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

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

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

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.

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).

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.

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.

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.

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

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.

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

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

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.

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

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.

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.

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

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

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

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