Duty of care A neighbour is a person so closely connected with and directly affected by (proximate to) my act (or omission) that I should have had them in mind when I committed the act (or omission).
In an emergency, wherever it arises, you must offer assistance, taking account of your own safety, your competence, and the availability of other options for care.
In an emergency, in or outside the work setting, nurses and midwives have a professional duty to provide care. When considering providing care in an emergency situation nurses and midwives need to remember that they are personally accountable for any actions and omissions in their practice and must always be able to justify their decisions. Therefore, if a nurse or midwife chooses to walk away from an emergency situation they could be called to account for this.
“ A doctor is not guilty of negligence if he acted in accordance with a practice accepted as proper by a responsible body of medical opinion ….A doctor is not negligent if he is acting in accordance with such a practice merely because there is a body of opinion that takes a contrary view”
“ With the increasing use of guidelines in clinical practice, they will probably be used to an increasing extent to resolve questions of liability. Those who draft, use and monitor guidelines should be aware of these legal implications”.
“ I always urge doctors when they depart from a NICE guideline to record in the patient’s notes at the time why they did so, because there is a general legal view that NICE guidelines will replace the Bolam test in medical negligence”
The defendant is only liable for damage that is of a kind which is reasonably foreseeable.
The thin skull rule
Causation issues in clinical negligence claims
Patients often already sick
Several different possible causes of illness
Recollections of staff and patients seldom coincide
Staff may be in conflict
Medical records often incomplete
Dependence on medical experts
Staff nurse Smith was under considerable pressure on a children's ward. A spate of very seriously ill patients being admitted and a few absences of staff had increased her workload and put strain on the ward. A junior doctor wrote up a four year old with suspected meningitis for a high dose of antibiotics and told the staff nurse he was prescribing a higher dose than was usual due to the severity of the condition. Normally Staff nurse Smith would have checked the dose in the BNF, but since they were so busy she took the doctors word for it and gave the higher than normal dose. The child went in to renal failure and died. Post mortem reveled the child had been given one thousand fold the normal dose.
Nurse Smith was working on a medical ward and was concerned that the kitchens had not sent up lunches. She telephoned the kitchens and was told that she would have to wait as there were no porters available. Rather than wait she decided to fetch them herself. She went into the kitchen passing a notice that said “no entry Kitchen staff only”. She went across to the serving bay. In doing so knocked into a cook who was removing a pan of gravy from the stove. The hot gravy splashed over the cook and Nurse Smith.