Malpractice claims are severe for nurse practitioners and can cause them to lose their nursing licenses and face financial ruin. Negligence is a common cause of a malpractice claim, so we’ll explain the different elements a claim needs to prove negligence against a nurse practitioner. Learn more about negligence to protect yourself from nurse practitioner malpractice suits.
Legal Negligence, Defined
Negligence, in a legal setting, is a term that generally describes conduct deviating from the standard of care expected from a professional such as a nurse practitioner (NP). While negligence and malpractice are similar and sometimes used interchangeably, they’re different legal terms.
Medical malpractice is the failure of a professional, like a nurse practitioner, to act with the prevailing professional standards. For example, a physician may misdiagnose a patient, or a surgeon could make an operating mistake. On the other hand, professional medical negligence against an NP must contain certain elements: duty to the patient, breach of duty, damages, and causation.
Elements of Negligence for Nurse Practitioners:
Duty to the Patient
If you’re a nurse practitioner and a malpractice case is brought against you, there’s a process the plaintiff has to follow. First, they have to prove the NP owed a legal duty to the patient. For example, an NP has a duty to monitor the patient and sometimes administer medication and other small but crucial tasks in a patient’s treatment plan.
An NP may also be responsible for monitoring a patient and alerting physicians and doctors should they become unstable in a reasonable amount of time. Before a malpractice negligence case can proceed, the plaintiff must first establish that there is a duty owed to the patient.
Breach of Duty to the Patient
Breach of duty is a common CRNA malpractice claim. Once the duty of the NP to the patient is covered, the litigant must prove that the NP breached that duty. These elements of negligence for nurse practitioners may be different, but they often go together as a plaintiff typically establishes the duty owed to the patient and the breach of that duty at the same time.
For a negligence case, the breach of duty may be that the NP failed to administer the proper medication to the patient or didn’t adequately monitor the patient and alert doctors when they became unstable.
Damages & Causation
Lastly, a negligence case against an NP must also prove that there are damages of pain and suffering to the patient and that the breach of duty outlined prior caused these damages. A court may find a breach of duty, but the damages and causes of those damages could be separate.
It’s also possible for a court to find a breach of duty but not any damage caused by the breach, which would mean a victory for the defendant. A plaintiff must prove a direct line from the NP’s breach of duty to the patient’s pain and suffering.
As a nurse practitioner (NP), you have the opportunity to work in a variety of healthcare settings and provide a wide range of services to patients. However, the scope of practice for NPs varies depending on the state in which you practice. Some states allow NPs to practice independently, while others require physician oversight.
In the healthcare community, there’s a debate about the scope of practice and independent practice for nurse practitioners (NP). In our guide, we’ll explain the basics of this discussion and break down the laws regarding the independent practice authority of NPs and the benefits of full practice authority to NPs and patients.
Scope of Practice for NPs
What does the scope of practice mean, and how does it apply to NPs? Scope of practice refers to the procedures, actions, and processes a healthcare professional, such as an NP, is legally permitted to do.
The scope of practice for an NP can vary from state to state, as each state has the legal authority to enact its scope of practice laws on healthcare professionals such as NPs. In all states, though, NPs have the scope of practice to assess, diagnose, treat, and manage illnesses by ordering, conducting, and interpreting tests or prescribing medication. The discrepancy from state to state involves the supervision of NPs.
Independent Practice for NPs
For NPs, independent practice allows them to provide care without the mandated supervision from a physician that some states require. An NP that works in a state with full practice authority can open their own practice and assess, diagnose, and treat patients in much the same way a physician might.
There are also degrees of independence that vary by state, and the debate of scope of practice vs. independent practice for NPs can be a contentious topic between NPs and physicians. There’s some friction among healthcare professionals because some states require NPs to compensate physicians for overseeing their work. Naturally, NPs prefer to be independent and not be on the hook for this expense.
Prescriptive Authority for NPs
Much of the discussion and debate on the independence of NPs revolves around the issue of prescriptive authority. Prescriptive authority is a health professional’s legal ability to prescribe prescriptive medication.
In all 50 states, NPs have prescriptive authority, but the degree to which they can exercise this authority without mandated physician supervision is where the debate between scope and independence hinges. NP advocates say the extra step of supervision and legal barriers is wasteful and only harms the patient through delays and expenses. In contrast, others claim that supervision is explicitly for the patient’s benefit.
State boards of nursing aim to earn the ability to regulate prescriptive authority instead of physician state boards, which is the situation in many states currently.
Practice Regulation for NPs
As we discussed, there are some discrepancies between states regarding the legal practice authority of NPs. The states are divided into three categories of varying independence—full practice, reduced practice, and restricted practice authority.
Full Practice Authority
There are benefits of full practice authority for nurse practitioners. In a full practice authority state, NPs can prescribe, diagnose, and treat patients without physician oversight. Full practice states allow NPs to establish and operate their independent practice as a physician may do in other states.
NPs can freely prescribe medication based on their education, training, and skills for a patient and also prescribe other health services like home care. As of this writing, around half the states (and Washington DC) have full practice authority laws for NPs, while the other half are basically evenly split between reduced and restricted laws.
Reduced Practice Authority
As its title suggests, reduced practice authority laws allow for some independence on behalf of NPs but limit their scope of practice in at least one area. The area that’s limited for NPs varies by state, but it’s most often in the area of prescriptive authority.
