Introduction
The prime concern in nursing is to promote the welfare of the sick, the injured or vulnerable members of the community. In particular, nursing is primarily concerned with the protection and restoration of individual health, preventing disease-related sufferings, and prevention of illnesses. Nurses play an important role in the promotion of individual and community healthcare (Crane, 2000, p.86). Nurses, therefore, must adhere to the highest ideals and professional ethics of nursing practice to prevent medical errors or negligence. Medical errors arise from lack of appropriate skills or knowledge on the part of the practitioner or failure to apply professional skills or knowledge appropriately as expected. In most cases, medical errors cause personal injury or even death of the patient, thus an offence in the court of law. In a nursing home, nurses are expected to ensure that the patients are safe and in good health by proper administration of the right prescriptive drugs to the patients. Typically, nursing negligence or malpractice arises from the inability of the nurse to administer proper treatment due to lack of proper documentation, failure to monitor the patients effectively during medical procedures, and the failure to notice improvement in the patient’s condition. Given the legal and professional implications of nursing malpractice, nursing documentation is integral in minimizing medical errors arising from negligence.
Negligence, Gross Negligence and Malpractice
Medical errors have an adverse impact on the general health of the patient. Medical errors arise from medical negligence or malpractice, which often make victims demand compensation over personal injury. A medical error in the course of a medical procedure or during administration of drugs can turn a highly treatable condition into a permanent disability. Wrongful prescription or improper medical procedures amount to medical negligence or medical malpractice. Negligence and malpractice are often used interchangeably; however, negligence is different from malpractice.
Medical negligence is a more general term that refers to carelessness in care provision or the inability of a practitioner to adhere to particular standards of the expected care. Negligence arises when a person, charged with the responsibility of providing care to a patient, acts in a non-competent manner; that is, below the recognized healthcare standards (Croke, 2003, p.54).. As a result, the practitioner’s lack of reasonable and expected action causes harm to the patient. Legally, the patient is entitled to compensation for personal injury, pain, and suffering caused by the practitioner’s negligence. However, the patient has to prove negligence from the part of the practitioner, which resulted to personal injury. In most cases, negligence is proved by first identifying negligence on the part of the practitioner(s) responsible for the duty of care followed by establishing a breach of duty by the practitioner.
Gross negligence goes beyond simple carelessness on the part of the practitioner or caregiver. While regular medical negligence entails simple carelessness that results to below expected standard actions, gross negligence implies a serious form of negligence whereby the practitioner fails to show care to the patient with total and willful disregard of the patient’s safety and wellbeing (Croke, 2003, p.58). Common cases of gross negligence include failure to uphold the highest standards of safety and sanitation resulting to disease outbreaks or failure to dress wounds which might lead to secondary infections. Gross negligence cases can attract a legal suit over medical malpractices on the part of the hospital or medical practitioner.
In contrast, medical malpractice is more specific and considers the professional status of the caregiver. In this regard, a professional medical practitioner is the only person who can be held responsible for medical malpractice (Crane, 2000, p.89). Medical malpractice arises due to failure of a professional practitioner to take appropriate action in accordance to the expected professional standards or inappropriate delegation of duties with inadequate supervision. A professional practitioner is expected to possess necessary skills and knowledge to foresee the consequences of a particular action ad therefore, can take appropriate actions to prevent medical errors. Legally, to prove medical malpractice, the breach of duty owed to the patient must be established followed by proof that the practitioner failed to foresee the consequences of a particular action resulting to medical errors.
The article in the NBH Newspaper, “Amputation Mishap; Negligence” represents a perfect case of gross negligence on the part of the practitioners. The practitioners involved in the amputation showed recklessness by failing to keep proper documentation of medical procedures, which resulted into the amputation of the wrong leg. In addition, the surgeon disregarded Benson’s safety and wellbeing by amputating the wrong leg, which will result to permanent injury.
I agree with the author’s views that the wrong amputation of Benson’s left leg, instead of the right leg, was negligence on the part of the surgeon. This action fell below the standards expected from a professional surgeon. A surgeon, being a professional with necessary skills and education, is expected to understand the particulars of a surgical procedure prior to undertaking it given the consequences of any wrongful action. Therefore, in the case of Benson, the surgeon recklessly amputated the wrong leg without checking the proper documentation, which amounts to gross medical negligence.
Importance of Nursing Documentation
In nursing, patient records are important in effecting appropriate health care plan. Nursing documentation or records entails handwritten or electronic patient information that describes the health status of the patient and the care service to be provided to that patient (Plawecki, & Plawecki, 2007, p.3). Usually, nurses document health information pertaining to an individual patient. However, health records of group of patients such as therapy groups can also be kept. Documentation provides a clear picture of the health condition of the patient or group of patients, the expected actions of the caregiver and the evaluation of the patient(s) outcomes.
Nursing documentation is important for many reasons; firstly, it facilitates communication between nurses or care givers regarding the health status of the patient, the interventions undertaken, and the outcomes that result from these interventions. In chapter eight of his masterpiece book, “Legal and Ethical Issues in Nursing” Guido (2010) overemphasizes the need of proper communication in nursing practices (p.209), because nursing documentation prevents any likelihood of miscommunication and thus prevents medical errors. Secondly, documentation leads to improved nursing care provided to patients. Through documentation, nurses can evaluate patients’ progress, determine appropriate interventions, and plan for health care needs of the patient. In addition, documents or health records provide valuable information for nursing research, which leads to improvement in the quality of nursing practice and patient care. Thirdly, nursing documentation is important for meeting the professional and legal standards expected in any nursing practice (Plawecki, & Plawecki, 2007, p.4). Effective documentation provides evidence that a nurse acted professionally in his/her judgment and application of skills. In lawsuits, the patient health records provide evidence of health care service accorded to the patient relative to the professional care expected.
Conclusion
In nursing, medical errors often result from negligence or failure of the practitioners to uphold the highest standards of the nursing practice. Medical errors attract lawsuits because of personal injury or death resulting from negligence. Gross negligence such as wrongful amputation of the leg, as in Benson’s case, can be avoided through proper documentation. Documentation minimizes the potential of medical errors occurring, leads to professional nursing practice, and contributes to improved care to patients.
Reference List
Crane, M. (2000). NPs and PAs: What’s the malpractice risk? Medical Economics, 77(6), 86-89.
Croke, E. (2003). Nurses, Negligence, and Malpractice. American Journal of Nursing, 103(9), 54-58.
Guido, G. W. (2010).Legal and Ethical issues in nursing (5th Ed.). Upper Saddle River, NJ: Prentice Hall.
Plawecki, L., & Plawecki, H. (2007).Your Choice, Documentation or Litigation? Journal Of Gerontological Nursing, 16(4), 3-4.