Chain of Command
There used to be a time when nurses
were expected not to question doctors’
orders—even if those orders seemed
wrong. As the nursing profession
advanced, nurses increasingly became
legally accountable for their patients’
safety and well-being. This means that
the communication of orders isn’t the
one-way street it once was. The nurse’s
first duty is to the patient—not the doctor. His or her professional responsibility is as the patient’s advocate.
All hospitals have a chain of command that requires nurses to report concerns about patient care to the attending doctor first. If he or she fails to take
corrective action, the nurse must notify
a supervisor. Failure to do so may leave
the nurse legally accountable for any
harm the patient sustains.
This legal responsibility is recognized in Rowe v. Sisters of the Pallottine
Missionary Society. In that case, a nurse
failed to notify the nursing supervisor of
the patient’s inappropriate discharge.20
A man who was hurt in a motorcycle
accident and taken to the hospital was
treated and then ordered to be discharged from the emergency room.
Although a nurse noted that the man
had no pulse in his injured leg and asked
the emergency room doctor about it,
the doctor was unable to explain why
there was no pulse. The nurse did not
take action to prevent the patient’s discharge by initiating the chain of command, and the patient eventually sustained permanent paralysis in the leg
from an undiagnosed laceration to his
popliteal artery.
The chain of command varies from
hospital to hospital, depending on the
size and service of the facility. Regardless of the structure, to determine if
the chain of command was initiated,
the attorney would look for entries
reflecting repeated, unsuccessful
attempts to reach the physician as well
as notification of the nurse’s immediate
supervisor. In addition, there should be
documentation by the staff nurse that
the nursing supervisor responded and
intervened, and what resolution was
achieved.
Miscommunicated, misunderstood,
or forgotten information too often
leads to patient injury in hospitals. To
find out whether a communication failure caused your client’s injuries, you’ll
have to understand hospital policies
and procedures, the requirements of
medical ethics, and the impact of technology on information sharing among
health care providers. The investigation
Law Offices of
John Gehlhausen, P.C.
Over 17 years experience handling tractor rollover cases
HE GOT ONE BREATH...HIS LAST.
Riding lawn mowers are small tractors. They roll over.
And they kill.
For years, manufacturers have had Roll Over
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in preventing deaths and serious injuries, but most
fail to make these systems standard equipment.
They should.
The majority of these cases are won by the defense.
However, Attorney John Gehlhausen has successfully
represented heirs of people killed or persons injured in
these roll over accidents for over 17 years.
Law Offices of John Gehlhausen, P.C.
Available for co-counsel and referrals
1-800-933-3729
tractorlaw.com
