Patient situation: Jimmy Smith is a 19-year-old

Patient situation: Jimmy Smith is a 19-year-old male who had a severe compound fracture of his tibia yesterday in football practice. Last evening about 4 pm he had surgery to set and cast the leg. The evening shift reported that he was having a bit of swelling from the severe trauma that accompanied the fracture, but that the toes on the effected leg were warm and he had good pedal pulses. By the time you received report and went to check on Jimmy, you felt that his pedal pulses were slightly diminished and his foot was slightly cool to the touch. By 2 am you felt swelling had increased and his toes were quite cool although they were not blue. You phoned his physician and he was upset to be awakened in the middle of the night. He instructed you to put ice on the cast and to elevate Jimmy’s leg higher to reduce the swelling and promised you that he would see Jimmy first thing in the morning. As the night wears on, you become increasingly alarmed. By the time the night supervisor arrived at 4 am you were so concerned that you asked her to check the casted leg. The supervisor rushed out of the room and said, “The circulation in this boy’s leg is severely compromised, why you haven’t gotten the doctor here to cut the cast?” Have you committed malpractice? Has the doctor? What is the nurse’s responsibility in reporting a patient conditions to their physician? Examine the elements of malpractice. If there is permanent damage to Jimmy’s leg, who will be liable for the failure to take action soon enough to prevent injury?

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