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NURSING JURISPRUDENCE




Defined as the department of law that
comprises all the legal rules and principles
affecting the practice of nursing.
It deals with:
1. All laws, rules and regulations.
2. Legal principles and doctrines governing
and regulating the practice of nursing.
3. Legal opinions and decisions of
competent authority in cases involving
nursing practice.

Sources of Nursing Jurisprudence in the
Philippines:
1. The Constitution of the Republic of the Philippines,
particularly the Bill of Rights.
2. Republic Act No. 9173 otherwise known as the Philippine
Nursing Law of 2002
3. Rules and regulations promulgated by the Board of
Nursing and/or Professional Regulation Commission
pertaining to nursing practice.
4. Decisions of the Board of Nursing and/or Professional
Regulation Commission on nursing cases.
5. Decisions of the Supreme Court on matters relevant to
nursing.
6. Opinions of the Secretary of Justice in like cases.
7. The Revised Penal Code.
8. The New Civil Code of the Philippines.
9. The Revised Rule of Courts.
10. The National Internal Revenue Code as amended

Types of Law Civil Law  Civil lawsuits involve personal injuries. and various other commercial interests. business disputes. libel and slander. . land deals.  Civil law actions must be brought by an attorney hired by the injured party (the plaintiff) against the alleged wrongdoer (the defendant).

its in the form of payment or compensation.In the NURSING Profession… Civil Liability: the basis is the damage suffered by the aggrieved party (patient) on the account of negligence of the nurse. Actual Damage – expenses incurred by the patient  .  Different kinds of damages 1. .

everything was alright  Nurse mistakenly gave or applied wrong medicine to patients wound resulting to allergy on the last day of confinement  Patient had to stay longer *****Expenses on the additional days of confinement = actual damages  .Scenario Patient underwent surgery.

Exemplary damage – those that are imposed by the court. sleepless nights 4.. Moral Damages – compensates mental anguish and sufferings. Lost of Income . usually imposed in cases of gross negligence ( repeatedly giving of wrong medications) 3.2.

If nurse is not capable of paying damages.Complaint maybe filed in the Municipal Trial court if less than P200. court may order the hosp to pay .00 or Regional Trial Court if patients claim is more than P200.000.00 Doctrine of Vicarious Liability – by virtue of employer-employee relationship .000.

The Captain of the Ship Doctrine wherein the surgeon is presume to be responsible for everything that happens within the operating room .

transport.g.Administrative law    is the body of law that governs the activities of the administrative agencies. Administrative law is considered a branch of public law. taxation. deals with the decision-making of administrative units of government (e. immigration. manufacturing) ..

the hosp has its own liability under hospital regulations and laws  Either reprimand or penalty  . meaning license of hosp is not affected by the negligence of the nurse  However.  Filed in the BON under PRC  Purely personal.In the NURSING Profession… Administrative Liability: violation of any admin law in RA9173.

. is designed to protect society as a whole rather than to compensate individuals who have been victims of criminal activity.Criminal law those dealing with homicide. and other antisocial behavior--are enforced by agents of the state against specific persons or corporations. theft. illegal drugs.

neither the Captain of the ship nor the Doctrine of Vicarious Liability applies.  Complaint filed to the Public Prosecutors Office  .In the NURSING Profession…  Criminal Liability – incurred by a guilty nurse having found guilty from homicide resulting from reckless imprudence or gross negligence Unlike in a civil liability.

relationship between individuals and the government and government agencies . PRIVATE OR CIVIL LAW body of law that deals with relationship among private individuals  PUBLIC LAW body of law for the welfare of the general public.

COURT An agency in the government wherein the administration of justice is delegated. LEGAL RIGHT  a claim which can be enforced by legal means against a person whose duty is to respect it. .

COURT MECHANISM LAWSUITproceeding in court for a purpose. Purpose: Enforce a right Redress a wrong .

 .  Example: negligence.STATUTE OF LIMITATIONS Refers to the length of time following the event during which the plaintiff may file a suit.filed within 2-3 years from occurrence.