In most reduced practice states, NPs can still diagnose and treat patients, but physician oversight is required when prescribing medicine or health services.
Restricted Practice Authority
At the other end of the spectrum, the opposite of full practice authority is restricted practice authority states. Clearly, these states are the most restrictive and require that an onsite physician supervise NPs for the prescription, diagnosis, and treatment of patients.
While a handful of states still have restrictive laws, their number has diminished in recent years as most states are at least creating legislation to lax restrictive laws and move towards reduced practice authority instead of restrictive.
Benefits of Full Practice Authority for NPs and Patients
NPs are strong advocates for full practice authority and offer many arguments for why it would improve the healthcare system and provide better care for patients. We’ll explain some benefits of full practice authority that NPs cite below.
Greater Access to Care
Perhaps the primary benefit of affording full practice authority to NPs is that it allows for greater patient access to medical care. In many areas of the country, especially rural regions that are sparsely populated, physicians and doctors are scarce, and medical resources are stretched thin.
With full practice authority, NPs can open independent practices and treat patients as a physician would without legally requiring supervision from a physician. This independence for NPs means that patients will have more choices in the areas where they live in to provide more healthcare to areas that traditionally have few options.
Fill Personnel Shortages
Unfortunately, gaps in the American healthcare system regarding access to care in many places are due to personnel shortages. During the pandemic, healthcare personnel shortages became evident in many areas of the country as physicians and nurses were shorthanded in dealing with the influx of patients.
According to many experts, those personnel shortages are expected to only worsen as physician and nursing shortages are predicted throughout the decade. NPs can help fill the gap in personnel from these shortages, especially for physicians, by providing quality care and access to full practice authority.
Better Care to Patients
Many NPs also rave about the direct benefit to the patient when NPs are allowed full practice authority. As we discussed, full authority means patients have more options—which means less time waiting for appointments and quicker follow-ups.
Patients no longer have to drive hours in some parts of the country to see a physician or wait around for NPs to have their prescription orders confirmed by supervising physicians. Overall, full authority means a faster, more accessible, and better healthcare experience for many patients.
Conclusion
There are many other considerations when discussing practice authority for NPs, including nurse practitioner malpractice insurance, but overall, NPs would prefer the accountability and responsibility of independent practice rather than the restrictive supervision measures. If you have further questions about nurse practitioner practice authority or malpractice insurance, don’t hesitate to contact our expert staff at Baxter & Associates.
Are you about to start a chiropractic practice? Before you open your doors, reduce the risk of litigation and malpractice claims when starting your chiropractic practice with these simple but effective tips.
Start Small
Whether starting a chiropractic practice or any new business, it’s best to begin lean and small. As you acquire more patients and your practice expands, you can increase the staff, if necessary, but most practices only have a handful of employees anyway.
One of the most common mistakes for new practices and businesses is overreaching too early and extending resources and money too thin at the beginning. Start with the basics and expand from there if needed.
Keep Accurate Records
Thorough documentation is crucial to any medical practice. Chiropractic practices must maintain accurate and secure medical records to help reduce malpractice risk and better treat patients.
For medical practices, there are three options for documentation—old-fashioned paper records, electronic medical records, and more comprehensive electronic health records. Consider your staff and documentation capability before choosing one system for your practice.
Create a Positive Office Experience
Another way to ensure that your patients are happy is to create a positive office experience in your practice. Whether they interact with only you or multiple employees, patient personal interactions can significantly influence whether they seek a malpractice claim.
Pro Tip: Consider an automatic call distribution or voice mail system to provide immediate assistance or help to patients in an emergency.
Patients who feel mistreated or disrespected are much more likely to file a malpractice claim than those who had a positive experience with the staff. Simple things like courtesy and maintaining appointments can go a long way in reducing risk for practices.
Get Insurance
Perhaps the most effective way to reduce risk when starting a chiropractic practice is to ensure you and your employees are covered by insurance. Chiropractic malpractice insurance is essential for any medical practice in case of errors or misunderstandings during treatment.
Without adequate professional liability insurance, you may be financially responsible for paying out a malpractice claim against an employee or for a mistake you had nothing to do with.
Emphasize Communication
Communication is at the heart of many malpractice claims. Emphasize it for yourself, and the rest of your team is crucial to reducing risk. Clear communication between you and the patient, the patient to you, and the patient to staff are essential for a well-functioning practice.
Make sure the patient is clear on the treatment, its effects, and the goals of the treatment before proceeding. And make sure there are clear procedures and rules with staff about communicating clearly and effectively.
Certified Registered Nurse Anesthetists (CRNAs) fulfill an essential role in healthcare, but with that responsibility comes risks and consequences when mistakes happen. In our guide, we’ll go over some of the most common errors from CRNAs in their profession that cause malpractice claims against them.
We’ll explain how these errors happen and offer some strategies on how CRNAs can avoid risk.
Do CRNAs Get Sued Often?
Before we get into the errors that may cause malpractice claims against CRNAs, we have to ask: do they get sued that often?
Yes. It isn’t uncommon to be named in a lawsuit as a nurse anesthetist.
CRNAs are not shielded from litigation and are the targets of malpractice claims if the patient determines an individual mistake from the CRNA caused their pain and suffering. CRNAs are the most frequently sued nursing specialty. The number of CRNAs as defendants has steadily grown over the years, and experts forecast the litigation to continue as the number of malpractice lawsuits grows.
