Question

Issues in practice: Nursing Now

1. Do you agree with the jury's decision against the nurse ? Why?

2. The nurse has a legal and ethical obligation (fidelity) to follow the physician's order. Is there ever a situation when the nurse can ignore a physician's order?

3. Under what legal principal was the hospital held liable for the nurse's actions?

4. What other actions might the nurse have taken, besides putting up the side rails, to prevent the patient from falling?

**** Please respond in well organized manner and concise thought response.

Making the Transition to Professional 184 Unit 2 Issues in Practice Washington Si The nurse as moutation was re was called away the client attempte attempted to get out of the hospital's own pol ed out the requirement that oy The Cler b Nurse Malpractice in Client Fall At a hospital in Washington State, a client with a recent leg amputation partially secated after surgery. The nurse assigned to his care was calle from the room and faled to raise the bed rails. The client attempted to bed, fol, and was injured. The client sued the hospital for negligence. Using the hospital's dles and procedures manual, the client's lawyer pointed out the requireme satisfactory precautions be taken to restrain disabled or sedated clients The nurse's lawyer based the defense on the argument that the was following the physician's standing orders to allow the client to ambulanta postoperatively to hasten recovery and prevent complications The court agreed with the client and concluded that the nurse had a obligation, based on the hospital's policy and procedures, to assess the client's physical and mental condition. Nurses have an obligation not to leave clients unattended in an unsafe bed configuration. All lawsuits aleging 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 hospitals policy and procedures upheld the suit but also emphasized the point that clients recently returned from surgery are disoriented from anesthesia and should never 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: A 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 be cause the hospital's staff nurses followed the physician's orders. That is 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 tions must be evaluated continually by the staff. The patient's present and mental state is all that matters. The nurses may have to disregard cian's standing orders and instead follow the hospital's policies and pro for a restraint in the form of raised bed rails when necessary to insure patient's safety alient's present physical to disregard the phys. and procedures

Answer 1

1.Yes. I agree with the Jury's decision. The nurse is the one who care of the patient throughout the day and responsible for the patient's safety. The nurse should work with an ethical principle in order to safeguard the hospital policies and procedures. Protecting Patient safety is the ultimate goal of nursing care.

2. The nurse is the one who acts as a liaison between the physician and the patient. The nurse must always follow physician orders as per legal responsibility. But being a professional nurse, the nurse has its own responsibilities in responding to patient care. She has to assess the patient's condition and to plan care accordingly. The nursing care plan must meet the patient's safety by keeping the environment free from harm. So the nurse should responsible for the patient's injury.

3. The hospital is held liable for doctors, nursing action, medical malpractices, patient's physical harm or violence, and violation of ethical laws. Under the Nurse Practice Act, the nurse has the legal responsibility to monitor the patient in all circumstances. The nurse should responsible for hospital-acquired falls or infections.

4. The nurse may avoid such a situation by following the prevention strategies. The nurse may get help from other nurses to supervise the patient closely until she came back. She can assess the patient's sedative level before leaving. She may educate the patient about the call bell to use if necessary. She should instruct the patient not to ambulate without the presence of the nurse.