Lawyer's Guide to California Nursing Injuries

Nurses provide some of the most important services designed to protect human life and patient dignity. The lengths to which nurses go to promote wellness and quality of life are immeasurable, invaluable, and demanding. While the rewards of seeing patients feel and get better are an inherent part of the job, the day-to-day physical labor, emotional commitment, and difficult, sometimes thankless obligations of nursing are often lost on others. Frequently the glory goes to doctors - and of course, doctors deserve their due - but when it comes to battling disease and discomfort, nurses are typically the boots on the ground; their heroic actions make the difference between comfort and suffering and life and death.

The purpose of The Lawyer's Guide to California Nursing Injuries is to outline some of the most common injuries suffered by nurses and other healthcare workers and to enhance your knowledge about what you can do if you are hurt on the job or injured off-hours and cannot work. As a nurse, you are so dedicated to helping others that it can be daunting having to protect and restore your own health and interests. We hope that by identifying possible next steps, it will provide you with some feeling of power and security should you ever get injured.

• Why are Nurses at a Higher Risk of Injury?
• The Duties Nurses Face Daily
• What Are the Typical Work Duties of Nurses?
• What Do Nurses Identify as the Most Difficult Part of the Job?
• How Do You Determine if Another Person is Negligent?
• Mistakes People Make When Choosing a Personal Injury Attorney
• You Hired a Personal Injury Attorney - What's Next?
• Deciding the Value of Your Personal Injury Claim
• If You Were Injured at Work
• The Five Benefits of the Workers' Compensation System
• What Are the Most Common On-the-Job Injuries Affecting Nurses?
• Should I Hire an Attorney for a Workers’ Compensation Claim?
• How Much Does it Cost to Hire an Attorney for My Workers' Compensation Claim?
• Workers' Compensation / Personal Injury Combination Cases
• One Last Thing

Of course, anyone can get injured on the job, or get into an accident off the job that prevents or impairs their ability to work, but nursing comes with perils unique to the vocation's scope of duties. The physical demands and risks are often extreme and compounded by long hours, the emotional toll of caring for sick and injured people who are often frightened and in pain, and tending to their families and friends. Unlike most careers, nursing requires great physical and emotional effort, tact, and compassion that extend beyond coworkers to an ever-changing roster of people making requests and demands. So, when we say that being a nurse is difficult, we say it with more than respect - we say it with awe. Few people could ever do what you do. We are forever in your debt for being up to the challenge because, without you, patients and their loved ones would be utterly lost. Nearly all of us on the outside have been patients at one time or another – and any of us can become one again. All it takes is a car accident, a fall, an unexpected illness, and suddenly, you become our lifeline. The toughest among us can suddenly become vulnerable and completely dependent on your skill, dedication, and caring. Our collective neediness can blind us to the trials and tribulations inherent in your job and to the fact that as a nurse here in California, you are too often overworked and a victim of understaffing. These factors and others can leave you vulnerable to injury.

Here in this handbook, we tackle the most familiar injuries facing nurses, so you have guidance regarding solutions and recourse should you ever need it.

Nursing is an important and rewarding career, one in which the opportunities to improve the health, comfort, and security of others are part of the daily routine, but it is not an easy one. Only people familiar with the extensive range of duties performed by nurses understand what a difficult, taxing, and complex job it can be.

The duties performed by nurses fall into a range of categories, each as demanding in its own way as the next. Some of these duties are fairly obvious to most people, while others are less understood by anyone outside the healthcare field. Some of the more commonly known tasks can be categorized as "work duties," and even this category includes many activities and requirements that laypeople might not think of when they consider what functions nurses perform.

Tending to Patients. This huge duty encompasses a vast array of commitments, including providing medical, social, and emotional care to people who are sick, in pain, and/or undergoing tests. It can also include happier moments, like welcoming a new baby into the world, but most often, people are in some sort of distress and depend on nurses to keep them safe and comfortable. As mentioned before, nurses often have to tend to and reassure patients' loved ones as well, which adds to the workload and stress factor.

Information Gathering & Documentation. Nurses must collect, document, record, and understand medical records and patients' accounts of their particular issues, administer scheduled medications, follow doctors' instructions for each patient, monitor changes in patients' status and needs, and share data with others relevant to each patient's overall care. Nurses must also learn and utilize related technologies and software, including calendars and scheduling, drug dispensation and interaction programs, project management, procedural coding, and other tools. And because technologies may be continually updated, nurses must remain apprised of changes in medical software, record-keeping, data-sharing, and archiving. Nurses must also commit long hours to technical documentation and review, forms, lists, and other paperwork, emails, texts, and phone calls...it can all seem endless. Probably because it is! Nursing is a noble and vital calling - but simple, it is not.