Common CRNA Mistakes That Cause Malpractice Claims
While CRNAs are not always the focus of malpractice litigation, some individual mistakes can get traced back to errors from CRNAs. In cases of these mistakes, CRNAs can become the target of litigation and held responsible for a patient’s suffering or even expiration. With that in mind, here are some common CRNA mistakes to watch out for.
Communication Problems
A common theme in many malpractice claims against CRNAs is that a lack of communication between the patient, CRNA, and anesthesiologist resulted in improper or inadequate procedures. CRNAs often have multiple patients to monitor, and most require extra care—some are in the preassessment stage, some are getting prepped for anesthesia, and others are in post-op observation.
With so many patients to juggle, it’s easy for things to get missed, lost in translation, or forgotten entirely. A common example of a communication problem is when a CRNA or anesthesiologist conducts a pre-anesthetic evaluation but doesn’t discuss findings with the other parties, resulting in a faulty anesthesia plan that harms the patient.
Improper Positioning
Another common error that CRNAs must avoid in their profession is unsuitable patient positioning during anesthesia and operation. During a procedure involving anesthesia, it falls on the CRNA and physician to position the body safely and harmlessly—sometimes for many hours.
Anyone who’s taken a nap on a couch understands that if your positioning is off for too long, you can wake up with a sleepy arm or leg. In procedures, awkward positioning can cause more lasting nerve damage and even loss of motor function in some cases.
Dental Damage
One of the primary duties of many CRNAs is to intubate patients. Intubation involves inserting a tube into a patient’s throat to ensure an open airway for breathing throughout the operation.
CRNAs may do this procedure thousands of times over their career, which is often a mundane task—but there’s still possible damage to the patient. One of the most common malpractice claims against CRNAs revolves around dental damage during intubation, where the patient’s teeth were accidentally chipped, cracked, loosened, or even knocked out.
Insufficient Assessment & Evaluation
CRNAs are also often responsible for performing the anesthesia preassessment, evaluation, and obtaining the patient’s informed consent. During these duties, it’s not uncommon for mistakes to get made, like a part of the patient’s history gets missed or the patient feels they weren’t fully informed before the procedure.
It’s the patient’s right to have the procedure explained to them, along with who will be performing it and their qualifications. It’s also the patient’s right to ask that only an anesthesiologist perform specific duties instead of a CRNA. There have been malpractice claims where patients felt they weren’t duly informed of the procedure or that they could request an anesthesiologist to perform certain tasks—resulting in the CRNA getting targeted for omitting important information.
Documentation Errors
Paperwork is vital to the job of a CRNA and everyone working in the healthcare field. Unfortunately, insufficient documentation is a typical reason for mistakes and for patients to file malpractice suits against CRNAs and other personnel.
If a CRNA fails to sufficiently update a patient’s documentation—like a patient’s history, physician’s orders, or medication prescription—it can have dire consequences later. Without all information, anesthesiologists and other physicians might administer harmful medication to the patient or perform dangerous procedures, making the CRNA liable for not updating the documentation correctly.
Neglecting Observational Duties
Much of a CRNA’s job is monitoring patients before and after administering anesthesia. Often, this observation is only prudent, and the patient recuperates painlessly from the procedure and anesthesia.
But, as we mentioned, CRNAs are often responsible for monitoring multiple patients simultaneously, and some can fall through the cracks with dire consequences. Suppose a patient begins to experience complications from the surgery or anesthesia, but the CRNA fails to notify the physician or help the patient in time. In that case, it can lead to more severe health damage or even death. In those cases, an investigation could find the CRNA responsible as their duty was the observation of the patient.
Strategies for Decreasing Risk as a CRNA
What can CRNAs do to decrease these risks and errors on the job? CRNAs are only human, so mistakes are bound to happen, but there are ways to help avoid and mitigate these risks as much as possible.
Obtain Informed Consent
Informed consent is at the heart of many malpractice claims against CRNAs—patients feel they weren’t duly informed of the dangers or the qualifications of personnel performing them. So, informed consent is an essential part of the preassessment process for CRNAs.
Ensure that the patient fully understands the anesthesia plan and knows their rights as a patient before consenting.
Have Malpractice Insurance
As we’ve said, mistakes happen—but when they do, they don’t have to cost a CRNA their career or financial security. That’s why CRNA liability insurance is essential for every CRNA.
Without proper malpractice insurance, CRNAs can have their entire financial future and career turned upside down because of one mistake or perceived error.
Avoid Burnout
Burnout is among the most common problems for nurses in healthcare, even CRNAs. Medical professionals can experience burnout from working long hours under stressful conditions and an imbalanced personal and work life.
When CRNAs experience burnout, they’re more likely to make mistakes, so mental health and wellness are also essential for CRNAs. CRNAs should do their best to maintain a healthy personal life outside of work, get plenty of rest, or even seek mental health counseling if they think it could improve their mental state.
If you have any further questions about malpractice insurance, don’t hesitate to contact our expert staff at Baxter & Associates. We can help you get the protection you need.
Insurance has so many terms and policies that it can be challenging to understand them all. That’s why we create these helpful guides to give regular people a clearer understanding of essential insurance terms and information.
