What Is Negligence in Nursing? Overview and FAQ

Over the past several decades, the nursing profession has seen more autonomy and increased responsibilities given to individual nurses. While this can lead to better quality care, these advances can also open nursing staff up to more legal exposure, including charges of negligence. Negligence in nursing can be generally defined as a situation in which a nurse fails to fulfill their duty to a patient — referred to as a breach of duty — which then causes injuries or other damages.

Nurses may face negligence charges for a wide range of actions or failures to act that lead to patient injury. The majority of negligence cases occur in hospital settings, followed by rehabilitation facilities and nursing homes. However, all facilities face this risk due to the very nature of nursing care and the vulnerability of patients.

Awareness is an important first step toward protecting your facility against negligence allegations. We’ll cover the elements of a negligence claim, provide examples so you know what it looks like in practice, and answer frequently asked questions.

Negligence in Nursing: Overview and Legal Elements

Negligence is a civil wrong that results in harm, also referred to as a tort. Although a broad category of the law, negligence can also be evaluated within the context of a given state’s Nurse Practice Act (NPA). NPAs outline the legal and ethical standards of acceptable nursing conduct and standards of care, but these are also informed by professional nursing organizations, facility policies, and industry best practices. Negligence is a failure to meet the standard that a reasonable and careful nurse would under similar circumstances.

State NPAs, institutional policies, and federal guidelines may be taken into account when allegations of negligence get adjudicated in court. A legal claim of negligence in nursing involves the following four elements:

• There is a duty of care.
• There is a breach of that duty.
• The breach is the cause of injury.
• The patient is harmed as a result.

A duty of care refers to a nurse’s legal and ethical obligation to the patient, and a breach of duty occurs when a nurse fails to meet the expected standards of care. A plaintiff must then prove that the breach caused the patient’s injury, suffering, or death, despite other potential causes.

Example of Negligence in Nursing

In healthcare, negligence can also be referred to as medical malpractice and involve situations that can be quite nuanced and complex. In some cases, multiple clinicians are involved in the breach of duty. Let’s go over an example of negligence in nursing in more depth so that you know what it looks like in real life.

Example: Negligent Nursing in a Med-Surg Setting

A 64-year-old female patient is admitted to a hospital for a total hip replacement. She spends time in the PACU after her procedure and her stay there includes episodes of hypotension. She is transferred to a medical surgical unit, where an RN assumes care.

The RN has a heavy assignment. He performs an incomplete assessment of the patient, deems her “stable” and delegates further monitoring to an LPN. The LPN fails to take vital signs according to hospital policy.

Two hours later, the patient is unable to tolerate an ordered respiratory treatment and vomits twice, but the LPN doesn’t communicate this to the team. Ten minutes after that the patient is cyanotic and unresponsive. The patient is transferred to the ICU and intubated, but dies due to lack of oxygen and blood flow to the brain.

Legal Implications of Negligence in Nursing:

Both the RN and LPN in this example could face a civil lawsuit for negligence, among other claims and potential penalties. The patient’s hypotension in PACU should have alerted the RN to the patient’s unstable condition and triggered closer monitoring.

The RN’s failure to thoroughly assess the patient upon admission to the floor, according to hospital policy, led to improper delegation. Neither nurse communicated the patient’s condition to a physician or NP in a timely manner.

Frequently Asked Questions About Medical Negligence

In nursing, negligence is a legal and ethical issue that can lead to poor patient outcomes, such as suffering, injury, disability, and death, and also serious consequences for the caregivers involved. Nurses often receive training about legalities in school, but may be underprepared to face the increasingly litigious atmosphere in healthcare today.

Facility leaders and nurse managers need to be aware and informed about negligence so that they can protect the wellbeing of their institution, nursing staff, and patients. Here are answers to frequently asked questions about this crucial topic.

What is negligence vs. malpractice in nursing?

Negligent nursing is a broad concept that relates to a failure to provide reasonable care to patients. Malpractice is a subset of this charge, a form of negligence that usually involves the failure to meet specific professional obligations and standards.

To differentiate between negligence vs. malpractice in nursing, it’s helpful to consider the duties and standards involved. For example, was a nurse simply acting unreasonably — like failing to remove tripping hazards near the bedside — or did they fail to meet specific protocols — like performing a wrongful delegation of tasks.

What are the most common types of negligent nursing?

In a nurse’s clinical practice, some of the most common types of negligence and malpractice stem from the failure to communicate important patient information to other providers. Other common examples include:

• Medication errors
• Documentation deficiencies
• Failure to monitor or assess a patient
• Improper or unsafe use of equipment

What kinds of evidence can be used to prove nursing negligence?

When a negligent nursing case goes to court, the patient’s attorney will need to prove that the nurse’s actions, or failure to act, caused harm. A legal team could gather testimonial evidence from other members of the healthcare team, medical experts, or other nurses who can help establish standards of care.

In addition, other types of evidence may be used to prove negligence, including:

• Medical records
• Documentation of the injury/harm (such as photographs or video)
• Incident reports
• Records of communication among healthcare team members
• Records of communication with the patient
• Physical items, such as medical equipment
• Record of financial losses, such as medical bills or proof of missed wages

What are the potential consequences of negligence in nursing?

Once negligence is proven, monetary compensation may be awarded to the patient. If the facility, and/or the nurse involved have malpractice insurance, the insurance providers will cover portions of the legal fees, settlement, or damages that are awarded, but the remaining expense could be significant.

In addition, negligence charges can bring unwanted media coverage, damage to a facility’s reputation (and subsequent loss of patients and revenue), and increased cost of insurance premiums.

How can facilities protect themselves against potential negligence claims?

In an effort to reduce instances of nursing negligence, facilities can utilize risk management strategies and establish robust safety protocols and procedures. Focusing on delivering high quality care to patients can help reduce instances where patients are unsatisfied, upset, or harmed. Other strategies include:

• Providing continuous staff training on unit policies and expectations.
• Obtaining insurance coverage.
• Seeking legal advice to identify potential areas of vulnerability and risk.
• Encouraging open, blame-free reporting of near-miss events and adverse events so that all staff members involved can learn from mistakes.
• Establishing a safety culture.
• Conducting audits regularly and identifying areas of improvement.

Learn More Ways to Protect Your Facility, Staff, and Patients

Legal problems, like accusations of negligence in nursing, are an increasing concern for healthcare providers, and it’s crucial for facility leaders to stay informed of legal and professional updates. Get more expert-written facility resources and guides to help you deliver safe, productive, and legally compliant patient care.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.