DUE PROCESS A fair and orderly process which aims to protect and enforce a person’s right. No use of violence. FUNDAMENTAL REQUIREMENTS OF DUE PROCESS: 1. threat. Right to competent counsel 4. Right to remain silent 3. Right to be informed 2. torture 5. Right to know the witness face to face .

eliminate matters not in dispute. agree on issues or settle procedural matters.facts are presented and determined.PHASES OF DUE PROCESS  PRE-TRIAL.  TRIAL. . law applied at the end.

chart to court ○ Ad testificandum (person) testify as witness at a specified time and place  SUMMON.WRITTEN ORDERS OF COURT WRIT. objects.a writ commanding an authorized person to notify a party to appear in court to answer a complaint made against him. .an order in court ○ Duces tecum (papers) bring documents. materials.legal notes from court  SUBPOENA.

directing the doing of an act addressed to a person competent to do it  Warrant of arrest.a court order to search for properties .a court order to arrest or detain a person  Search warrant.WARRANT.a writing from a competent authority in pursuance of law.

Civil Service Law Provide for the recruitment and selection of employees in government service. 442. personnel evaluation system.D.D. qualification standards. and personnel discipline . contract and nurse staffing in industrial clinics P. 807.Labor Code Defines among other things.LAWS THAT PROMOTE THE WELFARE AND WELL-BElNG OF NURSES   P. hours of work.

7305.Magna Carta for Public Health Workers Has provisions on benefits.  R.A. rights and responsibilities of public health workers R. 8344 “No Deposit Policy” Prohibits hospitals and clinics from demanding advance payments/cash deposits before patients are admitted or treated .A.

LEGAL CONCEPTS AND ISSUES IN NURSING   LIABILITY: is an obligation or debt that can be enforced by law A person who is liable for malpractice is usually required to pay for damages. DAMAGES: refer to compensation in money recoverable for a loss of damage .

Omission – total neglect of care – didn’t do anything  .  2 types: 1.PROFESSIONAL NEGLIGENCE Negligence – failure to do something which a reasonable & prudent person should have done. Commission – wrong doing 2.

the patient cannot bring suit against the nurse. If the patient’s careless conduct contributes to his own injury. .

Duty – an obligation 2. Causation – legal cause of injury  .Negligence results from…. ELEMENTS OF NEGLIGENCE 1. Injury that is unintentional due to failure to take the usual precautions expected or the legal standards of care. Breach of duty – failed to follow the standards 3. Injury – harm demonstrated by the nurse 4.

wrong dose Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients . 2. wrong route. wrong concentration.SPECIFIC EXAMPLES OF NEGLIGENCE 1. Failure to report observations to attending Physicians Failure to exercise the degree of diligence which the circumstances of the particular case demands Mistaken Identity Wrong medicine. 3. 4. 5.

vaporizers. Burns resulting from hot water bags. wrong concentration. unconscious. wrong dose  Defects in the equipment . wrong route. sedated patients  Falls of children whose bed rails were not pulled up and locked  Mistaken identity. sitz bath  Objects left inside the patient’s body. heat lamps.drug given to the wrong patient  Wrong medicine. confused. sponges suction tips  Falls of the elderly.

leg weakness. After injection was administered to his buttocks.DOCTRINES OF NEGLIGENCE 1. the patient experienced extreme pain.  The presence of sponges in the patient's abdomen after an operation. . and was subsequently paralyzed. RES IPSA LOQUITOR .“the things speak for itself” .  Fracture on a newly-delivered baby born by breech presentation.the injury is enough proof of negligence  A patient came in walking to the out-patient clinic for injection.

2. .The liability is expanded to include the master as well as the employee and not a shift of liability from the subordinate to the master. RESPONDEAT SUPERIOR .Let the master answer for the acts of the subordinate .

The hospital will be held liable. if. and these persons prove to be incompetent  The surgeon will be held responsible in case a laparotomy pack is left in a patient’s abdomen  . in an effort to cut down on expenses it decides to hire underboard nurses or midwives in place of professional nurses.

Flood.3. legal qualifications or fitness to discharge the required duty .Irresistible force. unforeseen or inevitable event .No person shall be responsible for those events which cannot be foreseen Ex. FORCE MAJEURE . earthquake  INCOMPETENCE: lack of ability. fire.

 Their responsibilities usually pertains to the routine care of chronically ill patients.  They are therefore responsible for their own actions.  They are usually given on-job-training by the Training staff.LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES  Nursing aides perform selected nursing activities under the direct supervision of nurses. .

.A. They are to be supervised by their clinical instructors. 9173. nursing students do not perform professional nursing duties.LIABILITY FOR THE WORK OF NURSING STUDENTS  Under the Philippine Nursing Act of 2002 R.

