Legal Risks of Nurses
Analyze the case of Mrs. Ard on page 215 of Legal Aspects of the textbook. Answer the following questions:
- What happened?
- Why did things go wrong?
- What were the relevant legal issues?
- How could the event have been prevented?
- What is your verdict?
CHANCE OF SURVIVAL DIMINISHED
On the afternoon of May 20, the patient, Mr. Ard, began feeling nauseous. He was in pain and had shortness of breath. Although his wife rang the call bell several times, it was not until sometime later that evening that someone responded and gave Ard medication for the nausea. The nausea continued to worsen. Mrs. Ard then noticed that her husband was having difficulty breathing. He was reeling from side to side in bed. Believing that her husband was dying, she continued to call for help. She estimated that she rang the call bell for 1.25 hours before anyone responded. A code was eventually called. Unfortunately, Mr. Ard did not survive the code. There was no documentation in the medical records, on May 20 between 5:30 P.M. and 6:45 P.M., that would indicate that any nurse or physician checked on Ard’s condition. This finding collaborated Mrs. Ard’s testimony regarding this time period.
A wrongful death action was brought against the hospital, and the district court granted judgment for Mrs. Ard. The hospital appealed.
Ms. Krebs, an expert in general nursing, stated that it should have been obvious to the nurses from the physicians’ progress notes that the patient was a high risk for aspiration. This problem was never addressed in the nurses’ care plan or in the nurses’ notes.
On May 20, Ard’s assigned nurse was Ms. Florscheim. Krebs stated that Florscheim did not perform a full assessment of the patient’s respiratory and lung status. There was nothing in the record indicating that she completed such an evaluation after he vomited. Krebs also testified that a nurse did not conduct a swallowing assessment at any time. Although Florscheim testified that she checked on the patient around 6:00 P.M. on May 20, there was no documentation in the medical record.
Ms. Farris, an expert in intensive care nursing, testified for the defense. She disagreed with Krebs that there was a breach of the standard of care. However, on cross-examination, she admitted that if a patient was in the type of distress described by Mrs. Ard and no nurse checked on him for 1.25 hours, then that would fall below the expected standard of care.1
WHAT IS YOUR VERDICT? (Pozgar 215-216)
Pozgar, George D.. Legal Aspects of Health Care Administration, 11th Edition. Jones & Bartlett Learning, 2011-01-27. <vbk:9781449643850#outline(9.1)>.
Discussion Question 1
Discuss how physician malpractice suits can be decreased. How can a doctor be sued for malpractice? What current practices do doctors perform in order to avoid law suits? What are the impacts of these practices? How can one check for any malpractice suit against a doctor?
Discussion Question 2
Evaluate why prescribing, control, and administration of medications is a major area of legal concern for health care providers. What is the impact of medication errors to the patient and the health care provider? Discuss ways doctors make mistakes in prescribing medication. What kinds of errors do nurses make regarding the administration of medications? Review the documentary Chasing Zero and, in addition to conducting your own research, address the methods or practices that you feel would be most effective in reducing medication/prescribing errors.