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NURSING

JURISPRUDENCE
BY: ATTY DEIRDREE CODAMON-
GALLMAN, RN
• NURSING JURISPRUDENCE-
department of law which comprise all legal
rules and principles affecting the practice
of nursing.
• NURSING LEGISLATION- the making of
laws, or the body of laws already affecting
the practice of nursing.
• LAW- a rule of civil conduct prescribed by
the supreme power in a state commanding
what is right and prohibiting what is wrong.
• LEGAL RIGHT- a claim which can be
enforced by legal means against a person
whose duty is to respect it.
• COURT MECHANISM:
• LAWSUIT- proceeding in court for a
purpose.
• Purpose:
1. to enforce a right
2. to redress a wrong
• Civil case- Complainant/ defendant
• Criminal case- Plaintiff/ accused
• STATUTE OF LIMITATIONS- the length of
time following the event during which the
plaintiff may file a suit.
• Example: negligence- filed within 2-3
years from occurrence.
• DUE PROCESS- is a fair and orderly process
which aims to protect and enforce a person’s
right.
• FUNDAMENTAL REQUIREMENTS OF DUE
PROCESS:
1. right to be informed
2. right to remain silent
3. right to a competent counsel
4. no use of violence, threat, torture
• TRIAL- facts are presented and
determined; law applied at the end.
• SUMMONS- is a writ commanding an
authorized person to notify a party to
appear in court to answer a complaint
made against him.
• SUBPOENA- is an order that requires a
person to attend at a specific time and
place to testify as a witness.
• SUBPOENA DUCES TECUM- is a
subpoena that requires a witness to bring
documents/ papers in his possession.
• WITNESS- person giving necessary
details
• Nurses as witness:
• Could not divulge PRIVILEGED
COMMUNICATION in a civil case- means that
the nurse is incompetent to testify on the
communications made to him by the patients, all
the device given and all the information gathered
by observation during the seal of secrecy.
• Exceptions: 1. criminal case
• 2. with the patient’s consent
• 3. patient sued doctor for damages
• Testimonies of Facts- factual information
• no opinion unless an expert witness
• PERJURY- is the willful telling of a lie
under oath.
• HEARSAY EVIDENCE- rumors, not
admissible in evidence
• DYING DECLARATION- considered
hearsay unless the dying person is a
victim of a crime.
• FELONIES- acts or omissions punishable
by law.
• Elements:
1. Deceit
2. Fault- due to imprudence, negligence or
lack of foresight/ skill
• CLASSES OF FELONY:
1. Consummated- all elements executed,
with successful result
2. Frustrated- all elements executed but no
successful result
3. Attempted- not all elements executed
• DEGREE:
1. GRAVE- capital punishment or above 6yrs
and 1 day imprisonment or fine > 6
thousand pesos.
2. LESS GRAVE- 1 mnth and 1 day to 6
years or fine not > 6 K but not less than
200 Hundred pesos.
3. LIGHT FELONY- 1 day to 30 days, fine
not > 200 hundred pesos.
• CLASSIFICATION OF PERSONS CRIMINALLY
LIABLE:
1. PRINCIPAL
a. By direct participation- a person who takes
direct part in the execution of the act.
b. By inducement- those who directly force or
induce others to do the act.
c. By cooperation- those who cooperate in the
commission of the offense by another act
without which the crime would not have been
possible.
2. ACCOMPLICE- a person who cooperate in the
execution of the crime by previous or
simultaneous acts; “ accessory before the
fact”- absent at the time crime is committed.
3. ACCESSORY- “ accessory after the fact”
a. Profiting themselves or assisting others to profit
b. Concealing/ destroying the evidence of the
crime
c. Harboring, concealing or assisting the escape of
the principal
• CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY:
1. JUSTIFYING CIRCUMSTANCES- not criminally liable
a. lawful self- defense
• Elements:
• Unlawful aggression on the part of offended party;
• Reasonable necessity of the means employed by the
offender to prevent or repel such aggression; and
• Lack of sufficient provocation on the part of the offender.
b. Obedience to an order issued by superior
for some lawful purpose
2. EXEMPTING CIRCUMSTANCES-
exempted from criminal liability
a. Imbecile/ insane, except lucid interval
b. Person below 9 years old
c. Person above 9 and below 15 years old
unless he acted with discernment
d. Any person while performing a lawful act,
causes injury by mere accident/ without
intention of causing it
e. A person who acts under compulsion or
irresistible force
f. A person who fails to perform an act
required by law when prevented by some
lawful cause.
