Nurses And The Ethical Dilemmas They Face
Malpractice By Nurses And The Ethical Dilemmas They Face
Lisa Hayes
ITT Technical Institute
Composition I GE 117
Ju1y 1, 2014
Outline
1. Thesis Statement
2. Introduction
3. Data on the malpractice lawsuits against nurses
4. Reasons for increase in lawsuits against nurses
5. Factors proving breach of law by the nurses
6. Healthcare Ethics
7. Ethical dilemmas faced by the nurses
8. The other side of the argument: Nurses make far less errors than other medical practitioners
9. Conclusion
Thesis Statement In recent years, the issues of malpractice in medicine has been significantly increased and many patients have to suffer. But how much is the nurses to be blamed for malpractice? The job of nurses is as significant as that of …show more content…
doctor’s and their role in the patient’s treatment is crucial. Therefore, it is important to acknowledge the responsibilities of the nurses and the ethical dilemmas nurses face during their practice that may, in some cases, become a legal case of malpractice.
Introduction
There is an increase in the number of malpractice lawsuits against nurses.
According to National Practitioner Data Bank (NPDB), the figure increased from 253 in 1998 to 413 by 2001.The number increased despite the proper training of the nurses to make them aware of their professional and legal responsibilities and boundaries. A nurse can be rightfully charged with negligence if his/her actions have caused harm to the patient, and this should eventually lead to a malpractice lawsuit against the nurse. (Croke, 2003)
Data On The Malpractice Lawsuites Against Nurses
In 1990, the NPDB started collecting information on health care practitioners subjected to malpractice lawsuits and had legal actions taken against them, like probation or license being taken back or monetary fines. According to the date collected, the registered nurses have been responsible for 3615 payments for malpractice (as shown by cases from 1990-2001). The non-specialized nurses made the most malpractice payments (2,311 or 63.9%), the nurse anesthetists made 820 (or 22.7%), and nurse midwives made 296 (or 8.2%). Nurse practitioners made the lowest malpractice payments- (188 or 5.2%). (Croke, 2003)
Reasons For Increase In Lawsuits Against …show more content…
Nurses
There are certain causes for the increase in the number of malpractice lawsuits against the nurses. In the new cost-cutting environment in hospitals, nurses usually delegate part of their work to staff members that are not qualified to perform that task. Some of the tasks they delegate can be considered as negligence and subjected to a malpractice lawsuit. Secondly, more patients get discharged early even when they require proper nursing for a couple of more weeks. In this case, if the patient’s situation deteriorates after discharge, the nurses may be blamed for not providing necessary care or checking up on the patient’s condition regularly. In recent years, a lot of nurses have been cut off and hospitals have been closed down. This increases the burden on the current nurses and this may increase the chances of error. There have also been great advancements in technology, resulting in complicated hospital equipments that may be difficult for nurses to use efficiently, especially those who have not been trained to use those devices. Due to the increase in awareness, patients are now fully aware of their rights and the responsibilities of the nurses and the issues of malpractice resulting from inadequate care. Lastly, the scope of nursing skills has increased and so has legal definitions of various professional responsibilities. This sometimes makes it challenging for nurses to comply with legal standards of medical care. (Croke, 2003)
Factors Proving Breach Of Law By The Nurses
There are particular types of negligence that can be used in a lawsuit against nurses. These include failure to follow the medial standards of care, obeying physician’s orders or complying with hospital policies and procedures, failure to operate the equipments in the proper manner, failure to update the physician timely on the patient’s condition, failure to record patient’s history adequately and respond to complaints of the patients and not imposing treatment on a patient without consulting the doctor. (Croke, 2003)
Malpractice and negligence are two significant issues faced by the nurses. It is important to observe the factors that are needed to prove malpractice. These include duty, breach, causation and damage. Nurse’s duty to comply with the standards of care is a legal obligation and negligence can lead to malpractice. If nurses do not fulfill their responsibilities and breach their duty, it falls under malpractice. Causation is the connection between the nurses’ violation of their duties and the harm it caused to the patients. Finally, the damages or physical, financial or emotional injury on the patient are compensated for by a monetary charge on the nurse. The causes for malpractice payment reports include monitoring, treatment, and medication problems.
