The following concepts and behaviors can help reduce nurse practitioner professional liability risks. Also included are steps to take if you believe that you may be involved in a legal matter related to your practice:
1. Practice within the requirements of your state Nurse Practice Act, in compliance with other professional boards, organizational policies and procedures, and within the standard of care.
2. Document your patient care assessments, communications, clinical decision-making process, diagnosis, treatment plan and patient care actions in an objective, timely, accurate, complete, appropriate and legible manner.
3. Never alter a record for any reason or add anything to a record after the fact unless it is necessary for the patient's care. If it is essential to add information into the record, properly label the addition as a late entry, but never add any documentation to a record for any reason after a claim has been made. If additional information related to the patient's care emerges after you become aware that legal action is pending, discuss the need for additional documentation with your collaborating/supervision physician, the organization's risk manager and/or legal counsel to determine appropriate action.
4. Immediately contact your personal insurance carrier if you become aware of a filed or potential professional liability claim asserted against you, receive a subpoena to testify in a deposition or trial, or have any reason to believe that there may be a potential threat to your license to practice nursing. Keep in mind that allegations involving failure to diagnose, delays in diagnosis, deaths and infection/abscess/sepsis are most likely to result in litigation.
5. If you purchase your own professional liability insurance policy, report possible claims or related actions to your insurance carrier, even if your employer advises you that he or she will provide you with an attorney and/or will cover you for a professional liability settlement or verdict amount.
6. Refrain from discussing the matter with anyone other than your defense attorney or the professionals managing your claim.
7. Promptly return calls from your defense attorney and the claim professionals assigned by your insurance carrier. Contact your attorney or claim professional before responding to calls, e-mail messages or requests for documents from any other party.
8. Provide your insurance carrier with as much information as you can when reporting real or potential legal situations, including contact information for the organization's risk manager and for the attorney assigned to the litigation by your employer.
9. Never testify in a deposition without first consulting your insurance carrier or, if you do not purchase your own professional liability insurance policy, without first consulting the organization's risk manager or legal counsel. In addition, do not testify in a deposition without having had specific deposition preparation by your attorney.
10. Copy and retain any summons and complaint, subpoena or attorney letters for your records and to share with your attorney and professional liability insurer.
11. Maintain signed and dated copies of any employer contracts, including past agreements.
References: CNA partnered with the Nurse Service Organization to provide a 2012 liability and work profile update for nurse practitioners. Download this guide to learn more about the risks that are essential to understanding nurse practitioners.
