Administer meds without a doctor's order? Proceed with caution.

Registered nurses generally should administer medications only with a physician’s order. Only certain advanced practice nurses have prescriptive authority, and their qualifications, as well as the type of drug and the amount they are allowed to prescribe, vary from state to state.

Charting by exception: the legal risks.

There are numerous variations to charting by exception. Virtually every facility that uses such a system does it differently.

Are You Filing Incident Reports Properly?

Knowing when—and how—to file incident reports can help you to protect yourself, your patients, your colleagues, and your organization.   

Keeping up with technology: your risks and responsibilities.

Information technology is constantly evolving. Among the most common types are electronic health records (EHRs) and computerized physician order entry systems (CPOEs).

Don't cross the line: respecting professional boundaries.

At best, nurses and patients develop a special bond based on trust, compassion, and mutual respect.

Do's and Don'ts of Documentation

Good documentation can help nurses defend themselves in a malpractice lawsuit, and keep them out of court in the first place. 

Nurse Fatigue Creates a Dangerous Environment

Nurses work long hours and play a critical role in keeping patients healthy. Many nurses feel that fatigue “comes with the territory” of such a high-stress, high-impact job. But what’s really at risk when a nurse is fatigued? 

Documentation: proactive prevention of litigation.

There is no quick and effective antidote to malpractice allegations. Prevention, however, is necessary.

Documentation on trial: 9 ways to protect your agency.

In most states, a patient can wait several years to file a lawsuit and then it can take years before the suit goes to court.

Defensive Documentation: Steps Nurses Can Take to Improve Their Charting and Reduce Their Liability

Whether you are an experienced nurse or recent grad, documentation can be challenging. Here is some information that can assist with improving your charting and reducing liability risks:  

How documentation could come back to haunt you.

The confusing or opinionated words you choose in charting today could come back to haunt you tomorrow.

Abbreviations in Documentation: A shortcut to disaster for Nurses

Trying to save time by using abbreviations? Make sure that you aren't putting yourself or your patients in jeopardy.

A Solution to Sitters That Won’t Fall Short

Patient falls continue to be a leading cause of preventable injury in U.S. hospitals¹.

Creating Inclusiveness for Transgender Patients

As a nursing professional, being attuned to the needs of transgender patients helps you ensure their health needs are met and reduces the risk of legal liability.

Hospital Workplace Violence and Safety Response

Healthcare workers, and in particular hospital workers, are at high risk for workplace violence. Yet many hospitals don’t have safety protocols in place, and those that do often haven’t examined protocol adherence or efficacy.

Dispensing Alert! Dial, Set, and Lock that Dose

NSO and the Institute for Safe Medication Practices (ISMP) have teamed up to help you practice safe medication use and keep patients safe. The following is an ISMP Medication Safety Alert from the August 2017 NSO Risk Advisor.

Social Media Etiquette for Nursing Professionals

Social media is a powerful tool that almost everyone uses, but it’s important to remember that what’s shared on social media can have negative effects on your life and career.   

The Ins and Outs of Patient Abandonment

What is patient abandonment, and why do nursing students need to know about it? 

End of Life Care: Responsibilities and Risks

Nurses can make a major contribution in easing the transition from aggressive treatment to palliative care, regardless of the setting. To do so, they must be prepared to make ethical and humane decisions while also avoiding professional liability exposures.

When to Refuse a Nursing Assignment

Being assigned to an unfamiliar clinical area is one thing, but what if you are ordered to perform an unfamiliar procedure or a task that’s outside the scope of nursing practice? When should you refuse an assignment?

Protect Your Professional License, Protect Your Livelihood

When you purchase your own professional liability insurance policy through Nurses Service Organization (NSO), you have peace of mind knowing that you have the resources available to protect your license and your right to practice.

Overcoming the pitfalls of medication reconciliation

Any time there’s a hand-off in patient care, there’s an increased risk for a medication error. Medication reconciliation has been used to help bridge this hand-off communication on admission, between transfers in the hospital, and at discharge.

Reducing readmissions through discharge communication

One of the most important transitions in the continuum of care is patient discharge. Unfortunately, many patients across the country will leave hospitals, clinics, and healthcare provider offices unsure about what medications to take, when to make a follow-up appointment, and other critical details about their care.

What to Do in an Active Shooter Situation

Does your workplace have a plan in place for how to handle an active shooter? Would you know how to react to protect yourself and your patients or clients?

