpractice.
- Steps can be taken to limit the risk of a lawsuit.
PALM SPRINGS, Calif. — Even with detailed records on how care is provided to a patient, there is no guarantee a nephrology nurse will not be sued by a patient for malpractice, a speaker said here.
“There is nothing you can do to completely preclude you from being sued or being named as a defendant in a medical malpractice lawsuit,” Wendy Lester, MSN, RN, CNN, said during a presentation at the American Nephrology Nurses Association National Symposium. “There is no magic bullet.”
Pristine records do not preclude a nurse from being sued by a patient for malpractice. Image: Adobe Stock.
Lester acknowledged that, in some cases, patients do have a legitimate reason to sue their caregiver. “I’m not saying there are not legitimate cases out there because, unfortunately, there are,” Lester said. “It is difficult to know why patients sue and what motivates them.” Limited research has shown that most patients want to sue because “they want to prevent a similar incident from happening again, they want to know how and why the injury happened, they want financial compensation for any losses and for future care, and they want to hold their health care team or health care providers accountable,” Lester said.
Law firms that focus on personal injury have become familiar with the dialysis process and openly promote on their company websites that providing treatments has the potential for mistakes. But Lester said variance on how patients are treated does not necessarily mean there is negligence or malpractice. “I get several cases of patient falls in the dialysis unit,” Lester said. “Are all falls a sign of negligence? Can you prevent all falls? Of course not. Even with all the measures you may take to mitigate that risk, patients, unfortunately, still fall. It doesn’t always mean it is negligence.”
Malpractice
For a malpractice claim to be filed against a member of the medical staff or the dialysis provider, four elements must be in place, Lester said. “The first is you have to establish a duty,” Lester said, “so a nurse-patient relationship involving a staff member taking care of a patient” qualifies as a duty, Lester said.
The other elements include “when a breach occurs, and a person’s conduct fails to meet the applicable standard of care. That breach causes the injury,” Lester said, “and then there are the actual injuries themselves. These injuries can be physical or emotional.
“So all four elements must be present in order for a lawsuit to be filed.”
Lester said that nurses who are served should limit the number of people they talk to about the case. “Be aware that any conversations you have other than with your attorney are not protected by the attorney-client privilege,” Lester said. “Discussions about the case with your colleagues is a big no-no ... Don’t talk to anyone about it.”
Documentation
Lester suggested to attendees that they review recommendations from the American Nurses Association (ANA) on how to maintain good documentation involving interactions with patients. “The key to good records are that they should be accessible and that they are accurate, relevant and consistent,” Lester said, citing the ANA document. “They need to be auditable, clear, concise and complete,” Lester said. “They need to be legible and readable. Documentation needs to be thoughtful, timely, contemporaneous and sequential,” Lester said, “and should be aligned with the nursing process and reflect alignment with assessment, planning, implementation and evaluation.”
“Finally, documentation should be retrievable,” Lester said. “It doesn’t help you or your patients if you can’t find what you are looking for.”
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Lester W. I’m being sued! How confident are you that your documentation will defend you?. Presented at: American Nephrology Nurses Association National Symposium; May 7-10, 2023. Palm Springs, Calif.
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