Education Resource from the Society for Endocrinology
R Wilson
Barrister, Belfast, Northern Ireland
Endocrine Nurses Training Course 9-11
September 2004
Wills Hall, Stoke Bishop, Bristol, BS9 1AE
Every nurse, in whatever area of practice they work and whatever their level of practice are personally legally and professionally answerable for all their actions and omissions. This includes what they write and don`t write and what advice they give or don`t give during the course of their practice.
Employers are vicariously liable for the actions and omissions of their staff, which means if something untoward does happen and a patient successfully sues for negligence, the Employer will pay the compensation and not usually the nurse. However this vicarious liability only extends to what a nurse is employed to do i.e. what is part of her job description, This means that the nurse who is intending to expand her role and work outside her job description (e.g setting-up and running a nurse-led clinic) MUST ensure that her Employer is involved in all aspects of her role expansion and agrees to add the new skills etc to her job description. In this way the continued vicarious liability of the Employer is assured.
The practising nurse is accountable in criminal law and civil law, to the NMC and to her Employer.
Nurses carry out many different procedures on patients but they have no legal right to touch any patient for any procedure ( except in excepted circumstances) without their “agreement” or their “consent”
This applies equally in nurse-led clinics where the nurse must obtain the proper consent of a patient before carrying out any procedure on them. The three essential elements of a valid legal consent are:
(I) That the agreement or consent is given voluntarily by the patient
(II) That the patient has the necessary mental capacity to understand what they are being asked to consent to and
(III) That they have been appropriately informed about the procedure
The nurse setting up and running a nurse-led clinic must have a full understanding of the law in relation to consent to ensure there is no breach of the patients human rights or no trespass to their person during their time at the clinic.
Every patient is entitled to confidentiality of the information obtained in the course of his pathway through a clinic. This is now a Statutory right under the Data Protection Act 1968 and the Human Rights Act 1998. The nurse setting up and running a nurse-led clinic must take all reasonable steps along with her Employer to protect the patients confidentiality, as far as possible, in a busy clinic. This means assessing the clinic and implementing such practices that aim to protect confidentiality which are reasonable and practicable in all the circumstances.
Every nurse is legally and professionally accountable for what they record or fail to record. Keeping records of the patients pathway through the clinic is a integral part of a nurses practice (Dimond 2002) and should not be seen as a distraction from it (NMC 2002)
Put simply, if a patient complains about the care they received at a nurse-led clinic or bring a legal action, the nurse will be relying heavily on what she had documented about that patients care, in an effort to evidence the care they received and to attempt to rebutt allegations of poor care or treatment.
When setting up and running a nurse-led clinic, great care should be taken to utilise time-efficient but also effective and comprehensive documentation and to ensure that all staff complete it properly.
The opinions expressed in this paper are those of the speaker and do not necessarily reflect the views of the Society