Nurse As Patient Advocate: Court Sees No Basis To Impose Liability On Hospital.

Nurse As Patient Advocate: Court Sees No Basis To Impose Liability On The Hospital.

Legal Eagle Eye Newsletter for the Nursing Profession

July 2017

Before the patient fell a nurse twice offered to help him out of the hospital in a wheelchair.

Before he was discharged again after evaluation of his head injury another nurse went to her charge nurse with concerns about sending him home without a CT. The charge nurse spoke with the physician, but the physician sent him home. UNITED STATES DISTRICT COURT WASHINGTON June 14, 2017

A patient came to the hospital for evaluation of knee pain from a fall at home a week earlier. He came in with a crutch but was nevertheless able to ambulate independently without a problem the whole time he was at the hospital undergoing various tests that lasted most of the day.

While he was sitting waiting for his ride home a nurse informed him she was going to help him out of the hospital in a wheelchair once his ride arrived. When he started walking out of the building on his own the same nurse twice offered to wheel him out in a wheelchair. The patient refused the nurse’s offers of help. Just outside the hospital the patient fell and hit his head. He was taken back into the hospital and was readmitted for evaluation of his head injury.

Later that day when the physician was ready to discharge the patient the nurse caring for him at that time went to her charge nurse with her concerns about sending him home without a CT. The charge nurse spoke with the physician about the possible need for a CT scan and/or the need to keep the patient overnight for further observation, but the physician sent him home.

The patient sued the hospital claiming the nurses failed in their legal duty to advocate for him as their patient. The US District Court for the Eastern District of Washington dismissed the patient’s lawsuit.

As to the first nurse, who at least twice offered to help the patient out of the building in a wheelchair, the patient’s nursing expert testified it was the nurse’s duty not just to offer to help but to insist and keep on insisting until the patient accepted the nurse’s help. The Court ruled, however, that the nurse did all that the law expected.

As to the second nurse, who was the patient’s nurse during his head-injury evaluation, the Court also saw no breach of the nurse’s duty to advocate for the patient. The nurse was uncomfortable with the physician’s intention to discharge a head-injury patient without a CT. She voiced her concerns to her charge nurse. That met her legal duty as a staff nurse to advocate for her patient. The charge nurse, in turn, met her legal duty by going to the physician directly and expressing her concern that a recent head-injury patient should get a CT scan and be kept for observation. The physician declined the charge nurse’s advice. The Court ruled that at that juncture the nurses were not expected or permitted to intervene further. Wright v. US, 2017 WL 2590339 (E.D. Wash., June 14, 2017).