GUIDELINES TO AVOID MISTAKES OF NURSING STUDENTS  Nursing students should always be under the supervision of their clinical instructors .

    They should be advised to seek guidance especially if they are performing procedure for the first time They should be oriented to the policies of the nursing unit where they are assigned They should be advised to seek guidance especially if they are performing procedure for the first time They should be oriented to the policies of the nursing unit where they are assigned .

Frequent conferences with the students will reveal their problems which they may want to bring to the attention of their instructors or vice-versa. . Discussion of these problems will iron out doubts and possible solutions may be provided.5. Their performance should be assessed frequently to determine their strengths and weaknesses 6.

. the patient cannot bring suit against the nurse.LEGAL DEFENSE IN NEGLIGENCE  The most common defense in a negligent action is when nurses know and attain that standard of care in giving service and that they have documented the care they give in a concise and accurate manner  If the patient’s careless conduct contributes to his own injury.

dental. are authorized to prescribe drugs. AND MEDICATIONS 6675 states that only validly registered medical. whether in private institution/corporation or in the government. .A. patient’s/client’s name. MEDICAL ORDERS. all prescriptions must contain the following information: name of the prescriber. R. professional tax receipt number.A. 6675 requires that the drugs be written in their generic names. or the pharmacy Act as amended. 5921.A. DRUGS. age. office address. In accordance with R. and date of prescription. and veterinary practitioners. professional registration number. R. and sex.

2. age. 1. sex. Name of the drug itself : both generic and brand name (RA 6675) . 3. name of physician. location of office.Ruling: Do not follow unless 3 vital information given above are present. PTR/PRC license no. Patient’s name.

Purpose : to let the patient choose among the different brand names available of a specific generic drug name .RA 6675 the Generics Act of 1988 which requires that all prescriptions of drugs should include the generic name and the brand name or the generic name alone.

: Alaxan. Minocin . Ex. Impossible prescription : are prescriptions written by a doctor in which the generic and brand names do not correspond to each other.  Exception to RA 6675 : The physician can only be allowed to write only the brand name if only one brand is available for the particular drug being prescribed.



General Rule : A nurse should never
prescribe any medication nor administer
drugs without a valid doctor’s order.
Exceptions to the general rule :
1. In case of emergency
2. In cases of national calamity
3. In cases of epidemic PLUS : there’s no
doctor around and the patient is in grave
danger of death. Good Samaritan Act

IV Therapy and Legal Implications
Philippine Nursing Act of 1991 Section 28
states that in the administration of

intravenous injection, special
training shall be required according
to protocol established
Board of Nursing Resolution No. 8

states that without such training and who administers
intravenous injections to patients shall be held liable
either criminally under Sec 30 Art. VII of said law or
administratively under sec 21 Art III or both (whether
causing or not an injury or death to the patient)

SCOPE OF DUTIES AND RESPONSIBLITIES IN IV
THERAPY
Interpretation of the doctor’s orders for IV therapy
2. Performance of venipuncture, insertion of
needles, cannulas except TPN and cutdown
3. Preparation, administration, monitoring and
termination of intravenous solutions such as
additives, intravenous medications, and
intravenous push
4. Administration of blood/blood products as ordered
by the physicians
1.

in accordance with established procedures 7.5. Maintenance and replacement of sites. Recognition of solutions and medicine incompatibilities 6. dressings. medicines. tubings. Utilization of thorough knowledge and proficient technical ability in the use/care. and evaluation of intravenous equipment . blood and blood components 8. Establishment of flow rates of solutions. maintenance.

Maintenance of established infection control and aseptic nursing interventions 11. . Maintenance of appropriate documentation. out-patient intravenous care 10. Nursing management of total parenteral nutrition. administration and termination of all forms of intravenous therapy. associated with the preparation.9.

MALPRACTICE     Doing acts or conducts that are not authorized or licensed or competent or skilled to perform. . resulting to injuries or non-injurious consequences Stepping beyond one’s authority Negligent act committed in the course of professional performance RN exceeding the scope of nursing practice & does an MD’s job.

ELEMENTS OF MALPRACTICE A.. vital signs. such as failure to check neurological status. .  Failure to take appropriate action or notify physician when significant changes of pts. or blood glucose levels on time. Standard of Care:  Failing to assess serious changes in patient condition.

"If you didn't document it.If the nurse successfully demonstrates that he/she has met an acceptable standard of care. Remember what your nursing instructors always used to say.in other words proper documentation can be your best defense! . it didn't happen!" . then there is no malpractice.