Wrongful Designation Attorney's Designation of A Testifying Expert Without the Expert Knowledge

At a recent annual conference of the American Association of Insurance Management Consultants (“AAIMCo”), the agenda included a session on an emerging issue which AAIMCo refers to as Wrongful Designation that expert witnesses may need to pay close attention to. Wrongful Designation is when an attorney designates an individual as a testifying expert without the expert’s knowledge.
 

Risk Management Considerations in Telehealth and Telemedicine

As the provision of healthcare services via technology—commonly called telehealth or telemedicine—expands during the current COVID-19 emergency period, questions arise regarding the permitted scope of practice, licensure requirements and compliance with the Health Insurance Portability and Accountability Act (HIPAA), among other regulatory-based inquiries.

Renewing in 4 Simple Steps

We’ve made it easy to renew your policy online. All you need is your policy number and zip code. And we’ve also included an autopay capability to make renewing next year even easier.

4 Risks Nurses Face Amid Coronavirus (COVID-19)

As the coronavirus spreads and nurses are tasked with caring for an influx of patients, the Nurses Service Organization risk management team has identified four specific risks/tips nurses should keep in mind to protect themselves. Download the infographic here.

5 Common Questions About NSO Malpractice Insurance

Have questions about your nursing professional liability insurance? Don’t worry, we’ve got answers! Coverage may seem complex, but it doesn’t have to be. Let’s dive into five common questions regarding coverage.

Thinking of relying on your employer's malpractice coverage? Think again

Employer-provided malpractice insurance delivers only partial coverage

Everything to Know About NSO Nursing Malpractice Insurance

What You Need to Know About Your Coverage

Are You in Compliance With the Recommended Standards of Care? Use Our Checklist

Nurses play a critical role in patient care, detecting potential problems, and advocating for a culture of safety. NSO and our insurance carrier partner, CNA, designed this self-assessment checklist based on significant topics from our Nurse Claim Report to help nurses enhance patient safety and minimize your liability exposure. 

Risks of Practicing Without Malpractice Insurance for Nurses

You wouldn’t risk driving a car without insurance. Nor would you go without health insurance. Going without malpractice insurance is just as risky financially. Because your nursing career and reputation are at stake, you have a lot more to lose than just your savings. 

Infographic: Medical Malpractice 101 for Nurse Practitioners

What are the most common injuries that lead to a malpractice lawsuit against nurse practitioners? What is the average payout by injury? Medical malpractice lawsuits are a reality for nursing professionals. If named in a lawsuit, what should you do? These and more questions are answered!

10 Surprising Facts from the Nurses Malpractice Claim Report

As a nursing professional, what do you consider to be the greatest risk to your career? In the Nurses Claim Report, NSO and CNA review and analyze malpractice and licensing claims to help nursing professionals understand your areas of greatest vulnerability. Armed with the knowledge gained from the Report, nurses can reduce their risks of potential litigation and take steps to help improve patient outcomes.

The 5 most important takeaways you need to know from nurse's claim report

5 Key Takeaways in the Nurses Claim Report 

The 4 most important takeaways you need to know from the Nurse Practitioners claim report

4 Key Takeaways in the Nurse Practitioners Claim Report 

Claims Made Vs. Occurrence Coverage

Claims Made or Occurrence Coverage? A quick overview of the difference and picking the right one for you.

3 Common Nurse Charting Mistakes to Avoid (Part 1)

Accurate and complete patient chart information is essential to providing the highest possible standard of care. Here are simple tips to improve nurse charting, protect patients from treatment error and prevent potential malpractice liability.

Documenting nursing assessments in the age of EHRs

Nurses have grown accustomed to documenting assessment results in the electronic health record (EHR), rapidly clicking responses to assessment checklist questions. However, at times nurses complete these actions without giving enough thought to their documentation because they want to move on to their “real” work: caring for patients.

Liability considerations as nurse practitioners’ scope of practice expands

The authors of the report from the National Academies of Sciences, Engineering, and Medicine state that allowing NPs to practice to the full extent of their education and training will improve access to care and health equity. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, released May 2021, calls for eliminating restrictions on the scope of practice of nurse practitioners (NPs).

Meeting the Nurse Staffing Challenge: Retention Tips

Ensuring appropriate nurse staffing levels is key to the financial health of healthcare organizations like hospitals and skilled nursing facilities. High quality nursing care helps to reduce the likelihood of patients safety events and costly medical malpractice lawsuits related to missed errors. The second of a two-part series, this article addresses effective retention strategies that leaders can utilize to help reduce turnover of nursing staff.

