Question

Making the Transition to Professional Practice Issues in At a hospital in Washington State, a client with a recent log amputation was partially sedated after surgery The nurse assigned to his care was caled a from the room and failed to raise the bed rails. The client attempted to get out The clent sued the hospital for negligence. Using the hospitals oin cles and procedures manual, the client's lawyer pointed out the requirement Nurse Malpractice in Client Fall bed, fell, and was injured satisfactory precautions be taken to restrain disabled or sedated clients The nurse's lawyer based the defense on the argument that the nue was following the physician's standing orders to allow the client to ambulate postoperatively to hasten recovery and prevent complications, The court agreed with the client and concluded that the nurse had an obligation, based on the hospital's policy and procedures, to assess the clents physical and mental condition. Nurses have an obligation not to leave clients unattended in an unsafe bed configuration. All lawsuits alleging health-care provider negligence require expert wit ness testimony. Without this, courts will almost always dismiss a negligence case decided by a lay jury, even when it is as obvious as a fall from bed. In this case the expert testimony not only supported the lawyer's contention that the hosptas policy and procedures upheld the suit but also emphasized the point that clie recently returned from surgery are disoriented from anesthesia and should nee be left alone unless the bed rails are raised to their full upright position. When the case was appealed, the court of appeals wrote the following ruling: CCA lawsuit against a hospital for negligence does not necessarily have to involve medical malpractice committed by a physician A hospital's nurses have their own independent legal duties in assessing and caring for their patients. A hospital is not relieved of its own legal liability for negligence just cause the hospital's staff nurses followed the physician's orders. That is, a hosp- tal's nursing staff cannot necessarily rely on a physician's standing orders patient to be up and out of bed and leave the bed rails down. A patient freshly out of surgery who is taking pain and sedative medica tions must be evaluated continually by the staff. The patient's present physical and mental state is all that matters. The nurses may have to disregard the phys cian's standing orders and instead follow the hospital's policies and procedures for a restraint in the form of raised bed rails when necessary to insure the patient's safety

Answer 1

Yes, I Completely agree with Juries decision. A nurse is a liason between patients and doctor, she is the first point of contact for the patient, In this situation nurse is supposed to monitor and provide care for the patient. Here because of the lack of empathy of the nurse toward the patient who had got amputation and sedation done, he suffered a fall further injuring himself.

Here the order of physician was to allow the patient to have early ambulation to prevent complications. Nurse should have taken care that ambulation should have to be done in presence of nurse, physiotherapist and other supporting staff and patient shouldnt be left to their own mercy. Further patient was sedated which means that he should not be well oriented with the space and soroundings hence presence of a nurse/attender with him is a must under such situations.

Hospital is liable for the faults of their nurses/physicians under the VICARIOUS LIABILITY. Where in hospital can be held legally responsible for neglectful act of physicians and nurses under their employment

Nurses responsiblity extends from the time of admission of the patient to patient going to their houses and sometimes even on subsequent visits

in this case nurse should have involved other members of the healthcare team in managing the patient.she should have educated the patient to ring a bell or raise alarm in case he needed to be ambulatory. she should have instructed him that he can get down from the bed only in presence of the nurse

She should have not left the patient unattended, instead could have taken help of some other person to stay with the patient

The process of ambulation of a amputated patient is a team work involving many professionals and not only just a nurse

she could have preconsulted the treating physician regarding the same and decide upon her own team.