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Unfortunately, medical errors are a common practice that can touch anyone. They can be committed knowingly or unconsciously due to a lack of knowledge or violation of the rules. However, nurses can protect themselves and other people from negligence and malpractice by fulfilling such standards as communication with patients and physicians, maintenance of documentation, accuracy in following medical prescriptions, and proper realization of procedures.
Medical negligence and malpractice are similar concepts in essence since they entail harmful or even fatal consequences for people. Nevertheless, they are based on the different actions of nurses as negligence is caused by heedlessness or carelessness, but malpractice is deliberate indifference to the safety and health of the patient (Pozgar, 2020). In other words, negligence can be the result of forgetfulness, misunderstanding, panic, or lack of knowledge, while willful acts or inaction cause malpractice.
Manifestations of negligence include inattentive monitoring of patients, lack of informed consent, non-compliance with the doctor’s instructions, lack of communication with patients and physicians, as well as an improper realization of the procedure. For example, in Busta v. Columbus Hospital Corporation, a nurse did not attach importance to the symptoms of the patient, who showed signs of psychosis after surgery, and did not report them to his physician (Croke, 2003).
As a result, the patient fell out of the third-floor window while trying to escape from the hospital and died (Croke, 2003). This case is an example of negligence, since the nurse did not monitor the patient’s condition, considering the symptoms as insignificant, and she did not realize the possible consequences; therefore, this case is not malpractice. If the nurse followed the protocol and made sure that the patient was unstable, reported physical symptoms, and took safety measures, such an outcome could be avoided.
Another example of negligence is the case of Hall v. Arthur, since a nurse ordered the Orthoblock that is forbidden for spinal surgery without consulting a doctor, and the patient got a significant back injury (Croke, 2003). In this case, negligence is manifested in the nurse’s ignorance of contraindications, and in the fact that she did not read the description of Orthoblok and did not report the patient’s request to the doctor. Moreover, all the possible consequences of surgery had to be written in the informed consent form. Since all the nurses’ wrong actions were due to incompetence but not a deliberate act, the case also cannot be qualified as malpractice. According to hospital policy, the nurse had to report the patient’s desire to the physician and get his or her confirmation.
Malpractice is a more severe violation both from morality and law as it is deliberate, and the case of Mrs. H is such an example. As a result of the untimely and inappropriate actions of a nurse, Mrs. H fell into a critical state of ketoacidosis and malnutrition of protein calories and died in the hospice after seven days (Wilson, 2018). The reluctance of the nurse to inform the patient’s physician or family about her health condition and to hospitalize her led to this state. The basis of the accusation is also the lack of proper documentation, which is an essential part of care provision because it reflects an understanding of the patient’s health state and necessary procedures (Wilson, 2018).
According to the rules, the nurse had to report to the doctor after the first drop in oxygen level and to document her actions. After the next drop, the nurse had to inform the patient’s relatives and hospitalize her with their consent. In any case, the nurse would have confirmation of her innocence, since she acted according to the rules and has documentary evidence of her actions.
Therefore, compliance with regulations is essential due to legal reasons and a need to ensure the best care and treatment of patients. A nurse should adhere to the following recommendations to prevent cases of negligence and malpractice.
- Keep clear and understandable documentation, which is a formal part of duties, but essential for understanding the state of the patient by a nurse on shift and the attending physician.
- Maintain constant communication with the patient to evaluate his or her symptoms, explain the necessity and danger of the procedures or medications, and also obtain his or her consent to perform them.
- Interact with the attending physician regularly, especially if a nurse needs to make decisions that do not fall within his or her area of competence.
- Follow all dosages and prescribed procedures according to the protocol, as well as check the operability of technical devices.
- Carefully approach the needs of patients; for example, a nurse has to ensure the safety of movement or help in fulfilling the basic needs of older people.
In conclusion, nurses can protect patients from medical negligence by following all the necessary rules prescribed by law and the hospitals in which they work. Compliance with the protocols in most cases gives positive results in the care and treatment of patients if workers perform them with knowledge and understanding of their duties. In addition, in the event of a false charge, medical workers will be able to justify their position by proving that they acted due to the general instructions.
Croke, E. M. (2003). Nurses, negligence, and malpractice: an analysis based on more than 250 cases against nurses. AJN American Journal of Nursing, 103(9), 54–64.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals. Burlington: Jones & Bartlett Learning.
Wilson, W. C. (2018). Inadequate nurse’s notes lead to lawsuit. Caring for the Ages, 19(3), 14–15.