Standards Of Nursing Practice

Standards of nursing practice are defined by the ANA as “authoritative statements of the duties of all registered nurses, regardless of role, population, or specialty, are expected to perform competently” (Masters, 2017, p. 382).  It is these standards that are used to determine if there is sufficient cause to pursue a malpractice suit.  Standards of care frequently used in courts are statutes, agency regulations, accreditation standards, facility documents, manufacturer’s instructions, nursing literature, and expert testimony.  Statutes are legal rules that direct certain behaviors.  Different states have different rules that can have an effect on standards of care.  Documents such as an organizations policies and procedures, in addition

to, manufacturer’s recommendations are looked at to determine what is the appropriate level of care or use of equipment when an error is made.
            There are six elements that must be proven by the courts to determine negligence or malpractice.

Two of these elements include duty owed to the patient and breach of the duty owed to the patient.  Duty owed to the patient is the expected standard of care to be delivered.  If the standard of care was not adhered to, it is considered to have been breached.  Additionally, it must be proven that the patient suffered an injury or harm as a result of said breach.  Other elements include foreseeability, causation, and damages.  Foreseeability is the reasonable assumption that injury occurred because of the nurse’s actions or inaction.  Causation is the ability to prove that the injury was the result of the conduct by the nurse.  “Damages may be awarded in one or more of four categories: general damages, special damages, emotional damages, and punitive or exemplary damages” (Masters, 2017, p.

385). 

Nurses may prevent legal problems in a number of ways.  “The nurse has a duty to practice competently and possess knowledge, skills, and abilities required for lawful, safe, and effective practice” (masters, 2017, p. 386).  A nurse must maintain competencies required for the population of patients they care for and keep current on skills needed to perform any required procedures.  Adhering to hospital policies and procedures, and unit standards of care will make it difficult to prove any wrongdoing on the part of the nurse.  Studies have shown that fatigue and excessive workload may contribute to mistakes.  Avoiding long hours and stretches, getting enough sleep, as well as, learning to manage stress can help to decrease the chance of errors.
In the book, Leading with Soul: An Uncommon Journey of Spirit, Bolman & Deal document Steve Camden’s spiritual path in finding a work-life balance in order to regain passion and motivation for the work he is doing (Bolman & Deal, 2011).

Nurse leaders can take a lesson from Steve in the importance of taking care of one’s self and role modeling that behavior to the caregivers they support.  In doing so, it will increase enthusiasm, engagement, and the willingness to participate in projects and process improvements, leading to better patient outcomes and overall safety.  In turn, igniting the spirit of others.  Caregivers will have overall satisfaction in their work and an increased pride in what they are doing.  Work satisfaction can extend to an overall sense of well-being and better ability to manage the stresses of healthcare and everyday life.  Learning how to manage stressors is important in the work that caregivers do.  It can improve attentiveness and help avoid rest and sleep disturbances which can have negative

consequences.
Caregivers need to feel they are cared for in order to continue the physically and emotionally charged work they do on a day to day basis.  Leaders who learn how to express love to their caregivers will encourage the same in others and likely get it in return.  Bolman & Deal
state, “when people know someone really cares, you can see it.  In their faces.  And in their actions.  Love really does keep on giving” (Bolman & Deal, 2011, p. 94).