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Dedicated to Serving the Insurance Needs of Nurses Since 1976™

The NSO Risk Advisor is published as an added benefit for the insurance customers of Nurses Service Organization. The Risk Advisor shares articles of interest, answers to frequently asked questions and actual case studies. Our panel of experts in nursing, insurance, and law comment on how you can minimize your professional liability risks.

2017 NSO Risk Advisor


2017 Nurse Edition

 Featured Article: Creating Inclusiveness for Transgender Patients


As a nursing professional, you’re committed to delivering optimal care to all patients as part of your legal and ethical responsibilities. Fulfilling that commitment requires you to understand the unique needs of various patient populations, including those who are transgender. Failure to deliver proper care to transgender patients not only puts you in opposition to nursing ethical principles, but can leave you liable for legal action.



2016 NSO Risk Advisor


2016 Nurse Edition V2

 Featured Article: This case study involves a nurse practitioner working as a forensic nurse in an emergency Summary department.


A 40 year old female (patient/plaintiff) presented to the emergency department after being sexually and physically assaulted. According to the healthcare record, the patient was working alone at a wireless telecommunication store when a male came in the door with a knife in his hand. He physically and sexually assaulted the patient for over an hour before leaving. Shortly after the assault, the male was arrested a few blocks away from the store.


2016 Advanced Practice Nurse Edition V2

Featured Article:This case study involves a licensed practical nurse working in the patient’s home.


The one year old minor patient had a history of extreme prematurity and had been cared for in her home by her mother and, for sixteen hours daily, by nurses who provided ventilator care, tracheostomy care, tube feedings, and prescribed medications. The patient had experienced multiple hospitalizations for episodes of respiratory distress and difficulty in replacing the tracheostomy tube, with the most recent episode occurring one day prior to the event at issue.

2016 Nurse Edition V1

 Featured Article: This case study involves a nurse working as an occupational health nurse.


Our insured registered nurse (defendant) was employed in a healthcare setting working as an occupational health nurse. While she was in the cafeteria during her lunch break, she was approached by a 42 year old, maintenance employee (plaintiff) complaining of a headache. She instructed the employee to come to the occupational health office after lunch and she would give him some over-the-counter medication.

An hour later, the employee came to the office stating that his head was hurting worse and he felt nauseated. He had been working on air condition units in an older part of the building which was known to have mold and dust. He contributed the dust and mold to the cause of his headache. The patient/ employee seemed in a hurry when he entered into the office, so the nurse bypassed assessing him or ascertaining about a medical history and instead gave him medications. She gave him 500 milligrams of acetaminophen and 25 milligrams of Benadryl® and told him to go home and rest. The employee thanked the nurse and left the office to take her advice of going home early from work to rest. This is the last contact our nurse had with employee.


2016 Advanced Practice Nurse Edition V1

Featured Article:This case study involves a nurse practitioner as an owner and treating practitioner in a family medical office setting.


Our insured family nurse practitioner (defendant) was the primary provider of a 67 year-old male patient (plaintiff) for various medical conditions including diabetes, Crohn’s disease and hypertension. He had a 50 year history of one to two packs-a-day cigarette smoking habit and for the past 40 years he admitted to being a “heavy beer drinker.” Our insured NP was his primary treating provider for five years after he was discharged from his previous primary medical provider due to non-compliance with his chronic illnesses and abusive statements to the former provider’s office staff. The patient claimed that he had issues affording medications and this is the reason for his non-compliance, but offered no explanation for his abusive behavior.



2014-2015 NSO Risk Advisor

2014-2015 Nurse Edition

 Featured Article: Caring for Aging Patients


A nurse working in a long-term care facility replaces a resident's gastric tube without an order and without notifying the nurse practitioner, who is the resident's primary care provider. The resident subsequently develops sepsis and dies. A nurse working on a medical/ surgical unit in the hospital fails to fully assess a 76-year-old patient who complains of abdominal discomfort. The patient has frequent complaints, and the nurse dismisses this latest as "gas." Unfortunately, the patient has a perforated ulcer and requires extensive surgery. These two cases would likely result in litigation, illustrating the legal risks associated with caring for older patients. As members of a vulnerable population, juries are likely to be highly sympathetic toward older plaintiffs. Fortunately, you can take steps to safeguard yourself.


2014-2015 Advanced Practice Nurse Edition

Featured Article: Evidence-based practice protects against litigation


You're a nurse practitioner (NP) in a primary care practice assessing Mr. Smith, a 66-year-old man who is new to the practice. Mr. Smith, who suffered an anterior wall myocardial infarction (MI), was discharged 3 weeks ago from the hospital. The steps you take to manage Mr. Smith's care will contribute to his short- and long-term outcomes. If you base those steps on the latest evidence, you'll also cover yourself from litigation if an unfortunate event occurs. Evidence-based practice (EBP) is a problem solving approach that encompasses research, clinical expertise, and patient values and circumstances. Advanced practice nurses (APNs) should use information from these three components to make informed decisions that are in the best interest of their patients. Integrating EBP with your practice will improve patient care and reduce your risk for legal action.

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