3. MITIGATING CIRCUMSTANCE- reduces
liabilty
a. Below 18 y/o or over 70 y/o
b. Does not meet all the requisite
circumstances under justifying and
exempting circumstance
c. Offender had no intention to commit so
grave a wrong as that committed
d. Sufficient provocation or threat was
present immediately preceding the act
e. Offender is deaf, dumb, blind or with other
physical defect
f. Voluntary surrender
g. Illness diminishing exercise of will power
4. AGGRAVATING CIRCUMSTANCE-
increases liability
a. advantage of public position
b. committed with abuse of confidence
c. on occasion of earthquake, epidemic,
calamity
d.for price or reward
e. by means of fire, poison, explosion
f. evident premeditation
g. treachery
h. use of fraud or disguise
5. ALTERNATIVE CIRCUMSTANCE- either
aggravating or mitigating
a. relationship
b. intoxication
c. degree of instruction/ education
• CRIMES CONCERNING NURSES/
HEALTH CARE PROVIDERS:
• Parricide
• Homicide
• Murder
• Infanticide
• Abortion
• Illegal detention
• Simulation of birth
• Misdemeanor
• Robbery
• Theft
• Acts of lasciviousness
• Rape
• Physical injuries
• Assault- imminent threat of harmful/
• Assault- imminent threat of harmful/
offensive body contact
• Battery- intentional, unconsented
touching of another person
• Invasion of right to privacy and breach of
confidentiality
• Defamation- character assassination
• slander- oral
• libel- written/ printed
• GUIDELINES TO PREVENT CRIMINAL
LIABILITY:
1. Be very familiar with the Philippine Nursing law
2. Be familiar with the laws affecting nursing
practice
3. Know agency rules, regulations, policies
4. Upgrade skills and competence
5. Develop good IPR with co-workers
6. Consult superior as needed
7. Verify vague/ erroneous orders
8. Always keep doctor updated regarding
patient
9. Ensure accurate recording and reporting
10. Get informed consent
11. Do not delegate responsibilities to others
• LEGAL CONSIDERATIONS IN CHARTING:
1. Don’t tamper with medical records- adding,
rewriting and destroying original record
2. Observe agency’s standards on documentation
• complete, concise, specific, use standard
abbreviations
• telephone orders
• TIPS FOR AVOIDING LEGAL PITFALLS:
1. Patient Falls
• do proper assessment
• appropriate assistance is given
• use protective measures
• document all nursing interventions
2. Medication errors
• observe 7 R’s of drug administration
• Check dr’s order
• Understand the medication you will
administer
• Consult drug handbook/ pharmacy
• Not exempt from liability for following dr’s
order
3. Equipment injuries
• refuse to use a device not know how to
operate
• report adverse events to superiors
• monitor patient regularly
• bring questionable orders to the attention
of the doctor or superior
• familiarize self with existing protocol
• Failure to communicate
– promptly report changes in the patient’s
symptoms and signs of distress to the Dr
– proper documentation of all assessments and
telephone conversations with the Dr
• BOARD QUESTIONS:
1. The nurse out of pity unhooked the
patient from a respirator. The patient
died after 15 minutes. This type of
felony is:
a. consummated
b. frustrated
c. attempted
2. Circumstances which are said to be in
accordance with the law are said to
be:
a. Justifying
b. Exempting
c. Mitigating
d. Aggravating
3. All of the following are exempting
circumstances except:
a. Imbecile
b. 8 year old
c. performance of a lawful act
d. offender is deaf and dumb
4. When a politician takes advantage of
his power in the performance of
unlawful actions, this is considered
as:
a. justifying circumstance
b. exempting circumstance
c. mitigating circumstance
d. aggravating circumstance
5. When one alters a record to conceal
possible evidence of negligence, she
can be charged as:
a. accomplice
b. accessory
c. principal
d. co-principal
• BOARD QUESTIONS:
1. A client in a long term care facility refuses to
take his oral medications. The nurse
threatens the client and tells him that, if the
medication isn’t taken, restraints will be
applied. The nurse’s statement constitutes
which legal tort?
a. assault
b. battery
c. negligence
d. right to refuse treatment
2. The nurse is at risk for lawsuit. Which of the
following actions will shield her from
possible lawsuits?
