Avoiding Liability as a Mental Health Nurse (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 Let's talk about avoiding liability.

    00:05 Just like we want to avoid crises, we always also want to avoid liability.

    00:11 When you do something, you document it.

    00:15 If you have not done something, you don't document it.

    00:19 But if you have done something and you don't document it, guess what? You haven't done it.

    00:27 So, in order to avoid liability, your number one friend is document, your number two friend is document, and your number three friend is...

    00:40 You guessed it.

    00:41 Document.

    00:44 Also, you want to make sure that you are communicating effectively.

    00:48 What does that mean? That means that you want to make sure that what you're hearing is what the person is saying.

    00:55 And when you respond, what you are saying is what the person is hearing.

    01:01 How do you do that? You ask if the person says to you, "I, I don't want to have this procedure." You're allowed to say to them, "What I'm hearing you say is that you don't want to have this procedure.

    01:15 Am I correct?" And let them say, "Yes, you are correct." And you can say, "Can I ask you why you don't want to have this procedure?" And that effective communication might actually begin a therapeutic engagement.

    01:33 And then you document, document what the patient says, why they don't want it, why they are refusing treatment, and that the conversation has taken place.

    01:45 You need to know what the standard of care is.

    01:48 If you are ever brought into the court system, they are going to compare your care to standard of care.

    01:59 What would a nurse who has the same education as you do in this situation? What is the standard of care that is acceptable? And you must meet or exceed that standard of care.

    02:19 And one of the most important things is that we know our patients, we know the clients that we're working with, and we are able to talk to them.

    02:30 When you are involved in providing care to another human being, you are legally allowed to do those things that are identified as being part of your scope of nursing practice.

    02:50 As an RN, your scope of practice is different than an LPN.

    02:55 As an LPN and an RN, your scope of practice are different from an NP.

    03:02 And so you must know what your scope of practice is.

    03:06 You also have to be a good judge of your own competence.

    03:10 Can I do this? And can I do this well enough? Am I making sure that my patient is safe in my hands? If you don't know how to do something, you've got to be able to turn around and ask your supervisor.

    03:27 Get someone to teach you how to do whatever it is that you must be doing.

    03:33 Because your competence and your scope of practice are what you are held to, that is what you need to be practicing at.

    About the Lecture

    The lecture Avoiding Liability as a Mental Health Nurse (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Accessing Acute Psychiatric Care (Nursing).

    Included Quiz Questions

    1. "I am hearing you say that you don't want to take your medication. Am I correct?"
    2. "It's okay, I can just document that you've already taken your medication."
    3. "Do you want me to crush the medication instead and mix it in applesauce?"
    4. "I'm sorry, but you are not allowed to refuse the medication."
    1. Understanding own level of competence
    2. Documenting tasks and interventions before it occurs
    3. Ensuring the work is below the standard of care
    4. Considering working outside the scope of practice

    Author of lecture Avoiding Liability as a Mental Health Nurse (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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