I’ve emphasized the importance of following employer policies and procedures in past blogs. The following case reveals that these policies are in place for good reason.
In this case, adhering to employer policies protected an emergency room (ER) nurse and her employer from a possible judgment of professional negligence.
A patient who fell and injured his right hand went to a medical center’s ER for treatment. A nurse assessed his injuries and treated abrasions on his right knee and lower left leg. She referred the patient to an ER physician to treat the hand injury.
A student studying to be a physician’s assistant (PA) treated and sutured the hand laceration under the supervision of her clinical supervisor, the ER physician.
Two days later, the patient sought additional treatment at another medical center’s ER. That ER staff determined that the hand wound had become infected and required surgery.
The patient filed a medical malpractice claim against the medical center that initially treated him, the physician who was the PA student’s clinical supervisor, the RN who treated his knee and lower leg injuries, and the PA student. He alleged their treatment caused the infection and that the resulting infection caused him to suffer pain, suffering, and loss of function in his right hand.
He also alleged lack of informed consent to treatment by a student PA and the negligent infliction of emotional distress.
The defendants filed Motions for Summary Judgment, which the trial court granted for all of the defendants. The plaintiff filed an appeal of the trial court’s decisions, alleging that he had placed material issues of fact concerning the liability of each of the defendants.
Appellate court’s decision
The appellate court affirmed the trial court’s decision. For the purposes of this blog, I’ll explore the nurse defendant’s motion.
The nurse’s motion was supported by affidavits and deposition transcripts. She stated that she understood the medical center’s policies did not allow her to “evaluate, clean, suture, or otherwise treat” the patient’s hand injury — so she did not do it.
The plaintiff’s nurse expert witness opined that the ER nurse “should have been more proactive and directive with the doctor.”
The court pointed out that although the nurse expert witness did give an opinion on the standard of care, she did not testify that the ER nurse’s conduct was the proximate cause of the injury to the patient. As a result, the trial court’s granting of the nurse’s Motion for Summary Judgment was proper.
As far as the plaintiff’s allegation of negligent infliction of emotional distress, the court held that the plaintiff did not prove the essential elements of such a claim, which are:
- Emotional distress
- Physical harm manifested by objective symptomatology
- That a reasonable person would have suffered emotional distress under the circumstances of the case
As a result, this claim against the ER nurse was properly dismissed, as well.
Talking points of this case
The judicial system of the United States is an open one. In other words, anyone is able to file a claim for whatever harm they believe they have suffered. However, the claim must be backed with factual evidence in order to prevail. Here, the plaintiff did not present any factual evidence to support his allegations against the defendants, including the ER nurse.
Also illustrated is the effectiveness of the Motion for Summary Judgment. If a negligence case is weak and there is no material issue of a fact or facts, litigation can end instead of progressing to a full trial.
Here are some important tips to keep in mind where your practice is concerned:
- Know your scope of practice as defined in your state nurse practice act and rules, and strictly conform to it.
- Know your employer’s policies and procedures as they pertain to your scope of practice and strictly conform to them.
- Confirm that your employer’s policies and procedures concerning your nursing practice align with those of your state nurse practice act and rules.
- Nurse expert witness testimony is essential when nursing negligence is alleged. A nurse expert witness’ opinion must address all the essential elements of the case.
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