Legal Aspects of Nursing Legal A: Nurs Introduction. Nursing practice is governed by many legal ‘concepts. Its important for nurses to know the basic of legal concepts because nurses are accountable for their proffesional judgments and actions, Accountability is an essential concept of proffesional nursing practice and the law. Source of Law. > Constitution > Legisation (Statutes) > Administrative Law > Common Law Types of Laws.> Private Law / Civil Law > Public Law Kinds of Legal Actions, > There are two kinds of legal actions: > Chul or Private actions > Criminal actions Nurses As Witnesses Annurse may be called to testify in legal action. It is advisable that any nurses who is asked to testify in such situation seek the advice of an attorney before providing testimony. In most cases, the attomey for nurse's employer will provide support ‘and counsel during the legal case. Nurse Practice Act. Each State has a nurse practice act which protects the public by legally defining and describing scope of nursing practice. State nurse practice act also legally contro nursing practice through licensingrequirements, Credentialing Itis the process of determining and maintaining in nursing practice, Licensure, A legal permit that government agency grants to individuals to engage in the practice of a profession and to use a particular ttle, Certification. Certification is the voluntary practice of validating that an individual Accreditation / Approval of Basic Nursi Education Programs. (One if the functions of a state board of nursing is to ensure that school preparing nurses maintain minimum standards of educationStandards of Care. The purpose of standards of care isto protect the public. Contractual Arrangement in Nursing What is contract? — contract may be defined asa legally binding agreement that recognizes and govern the rights ‘and duties ofthe parties to the agreement. — In Healthcare contract is @ mutual agreement between patient and a nurse concerning their expectations of each other during a hospital stay Types of Contract. + Veshal - Contract in which in terms are agreed by spoken communication. No legal document binding it however has been discussed and agreed upon by the parties invohed + Watten - an agreement made on printed document that has been signed by parties to‘a contact. A written contract cannot be change legally by an oral agreement, + Expressed - two parties discuss and agree orally or writing to its terms. + Implied - when it has not been explicitly agreed upon by the parties but considered to exist by the law. Contructual Agreements in Nursing. + Liability is the quality or state of being legally responsible for ones obligations and action for making financial restitution for wrongful acts, + Contractual obligations refer to nurses duty to render case established by the presence of an expressed or implied contract. Contractual Relationship Patient to Nurse. Contract may exist between > Nurse and Client - assist in establishing the terms, goals, and expectations of both parties tothe contract. In the contract one or both parties commit to a set of behaviors related to care of the patient, > Nurse and Employer What is Breach of contract? *Occurs when one or more parties to a contact fail to meet up with obligations/responsiblties. “Its also means of violation of contract through failure to perform contractual obligations whether partially, or wholly or as described in the contract ‘Types of Breach of Contract. a. Actual Breach - this occurs when one party fails or refuse to perform his/her promises under the contract. b. Anticipatory Breach - renunciatoty breach. ‘Occurs when a party demonstrates his intention to breach a contract Informed Consent.‘An agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment, alternatives to the treatment, and prognosis ifnot treated by a health care provider “the goal ofthe informed consent is ‘mutual decision-making between both proffesional and patient over the treatment option that the patient wishes to receive or not. ‘Two (2) types of consent. 1. Express Consent - may take the form of either oral or writen agreement 2. Implied Consent - exists when the individuals nonverbal behavior indicates agreement. General Guidelines include the following: + The diagnosis or treatment that requires treatment, + The purpose of the treatment.