Keeping Legal Troubles at Bay

Most health care providers, including nurse practitioners are ever vigilant to issues of malpractice. We all chant “do no harm”. And yet we are human. We fly through the day trying to get everything done – seeing our patients, refilling medications, filling out authorizations, reports and other paperwork; ordering consults, therapies and test; interpreting test results, and so much more. And occasionally something does not get the attention it deserves – including you!

Here are just a few tips that can serve to protect you against some of the most common complaints.

  1.  Document, document, document. This means everything. Your discussions with patients, findings, results and your conversation with patients regarding results, any intended follow up and if so, with whom – including any referrals that you’ve made.
  2. Medications.  Prescriptions remain a significant problem. Most commonly, it’ has to do with prescribing the wrong medication.  You’ll want to review which patient you are prescribing for, how much and how often; medication indications and likelihood of interactions.
  3. Diagnosis. When you are diagnosing a problem, make sure you are ruling out the worse thing first. And pay attention to the “red flag” diagnosis – those that tend to end up in lawsuits more frequently than others. They include certain cancers – breast, cervical, pulmonary and colorectal; myocardial infarctions; and appendicitis to name a few.
  4. Do not delay in making referrals or getting consultation when you are unsure. Make sure you document that you have done so, and follow up with any recommendations.
  5. Talk with your patients. Make sure they get their questions answered, their concerns addressed. Work in partnership with them – it is their body after all.
You’ll want to carry your own policy, even if your employer is covering you. And if you hire clinical staff, make sure they are covered as well, this includes your assistant.  Above all, if there is a question, do not hesitate to get legal counsel when needed. Make sure you find someone who understands health care, and specifically your role as a nurse practitioner. You may want to check out the American Association of Nurse Attorneys  for someone in your area.

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