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Three Risk Areas Nurses Face in the Time of COVID-19

Friday, September 4, 2020   (0 Comments)
Posted by: Shanna Howard
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Stressed nurse looking out window

By Georgia Reiner, MS

Georgia Reiner, MS, is a senior risk specialist with Nurses Service Organization (NSO), the nation's largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. Texas Nurses Association endorses the individual professional liability insurance policy administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited.

The spread of COVID-19 (novel coronavirus) reinforces the dedication and selflessness of nursing professionals. This is a scary and uncertain time for everyone, especially nurses on the frontlines working tirelessly to help curb the spread of COVID-19 and balance an influx of patients.

As nursing professionals tirelessly work to provide the best care possible to their patients during a difficult time, they need to know the steps to take to mitigate the risks that can impact their license, career and reputation.

Three risk areas nurses need to have on their radar include social media, medication errors and unfamiliar assignments.

Using social media best practices

Nurses are held to a higher standard than others because of their role as caretakers and because they have intimate access to patients’ private information. Their social media presence should reflect this heightened responsibility, especially in this uncertain time. They must consider patients’ right to privacy and act professionally before posting.

As the media and social media are consumed by COVID-19 news, nurses may want to join in and share their thoughts or may be tempted to air their grievances. Online comments or statements made to members of the media by a nurse regarding employers or co-workers, even if posted from home during non-work hours, may violate their employer’s social media or media relations policies. Violations of employer policies may lead to employment consequences for the nurse, including termination. Nurses may want to think twice before posting or otherwise giving the appearance they are speaking on behalf of their employer unless authorized to do so and must follow all applicable employer policies.

Preventing medication errors

Nurses must continue to work to catch their own potential medication errors, as well as the errors of other health care providers in the medication administration chain. Research has found that the majority of medication errors result from human factors, including inadequate communication, biased reasoning, reduced memory, and insufficient training and inexperience. Nurses also identify distractions and fatigue as contributing to medication errors — factors that the COVID-19 crisis can exacerbate.

Since the beginning of April 2020, the Institute for Safe Medication Practices has received reports of COVID-19-related medication errors. One error involved a redeployed operating room nurse who administered the wrong type of inhaler after failing to engage unfamiliar barcode medication administration technology. Other missed dose errors have been reported due to communication failures between nurses and respiratory therapists.

To prevent medication errors and other adverse outcomes, nurses pulled to an unfamiliar unit should be oriented to the patient population, technologies, processes and medications typically used on the newly assigned unit. Nurses should also employ communication techniques such as a double-check or “check back” to verify they understand all verbal orders and instructions.

Preparing to accept unfamiliar assignments

Nurses are at the forefront of this public health crisis — treating, educating and preventing the spread of COVID-19. As the pandemic continues to evolve, nurses may be given patient assignments outside of their accustomed practice areas and locations. No circumstances change nurses’ obligation to practice ethically, but nurses should be aware of their employers’ protocols for protecting nurses operating in extreme conditions and scarcities, and to ensure that patients receive appropriate treatment and care as much as possible in the situation.

With so much still unknown about the coronavirus, it’s also important for nurses to be aware of the steps they can take if they do not feel equipped to handle an assignment. When the assignment is within a nurse’s scope of practice but not within their realm of experience or training, saying “no” could lead to dismissal. In these scenarios, nurses need to share their concerns with their supervisor or invoke safe harbor. Nurses should describe the task or assignment they don’t feel equipped to handle, the reason for their feelings, and the training they would need to be more confident and better prepared. Speaking up can lead to positive outcomes for nurses and patients.

These are trying times for health care workers. Being aware of potential risks helps nurses take steps to protect themselves as they care for others.

This information has been provided as an informational resource for Aon clients and business partners. It is intended to provide general guidance on potential exposures and is not intended to provide medical advice or address medical concerns or specific risk circumstances. Due to the dynamic nature of infectious diseases, Aon cannot be held liable for the guidance provided. We strongly encourage visitors to seek additional safety, medical and epidemiologic information from credible sources such as the Centers for Disease Control and Prevention and World Health Organization. As regards insurance coverage questions, whether coverage applies, or a policy will respond to any risk or circumstance is subject to the specific terms and conditions of the policies and contracts at issue and underwriter determinations.

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