Failure to Rescue

Failure to recognize changes in a patient's condition and communicate those changes to the appropriate provider is one of the most common allegations in malpractice claims involving nurses. This is especially challenging for new graduate and relatively inexperienced nurses.

Failure to rescue is a term commonly used when a patient experiences serious harm, or even death, because complications from a disease process, medical intervention, or surgery were not recognized or addressed in a timely manner.

It is often the subtle, insidious changes in a patient's condition that are the easiest to miss. A thorough baseline assessment at the beginning of the shift, or during handoff, is essential because it allows you to recognize when something has changed.

One of the things I hear most often from new nurses is their hesitation to call a provider. Unfortunately, incivility still exists in healthcare. Having your assessment questioned or your concerns dismissed can undermine your confidence, especially early in your career. When that happens, remind yourself that your primary responsibility is to advocate for your patient. If your concerns are not adequately addressed, follow your organization's chain of command and escalate those concerns appropriately.

Equally important is documenting provider communication objectively and professionally. Document when you notified the provider, the clinical concerns you communicated, the provider's response, and any resulting orders or recommendations. If a reasonable amount of time has passed without a response, or if the patient's condition continues to deteriorate despite the response received, continue to escalate your concerns through the appropriate chain of command.

Practice Takeaway

Patients rarely deteriorate without warning. More often, there are subtle changes that, when recognized early and acted upon, can alter the course of a patient's outcome. Trust your assessment, advocate for your patient, and never let fear of making a phone call outweigh your clinical judgment.

Reference

Agency for Healthcare Research and Quality (AHRQ) (2025). Failure to Rescue. https://psnet.ahrq.gov/primer/failure-rescue