Nurse Risk Management

Georgia Reiner with Nurses Service Organization (NSO) discusses two recent case studies and six ways CRNAs can manage risks specific to their practice.

Georgia Reiner is a Risk Specialist for Nurses Service Organization (NSO) in the Healthcare Division of Aon’s Affinity Insurance Services, Inc. She earned a BS in Healthcare Policy and Administration from Penn State University, a certificate in Paralegal Studies from Villanova University and is a licensed property and casualty insurance producer. At NSO, she is responsible for educating healthcare professionals on professional liability issues and risk management strategies by creating informative risk management content, including self-assessment tools, newsletters, webinars, and claim reports.


Neal Howard: Hello and welcome to the program. I’m your host Neal Howard, here on Health Professional Radio. Our guest is Georgia Reiner, she’s a risk specialist with Nurses Service Organization and she’s joining us here today to talk about risk and how to manage the risk that CRNAs face. Welcome to the program Georgia, how are you?

Georgia Reiner: I’m doing well, thank you for having me.

Neal: Well I did mention that you’re a risk specialist with NSO, what is a risk specialist? It sounds like you’re an insurance investigator or something.

Georgia: Well that makes it sound really exciting, so thank you for putting it that way. And as you said, my name is Georgia Reiner. I am a risk specialist for Nurses Service Organization or NSO as you said and my main responsibilities with NSO is to really key in on those top risks that nurses face in their practice and to develop resources to help educate them about how they can combat those risks. NSO as an organization is devoted to helping nurses protect themselves and the important role that they play in patient care by providing affordable malpractice  insurance and valuable risk education and that’s that’s really where I come in is that risk education aspect. So what I do is I am responsible for creating that informative risk management content so that includes things like self assessment tools, newsletters, webinars and claim report for a variety of healthcare professionals but that includes nurses, advanced practice nurses and now nurse anesthetists or CRNAs.

Neal: When it comes to risk, doesn’t the nurse work for the physician, the surgeon, the specialist? Aren’t they kind of under that umbrella of responsibility? Does it work that way in healthcare as it does in so many other areas?

Georgia: Well when it comes to nurse anesthetists or CRNAs, becoming a CRNA is quite an arduous process and it involves years of schooling and experience. And I’m sure CRNAs would be quick to tell you that it’s all worth it because of the difference that they get to make every day in caring for their patients but because of all of that schooling and experience, CRNAs are actually able to practice with quite a high degree of autonomy and because they play a critical role in patient outcomes. So this makes them a valuable resource for healthcare overall and it allows them to work without the supervision of a physician in certain states as well. So in that regard, CRNAs can actually provide anesthesia care including obstetric, surgical and trauma services in more rural areas of the country that may not otherwise be able to offer that same level of care.

Neal: That level of care can differ based on where in the country as you say you are. Can you tailor protection based on nurses’ skillset or based on the fact that she’s moved from a metropolitan area and not going to be providing certain services anymore to a rural area? Or is it like an all-encompassing coverage for anything that she may encounter or may be accused of?

Georgia:  We certainly tailor our coverage for nurses based on their practice and the state that they practice in and because facing a malpractice suit can be so stressful and overwhelming and it can be quite a long unpredictable and costly process, we are dedicated to educating CRNAs/nurse anesthetists about steps that they can take to protect their patients from adverse events and to also protect themselves from the event of a lawsuit or licensing board action.

Neal: Do you feel that there’s a higher level of trust when it comes to the more highly skilled nurses as opposed to the nurses who haven’t had that specialized training as from a patient’s standpoint? Do you think that the CRNA is more likely to be involved in a lawsuit than someone with lesser training simply because they have that degree of training and skill and maybe they’re a better target for a lawsuit?

Georgia: Well I can’t really speak to patients’ attitudes about nurse anesthetists specifically, but nurses and advanced practice nurses and CRNAs in general are held in very high regard with their patients and the public. I think just about every year, you see surveys come out that say that nurses are one of the most trusted professions in the United States. But with that trust comes responsibility to serve your patients to the utmost care possible and that’s where I think NSO and myself as a risk specialist comes in where we are committed to educating nurses about those liability issues that they face and educating them about risk strategies to help them assess their patient care practices and protect themselves from liability.

Neal: So it seems that in the past and I mean far back in the past when it seemed that only malpractice apply to the physician or the specialist, now these highly specialized nurses are I guess just as responsible providing that high level of patient outcome activity as the physician.

Georgia: Sure. With that higher degree of autonomy, they have a higher level of control over patient outcomes and that’s why it’s important for CRNAs and other advanced practice nurses to assess their practices and make sure that they’re taking the steps to ensure safe patient care.

Neal: How is NSO involved in educating nurses facility, her practice the people that she works for or he works for in recognizing some of these risks of their higher skilled nurses? Is that something that they should be providing that protection or is this something that you educate them and give them the means to provide?

Georgia: Well I think it’s a dual responsibility where organizations have a responsibility to encourage their providers, to educate themselves about patient safety, best practices. But as an organization, NSO, we do our part to use the information and the resources that we have at our disposal to identify those top areas of risk based on specialty. So for instance, according to a claim analysis from NSO’s underwriters, CNA, we know that some of the top allegations made against CRNAs in malpractice lawsuits involve things like improper treatment or medication errors, inadequacies in the anesthesia plan and failure to monitor the patient’s condition. And the fact is, CRNAs ncounter these liability risks on a daily basis in their practice so it’s important for them to assess their current practices and then to take steps to protect their career and livelihood while also focusing on improving outcomes for their patients.

Neal: When is the earliest time that a person can come in contact with the NSO or the NSO contact a person about their careers? Is this something that they can learn about in school or is it something that they learn about a lot further in their nursing career and skill level?

Georgia: We encourage nurses at all levels of their careers to interact with NSO. We do offer coverage for students and we do offer educator resources as well. If you go to our website you can visit our learning center and access some of those resources to learn about the risk that nurses face and our risk control educational materials to help combat those risks.

Neal: Well I thank you for coming in today and giving us that website where our listeners can go and get some more information about Nurses Service Organization. Thank you so much for joining us on the program this morning Georgia, it’s been a pleasure.

Georgia: Thank you again for having me Neal.

Neal: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at and

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