Professional Documents
Culture Documents
obligations of nurses.
3
Learning Objectives
negligence.
4
Legal Limits of Nursing
Nurses have a fiduciary relationship with
patients
Sources of law
Constitution of Canada
Civil law (Quebec) and common law (rest of
Canada)
Statute law
• Federal, provincial, and territorial statutes
• Created by elective legislative bodies (Parliament,
provincial/territorial legislatures)
Precedent
Public law and private law
5
The Profession of Nursing
6
Legal Limits of Nursing
7
Professional Regulation
8
Quick Quiz!
9
Regulation of Nurse Practitioners
10
Standards of Care
11
Legal Liability Issues
in Nursing Practice
Tort
A civil wrong committed against a person
or property
Intentional tort
Willful act that violates a person’s rights
12
Legal Liability Issues
in Nursing Practice
Examples of intentional torts
Assault: physical or verbal threat
Battery: intentional physical contact without
consent
Invasion of privacy: unwanted intrusion into private
affairs, release of confidential information,
computers and confidentiality, social media
False imprisonment: loss of individual liberty and
basic rights
13
Legal Liability Issues
in Nursing Practice
Unintentional torts
Negligence
Preventing negligence
Communication and documentation
Criminal liability
May involve civil suit and criminal charge
14
Consent
Informed Consent
A signed form is required for all routine treatment, all
hazardous procedures, and some other treatments.
• The person must have the legal and mental capacity to make a
treatment decision.
• The consent must be given voluntarily without coercion.
• The person must understand the risks and benefits of the procedure or
treatment, the risks of not undergoing the procedure or treatment, and
any available alternatives.
Provisions are made for hearing-impaired, illiterate, or
foreign-language patients.
15
Quick Quiz!
16
Nursing Students and Legal Liability
17
Professional Liability Protection
Malpractice insurance: may be carried by
employer
Not applicable to employee working outside
normal scope of employment
Provides a defence when a nurse is in a lawsuit
involving negligence or malpractice insurance
Canadian Nurses Protective Society
18
Abandonment, Assignment, and
Contract Issues
Short staffing:
Can cause legal problems to occur because of
inadequate number of nurses to provide care
Abandonment
Floating:
Based on census load and acuteness of patients’
conditions
Prescriber’s orders:
Must be followed unless nurse believes an order is
in error, violates agency policy, or is harmful to
patients
19
Abandonment, Assignment, and
Contract Issues
Dispensing advice remotely (e.g., over the
phone)
High-risk activity and nurse is legally accountable
Contracts and employment agreements
Nurse expected to perform competently, adhering
to policies and procedures of agency
20
Legal Issues in Nursing Practice
Abortion
Prescription medications and controlled
substances
Communicable diseases
End-of-life issues
Advance directives and health care proxies
Organ donation
Mental health issues
Public health issues
21
Abortion
R v. Morgentaler (1988)
Unregulated by law
Problems with accessibility
22
Prescription Medications and
Controlled Substances
Nurses are not legally entitled to prescribe
medications.
Nurses administer medications with
physician’s/prescriber’s orders.
Nurses:
Must know the purpose, effect, potential adverse effects, and
contraindications of any medication administered
Are responsible for questioning any prescriber’s orders that
may be incorrect or unsafe
May be found negligent if they follow a prescriber’s order
that is unclear or incorrect
Cannabis
23
Communicable Diseases
Definition of death
Legal right to refuse life-prolonging treatment
Euthanasia
Medical assistance in dying (MAID)
25
Advance Directives and Health Care
Proxies
Advance directive: a mechanism enabling a
mentally competent person to plan for a time
when mental capacity is lost
Living will
Instructional directive
Proxy directive
Psychiatric advance directive
Nurses required to follow the wishes of a validly
appointed proxy
26
Quick Quiz!
Which of the following is an INCORRECT procedural
safeguard for MAID:
A written request must be made and signed by an
independent witness.
A doctor or nurse practitioner must provide an
27
Organ Donation
28
Mental Health Issues
A patient can be admitted to a psychiatric unit
involuntarily or on a voluntary basis.
Patients admitted on a voluntary basis have
the right to refuse treatment and the right to
discharge themselves from hospital.
If the patient may cause harm to self or
others, provincial/territorial mental health
legislation permits police officers to bring the
person for examination and treatment without
the person’s consent.
29
Public Health Issues
Public health acts assist in the prevention,
treatment, and suppression of communicable
diseases.
Nurses have the legal responsibility to follow
the laws enacted to protect the public health:
Reporting suspected abuse and neglect
Reporting communicable diseases
Reporting other health-related issues to protect
the public’s health
Some provinces/territories have legislation
regarding mandatory immunizations.
30
Risk Management
A system of ensuring appropriate nursing
care by identifying potential hazards and
preventing harm from occurring
Tools include incident report (adverse
occurrence report)
Steps involved:
Identify possible risks
Analyze risks
Act to reduce risks
Evaluate steps taken
31
Summary
32