5.5 Protecting Your Nursing License
You have worked hard to obtain a nursing license and it will be your livelihood. See Figure 5.7[1] for an illustration of a nursing license. Protecting your nursing license is vital.
Actions to Protect Your License
There are several actions that nurses can take to protect their nursing license, avoid liability, and promote client safety. See Table 5.5 for a summary of recommendations.
Table 5.5 Risk Management Recommendations to Protect Your Nursing License
| Legal Issues | Recommendations to Protect Your License |
|---|---|
| Practicing outside one’s scope of practice |
|
| Failure to assess & monitor |
|
| Documentation |
|
| Medication errors |
|
| Substance abuse and drug diversion |
|
| Acts that may result in potential or actual client harm |
|
| Safe-guarding client possessions & valuables |
|
| Adherence to mandatory reporting responsibilities |
|
Culture of Safety
It can be frightening to think about entering the nursing profession after becoming aware of potential legal actions and risks to your nursing license, especially when realizing even an unintentional error could result in disciplinary or legal action. When seeking employment, it is helpful for nurses to ask questions during the interview process regarding organizational commitment to a culture of safety to reduce errors and enhance client safety.
Many health care agencies have adopted a culture of safety that embraces error reporting by employees with the goal of identifying root causes of problems so they may be addressed to improve client safety. One component of a culture of safety is “Just Culture.” Just Culture is culture where people feel safe raising questions and concerns and report safety events in an environment that emphasizes a nonpunitive response to errors and near misses. Clear lines are drawn between human error, at-risk, and reckless behaviors. [8]
The American Nurses Association (ANA) officially endorses the Just Culture model. In 2019 the ANA published a position statement on Just Culture. They stated that while our traditional health care culture held individuals accountable for all errors and accidents that happened to clients under their care, the Just Culture model recognizes that individual practitioners should not be held accountable for system failings over which they have no control. The Just Culture model also recognizes that many errors represent predictable interactions between human operators and the systems in which they work. However, the Just Culture model does not tolerate conscious disregard of clear risks to clients or gross misconduct (e.g., falsifying a record or performing professional duties while intoxicated).[9]
The Just Culture model categorizes human behavior into three categories of errors: simple human error, at-risk behavior, or reckless behavior. Consequences of errors are based on these categories.[10] When seeking employment, it is helpful for nurses to determine how an agency implements a culture of safety because of its potential impact on one’s professional liability and licensure.
Read more about the Just Culture model in the “Basic Concepts” section of the “Leadership and Management” chapter.
- “aid9688616-v4-728px-Get-a-California-Endorsement-for-Your-Nursing-License-Step-11.jpg” by unknown is licensed under CC BY-NC-SA 3.0 ↵
- Nurses Service Organization (NSO) and CNA Financial Corporation. (2020). Nurse professional liability exposure claim report: 4th edition: Minimizing risk, achieving excellence. https://www.nso.com/Learning/Artifacts/Claim-Reports/Minimizing-Risk-Achieving-Excellence ↵
- Nurses Service Organization (NSO) and CNA Financial Corporation. (2020). Nurse professional liability exposure claim report: 4th edition: Minimizing risk, achieving excellence. https://www.nso.com/Learning/Artifacts/Claim-Reports/Minimizing-Risk-Achieving-Excellence ↵
- Brous, E. (2019). The elements of a nursing malpractice case, Part 1: Duty. American Journal of Nursing, 119(7), 64–67. https://doi.org/10.1097/01.NAJ.0000569476.17357.f5 ↵
- Brous, E. (2019). The elements of a nursing malpractice case, Part 1: Duty. American Journal of Nursing, 119(7), 64–67. https://doi.org/10.1097/01.NAJ.0000569476.17357.f5 ↵
- Brous, E. (2019). The elements of a nursing malpractice case, Part 1: Duty. American Journal of Nursing, 119(7), 64–67. https://doi.org/10.1097/01.NAJ.0000569476.17357.f5 ↵
- Nurses Service Organization (NSO) and CNA Financial Corporation. (2020). Nurse professional liability exposure claim report: 4th edition: Minimizing risk, achieving excellence. https://www.nso.com/Learning/Artifacts/Claim-Reports/Minimizing-Risk-Achieving-Excellence ↵
- The Joint Commission. (2017). The essential role of leadership in developing a safety culture. Sentinel event alert, Issue 57. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_57_safety_culture_leadership_0317pdf.pdf ↵
- American Nursing Association. (2010). Position statement: Just culture. https://www.nursingworld.org/~4afe07/globalassets/practiceandpolicy/health-and-safety/just_culture.pdf ↵
- American Nursing Association. (2010). Position statement: Just culture. https://www.nursingworld.org/~4afe07/globalassets/practiceandpolicy/health-and-safety/just_culture.pdf ↵
Culture that embraces error reporting by employees with the goal of identifying root causes of problems so they may be addressed to improve patient safety.