The answer is that the sources for nursing practice standards are varied. The court relies on some or all of theses sources to help determine the applicable standard of care in each individual case. The policy and procedure manual of your facility should contain nursing care guidelines. However, if the facility you are working in does not adhere or comply with the generally accepted standard of nursing care, then following the facility s policies and procedures will not protect you from a charge of malpractice. This is because all nurses are accountable for the nurse s standard of care.
Every nurse has an ethical and legal obligation to serve as a patient advocate.
Therefore nurses are obliged to report when another health care professional breaches a standard of care. For example, if you observe a co-worker render care while under the influence of alcohol, or falsify a medical record, you have a duty to act promptly to protect the patient s welfare if necessary and to then report your observations. Always check with your employer s policy and procedure manual regarding how to address a reportable situation. Your facility may recommend making a report to your manager or to another authority in your facility s nursing administration, or filing directly with the appropriate regulatory agency in your state. The important point is that you should make a report to the proper authority.