. care.B. and diligence possessed or exercised by competent and careful nurses. Duty By accepting the assigned patients the nurse has assumed a duty to treat the patient with that degree of skill.

. Legal Causation A legal cause of action for negligence usually exists when it is determined that the breach of the standard of care proximately caused damages. usually physical or emotional in nature to the victim.C.

Damages: Substantial injuries caused by breach of the standards of care that satisfy the "damages" element of a medical malpractice claim include: Death Disability Deformity Additional hospitalization or surgery to correct a medical error Severe and prolonged pain .      D.

Telephone Orders and Reports When reporting via telephone.  .  organize information beforehand to ensure that reports made by telephone are brief and clearly understood by the receiver. the nurse must demonstrate courtesy and professionalism.

 when reporting changes in the client's condition to the attending physician. . it is prudent for the nurse to review his/her notes and have assessment data ready before placing the call.

The nurse should also document in the nurses' progress notes the following: the date and time of the telephone report  the name of the physician the nurse spoke with  the data reported.  . and any order given by the physician in relation to the telephone report accomplished by the nurse.

the nurse should spell the name of the drug to the physician to avoid errors.Things to consider: Telephone orders should be brief and the person receiving it should read the order to the physician verbatim.  .  When taking medication orders.  The use of abbreviations such as "U" for units and "mcg" for micrograms is also avoided.

 The nurse also signs the order beginning with a t.  .the nurse should accomplish the following: record the date and time the order was given and write the order as dictated by the physician.o. (telephone order). the physician's name followed by her (the nurse's) name and signature and the signature of another nurse who witnessed the telephone order.

. The nurse should ensure that the physician countersigns the telephone order within 24.

For physician's orders transmitted via fax.  The nurse documents the telephone order in the nurses' progress notes immediately after the call. the order should bear the physician's name and signature.  . The nurse should also call the physician to verify if he or she initiated the order.

. “whatever is not written is not an order” Exception: During extreme emergency only! What to do? 1. 3. The nurse should sign the physician’s name per her own and note the time and order was received. Nurse should read back such order to the physician to make certain the order has been correctly written.Verbal or telephone order General rule: as possible avoid T.O. 2. Such order should be signed by the physician within 24 hours.

Negligence and malpractice . Unintentional.INTENTIONAL WRONGS  TORTS: A legal wrong. Ex. an injury committed against a person or property TYPES: 1.do not require intent but do require the element of harm.

injury or damage is needed to be liable. no harm.an attempt or threat to touch another person unjustifiably.the act was done on purpose or with intent. mental or physical threat Ex.2. ASSAULT.. Intentional.forcing a pt. to take his medication or treatment .

Unjustifiable detention of a person without a legal warrant . . Ex.BATTERY.occurs when the person is not allowed to leave a health care facility when there is no legal justification to detain the client. – giving of injection without pt’s consent  FALSE IMPRISONMENT .physical harm through willful touching of person or clothing without consent.

 INVASION OF PRIVACY  Right to privacy is the right to be left alone  Right to be free from unwarranted publicity  Exposure to public view  Divulge information from patient’s chart to improper sources or unauthorized person .

 PRIVILEGED COMMUNICATION: Statements uttered in good faith. not permitted to be divulged in court of justice .

Communicable diseaseEthics . if there is a Crime.Exceptions: Confidential information can be revealed! Pt. consent. child abuse.

DEFAMATION  Character assassination  There must be a third person who hears or read the comment before it can be considered defamation TYPES:  Slander-oral defamation  Libel-written words .

g. psychotrophic drug  . TYPES:  Physical restraints: restrict client’s movement through the application of a device e.RESTRAINTS Restraints are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity. restraint jacket.  Chemical restraints: Medications given to inhibit a specific behavior or movement. straps. sedation.g. e.

Points to consider…  Restraints are applied only when absolutely necessary and are used as a last resort.  Restraints are applied to protect the client and others from injury.  Restraints are never used as a form of punishment or used for the nurse's convenience. .

