Professional Negligence In Nursing

Professional Negligence

In relation to professional negligence the concept of the reasonable man becomes that of the reasonable professional. The reasonable man will normally lack the skill and expertise acquired by the professional. These professional men and women are not only required to take reasonable care but also to measure up to the standard of competency that can be expected from such professionals-that is the standard of, for example the reasonable nurse or the reasonable solicitor.
The Irish Supreme Court considered the issue of Medical Negligence in The case of Dunne v. The National Maternity Hospital {1989} IR 91 and set out the standard of care in what we call professional negligence. In this case the plaintiff sued the
It was contended that the Health board was negligent in the discharge of the plaintiff’s father who committed suicide following discharge. This man had been admitted to a psychiatric hospital suffering from depression and was discharged after nine days. It was claimed that the discharge procedure was not properly conducted. This procedure in relation to a patient suffering from depression involved consideration of the potential risk of suicidal traits.
An expert witness concluded that the hospital notes did not appear to show a proper assessment of risk had been undertaken prior to discharge. Apart from one note there was no evidence that staff carried out a suicide risk assessment.
Another expert was of the view that it was not sufficient to ask the patient about suicide especially when there were some pointers towards suicidal thoughts. Expert witnesses said that in relation to suicide assessment there were two schools of thought .One school believed that the process of suicide risk assessment must be a formal one consisting of consistent and continuous inquiry into the mental state of the patient .The discharge must be as a result of an informed decision accompanied by the risk
The test applied then was whether the defendant acted with ordinary care of an equally competent practitioner as to the administration of a general practice approved by a substantial amount of practitioners of like skill and specialisation. The principles in the Dunne case state that a difference of opinion is no grounds to establish liability.
Applying these principles to the case the court held:
It was not up to the judge to decide which of two schools of thought –the formal or informal – was to be preferred. It was however inherent in both that the risk of suicide in a patient with depression was assessed prior to discharge. In this the court did not interfere in the professional judgement as to which form that assessment took but it was clear that it was “ general and approved practice” that the risk of suicide was assessed prior to discharge of a patient suffering from depression.
In this instance the court accepted that the procedure was not incorrect but the question arose as to whether it was carried out in a manner that accorded with general and approved practice. The court held that there was no indication that the assessment had been carried out, as was good practice and noted in the patients clinical notes. There was no evidence then that the patient was in firm