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 that of other nurses in pediatrics. The theory of personal liability holds everyone responsible for their 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 that the nurses you manage provide 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 who requires positioning regularly 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 that you delegated his care to this nurse if he can prove it, 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.
Please remember, then, that your duty as a charge nurse is not a higher duty of care than the staff nurses you manage. Instead, it has a different form of liability, with other duties.
As a nurse manager, one of the best ways to avoid potential liability for your role is to emphasize the importance of preventing foreseeable and unreasonable risks to patients.
Following a sound risk-management approach can help you 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 your nursing staff's strengths and weaknesses, and assign and delegate patient care based on their 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 challenging and interesting and can bring satisfaction in ensuring non-negligent care is being given to the patients on your unit.