 The use of restraints is ordered by a physician and the order should be signed. and should specify the type of restraint used and for how long. Before applying restraint to a client. dated. . know the healthcare facility's policy on restraints first.

restraints may be applied by an authorized and qualified member of the healthcare unit.  . an order should be obtained from a physician within 24 hours.  Ideally. However. a physician's order should be obtained within the first hour and a registered nurse should evaluate the need for continued restraint after the first four hours of use.In emergency situations.

check the policy on restraints immediately.waiver needed.  If an ordered restraint is refused by the client or the guardian.Always obtain consent from a competent client or from the guardian in the case of a legally incompetent client before the application of restraint to avoid legal complications (the nurse may be charged with false imprisonment. battery. --. and lack of informed consent).  .

 Restraints should support normal anatomic position of body parts to prevent complications.  Restraints are applied securely and in such a way that it can be easily removed in cases of emergency.  .Choose a type of restraint appropriate for the client.

 Restraints should also be removed for 10 minutes every 2 hours to provide for ROM exercises. Watch out for cyanosis.Ongoing assessments should be performed every 30 minutes.  . or coldness. ambulation. pallor. broken skin. repositioning. and skin care.

If necessary. . When restraints are temporarily removed. the client is never left unattended or left with a family member. responsibility should only be delegated to an authorized qualified personnel and never to the client's family member.

protective care rendered.  Documentation should include the rationale for restraining the client. and notification of the physician.Proper documentation should be accomplished. client's consent.  . times restraint was applied and removed. type of restraint used. clients responses. explanations given to client and significant others. alternative to restraints tried.

TV & radio (to decrease disorientation) or any relaxation techniques. use clocks.ALTERNATIVES TO RESTRAINTS  Before restraints offer explanations. calendars. . ask someone to stay with the client.  Assign confuse and disoriented clients to rooms near the nurse’s station.  Maintain toileting routines & institute exercise and ambulation schedules as the client condition allows.

CRIMES & OTHER ACTS CRIME: An act committed or omitted in violation of the law Two elements: 1. Criminal act 2. Evil/criminal intent .

Criminal negligence  Reckless imprudence.person does an act /failing from to do an act by which damage results immediately (imprisonment 1-4 yrs)  Simple imprudence.did not use precaution and the damage was not immediate(imprisonment 1-6 months) .

negligence or lack of foresight and skills .Felony.a public offense committed with deceit and fault Manner of commission:  Deceit (dolo) when act is performed with deliberate intent  Fault (culpa) when the wrongful act results from imprudent.

Done voluntarily 3.ELEMENTS OF A FELONY 1. An act or omission 2. Punishable by law .

abortion. infanticide. rape. mutilation . parricide.(highest form of destruction).Intentional Felonies  Physical injuries. murder.

are those who.are those who.  Accomplices.  Accessories.  . Assisting the offender to profit from the crime either by disposing the body. concealing or assisting in escape of the principal of the crime. who directly force or induce others to commit it. not being principals. having the knowledge of the commission of the crime.are those who take a direct part in the execution of the act. cooperate in the execution of the offense by previous and simultaneous act.Persons liable for the crime Principals.

when all the elements necessary for its execution and accomplishment are present. Consummated felonies as well as attempted and frustrated are all punishable by law. Frustrated. do not produce it by reason of causes independent of the will of the perpetrator.Classes of Felonies Consummated.when the offender commences the commission of the same directly by overt acts. . and does not perform the acts which shall produce the felony.when the offender performs all the acts or execution which will produce the felony as a consequence but which nevertheless. Attempted.

Felonies according to degree of punishment  Grave Felonies.are those infractions of law for the commission of which the penalty of “arresto menor” (imprisonment for 1 day to 30 days or a fine not exceeding 200 or both of which are imposed) .000 but not below 200)  Light Felonies.are those which the law punishes with penalties which in their maximum period are correctional (imprisonment ranging from 1 month and 1 day to 6 yrs or fine not exceeding 6.are those to which the law attaches the capital punishment or penalties which in any of their periods are afflictive.000)  Less Grave Felonies. (imprisonment ranging from 6 yrs and 1 day with fine not exceeding P6.

JE MAA Circumstances affecting criminal liability .

JUSTIFYING SELF-DEFENSE These are the defenses in which the accused is deemed to have acted in accordance with the law and therefore the act is lawful. Since the act is lawful. no criminal liability and no civil liability . it follows that there is no criminal.

 When he acts in defense of his rights  When he acts in defense of his relatives rights  When he acts in defense of a strangers rights and that the person defending is not induced by revenge or evil motives.  In order to avoid evil or injury  In a fulfillment of a duty .

