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LNCtips.com: Avoiding Absolutes


Absolutes are words like "never" or "always," as in, "I always give patients their medication on time." There's a problem with absolutes in that they may not be true. For example, what if the patient was in Radiology getting an MRI at his scheduled medication time? Assisting the attorney with witness preparation includes helping the witness to avoid absolutes.

In addition to "always" and "never," the words "yes" and "no" are absolutes. The attorney for the opposing side loves it when witnesses answer in absolutes, because absolutes commit the witnesses to their testimony. Then if the witnesses deviate from that absolute, it implies that the witnesses were negligent. Was the nurse negligent by not giving medication to a patient that's in Radiology? Maybe or maybe not.  However, the nurse LOOKS negligent because of the testimony that medications are always given on time.

Nurses, in particular, are prone to testify in absolutes. After all, our employers have trained us NEVER to deviate from the procedure manual and ALWAYS to document everything. However, employers hire us for our clinical judgment, which means that absolutes aren't necessarily appropriate for patient care.

Here a few phrases to help witnesses avoid absolutes. I've used them in the context of medication administration, but they work in other situations as well.

"For the most part..." For the most part, I give medication within a half-hour before or half-hour after the time listed on the MAR.

"It depends on the circumstances." It depends on the circumstances when I give the patient medications. In this particular case, I gave the patient his meds after he returned from Radiology. (Expect a follow up question from the attorney about why the meds were given after and not before the MRI.)

My normal practice is..." My normal practice is to give medications at the scheduled time or shortly before or after, but that isn't written in stone.

"My routine is..."  My routine is to administer medications at generally the time listed on the MAR.

"What I usually do is..." What I usually do is give patients their medications on time, but there are exceptions to that.

Can you see how the above statements make the nurse look reasonable instead of negligent?  Helping witnesses to avoid absolutes is a great way to help the attorney prepare their witnesses for questions by the opposing side.

...Katy Jones