Negligence is a risk in nursing.

http://www.extensionhealthcare.com/studying-alarm-safety/  The Joint Commission has set a goal for patient safety on alarm management.  After listening to the course which is the second in a series you can earn 1 free CEU.  Also go the the LinkedIn.com group - Health care Technology Safety Institute to ask questions regarding the topics presented.  There are many different kinds of patient alarms that eventually become tuned out by the nurses, thus it is necessary to gather data about the various types of alarms and categorize them according to level of urgency.

When the environment is charged with stress and noise it becomes important for nurses to recognize how their own behavior adds to the affray http://legal-dictionary.thefreedictionary.com/affray which means a verbal altercation or row.  Working in an environment where there is tension and lack of civility makes everybody anxious and issues should be addressed in a constructive manner.  First by talking with the person  with whom you are upset, directly with a courteous tone of voice and manner.  If you cannot talk about the issue then it has to be taken to a supervisor for guidance and documentation.  Hoping that the situation will get better on its own won't work.  Cynthia Clark RN, PhD of Boise State University defines civility as 'an authentic respect for others that requires time, presence, willingness to engage in genuine discourse, and intention to seek common ground.'  She asks why does so much incivility exist in the nursing profession?  You have a choice to respond to others in a way that produces a civil conversation or not.  This is part of the professional role.  Incivility can be conveyed through covert means such as eye rolling, sarcastic comments, intimidation and physical violence.  http://nurseinterupted.wordpress.com/2012/04/12/the-downward-spiral-does-it-apply-to-cyberspace/  Please read the full article 'The Downward Spiral: Incivility in Nursing,' by Cynthia Clark, RN, PhD, and Sara Ahten MSN.  

http://www.gofundme.com/RNneedsachancetowin  Amanda Trujillo RN needs your support with her legal fund as she defends her license.  Amanda is a strong patient advocate and if you go to the site and read her story you will most likely share the same feelings as many others - Amanda did the right thing for her patient.

Eileen M. Croke EdD;, ANP, LNC-C, Nurses, Negligence and Malpractice is an article which educates nurses about the kinds of situations where errors can occur leading to charges.  The following failures are listed from the article to highlight the importance of using this information.

'Standards of care: failure to adhere to standardized protocols or institutional policies (e.g. improper IM site;) follow physician verbal or written orders.

Equipment:  failure to follow the manufactures recommendations for operating the equipment or to check the equipment for safety; place equipment properly during treatment and learn how equipment functions.

Communication:  failure to notify a physician in a timely manner when conditions warrant it; listen to complaints and act upon them; communicate effectively with a patient (e.g. inadequate or ineffective communication of discharge instructions; seek higher medical authorization for a treatment.  

Documentation: failure to document a patients progress and response to treatment; patient injury; pertinent nursing assessment information (e.g. drug allergies;) physician medical orders; information on telephone conversations with physicians, including time, content of communication between nurse and physician, and actions taken.

Assess and Monitor: failure to complete shift assessment; implement plan of care; observe patients ongoing progress; interpret patients signs and symptoms.

Patient Advocate: failure to question discharge orders when a patients condition warrants it; question incomplete or illegible medical orders; provide a safe environment.'

 After you read this article 2 CEU hours are available to take on line.

www.bbc.com/news/uk-england-essex-25091938  Nurses as part of the team involved in the management of a patient who had a massive hemorrhage following the birth of a baby girl.  The team was unaware of a condition that the patient had that prevented her blood from clotting.  The registar, Dr. James Pennington told a hearing there was  'no discussion about getting more blood more quickly.'  The patient subsequently suffered a cardiac arrest and died.  If you look at the areas that a nurse will be held accountable, it is probably the case that negligence can be found in all of those listed above.  Communication is key and if the registar says that there was 'no discussion' about the need for more blood he is saying that he was not fully appraised of the patients clinical condition at the time.  

I am not a lawyer and hope that nurses will learn from this tragedy and read more about the legal aspects of nursing and how to respond in such a manner that provides safe patient care even if you have to seek higher authorization for treatment as patient advocate you are responsible for taking this step.

When it comes to Money - Money is important!  

Lenders for Student Loans can be switched on this site https://www.credible.com/ to help pay off student debt.  According to Suze Orman, current law states that student loans cannot be dissolved or written off in a bankruptcy.   Organizing your debts under one umbrella can help you become debt free.  https://www.readyforzero.com/auth#logout  Ready for zero is an online system for tracking your payments to creditors and your credit score.  Bankruptcy peaked in 2008 due to the recession.   Nurses who have had issues with their licenses have probably found it hard to get work and Suze Orman says it is better to file for bankruptcy and face the issue head on http://suzeorman.com/blog/the-good-thing-about-bankruptcy/  It is a difficult decision but will help you to move forward with your life and start your business. 

http://www.slatergordon.co.uk/media-centre/blog/2014/02/advice-on-how-to-approach-difficult-performance-reviews-at-work/  Performance reviews are given to document the goals that have been set by your employer with you and should not be a time for bringing up the unexpected.  In case you have problems with your annual review consult with a lawyer who specializes in employment law such as Caroline Phillips.  Nurses can benefit from being proactive and making sure that you get fair and appropriate treatment from your employer.

I encourage nurses to read and share information that will help you to deliver safe care.  If you do encounter a situation in which you end up with charges find a lawyer who specializes in license law and defend your license.  Stay tuned in to this on line community for support and join with others to meet in person so that you can network and share resources.  Follow your lawyers guidance and do not discuss your particular case with anyone as this information is solely between you and your lawyer.  Do let others know if you can recommend a particular lawyer and any other information that will help others adapt.

My very best wishes are with you as you defend your license and move forward with your life in business and earn the money you deserve.

Rita.