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Duty of care

This guide for RCN members explains your legal and professional duty of care, covers conflicts with employer's instructions and explores your duty of care in emergency situations.   

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Duty of care

The "duty of care" refers to the obligations placed on people to act towards others in a certain way, in accordance with certain standards. The term is sometimes used to cover both legal and professional duties that health care practitioners may have towards others, but there are distinctions between the two.

Generally, the law imposes a duty of care on a health care practitioner in situations where it is "reasonably foreseeable" that the practitioner might cause harm to patients through their actions or omissions. This is the case regardless of whether that practitioner is a nurse, midwife, health care assistant or assistant practitioner. It exists when the practitioner has assumed some sort of responsibility for the patient’s care. This can be basic personal care or a complex procedure.

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To discharge the legal duty of care, health care practitioners must act in accordance with the relevant standard of care. This is generally assessed as the standard to be expected of an "ordinarily competent practitioner" performing that particular task or role.

The standards to be expected are not generally affected by any personal attributes, such as level of experience. The legal standard of care to generally be expected of a newly-qualified nurse is the same as that expected of a more experienced nurse performing the same task.

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Professional duty of care

The Nursing and Midwifery Council's main aim is to protect the public. It sets standards for education, conduct, training and - ultimately - performance. Those standards may inform the legal standard mentioned above.

Nurses and midwives should always follow the NMC Code and other NMC guidance, including their publication Enabling Professionalism.

Although health care assistants (HCAs) and assistant practitioners (APs) are not regulated by the NMC or any other professional body, NMC guidance is useful when considering best practice. 

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When your duty of care conflicts with your employer’s instructions

At work you may experience inadequate staffing levels and skill mix, resource constraints and increased demands from management and clients. These pressures can lead to failures in the duty of care.

Some examples of situations where your employer’s expectations may conflict with your duty of care include excessive or unsafe workload, taking on tasks for which you are not trained or competent and being expected to work in an unsafe environment.

If you are concerned that a situation at work could lead to your duty of care being compromised then you should raise these concerns with your employer. Read our raising concerns advice and contact us on 0345 772 6100 if you have concerns.

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Being a volunteer or ‘Good Samaritan’

There are two aspects that need to be considered:

Legal duty

There is no legal duty to volunteer help in an emergency situation. The legal duty of care generally only arises when a practitioner has assumed some responsibility for the care of the patient concerned (see above). Accordingly, if a nurse is at a road traffic accident they do not have a legal duty of care to offer aid to any person injured in the accident. Many people mistakenly assume that nurses have first aid training which would assist the injured person. This is not always the case.

Professional duty

However, all registered nurses should be aware that the NMC Code places a professional duty on a nurse to provide appropriate assistance, within their sphere of knowledge and competence, in such circumstances. Wherever possible, a nurse should arrange for emergency care to be accessed and provided promptly and should always take account of their own safety, the safety of others and the availability of other options for providing care. This professional duty may vary in practice, depending on the circumstances and the expertise of the nurse concerned, from simply providing some psychological comfort to the injured person, through to offering more hands on care. This is illustrated in the following examples:

  • If a nurse has an understanding of the impact of moving a person with spinal injuries, then they may be expected to volunteer that knowledge at the scene of the accident. 
  • If an RGN with no midwifery training or knowledge came across a woman in labour their professional duty of care may be limited to reassuring the woman, making her comfortable and then calling an ambulance, acting within their competence.
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Further information

HCAs/APs: accountability and delegation 

Raising concerns guidance

Duty of candour

Nursing and Midwifery Council (NMC)

Enabling Professionalism (NMC)

For advice on referencing this web page, refer to your university's guidance. There are different styles of referencing so it's important to check which one is preferred by your course provider. You can read more about referencing on the RCN's library site

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