Risk management is one way nurses can minimize errors and avoid malpractice lawsuits. Many healthcare facilities now provide nurses with courses for risk management and ways to reduce medical errors. Many regions in America now promote such courses like Florida and Ohio, where such courses are necessary to become aware of the state nurse practice act. Some nursing malpractice insurance companies also give discounts to those nurses who opt for such courses. (National Commission on Correctional Health Care, 2011)
Health Care Ethics
There are four major values for healthcare ethics that must be followed when practicing medicine: Non-maleficence, beneficence, autonomy and justice.
Under beneficence, nurses must always put the patients’ best interest in top priority. In non-maleficence, nurses must avoid inflicting any kind of harm to the patient. Under autonomy, nurses should make sure patients are given free will and nothing is imposed on them against their will. Justice requires fair treatment for all patients without discrimination. Nurses need to put aside their personal values and comply with professional moral code. The American Nurses Association Board of Directors and the Congress, initiated a program called the Code of Ethics for Nurses in 1985 (updated in 2001), to outline the code of ethics and responsibilities of the nurses. Nurses are supposed to comply with the standard of ethical guidelines. (The National Commission on Correctional Health Care,
2011)
Ethical Dilemmas Faced By Nurses
Ethical dilemmas are usually faced by those nurses with strong personal moral values and a high level of concern for the ethical aspects of the patient’s situation. A study was conducted on the ethical involvement of nurses in different cases which showed that nurses with higher involvement in the patient’s treatment and ethical aspects of the clinic and those with strong personal moral beliefs and fewer adherences to the abstract standard rules and procedures faced more ethical dilemma than other nurses. (Penticuff & Walden, 2000)
The most common ethical dilemmas faced by nurses are the following:
1. Pro-choice versus pro-life: this issue has a personal effect on the nurses and for many nurses, their personal beliefs and moral values decide their stance. For example, a nurse may not be able to care for the patient with the required standard for care if her personal stance is against abortion, which the nurse considers a murder.
2. Freedom versus control. What if the patient wants to make a choice that may harm him/her? The nurse may or may not respect the patient’s decision in this case.
3. Truth telling versus deception. This usually occurs when the family of the patient deliberately tells the nurse to keep the truth from the patient because it may emotionally/mentally harm him/her.
4. The distribution of resources. If a patient is on life support, should the nurse delegate resources for such a patient or that particular resource should be used for another patient that might need it more?
5. Empirical knowledge versus personal belief. Sometimes research-based knowledge may conflict with the religious views of the patient. For example, if the patient needs a blood transfusion to recover, but the patient refuses to accept it on religious grounds. In this case it is hard for nurses to care for or empathize with a patient who is giving up his/her life based on a religious belief that the nurse may not personally agree with. (Muscari, 2009)
Ethical dilemmas are common for nurses and the decisions that they make could sometimes conflict with their personal values and beliefs.
The Other Side of The Argument: Nurses Make Far Less Errors Than Other Medical Practitinors
Nurses can be held accountable for their actions and legal actions can be taken against them. However, the majority of the nurses seldom engages in unprofessional behavior. According to HRSA 's 2003 National Practitioner Data Bank (NPDB), only about 1 in 50 malpractice payment reports were for nurses. Over the history of NPDB, all types of registered nurses were responsible for only 4,512, or 1.8%, of malpractice payments over the record of the NPDB. (Muscari, 2009)
Conclusion
Though issues like ethical dilemma, negligence on the part of the nurses can all lead to malpractice lawsuits against them, due to the increase in nurse training schools and courses like risk management, errors on the part of the nurses have been greatly reduced. Nurses are responsible for some of the mishaps in the hospital, but that percentage is far less than other medical practitioners who are directly involved in deciding the treatment for a particular patient. Therefore, we can’t dismiss the fact that negligence by nurses is a significant cause of accidents in hospitals.
References
Croke, E. M. (n.d.). Nurses, Negligence, and Malpractice. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?article_id=423284
Ethical and Legal Issues. (n.d.). Retrieved from http://www.ncchc.org/cnp-ethical-legal
Fant, C. (2013). Retrieved from http://www.nursetogether.com/ethical-dilemmas-in-nursing
Muscari, M. E. (2009). Becoming a Nurse. Learning Express Editor.