Full practice authority: What it means for NPs

Recent developments have led to significant progress with achieving full practice authority (FPA) for nurse practitioners (NPs) in the United States. However, it’s crucial for NPs to understand that FPA comes with professional responsibilities and the need to protect yourself against potential liability. This article provides a general overview of state practice and licensure laws, trends driving FPA, and strategies that NPs can use to reduce potential legal action related to their practice.

Protecting your Nursing License

Understanding the process and how to protect your license is critical to maintaining your career. Our infographic outlines why it is important to protect your nursing license and what it takes to defend it.

Check out the infographic below or download it!
 

How nurses can counter health misinformation

Although recent issues involving health misinformation have emerged related to the COVID-19 pandemic, misinformation has been a problem in many other areas related to wellness and healthcare. Misinformation isn’t a new issue, but the internet and social media have supercharged the ability for it to spread. This article helps explain the nature of the problem, why people may be inclined to believe information that is not grounded in science, and what nurses and nurse practitioners can do to counteract misinformation.

Strategies to Prevent Patient Falls and Minimize Liability

Think like an expert witness to minimize the risk of inpatient falls

An 88-year-old patient slips on the floor, falling and breaking his hip. Your immediate concern is getting him the help he needs, but another thought crosses your mind –could you be legally liable for what happened? By thinking like an expert witness, you can help determine if this concern is valid and whether you could have taken steps to prevent the patient fall in the first place. But first, you need to understand some background information.

Reducing legal risks in retirement

Retirement. The word conjures up an image of relaxation and a leisurely lifestyle. But for many nursing professionals, the picture is one of a life nearly as busy as when they were working full-time. Many retirees choose to volunteer, whether it’s responding to disasters, working at a pop-up clinic in an underserved area, answering questions for members of the community, or something else. 

Advancing your career – and minimizing risk

You just landed your first leadership role as a nurse manager. Or perhaps you’re shifting your career from bedside, hospital-based nursing to home care nursing because you’re ready for a new challenge. Congratulations! Advancing your career, whether by taking a leadership position or exploring a new specialty, can lead to enhanced job satisfaction and a bigger paycheck.

When the patient disagrees

Nurses and nurse practitioners take pride in providing detailed information to patients to help them make treatment decisions. But what happens when patients don’t make what you think is the “right” choice? Ultimately, you need to respect the patient’s autonomy and right to choose (self-determination) even if you feel the patient isn’t making the best decision, for example, by refusing an important diagnostic test.

A systematic approach to ethical decision-making for nurses

Throughout their careers, nurses, nurse practitioners, and other nursing professionals will encounter challenging situations at work that present ethical dilemmas. Deciding what to do in these situations can cause significant stress, as the appropriate course of action can vary depending on each unique set of circumstances. This article reviews a model that nursing professionals can use as a guide to help them gain a better understanding of conflicting issues and navigate ethical dilemmas.

Avoiding diagnostic errors: Strategies for nurse practitioners

Diagnosis is an essential part of the nurse practitioner (NP) role. An accurate diagnosis serves as the basis for treatment and achieving optimal patient outcomes. Unfortunately, making a diagnosis can be a complicated process that can lead to errors. An inaccurate or missed diagnosis can result in an NP being named in a lawsuit, which can have professional (loss of job) and personal (loss of income) consequences. In fact, NSO and CNA’s 2022 report, Nurse Practitioner Professional Liability Exposure Claim Report: 5th Edition, notes that diagnosis-related malpractice claims topped the list of reasons for allegations against NPs at 37.1 percent of claims in the report dataset. But by understanding potential sources of error during the diagnostic process, NPs can help ensure patients receive optimal care and reduce their risk of legal liability.

5 Common Legal Issues in Nursing

While registered nurses and licensed practical/vocational nurses (“nurses”) work to ensure the safety and well-being of their patients, they may also face a range of potential legal challenges - from malpractice lawsuits to licensing board complaints - that can have a significant impact on their careers and personal lives. By understanding the legal issues that may arise in their practice, nurses can protect themselves and their patients while delivering the best possible care.

Substance use disorders and drug diversion among nurses

Drug diversion occurs when a healthcare clinician diverts a drug intended for a patient for their own purposes. Clinicians steal drugs to sell or use themselves because they are suffering from substance use disorder (SUD).

Workarounds: 6 ways nurse leaders can reduce their risks

Nurses must contend with many competing demands during a typical shift (delivering care to patients, educating families, communicating with other members of the healthcare team, to name just a few), often causing them to seek ways to compress everything they must do into a short time frame.

4 Common Nurse Charting Mistakes to Avoid (Part 2)

Following nurse documentation best practices helps keep your patients safe and ensures that you are complying with your employer’s policies – and avoiding potential legal consequences such as a malpractice lawsuit.

