Basic Nursing: Foundations of Skills & Concepts Chapter 6

1. Basic Nursing: Foundations of Skills & Concepts Chapter 6 LEGAL RESPONSIBILITIES

2. The Law Laws may be thought of as rules of conduct that guide interactions among people.

3. Two Types of Law • Public Law: Deals with an individual’s relationship to the state. • Civil Law: Deals with relationships among individuals.

4. Types of Public Law • Constitutional Law - defines and limits powers of government. • Statutory Law - enacted by legislative bodies. • Administrative Law - regulatory laws. • Criminal Law - deals with acts against safety and welfare of the public.

5. Types of Civil Law • Contract Law (the enforcement of agreements among private individuals). • Torts (civil wrongs committed by a person against another person or property).

6. Nursing Practice & the Law • Nursing practice falls under both public and civil law. • Nurses are bound by rules and regulations stipulated by the nursing practice act as determined by the State legislature.

7. Standards of Practice • Guidelines developed under the auspices of the nursing practice acts to direct nursing care. • Liability is determined by whether the nurse adhered to the standards of practice.

8. Legal Issues in Practice • Physician’s Orders - nurses are liable for carrying out erroneous orders. • Floating - nurses must be given orientation when “floated” to unfamiliar areas. • Inadequate Staffing - nurses leaving an inadequately staffed units may be liable. • Critical Care - nurses must constantly observe and assess. • Pediatric Care - nurses must report any suspected child abuse.

9. Legal Issues in Nurse-Client Relationships Intentional Torts: • Assault and Battery. • Defamation. • Fraud. • False Imprisonment. • Invasion of Privacy.

10. Legal Issues in Nurse-Client Relationships Unintentional Torts: • Negligence - A general term referring to negligent or careless acts on the part of an individual who is not exercising reasonable or prudent judgment. • Malpractice - Negligent acts on the part of a professional.

11. Documentation • A client’s clinical history is the medical record, or chart, a legal document. • “If it was not charted, it was not done.”

12. Documentation Protocol • Documentation must be accurate and objective. • Entries must be neat, legible, spelled correctly, written clearly, and signed or initialed.

13. Informed Consent Informed consent occurs when: • The nurse discusses the surgical procedure with the client. • The client understands the risks, benefits, and alternatives to treatment. • The client signs the consent form.

14. Incident Report • A risk management tool used to describe and report any unusual event that occurs to a client, a visitor, or staff member.

15. Advance Directive • A written instruction for health care recognized under state law and related to the provision of such care when the individual is incapacitated.

16. Advance Directive Documents • Durable Power of Attorney - Designates who may make health care decisions for a client when that client is no longer capable of decision making. • Living Will - Allows a person to state preferences about use of life-sustaining measures when person is unable to make wishes known.

17. Malpractice Insurance • Many institutions provide insurance to nurses. • Personal insurance provides off the job coverage and individual legal counsel.

18. Impaired Nurses • A nurse who is habitually intemperate or is addicted to the use of alcohol or habit-forming drugs.

19. Impaired Nurses are Everyone’s Concern • Dates and times of inappropriate behavior should be documented and reported.

20. Impaired Nurses: Rehabilitation • Some employers offer an employee assistance program for the impaired nurse. • Most states have peer assistance programs to aid in rehabilitation.