In this guide, we’ll look closely at tail coverage, its benefits, and how important it can be to many professions, from physicians to lawyers. Keep reading to learn more!
What Is Tail Coverage?
Tail coverage is an addition to an insurance policy that protects a business or individual from liability or loss. After the policy expires or is canceled, the policyholders can opt for tail coverage, which acts as an extension of the policy.
Tail coverage is not a separate policy but more of a temporary extension—providing the same protection and coverage of the original policy for an extended period. It’s a temporary solution to a momentary loss of coverage and is ideal for people transitioning from one policy or insurance provider to another.
Types of Tail Coverage
Tail coverage can add to many different policies and industries. While it’s widespread for medical malpractice insurance, many other types of policies can incorporate tail coverage, including:
Errors and omissions
Employment practices liability
Data breach insurance
Management liability
Professional liability
From small business owners to law firms and physicians, many professions and industries utilize tail coverage for insurance protection.
Tail Coverage & Claims-Made Policies
In many cases of professional liability insurance, policyholders have two choices: claims-made and occurrence-based policies. Tail coverage is only suitable for claims-made insurance policies.
A claims-made policy is insurance that covers the policyholder for claims reported while the policy is active. The incident or claim must occur after the active date of the coverage and before the expiration date. Tail coverage can extend this time frame even though the policy officially expires, so any claim or loss after the claims-made policy expires is still covered.
Do I Need Tail Coverage for Occurrence-Based Policies?
What about occurrence-based policies—do I need tail coverage for that? Occurrence-based policies are more comprehensive than claims-made as they protect the policyholder indefinitely for any claim or loss that occurs while the policy is active.
For instance, even if an individual’s occurrence-based policy expired three years ago but a claim arose for an incident five years ago—when the policy was active—the individual would be covered. Tail coverage isn’t paired with occurrence-based policies because it’s unnecessary—how long the policy is active is irrelevant because it covered any claims or incidents when it was active.
How Long Should Tail Coverage Last?
The length of tail coverage varies from individual to individual. For many, tail coverage is like gap insurance—temporarily providing coverage for a short period in an insurance transition phase.
For that reason, tail coverage can be as short as a few months or weeks. It’s not uncommon for tail coverage to last for years—mainly for retiring policyholders. Whatever the individual needs, there’s typically a tail coverage available that suits their requirements.
Is Tail Coverage Expensive?
How much should a person expect to pay for tail coverage? It’s difficult to speak generally about the price of tail coverage because every insurance provider and individual with different extenuating circumstances vary regarding the policy and cost.
Typically, tail coverage comes with a higher premium than the initial policy because it’s an add-on and temporary coverage. Most policyholders can expect tail coverage premiums to be between 100 and 300 percent of the original policy’s final premium. It’s more expensive, so most policyholders only use tail coverage for short periods.
Tail vs. Nose Coverage
You may also hear the term “nose” coverage in professional liability and other insurance policies—is that the same as tail coverage? No, nose coverage (also known as prior acts coverage) is like tail coverage in that it’s an addition to an original policy. Nose coverage applies to incidents when the policyholder was covered by a previously terminated policy from a different insurance provider.
Even if you’ve switched policies or insurance providers, nose coverage provides the same protection and benefits of the current policy retroactively to when a different provider insured you. Like tail coverage, it adds more protection to the individual, but it’s retroactive instead of the future.
Why You Need Tail Coverage
Why does someone need tail coverage with their insurance policy? There are many reasons to consider tail coverage, but the most common are individuals looking to fill a gap in coverage or professionals who have recently retired.
Gap Coverage
While it’s ideal for a professional in healthcare, law, or any other industry requiring professional liability insurance to have complete protection, gaps can occur. Some of the reasons there could be a gap in professional liability coverage include:
An individual who is part of a group work policy decides to change jobs
An individual in a group policy leaves for an individual policy
An individual goes from one group policy to another
A policyholder switches insurance providers
There’s a gap between an expired claims-made policy and a new one
Whatever the reason, there are many instances where a gap between an old and new policy can occur. For many professionals in industries with liability insurance—like malpractice insurance for healthcare professionals—any gap in coverage risks their financial security and career.
No professional who can be hit with a malpractice lawsuit wants to leave anything to chance, even if it’s only for a few days. That’s why many professionals need tail coverage.
Retirement Coverage
Another common reason for tail coverage is to stay protected into retirement. Some retirees schedule their policies to end when they retire, but there’s still the risk of a loss or malpractice claim against individuals after they retire.
Tail coverage provides retirees with peace of mind and adequate protection should they face a loss or litigation after they’ve left their profession.
Now, you should know a bit more about tail coverage, its importance, and how it can benefit you. If you are switching insurance policies or providers or are near retirement, consider tail coverage to ensure you’re not vulnerable in a transition period of claims-made policies.
If you have further questions about tail coverage or any other professional liability or malpractice insurance matters, don’t hesitate to call the experts at Baxter & Associates.
In insurance, there are many phrases and terms that get thrown around that may be confusing to people unfamiliar with the industry. To help, we’ve put together a brief guide on insurance premiums and what they’re for so you can be more informed while shopping for an insurance policy.
What Are Insurance Premiums?
You have probably heard the term “insurance premiums” get thrown around a lot—but what are they, and what are they for? In essence, insurance premiums are the amount the policy owner pays for their insurance, whether home, auto, life, or another policy.
