Duties and Liabilities of a Nursing Practitioner Failure to Question Patient Discharge A nurse has a duty to question the discharge

e of a patient if he or she has reason to believe that such discharge could be injurious to the health of the patient. Jury issues were raised in Koeniguer v. Eckrich by expert testimony that the nurses had a duty to attempt to delay the patients discharge if her condition warranted continued hospitalization. By permissible inferences from the evidence, the delay in treatment had resulted from the premature discharge contributed to the patients death. Summary dismissal of this case against the hospital by a trial court has been found to be improper. Failure to note changes in patients condition Nurses have the responsibility to observe the condition of patients under their care and report any pertinent findings to the attending physician. Failure to note changes in a patients condition can lead to liability on the part of the nurse and the organization. Eyoma v. Falco case The recovery room nurse, who had been assigned to monitor a postsurgical patient, left the patient and failed to recognize that the patient stopped breathing. Nurse Falco had

been assigned to monitor the patient in the recovery room. She delegated that duty to another nurse and failed to verify that another nurse accepted that responsibility.

Failure to report defective equipment

A nurse has a duty to report defective equipment; a failure to report defective equipment can leave a nurse liable for negligence if the failure to report is the cause of the patients injury.

Ex: Other common sources of malpractice suits filed against obstetric and neonatal nurses include failure to monitor equipment, use of defective equipment.

The defect must be known and not hidden from sight. Failure to take correct telephone orders Orders should be repeated, once prescribed, for verification purposes. A failure to ensure that telephone orders are correctly transcribed can lead to civil liability. Failure to take correct telephone orders can be just as serious as failure to follow understand and/or interpret correctly a physicians practice. Verification of a order by another nurse on a second telephone is helpful, especially if an order is questionable. Any questionable orders must always be verified with the physician initiating the order, Physicians must authenticate their verbal orders. Report to supervisor any difficulty in resolving a difference of opinion with the physician. Switching of infants The inadvertent or negligent switching of babies born at the same time can lead to damages. Maternity Ward Security.

Most maternity wards have some sort of an infant protection system to prevent baby switching and abductions. The security in the maternity ward Cape Cod Hospital is typical of many such wards across the country. Every infant in the maternity ward is fitted with a leg band that will signal an alarm if taken too close to the sensors places at doorways. Sponge and/or instrument miscounts Nurses have the duty to do one final count to be sure all instruments, sponges and suture are accounted for before the patient leaves the room, labels lab specimens, removes drapes, helps move the patient to the recovery room, and makes sure all paperwork is signed.

An example is the Holger v. irish Inadequate staffing

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has established guidelines for determining the number of staff needed for any given situation (Staffing ratios)

- when there are not enough nurses to meet the staffing ratio and provide competent care, substandard care may result.

Placing clients at physical risk and the nurse and the institution at legal risk. The nurse in this situation should provide nursing administration with a written account of the situation.

A nurse who leaves an inadequately staffed unit could be charged with client abandonment. Critical care. Because the critical care units are not infallible, constant observation and assessment of clients are required, making a 1:1 or 1:2 nurseclient ratio imperative. Patient falls Patients are highly susceptible to falling, and the consequences of falling are generally more serious with older age groups.

Among senior citizens, falls represent the 5th leading cause of death and the mortality rate falls increases significantly with age. For those aged 75 years and older, the mortality rate from falls is 5x higher than for those in the 65-74-year-age group and the rate increases such that persons older than 80 have an ever greater chance of experiencing fatal fall. If the nurse had any reason to suspect that the patient is at an increased risk for falling, she must take appropriate measures to safeguard the patient The case of Stevenson v. Alta Bates (1937) Patient had a stroke and was learning to walk again. As two nurses, each holding one of the patients arms, assisted her into the hospitals sunroom, one nurse let go of the patient and stepped forward to get a chair for her. The patient fell and sustained a fracture.