The nursing profession is evolving as more nurses are taking on additional responsibility and not only acting under a physician’s direct orders. In fact, many states have been debating whether a nurse practitioner with an advanced degree can provide primary care without a medical doctor looking over his or her shoulder. Nurses are spending more time with patients, and cost less to provide services as their income is far lower than their physician counterparts.
With these increased responsibilities and independence come additional risks, particularly when it comes to professional liability exposures. This affects every organization, including those nurses who are working at nursing homes and assisted living facilities.
According to a recent study by the Nurses Service Organization (NSO) in collaboration with their insurance carrier which looked at its closed claims from 2006-2010, over $83 million was paid by the insurer in judgments, settlements, and expenses on behalf of nurses, with an average of $204,594.00 per claim. Fifty-seven percent of Registered Nurses (RNs) who experienced a license defense paid claim worked in a hospital while 56% of Licensed Practical Nurses/Licensed Vocation Nurses worked in an aging services setting (nursing homes, assisted living centers, and independent living facilities).
Types of Claims
The following is not a comprehensive list by any means, and does not reflect the hierarchy of claims…but serves to provide you with additional insight as to the type of exposures nurses face so that you can help them with risk management and safety procedures.
- Practicing outside one’s scope of professional license – these are the most difficult to defend successfully; for example, a nurse removed and replaced an aging resident’s gastric tube without a practitioner’s orders and without notifying the practitioner, and the patient suffered severe infection, sepsis, and subsequent death from respiratory arrest
- Patient assessment and monitoring – this includes delay or untimely patient assessment; failure to reassess the patient after any change in his or her medical condition; failure to assess the need for medical intervention; among others
- Treatment/Care – includes failure to respond to a patient’s concerns as it relates to the treatment plan, failure to respond to equipment warning alarms, failure to invoke/use chain of command, equipment malfunction, failure to supervise, patient abandonment; among others
- Medication administration – wrong medication, wrong dose, wrong patient, etc.
- Patient’s rights/patient abuse/professional conduct – nurse’s substance abuse, creating a unsafe environment, sexual abuse, violation of patient’s privacy rights, verbal abuse, and more
- And others
As you can see many of the claims are as a result of the core competencies of a nurse’s activities. In addition, lack of documentation to provide the information needed to make sound clinical decisions also contributes to losses. A clear risk management program and risk-control techniques that incorporates communication is critical in helping to stem losses and minimize a nurse’s liability exposures.
Caitlin-Morgan can provide your agency with an insurance program for nursing homes and assisted living facilities, including the Professional Liability coverage that your insureds require. Give us a call at 877.226.1027.