Penticuff, J. H., & Walden, M. (n.d.). Influence of Practice Environment and Nurse Characteristics on Perinatal Nurses ' Responses to Ethical Dilemmas. Retrieved from http://journals.lww.com/nursingresearchonline/pages/default.aspx
Lisa Hayes
ITT Technical Institute
Composition I GE 117
Ju1y 1, 2014
Outline
1. Thesis Statement
2. Introduction
3. Data on the malpractice lawsuits against nurses
4. Reasons for increase in lawsuits against nurses
5. Factors proving breach of law by the nurses
6. Healthcare Ethics
7. Ethical dilemmas faced by the nurses
8. The other side of the argument: Nurses make far less errors than other medical practitioners
9. Conclusion
Thesis Statement In recent years, the issues of malpractice in medicine has been significantly increased and many patients have to suffer. But how much is the nurses to be blamed for malpractice? The job of nurses is as significant as that of …show more content…
doctor’s and their role in the patient’s treatment is crucial. Therefore, it is important to acknowledge the responsibilities of the nurses and the ethical dilemmas nurses face during their practice that may, in some cases, become a legal case of malpractice.
Introduction
There is an increase in the number of malpractice lawsuits against nurses.
According to National Practitioner Data Bank (NPDB), the figure increased from 253 in 1998 to 413 by 2001.The number increased despite the proper training of the nurses to make them aware of their professional and legal responsibilities and boundaries. A nurse can be rightfully charged with negligence if his/her actions have caused harm to the patient, and this should eventually lead to a malpractice lawsuit against the nurse. (Croke, 2003)
Data On The Malpractice Lawsuites Against Nurses
In 1990, the NPDB started collecting information on health care practitioners subjected to malpractice lawsuits and had legal actions taken against them, like probation or license being taken back or monetary fines. According to the date collected, the registered nurses have been responsible for 3615 payments for malpractice (as shown by cases from 1990-2001). The non-specialized nurses made the most malpractice payments (2,311 or 63.9%), the nurse anesthetists made 820 (or 22.7%), and nurse midwives made 296 (or 8.2%). Nurse practitioners made the lowest malpractice payments- (188 or 5.2%). (Croke, 2003)
Reasons For Increase In Lawsuits Against …show more content…
Nurses
There are certain causes for the increase in the number of malpractice lawsuits against the nurses. In the new cost-cutting environment in hospitals, nurses usually delegate part of their work to staff members that are not qualified to perform that task. Some of the tasks they delegate can be considered as negligence and subjected to a malpractice lawsuit. Secondly, more patients get discharged early even when they require proper nursing for a couple of more weeks. In this case, if the patient’s situation deteriorates after discharge, the nurses may be blamed for not providing necessary care or checking up on the patient’s condition regularly. In recent years, a lot of nurses have been cut off and hospitals have been closed down. This increases the burden on the current nurses and this may increase the chances of error. There have also been great advancements in technology, resulting in complicated hospital equipments that may be difficult for nurses to use efficiently, especially those who have not been trained to use those devices. Due to the increase in awareness, patients are now fully aware of their rights and the responsibilities of the nurses and the issues of malpractice resulting from inadequate care. Lastly, the scope of nursing skills has increased and so has legal definitions of various professional responsibilities. This sometimes makes it challenging for nurses to comply with legal standards of medical care. (Croke, 2003)
Factors Proving Breach Of Law By The Nurses
There are particular types of negligence that can be used in a lawsuit against nurses. These include failure to follow the medial standards of care, obeying physician’s orders or complying with hospital policies and procedures, failure to operate the equipments in the proper manner, failure to update the physician timely on the patient’s condition, failure to record patient’s history adequately and respond to complaints of the patients and not imposing treatment on a patient without consulting the doctor. (Croke, 2003)
Malpractice and negligence are two significant issues faced by the nurses. It is important to observe the factors that are needed to prove malpractice. These include duty, breach, causation and damage. Nurse’s duty to comply with the standards of care is a legal obligation and negligence can lead to malpractice. If nurses do not fulfill their responsibilities and breach their duty, it falls under malpractice. Causation is the connection between the nurses’ violation of their duties and the harm it caused to the patients. Finally, the damages or physical, financial or emotional injury on the patient are compensated for by a monetary charge on the nurse. The causes for malpractice payment reports include monitoring, treatment, and medication problems.