Caring for People. Perhaps the most fundamental aspect of nursing is being able to treat, protect, manage, and comfort sick, injured, and/or nervous patients, as well as their loved ones. Nurses are medical practitioners, biologists, sociologists, teachers, psychologists, technicians, IT professionals, and therapists, all rolled into one human being who usually works long, fast-paced and inconvenient hours. The physical demands of nursing can be extraordinary. There's the constant walking - nurses walk an estimated 4-5 miles during a 12-hour shift - which can stack up day after day, especially if you have any sort of physical injury or limitation. Lifting patients, whether to roll them over or move them from a bed to a gurney or exam table, can be taxing on the back and joints and requires significant trunk strength to perform. You must be able to stoop, bend, twist, climb, and maintain balance, often while concentrating on fine tasks. Your hands and wrists are in constant use and must remain strong, nimble, and pain-free. The average adult might be easily overwhelmed by the physical challenges of nursing.

And then there are the emotional demands. Most patients and their relatives and friends are people you enjoy caring for - and their concerns are greatly alleviated by your training, talent, and kindness. Because of such close interaction, it can be easy to become attached to patients, and seeing their health or comfort take a turn for the worse is stressful, and seeing them die can be devastating. This can be particularly true for pediatric nurses, who must deal with the reality of seriously ill and injured children. Conversely, some patients (or their loved ones) are difficult to deal with, which is understandable, given they are often in pain, scared, or anxious. But having even one overly demanding, angry, or demeaning person on your rounds can make your job feel much more difficult - and having several can place tremendous strain on even the most experienced healthcare professional.

Countless Other Duties.  Every day, nurses must maintain patient medical records and interact and collaborate with doctors and other medical staff to ensure patients are receiving appropriate and timely care. They also tend to on-the-spot emergencies, monitor patients before, during, and after treatments, and administer non-intravenous medications and treatments for illnesses, injuries, wounds, infections, and pain management. In addition, they relay messages between patients and doctors and assist both doctors and patients during examination, intake, and surgery, just to scratch the surface. As if that were not enough, there is a laundry list of other tasks, like prepping patients for procedures, setting up, monitoring and inventorying medical tools and equipment, providing guidance and direction to other medical care staff, supplying patients with information and medical referrals, and coordinating care and records with other staff members. Many nurses also provide training to other practitioners and/or the public. Some nurses also prescribe medicine, order and analyze diagnostic tests, and assess patients' everyday environments for threats to health and safety. Travel nurses must perform some or all of these duties while traveling to different towns and even states, sometimes taking them away from home and loved ones for long periods while they adjust to foreign environments, protocols, and staff.

This is a small summary of the huge number of tasks and responsibilities that comprise the vocation of nursing. To go into it further would be a book in and of itself.

Through it all, nurses must remain calm and in control, engage in empathetic speaking and teaching, perform active listening (which can be difficult when an environment is especially busy), be socially perceptive about others' issues, engage in critical thinking to offer alternative approaches or solutions to problems, make on-the-spot judgments about critical choices and actions, and maintain a fast pace throughout, all while keeping errors, especially critical ones, to an absolute minimum. And because nurses tend to people from every background and social environment, they must have a superior ability to understand different cultures, and sometimes interpret the meanings of languages, expressions, and customs that are foreign to them. It can be overwhelming.

Research across job industries shows that nursing is among the most stressful jobs in existence. Here in California, the already high-stress levels are compounded by the present shortage of nurses, which is likely due to a lower number of Californians entering nursing school than in previous years combined with the large population of Baby Boomers aging into needing care. Our state is experiencing massive insufficiencies in staffing in hospitals, clinics, and other care facilities, making nurses' jobs even more difficult.

