Nurses are known for being caring people who want to do what’s best for their patients. Unfortunately, good intentions do not protect healthcare providers from legal trouble or ethical dilemmas. All healthcare providers must be aware of different laws and know how to protect patient privacy and confidentiality while also protecting themselves from lawsuits.
Legal risks of nursing
For the most part, licensed nurses are well protected from patient lawsuits and legal problems that face hospitals. If nurses are acting reasonably, following hospital policy, and practicing within their scope, nurses should feel confident that they can practice nursing care.
Related: Legal Issues for Nursing Documentation, 4th Edition
Scope of practice
Nurses should always practice within the scope of their license. The American Nurses Association helps guide nurses on scope of practice questions and keeps them in compliance. If a nurse has a question about whether something is within their scope, they should ask their nursing supervisor.
It is appropriate to turn down any tasks or assignments that fall outside of your scope of practice. This might include making a diagnosis or performing an invasive procedure.
HIPAA and patient rights
HIPAA stands for the Health Insurance Portability and Accountability Act. It is a set of rules and regulations created to protect the safety of a patient’s health information while still allowing healthcare and insurance providers to use the information to create care plans and reimburse the patient and hospital for the cost of care.
Nurses can adhere to the standards of HIPPA by refraining from talking about patient information outside of work, only sharing medically necessary information with providers, destroying paperwork and report sheets in a shredder, and keeping their passwords protected.
Informed consent
Nurses have a responsibility to advocate for their patient’s physical, mental, emotional, and social health. No patient should ever receive a medication or undergo a treatment that they do not understand or agree with.
Occasionally, the care team and patient may disagree on the best course of action. Rather than trying to convince a patient what to choose, nurses simply provide information and education and let the patient decide for themselves. Coercing a patient or failing to obtain informed consent before a procedure is not only unethical, it can get the nurse into trouble.
Risks and benefits of electronic charting
Almost all healthcare facilities have moved away from paper charting and rely on electronic charting only. There are benefits and drawbacks to this type of documentation.
Related: Documentation in the Electronic Age for Nurses
Pros of electronic charting
- Real-time vital sign recording
- Record sharing between providers
- Password protected
- Eliminates problems with handwriting
- Improved safety with medication scanning
- Pop-up warnings and reminders
Cons of electronic charting
- Security breaches
- Limited charting or free texting options
- Software glitches and problems
- Incompatibilities between systems
- Fraud
Protecting patient privacy and confidentiality
Protecting patient privacy is an important part of building and maintaining a trusting relationship between the nurse and his or her patients. The American Nurses Association has released a statement warning nurses about the risks of electronic health records, information sharing, social media, and other technological advances that can put patient privacy and confidentiality at risk.
Nurses can overcome most of these risks by only sharing essential information with people directly involved in the patient’s care, avoiding conversations about work outside of the hospital, creating strong passwords and keeping them safe, and avoiding any patient interactions or posting hospital information on social media.
Professional guidelines for the use of social media
Social media is a tool that can bring people together and allow information sharing. It has become a place where people discuss everything from politics to cookie recipes, and some care providers are tempted to share patient information or discuss hospital events on their social media platforms.
As of 2024, over 80% of Americans use some kind of social media platform. Because social media use is so common, it can be easy for nurses and patients to find each other online. Some nurses, especially those who care for patients over long periods of time or who form close relationships with the patient and their families, may be tempted to connect via social media platforms like Facebook or Instagram.
As many as 15% of providers state that they would consider accepting a friend request from a patient. This is a risky move for both the healthcare provider and the patient. The Journal of Oncology Practice states that social media makes it difficult for patients and providers to maintain appropriate boundaries and that even posts that seem benign can put caregivers and patients at risk.
Professional boundaries and appropriate nursing care
Building a strong nurse-patient relationship is an important part of nursing care. Nurses interact with patients during some of their most vulnerable moments, and patients may share information about their past, their trauma, their family, and their lives that has little to do with their current care. While this can be helpful for the patient, it can be difficult for nurses to learn so much personal information about a patient and still maintain professional boundaries.
Nurses can use therapeutic communication to help the patients deal with strong emotions and trust their care team without sharing too much information about themselves. Strategies that nurses can use include:
- Active listening
- Seeking clarification
- Use therapeutic touch
- Find and share appropriate humor
- Rephrase what the patient says
- Present reality
- Share vague personal experiences
- Show empathy
Most importantly, nurses should remember that they are there to support the patient in their healing. Nurses can listen, educate, and empathize, but should avoid sharing too much personal information or details about their own life.
