The root cause of most cases of nursing negligence is, in reality, hospital negligence in failing to properly staff its units with an adequate number of experienced registered nurses. A new culprit is the electronic medical record, which is prone to medication errors and creating fields of useless, unreliable and inaccurate data in a patient’s hospital chart. Following is a discussion about common medical malpractice claims that arise out of nursing care in the in-patient setting.
Negligence by nurses typically falls into one of the following categories:
- Failure to alert the attending physician to a patient’s deteriorating condition or the patient’s failure to respond to treatment.
- Failure to advocate on behalf of a patient whose medical needs are not being addressed by the physician staff.
- Failure to communicate abnormal test results to the attending physician in a timely fashion.
- Errors in bedside treatment, including administration of the wrong medicine or the wrong dose.
It is helpful to look at the nursing process to understand how hospital care is supposed to be provided. Patients are admitted to the hospital under the care of an attending physician. The attending physician is responsible for making a diagnosis and giving orders to treat the patient. Orders might request certain tests, like blood work and imaging, or consults with specialists to assist in diagnosis. Orders also specify the frequency and type of monitoring that a patient requires. Finally, orders are given for treatments, such as medications and procedures.
Nurses are critical to good outcomes in the hospital setting. Their role includes assessment, diagnosis, planning, and implementation of treatment plans. Nursing assessments collect and analyze data about a patient, like vital signs and symptoms. Nursing diagnosis is the nurse’s clinical judgment about the patient’s condition and response to treatment. The diagnosis is the basis for the nurse’s care plan. Based on the assessment and diagnosis, the nurse sets short- and long-range goals for this patient. Nursing care is implemented according to the care plan. Care is documented in the patient’s record to assure continuity and to chart progress. Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed.
It is apparent that nursing negligence is largely affected by the adequacy of staffing and the level of training of the nursing staff. However, random mistakes also occur, like giving the wrong medicine or wrong dose. Under Ohio law, when such negligence occurs, the hospital itself is held liable as the employer, which is how it should be since the hospital is at fault for the unsafe staffing practices that belie most nursing errors.
