Malpractice, Research Paper Example

Introduction

Pediatric Nurse Practitioners (PNPs) face critical challenges in providing optimal care and treatment for their patients. There are risks associated with any practice or procedure, so this group must utilize their knowledge and skill sets carefully to ensure that patients are protected from unnecessary risks or harm. However, the intent to provide optimal treatment in a careful manner is not sufficient, and PNPs must be protected in the event of harm to their patients. Malpractice insurance is one such avenue which provides financial and legal protection against the threat of a lawsuit if there is suspected wrongdoing by a PNP. Malpractice is a common phenomenon throughout the healthcare system and requires an effective understanding of the primary risks associated with patient care and treatment. Since healthcare is a business above all else, malpractice is widespread and frequent, particularly with some diagnoses and procedures (McAbee et.al, 2008). As a result, PNPs must be protected against the threat of malpractice to preserve their roles and reputations within the healthcare industry.

Analysis

PNPs have a unique responsibility to provide advanced care and treatment to young patients. When patient health is compromised in a precarious or unsafe manner as the result of the possible wrongdoing of PNPs, the risk associated with these actions is placed squarely on their shoulders. PNPs are ultimately responsible for a significant component of advanced patient care and diagnostics, and the actions that they perform have the potential to negatively impact patients if procedures are not performed correctly. With a shortage of providers in many communities, PNPs are stretched thin to provide services to a large group of pediatric patients, which may lead to greater risks (Fairman et.al, 2011). These findings suggest that PNPs must develop strategies that will enable them to provide direct patient care in a manner that emphasizes optimal quality at all times, even when the burden placed upon them is significant (Fairman et.al, 2011).

PNPs face a great risk of malpractice in modern healthcare settings because of their responsibilities to pediatric patients and the economics of healthcare practice. It is known that “Nursing practice is not just a list of tasks that one can perform in their profession; it is a scientific process that changes with healthcare advancement and public policy” (Walker, 2011, p. 9). The protection of PNPs from potential malpractice lawsuits requires them to be apprised of specific regulations and to comply with these regulations exactly to avoid compromising patient care in any way, and if this is not the case, there is a greater risk of negligence on behalf of patients (Walker, 2011). For example, nurse practitioners in the State of Oklahoma are prohibited from prescribing drugs from the Exclusionary Formulary, a specific class of controlled substances (Oklahoma Board of Nursing, 2012). When these rules are violated, there is a much greater risk of negligence and malpractice lawsuits, which could be avoided if these actions are not taken (Oklahoma Board of Nursing, 2012). This is true throughout nursing practice, particularly when PNPs are discussed because this level of authority introduces a higher level of risk and potential negligence. As a result, PNPs must strictly adhere to all required regulations and guidelines in order to prevent any possible missteps with respect to negligence and other negative behaviors.

The development of strategic approaches to prevent malpractice for PNPs is an important step in establishing limitations regarding the scope of practice for this group at a variety of levels. Leaders who are responsible for developing these strategies must emphasize the risks associated with nursing care for different population groups, and which steps are required to protect PNPs from potential acts of negligence or other harm. One area to consider is how malpractice impacts PNPs from an emotional perspective, as there are many challenging circumstances that may arise with PNPs who are at risk for negligent acts in the workplace (Larson and Elliott, 2010). When malpractice occurs, there is a distinct emotional response to this news that may be difficult for PNPs to overcome, given the serious nature of the offense(s) put forth by the accusers (Larson and Elliott, 2010). From a strategic point of view, the accused should have a social network and support system in place that will provide comfort and understanding while the alleged acts of malpractice are under investigation (Larson and Elliott, 2010). This will enable the accused to better manage the outcomes associated with the lawsuit: “Colleagues and friends can be of great support and advocacy to the nurse named as a defendant in malpractice. Through de-identified conversation, the nurse’s emotional turmoil can be discussed with other individuals without relaying any details or specifics of the case” (Larson and Elliott, 2010, p. 154). With this approach, it is likely that PNPs who face potential malpractice lawsuits will be provided with a much-needed level of emotional support to overcome this problem (Larson and Elliott, 2010). In general, PNPs are likely to respond well to emotional support from their peers, particularly in times of crisis such as potentially devastating malpractice lawsuits. From this perspective, it is difficult for PNPs to cope with a possible suspension until the investigation is complete or other form of probation that would limit their ability to provide patient care in the desired manner. This is particularly true when negligence has not been proven or is likely to be false. Under these circumstances, PNPs must be prepared for the emotional repercussions of these events and how they might impact their emotional wellbeing during and after the malpractice investigation has taken place.

