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Nurses are required to decline assignment to patients that they can't safely and competently care for Contact Now

Not every nurse is qualified to take care of every patient, but some hospitals seem to ignore this fact

Nurses are required to decline assignment to patients that they can't safely and competently care for

“The luck of the draw.” Based on years of handling medical malpractice cases for plaintiffs at Painter Law Firm, I’ve concluded that it’s sometimes the luck of the draw on whether a hospitalized patient is assigned a competent, qualified nurse.

Just yesterday, I took the deposition testimony of a registered nurse who has been an employee for over 20 years at a well-known hospital in Houston’s Texas Medical Center. She worked as a nurse on an orthopedic surgery floor. My client had a lumbar neurosurgery that was complicated by an incidental durotomy, or damage to the protective lining around the spinal cord.

Near the beginning of her deposition, this registered nurse blurted out that the patient “should have been on the neuro floor.” She explained that her floor, an orthopedic unit, sometimes handled overflow for the neuro floor. Our clients had told us the same thing months ago. They also shared that a nurse told them that there was no room on the neuro floor because of construction, but reassured them that nurses on the orthopedic surgery floor were completely trained and competent to handle the patient.

It’s terribly sad that my client will suffer lifelong problems because of an error by a nurse on a unit where he probably should’ve never been admitted after a neurosurgical complication occurred. We’re  currently investigating why, if the neuro floor wasn’t available, they didn’t admit him to a higher level of care than a general orthopedic floor. There were several options, including the intensive care unit (ICU), neuro ICU, and various intermediate care units.

As I progressed through the deposition and questioned this nurse on her experience in handling complications of neurosurgery, it was clear to me that she was growing uncomfortable. I decided to ask her if she thought that she had the preparation, experience, and knowledge necessary to safely treat this patient. Incredibly, and much to the chagrin of the hospital’s attorney sitting next to her, she admitted, “No.”

I have no doubt that this experienced registered nurse was qualifid and competent to take care of other types of patients, but not this one.

According to Texas Board of Nursing Rule 217.11, all nurses shall accept only those nursing assignments that take into consideration patient safety and that are commensurate with the nurse’s educational preparation, experience, knowledge, and physical and emotional ability.

In other words, when nurses feel over their heads with a complex medical condition or patient, they are required to refuse the patient assignment. Hospitals aren’t permitted to retaliate under the circumstances when a nurse puts patient safety ahead of administrative or scheduling convenience.

What you can do

Any time you’re hospitalized, I recommend learning more about your nurses through casual conversation. Find out where they did their training. Ask how long they’ve been a nurse and if they enjoy it. Discuss your particular condition and see if they have treated patients like you before. Ask if they have any advice or ideas for you from that past experience.

Based on this information, you can develop a comfort level (or lack of one) with the competence of the nurse who is providing your bedside care. Remember, nurses are independent licensed practitioners who conduct their own assessments and reassessments, and are required to report important findings to the attending physician. Just as would be the case in any other career, inexperienced nurses often don’t know what they don’t know.

If you find yourself in that situation, ask to see a charge nurse or nurse supervisor so you can explain why you need position notification or additional care.

If you’ve been seriously injured by poor nursing, physician, or hospital care, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for help in evaluating your potential claim.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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