Recent administrative changes to Alberta Health Services are bringing changes to the organization. Within the Calgary area, for example, Women’s Health Services no longer exist. And the word is that this may be slated to happen province-wide.
The immediate effects are seen in the absence of top level management positions to advocate for health care services geared toward women’s health care. At a time of record numbers of maternity cases, maternity units in dire need of renovation and updating and increasing demand for gynecology services, there is no leadership with a specific interest in this specialty. There has also been a hiring freeze placed on nursing staff and support staff in these areas despite clear indications that there are understaffing issues and pending retirements.
What does this mean for medical liability attorneys? It means there are going to be cases emerging as a direct result of insufficient resources to provide the standard of care expected in Canadian hospitals. The staff will not available to maintain the current standard of nurse-patient ratios. Less qualified and experienced staff will be hired as a cost-cutting bridging measure which puts patients at risk. The equipment necessary to monitor patients for their safety and best outcome will either not be available or will be outdated and not meet current standards. The physical environment of the hospital patient will deteriorate—even to the point of being dangerous from an infectious disease standpoint with such things as cracks in the floors under delivery beds and beds unable to be cleaned to acceptable standards because they are need of replacement after years of use and breakdowns.
Nurses are aware of the shortfalls of working within a hospital environment during times of economic downturns while patient populations and acuity rise. Having that experience and perspective will assist you in evaluating and building your next case involving women’s health gone wrong.
Saturday, May 30, 2009
Wednesday, May 27, 2009
Nurses are active in risk management
I am about to begin an interesting new task on the busy obstetrical unit at the hospital. My task will be to audit medical charts of patients recently cared for within the unit-- and they need a nurse to do it.
I am excited by this opportunity because it is another demonstration of the important role nurses play within the medical industry. This is not a blame game. The risk management team for the health authority recognizes that nurses are uniquely qualified to evaluate the documentation of patient care. Not only do audits check to see if policies and procedures are being followed but also if a complete course of care can be tracked for, in this case, multiple patients under one system (mother and baby or babies).
We all learn from doing and sometimes a gentle reminder of what was missed or a congratulatory note of a task well done may lead to improved documentation that assists the legal team in a case up to twenty years down the road. On that note, what were the charting practices ten or twenty years ago? Is your team prepared to deal with "exception charting" or "SOAP" charting that were common directives then?
A legal nurse consultant cannot be a recent graduate of a school of nursing because policies, procedures, knowledge, equipment and, yes, even charting were not the same even five years ago. This is a specialty area of nursing where experience is the rule not the exception and it is an exciting opportunity for these senior nurses to use their background in a whole new way!
I am excited by this opportunity because it is another demonstration of the important role nurses play within the medical industry. This is not a blame game. The risk management team for the health authority recognizes that nurses are uniquely qualified to evaluate the documentation of patient care. Not only do audits check to see if policies and procedures are being followed but also if a complete course of care can be tracked for, in this case, multiple patients under one system (mother and baby or babies).
We all learn from doing and sometimes a gentle reminder of what was missed or a congratulatory note of a task well done may lead to improved documentation that assists the legal team in a case up to twenty years down the road. On that note, what were the charting practices ten or twenty years ago? Is your team prepared to deal with "exception charting" or "SOAP" charting that were common directives then?
A legal nurse consultant cannot be a recent graduate of a school of nursing because policies, procedures, knowledge, equipment and, yes, even charting were not the same even five years ago. This is a specialty area of nursing where experience is the rule not the exception and it is an exciting opportunity for these senior nurses to use their background in a whole new way!
Tuesday, May 26, 2009
What role could a nurse have in a law firm?
Canadian nurses have discovered a new area of specialty-- legal nurse consulting. It can be the best of both worlds for an experienced RN. She can use her established knowledge and skills in a whole new way. She can explore employment options outside of shiftwork. She can remain an important member of a professional team that can make a difference.
