SuperHumanEagle2135
At a hospital in Washington State, a client with a recent leg…
At a hospital in Washington State, a client with a recent leg amputation was still partially sedated after surgery. The nurse assigned to his care was called away from the room and failed to raise the bed rails. The client attempted to get out of bed, fell, and was injured.
The client sued the hospital for negligence. Using the hospital’s own policies and procedures manual, the client’s lawyer pointed out the requirement that satisfactory precautions be taken to restrain disabled or sedated clients.
The nurse’s lawyer based the defense on the argument that the nurse was following the physician’s standing orders to allow the client to ambulate postoperatively to hasten recovery and prevent complications.
The court agreed with the client and concluded that the nurse had an obligation, based on the hospital’s policy and procedures, to assess the client’s physical and mental condition. Nurses have an obligation not to leave clients unattended in an unsafe bed configuration.
All lawsuits alleging health-care provider negligence require expert witness testimony. Without this, courts will almost always dismiss a negligence case decided by a lay jury, even when it is as obvious as a fall from bed. In this case, the expert testimony not only supported the lawyer’s contention that the hospital’s policy and procedures upheld the suit but also emphasized the point that clients recently returned from surgery are disoriented from anesthesia and should never be left alone unless the bed rails are raised to their full upright position.
When the case was appealed, the court of appeals wrote the following ruling:
A lawsuit against a hospital for negligence does not necessarily have to involve medical malpractice committed by a physician. A hospital’s nurses have their own independent legal duties in assessing and caring for their patients.
A hospital is not relieved of its own legal liability for negligence just because the hospital’s staff nurses followed the health-care provider’s orders. That is, a hospital’s nursing staff cannot necessarily rely on standing orders for a patient to be up and out of bed and leave the bed rails down.
A patient freshly out of surgery who is taking pain and sedative medications must be evaluated continually by the staff. The patient’s present physical and mental state is all that matters. The nurses may have to disregard standing orders and instead follow the hospital’s policies and procedures for a restraint in the form of raised bed rails when necessary to ensure the patient’s safety.
Questions for Thought
1. Do you agree with the jury’s decision against the nurse? Why?
2. The nurse has a legal and ethical obligation (fidelity) to follow the health-care provider’s order. Is there ever a situation when the nurse can ignore an order?
3. Under what legal principle was the hospital held liable for the nurse’s actions?
4. What other actions might the nurse have taken, besides putting up the bed rails, to prevent the patient from falling?