Another strategic perspective to consider is to provide optimal education and training regarding the risks associated with malpractice and negligent behaviors for new hires and as refresher courses for experienced employees. In another article by Larson and Elliott (2009), it was determined that “Nurses tend to harbor a false sense of immunity to this event, but statistical trends show that malpractice claims and payments made by nurses are on the rise…medical malpractice payments indicate a gradual\ escalation of malpractice cases involving both non-specialized registered nurses (RNs) and advanced practice nurses (APNs)” (p. 375). These findings suggest that PNPs at all experience and training levels must take malpractice seriously, and recognize that this is not merely a physician’s problem, but also a serious problem for this group of professionals (Larson and Elliott, 2009). The facts associated with malpractice within the nursing population is often misunderstood or taken less seriously than at other clinical levels; therefore, it is important for both new and experienced PNPs at all levels to be provided with updated knowledge and information which will drive their decision-making to prevent negligent acts and other associated risks (Larson and Elliott, 2009). Although malpractice is largely a legal issue and legal jargon is often not well understood, it must be explored in greater detail by PNPs at all levels because this issue directly impacts them in many different ways. One common misconception is as follows: “The belief that a dedicated and competent nurse cannot be sued is naïve and falsely secure. Malpractice is a rare but growing occurrence. Education regarding the litigation process and the emotional impact is crucial for all nurses to understand” (Larson and Elliott, 2009, p. 376). This information is highly relevant for all PNPs because there is often a misunderstanding of what malpractice entails and how it only impacts physicians at this higher level; however, this is far from the truth. PNPs must be well aware of the risks associated with the provision of direct patient care and how these actions might cause harm to patients, whether intentionally or unintentionally. In either case, it is necessary for PNPs to fully recognize that each and every action that they take with patients must fall under specific regulations and should be conducted with care and caution. Without these circumstances in place, it is likely that PNPs will continue to be at a much higher risk for negligence and malpractice in the future. Initial education at the hire level as well as ongoing education must be provided to all PNPs within a given healthcare setting so that they are aware of the risks of the job, the role that they play in protecting patients, and in understanding what steps must be taken to protect patients from unnecessary risk or harm, no matter the type of intervention or action that is taken. Furthermore, “Just as nurses prepare for a crisis situation, such as a cardiac arrest, nursing leaders need to educate themselves and their staff members on the malpractice process and the expected emotions that accompany a lawsuit” (Larson and Elliott, 2009, p. 377). Efforts by nursing and healthcare leaders in this capacity are likely to make a difference in preparing PNPs to perform their duties to the best of their ability and to not intentionally compromise the health and wellbeing of their patients, knowing that they face significant risks if these actions take place (Larson and Elliott, 2009).

Conclusion

PNPs must expand their knowledge and understanding of malpractice and how it impacts their professional careers in different ways. The legal and emotional impacts of malpractice are significant and must be explored in greater detail so that PNPs are fully aware of the risks associated with their interactions with patients on a daily basis. PNPs who are knowledgeable of their responsibilities and limitations in practice will have a greater understanding of their boundaries and may take fewer risks. In any case, PNPs must be provided with a strong foundation of knowledge and education regarding malpractice, including the legal and emotional impacts of these actions on individual PNPs and on nursing practice as a whole, including the economic repercussions. Furthermore, there is a potential lasting emotional impact of malpractice for PNPs, particularly when they are found to be negligent and are either disciplined for their actions and/or dismissed. PNPs must have a strong emotional support system in place so that they are prepared to manage the risks associated with malpractice and what it could entail for their careers for the foreseeable future.

References

Fairman, J.A., Rowe, J.W., Hassmiller, S., and Shalala, D.E. (2011). Broadening the scope   of nursing practice. The New England Journal of Medicine, 364(3), 193-196.

Larson, K., and Elliott, R. (2010). The emotional impact of malpractice. Nephrology Nursing Journal, 37(2), 153-156.

Larson, K., and Elliott, R. (2009). Understanding malpractice: a guide for nephrology PNPs. Nephrology Nursing Journal, 36(4), 375-377.

McAbee, G.N., Donn, S.M., Mendelson, R.A., McDonnell, W.M., Gonzalez, J.L., and Ake,    J.K. (2008). Medical diagnoses commonly associated with pediatric malpractice lawsuits in the United States. Pediatrics, 122(6), e1282-e1286.

Oklahoma Board of Nursing (2012). Exclusionary formulary for advanced practice registered        PNPs with prescriptive authority. Retrieved from http://www.ok.gov/nursing/prac-exclusfrm.pdf

Walker, R. (2011). Elements of negligence and malpractice. The Nurse Practitioner, May 2011, 9-11.