LEGAL ASPECTS OF NURSING

By: Sathish RAJAMANI M. Sc (N) Lecturer, BKIN - Daudhar

INTRODUCTION
• As a nurse it has become an important necessity to be aware of the legal aspects associated with caring and helping people in the health industry today. • Consumers are becoming increasingly aware of their legal rights in the health care. • The first nursing law created was that of nursing registration in 1903.

DEFINITION
• “Those standards of human conduct established and enforced by the authority of an organized society through its government.” – Creighton. • In nursing practice its means the way in which you are obligated to obey the in professional activities. Disobedience of the law results in punishment.

IMPORTANCE OF LAW TO THE NURSE
• Nurses have more responsibility. • Increased numbers of Advanced Practice Nurses. • Law is there to assist in the decision-making process involved in nursing practice • Law is there for the protection of nursing practice. • Law is there for the identification of the risk of liability

NURSING LEGISLATION
• First Nursing Law was created in 1903. • In India Nursing practice was governed by state legislation, as state registration acts and a central act, the Indian Nursing Council Act, which was enacted in 1947.

LEGAL IMPLICATIONS
 TORTS  ASSAULT  BATTERY  NEGLIGENCE  MALPRACTICE  FRAUD  FALSE IMPRISIONMENT  INVASION OF PRIVACY  LEGAL DOCUMENTS  INFORMED CONSENTS

TORTS
• The word Tort comes from the Latin expression „Tortum‟, which means to twist. • Tort law deals with situations where a person's behaviour has unfairly caused someone else to suffer loss or harm. Examples of Tort Law include: 1. Negligence & Malpractice 2. Assault & Battery 3. False Imprisonment 4. Restraints or Seclusion 5. Invasion of Privacy 6. Defamation 7. Fraud

NEGLIGENCE
• Negligence is a failure to use reasonable care that results in harm to another party. Under negligence law, there are two different forms of negligence. • In one form, a person does something that a reasonable person would not do. • In the other form a person fails to take action that a reasonable person would take to prevent harm.

ASSAULT & BATTERY
• “Assault and Battery" are typically components of a single offense. • An intentional, unlawful threat or "offer" to cause bodily injury to another by force. • A battery is the willful or intentional touching of a person against that person‟s will by another person.

MALPRACTICE
• Malpractice refers to Negligence or misconduct by a professional person, such as a lawyer, a doctor, a dentist, or an accountant • Illegal or immoral conduct; practice contrary to established rules; specifically, the treatment of a case by a surgeon or physician in a manner which is contrary to accepted rules and productive of unfavourable results.

FRAUD
•A fraud is an intentional deception made for personal gain or to damage another individual.

FALSE IMPRISONMENT
• It occurs when the person is not allowed to leave a health care facility when there is no legal justification to detain the client. • It also occurs when restraining devices are used without an appropriate clinical need.

INVASION OF PRIVACY
• “Invasion of privacy" refers primarily to a person's right to keep his or her life private and free from the intrusion of others.

LEGAL DOCUMENTS

• Advanced Directive • Do not resuscitate orders • Informed Consent

ADVACED DIRECTIVE
•Written document recognized by law that provides directions concerning the provision of care when a person is unable to make his or her own treatment choices.

DO NOT RESUSICTATE ORDERS
* Written order by a physician when a client has indicated a desire to be allowed to die if the client stops breathing or the clients heart stops beating.

INFORMED CONSENT
•It is the clients approval to have his or her body touched by a specific individual.

LEGAL RESPONSIBILITY
• It means to practice nursing within the guidelines laid down by the law of centre/state/stautory bodies/ institution.

LEGAL FRAMEWORK FOR NURSES IN INDIA
INC ACT Norms Code of Conducts and Ethics

Central or State Govt Acts

Legal Framework for Nursing Practice

Institutional Polices, Rules & Regulations

Precedents

REGISTRATION
• Licensing is a mandatory procedure for practice of nursing. • Registration aims at protecting patients by providing care by qualified nurses. • The nurses is responsible to obtain registration in the respective state Nursing Registration Council.

LEGAL LIABILITY / ACT OF NEGLIGENCE
• License of a nurse can be suspended or cancelled for any act of negligence or mal practice. Following a specified procedure.

MEDICO-LEGAL CASES
• A medico-legal case is a patient who is admitted to the hospital with some unnatural pathology and has to be taken care of in concurrence with the police and court.

CORRECT IDENTITY
• A nurse/midwife is responsible to make sure that all babies born in hospital are correctly labeled at birth and handed over to right parent. • OT Scrub nurse has to see all the instruments / swabs are returned. She has to say OKAY‟ before closure by the surgeon.

LEFT AGAINST MEDICAL ADVICE
• Medical officers in charge of hospital must take signatures of both patients and witness to be taken as per institutional policy.

PATIENTS PROPERTY
• Inform patient on admission that hospital does not take responsibility of his belongings. • If patient is unconscious then a list of items must be made, counter checked by two staff nurses and kept under safe custody.

DYING DECLARATION
• Dying declaration can be recorded by the nursing staff with two nurses as witness when medical officer is not present. Then the declaration has to be sent immediately in a sealed cover to the magistrate.

ARTIFICIAL HUMAN INSEMMINATION
• Written consent must be obtained from both donor and recipient. • Donor and recipient must have same blood group. • Donor‟s and recipient‟s identity must be kept confidential.

RIGHTS OF A CONSUMER
• RIGHT OF SAFETY • RIGHT TO BE INFORMED • RIGHT TO CHOOSE • RIGHT TO BE HEARD • RIGHT TO CONSUMER EDUCATION

LEGAL RIGHTS OF NURSE
Right of appointing and assigning. Right of quality control. Right of using equipments. Right to care public. Right for observation and reporting. Right for record keeping.

NURSES ROLE TO PREVENT LEGAL COMPLICATION
• KNOWLEDGE OF RULES AND REGULATIONS • KEEN OBSERVATION • MAINTANANCE OF RECORDS AND REPORTS • FOLLOW 7 R‟S- RIGHT PATIENT, RIGHT DRUG, RIGHT DOSE, RIGHT TIME, RIGHT ROUTE, RIGHT REASON AND RIGHT DOCUMENTATION • AWARENESS ABOUT NURSING PRACTICE.

SOME DO’S & DO NOT’S FOR SAFE NURSING PRACTICE
• Do document all unusual incidences. • Do keep current year license to practice. • Do follow polices and procedures. • Do protect patients from injury themselves. • Do not accept money or gift from patients. • Do not give advice that is contrary to doctor‟s orders or the nursing care plan. • Do not witness a patient‟s will. • Do not work as a nurse without license.

CONCLUSION
• Every nurse should act as per the legal guidelines for nursing practice while caring for patient since negligence may cause a great distress to nurse. The knowledge of rights is integral with the expanding role and a logical application of the planned systematic and focused care.

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