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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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.Back to contents
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.Back to contents
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.
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.Back to contents
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.Back to contents
There are two aspects that need to be considered:
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.
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:
HCAs/APs: accountability and delegation