Here is how a nurse works within the team:
*Strategizes with the legal professional for successful resolutions between parties involved in health care-related litigation or other medical-legal or health care-legal matters;
*Educate attorneys and/or others involved in the legal process regarding the healthcare facts and issues of a case or claim;
*Research and integrate healthcare and nursing literature as it relates to the healthcare facts and issues of a case or a claim:
*Review, summarize, and analyze medical records and other pertinent healthcare and legal documents and comparing and correlating them to the allegations;
*Assess issues of damages and causation relative to liability within the legal process;
*Identify, locate, evaluate, and confer with expert witnesses;
*Interview witnesses and parties pertinent to the healthcare issues in collaboration with legal professionals;
*Draft legal documents in medically related cases under the supervision of an attorney;
*Develop collaborative case strategies with those practicing within the legal system;
*Provide support during discovery, depositions, trial, and other legal proceedings;
*Support the process of adjudication of legal claims.
Source: AALNC
Here is how a nurse works within the team:
*Strategizes with the legal professional for successful resolutions between parties involved in health care-related litigation or other medical-legal or health care-legal matters;
*Educate attorneys and/or others involved in the legal process regarding the healthcare facts and issues of a case or claim;
*Research and integrate healthcare and nursing literature as it relates to the healthcare facts and issues of a case or a claim:
*Review, summarize, and analyze medical records and other pertinent healthcare and legal documents and comparing and correlating them to the allegations;
*Assess issues of damages and causation relative to liability within the legal process;
*Identify, locate, evaluate, and confer with expert witnesses;
*Interview witnesses and parties pertinent to the healthcare issues in collaboration with legal professionals;
*Draft legal documents in medically related cases under the supervision of an attorney;
*Develop collaborative case strategies with those practicing within the legal system;
*Provide support during discovery, depositions, trial, and other legal proceedings;
*Support the process of adjudication of legal claims.
Source: AALNC
Thursday, May 14, 2009
Critical Flaw Costs Lawyer Thousands
A critical flaw was discovered by a defending attorney after the plaintiff’s attorney had spent thousands of dollars bringing the case to discovery.
a. 25 yr old woman in third pregnancy with one living child; first pregnancy had a compromised outcome
b. Premature rupture of membranes at 34 weeks of pregnancy; stabilized and transferred to antepartum unit to wait for pregnancy to reach 36 weeks, a common practice at this time
c. Sudden onset of bleeding and pain at 35 ½ weeks; fetal monitoring shows fetal distress; to OR and baby delivered within 8 minutes of primary nurse entering patient’s room
d. Mother had significant blood loss but fully recovered; baby needed extensive resuscitation but died two days later
e. Claim was made against the primary physician, admitting physician, and primary care nurse. Basis of the claim was that the patient’s call for help was not answered for twenty minutes by primary care nurse. This was substantiated by the patient’s husband watching the clock on the wall of the room.
Two vital errors were made by the plaintiff’s attorney that could have been identified by a legal nurse consultant:
1. He did not ask the primary care nurse what her patient load was at the time of the incident. There had been layoffs on the unit at this time. The incident also occurred during a time of night when nurses commonly take a one hour break and patient loads can be heavy. On this night, the primary care nurse was caring for six triage patients, an early labour patient and two antepartum patients which she had told the nurse in charge was too heavy for patient safety. However, the primary care nurse was never obliged to give him this information during discovery.
2. He did not confirm the actual presence of a clock on the wall of the patient’s room for her husband to time the response time. This unfamiliarity with hospital layout and the custom of clocks on the walls of rooms in other parts of the maternity unit cost the plaintiff their claim against the primary care nurse and wasted the attorney’s resources in preparing the case as well as three hours in discovery with the primary care nurse.
a. 25 yr old woman in third pregnancy with one living child; first pregnancy had a compromised outcome
b. Premature rupture of membranes at 34 weeks of pregnancy; stabilized and transferred to antepartum unit to wait for pregnancy to reach 36 weeks, a common practice at this time
c. Sudden onset of bleeding and pain at 35 ½ weeks; fetal monitoring shows fetal distress; to OR and baby delivered within 8 minutes of primary nurse entering patient’s room
d. Mother had significant blood loss but fully recovered; baby needed extensive resuscitation but died two days later
e. Claim was made against the primary physician, admitting physician, and primary care nurse. Basis of the claim was that the patient’s call for help was not answered for twenty minutes by primary care nurse. This was substantiated by the patient’s husband watching the clock on the wall of the room.
