A surgeon booked five cases and has two cases going on right now. One case is going to take thirty minutes. The other? Two hours.

The surgeon struts into the operating room, eagerly anticipating the first cut. The circulating nurse says nothing. “This doctor hates doing surgical timeouts. He thinks it’s a waste of time. I don’t want him to think I’m patronizing him,” the nurse thinks. 

Turns out, the surgeon got mixed up with another case and amputated the right leg instead of the left. There was no documented timeout, making the nurse liable, as well as the surgeon, and everyone else in the operating room who failed to call the timeout.

According to Irnise Williams, JD, RN, a nurse and attorney, mistakes like this hypothetical scenario happen all the time due to these types of miscommunication. “Many times… we’re moving too fast and we're afraid to communicate.”

Read on to hear more insights from Williams, an expert at the intersection of healthcare and law, and to learn what she wants nurses to know.

Leaving Bedside During the Pandemic

Williams has been a nurse for sixteen years, but three years in, she decided she wanted to go to law school. 

It may seem like an easy transition to get a second degree and move on to another career, Williams shared, “But it wasn’t easy.” Williams searched for a career that would provide her the flexibility she needed to raise a small child.  “I love nursing. What I didn’t like were the politics and bureaucracy… but I like the patient care and community. I had no intention of leaving nursing until the pandemic happened.”

Williams was working and living in New York when she felt it was the end of her journey balancing nursing and law simultaneously. She went full-time at her law firm in 2021. She integrates her experience with inpatient, outpatient, and community nursing into her law practice. 

The pandemic gave her an opportunity to build a brand from her unique perspective. “Nurses are starting to lead conversations on change in healthcare,” Williams observes.

“I Didn’t Want the Humdrum Day-To-Day Work”

Right now, Williams spends about 40% of her time on building her law firm clients and fostering client relationships, and about 60% of her time with content creation. Now that she’s had her firm for a few years, the workflow comes more naturally, so she can allocate more time to social media content. 

“I don’t necessarily want to sit in front of a computer all day doing the same thing, which is why I didn’t really want to be a lawyer in the first place. I didn’t want that humdrum day-to-day work. And so I found a way to integrate creativity into the work I do.” 

Williams practices in the regulatory compliance area of law, which includes topics like:

• CMS regulations, which oversee programs like Medicare and state Medicaid programs
• HIPAA
• Compliance within clinics or health systems; for example, telehealth requirements for reimbursement

She also does occasional malpractice case consulting. 

Williams doesn’t litigate or go to court, but she is a valuable resource for her clients who need help staying within compliance. 

Nurses as Defendants

“Always understand the policies and procedures of your organization,” Williams suggests. She also recommends reporting and escalating issues, communicating effectively, and not letting fear or intimidation corner you into a malpractice case.

“I share and teach from extreme cases that can happen [like the wrong-site anecdote above], but in reality, it’s really simple things we could do to prevent it from happening.” 

Nurses might say, “The doctor didn’t call me back,” or “The doctor never put in an order,” or “They didn’t do what I thought they should do.” However, Williams explains, if you get the doctor in a room, they’re going to say what the nurse might have done wrong. “Now the hospital is going to be liable for something. I don’t have to figure out what it is, but it’s going to be some type of negligence or malpractice because of poor communication,” Williams explains. “You can’t point fingers… You can’t document what other people should have done.”

“Literally, most of what malpractice cases are? Poor communication,” Williams says. 

Nurses as Plaintiffs

On the other hand, nurses can be taken advantage of when they don’t fully understand their legal rights. 

Williams recommends you:

• Understand your employment contract and offer letter
• Know the rules in every single state from the Board of Nursing that you are a part of
• Reach out to an employment lawyer for a consultation if you believe you were wrongfully terminated

Termination does not always equal discrimination and is different from wrongful termination. Williams clarifies that discrimination must be due to a violation of your constitutional rights. While wrongful termination may be discriminatoin or any other type of unlawful firing.

Outdated Nursing Curriculum

As a nurse lawyer, Williams wasn’t exposed to this career in school.

The current nursing school curriculum is outdated, according to Williams. “We have reached a point where nurses have to find out about other specialties through social media.”

Plus, discovering new nursing career paths through social media can be deceiving. “You’re not getting the full scope of what it’s like to be an aesthetic nurse or a traveler. You’re getting the image someone is creating for you.” An updated nursing school curriculum would allow nurses to gain clinical experience in unique specialties and see the pros and cons up close and personal.

Unsurprisingly, Williams also hopes nursing school improves on their legal education for new nurses, like the responsibilities of their hospital’s legal department, who to contact in regulatory compliance, and what resources are available if you’re unsure about a potential legal issue.

Exciting Projects from Your Nurse Lawyer

Williams has a documentation course that teaches nurses how to defensively chart to avoid litigation. She also has courses for health care providers and business owners.

She created the course because nurses had so many questions about the secret to the process of documentation. “I’m really giving people transparency about what I look for when I review medical malpractice cases.”

In addition to these courses, Williams creates free content on her Instagram and YouTube accounts. She loves to dissect case studies in healthcare law and discuss takeaways for nurses. 

Disposition

Williams has forged her own career path to integrate two fields she is passionate about, nursing and law.

“Nursing gives you the ability to do different things every day and have a lot of experiences,” Williams says. 

Don’t be afraid to try something new, or create your own new thing.

Follow Wiliams on Instagram, YouTube, and her website to learn what you should know about the intersection of healthcare and law.

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18 July 2024. Exclusive interview with Irnise Williams, JD, RN