+ What the client can expect to feel or experience + The intended benefits of the treatment. + Possible risks or negative outcomes of the treatment, + Advantages and disadvantages of possible alternatives to the treatment. (including no treatment) Informed consent has three major elements: + The consent must be given voluntary + The consent must be given by a cient or individual with the capacty and competence to understand. + The client or individual must be given enough information to be the utimate decision-maker. ‘Three groups of people that cannot provide consent: + Minors + Individuals who are unconscious or injured+ People with mental illnesses who have been Judged by proffesionals to be incompetent Nurse's Role The nurse's signature confirms three things 1, The client gave consent individually 2. The signature is authentic 3. The client appears competent to give consent Delegation Defined as "Process for a nurse to direct another person to perform nursing tasks and activities > during delegation, delegators transfer responsibilty and authority for completing a task to the delegate; however, the delegators always ‘maintains accountability forthe task’s completion Violence, Abuse, and Neglect. Violent behavior can include domestic violence, child abuse, abuse of older adults, and sexualabuse. > Neglect is the absence of care necessary to ‘maintain the healthy and safety of a vulnerable individual such as a child or older adult. Controlled Substances. U.S Laws regulate the distribution and the use of controlled substances such as narcotics, depressants, stimulants, and hallucinations. Misuse of controlled substances leads to criminal penalties. The Impaired Nurse ~ refers to a nurse's inability to perform essential jb functions because of chemical dependency on drugs or alcohol or mental illnesses. > top four risks factors that make nurses susceptible to substance use disorders in the workplace are access, stress, lack of educetion, and attitude. ‘Sexual Harassment.inwelcome sexual advances, request for sexual favors, and other verbal or physical conduct of a sexual nature Abortion, Medical process of ending a pregnancy so it does ‘not result in the birth of a baby. ‘Advance Health Care Directives. Includes a variety of legal and lay documents that help ensure a person receives the medical care they want if they carit make decisions for themselves. Two (2) types > Living Will > Health Care Proxy ‘Autopsy or Post mortem Examination. is an examination of the body after death, itis performed only in certain cases.Certification of Death. By law, DC must be made out when an individual dies. It is usually signed by the attending primary care provider and filed with a local health or other government office, DO-NOT-RESUSCITATE ORDERS (DNR). Generally written when the client or he proxy has expressed the wish for no resuscitation in the event of 2 respiratory or cardiac arrest. Euthanasia. > is an act of painlessly putting to death people suffering from incurable or distressing disease. ~ Mercy Kiling > Voluntary Euthanasia refers to situations in which the dying individual desires some control over the time and manner of death Inquest is a legal inquiry into the cause or manner ofdeath ~ Inquest is conducted under the jurisdiction of a coroner or medical examiner. ‘Organ Donation. ~ the process when a person allows an organ of their own to be removed and transplanted to ‘another person, legally ~ the donation can be made by a provision in a will cr by signing @ card-tike form. This card is usually carried at all times by the person who signed it. ~ CRIMES AND TORTS - + CRIME -is an act committed in violation of public (criminal law and punishable by a fine or imprisonment. FELONY -isa crime ofa serious nature, punishable by a term in prison Severe compared to crime. + MISDEMEANOR - is an offense ofa less serious nature and is usually punishable by afine or a short-term jail sentence, or both + TORT isa cil wrong committed against a person or a person's property UNINTENTIONAL TORT. + NEGLIGENCE - is a misconduct or practice that is below the standard expected of an ordinary, reasonable, and prudent person + Gross Negligence - involves extreme lack of knowledge, sil, or decision making that the person clearly should have known would put others at risk or harm. + MALPRACTICE - is ‘profesional negligence,” that is, negligence that occurred while the person was performing as a proffesional Six (6) elements must be present for a case of nursing profesional 1. Duty 2. Breach of Duty 3. Forseeabilty4, Causation 5, Harm or Injury & Damages INTENTIONAL TORT. > assault, battery false imprisonment, invasion of privacy (Libel or Slander) (Liability) = requirement for consent is that a client be competent to give consent. ‘The client must be protected from four (4) types of invasion, 1, Use of a client's name or likeness for profi, without consent, 2. Unreasonable intrusion. 