Insurance premiums can be paid monthly, semi-annually, or annually but are most often a monthly payment. If, for example, you spend $200 a month for a policy, your yearly insurance premium would be $2,400.
What Determines an Insurance Premium?
So, an insurance premium is a term for how much you pay for the insurance policy, but what determines how high or low your premium is?
Type of Coverage
There are obviously many different types of insurance and coverage—some are inherently more expensive and have higher premiums than others. For example, a standard auto insurance policy will have different insurance premiums than a professional liability policy from a malpractice insurance agency.
Amount of Coverage
What the policy covers significantly influences the insurance premiums along with the coverage type. The more extensive and comprehensive the coverage for your policy, the more you’ll have to pay in insurance premiums.
Plus, the value of what you’re insuring affects the premiums. Insuring a $200,000 house will cost less in premiums than a $500,000 home.
Deductible Amount
A deductible is an amount the policyholder pays out-of-pocket toward a covered claim. For example, even if your professional liability policy covers a malpractice litigation claim, you’ll still be on the hook to pay the deductible.
Most policies offer a range of deductibles for a policy, and, typically, the higher you pay, the lower the insurance premiums you can get. It’s a trade-off between how expensive a one-time payment is versus a series of payments.
Personal Info & Background
Of course, your background and info will also greatly influence how high your insurance premiums are. The greater the insurance company determines the risk of insuring you or your property, the higher your premiums will be.
If, for instance, you’ve been in multiple car accidents in the past couple of years, your insurance premiums will be higher than someone with a spotless record.
Now you understand a little more about insurance policies and insurance premiums. If you’d like to learn more about insurance or malpractice insurance, don’t hesitate to contact the experts at Baxter & Associates!
CRNAs play a crucial role in the health-care profession, and there are numerous benefits to the occupation. But there are also many challenges that CRNAs face in their profession. Current issues like burnout, staffing shortages, and training barriers are some of the responsibilities nurse practitioners face in their practice.
In our guide, we’ll take a closer look at the CRNA role, the responsibilities, what it takes to become one, and the current and future problems.
What Is a CRNA?
A Certified Registered Nurse Anesthetist (CRNA) has an essential job in anesthesiology. Surgeons and physicians administer anesthesia to a patient through intravenous drugs or inhaled gasses before performing surgery or a medical procedure so that they don’t feel pain.
The CRNA works with the anesthesiologist throughout the procedure. Some of the tasks a CRNA will do include:
Developing an anesthesia plan
Educating the patient on the anesthesia plan and procedure
Physically assessing the patient
Preparing the patient for the procedure
Assisting in the administration of the anesthesia
Supporting, positioning, and monitoring the patient during the procedure
Monitoring the patient post-procedure
As you can see, a CRNA has many serious responsibilities that will determine the well-being of the patient and the result of the surgery or medical procedure. While an anesthesiologist may develop a big-picture treatment plan for many patients, the CRNA is responsible for the daily tasks and monitoring of patients.
Where Do CRNAs Work?
CRNAs can work in any health-care facility that performs medical procedures or surgeries requiring local or general anesthesia. CRNAs work in:
Hospitals
Surgical clinics
Outpatient care centers
Doctor’s offices
Emergency rooms
Military facilities
How Do You Become a CRNA?
Joining the CRNA profession is a long and challenging process that can take nearly a decade of schooling, training, and working. First, an individual must become a Registered Nurse (RN) before becoming a CRNA.
Therefore, they must first obtain a degree in nursing or an associate degree and pass the National Council Licensure Exam to get an RN license. It typically takes two to four years for an individual to begin schooling and eventually obtain an RN license.
Once licensed, an RN will work to gain experience, typically for about a year, before entering a postgraduate nursing program. A CRNA postgraduate program will usually take two to three years, although some accelerated curriculums are faster by a few months.
After years of courses and clinicals, the individual can take the certifications exam from the National Board of Certification and Recertification for Nurse Anesthetists. Once passed, they receive their license.
The Benefits of Becoming a CRNA
As anyone can see, it takes a lot of commitment to become a CNRA, so what are the benefits of joining the profession? CRNAs are a growing career, and industry experts expect the demand for their skills and training to grow in the coming years.
Good Wages
There’s no doubt that some choose the CRNA profession because it’s one of the best-paying nursing jobs available. Various factors affect individual wages, but the median salary in the profession is around $180,000.
In more rural states and areas, like Wyoming or Idaho, demand is high for CRNAs, so the salary increases even more. The top wage for CRNAs hovers around $270,000 a year, so there’s a payoff for those years of school and training.
In Demand
The anesthesiology field already has a strong demand for capable and effective CRNAs, and industry experts predict that demand will continue to increase in the coming years. The US is an aging population, which means there’ll be a more significant proportion of older people in the coming years.
An aging population means more chronic conditions and comorbidities—ailments that require more surgical procedures and anesthesia. Over the next decade, CRNAs will be one of the most in-demand jobs in the health-care industry, which will lead to higher wages and better benefits.
Autonomy
Although CRNAs work hand-in-hand with anesthesiologists, they enjoy a lot of autonomy in their daily tasks and responsibilities. They don’t do their job with a supervisor breathing down their neck all day— they perform the bulk of the work on their own in many cases.