A recent survey identified the following as some of the toughest tasks reported by nurses:

1. Losing patients. As mentioned above, losing a patient you have cared for and grown fond of can be rough, as can seeing the devastation to the patient's loved ones. Nurses do not usually have the freedom or time to fully express their sorrow and must conceal their feelings, maintain control, and keep going. The emotional toll can be tremendous, especially since this is a vocation in which there will always be losses.
2. Long, demanding shifts. The physical, mental, and emotional labor, long shifts, and brief breaks can be exhausting. Most nurses work 12-hour shifts, and some work double or even triple shifts, with sometimes as little as a 6-hour break in between, and then do it all over again. Given how intensive and attention-demanding a nurse's duties, it is especially taxing to work all night and then be back at it all the next day. Nurses must also work on weekends and holidays, and many find it difficult to schedule time off because illness and injury do not take a break - ever. Few jobs in the United States exact such requirements.
3. Lack of time. Despite the long shifts, nurses may find that there is insufficient time to stay on top of everything and still be able to tend to their own needs, like going to the restroom, much less taking a break, grabbing a meal, or getting adequate rest. In nearly any other job, this would be unacceptable, a violation of workplace standards. In nursing, it is "normal."
4. Workplace politics. Many, if not most, healthcare practices in California are for-profit businesses and, as such, come with a certain amount of political and budgetary jockeying. Many nurses are made to feel like an extraneous expense rather than a vital part of the healthcare system. Considering how arduous nursing can be, this perceived lack of importance can feel disconcerting, diminishing, and downright unjust.
5. Lack of respect. The healthcare system, as a whole, as well as other staff members, patients, even their own families, can treat nurses with far less respect than they deserve. Too often, nurses suffer verbal, emotional, and even physical abuse, including everything from being treated dismissively to being insulted and physically assaulted. There is also the issue of patients and their loved ones Googling medical problems and treatments and assuming they know more about what is medically necessary than the attending nurse, and giving the nurse advice about what to do. On the other hand, there are patients and families who expect a nurse to know everything, even things outside their area of specialization and training. For example, a critical care nurse may not know everything that a pediatric nurse knows and vice versa, and this lack of familiarity with certain details can be met with umbrage and criticism. All of this is so outside the treatment nurses deserve, it can be hard for people who do not understand the job of nursing to comprehend.
6. Outdated technology. Many hospitals and clinics are behind the technology curve when it comes to EMR and other critical software, causing glitches, errors, and time lost. Outmoded technologies, old record-keeping software, and slow computer systems create headaches, frustration, and extra effort for nurses and, sadly, can promote injury and even death among patients. And facilities that do manage to stay on top of current technologies require nurses to continually stay abreast of the changes.
7. Handling drug-addicted patients. The epidemic of drug-addicted patients is a national tragedy. Americans' addiction to opioids rose from roughly 302,000 cases in 2002 to 520,000 in 2012, and the cases of life-threatening infections related to IV opioid use nearly doubled during that period. The numbers are estimated to be even higher now. This forces enormous costs on healthcare facilities – in some cases doubling their expenses – and places mammoth strain on the medical staff. Drug-addicted patients can be particularly needy, manipulative, and even abusive, making caring for them especially difficult.

These are just some of the challenges reported by nurses, but there are countless others. Given all of these trying circumstances, one might wonder why anyone would choose to be a nurse. The team at AutoAccident.com has listened to many California nurses talk about the difficulties, hardships, and challenges of their job, and the resounding reason they give for loving their profession is a genuine compassion for patients. The nurses we have assisted over the years are among the most caring, competent, intelligent, and dedicated people we have ever had the pleasure of meeting. Their devotion to their patients is phenomenal, and despite all the hardships they face, they consider what they do to be an honor and a calling. We at our firm know, some of us firsthand as patients ourselves, that humanity as a whole would be in dire straights without the skill, consideration, knowledge, assistance, and all-out love nurses provide every day. Through superhuman struggles, you continue to deliver kindness and compassion to people who are sick, hurt, scared, and in need of kindness.

One might ask why a firm named AutoAccident.com has such an affinity toward nurses. As a firm devoted to accident injury cases, we have helped many nurses who were injured, sometimes severely, on and off duty. Like any driver on the road, nurses can be injured in car accidents, and we have handled plenty of those cases. But even more often, nurses are injured on the job. Along with the challenges previously mentioned, the risk of injury to nurses and other healthcare staff during the performance of their everyday duties is much higher than with most jobs. Each day, nurses face extraordinary situations in which they can become injured, either suddenly or over time, due to repetitive-stress activities that place undue pressure on joints, ligaments, tendons, and muscles. People may be unlikely to consider the fact that during the commission of their jobs, nurses are often forced to become patients themselves.

