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Last week, we went through details of the RaDonda Vaught conviction to provide some context for today’s discussion. This week, Kati interviews Lorie Brown, who is both a nurse and lawyer. She works to help nurses protect their licenses and offers her legal perspective on this case as well as why professional liability insurance is a must for nurses.
But first, I do want to add a few pieces of information I have learned since publishing Part 1.
- Glen Funk, Nashville DA, is a professor of law at Vanderbilt University. This is an interesting connection to the case, and it’s been pretty clear that Vanderbilt Medical Center will not face disciplinary action outside of policy changes that were a response to the CMS surprise investigation (SOURCE).
- In the previous post, there was an important typo that has been corrected. I inadvertently wrote the radiology technicians in the PET scanner could administer and monitor the patient after being medicated. This was an error in my transcription; it now reads they cannot medicate or observe patients.
- Shared Governance was changed to the more updated term of Professional Governance.
- The patient went down to Radiology unmonitored, but for certain stable patients, this was a standard acceptable practice.
Now, let’s get into the main points of the interview with Lorie Brown, RN MN JD!
For Lorie’s full bio, click here.
Nursing Professional Lability Insurance
It is important to have your own professional liability insurance. This is separate from your hospital’s coverage (more on that soon).
There is professional liability insurance for nurses, but it is not all created equally. You want to ensure whatever coverage you purchase includes professional licensing defense.
So, what’s a professional licensing defense for nurses in terms of insurance?
Essentially, this would cover the cost of legal representation (a lawyer) if you find yourself under disciplinary action by the board of nursing in your state. Traditional nursing liability insurance may cover things like legal fees, defense costs, settlements, and loss of income if having to be deposed or attending a trial. But often these policies do not cover legal representation in front of your board of nursing.
Examples of when this would be necessary
Let’s say you got sued by a patient for malpractice. Maybe you committed a med error by programing a pump incorrectly. The patient’s family sues you. You would need legal representation for this.
Let’s say that med error also gets reported to your state board of nursing as well. The board decides to have a disciplinary hearing about you and your license. You would also need legal representation for this situation as well, ideally from lawyers experienced in dealing with departments of professional regulation. However, not all liability insurance for nurses has coverage for professional licensing defense.
While many of us think we’d never get disciplined/we’re too careful to end up in front of a professional disciplinary committee, here are some of the most common reasons for complaints against nurses (according to this law firm’s website):
- Unprofessional conduct. This would be things like falsifying patient records, or documents. Essentially actions that can deceive or defraud the public would fall into this category.
- Criminal convictions. While not common, it is still possible. Most felonies and misdemeanors fall into this category.
- Unsafe practices. If you provide care that is reckless or below the accepted standard of care
- Inappropriate use of substances. You may find yourself working impaired, diverting drugs, or the subject of an investigation.
- Unethical practices include harassment, discrimination, inappropriate sexual relationships with patients, breeching confidentiality, and more.
You may also need legal representation if your application to the board of nursing for a nursing license is denied. If you’re ever in front of the board of nursing in a disciplinary capacity, it is wise to have legal representation – even if you don’t think you have anything to hide.
Remember, anyone can file a complaint and they must investigate all complaints.
Where to get this insurance
NSO was highly recommended by Lorie.
Full disclosure: They do partner with the American Association of Nurse Attorneys, an organization Lorie is a part of. Granted, they are a partner of many professional nursing organizations as well. However, she is a big proponent of this insurance policy because it carries a professional licensing defense.
If you have homeowners’ or car insurance, that company may also offer professional liability insurance policies. However, ensure that they also cover professional licensing defense before purchasing.
Lorie recommends searching online for your state + “state department of insurance carriers for nursing malpractice”. So, for example, “New York State Department of Insurance carriers for nursing malpractice”. Just make sure you get one that has a professional licensing defense included!
Your hospital’s coverage isn’t enough
Some hospitals will tell nurses not to get their own insurance, saying they’ve got insurance policies that cover their employees.
However, as Lorie discusses in the interview, what if your hospital’s version of what happened doesn’t align with yours? What if it’s a he-said-she-said situation with a highly regarded surgeon at your hospital, and they’re taking the surgeon’s side? You likely would not have coverage at all in that instance if they’re wanting you to absorb all blame and accountability for an error.
And even if the hospital doesn’t blame you for something and does cover legal representation for a civil case and settlement, they likely are not going to cover any legal representation for professional licensing defense if you’re under discipline by your state board of nursing.
Another recent prominent case of a nurse with criminal charges
In our interview, Lorie mentions a few other cases involving nurses and criminal charges and I wanted to list them here.
Christann Gainey (2018 indictment, 2022 sentencing) – She was an LPN at a senior living facility. A patient fell and hit his head. He was supposed to have routine neuro assessments after the fall. Gainey documented that she completed the checks, but video surveillance showed that she was nowhere near the patient during the times she documented her neuro checks for him. CPR was not performed on him when he was found unresponsive in the hallway.
She was originally charged with neglect of a care-dependent person, involuntary manslaughter, and tampering with records. She plead guilty to neglect of a care-dependent person and tampering with records. She was sentenced to 6-months of house arrest and cannot seek reinstatement of her LPN license or work in a care facility/home during her 5-year supervision period.
This case hasn’t made quite as many headlines, but that could be due to the fact that it didn’t go to a jury trial as the Vaught case did.
Resources and Encouragement from Lorie
While all of this seems pretty scary and intense, it is still possible to be able to safely practice as a nurse without constantly worrying about criminal charges due to errors.
Again, Lorie highly recommends good nursing malpractice insurance with professional defense coverage.
Next, know your state board of nursing’s State Practice Act. You can click here to find your state practice act. These can get quite technical, so it’s important to do your due diligence and know what’s expected of you as a licensed professional nurse in your respective state.
And finally, practice diligently. Often, cases that involve criminal charges against a nurse involve pretty serious instances of neglect or practicing far below the accepted standard of care for the patient population.
Therefore, that means that you’re not skipping safety steps, not documenting something you didn’t actually do, advocating for safe processes in your unit, and recognizing when you’re working in an unsafe environment that is putting your professional license at risk.
As Lorie stated,
“You can get a new job, but you can’t get a new license.”
She is a big advocate for getting a mentor who is a registered nurse, but who doesn’t work on your unit/in your area. You might not realize that the accepted culture in your unit is doing something completely unsafe that you wouldn’t think to question. Therefore, having another professional’s perspective can be invaluable when you’re talking through situations.
I am very excited to share with you that Lorie is coming out with a brand-new book on May 9th called What They Don’t Teach You in Nursing School. She’s going to go over a lot of the legal aspects of safely practicing as a streetwise and knowledgeable bedside nurse.
I’ll make sure to post when her book goes live, as she’s going to have it discounted to only $0.99 for the first 24 hours of release, then it will go up to its normal list price of $24.99. It will include two bonus chapters: One on nursing in a pandemic, and another on starting your own business.
In the meantime, Lorie has an amazing video series specifically for new nurses that discusses important legal considerations and ways to protect your license, which even includes an ebook! When you get on her email list, you get immediate free access to these outstanding resources. Click here to sign-up.
After you get access to your free video series and ebook, you’ll then get weekly tips and advice to become empowered.
A major, major thank you to Lorie for the interview, and for all that she does with nurses to empower and support them!
More Resources on Professional Liability Insurance
- Deep Dive: RaDonda Vaught Trial, Charges, and Timeline (Part I)
- Protecting Your License (video seriers from Lori Brown)
- Law and Order for Nurses: The Easy Way to Protect Your License and Your Livelihood