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District Nurse Negligence

Claims against Both Community Nurses and District Nurses are on the rise. Like many aspects of modern medicine, patients are increasingly aware of thier rights and are not scared to stand up for them.  The Families of the elderley and the infirm often approach our Solicitors for help and assistance and in most cases we are able to assist.

There are hundreds of differnt types of nursing negligence; regardless of wether this is District Nurses, Community Nurses or Hosptial Ward Nurses but the end result is always exactly the same; a patient needlessly suffering mentally or physically.

The district nurses or community nurses often find themselves dealing with a large community of patients many of whom just a few years ago would not have been discharged home. The needs of this group vary, however, some of them need very serious care and the time necessary to give it is just not at the nurses disposal. This can lead to things getting missed and symptoms that should be warning signs of more serious injury or infection just getting ignored or misinterpreted. The outcome for the patients can be catastrophic. 

It is important to remember that everyone has the right and the duty to raise the flag if things are going wrong or if people are suffering because of poor nursing practice. If you have suffered district nurse negligence, no matter who is at fault it is then you should bring an action. If you do not do this then the system will likely go on ignoring the issues and continuing to bring the wrong answers to 21st Century medicine.  

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Who pays for the claim? Law Med members have a unique agreement which is industry beating.

Nursing Negligence Example

Some examples of nursing negligence would be:

  • Failing to refer a patient who is suffering from an open wound or pressure sore that is not healing.
  • Failing to gaurd against pressure sores, ulcers and weeping wounds.
  • Failing to lift a patient safely leading to fractured bones which can go unnoticed or untreated
  • Keeping a patient on antibiotics for a urinary tract infection when the infection is not responding.
  • Not keeping a patient hydrated or not noticing that a patient is dehydrated or undernourished.
  • Administering the wrong medication or the wrong dose.
  • Not reffering a patient who is not responding to medication
  • Not taking a patients consent or ignoring a patients wishes
Nursing Negligence Consequences

The consequence of negligence for the patient is nearly always injury or harm, for the responsible nurse the consequences vary but could be:

  • The Nurse will likley have to be questioned and a statment taken by the Hospitals legal department.
  • The Nurse will likely have to given an account to thier manager or supervisor
  • They may face and investigation by the NHS Trust or the Hospital.
  • They may have to face an investigation by the Royal College of Nursing and Midwifery.
  • They may have no conseqeunces at all.

Ultimately much depends on the degree of negligence or harm that has been caused.

Nurse Negligence Wrongful Death

FATAL ACCIDENT INQUIRY INTO THE CIRCUMSTANCES OF THE DEATH OF MR JAMES MCNEILL [2010] FAI 50

DESCRIPTION

In terms of section 6(1)(a) of the Fatal Accidents and Sudden Deaths Inquiry (Scotland) Act 1976, the Sheriff found that Mr James McNeil (DOB 14th September 1935) died at 08:30 hours on the 22nd of October 2008 at Belhaven Hospital, Dunbar. The cause of death was (i) bronchopneumonia; (ii) pressure sores on back, ischemic heart disease, and dementia.In 1989, Mr McNeill was diagnosed with Alzheimer’s disease, and his condition eventually deteriorated in 2007. On 18th April 2008 Mr McNeill was admitted to Lennel House Nursing Home, Coldstream; Lennel House was a nursing home owned and operated by Guardian Care Homes (UK) Ltd. On admission to Lennel House an Admission Assessment Form was completed by the duty staff nurse. The assessment covered, inter alia, the risk of pressure sores; Mr McNeill was assessed as being at high risk of developing pressure sores.


On 19th May 2008 two blood blisters were noticed on Mr McNeill’s sacral cleft. These were the first manifestations of the early stages of pressure sores. In the course of the following days the blisters were treated with creams and dressings. However, the area of the wound, which was measured and recorded daily, increased. By 30th May 2008 the blisters measured 3 x 1.5cm and 1 x 1cm and were recorded as being necrotic and producing an odour, signs consistent with infection. By 9th June 2008 the measures put in place produced no improvement and the odour from the wound was now described as offensive. On 11th June 2008 the districtnurse visited Lennel House by prior arrangement. The wound now measured 13 x 4.5cm and was discharging thick yellow puss. A hole had appeared in the sacral cleft from which fluid leaked. The districtnurse arranged for Mr McNeill to be examined by a GP which examination was conducted on 12th June 2008. As a result of this examination the GP arranged for Mr McNeill to be admitted to the Borders General Hospital on 12th June 2008 in order to obtain a surgical opinion.

On 13th June 2008 surgical debridement of Mr McNeill’s pressure sore wound was carried out. The operating surgeon considered the wound to be serious and described the operation as a “planned emergency”. In his experience of having carried out 12 or so pressure sore debridements over the years, this was described as the worst which he had encountered.Mr McNeill remained at Borders General Hospital until 24th September 2008 when he was transferred to Roodlands Hospital, Haddington. On 20th October 2008 Mr McNeill was transferred to Belhaven Hospital in Dunbar. At about 06:00 hours on Wednesday 22nd October 2008 nurses attended on Mr McNeill to administer medication, including morphine sulphate, and prepare him for a bed bath. After about 30 minutes, when in course of being bathed, Mr McNeill’s condition deteriorated and he expired in the presence of nursing staff.


The Sheriff noted that from the evidence there could be little doubt that Mr McNeill’s care at Lennel House would have benefitted from better and more promptly implemented care plans and risk assessments; from being cared for by nursing staff who had the advantage of better managerial support; better induction procedures; better training especially in respect of pressure sores and the care of the elderly; better dissemination of information regarding policies and procedures; better access to specialist equipment; and from allocated time for communication as between staff on different shifts.

