Physical Condition of Hospitals

When was the last time you spent time in a hospital ward looking closely at the physical condition of the building?

Did you notice the chipping paint? The peeling wallpaper? The cracks in the floors? The stained ceiling tiles? The upholstery that was worn thin and so stained it can't be cleaned anymore? The blinds that are missing slats and won't open or close? The curtains that are worn and stained? The bed linens that are stained? The clutter of equipment in the hallways and rooms?

I notice these things every time I step into the hospital ward I work on. I do my best to make sure stained linen is changed before my patient ever goes near the bed. That stained curtains are taken down and replaced. But it is impossible to hide the deterioration of everything else.

The patients who are admitted to hospital are acutely ill or requiring some immediate intervention. Mothers are arriving to deliver their babies. The physical environment should be one of impeccable cleaniless and condition. Yet Canadian hospitals are often falling far short of this standard under the guise of fiscal restraint. Even if the money would be spent to restore the units, there isn't any place to physically put patients while the work is done.

Can a hospital defend its infection rate and care when it can't provide patients with an environment that promotes health and healing?

Economy and healthcare changes bring business to lawyers

This week saw glimmers of recovery in the Canadian economy. Mortgage rates, always tied to the bond market, have started to rise and this is a sign that the slump is beginning to come to an end.

However, the healthcare industry is not going to follow that trend. Layoffs and budget cuts have begun in major hospitals at a time of increasing patient loads. Nursing shortages that were the focus of news articles as recently as two weeks ago are suddenly announced "over" by politicians seeking to justify radical changes to the voting public. Clinical educators are slated for layoffs as well which directly impacts the continuing education for nurses and other professionals.

This has been good news for nursing and other health professional recruitment firms from other countries; they have begun actively seeking to recruit our experienced, well-educated registered nurses and they are succeeding. Offers are for positions with great wages and benefits in prime locations.

How does all this bring business to lawyers?

Patient care is coming under direct duress in the current work environment and this leads to mistakes.

Management is being shifted so that managers are in charge of units in which they have no clinical experience. Management of units is being consolidated under the supervision of one manager.

Education and training programs are being cut so staff will not maintain their skill levels at current standards. New staff, already coming in without the background of a registered nurse, will not receive a consistent orientation program so their care may not reflect policies and procedures.

Hiring freezes mean no replacements for maternity leaves of up to one year, no replacements for the retiring nurses, no replacements for nurses injured on the job and no coverage for absent staff. Nurses already have the highest absentee rate in Canada and this will only increase as staff become more overworked and stressed.

Less staff on the floor means current standard nurse-patient ratios will come under pressure to change. Areas where levels of care now dictate 1:1 nursing for the optimum patient outcome may see nurses caring for 2 or 3 patients and important information on the patient's condition will be missed or delayed in being seen resulting in compromised outcomes. Even layoffs in the clerical sector impacts patient care when nobody is at the desk to answer calls from the rooms while the nurses are busy with patient care in other areas of the unit.

There are implications for the mental health of all hospital staff during this period. Rumours and awareness of the impact of these changes have created an environment of high stress, lack of concentration and decreasing commitment to an employer who cuts jobs. Stressed hospital staff simply cannot perform at optimum levels.

Legal nurse consultants have the experience of hospital nursing to know the implications for patients and families during times of high stress and staff cutbacks. They can tell the legal team what to look for to see if the employer is at fault for the care that was or was not received during a hospital stay. Legal nurse consultants can pick up the subtle wording of other nurses that provides clues about the unit activity that affected your client. They can also give advice on questions for interviews that will demonstrate the environment during the event and its impact on your client.

Legal cases involving hospitals in Canada will see an increase as acuity, activity and populations rise while staff and budget levels decrease. Are you ready with your full legal team that will best represent your client?

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

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.

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.

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.