Malpractice Insurance: Do I need it?  

Our thanks to Ruthe Catolico Ashley, Esp., for providing the following answer.

Question: Do I need individual liability insurance if my employer covers me?

Answer: Yes, you absolutely do. Although you may have been discouraged from purchasing malpractice insurance by your risk manager or hospital attorney, it is likely that this individual did not wear both hats of nurse and lawyer.

Some lawyers set forth the argument that getting your own liability insurance would make you a "deep pocket" and more likely to be sued. Unfortunately, if you have been directly involved with any injury to a former patient who is now a plaintiff (the individual suing you for damages), it is highly unlikely that the injured plaintiff will care whether or not you have malpractice insurance. In most cases, the information regarding insurance is not available prior to the filing of a lawsuit anyway, and the plaintiff will name any party who may have contributed to his/her injury.

The main reason why each individual nurse practitioner needs to have individual malpractice coverage is because of the liability that attaches to every nursing act or nursing service provided when you are beyond the "scope of employment." This phrase simply means that you are not on the job as an employee or as an independent contractor, and you have not formed the PNP-patient relationship.

This covers all volunteer situations, emergency situations off the job, and any other time you respond as a nurse. Your employer's malpractice insurance provides a defense only when you are in your capacity as an employee. These are some of the situations where you may be liable beyond the scope of employment.

Imagine that your neighbor has a child that comes down with a high fever, vomiting and diarrhea. As her friend and neighbor, she asks you for help and your opinion. She asks you because you are a nurse, and you respond and perhaps provide services as a nurse.

As soon as you have responded as a nurse, you have voluntarily formed the nurse-patient relationship and you are now legally responsible for the care that you provide. Remember, you did not have the nurse-patient relationship before she asked and you responded.

Perhaps you are out to dinner with friends, and someone at the next table starts gasping and clutching his chest. As he falls to the ground, you quickly respond by checking a pulse and doing a quick physical assessment. It is clear he is having a cardiac arrest right there in the restaurant. You immediately respond as a nurse, clearing his airway and beginning cardio-pulmonary resuscitation. Again, you have voluntarily formed the nurse-patient relationship where none existed and now you are legally responsible for the care that you provide.

This is not to discourage you to stop responding in situations beyond the scope of employment. This is simply information to alert you of the legal responsibility that you incur once you respond as a nurse.

Because of this legal responsibility that attaches to everything you do as a nurse, it is of utmost importance that you purchase your own individual malpractice coverage for those 16, 14, or 12 hours of the day when you are not on the job and you still respond, act and speak as a nurse.