The Four Elements of Medical Malpractice in Nursing

Medical malpractice – two words you definitely don’t want to hear too often if you work in the healthcare sector. Unfortunately, it happens all too often, and recovering from the situation can be a lengthy and costly process for both the facility and the individuals involved. While the issue is most often associated with physicians, medical malpractice is also widespread in nursing as well. Indeed, the prevalence of medical malpractice in nursing has surged in recent years, and it likely has a bit to do with the fact that it isn’t discussed much as it relates to nurses.

If you’re a nurse that works in a hospital or other organization, here’s what you need to know about medical malpractice in nursing.

Standard of Care

The concept of “standard of care” varies from facility to facility but is generally drawn from the policies and procedures of the facility in question, or rather, the facility where the employee in question works. As it relates to nursing, these policies usually consist of general nursing policies that are accepted around the state or country as well as organization-specific elements for employed nurses. The identified Standard of Care, therefore, needs to cover just the right scope instead of being too vague or specific.

In essence, though, the Standard of Care as set forth by the policy and procedure of the facility is the absolute minimum expectation for nurses and other staff. Of course, employees should be aiming for a higher standard and taking it upon themselves to offer the best care possible. To ensure that nurses are following the guidelines, the policies need to be widely available for review and consultation if a nurse is unsure of how to proceed in a certain situation.

The Elements of Malpractice

Before a plaintiff can file a complaint about staff or a facility, there are four main components that need to be satisfied. Otherwise, there is no firm basis for the malpractice suit. These components are as follows:

  1. Duty

Duty, responsibility, role – these are all terms for what the nurse owes to the patient they are caring for. When describing or defining the duties of a nurse, a facility may opt for somewhat vague or broad wording. For instance, a policy handbook may indicate that a nurse must “provide a safe environment” as opposed to “prevent harm.” A nurse can provide a safe environment as far as she is able, but that doesn’t necessarily mean that harm will not befall the patient. However, a patient may still be able to cause harm to themselves even within the safe environment provided by the nurse and her organization.

It is important to remember that duties that are defined by the facility are performed correctly. In broad terms, a policy might state that a nurse must follow the physician’s orders. How well those orders are followed may be subject to some interpretation, but in the end, the task must be completed correctly. If a nurse is unable, for whatever reason, it is their duty to find someone to take over and complete the task.

  1. Breach of Duty

Once the duty is identified, it is the plaintiff’s responsibility to identify the breach of duty that was committed by the nurse. The plaintiff must identify where the nurse failed in complying with the policy. In our previous example of ensuring a “safe environment,” the nurse may have breached her duty of doing so if she failed to lower the bed for the patient, leading to patient injury.

  1. Damages

The injury, illness, pain, or other harm to the patient constitute the damages. In other words, there must be some lingering effect due to the breach of duty on the part of the nurse. To continue on with our example of the safe environment, let’s say that the nurse breached her duty by failing to lower the bed, as mentioned above. The patient then falls out of the bed, breaking their leg. The duty was clear, and the breach of that duty also obvious. The damages are the injury sustained – the broken leg. However, even if there was a breach of duty and the patient fell out of the bed, if the leg was not broken (and there were no other bodily injuries), there were essentially no damages, and therefore no grounds to sue.

  1. Causation

This is the part of medical malpractice that is most difficult to identify. Broadly speaking, there needs to be a determination of cause and effect, wherein the nurse is undeniably at fault for the damages. Let’s go back to our improperly lowered bed. The patient fell out of the bed and broke their leg. The question is whether they would have fallen out regardless of whether the bed had been lowered or not. If it is determined that the patient did fall because the bed was too high, the nurse is at fault. However, if the patient would have fallen out of the bed regardless of the height, the nurse is not responsible, even if the patient sustained an injury.

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