3. Public disclosure of private facts 4, Putting a person in a false light. Defamation. is communication that is false, or made withcareless disregard forthe truth, and result in injury to the reputation of a person. Libel, Slander The Health Insurance Portability and Accountability Act. Of 1996 (HIPPA) HIPPA includes specific areas Electronic transfer of information ‘Standardized numbers Security rule Privacy rule > The inappropriate use of Social Media of Nurses. Avoiding the inappropriate use of social media + Remember the standards of professionalism client's privacy and confidentiality tall times. + Do not take photos or videos of clients on personal devices, including cell phones. + Maintain professional boundaries when using electronic media,* Do not transmit or place online individually Identifiable cient information + Report any identified breach of confidentiality or privacy. Loss of Client Property. ‘such as jewelry, money, eyeglasses, and dentures, is a constant concern to hospital personel. Good Samaritan Acts. > Good Samaritan acts are laws designed to protect health care providers who provide assistance at the scene of an emergency against claims of professional negligence unless it can be shown that there was a gross departure from the normal standard of care or willful wrongdoing on their part Guidelines for nurses who choose to render ‘emergency care are as follows: + Limit actions to those normally consideredfirst aid, if possible + Do not perform actions that you do not know how to do. + Offer assistance, but do not insist. + Have someone call or go for adcitional help. * Do not leave the scene until the injured person leaves or another qualified person takes over. Do not accept any compensation. Professional Liability Insurance. > for nurses helps protect you from claims of ‘medical malpractice resulting from professional services Carrying out a Physicians orders. There are several categories of orders that nurses must question to protect themselves legally * Question any order a client questions, * Question any order if the client's conditionhhas changed + Question and record verbal orders to avoid miscommunications. + Questionany order that isillegible, unclear, or incomplete. Providing Competent Nursing Care. >> Competent practice is a major legel safeguard for nurses. >> Nurses need to provide care that is within the legal boundaries of their practice and within the boundaries ‘of agency policies and procedures. Documentation. >> The client's medical chart or record is a legal and formal document that can be presented in court as evidence, >> Nurses need to provide accurate and complete documentation of the nursing care provided to clients.The Incident Report. >> also called an unusual occurrence report >> is an agency record of an accident or unusual Whistle blowing. Referred to as an avt of reporting such events. Reporting a Crime, Tort, or Unsafe Practice a Write a clear descriptionof the situation you believe you should report. b. Make sure that your statements are factual and complete Make sure you are credible 4d. Obtain support from at least one trustworthy person before fling the report. Report the matter starting at the lowest possible level in the agency hierarchy. Assume responsibilty for reporting the individual by being open about it Sign your name to the letter.9. See the problem thoroughly) once yoi have reported it = Nursing students are responsible for their own actions and liable for their own acts of negligence committed during the course of clinical experiences, = Nurses decide their morality of their own actions ‘when they face many ethical issues that surrounds such sensitive areas. Values. Values are enduring bellefs and attitudes about the worth of a person, object, idea or action. Itis Important as it influence nurses’ ethical decision making. Beliefs are based more on faith than fact that people accept as true.Attitudes are mental positions or feelings toward a person, object, or idea that are often judged as bad or good positive or negative Moral Frameworks. ‘Nurses can use moral theories that provide different frameworks in developing explanations for their ethical decisions and actions in discussing problem situation with others. There are three types of moral theories that are ‘widely used and they can be differentiated by their ‘emphasis: (a) consequence-based (teleological) theories (b) principles-based (deontological theories (0) relationships-based (caring) theories Moral Principles, Autonomy NonmaleficenceBeneficence Justice Fidelity Veracity Nursing Code of Ethics. Its @ set of ethical principles that ‘a. Is shared by memebers of the group b.refelcts their moral judgements over time serves as a standard for thier professional actions The International Council of Nurses (ICN) first adopted a code of ethics in1953 The American Nurses Association (ANA) and the Canadian Nurses Association (CAN) are the ‘examples of national codes of ethical nurses. Nursing codes of ethics have the followingpurposes. + Inform the public about the minimum standards of the profession and help them understand professional nursing conduct + Provide a sign of the profession's commitment to the public it serves. * Outline the major ethical consideration of the profession. * Provide ethical standards foe professional behavior. * Guide the profession in self-regulation. Remind the nurses of the special responsibility they assume with caring for the sick Nurses of four (4) Fundamental Responsibilities. %& To Promote Health To Prevent lliness 8 To Restore Health % To Alleviate Suffering