Two vital errors were made by the plaintiff’s attorney that could have been identified by a legal nurse consultant:
1. He did not ask the primary care nurse what her patient load was at the time of the incident. There had been layoffs on the unit at this time. The incident also occurred during a time of night when nurses commonly take a one hour break and patient loads can be heavy. On this night, the primary care nurse was caring for six triage patients, an early labour patient and two antepartum patients which she had told the nurse in charge was too heavy for patient safety. However, the primary care nurse was never obliged to give him this information during discovery.
2. He did not confirm the actual presence of a clock on the wall of the patient’s room for her husband to time the response time. This unfamiliarity with hospital layout and the custom of clocks on the walls of rooms in other parts of the maternity unit cost the plaintiff their claim against the primary care nurse and wasted the attorney’s resources in preparing the case as well as three hours in discovery with the primary care nurse.
Tuesday, May 12, 2009
Nursing shortage is important to lawyers
A report issued by the Canadian Nurses Association shows that the shortage of registered nurses is expected to grow to 60 000 by 2022. The current absentee rate for RNs is twice as high as any other profession with an average of 14 days per year. Workload, short-staffed units, lack of basic equipment and large numbers of less qualified and less experienced staff are taking a huge toll on the skilled work force in Canadian hospitals.
"It gets to a point where you have nurses so tired that when one of their colleagues calls in sick, they just say: 'Give me a warm body' - regardless if he or she has the education." Personal care workers are heavily relied on in some regions. "We need (them), don't get me wrong," Linda Silas, President of the Canadian Federation of Nurses Unions said. "But for patient safety and quality care, you need the nurses around and we shouldn't jeopardize this because of the shortage."
There is also a noticeable shortage of doctors, pharmacists, and physiotherapists.
Why should this matter to a lawyer? Because when your client comes to you with their story of what happened to them in the healthcare system, you need to be aware of the dynamics of the environment in which the event(s) took place. What were the staffing levels at that moment? What were the qualifications and experience of the direct care givers as well as their supervisors? Was the care being given by a worker outside of their scope of practice? Was fatigue or illness a factor in the level of care being provided at that moment?
Legal nurse consultants are registered nurses who have hands-on experience with the healthcare environment. They know first hand how the level of care is affected by the dynamics of the unit and the people in it. Let their expertise and insight bring to light nuances of the case that could so easily be missed.
"It gets to a point where you have nurses so tired that when one of their colleagues calls in sick, they just say: 'Give me a warm body' - regardless if he or she has the education." Personal care workers are heavily relied on in some regions. "We need (them), don't get me wrong," Linda Silas, President of the Canadian Federation of Nurses Unions said. "But for patient safety and quality care, you need the nurses around and we shouldn't jeopardize this because of the shortage."
There is also a noticeable shortage of doctors, pharmacists, and physiotherapists.
Why should this matter to a lawyer? Because when your client comes to you with their story of what happened to them in the healthcare system, you need to be aware of the dynamics of the environment in which the event(s) took place. What were the staffing levels at that moment? What were the qualifications and experience of the direct care givers as well as their supervisors? Was the care being given by a worker outside of their scope of practice? Was fatigue or illness a factor in the level of care being provided at that moment?
Legal nurse consultants are registered nurses who have hands-on experience with the healthcare environment. They know first hand how the level of care is affected by the dynamics of the unit and the people in it. Let their expertise and insight bring to light nuances of the case that could so easily be missed.
Sunday, May 10, 2009
Top 5 Reasons to Have Legal Nurses of Canada on Your Team
Because of the legal nurse consultant’s expertise in healthcare-related issues, he or she can bring the following benefits to the litigation team:
1. Cost-effectiveness: The LNC critically analyzes the healthcare facts of a case and
helps the attorney select and manage cases. Many cases can be either rejected or
settled quickly by using the resources and knowledge of an LNC.
2. Resourcefulness: The LNC has access to a national network of healthcare and
professional resources and contacts. The LNC is well versed in the use of medical
libraries, medical equipment, and other resources.
3. Knowledge: The LNC has a thorough understanding of healthcare issues and trends
related to the entire litigation process. The LNC “speaks the language” of
physicians, healthcare providers, and patients.
4. Experience: The LNC has a background of clinical experience, which includes the
ability to interpret medical records, documents, and health science literature.
5. Advantage: The LNC is a relatively new area of expertise which means adding one to your legal team is an advantage during the legal process.
