The likelihood of a malpractice claim increases with a nurse’s years of experience, contrary to some expectations. There are several possible explanations and solutions.

• The average payout on claims also increases with experience.

• Experienced nurses should be encouraged to maintain their skills and education.

• Risk managers should use the data to alert experienced nurses to their risk.

Data on malpractice claims involving nurses indicate a somewhat surprising trend: The more experienced a nurse is, the more likely he or she is to have malpractice claims.

This may be attributable to several factors. They may get too comfortable in their environment and let their guard down, older nurses often take on more complicated cases, or they may be mentoring younger nurses, which can leave them vulnerable.

Years in practice at the time of the incident are associated with malpractice claims, says Jennifer Flynn, CPHRM, risk manager with the Nurses Service Organization (NSO) in Warrington, PA. The most recent NSO data indicate that none of the surveyed nurses who had been working for up to two years experienced a malpractice claim, she notes.

However, nurses who have been in practice for at least 16 years are more likely to have a claim, she says, and the largest average indemnity payment ($70,171) was for nurses in practice for three to five years. (The most recent research is available online at: https://bit.ly/2oYRfcB. It is updated every five years.)

“In addition to the increase in claims, we also see that the average paid indemnity increases with experience. Not only are we seeing increased likelihood to experience a claim as a nurse’s experience increases, but the payment made to that injured third party also increases,” she says.

The first likely explanation is that more experienced nurses are treating more seriously ill patients with complex care needs, Flynn says. They also may be taking on more patients than less experienced nurses and mentoring less experienced colleagues.

“If you ask a nurse who is more likely to be sued, they might say it’s definitely the newer nurse because they’re not as familiar with policies and procedures, or they’re taking longer with patients and not recognizing signs of distress as easily as someone who is more experienced,” Flynn says. “These results were interesting to us because it flips that mentality and says to the experienced nurse that because of all the things you might be doing in your unit, you are more likely to face a malpractice lawsuit.”

Risk managers can use this information to encourage more experienced nurses to keep up with trends in the industry and not rely on their years of experience to protect them, Flynn suggests. The NSO research also indicates that nurses who took continuing education and risk management courses had lower incidence of malpractice lawsuits, and the payouts on claims were lower, she says.

“The risk manager can encourage experienced nurses not to get complacent and to keep up with their continuing education, but if the nurse is going to be held accountable, then the healthcare organization needs to invest in those nurses’ training in the same way they would for nurses new to the practice,” she says.

Flynn also suggests risk managers might implement a peer review process to ensure that all nurses, including those most experienced, are compliant with policies and procedures, as well as best practices and clinical standards.


• Jennifer Flynn, CPHRM, Risk Manager, Nurses Service Organization, Warrington, PA. Phone: 215-773-4513. Email: jennifer.flynn@aon.com.