Speaking Topics

Playing God in Critical Care - Adult & Peds

Despite the emergence of hospice & other palliative care programs, it remains true that for most people, they will die in a hospital or nursing home setting. For those individuals who die in the hospital, most will have suffered from an acute illness where advanced technological interventions including intensive care, mechanical ventilation, and major surgical procedures are the presumed modality for "treatment." Often times, these interventions provide a limited chance of success at best, and may only prolong the inevitability of the patient's death, while causing undue suffering. Who decides whether such medical treatment is appropriate when the goals of prolonging life & alleviating pain & suffering do not coincide? Must all life, no matter how compromised, be maintained if it is technologically possible? Conversely, can a health care provider deny care that is medically futile except in the nature of comfort or palliative care?

Highly publicized legal cases and developing legislation have had dramatic effect on clinical care, redefining medical & social responsibility to the dying patient. These legal developments underscore the need to promote respect for patient autonomy, advanced care planning to insure proper informed consent, and in cases of refusal, facilitate an environment for a peaceful death. This presentation will bring into focus the overlapping legal & ethical implications involved with end-of-life decision making. Discussion of the debate in public policy will highlight the areas of concern and confusion, and case studies will illustrate what is, and is not, legally permissible.

The Trauma & Drama of a Nursing Malpractice Lawsuit

Attendees will participate in a mock trial involving pediatric, emergency, and/or critical care nursing related issues. Prior to the mock trial, a series of case studies will be discussed to educate attendees on the legal issues involved in nursing malpractice cases and will provide the backdrop for the issues that will be illustrated by the mock trial. The expanded role of nurses and the increasing demands placed upon them in the care and treatment of patients has led to concomitant expansion of legal liability for malpractice. Historically, liability for treatment issues fell primarily upon physicians and nurses were perceived largely as ministerial. However, with the responsibility of patient care assessment, planning & management increasingly being undertaken by nurses, and the demands brought about by the effects of managed care, there is a much greater potential for malpractice claims. The inherent difficulties caused by reductions in force policies and/or hospital restructuring only exacerbates the problem and creates great potential for liability. Unfortunately, whereas most states restrict damage awards against hospitals that are charitable institutions, there is no similar limitation for individual care providers, including nurses, if liability is assessed.

Through case presentations, events that commonly result in legal action will be illustrated. This presentation will instruct the nurse on preventive measures that can limit potential exposure. Analyzing these events is essential to understanding the liability issues that place nurses at risk. Furthermore, practical tips regarding documentation when every second counts and necessity of individual malpractice insurance will be discussed.

At the conclusion of this interactive program members of the audience will participate in a presentation of a malpractice trial brought against nurse in critical care, emergency, or pediatric nursing. This mock trial, designed to be both educational and entertaining, will illustrate the concepts that have been discussed during the day's program and highlight the common issues that occur in nursing malpractice cases.