A Guide to Your Nurse Practice Act

Nursing professionals have a wide range of valuable resources to help them in their jobs, such as organizational policies and procedures and databases of clinical practice guidelines. Many nursing professionals use these on a regular basis to help them deliver quality care. But they tend to overlook one essential practice resource — the nurse practice act (NPA). As the name implies, a state’s or jurisdiction’s NPA provides guidance for practice; adhering to the provisions of the act makes the nurse less vulnerable to legal action. Here’s what you need to know about NPAs.

Essential tips for mentoring new nurses

Nursing shortages are persistent, and because of turnover, many in the current workforce are less familiar with the organizations they work for and less experienced in nursing. Travel nurses are a mainstay in many areas of the country, and nurses who are newer in the field are often being called on to serve as mentors early in their careers. Mentorship is a key part of helping new nurses to be successful in their current jobs and in their careers. It also helps with retention, which benefits all nurses working in an organization.

Questions you should ask before volunteering

Volunteering is a great way for nursing professionals, including registered nurses (RNs) and advanced practice nurses (APRNs), to get involved in their communities and to support causes that are important to them. However, there are some operational and legal considerations that nurses should investigate before agreeing to take on a volunteer position. This article will review some questions nurses should ask prior to taking on a volunteer position. It will also review some of the legal protections for nurses who are volunteering, and when those legal protections generally do and don’t apply.

Incident reports: A safety tool

Nurses tend to cringe when they think about completing an incident report. Reasons for this reaction include the distress that occurs when something untoward has happened, anticipated loss of precious time to complete the report (particularly if the organization’s reporting system is cumbersome), and fear of being blamed for the incident or becoming embroiled in a court case. In this situation, it’s easy to forget that incident reports are a valuable resource for keeping patients safe. They also can keep employees safe by identifying system-wide problems such as insufficient staffing or equipment to move patients, which often contributes to staff injuries.

Do’s and don’ts of defensive documentation in the EHR

Documenting care is a basic nursing responsibility, but it’s one that nurses often struggle with because of time constraints and challenges associated with electronic health records (EHRs), such as poor user interfaces that leave nurses unclear as to where to document findings. However, taking time to document correctly and completely provides the first line of defense should you be named in a lawsuit.

Delegating vs. assigning: What you need to know

Registered nurses (RNs) often delegate to other RNs, licensed practical nurses/vocational nurses (LPN/LVNs), and assistive personnel (AP). (In some states or jurisdictions, LPN/LVNs may be allowed to delegate, so “licensed nurses” will be used in this article.) Delegating appropriately protects patients and reduces the risk of legal liability, yet the parameters of delegation often are not fully understood.

Protect yourself from secret recording

A nurse accidentally discovers a recording of himself giving patient care posted on the Facebook page of a patient’s family member. Another nurse receives a notice that a State Board of Nursing complaint has been filed against her for disparaging comments she made about a patient without knowing that the patient was recording her on his cellphone.

What Nurses Need to Know About Metadata, Documentation, and Legal Liability

Metadata analysis of information in a patient’s electronic health record (EHR) has the potential to provide valuable information to attorneys in the case of a lawsuit. This information, such as patterns of missing data, can bolster a legal case, leaving nurses vulnerable to punitive action. The best way to avoid negative results of a metadata analysis and subsequent legal action is effective documentation.

How Long Does Disciplinary Action Stay on a Nurse’s License?

This article was originally published on EmpoweredNurses.org, authored by Lorie Brown, June 6, 2024.

Nursing is a profession built on trust, compassion, and rigorous standards. When a nurse faces disciplinary action, it can have significant repercussions, both professionally and personally. One common concern is how long this disciplinary action remains on a nurse’s license. Understanding this is crucial for nurses aiming to navigate their careers post-disciplinary action.

Why patients sue — and how effective communication can help avoid a lawsuit

No healthcare provider welcomes being on the receiving end of legal action from a patient. A lawsuit can leave providers feeling frustrated and disappointed. After all, as a nurse, you are committed to delivering quality care and likely pride yourself on your positive relationships with your patients.

Nursing Professionals: 5 Reasons You May Need Individual Liability Coverage

As a nursing professional, you and your assets may be at risk if named in a lawsuit. Being involved in a lawsuit may potentially impact your finances; damage your reputation and can be a very stressful situation.

Coverage that's portable

Venturing into a career as a healthcare professional means you’ve dedicated your life to helping others. While your first instinct may be to think of your patients, it’s important that you also keep yourself and your practice front and center; especially when it comes to safeguarding your career and setting yourself up for a successful future.