Liability For Negligence In Nursing

Liability for Negligence
The nurse in this situation could be liable for negligence due to the duty and relationship established when the nurse prescribed Tylenol to the child. Negligence can be proven when there should have been a duty to a patient, but for some reason the duty has inflicted an injury to a patient (Ruth, 2003, pg. 72). Legal causation regards the harm done because there was a breach in the standard of care. In considering whether there was negligent behavior involved, one must also take into consideration whether there was an established duty and what was the standard of care for the patient. As was previously discussed in this paper, the duty was established once the nurse gave medical advice to the patient, otherwise, there

would have been no duty owed. The nurse was off the clock from the hospital and was not supposed to be treating patients unless they were her patients from the hospital.
The nurse did not follow the standard of care which is what a “reasonably prudent person would not do, or the failure to do something which a reasonably prudent person would do” under similar circumstances would have done (Ruth, 2003, pg. 72). Prescribing the Tylenol without taking into consideration the patient’s medical history was not following the standard of care. The breach of duty, in this case, would be giving medical advice when there was no duty to do so in the first place. By offering the medical advice to the friend’s child, they become the patient and you must follow the standard of care as you would in the hospital. According to Tingle (2002), a breach of duty is determined by considering what a reasonable nurse, in this case, would do in the same position and if there are any reasonably predictable risk of injury resulting from this action (pg. 1130). In the case of the nurse giving medical advice to a friend, the nurse failed to follow the standard of care because she was off duty. The child could have had a reaction to the medication or possible side effects because a proper assessment was not made.
Through further examination of the legal responsibilities held by registered nurses, we can determine that there was a breach of duty of the care in negligence. According to public policy, there is no legal duty for health professionals to help someone in danger, therefore they are not required to rescue as good Samaritans (Cox, 2010, pg. 18). With this being said, there was nothing requiring the nurse to provide the medical advice to her friend instead she should have referred her to the clinic where she could get a proper diagnosis for her child. The moment the nurse gave medical advice, she assumed responsibility and it became her legal duty to care for that patient. Once the duty to the patient has been set, the standard of care is a concern. The nurse was unable to provide standard care because this may not have been her specialty and he/she may have little or no background knowledge in pediatrics.
No matter how close the relationship between the nurse and patient is, legal issues can arise when one party does not agree with the other or when one believes there was a wrongdoing.

The article Ethics, Law, and Policy by Anselmi discusses liability which is the obligation that someone has to another person “enforceable by civil remedy or criminal punishment” (pg. 45). Certain protocols are implemented to prevent liability issues, but nurses are still responsible for their own actions. Not only are there patients to deal with but also ethical issues regarding the health of the patient. There are also other types of relationships that summon indirect liability. Not only does the nurse have a relationship with the patient but also between the employer, making the business entity under which the nurse for “also culpable for negligent acts and omissions of the nurse employee” (Anselmi, 2012, pg. 46). This may be the case since the nurse works for a specific department within a hospital. Although at the time that the medical advice was given the nurse's employer was not involved, there is an employee/employer relationship. The manager of the nurse is responsible for her tasks while on duty but since the nurse took the initiative to take her friend’s child as her patient, the manager may also be subject to the

law.
Ethical Issues
In health care what is considered to be ethical or not is sometimes uncertain, but in order to have some control nurses act upon these four principles of health care ethics; autonomy, beneficence, nonmaleficence, and justice.

Autonomy deals with having the option to make your own decisions with the condition that the decisions do not harm others. Beneficence refers to doing good for others, not out of obligation, but because you have a sense of desire. Going back to the nurse’s case, she may have genuinely given the advice to the friend, but she failed to take into consideration whether she was competent in treating the

child.
Nonmaleficence means causing no harm to others. After being prescribed Tylenol the child’s condition worsened and ended up in a coma. The nurse should have never prescribed medication without proper diagnosis and looking at the medical history. The basic idea to this principle is that the “patients should not leave encounters with physicians worse off than they were before” (Pence, 2015, pg. 17). According to nonmaleficence the patients’ health should have improved making the nurse at fault for the worsening condition. The nurse should have taken into consideration the consequences of giving advice to the friend to treat her child; having done so may have prevented worsening the child’s health. Lastly, justice deals with equality regarding patient care, medical providers cannot let biased opinions interfere with their diagnoses and treatment. When evaluating the situation the nurse should have weighed and balanced the “possible benefits against possible risks” of advising her friend to give Tylenol to her child (Pantilat, 2008). Although the nurse’s friend made the decision to follow her advice and the nurse acted on behalf of the principle of beneficence, the outcome was that the child went into a coma.
There are certain things that should be expected when giving medical advice to friends and family. These can include a broad range of ethical, legal, and practical aspects that must be taken into account. As a suggestion to giving medical advice Eastwood (2009) states that the expectations about the information being requested are essential (pg. 1333). Even family members and friends must be treated in the same manner as any other patient. A legal relationship can be established with the family/friend as your patient by requesting a physical examination before giving the medical advice. As was advised by Eastwood (2009) due to the implications regarding offering medical advice to acquaintances his recommendation in this situation is to document the encounter and offer the patient to see the medical professional in the office where they can view their records if necessary. As a precaution and for the patient's safety, the nurse should have requested that the friend bring her daughter to the clinic to run tests and to examine her. In this case, the patient-nurse relationship was implied and the moment the informal consultation was made that relationship was established.
Conclusion
These are the many compelling reasons for nurses as well as other health care professionals to consider giving medical advice while off the clock to friends and family. Although it may seem like a simple request due to the high risk, health care professionals are not expected to give advice off the clock. Without proper procedures and standards of care in the medical field, many unlawful things would go unnoticed. In this paper, a brief overview of the legal ramifications, limitations, and liability concerning nurses when offering medical advice to friends/family was presented. After closely examining the nurse’s scope of practice, the four Principles of Bioethics, and negligence the nurse’s actions can be considered unethical and negligent. The nurse should have not prescribed Tylenol to her friend’s child because she was not following the standard of care. The registered nurse had a duty to the patient once she offered the medical advice and is therefore at fault.

References
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