Many CRNAs say that one of their favorite parts of the job is the leeway they have to make decisions about treatment and patient monitoring. But is being a CRNA stressful? Like most health care professions, it is more physically and emotionally demanding than many other jobs.
6 Challenges CRNAs Face
It’s not all positive for CRNAs, though. There are still many challenges that CRNAs face in their profession, from staffing shortages to education barriers and more.
Burnout
CRNA burnout is real, and it’s perhaps the biggest challenge that CRNAs face is the mental and physical fatigue from the job. Burnout is not exclusively a CRNA problem—the entire medical profession deals with this dilemma, which the COVID-19 pandemic worsened.
According to the American Association of Nurse Anesthesiology, four out of every 10 CRNAs reported high levels of occupational burnout during the pandemic. Burnout amongst CRNAs means that more people are likely to change careers, retire, or make mistakes on the job due to physical or mental fatigue. The causes of burnout varies, but one culprit is a CRNA shortage.
Nurse Shortage
One of the principal reasons for burnout amongst CRNAs and the entire industry is the nursing shortage. A shortage of nurses was a problem for many areas of the health-care industry before the pandemic, and COVID-19 exacerbated the challenge.
Over the next decade, the health-care industry expects to have a shortage of nurses in numerous professions, including CRNAs. More nurses are leaving voluntarily or retiring, and because the education and training of CRNAs is such a long and arduous process, many people worry that there won’t be enough trained professionals to fill the gaps left open.
Increase Demand
While this shortage is occurring, there’s also an increase in demand for CRNAs. Many rural or impoverished communities are trying to expand their health-care capabilities, and CRNAs play an essential role.
But are there enough CRNAs to fill these roles? That’s one of the significant challenges facing the profession in the next decade.
Education and Training Barriers
As we laid out, it takes many years of schooling and training for an individual to become a CRNA. They have many crucial responsibilities, so education is necessary, but it presents a considerable barrier to growing the profession. After all, many people don’t have the time or money to spend six or eight years working toward becoming a CRNA.
Significant Responsibilities
Every day, a CRNA works with patients that could be facing life-or-death circumstances, depending on the setting and the medical procedure. Anesthesia can present many severe problems to a patient’s health if there are mistakes, which is why CRNAs and anesthesiologists undergo so much training and education. But it’s no doubt a challenge for CRNAs to have such drastic responsibility almost every day at work.
Malpractice Lawsuits
Nobody, not even a CRNA, is perfect. In fact, the issues nurse practitioners face happen in most other health care professions. CRNAs make mistakes like everyone else, but when errors happen, they can result in dire consequences, leading to malpractice lawsuits. Everyone working in the medical profession has to deal with malpractice claims, and CRNAs are no different.
That’s why CRNA liability insurance is necessary for all CRNAs to protect their careers and financial lives. Liability coverage ensures that CRNAs have a fair chance and won’t lose their career over a mistake. Contact us for a quote regarding malpractice insurance. To learn more about CRNA burnout, shortage, and other challenges, explore our blogs.
A nurse practitioner is an essential job in the health care industry with many responsibilities, but with those responsibilities comes risk. Nurse practitioners play a critical role in providing patient care and improving health outcomes. However, with this important role comes significant responsibility, including the need to mitigate risks that can lead to medical errors, malpractice claims, and other adverse outcomes. Medical malpractice claims are part of working in healthcare, so to help, we’ve put together a guide on the duties, malpractice claim reasons, and how to reduce risk as a nurse practitioner.
What Is a Nurse Practitioner?
Nurse practitioners occupy a vital role in the health care industry, and even if you don’t visit the doctor often or remember it, you’ve probably interacted with one before. They operate in a middle ground between physicians and nurses, taking on more primary care responsibilities than a registered nurse.
Nurse practitioners are helpful in regions with a high volume of patients or a low number of physicians. They can take some of the load off of physicians by administering primary care to more manageable patients and fill in communities where there aren’t many physicians for the residents.
Interesting Stat: Americans make over a billion visits to nurse practitioners every year.
Responsibilities of a Nurse Practitioner
A nurse practitioner has many responsibilities, with about 70 percent of them providing primary care for patients. In many areas in the country, a nurse practitioner is the closest thing to a physician a community can offer.
As part of primary care, nurse practitioners are responsible for:
Ordering, performing, and analyzing lab work and x-rays
Prescribing and administering medications
Diagnosing and treating chronic conditions (diabetes, infections, physical ailments, etc.)
Educating patients on healthy lifestyle choices
Managing overall patient care
That’s just a brief description of the duties a nurse practitioner can perform in their role. It also varies in the facility, other staff, and specialty they practice.
Areas Nurse Practitioners Practice
A nurse practitioner has a broad set of skills that apply to almost any specialty in healthcare. Some of the most popular practices nurse practitioners specialize in include:
Acute care
Adult health
Family health
Oncology
Pediatrics
Emergency
Do Nurse Practitioners Get Sued?
Can you sue a nurse practitioner? Although nurse practitioners may not have the same responsibilities for patient care as physicians, they’re still liable for their well-being, and patients can hit them with a medical malpractice claim. Nurse practitioners make up a small portion of malpractice claims, but they’ve been steadily rising since the early 1990s.
In a study analyzing malpractice claims between 1990-2019, nurse practitioners have steadily been named in a more significant percentage of lawsuits, even though paid malpractice claims have fallen by more than half in roughly the same period.
