I work on a rehabilitation unit in a small hospital. Often I am the only nurse with as many as four patients. Each patient has an alarm on his or her bed, but when I am in another room, a confused patient can and often will get out of bed before I can get there. Am I legally responsible if a patient is injured while I am rendering care to another patient? Would the hospital be responsible for the staffing pattern? Would I be responsible also, because I accepted the assignment?
Nancy Brent replies:
There is no question that the staffing on your unit is inadequate. There are many resources to help you convince the facility where you work of this fact, including the ANA’s Principles of Nurse Staffing, (2nd Edition, 2012) and its feature on the association’s website, Staffing and Work Environment. Both are available under the Practice and Health and Safety tabs respectively at www.nursingworld.org.
Also, the American Association of Rehabilitation Nurses (www.rehabnurse.org) has a position statement, Factors To Consider In Decisions About Staffing In The Rehabilitation Setting, under the Health Policy and Advocacy tab.
You are correct as to the potential liability for understaffing resting with the facility. However, as you indicated, you have accepted those working conditions and also may be found liable for any injury to the patients for whom you provide care. There can be more than one defendant named in a case alleging professional negligence (your potential liability) and alleging the facility failed to provide adequate staff, a duty they have under the corporate theory of liability.
Also, you face disciplinary action by the state board of nursing should this situation, or an injury to a patient, form the basis of a complaint against you. Your accountability under the act and rules rests upon your shoulders only.
Consult with a nurse attorney or attorney who can advise you as to how best to handle this situation, should there be an injury or worse to a patient on that unit. It may be that adding an experienced and capable CNA, and another rehabilitation RN, may help reduce the clear safety risk to the patients on the unit and the safety and legal risks to you as well.