1. knowledge and implementation of standards
of care
2. documentation of actions accurately and
concisely
3. document outcome of care
4. following all doctor’s order
a. 1,2,4 b. 2 & 3 c. 1,2,3 d. 2,3,4
3. One of the midwives in the health center
injected Cotrimoxazole to a 5 year old
patient without the consent of the parents.
Which of the following can the midwife be
possibly accused of?
a. malpractice
b. battery
c. negligence
d. assault
4. If that nurse divulges the information
that she is caring for the child of a
patient with sexually transmitted
disease, she can be liable for:
a. libel
b. slander
c. tort
d. invasion of privacy
5. Two janitors were having a heated argument
as to who shall dispose the waste of a
patient with typhoid fever. The first one
called the other “lazybone” and “pain in
the neck” within the hearing of the rest of
the nurses.The case is:
a. libel
b. invasion of privacy
c. slander
d. negligence
6. Should the accusation be written in the
newsletter of the hospital, such
liability is a:
a. assault
b. libel
c. slander
d. battery
7. The nurse observed that in the hospital where she
worked, it is a practice to accept medical orders by
telephone. In this aspect, she should remember the
following:
a. T.O should be countersigned by the attending
physician at the first opportunity to make it legal
order
b. T.O are risky and should not be accepted
c. The nurse could write on the the doctor’s order
sheet the exact date, time and full name of the dr
giving the order
d. The nurse can sign for the doctor on the order sheet
• a. 1,4 b. 1,2 c. 3 only d. 1, 3
8. The nurse noticed that restraining patients is
a common practice. Which of the following
should she remember?
a. Restraints are necessary so that the nurse
could do more work for patients
b. Use of restraints is an effective intervention
c. Restraints require a physician’s order
d. Refusal to be restrained is a ground for
terminating the nurse-patient relationship
• 9. Patient records are very important in
court litigations. Which of the following
safeguards should be adopted by the
nurse?
• A. follow standard charting
• b. photocopy pt’s chart before submitting
to the medical records Office
• c. maintain a logbook of potential legal
case
• all of the above
• NURSE’S AND CONTRACTS / WILLS

• CONTRACT- agreement between atleast


two parties which create an obligation
recognized by law.
• Elements of a valid contract:
1. given freely/ voluntarily- no coercion/
pressure
2. competent parties- 18 yrs old, sound mind
3. lawful object- within the bounds of law
4. valid consideration- has monetary value
• Essential requisites:
1. Consent
2. Object certain
3. Cause of the obligation
• Types of Contract:
1. Implied- terms are inferred from actions of
contracting parties.
2. Expressed- verbal/ written, terms are
specified/ given at the time the contract is
made.
• BREACH OF CONTRACT- failure without
legal excuse to perform any promise which
forms the contract.
• WILL- an act whereby a person is
permitted with formalities of law to control
to certain degree the disposition of a state
to take effect after his death.
• DECEDENT- person whose property is
transmitted through succession.
• TESTATOR- a decedent who left a will
• TWO KINDS:
1. notarial will- acknowledged before a
notary public, with attestation clause
2. holographic will- entirely written, dated
and signed in the handwriting of the
testator
• Who makes wills:
1. those not expressly prohibited by law
2. 18 yrs old
3. sound mind
• Who could be witnesses:
1. sound mind
2. 18 and above
3. not blind, deaf or dumb
4. able to read and write
• NURSE’S OBLIGATION IN THE
EXECUTION OF A WILL:
1. Note the soundness of client’s mind and
to ensure that there is freedom from fraud/
undue influence.
2. Note that the will is signed by the testator.
3. Note that the witnesses shall be present
at the time and sign in the presence of
testator.
• GIFTS MORTIS CAUSA- disposing of gifts
by a person in anticipation of death/ belief
in approaching death.
Limitations:
1. limited to personal properties
2. acceptance by the recipient
3. gifts are revocable and subject to the
claims of creditors without proof of intent
of defrauding them