In 2019, 420 malpractice claim payments were made on behalf of nurse practitioners—the highest number on record. But, considering there are over 350,000 nurse practitioners in the country, it’s not exactly typical for one to get sued.
Cost of a Medical Malpractice Claim Against Nurse Practitioners
There may be a relatively low number of paid medical claims against nurse practitioners, but they’re still noteworthy and worth taking preventive measures against. The average cost of a paid claim against a nurse practitioner is over $350,000.
If you don’t have professional liability insurance for nurse practitioners, the cost of paying the claim could significantly hamper your finances and limit your career. Like anything else, it’s better to be safe than sorry with insurance.
Common Reasons for a Malpractice Claim Against a Nurse Practitioner
Since nurse practitioners perform so many duties and have so many responsibilities, the reasons for the malpractice claim can vary. However, most of the malpractice claims against nurse practitioners fall under the following categories, ordered from most common to the least common:
Medication-related allegations and errors have risen the most due to the ongoing opioid epidemic that damaged many parts of the country. In the previous decade or so, medication allegations have nearly doubled. Because nurse practitioners are responsible for prescribing drugs like opioids in many cases, they can be held accountable in some instances of addiction.
Medication Administration
The opioid epidemic has been one of the most significant and damaging developments in the healthcare industry in the 21st century. The over-prescribing of an opioid is a common complaint filed against nurse practitioners. However, such claims typically focus on the manufacturers and sellers rather than the physicians and nurse practitioners.
Medication-related allegations aren’t limited to just overprescribing. Sometimes the incorrect amount is prescribed to a patient, or a nurse practitioner prescribes them a drug they’re allergic to. Some claims are as simple as the wrong medication being administered to the wrong patient—basic errors that can slip through the cracks.
Diagnosis Errors
There are different kinds of negligence that can affect nurse practitioners and other clinicians. The most common malpractice complaint against nurse practitioners is diagnosis errors. As most nurse practitioners administer primary care, this means ordering tests, analyzing, and coming up with a diagnosis.
They’re rare, but mistakes happen, and sometimes an X-ray is misread, or a diagnosis takes too long, and it’s too late to give adequate treatment.
Risk Reduction Strategies for Nurse Practitioners
There’s a risk for nurse practitioners, but there are ways to reduce risk as a nurse practitioner against medical malpractice claims. Risk reduction strategies often come down to open communication with the patient and proper documentation.
Be Present With the Patient
A common refrain from patients about nurse practitioners—and physicians, nurses, and other medical professionals—is that they didn’t feel heard or understood. Nurse practitioners typically have a lot of patients, and when the waiting room fills up with anxious patients, it can get distracting and difficult to give everyone the time they need.
But it’s still paramount that nurse practitioners give the patient their full attention. Explain their diagnosis, treatment, symptoms, and medication as plainly to them as possible, and give them adequate space and time to ask questions.
Sometimes, a patient or family member wants to blame someone for a negative outcome, and if they feel they weren’t treated respectfully, they might choose the nurse practitioner.
Keep Thorough Documentation
Proper documentation is vital in health care—every nurse practitioner and medical professional knows this. It can be a chore, but you should never take shortcuts when promptly filling out proper documentation with precise detail.
The documentation gives us a clear, written timeline of the patient’s admittance, symptoms, treatment, tests, and other important information. Since most claims occur years after the patient’s treatment, this information is essential to understanding what happened. When your career and finances are at stake, you’ll be thankful you were as detailed as possible.
Make Personal Notes
Along with the official documentation, it’s not a bad idea to keep a personal log and journal of patient notes handy. In personal notes, you can be more detailed and add more info than may be needed on the patient’s documentation.
Especially if you feel a patient interaction was hostile or antagonistic, it’s a good idea to start keeping notes sooner rather than later, just in case.
Double-Check the Medicine and Patient
Over a day, a nurse practitioner can fill out and administer dozens of medical prescriptions. With such a high volume every day, mistakes are bound to happen—the wrong patient receives the incorrect medicine, or it’s the wrong amount, or even given at the wrong time.
It’s easy to become complacent, but the best advice to avoid these possible critical errors is to do what carpenters do—measure twice and cut once. Always double-check the drug, dosage, and patient to be 100% certain, even if it means losing a couple of minutes every day.
Insurance provides protection when we need it most. For example, medical professionals access their medical malpractice insurance in the event of a patient claim. What isa claims-made policy coverage trigger? Here is a brief overview of the insurance procedure.
Claims-Made Malpractice Insurance Policies
Medical malpractice insurance comes in two main types: occurrence and claims-made policies. You can read more about them here.Though both kinds of insurance require a triggering event, incident claims triggers mainly relate to aclaims-made policy. Claims-made medical malpractice insurance covers the insured when a patient makes a claim against their attending physician, CRNA, or another medical professional. A claims-made policy requires both the incident in question and the claim from the patient to occur while under the policy. Unlike occurrence policies, claims-made insurance sets the parameters a bit tighter to provide more accurate coverage.
