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Navigating Legal Minefields in Your Nursing Practice

Submitted by Editor on November 10, 2009, 10:11 am
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A midwife accused of administering a drug that led to the deaths of unborn twins...an ER nurse blamed for not reporting signs of child abuse...a public health nurse fired for reporting unsafe management practices and subsequently filing a lawsuit...

These and dozens of other nursing-related legal issues made the news in 2009. The nurses in the first two examples were quickly proved innocent of the horrific charges, but the shock and anxiety they experienced are probably slower to fade. One of a nurse's worst nightmares must be to face legal charges, whether justified or not. It's important for nurses to protect themselves by knowing the regulations within their specialty and understanding the legal aspects of nursing practice.

The modern nurse functions within a complex network criss-crossed by health care issues, local legislation, professional standards and social perceptions. In order to work at the full potential of their skills and ability, nurses should be aware of their rights and obligations as they interact with patients, families of patients, and other health care practitioners.

While the sensitive nature of providing health care has always exposed nurses to the threat of legal action, over the past few decades nurses have taken on greater professional responsibility, which has increased their risk of lawsuits. For example, the scope of practice by advanced practice nurses has vastly increased. Nurse practitioners have taken on responsibilities that were previously held by physicians, while nurse anesthetists are playing roles that were previously dominated by anesthesiologists.

The next generation of nurses will enjoy the greater challenges provided by advanced practice roles and diverse specialties within the field of nursing. However, new nurses must also prepare themselves for a higher standard of legal knowledge during the course of their education and practice.

Schools provide nurses with legal education in a number of ways. One of the more creative approaches is the mock malpractice trial the Texas Nurse Association holds yearly. The trials are intended to educate registered nurses, licensed vocational nurses, student nurses, medical students, law students and all other health care-related professionals, according to TNA's administrative director, Pat Pollock. Pat explained in the Dallas Morning News that the trials help nurses to "identify how the standards of care regulate their nursing practice." She went on to say, "It also really brings home one of the most important things, and that's the necessity for complete and accurate charting....(The trial will give nurses) the legal implications of their professional nursing practice and...basic legal terminology that's relevant to nursing negligence cases."

It well behooves all nurses, from LPNs to RNs to NPs, to incorporate some knowledge of legal issues into their practice. However, some nurses become fascinated by the legal aspects of nursing and choose to carve out a unusual career path. One original opportunity for legally-minded nurses includes a position as a legal nurse consultant. Legal nurse consultants "bridge the legal and medical world," according to Mindy Cohen, past president of the American Association of Legal Nurse Consultants."

This nursing specialty is becoming more popular, since legal nurse consultants provide a valuable service to lawyers but are less costly than doctors to work with. In a May 2009 article published in the Minnesota Lawyer, Correy Stephenson quotes Cohen as saying that legal nurse consultants “understand the nuances of the medical world and can pick up on subtleties in the medical records and hospital experience that a non-medical professional might not.”

Legal nurse consultants enjoy excellent pay and are in high demand, so this is a good field to explore for experienced nurses who want to take their skills in a new direction. Kaplan University offers an accredited online legal nurse consulting certification program that can be completed in under a year. Your nursing education and clinical experience combined with the legal knowledge and research ability gained through the Legal Nurse Consulting Certificate will provide an abundance of career opportunities. Even if graduates don't plan on working as legal nurse consultants, this certification can also be helpful for upper-level nurse administrators and nurse educators.

For all nurses, whether you see legal issues as fascinating challenges or confusing tangles, make sure that you play it safe by becoming aware of legal minefields and learning how to navigate them. Sticking to thorough documentation and following regulations today could keep you out of the news tomorrow--and save you from unnecessary anxiety and costly protection.

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