Avoiding Liability Bulletin – December 2015

The other day I was visiting a friend in the hospital and I was amazed at how hectic things seemed there. The patient census on the floor was high and the nursing staff a bit short. Everyone was walking rapidly rather than at a slower pace and interaction between staff seemed minimal and brisk.

I imagine the minimal and brisk communication between staff, including all the nursing staff and others on the unit, was necessary to get patient care, patient tests, consults, discharges, admissions, and labs done in a timely manner. But, I also wondered how much respect, if any, was fostered in this “necessary approach” in communicating with each other.

Respect, defined as admiration for or a sense of worth or excellence of a person (Random House College Dictionary), is essential, both legally and ethically in today’s work environment. In fact, when browsing the Internet, I came across an article by Stephanie Staples titled: Ethical Issues in Nursing: Gaining the Respect of Your Co-Workers (2012).

The pointers Ms. Staples identified are practical ones that an individual can incorporate into his or her daily practice when at work. They also incorporate sound risk management directives. Here are a few of her tips:

1. Mean what you say –If you tell a fellow staff member you are going to do something for patient X, do so. If you fail to follow through, not only might your colleague distrust and not respect you, you may be setting the two of you up to be named in a lawsuit if a patient injury occurs because you did not carry out the care you said you would.

2. Don’t be condescending—Talk to each other, and behave towards each other, with consideration. When one is treated in a condescending manner, animosity and anger can become touchstones of the relationship. This can also result in not following through with patient care in an attempt to “get back” at a colleague for being treated in a patronizing manner. Should a patient injury occur under these circumstances, involved staff may be at odds with each other as named defendants if there is an issue about who did not follow through with required care and why the follow-up didn’t take place.

3. Honesty matters, always—This is an extremely important principle. Saying you did something for a patient when you didn’t or saying you did not do something for a patient when you did is the hallmark of falsity. Once you have committed yourself to a particular untrue position, it is difficult to change that position and one false comment leads to another and to another.

It can also lead to false documentation in the patient’s record. Since your staff nurses, and other colleagues, rely on the documentation in the patient’s record and rely on it as true, when it isn’t, patient care can be easily compromised.

4. Praise good work sincerely and validate others—Everyone likes to be told they have done a good job, whether a nurse aid, the nurse manager, or a fellow nurse staff member. Be generous with praise for good work done and validating those who do it. Be certain to appropriately provide feedback to those who are not doing their best.

If you are in a nurse manager or supervisor, this is particularly important. Ignoring those who are not doing their job can result in the staff nurse continuing to provide poor nursing care, ignore medication administration requirements, and generally create resentment among fellow staff nurses.

You can read more of Ms. Staples’ principles on the website. Including them in your daily practice will help establish respect for you, help you show respect for others, and allow you to practice not only in an ethical manner but in a legal manner as well.

THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK ADVICE FROM A COMPETENT PROFESSIONAL.

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About the Author

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Nancy Brent

NANCY J. BRENT, MS, JD, RN, received her Juris Doctor Degree from Loyola University Chicago School of Law. Ms. Brent has been in practice for over 40 years and concentrates her solo law practice in education and consultation for nurses, nursing organizations, and health care delivery systems. She also defends nurses before the Illinois Department of Financial and Professional Regulation. Ms. Brent has published and lectured extensively in the area of law and nursing practice.