EXEMPTING There is a crime committed but there is no criminal on account of the absence of a freewill and voluntariness to act. Insane Under 9 y/o Under compulsion of uncontrollable force or by mere accident without intention Under impulse of uncontrollable fear Failure to perform an act required by law when prevented by some lawful cause .

MITIGATING Lessens the penalty Under 18y/o or over 70 y/o No intention to commit so grave a wrong Voluntary surrender Deaf & dumb/ with physical defect Suffer from such illness that diminishes willpower .

reward Use of fire. explosion Calamities Fraud or disguise employed Cruelty . poison.AGGRAVATING Increases the penalty Treachery/taking advantage of superior strength or position Price.

ALTERNATIVE May increase/ decrease criminal liability depending on the nature and effects of the crime Relationship Voluntary surrender Disguise in being employed Defense of a stranger Acts under the impulse of an uncontrollable fear Offender is insane .

CRIMES CONCERNING THE NURSE .

) Ordinary rape – forcible penetration of sex organ to a sex organ b. Rape: a.MORAL TURPITUDE  Are acts contrary to the accepted and customary rule of right 1. .  Intervention Safety (emotional and physical) Report the incidence Referral (if the father is the rapist.) Sexual assault – anything forcibly inserted to any orifice.

A.Asking sexual favors in exchange of another favor .ANTI. 7877 – Anti-sexual Harassment Act 1.RAPE LAW (RA 8353) R.Any person who exercises authority 2.

MURDER. mother 3. PARRICIDE  Killing of a person to whom you have a relationship 1. HOMICIDE. father 2.killing of another with intent 3. spouse . brothers/sisters 4.unintentional killing of another person 4. descendants 6.2. ascendants 5.

5. ABORTION- termination of
product of conception before
the age of viability.

6. INFANTICIDE
- the killing of an infant less than
three days or 72 hours.

7. ROBBERY
-

Anyone who gets the
personal property of
another with the use
of force, violence or
intimidation.

8. THEFT- -anyone who gets the personal
property of another without the latter’s
permission.

9. SIMULATION OF
BIRTH
1. Pretend that a woman gave birth
2. Substitution or exchanging of babies
in the nursery
3. Intentionally putting wrong
information in the birth registration
form
P.D. 651 – Birth Registration Act - requires
any person (RN,OB, midwife) who shall
assist in giving birth to report within 30
days without penalty any live birth at Local
Civil Registrar’s Office.

with appropriate prescription .A. Ex. DISPENSING OF PROHIBITED DRUGS R. dormicum . cocaine. 6425 (1965) – Dangerous Drugs Act A.MD with appropriated license Ex. Regulated – can use this drug . Prohibited – chemicals or substances that are totally and absolutely can’t be consumed by human being.Valium. Shabu. cannabis B..10.

PENALTY FOR VIOLATING THE ACT For licensed health care providers Fines Imprisonment Automatic revocation of license .

Develop good IPR with co-workers 6. Do not delegate responsibilities to others . Get informed consent 11. Be familiar with the laws affecting nursing practice 3. regulations. Verify vague/ erroneous orders 8. Upgrade skills and competence 5. Be very familiar with the Philippine Nursing law 2.GUIDELINES TO PREVENT CRIMINAL LIABILITY: 1. Ensure accurate recording and reporting 10. policies 4. Consult superior as needed 7. Know agency rules. Always keep doctor updated regarding patient 9.

.

Consent is defined as a “ free and rational act that presupposes knowledge of the thing to which consent is being given by a person who is legally capable to give consent”  Nature of consent.an authorization by the patient or a person authorized by the law to give the consent on the patient’s behalf.  Informed Consent-A written consent should be signed to show that the procedure is the one consented to and that the person understands the nature of the procedure  .

 The

nurse’s responsibility in
witnessing the giving of informed
consent involves:
 (1) witnessing the exchange b/w the
client and the physician (2)
witnessing the client affix his
signature (3) establishing that the
client really understood.

ESSENTIAL ELEMENTS OF
INFORMED CONSENT:
The diagnosis and explanation of the condition
2. A fair explanation of the procedures to be done
and used and the consequences
3. A description of alternative treatments or
procedures
4. A description of the benefits to be expected
5. The prognosis, the recommended care,
procedure is refused
1.

Patient must consent in his own
behalf If he is incompetent, or
physically unable, and is not in
emergency case, consent must be
taken from another who is
authorized to give it in his own
behalf.

Parents or someone standing in their behalf. gives the consent to medical or surgical treatment of a minor. Parental consent is not needed if the patient is married or emancipated .

