There are so many conflicting opinions on whether or not health care workers, especially nurses, should protect their licenses with professional liability insurance. While there is no right or wrong answer, there are more pros than cons to be covered by personal malpractice insurance. A few pro’s of having personal malpractice/liability insurance are: patients are more aware of their legal rights, nurses can be sued individually or be named in a lawsuit, an alleged claim can be filed based on perception wrongdoing; with or without injury, policies usually include coverage of libel, slander, patient confidentiality, and HIPAA issues, affordable low cost plans to purchase, legal representation on behalf of the nurse not the facility in which they’re employed, litigation costs are expensive, lawsuits can take years to settle and either party may appeal the decision to a higher court increasing legal fees, and providing care outside employment. A con to not having insurance is the inability to afford the premium due to personal financial situation (NSO, 2018).
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The Nurses Service Organization (NSO) is the nation’s largest administrator of professional liability insurance coverage to individual nursing professionals. A report created by CNA and NSO shed light on closed claims from 2010-2014 with compensation of greater than $90 million involving nurses with less than 6 years of experience (Frank & Danks, 2018) to reduce nurse’s risks of exposure and data analysis on areas of vulnerability. Nurse Professional Liability Exposures: 2015 Claim Report Update (2015) stated of the closed cases more than 88% of cases involved a nurse, 58.5% of those nurses were employed by hospitals and included additional breakdown of areas such as severity by nurse specialty, injury, as well as recommendations to control risk. In 2015, the average compensation of claim settlements and court judgements were approximately $164,586 (Brown, 2016).
Nurses are not required to carry personal malpractice/liability insurance. It’s uncommon for a nurse to be sued as an individual for medical malpractice but it can happen (Butler & Lostritto, 2015). Even if the allegations are unfounded, it can seriously damage a professional reputation (Mathes, 2015). A few misconceptions regarding personal nursing liability insurance coverage is that a nurse can only be sued if they make a mistake, is self-insured, or the employer policy coverage is enough to settle the claim, none of these are true (Pohlman, 2015). Nurses can be named in a lawsuit of negligence (mistake) or malpractice for deviations from standards of care, during discovery is when the plaintiff’s attorney would know if a nurse is self-insured and the nurse can be held accountable if the allegation action took place off duty (Butler & Lostritto, 2015).
As stated by Brown (2016) and Frank & Danks (2018) malpractice claims involving nurses are growing rapidly. The most common reasons for malpractice claims include failure to follow nurse’s standard of care; failure to communicate and improper delegation; medication errors; poor documentation; charting by exception and legal risks; nursing fatigue and incident reports; failure to assess and monitor; not reporting abnormal assessment data and not acting as a patient advocate.
Failure to communicate has been the most reported claim against nurses for a malpractice suit. Communication surrounds the entire nursing process and nurses have been determined negligent by communication errors, not informing patient issues and concerns with colleagues, charge nurses and physicians. Good communication between nurses and patients is essential for the successful outcome of nursing care of each patient. Nurses have a multitude of responsibilities when it comes to communicating patient care to the patient and family from assessment, medication/diagnosis education, pre and post procedures to discharge (Brown, 2016).
Written communication in the form of documentation is another major part of a nurse’s job. Ensuring proper documentation including details of care provided, information to patient and family including outcomes can decrease consequences of care and legal action (Brown, 2016). With all lawsuits, the medical record becomes evidence to that suit, known as exhibits. These exhibits can be enlarged and displayed before the courtroom and jury (Butler & Lostritto, 2015). Nurses document utilizing nurse notes to paint a picture of detailed pertinent findings, negative findings, patient care with outcomes and patient checks (Brown, 2016).
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Each interaction a provider i.e. nurse has with a patient affects health insurance claims and is subject to a potential liability risk (Karl, Born & Viscusi, 2016). A lack of knowledge, skill, and competency will not protect any health care provider including nurses from professional liability. Every provider is accountable for their own actions or mistakes (Brown, 2016). Regardless of how educated a nurse is, how many years of experience or how careful with a patient, unintentional mishaps or mistakes can happen. By providing care within the standard of care protocol and within the nurse scope of practice based on one’s education and experience can help minimize the risks of being involved in a malpractice lawsuit (Mathes, 2014).
In today’s society we protect and insure almost anyhing from our homes, vehicles, pets, health, lives and even our identities. Therefore, in my opinion, I feel that it is very important for a nurse to carry their own personal malpractice/liability insurance to protect themselves, their profession as well as their license to practice. Nurses act as advocates for the rights of their patients and are frequently involved in ethical issues and ethical decision-making processes and unintentional mistakes can happen. In the end, the question of whether or not the nurse should carry malpractice/liability insurance is a personal one and should be seriously considered. Knowing that you are protected from a lawsuit is reassuring. As nurses’ we are advocates for our patients, families and the community. Having personal malpractice/liability insurances is like an advocate for the nurse.
- Brown, G. (2016). Averting Malpractice Issues in Today’s Nursing Practice. ABNF Journal, 27(2), 25–27. Retrieved from https://search-ebscohost-com.ezproxy.snhu.edu/login.aspx?direct=true&db=asn&AN=114898945&site=eds-live&scope=site
- Butler, K. A., & Lostritto, M. D. (2015). Malpractice 101: Strategies for Defending Your Practice. Journal of Radiology Nursing, 34(1), 13–24. https://doi-org.ezproxy.snhu.edu/10.1016/j.jradnu.2014.12.006
- Frank, L., & Danks, J. (2019). Perianesthesia Nursing Malpractice: Reducing the Risk of Litigation. Journal of PeriAnesthesia Nursing, 34(3), 463–468. https://doi-org.ezproxy.snhu.edu/10.1016/j.jopan.2018.10.001
- Karl, J. B., Born, P. H., & Viscusi, W. K. (2016). The relationship between the markets for health insurance and medical malpractice insurance. Applied Economics, 48(55), 5348–5363. https://doi-org.ezproxy.snhu.edu/10.1080/00036846.2016.1176119
- Mathes, M. (2015). Legal action: protect yourself. Nursing Management (Harrow, London, England: 1994), 22(4), 13. https://doi-org.ezproxy.snhu.edu/10.7748/nm.22.4.13.s10
- NSO-medical-malpractice-101-infographic [PDF]. (2018). Affinity Insurance Services. https://aonaffinity-blob-cdn.azureedge.net/affinitytemplate-dev/media/nso/images/documents/nso-medical-malpractice-101-infographic.pdf
- Nurse Professional Liability Exposures: 2015 Claim Report Update [PDF]. (2015, October). CNA. https://aonaffinity-blob-cdn.azureedge.net/affinitytemplate-dev/media/nso/images/documents/cna-nurse-claim-report-101615.pdf
- Pohlman, K. J. (2015). Why you need your own malpractice insurance. American Nurse Today, 10(11), 28–30. Retrieved from https://search-ebscohost-com.ezproxy.snhu.edu/login.aspx?direct=true&db=ccm&AN=111319125&site=eds-live&scope=site
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