Chain of
command is one favored tactic to put nurses (and thus the hospital) on the hook
for a doctor’s decisions. Many times
this makes sense to jurors – if they as laypeople question the doctor’s course
of action, they can conclude a nurse should have as well.
It’s an easy
argument to make since, in hindsight, another course of action “might” have
prevented a negative outcome – if only that nurse had had the guts to stand up
to that wrong-headed doctor.
Unfortunately, a survey we recently conducted shows jurors expect nurses
to do just that.
In a May survey
of more than 1,200 potential jurors nationwide, an alarming 84 percent of
respondents indicated they believe nurses have a duty to question a doctor’s
decision if they disagree with it. This
jibes with what we have observed during focus group research – jurors
increasingly expect nurses not only to be patient advocates, but also to have
enough medical knowledge to second-guess doctors.
We’ve also
learned that for whatever reason, jurors believe nurses rarely if ever take the
step of going up the chain of command.
The same May survey found that 39 percent of respondents believe nurses
“almost never” question a doctor’s orders.
Based on our discussions of the topic during focus groups, this perception
is likely due to the shared juror predisposition that many doctors are
“arrogant” and would likely disregard such disagreement anyway.
We have had the
most success overcoming this plaintiff theme during case research by
emphasizing how the medical chain of command, like its military counterpart,
functions because nurses follow doctors’ orders – except in extraordinary circumstances. These circumstances might include a doctor
who is incapacitated by health or alcohol, or who orders a C-section for a patient
who has expressly withheld consent. Like
a foot soldier, however, the nurse is not considered the appropriate person to
weigh in on or dispute routine medical decisions because they don’t have a
doctor’s training and background – and the treatment environment and patient
safety might suffer if they did.
The best way to
counter a plaintiff’s chain-of-command claim will vary based on the unique
factors of each case. If you’d like to
hear our thoughts about your case, contact Senior Vice President Claire Luna at
cluna@juryimpact.net.
* * *
We consistently advise clients to humanize defendants as a
way to help level the playing field. In
that same vein, we will be doing more to humanize ourselves by sharing notable
events for the Jury Impact team. We look
forward to working with you soon!
Senior analyst Erik Holmes will be moving to Charlotte,
N.C., at the beginning of July. His wife
will be joining the faculty of the University of North Carolina at Charlotte as
an assistant professor of criminal justice and criminology. Erik will remain an integral part of the JI
staff, and this move will be a great benefit to our East Coast clients.