1. Cost-effectiveness: The LNC critically analyzes the healthcare facts of a case and
helps the attorney select and manage cases. Many cases can be either rejected or
settled quickly by using the resources and knowledge of an LNC.
2. Resourcefulness: The LNC has access to a national network of healthcare and
professional resources and contacts. The LNC is well versed in the use of medical
libraries, medical equipment, and other resources.
3. Knowledge: The LNC has a thorough understanding of healthcare issues and trends
related to the entire litigation process. The LNC “speaks the language” of
physicians, healthcare providers, and patients.
4. Experience: The LNC has a background of clinical experience, which includes the
ability to interpret medical records, documents, and health science literature.
5. Advantage: The LNC is a relatively new area of expertise which means adding one to your legal team is an advantage during the legal process.
Thursday, May 7, 2009
Another Diet Pill Recall Alert
According to a May 1, 2009 news release by attorneys at Morgan & Morgan, the Food & Drug Administration (FDA) issued a warning to consumers to immediately stop using Hydroxycut products. Hydroxycut products, dietary supplements manufactured by Iovate Health Sciences, Inc., have been linked to serious liver injuries and at least one death. The products were sold in Canada as well.
This recent example in the product liability field is within the expertise of the legal nurse consultant as part of the legal team. Legal nurse consultants are not hired to know the law but rather to understand the injury, what caused it, its extent and how it could have been prevented. Once the free legal consultation has been completed, the legal nurse consultant can piece together vital pieces of information to assist the attorneys in evaluating the merit of each case.
Nurses have specialized knowledge and resources to assess the risks and benefits of a product, whether it was regulated and for what particular use, identify common off label uses of a product, explore the history of the product and the side effects that have been reported as well as personal patient histories which might have affected the outcome with this product. Then they can assist in the preparation of cases for legal teams faced with a large scale recall within the healthcare-related industry.
This recent example in the product liability field is within the expertise of the legal nurse consultant as part of the legal team. Legal nurse consultants are not hired to know the law but rather to understand the injury, what caused it, its extent and how it could have been prevented. Once the free legal consultation has been completed, the legal nurse consultant can piece together vital pieces of information to assist the attorneys in evaluating the merit of each case.
Nurses have specialized knowledge and resources to assess the risks and benefits of a product, whether it was regulated and for what particular use, identify common off label uses of a product, explore the history of the product and the side effects that have been reported as well as personal patient histories which might have affected the outcome with this product. Then they can assist in the preparation of cases for legal teams faced with a large scale recall within the healthcare-related industry.
Wednesday, May 6, 2009
What is a legal nurse consultant?
The legal nurse consultant is a licensed registered nurse who performs a critical
analysis of healthcare facts and issues and their outcomes for the legal profession,
healthcare profession, and others, as appropriate. With a strong educational and
experiential background, the legal nurse consultant is qualified to assess adherence to standards of healthcare practice as it applies to the nursing and healthcare professions.
There is a diversity of practice settings and services performed by legal nurse
consultants nationwide.
The legal nurse consultant practices the art and science of this nursing
specialty in a variety of settings, including law firms, government offices, insurance
companies, hospital risk management departments, and as self-employed practitioners.
The legal nurse consultant is a liaison between the legal and healthcare communities and
provides consultation and education to legal, healthcare, and appropriate other
professionals in areas such as personal injury, product liability, medical malpractice,
workers’ compensation, toxic torts, risk management, medical professional licensure
investigation, and criminal law.
analysis of healthcare facts and issues and their outcomes for the legal profession,
healthcare profession, and others, as appropriate. With a strong educational and
experiential background, the legal nurse consultant is qualified to assess adherence to standards of healthcare practice as it applies to the nursing and healthcare professions.
There is a diversity of practice settings and services performed by legal nurse
consultants nationwide.
The legal nurse consultant practices the art and science of this nursing
specialty in a variety of settings, including law firms, government offices, insurance
companies, hospital risk management departments, and as self-employed practitioners.
The legal nurse consultant is a liaison between the legal and healthcare communities and
provides consultation and education to legal, healthcare, and appropriate other
professionals in areas such as personal injury, product liability, medical malpractice,
workers’ compensation, toxic torts, risk management, medical professional licensure
investigation, and criminal law.
Subscribe to:
Posts (Atom)
