Don’t sue me! 5 tips to stop it from happening

By Stephen W. Earnhart, MS CEO Earnhart & Associates Houston, TX

Most of us cringe at thought of someone suing us. How rude! But it does happen, and we all need to be reminded of what to do to protect ourselves.

In the healthcare industry, it seems like we have a big ‘ole bulls eye on our back and someone is just waiting for the opportunity to take our savings and our homes away from us because we messed up on something. Because of what we do and where we work, we are more prone to litigation from some event — much more so than if we worked in an office or some other profession. We need to have a better understanding of how to avoid it.

I am not an attorney, and I am sure they have much better advice, but I do have some practical and helpful ideas on how to avoid the whole mess:

Be friendly!

Strange as it sounds, people who like you are much less likely to sue you. Most of us have little time in the surgical area to get to know our patients. What is our interaction time? Thirty minutes? An hour? But during that timeframe is probably the greatest risk for something to happen to the patients that they feel was wrong, inappropriate, or harmful to them. They, or their families, are going to make it right in their eyes by suing us. Not every lawsuit is frivolous; some probably are justified, and we do not want to be caught in that trap.

Make an impression upon all patients, and treat them in a helpful manner.

Go out of your way to make them feel safe and secure. That is not sucking up; it is a big part of our job as caregivers. When the attorney is meeting with the patients and asking about details of whatever the event was that spawned the suit, you want that patient to say to the attorney, “Mary (you) was so nice to me, I don’t want her included in suit. She made me feel good.” Corny? You bet! But it is also true: It is difficult to sue someone you like or who did right by you.

Know your boundaries!

The greatest protection we all have is to practice and stay within our policies and procedures. The governing body of every healthcare organization dictates what we can and cannot do in our jobs. Read your policies and procedures. Make sure they are updated and that you understand what they mean. You have protection from liability if you stay within the guidelines of the governing body, which approved them. If you step outside those policies, you are on your own when and if something happens as a result of it.

For example, your policies procedures say that every patient must have a responsible adult drive them home after surgery. Your governing body approved that, so did your state, and so did your accrediting agency (The Joint Commission or AAAHC). But, a situation comes up when it is late and you have a patient that has been waiting for a long time in your recovery room for a ride home. You and everyone else want to go home. The patient, who was sedated hours ago, insists that he is fine and can drive home. “I just live just down the street,” he says. You say “OK, but be careful!” The patient crashes into another car and kills an occupant. (This is a true story). Who do you think the lawyers and the family went after? Know your rules and stick by them!

Work within the parameters of your job description.

It is OK to say, “Sorry! That is not in my job description!” You were hired to do a job based upon your skills, background, and education. If you think you can do more, have it added to your job description so you can rightfully perform those tasks. If your boss won’t add it, there is probably a reason, so don’t do it.

An example is transferring a patient. You were never trained to do it properly, but everyone else is busy, and you know you can move the patient from one stretcher to the other and save a lot of time for everyone. The patient falls between the table and the stretcher and breaks her hip. The number one question the attorney will ask you in front of the jury is, “When were you trained on the technic of transferring a patient off an operating room table sir?” Gulp!

Don’t work outside the scope of your license.

A big issue with nurses and other licensed professionals in the hospital or surgery center is doing things your state says you cannot do. Every state is different, so make sure you read and understand the regulations. Remember that the regulations change from time to time, and it is your responsibility to stay on top of them. There are many times when all of us have been asked to do something that we probably shouldn’t have in our job. Sometimes we are pressured by the surgeon or anesthesia to push a medication we know we are not authorized to do, or we are asked to do other things that there is no one else around to do. Often the easiest course is just to do it. You think nothing will go wrong, but if it does, you are on your own. Be careful.

The bottom line: Use your judgment when and if these situations come up, and act accordingly. Typically, if you did everything right and were just caught in a widely cast legal net that included everyone in the room or the facility (which often happens), you eventually will be exonerated because you acted accordingly and within the legal structure of your organization.

If you remember nothing else, try to stop and think, “Hmmm. How would I explain what I am getting ready to do to a jury?” [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates’ address is 238 S. Egret Bay Blvd., Suite 285, Houston, TX 77573-2682. Phone: (512) 297.7575. Fax: (512) 233.2979. E-mail: searnhart@earnhart.com. Web: www.earnhart.com.]