The staff of AutoAccident.com has had the honor and pleasure to represent exceptionally hard-working and dedicated nurses in various injury cases over the years, and in each case, we worked diligently to help achieve fair compensation for their pain, disability, and lost income, both present and projected. If you have been injured outside of work, such as in an off-duty automobile accident, you may have a viable personal injury (PI) claim if the other party involved in the accident was found to be negligent.

In order to establish negligence, you must be able to prove the following criteria:

1. A Duty Of Care Existed: "Duty of care" means that the other person had a legal duty to act in a way that reasonably prevented you from being harmed.  In the case of an auto accident, other drivers have the duty to maintain a safe distance from your car so they can stop their vehicle in time to avoid crashing into you.  They have a duty to not run red lights.
2. A Breach Occurred: The other party breached that duty of care by acting in a manner that placed you at risk.
3. These Actions Caused You Harm: The other party's negligence caused you to suffer an injury.
4. You Suffered Losses: Your injury caused you to suffer measurable losses like lost wages and medical expenses.

When the injury occurred in an automobile accident, while a determination of fault may be issued by the negligent party's insurance company, they will often fight back on how much damage and injury that negligence caused.  That is why it is often beneficial to hire a personal injury attorney.

Yes, I Was Seriously Injured, But Do I Really Need a Personal Injury Attorney?

Lawyers cost money, so naturally, people often hesitate before hiring one. In very minor cases, a personal injury attorney may not be necessary; in fact, they may cost more than it is worth with respect to your claim. Consider your circumstances when thinking about whether or not to hire legal counsel. If you sustained significant injuries and incurred economic damages of medical bills and wage loss, a seasoned personal injury attorney can protect your interests now and going forward.

A truly solid personal injury attorney possesses the skill, experience, and knowledge necessary to:

1. Fully and accurately assess and outline the total value of your claim.
2. Work directly with you while managing all the insurance hassles and legal meetings, paperwork, telephone calls, negotiating, court appearances, etc., necessary to resolve your case.

If your claim is simple and the required paperwork and negotiation is minimal and straightforward, any experienced and ethical attorney should advise you that you are likely to pocket more money by handling the claim yourself, either directly with insurance, with the at-fault individual, or in small claims court.

On the other hand, if your case is even moderately complicated, meaning it includes an injury that may require ongoing attention, has impacted your ability to work, has affected your relationships or involves legal questions that you cannot answer, hiring a knowledgeable personal injury attorney has the potential to garner far more on your claim. Why? Because a seasoned PI attorney knows about the unforeseen impact and expense that accidents can present months or years after the fact, and how to factor these damages into your claim.

An experienced PI attorney will be able to handle all the insurance and legal requirements necessary to fairly resolve your claim while avoiding the numerous stumbling blocks that will be thrown up by the adverse insurance company in order to slow the process. A good PI attorney can maximize the value of your claim by presenting every appropriate medical and legal fact to the relevant insurance company, insurance defense attorney, or jury. They will track down every important detail of your case and present it in a way that will bolster the value of your claim.

For example, if your doctor tells you that your accident caused only a relatively minor strain injury to your neck, but your very real pain is preventing you from performing the considerable physical demands of nursing, a well-connected PI attorney should know medical experts who can offer a second opinion. These and countless other factors can make a difference in your damages claim.

An expert personal injury attorney will listen to you, your family members, and friends. Listening carefully will reveal the many ways that your injury has impacted your family, as well as your work and social life. These are important considerations not to be overlooked. If your pain or injury has negatively altered how you interact with the people in your life, it is relevant to the value of your claim.

Finally, a reputable personal injury attorney will collaborate with you as your case moves through the legal process. Handling an injury case is a cooperative effort. Make sure you feel comfortable with the attorney you hire, as well as their staff. Some personal injury cases can go on for a long time, so make sure to find a PI attorney who makes you feel cared for, interacts with you directly, fully comprehends the details of your case, and understands the rigorous demands of nursing to help ensure that you end up getting everything you are due.

While many lawyers may offer to represent you, it is important to choose one who has extensive experience with serious accident injury cases and understands how your injuries specifically impact you as a nurse. An inexperienced attorney may fail to effectively deal with your case. This could cause you to lose your benefits and the opportunity to obtain a fair settlement.

