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Another way to avoid the legal hot seat

Keep certifications and trainings current

How often do you review staff certifications and trainings to make sure they’re current?

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Now choose the best answer: continually, very frequently, or every week.

If certifications and trainings have lapsed and a patient is injured, those records become evidence against the hospital. And you will find yourself in the hot seat.

Let’s look at how expired certifications and unaddressed competencies can come home to roost. Imagine that your unit is sued in a wrongful death action after unsuccessful emergency resuscitation efforts. The attorney for the patient’s family discovers that one of the nurses working the code wasn’t current in CPR. That out-of-date certification raises doubts about [more]

Free Download: Job Description Update Confirmation

As promised, you can now download the very practical and simple tool  I mentioned in last week’s post (Not My Job: The legal perspective on updating job descriptions). I’ve created a Word file of the standard job description update letter, which you’ll find here. Don’t let its simplicity fool you; this is useful tool for legal risk reduction.

downloadicon2About the Word file: You can customize it to include your organization’s logo, address, and such. Use it as a simple way to document that your staff members understand changes in responsibilities and duties included in their job descriptions.

When you incorporate new practices or adapt to new standards that are reflected in updated job descriptions, you’ll simply ask each staff member to sign the letter acknowledging and committing to adhere to the revised job description, and place a copy in each employee’s file.

Many thanks to Dinah Brothers for this tool…


Dinah Brothers, RN, JD, is the author of The Essential Legal Handbook for Nurses (just released), sold as a set of 10 handbooks for staff nurses,  and The Nurse Manager’s Legal Companion (release: July 2015), a book offering nurse managers guidance on everything from employment law to dealing with whistleblowers and everything in between.

Not My Job: The legal perspective on updating job descriptions

As a nurse manager, how often do you review the duties and responsibilities laid out in your staff job descriptions? The human resources department may “own” the files, but you probably review them when you have an open position. From a legal perspective, though, job descriptions deserve more regular scrutiny to ensure that duties align with your organization’s policies and procedures, and meet the standard of care.

For example, if new procedures have been introduced, staff must be trained, checklist2competencies documented, and job descriptions updated to support the revised standard of care. In the event of a patient injury, one of the first things the patient’s attorney will do is look for gaps in the standard of care, so you must be proactive in this area.

Dinah Brothers, RN, JD, suggests that, at a minimum, you review your staff’s job descriptions once a year. In addition, you must revise your staff’s job descriptions whenever any one of the following occurs:

  1. When there are professionally recognized changes to the standard of care
  2. When new medical advancements are accepted and implemented at your facility
  3. When new technology is implemented in your facility
  4. When policies and procedures change in your facility that impact the nurse’s role and/or job responsibilities change

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The unofficial whistleblower flowchart for nurses

Last week, a whistleblower lawsuit was filed by Kim Cheely, a nurse manager at Georgia Regents Medical Center prior to being fired last October for “insubordination.” In this case, “insubordination” appears to mean that the trusted, 37-year veteran of GRMC dogged management to address quality-of-care concerns related to repeated staff reductions in the oncology and bone marrow transplant units.

The story in The Augusta Chronicle documents a situation where anything that could go wrong, did. Cheely took every logical step she could to affect change, and thought she would be protected from retaliation by invoking the hospital’s conflict resolution policy. This did not turn out well for Cheely, unfortunately. In fact, to be protected as a whistleblower, you must report to the state or national agency responsible for regulation of your employer.

For anyone considering blowing whistleblower flowchartthe whistle, take a look at the flowchart I created from advice offered on the ANA website. The chart, which illustrates just the bare bones, will be available for download later in the week, in case you want to share it with your colleagues.

On a related note: I’m currently reading draft chapters for an upcoming HCPro book, The Nurse Manager’s Legal Companion, by a wonderful nurse and attorney, Dinah Brothers. We’ll also have a handbook for staff nurses. Neither is available for preorder quite yet, but I’ll be sure to let you know when they are.