Negligence Acts in Nursing

by Samantha Rhea, MSN, RN

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    00:01 Let's look at negligence a little bit more closely.

    00:04 Here's some great examples of negligence in nursing.

    00:08 So, it's failure to assess and monitor.

    00:11 Here's a great example of one that I've had come up with a student.

    00:17 I hate to talk about this but this is a great thing to think about when you're rounding on your patients and checking on them to make sure they're safe.

    00:25 So, I've had a situation where I was a clinicals with a student.

    00:29 This nurse failed to monitor her patient appropriately, so my student came up on the floor.

    00:35 They checked on this patient, we were on a stroke floor and the patient had some residual, meaning some effects from the stroke that were present so the patient had a little bit of slurred speech.

    00:49 They could move their right arm, but it was still a little bit weak.

    00:54 So, when my nursing student came on shift, they noted this, so they went to let the nurse know because they weren't sure, hey, is this normal or not? They just got on shift, they were just students, they were new, so they went to check with the nurse and they informed the nurse of this.

    01:07 Well, the nurse didn't really go back and checked as far as we know, so the nursing student reported it.

    01:14 They went to round and performed their other duties in clinical as they should.

    01:18 I checked in with the nursing student, and the nurse still hasn't check on that patient.

    01:25 So, the nursing student let me know, me and the nursing student went in with the patient after he had again, tried to tell the nurse, hey, something's going on with this patient.

    01:35 So, I went in with my student, looked at this patient, we assessed together, and surely enough, the patient had a stroke neurological change.

    01:45 So, after this assessment, I went and talked to the nurse, she immediately finally got up, went, assessed the patient, and you can imagine this has been some time, so once she realized what was going on, she let the provider know and that patient had to go to a higher level of care.

    02:04 So, this has to do with failure to assessing and monitoring your patient in a reasonable time frame.

    02:12 So, please keep that in mind. So, checking on your patient frequently and assessing, is definitely a big failsafe to keep from further injury.

    02:22 So lLt's also talk about failing to follow the rights of medication administration.

    02:28 Now, there's other pieces in this video series that talks about medication administration and how very important it is.

    02:36 But because as nurses, we give medications everyday to lots of patient day in and day out, sometimes we get a little bit lax, to be honest, in how we are supposed to follow those med administration rights, so making sure we are thorough with this, is really important.

    02:54 If we give the wrong dose to a patient it can definitely make their vitals signs abnormal and it can cause injury to our patient, so don't forget to follow the rights of medication administration.

    03:06 And, next, we talked about this a little bit earlier, that example of giving injections to a patient without giving adequate instructions.

    03:15 We wanna make sure that we empower our patients, to give enough information that they can adequately take care of whatever they need to at home, so they don't come back to see us in the hospital.

    03:26 Let's not forget about how to properly delegate and supervise.

    03:32 So, if I tell my nursing assistant that day that's assigned with me, to go get a set of vital signs and maybe she gives me a value on the wrong patient, and I go and treat that, that's definitely an issue and that comes back to me as a nurse, because anything that I delegate, I as the RN, am responsible for that.

    03:54 And let's not forget to notify the health care provider.

    03:58 Now this seems kind of like a no brainer, but here's a great instance.

    04:02 We typically get morning labs for our patient when we come on a shift.

    04:06 Now potassium level may be in that. If the potassium level is really high and abnormal, we have to notify the health care provider. So why is that the case? Well, if the potassium level gets really high, this can cause a really dangerous heart rhythm for our patient.

    04:25 We obviously don't want that to go on, right? So, if we notify the health care provider, we can get prompt treatment and hopefully help correct or prevent that heart arrythmia from happening.

    04:37 And don't forget that we have physician orders.

    04:41 Failure to follow these orders can definitely cause legal repercussions, so we need to make sure as nurses that we follow through to the T those orders.

    04:51 Also, here's biggie, if those orders don't make sense to you as a nurse, hey, trust your gut.

    04:57 The reason why, is health care providers are humans, right? You can imagine that they have patients all over the hospital, so we as a nursing advocate need to be the ones that screen those orders, are they appropriate for your patient? So, we are that safeguard for those.

    05:16 And ensuring patient safety.

    05:19 There are so many facets of this and there's so many different pieces of this.

    05:24 In medication administrations a really common one, we talked about earlier, so making sure we do all we can to keep that patient safe, so they get to discharge and go home to their families.

    05:35 And, lastly, your policies and your procedures of your health care agency.

    05:40 Now this gets a little tricky, there's a lot of them.

    05:44 But, you typically have resources at your fingertips on your unit to refer to.

    05:50 Also, don't forget about your charge nurse or maybe a nurse you trust to find this, but we're responsible as a nurse to follow polices and procedures of our health care agency.

    06:03 Okay, so that was a lot of legality talk as a nurse.

    06:08 You're thinking, "Well, hey, I don't have my license yet, that's not for me." Sorry, that's not true.

    06:14 So, there are legality things to follow when you're a nursing student, so you are liable for your actions because we can cause harm to patients, so just keep that in mind in regards to being a nursing student, you also have legal responsibility.

    06:31 So, you are expected to perform as a professional such as patient safety, communication, there's so many facets of that, and us as clinical instructors will help guide you on that process.

    06:44 And you must act only under the scope of a student nurse, within that specific facility, so just know, every facility is a little bit different on what they let a nursing student do, so you need to make sure you are acting within your scope.

    About the Lecture

    The lecture Negligence Acts in Nursing by Samantha Rhea, MSN, RN is from the course Ethics and Legalities in Nursing Practice.

    Included Quiz Questions

    1. Administering an antihypertensive intravenously and checking a blood pressure 3 hours later
    2. Administering an opioid intravenously and checking the pain level 15 minutes later
    3. Administering a moderate sedative intramuscularly and checking the respiratory rate 20 minutes later
    4. Administering an antipyretic orally and checking the temperature a half hour later
    1. Telling the client to get the answers to their questions on the internet
    2. Withholding resources that the client has a right to have access to
    3. Giving the wrong discharge paperwork and prescriptions to the client
    4. Asking the provider to answer a question for the client that the nurse can't answer
    5. Showing the client how to organize their medications
    1. Failure to notify the health care provider
    2. Failure to assess or monitor
    3. Failure to follow orders
    4. Failure to ensure client safety
    1. Nursing students are liable for their actions if they cause harm to clients.
    2. Nursing students are expected to perform as professionals.
    3. Nursing students must work within the scope of practice as a student nurse.
    4. Nursing students can do the same tasks as registered nurses if the client gives them permission.
    5. Nursing students have the same scope of practice in every facility.

    Author of lecture Negligence Acts in Nursing

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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