The consent must be taken from parents or legal guardian .A mentally incompetent person cannot legally consent to medical or surgical treatment.

speech. decision making and physical and mental status are very useful in establishing his/her mental competency  .MENTAL COMPETENCY All patients are presumed to be competent unless declared incompetent by a court of law.  Supporting documentation of the patient’s behaviors.

. If time is available and an informed consent is possible.No consent is necessary because inaction at such time may cause greater injury. it is best that this be taken to protect all the parties concerned.

.A patient who is mentally and legally competent has the right to refuse the touching of his body or to submit to a medical or surgical procedure no matter how necessary. nor how imminent the danger to his life or health if he fails to submit to treatment.

Sterilization is the termination of the ability to produce offspring's. The husband and the wife must consent to the procedure if the operation is primarily to accomplish sterilization. . consent from patient is sufficient. If emergency cases like ectopic pregnancy and abruptio placentae.

g. Medicare)  good evidence in legal suits but are not admissible evidence against the patient.to provide legal documentation.  serve two important functions: 1.  .obtain third party payments (e.MEDICAL RECORDS created as a means of communication among health care practitioners. and 2.

a nurse is not liable for a non-observable and nondiscoverable defect in the equipment. . Generally.The nurse should exercise reasonable care in selecting equipment to be used in patients.

.WILL An act whereby a person is permitted by law to have control in the manner of disposing his estate but will take its effect at the time of his death.

Important terms… Decedent : a deceased person  Testator : the dead person who made the will (male)  Testatrix : the dead person who made the will (female)  .

* Without a last will and testament : heirs should divide estate in equal sharin . Intestate : succeeding by law and not governed by a will. Testate succession : the mode of succession wherein the heirs inherit by virtue of a last will and testament.  2.Two types of succession by heirs 1.

Holographic will 1. . Two types of last will and testament Concerning properties & Concerning body / life Notarial/Ordinary will 2.

at the end of the will written by the patient b. Check the patient’s level of consciousness : the nurse must ascertain that the patient is capacitated to make a will  2.  3. Presence of three witnesses  .Notarial or Ordinary Wills : The following are the nursing considerations : 1. Check the proper locations of the signatures :  a. in all pages at the sides of the paper. by the testator/testatrix and 3 witnesses.

* If nobody witnessed the writing of the will. It should be dated and signed using the hands of the testator/testatrix.Holographic Will : wills that are executed during emergencies but the patient is still conscious.  .  Requisites of a holographic will :  1. comparison to other documents made by the testator/testatrix is necessary to ensure its validity. It should be entirely handwritten  2.

and funeral services  . Living will  2.Advanced directives : are directions or instructions made by the patient in advance with what to do with the patient’s body. Instructions for DNR. cremation. organ donation. such :  1.

 Legal rights of a nurse and illegal detention : Illegal detention is a crime if a person. will limit the freedom of a patient to move or travel from one position / place to another  Exception : when there are quarantine regulation orders such as what happen in migration  . such as a nurse.

that it be for probate within a specified time  . that it is done in the place in which a he dies.HEIR is a person called to succession either by the provision of a will or by operation of law  There should be a witness who knows the handwriting and signature of the testator explicitly declares that the will and the signature are in the handwriting of the testator  ORAL WILL is also called as NUCUPATIVE WILL or NUNCUPATION it is during the last illness. that the will be put in writing within a given number of days. that he asked one or more witness to the will.

NURSE’S OBLIGATION IN THE EXECUTION OF A WILL The nurse should note the soundness of the patient’s mind and that there was free from fraud or undue influence and that the patient was above 18 years or of age . that the witnesses were all present at the same time and signed the will I the presence of the testator  .  The patient should write that the will was signed by the testator.

 The person who makes a will should at least be 18 years old and is not prohibited by law.  There is no legal reason for the nurse to refuse to witness the preparation of a will.  . unless it is holographic will.WHAT SHOULD A NURSE REMEMBER ABOUT WILLS? A nurse especially those taking care of well-to-do patients should remember that the main requisite for making a will is testamentary capacity or sanity. T  The will is written and should be witnessed by three credible witnesses.

 .WHAT IS AN INCIDENT REPORT It is an administrative report that is required of nurses if there are violations of standards and policies whether or not injury occurs. hospital administration can monitor quality of patient care and institute some measures to prevent similar incidents in the future.  Through incident reports.