n NAPNAP President’s Message n

P rofessional liability risk management is emerging as an important issue for us as nurse practitioners to understand and incorporate into our nursing practice.

Most PNPs practice in collaboration with physi- cians. The concept of collaboration implies indepen- dent decision-making in those areas of our practice in which we have, by education and experience, at- tained the expertise to make independent decisions regarding our clients. We must decide when we need to consult the physician about a problem. With the satisfaction and autonomy and increased responsibility that come with our evolving role, there is also increased accountability and professional liability.

Numerous articles and explanations have been written to explain the numbers of liability claims brought against health care providers in recent years. Kathleen Flynn Peterson, nurse lawyer, summarized them:

. Increased consumer awareness of patient rights and the legal mechanisms for enforcing these rights;

. The breakdown in the health care provider- patient relationship and the overall imperson- alization of the health care delivery system;

. The growing complexity of medical care;

. The growing cost of health care, leading to greater consumer expectations;

. The growing litigiousness of society in general;

. The expanding roles of health care professionals;

. Unrealistic public expectations in regard to medical treatment;

. A tendency to regard good health as a matter of right;

. The fact that medical malpractice does happen. Health care professionals make mistakes. If that mistake results in damage to the patient, com- pensation is often sought.

One of the goals of the NAPNAP Executive Board this year has been to develop a professional liability risk management program for members of our or- ganization. A very important piece of that program is the availability of malpractice insurance. The crisis in that area seems to be past and the cost to partic- ipants reduced to a more reasonable amount. Al- though we must continue to monitor our insurance coverage and its availability, we need also to under- stand what things we need to do on a day-to-day

JOURNAL OF PEDIATRIC HEALTH CARE

Cynthia Hobbie, MPH, RN, CPNA

President and Fellow NAPNAP

basis in our individual practice settings to protect us from professional liability.

Kathleen Flynn Peterson, nurse laywer from Min- nesota, has written a document on Risk Management for Pediatric Nurse Practitioners. In this paper, she discusses the principles of professional liability in nursing; high risk areas for PNPs; the practitioner- client relationship; communication and informed consent; the need for pediatric clinical expertise; self- evaluation and professional growth; documentation; the appropriate use of policies, procedures and pro- tocols; and other issues dealing with the area of professional risk management. Within each of these areas, she gives specific examples and information about what PNPs can do to reduce their risks of professional liability.

Our plan is to publish this document in the form of a brochure that will be available to all NAPNAP members.

Ms. Peterson will also be presenting the plenary session on the application of risk management prin- ciples in PNP practice at NAPNAP’s annual confer- ence in Orlando, Florida, March 15-19, 1989.

I am very pleased that we are able to provide mem- bers with information on this very important issue. n

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