Focusing on Mr McNeill’s development of pressure sores, the risk of these developing would almost certainly have been reduced with earlier provision of special mattresses, cushions and organised and recorded positional changing. The Sheriff concluded from the evidence that the latest date when Lennel house nursing staff ought to have contacted the district nurse, or general practitioner, regarding Mr McNeill’s pressure sore would have been 4th June 2008. However, the Sheriff noted that in the interim period, key staff had changed at the nursing home and that following the death of Mr McNeill, procedures had been improved radically. For these reasons, the Sheriff considered it inappropriate to make any findings under the Act in terms of section 6(c) and (d).

FATAL ACCIDENT ENQUIRY INTO THE DEATH OF NASRULLAH KHALID, SHERIFF KENNETH ROSS, DUMFRIES SHERIFF COURT, 9TH MARCH 2011

DESCRIPTION

In terms of section 6(1)(a) of the Fatal Accidents and Sudden Deaths Inquiry (Scotland) Act 1976, the sheriff found that Nasrullah Khalid died within cell B/17 at H M Prison, Terregles Street, Dumfries on 23 November 2009 between the hours of 3.15pm and 4.55pm. In terms of section 6(1)(b), the cause of death was (a) Ischaemic Heart Disease (b) Coronary Artery Thrombosis and (c) Coronary Artery atherosclorosis. A formal determination was made under section 6(1)(c).


Background:
Mr. Khalid had suffered from a heart condition since 1996 when he had had a heart attack. The symptoms of his condition were stable angina, hypertension and atherosclerosis. For the three years prior to his death the deceased exercised regularly in Dumfries Prison gym. There was no medical reason why Mr. Khalid should not have participated in the exercise regime.


At about 1.50pm on 23rd November 2009 Mr. Khalid attended the prison gym as usual. About five minutes before the end of his routine the deceased experienced nausea and pains in the centre of his chest. He was examined by the duty nurse who concluded that he had suffered an angina attack. He was returned to his cell at 3.15pm and advised to rest and take his angina medication. At about 4.55pm Mr. Khalid was discovered lying on his bed with his eyes open and with vomit on his face. Officers commenced CPR and continued to do so until paramedics arrived about ten to fifteen minutes later. They took over the attempts to resuscitate Mr. Khalid which continued for a further twelve minutes. Throughout the procedure there was no response from Mr. Khalid. He was pronounced dead when the prison doctor arrived at 5.45pm.

Determination:

Under s.6(1)(c) the sheriff found that, in the examination of Mr. Khalid at the Prison gym, it should have been established if the chest pain of which he had complained had disappeared completely. In the absence of such a finding, the prison doctor should have been contacted and an ambulance called. However, to have done so would not have guaranteed Mr. Khalid’s survival. Nor would that survival have been a probability.


What is a District Nurse or a Community Nurse?

Generally its the sort of care that a patient cannot reasonably be expected to self perform that is fulfilled by community nurse. Its frequently a failure to deal with issues such as wound care that leads to a district nurse claim.

The role of a modern-day nurse might seem simple enough to those not in the know; a patient is admitted to hospital and care is administered. However, in the UK most of the roles filled by Nurses are not really commensurate with Hospital care. For instance the roles of district and community nursing. Frequently these two roles are confused and more often than not they are in fact the same role.

What is a district Nurse’s role.

A district nurse is a registered general nurse (RGN) who operates within a defined community. Specially trained, these nurses play a pivotal role in the modern-day primary healthcare team and are charged with leading teams of community-based nurses and support workers. Typically, a district nurse will perform their duties away from the doctor’s surgery however, it is usual that they are organised by the GP services (although confusingly, that is not always the case) with house-bound patients, although work can take place in local healthcare centres. Whoever organises them, the District nurses usually have a very high level of autonomy, more so than nurses who work in multidisciplinary hospital teams.

Who Do District Nurses Treat?

While a district nurse’s patients will often be elderly, there is no restriction when it comes to the age of those in need of care. Suffering from a wide range of conditions, some patients may have recently been discharged from hospital, while others may have physical disabilities or terminal illness.

What Are A District Nurses Responsibilities?

The role of a district nurse is to provide care to housebound patients by performing frquent home visits. These visits may be once a day or more depending on the level of care required. As these visits take place away from a hospital, it is the duty of a district nurse to perform thorough risk assessments upon every visit, ensuring the safety of both themselves and the patient. During these home visits, a district nurse has a number of responsibilities, including wound management, medication support, rehabilitation assistance and catheter care. A district nurse should also identify any key healthcare needs. In doing so, the district nurse can act as a teacher, imparting knowledge on the varying aspects of healthcare.

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What is a community nurse?

Delivering care to the elderly, disabled and vulnerable patients who are unable to travel to a hospital or doctor’s surgery, community nurses are registered nurses who have undertaken degree level training as a specialist practitioner. This course focuses on four key aspects of nursing including clinical nursing, care and programme management, clinical practice development and clinical practice leadership.

Community nurse roles and responsibilities

A community nurse is responsible for performing many of the same duties as a district nurse. These include basic care (checking temperature, blood pressure and breathing), wound management, administering injections, setting up intravenous drips and assisting doctors with examinations and medical procedures. Community-based nurses are also able to provide vital information to clients, their families and carer/s, much in the same way as district nurses, while emergency support may also be required in cases when a patient is suffering cardiac arrest or a stroke. This demonstrates the many hats a community nurse must don in their line of care.

So what is the difference between community and district nurses?

In recent times, the terms district and community have become interchangeable as a way of describing areas of villages, towns and cities, meaning that there may be no difference between community and district nurses at all.


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