December 22, 2020 | Health System Risk Management
Nursing liability is a perennial risk for all practicing nurses and their employers, and an issue that must not be taken lightly. A nurse can be liable in civil damages for negligence, and so can the nurse's employer. A nurse can also be liable for any adverse event that arises out of a deviation from the state nurse practice act. Additionally, nurses can be, and have been, charged criminally for gross negligence or for intentional acts. While nursing liability is generally less problematic than medical malpractice, both in terms of number of claims and indemnity payments, it is nonetheless a significant issue.
Nurses are at risk for liability at all points in the nursing process. The nursing process can be summarized in five steps:
The process repeats throughout the episode of care provided by the nurse. (Toney-Butler and Thayer)
The nursing assessment involves the collection of objective and subjective data, including the patient's statements, the caregiver's statements, the nurse's observations, and physical data (such as vital signs, height and weight, input and output, and laboratory test results). Nursing assessment involves critical thinking skills and leads the nurse to formulate a nursing diagnosis or diagnoses.
A nursing diagnosis, according to the North American Nursing Diagnosis Association, is defined as a clinical judgment about responses to actual or potential health problems on the part of the patient, family, or community (Toney-Butler and Thayer). Nursing diagnoses draw heavily on Maslow's hierarchy of needs. A medical diagnosis identifies a specific medical condition from which the patient is suffering. A nursing diagnosis, on the other hand, is based on the response of the patient to the medical condition. For example, a patient might have a medical diagnosis of "pneumonia." The patient's nursing diagnosis would be "ineffective airway clearance." (Vera). The formulation of a nursing diagnosis is integral to...