While much attention is given to cases where a physician commits medical malpractice, nurses also must meet a certain level of standard of care. Oftentimes in Illinois medical negligence a nurse’s obligations seem to be overlooked.
For example, let’s say that a Chicago patient has known allergies to certain medications which his or her physician has prescribed. The nurse has a duty to be aware of these allergies and inform the physician. If the nurse does not inform the attending physician that the patient should not be receiving these medications then he or she is acting below the standard of nursing care. This is just one example of how a nurse can fail to perform his or her duties.
Good communication is the cornerstone of any relationship, and the physician-nurse relationship is no exception. Nurses have an obligation to question a doctor’s treatment if it is inconsistent with customary medical practices.
For Illinois medical malpractice cases, both Illinois and Chicago courts have upheld this duty of nurses to go over a physician’s orders in instances where a failure to intervene could ultimately result in the patient suffering dire consequences. Or if the nurse perceives that a physician is insensitive to a patient’s condition, or is not making appropriate decisions regarding the patient’s condition, then he or she must intervene. One way to intervene is by initiating the chain of command to exert the pressure necessary to change the course of treatment.
Even though nurses do not have as much responsibility or control as a physician might, they are still an integral part to any patient’s care. Any medical facility should have a chain of command policy that is known to all nurses and physicians. This chain of command is in place to safeguard the patient by making all treaters responsible and accountable, from the hospital administrators to the attending physician.
While the chain of command can be an invaluable tool, in some cases it fails. For example, some claim that if a nurse is insecure in his or her knowledge or authority then they will not implement the chain of command, even when it is necessary. Physicians can continue to support a nurse’s sense of inferiority by not returning pages, becoming frustrated with the nurse for calling too often, or merely just blowing off a call or informing the nurse that they will call back later. In these ways a physician demonstrates a lack of respect for the nurse’s judgment, which could put the patient’s well-being in jeopardy.
Even when the chain of command is used it is important to ensure it does not become abused. The nurse should not be using it as a way to settle a personal vendetta, or in any other irresponsible manner. In order to protect all parties involved, patient, nurse, and physician, documenting an incident is critical.
There are three principles that are followed when documenting under the chain of command process. First, the nurse must make note of the all facts (including the time) that pertain to the incident. Secondly, documentation of observations and events must be done in a transparent and objective way. And lastly, it is also important not to point fingers at anyone, or let emotions take control of your actions.