Case of Negligence in Nursing Who is At Fault

Claim of Negligence

In determining whether negligent care occurred, proper assessment is needed. This paper discusses the elements necessary for a case of negligence to be claimed. It then evaluates the case of the unstable child under the care of the new graduate nurse. Ultimately, the case centers on breaching duty of care and whether or not that breach occurred.

To determine if negligence occurred, four elements must be proved: duty, breach of duty, causation, and damages (Cheluvappa & Selvendran, 2020). In other words, to establish a claim of negligence, firstly, there must be a demonstration of a duty of care owed by the defendant (the care provider) to the plaintiff (the patient or patient’s family). In healthcare, this duty arises naturally from the professional relationship between the healthcare provider and the patient (Sand et al., 2022). The second element is a breach of this duty, where the defendant fails to fulfill the obligation to provide care that meets the standard expected of them. This breach is evaluated based on what a reasonable and prudent healthcare provider would do in similar circumstances.

The third element is causation, which requires showing that the defendant's breach of duty directly caused or substantially contributed to the harm suffered by the plaintiff (Wright, 2022). This involves establishing a clear link between the actions or omissions of the defendant and the harm that occurred. Finally, the fourth element is damages, where the plaintiff must demonstrate that they suffered actual harm or losses as a result of the defendant's breach of duty. Damages can include physical injuries or financial losses. Successfully proving all four elements is necessary to establish a claim of negligence and seeking legal redress.

The child’s family can assert a claim of negligence against the new graduate nurse; however, proving the claim is another matter. In this case, the new nurse had a duty to provide competent care to the child, as is standard in nursing practice. That much is clear. It is also clear, though, that the standard of care for a nurse is that the nurse needs to accurately assess and communicate changes in a patient’s condition to the healthcare team. The record shows that the nurse did this. In order to make a claim of negligence, the family would have to be able to show that the nurse had breached her duty by failing to notify the team. Yet, the record indicates that the nurse kept her charge nurse abreast of the situation and communicated with the physician by phone four times over the course of the night and that none of the doctor’s orders resulted in an improved condition. In short, the nurse did all that could be expected of her, so far as the standards of care are concerned. Everyone with seniority over her was aware of the situation. Awareness of a situation, however, does not necessarily mean that the team has the power to save a life if the situation is dire. The child’s condition was very unstable and everyone was aware of that. Negligence does not appear to have been a factor in the child’s death.

Likewise, establishing causation means proving that the breach of duty directly caused or contributed to the harm suffered by the patient (Radanovi? & Vukuši?, 2020). In this case, it would need to be shown that the delay in obtaining timely intervention from the physician contributed to the child's deteriorating condition and eventual death. Yet, the physician was informed four times, and none of the interventions helped. There is no evidence of delay of care.

The child's family could potentially assert a claim of negligence against the new graduate nurse, but the family would need to show that the nurse failed to meet the standard of care, and that this failure led to the harm suffered by the child. The hospital, for its part, could show that utmost care was taken to monitor the child, inform the team, and intervene insofar as was possible. With this record, the hospital would be able to show that the child’s death was due to illness—not negligence.

Would the physician’s knowledge of the child’s condition serve as a defense against a claim of nursing negligence, particularly because the new graduate had spoken to the physician four times? Yes, absolutely, it would. The nurse was informing the doctor and the charge nurse all along. It is assumed that this information was conveyed accurately and timely.

The charge nurse also had a duty to the child as did the physician. As a more experienced nurse, the charge nurse had even more responsibility than the new graduate nurse to make sure adequate care was given to the child and that the child was supported and supervised, especially given the unstable nature of the child’s condition. The charge nurse’s advice to the new nurse indicates an awareness of the seriousness of the situation, and shows that she recognized the need for immediate action.

Regarding the physician, his knowledge of the child's condition and the telephone orders issued could be used in his defense against a claim of nursing negligence, too. However, this would depend on whether the physician's orders were appropriate and if they were followed correctly by the nursing staff. The fact that the new nurse contacted the physician four times does show her attempt to seek guidance and follow medical advice.