Risk management is one way nurses can minimize errors and avoid malpractice lawsuits. Many healthcare facilities now provide nurses with courses for risk management and ways to reduce medical errors. Many regions in America now promote such courses like Florida and Ohio, where such courses are necessary to become aware of the state nurse practice act. Some nursing malpractice insurance companies also give discounts to those nurses who opt for such courses. (National Commission on Correctional Health Care, 2011)
Health Care Ethics
There are four major values for healthcare ethics that must be followed when practicing medicine: Non-maleficence, beneficence, autonomy and justice.
Under beneficence, nurses must always put the patients’ best interest in top priority. In non-maleficence, nurses must avoid inflicting any kind of harm to the patient. Under autonomy, nurses should make sure patients are given free will and nothing is imposed on them against their will. Justice requires fair treatment for all patients without discrimination. Nurses need to put aside their personal values and comply with professional moral code. The American Nurses Association Board of Directors and the Congress, initiated a program called the Code of Ethics for Nurses in 1985 (updated in 2001), to outline the code of ethics and responsibilities of the nurses. Nurses are supposed to comply with the standard of ethical guidelines. (The National Commission on Correctional Health Care,
2011)
Ethical Dilemmas Faced By Nurses
Ethical dilemmas are usually faced by those nurses with strong personal moral values and a high level of concern for the ethical aspects of the patient’s situation. A study was conducted on the ethical involvement of nurses in different cases which showed that nurses with higher involvement in the patient’s treatment and ethical aspects of the clinic and those with strong personal moral beliefs and fewer adherences to the abstract standard rules and procedures faced more ethical dilemma than other nurses. (Penticuff & Walden, 2000)
The most common ethical dilemmas faced by nurses are the following:
1. Pro-choice versus pro-life: this issue has a personal effect on the nurses and for many nurses, their personal beliefs and moral values decide their stance. For example, a nurse may not be able to care for the patient with the required standard for care if her personal stance is against abortion, which the nurse considers a murder.
2. Freedom versus control. What if the patient wants to make a choice that may harm him/her? The nurse may or may not respect the patient’s decision in this case.
3. Truth telling versus deception. This usually occurs when the family of the patient deliberately tells the nurse to keep the truth from the patient because it may emotionally/mentally harm him/her.
4. The distribution of resources. If a patient is on life support, should the nurse delegate resources for such a patient or that particular resource should be used for another patient that might need it more?
5. Empirical knowledge versus personal belief. Sometimes research-based knowledge may conflict with the religious views of the patient. For example, if the patient needs a blood transfusion to recover, but the patient refuses to accept it on religious grounds. In this case it is hard for nurses to care for or empathize with a patient who is giving up his/her life based on a religious belief that the nurse may not personally agree with. (Muscari, 2009)
Ethical dilemmas are common for nurses and the decisions that they make could sometimes conflict with their personal values and beliefs.
The Other Side of The Argument: Nurses Make Far Less Errors Than Other Medical Practitinors
Nurses can be held accountable for their actions and legal actions can be taken against them. However, the majority of the nurses seldom engages in unprofessional behavior. According to HRSA 's 2003 National Practitioner Data Bank (NPDB), only about 1 in 50 malpractice payment reports were for nurses. Over the history of NPDB, all types of registered nurses were responsible for only 4,512, or 1.8%, of malpractice payments over the record of the NPDB. (Muscari, 2009)
Conclusion
Though issues like ethical dilemma, negligence on the part of the nurses can all lead to malpractice lawsuits against them, due to the increase in nurse training schools and courses like risk management, errors on the part of the nurses have been greatly reduced. Nurses are responsible for some of the mishaps in the hospital, but that percentage is far less than other medical practitioners who are directly involved in deciding the treatment for a particular patient. Therefore, we can’t dismiss the fact that negligence by nurses is a significant cause of accidents in hospitals.
References
Croke, E. M. (n.d.). Nurses, Negligence, and Malpractice. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?article_id=423284
Ethical and Legal Issues. (n.d.). Retrieved from http://www.ncchc.org/cnp-ethical-legal
Fant, C. (2013). Retrieved from http://www.nursetogether.com/ethical-dilemmas-in-nursing
Muscari, M. E. (2009). Becoming a Nurse. Learning Express Editor.
Penticuff, J. H., & Walden, M. (n.d.). Influence of Practice Environment and Nurse Characteristics on Perinatal Nurses ' Responses to Ethical Dilemmas. Retrieved from http://journals.lww.com/nursingresearchonline/pages/default.aspx