Registered Nurses provide a range of acute and chronic emergency care that  leave them vulnerable to potential liability issues. Like being sued for medical negligence by an unhappy patient.

So, it is important to understand those legal liabilities and protect yourself against them.

The 4 Ds of Medical Negligence 

The four Ds of medical malpractice are:

DUTY: A Registered Nurse provides medical services at the direction of a Doctor’s orders, or in the case of a Nurse Practitioner, in some states, can provide and direct patient care independently. Registered Nurses have a duty to provide this care, but also to use their own judgment and clinical skill set to assess the patient and double  check that those orders are accurate. 

DEVIATION: The patient must demonstrate that the Registered Nurse didn’t follow—deviated—from accepted best practices.

DIRECT CAUSE: If the plaintiff has proven both DUTY and DERELICTION, they must then show that the Registered Nurse’s deviation directly caused the injuries and not some other intervening event.

DAMAGES: The patient must also prove they have suffered actual harm—physically, mentally or both—through medical records, prescriptions and/or testimony.


What is a Tort? 

A tort is a legal wrong which one person or entity (the tortfeasor) commits against another person or entity and for which the usual remedy is an award of damages.

Here are the most common ‘legal wrongs’ a Registered Nurse might face:


Nonfeasance is an act of omission. That means you had a duty to act and didn’t do so. For example, an RN watches a patient’s vital signs and recognizes a negative change but does not intervene or report to the doctor in a timely manner.


Misfeasance means you performed a service you are legally allowed to provide, but you did it badly. For example, log rolling a patient with a spine injury incorrectly which then caused further injury.


Malfeasance is an act of commission. The Registered Nurse or healthcare provider tried to perform a procedure that they were not trained to perform resulting in injury. An example would be an Registered Nurse performing a tracheotomy or intubating a patient. 

These matters could be very subjective, or even claimed fraudulently. Innocent or guilty, lawyers are not cheap. This is why the NSO strongly recommends Registered Nurses carry professional liability insurance to cover them against such claims. 

PLI Providers

PLI insurance protects Registered Nurses from bearing the entire cost of a malpractice claim made by a current or former patient.

Provider #1 – NSO

Nurse Service Organization (NSO) Brings you Malpractice/ Liability insurance through the American Casualty Company of Reading, Pennsylvania, a CNA company. CNA is a registered trademark of CNA Financial Corporation. Based on feedback, they  also offer the most competitive pricing. 

Provider #2 – MERCER/ ProLiability

Mercer is a partner that offers full and comprehensive professional liability insurance for Registered Nurses. CLICK HERE TO GET  A QUOTE 

How much does it cost?

Plans typically start around $200 for the year. This includes $1,000,000 per incident and $3,000,000 aggregate coverage.  

Premiums can be influenced by things such as employment status and amount of coverage, so make sure you know what you are getting and what is covered prior to purchasing. If you are working full time in a hospital but are also working per-diem as a 1099, your coverage situation may be unique. Call NSO to find out more specifics as it relates to your personal employment situation.  

Call: 800-247-1500 or Email:

Am I covered through my employer and is PLI through my employer sufficient?

Many Nurses are told NOT to get PLI, as you are covered under the hospitals insurance policy and you will be targeted if you have your own. This is simply not true and there are many areas for this advice to fall apart. 

First, you must understand if your employer pays for your professional liability insurance coverage and continues to have you covered under the employer’s policy. How do you know if you are actually covered under the employer policy? Check your pay stub and/or your W2! Many times, if covered under an employer policy, they will be a withholding for PLI taken out of your pay. If you do not see a withholding for PLI, contact your HR department for more information.

If I work in a hospital but also work for Go4 as a 1099 employee, how do I fill out my quote application?

According to NSO, “If you are both (working for different companies in different capacities), then you can apply as “self-employed” to be insured for both your employed and self-employed work.

If your employer pays for your professional liability insurance coverage and continues to have you covered under the employer’s policy, please sign up as employed. However, if your employer has removed the employer’s insurance policy to cover you, please sign up as self-employed. If you are unsure, sign up as self-employed.

So, to sum up, get yourself some PLI. Seriously. And if you have more questions about PLI, shoot our RN Community manager an email:

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