In a personal injury case, you get only one chance to obtain the compensation you deserve. To help you choose the right representation, know the seven common mistakes people make when selecting a personal injury attorney:

MISTAKE #1: Hiring an attorney who is not a specialist. For various reasons, people often choose the wrong attorney for their accident injury case. Sometimes it is because they know an attorney or they may have received a referral from a friend, and figure if the person has a law degree, that will suffice. But an attorney who practices bankruptcy or real estate law will not know the intricacies and specific deadlines, rules, and practices involved in a personal injury case. Whomever you choose, make sure they practice personal injury law exclusively and are experienced enough to accurately assess the total value of your claim. As with nursing, you want someone who is expertly trained and experienced in the specifics relevant to your situation.

MISTAKE #2: Hiring an attorney who avoids going to trial. Many of the attorneys who advertise that they are experienced in personal injury cases have never seen the inside of a courtroom or been part of an arbitration or mediation. Sure, we would all like to avoid court, but it is a mistake to pick an attorney who is inexperienced in – or afraid of – moving a case forward if needed. Insurance companies can be very aggressive, and once they know your attorney is afraid to go to trial, they will lowball your claim – and too often, a paltry and inadequate sum will get accepted just to settle the case. The attorney may even suggest it is the best solution for you, even if it is not.

A worthwhile attorney will not back down from a fight to get you everything you deserve, and sometimes the only way to do that is in front of a jury, arbitrator, or mediator.

MISTAKE #3: Hiring an attorney without a track record. If you have serious injuries that impact your ability to work, it is important to know that your attorney can deliver a large verdict or settlement. Ask your attorney how many million-dollar verdicts or settlements they have had. Are they a member of the Million Dollar Forum, a renowned organization of attorneys who have settled or tried cases worth a million dollars or more? Of course, not every case is worth a million dollars, but if you have that kind of a case, make sure you have an attorney who can deliver the goods.

MISTAKE #4: Hiring an attorney who is not adequately affiliated. Make sure your attorney is a member of national and local trial lawyer groups such as the Consumer Attorneys of California and the American Association for Justice. Why? Because connection with other legal professionals across the state and country is critically important. Serious personal injury attorneys collaborate with and learn from other excellent PI attorneys. We share insurers' evolving list of dirty tricks and underhanded methods to undermine injured people's credibility. By regularly collaborating with other specialists, our firm stays on top of the schemes that insurance companies come up with to avoid fairly compensating injured clients.

MISTAKE #5: Hiring an attorney who does not have sufficient resources. Serious personal injury cases are expensive to prepare. Done right, the expense of a single case can often exceed $100,000 or more. Experts like your doctor(s) and possible others, including economists and vocational rehabilitation specialists, must be consulted and have their depositions taken. They may need to testify in court. Your attorney needs to be able to front these costs, and if they do not have the funds, your case is going to suffer, perhaps even collapse. So, when you meet with a prospective PI attorney, look around their office – do they appear to be successful? Is the office well-appointed and do they have sufficient staff? If the practice seems small or underfunded, ask the attorney if they have access to the funds necessary to properly prepare your case. If your attorney is not committed to spending enough money to seriously represent you, consider looking elsewhere.

MISTAKE #6: Hiring an attorney who does not encourage you to talk to their prior clients. If an attorney is any good, they will not have any problem allowing you to talk to clients they have represented. Any attorney worth their salt will be proud to oblige. After all, the best endorsements come from satisfied clients with firsthand experience. If an attorney does not have clients you can speak to, perhaps that says something about their capability.

MISTAKE #7: Hiring an attorney who has not written and lectured in the personal injury field. Ask the attorney you are considering hiring about articles they have written in the personal injury field and presentations they have given to other personal injury lawyers. Why is this important? Because if an attorney does not have the experience and acumen to present in front of other people, including peers in the personal injury arena, they may not have the skill to best represent your case, especially if the case goes to trial.

And remember, pick an attorney you truly feel comfortable with, one who asks questions about you, your family, and others who may be affected by your injuries and damages, and who really listens to your answers. If the attorney cannot be bothered to get to know you personally, how can they be relied upon to adequately pursue your case? Find one who understands the particular demands and challenges inherent to nursing so they will be especially committed to your case.

Over the years, we at AutoAccident.com have found that some insurers have little interest in resolving claims fairly, so you will need an experienced personal injury lawyer on your side, one who understands insurance companies' tactics and is fully prepared to put up an effective and vigilant fight.