Malpractice, Negligence & Liability
Every nurse carries personal legal liability for patient harm — and "I was just following orders" is not a defense. Knowing the four elements of malpractice can protect your license and your patient.
Core Concept
Malpractice is a specific type of negligence committed by a professional. To prove nursing malpractice, the plaintiff must establish all four elements — miss one and the claim fails. First, duty: a nurse-patient relationship existed, creating an obligation to provide care meeting professional standards. Second, breach: the nurse failed to act as a reasonably prudent nurse would in the same situation. The standard is peer-based — what would another competent nurse with similar training do? Third, causation: the breach directly caused the patient's injury (not just that something bad happened). Fourth, damages: the patient suffered actual harm — physical, emotional, or financial. All four must be proven; they are not interchangeable. Negligence becomes malpractice only when the person has professional duties. A nurse who fails to raise side rails, doesn't document a critical change in condition, or administers a medication without checking allergies may face malpractice claims. Incident reports document facts but are not admissions of liability. Carrying personal malpractice insurance is separate from employer coverage and protects the individual nurse.
Watch Out For
Don't confuse negligence (general carelessness by anyone) with malpractice (professional negligence requiring a duty of care). Students mix up causation and breach — breach is what the nurse did wrong, causation is proving that specific breach led to harm. An unintentional tort like malpractice differs from intentional torts (assault, battery, false imprisonment), which have their own required elements (intent, act, harm) but do not require proving the four malpractice elements.
Clinical Pearl
Remember the malpractice chain: Duty → Breach → Causation → Damages. Like a chain, break one link and the malpractice claim falls apart.
Test Your Knowledge
3 quick questions — see how well you understood Malpractice, Negligence & Liability