The Place of Incident Claims Triggers
Triggers can vary in detail, but there are two main ways to initiate insurance action: written notifications and reported incidents. On the one hand, when a notification of intent or a notice of a claim arrives at an insurance company, they know the details and severity of the issue at hand. In response to the written communication, they will trigger your insurance policy. On the other hand, depending on the provider, if an insured notifies their insurer of a potential incident, this will also trigger the policy. Some insurance providers will not accept reported incidents as grounds for action, but here at Baxter & Associates, we take such information seriously. For example, our preferred CRNA malpractice insurance program includes the incident claims trigger benefit as well as several others.
How This Affects You
At the end of the day, the type of coverage trigger in your policy affects how your insurance takes effect when you need it. You want an insurance agency that will listen to your concerns and make funds available to you as needed. Make sure you know what to look for in a malpractice insurance provider. When you shop for insurance, ask agents whether they offer incident claims coverage triggers and what forms of notification the carriers they represent accept. This will give you an idea about their willingness to back you in times of duress.
What’s a claims-made policy coverage trigger? We can talk you through it. If you need medical malpractice insurance as a medical professional in any role, reach out to us at Baxter & Associates for more insurance information today.
When entering or developing your professional life, you must know the best practices as well as the potential pitfalls. While no one is impervious to ignorance or error, you should do your best to establish a firm vocational foundation. Here are the most pervasive CRNA career mistakes to avoid.
Overlooking the Professional Environment
The day-to-day work of health professionals involves life and death treatments for dozens of patients. While it is completely understandable that someone may become lost in the thrill and details of managing patients, it is important not to overlook your professional environment. Promotions, career opportunities, and professional development are less likely to come your way without direct effort on your part.
Ignoring Professional Development
A well-run workplace will offer professional development tools. If your hospital or office gives you an opportunity to develop your skills, learn new techniques, or keep up with your field of study, you must take advantage of it. Ignoring professional development is like landing a job and expecting nothing to change for the next 50 years. While you may know enough about your subject to do a good job, you won’t stay up to date on new software, medical breakthroughs, scientific research, and more. You shouldn’t lose sight of the tenacious student you were in nursing school and should nurture that instinct to keep learning and growing.
Dismissing Your Career Goals
When you entered your degree program, you fantasized about your career trajectory and thought about all the places you would go. As the months and years pass, these aspirations can fade, leaving you with a sense of stagnancy. While you cannot help the fact that goals change over time, you shouldn’t dismiss your career goals outright and leave them on the backburner.
Many working professionals lack the foresight to develop their career goals now. While it makes sense that long-term goals take time to mature and become fully realized, you must start somewhere, sometime. As a certified registered nurse anesthetist, you want to build a solid foundation for your future. This includes things like finding CRNA malpractice insurance. It’s essential for you to have coverage.Other considerations includeattending networking events, and completing more education, all with the aspiration of developing your professional life and achieving your career goals.
Underestimating Bedside Manner
How nurses interact with patients matters deeply. While doctors have a reputation for being condescending and dismissive—despite many being quite nice people—nurses are the backbone of personalized healthcare. Nurses spend time learning about patients and their lives, all the while attending to their daily needs and treatments. Bedside manner is critical for a nurse, but even more so for CRNAs who spend less time with patients and manage one of the most critical parts of a person’s procedure.
Talking Negatively
Your patients are in the hospital because something is going wrong with their bodies, and they need specialized attention. Just because you have a bad day or are in a professional slump, it does not excuse unbridled negativity, especially toward patients. Bedside manner is just as much about what you say as it is how you conduct yourself. Patients who hear you talking negatively about your work, your other patients, or your superiors will internalize this pessimism and translate it into fear—fear that their medical attention is subpar.
Talking negatively also reinforces your own feelings of frustration and leads to stewing emotions. While you may not acknowledge it in the moment, this internal turmoil can lead to mistakes when treating patients. And, as a CRNA, such errors can be costly or even fatal. Work on your inner dialogue and seek ways to find gratitude and positivity around you at work. If there are challenging situations or people eating at you inside, talk with an HR representative or trusted superior to work things out. Your career is intricately tied to who you are as a person. So, work on yourself to avoid painful career mistakes.
Treating Patients Inconsistently
Your patients may not communicate with one another, but you know your superiors will notice any discrepancies in your care. It is problematic enough to treat two different patients with alternate standards of care; it is even worse if you do so discriminatively. Mistreating patients due to personal prejudice against people of certain races, ages, or genders is downright illegal and could result in dismissal. Address any discriminatory behaviors you notice in yourself before they cause detriment to your career aspirations.
Disregarding Patient Concerns
Every patient has a right to know what you do with their body, especially during an operation where you put them under anesthetic. As a CRNA, you are responsible for keeping the patient informed about their anesthesiologic care every step of the way, including post-operation. If you disregard patient concerns or verbalized problems, you could be ignoring essential cues that something is amiss. Disregarding patient concerns and making patients feel unheard is terrible enough. Disregarding medically relevant information that results in injury or death is even worse. The quality of your bedside manner could truly mean the difference between death and life.
Remember these CRNA career mistakes to avoid as you work each day. You are the only one looking out for yourself and your career trajectory, so make every effort to dig into your professional life. It is always okay to make mistakes, just ensure you actually learn from them. It can help to keep these risk management tips in mind. When you make a career mistake, you may take one step back. However, you have the full capacity to take two steps forward and continue growing.
If you need help figuring out how to maximize your professional life in medicine and protect your career, reach out to us at Baxter & Associates to learn more about our malpractice insurance policies. To learn more about CRNA coverage, read here.
