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Understanding liability for a charge nurse

As you probably know, allegations of professional negligence are possible against any nurse. As a nurse, you must conform your conduct to the overall standard of care; that is, what other ordinary, reasonable and prudent nurses would do in the same or similar circumstances in the same or similar community.

If you work in med/surg nursing, then the standard of care becomes that of ordinary, reasonable and prudent nurses in med/surg nursing in the same or similar community. If you practice in the pediatric setting, your conduct is compared with other nurses in pediatrics.

And the theory of personal liability holds everyone responsible for their own behavior, including negligent behavior.

When you undertake a charge position, you have responsibilities to provide care to any patients you directly care for in a non-negligent manner.

You also have responsibilities to ensure those nurses you manage are also providing non-negligent care to their patients. If professional negligence is alleged against you in the latter role, your overall standard of care would be compared with other nurse managers/charge nurses.

The duty to manage your staff nurses does not require you to be aware of each and every possible injury that a patient may be exposed to because of staff nurses’ negligence. Rather, the duty requires you to be aware of those foreseeable and unreasonable risks of harm that the patient might be exposed to if the staff nurse does not provide care as required (an act of omission) or provides care negligently (an act of commission).

The duty to manage your staff also requires you to supervise nursing staff in a non-negligent manner. Negligent supervision might occur when, for example, you do not check on whether a nurse assigned to a patient that requires positioning on a regular basis is fulfilling that obligation and the patient develops several decubiti. The patient can file a suit alleging the nurse assigned to him to provide care was professionally negligent in not turning him as ordered and also can include you as the charge nurse for not properly supervising the staff nurse.

Or, the same patient may allege, if he can prove it, that you delegated his care to this nurse and she was not competent to provide the care he needed.

A nurse manager may also face a negligent supervision allegation for not adhering to a policy governing patient care that results in an injury to the patient.

Remember, then, that your duty as a charge nurse is not a higher duty of care in comparison with the staff nurses you manage. Rather it is a different form of liability, with different duties.

As a nurse manager, one of the best ways you can avoid potential liability for your role is to underscore the importance of preventing foreseeable and unreasonable risks to patients. Following a sound risk-management approach can do wonders to avoid such risks.

Open lines of communication with your staff, as well as with patients and their families, is essential. Foster trust and respect for and with your nursing colleagues. Respond to patient and family concerns promptly and sincerely.

Know the strength and weaknesses of your nursing staff and assign and delegate patient care based on the staff’s strengths. Provide additional orientation and supervised patient experiences for those who need to improve their patient care skills.

Last, but by no means least, don’t shy away from the charge nurse/nurse manager role. Yes, the liability is different, but the role is a challenging and interesting one that can bring satisfaction in ensuring non-negligent care is being given to the patients on your unit.

Editor’s note: Nancy Brent’s posts are designed for educational purposes and are not to be taken as specific legal or other advice.

By | 2015-11-24T18:49:45+00:00 November 25th, 2015|Categories: Nursing careers and jobs|5 Comments

About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

5 Comments

  1. Avatar
    Clarice Sims November 19, 2016 at 1:30 am - Reply

    I am employed full time on an acute care Psychiatric unit. The terminology, “team leader” is assigned to an RN with lateral duties of one or two other RN’s on the unit. Recently, I was assigned as, “team leader.” another employee turned the lights off on the unit after being asked not to do so. Afterwards, I was threatened with disciplinary action if the lights were,
    “discovered” to be turned off when the supervisor made rounds. Really, can a facility actully make a RN responsible for lights?

  2. Avatar
    becca rodriguez March 9, 2017 at 4:23 pm - Reply

    Very informative. We have nurses who are in charge of our specialty unit (NICU level III) who have no experience in Neonatal nursing. We have been trying to explain to them that we need the leadership and we need it in the NICU (not shared with Labor and Delivery). I will be posting your essay on our bulletin board.

  3. Avatar
    Loretta Stasa March 28, 2017 at 4:04 pm - Reply

    Recently the facility I work at allowed an LVN to assume the charge nurse role. As an RN, I questioned this as I believe it violates the nurse practice act, I was then disciplined for questioning the ability of a charge, which I feel was wrong. Can you help explain the law in this situation? I practice in CA.

    • Avatar
      j October 16, 2019 at 5:32 pm - Reply

      An lpn can be acharge. However an rn is whose license she still must work under.

  4. Avatar
    Dan February 9, 2019 at 4:42 am - Reply

    I have a question. My mother in law is heavy lady that requires assistance to get on and off of tables for exams. When she went to her last appointment. A nurse refuse to assist her on to a exam table. What are the legal matter that nurses have to assist a patient while at a appointment can they refuse to assist patient in fear of hurting them selves.

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