Class 2 - Legislation Governing Practical Nursing Practice Flashcards
What does the law serve in respect to nursing?
there are 3 points to remember
- Provides a framework for establishing which nursing actions in the care of clients are legal.
- Outlines the responsibilities that govern nursing practice & nurses’ relationships with physicians, other health care practitioners, and the health care system.
- Assists nurses in ensuring they are consistent, competent, & safe in providing quality care that serves society while preserving individual rights & human dignity.
What does common law tradition mean?
there are 3 points to remember
- Legal principles & rules evolve through the courts.
- Judges interpret & apply principles from similar decisions in previous cases (precedents) to the case before them to make a decision.
- No two cases are identical & common law develpos through judges making distinctions between cases. Provides consistency & predictability.
What does civil law tradition mean?
there are 2 points to remember
- Laws are written down in a “code.”
- This code provides all citizens with an accessible & written collection of the laws that apply to them & that judges must follow.
What does statutory law mean?
there are 4 points to remember
- Parliament has the power to pass laws for all of Canada.
- Legislatures of each province & territory pass laws of a more local nature.
- Laws enacted by these legislative bodies are called statutes, legislation or acts.
- When Parliament or one of the legislatures enacts legislation, that legislation then supersedes any case law dealing with the same subject.
What does criminal law mean?
- Laws that affect the public welfare.
- Breaking the law is a crime punishable by imprisonment, probation, loss of license, fines or a combination.
- Designed to preserve society.
Punishments designed to deter people from committing crimes. - Any violation of the law that governs the practice of nursing is considered a crime. (ex. LPN representing self as an RN)
Who is responsible for the Canadian health care system?
Federal and provincial/territorial governments are responsible for the Canadian health care system.
Who is responsible for regulating health care professionals?
it is the responsibility of the provinces & territories and delegated to the provincial/territorial professional organizations, like CLPNBC etc.
What is tort law?
it is the body of law through which a person who suffers injury caused by another person is able to claim compensation for that injury. The goal is to put the person who suffered the harm back in the position he/she would have been in had the injury not happened.
Two categories: 1. Intentional torts
2. Negligence
Define negligence
failure to behave in a reasonable and prudent manner
Ex. failing to follow proper procedure in moving a patient
Define assault
an attempt or threat to touch someone with out consent
Define battery
willful or negligent touching of a person which may or may not cause harm
Define false imprisonment
the unlawful restraint or detention of another person against their wishes.
What is disclosure
refers to the provision of information as it pertains to the risks of treatment, alternative treatments and any associated risk and the affects of no treatment
What is meant by capacity
refers to the patients ability to understand relevant information and the consequences of the decisions
Define informed consent
patient is advised of all of the information and has the ability to make a decision
Define expressed consent
a clear statement by the patient and can be oral or written.
Ex: a nod by a patient to go ahead with intervention
Define implied consent
non verbal behaviour indicating willingness to proceed with intervention
Define confidentiality
the right of anyone that any information about that individual will not be made public or available to others
Define privacy
a degree of of social retreat that provides a feeling of comfort
Define problematic substance use (drug abuse)
a disruption in any area of a persons life caused by excessive intake of a substance either continually or periodically
Define chemical dependancy
addiction to a mood or mind altering drug
Ex: alcohol or cocaine
What is it about confidentiality and social media that nurses neeed to be aware of
that nurses are held to a certain level of professionalism and that putting anything on Facebook, twitter etc… about collegues or clients can have serious legal consequences.
What is advanced care planning
Allows older adults to have a say in what they would choose for health care/interventions if/when they become unable to make those decisions (i.e. dementia, strokes, etc.)
What information is in an advanced care plan
- Who do you want to make your health care decisions for you?
- What health care treatment(s) do you agree to, or refuse, if a health care provider recommends them?
- Would you accept or refuse life support and life-prolonging medical interventions for certain conditions?
- What are your preferences should you need residential care and not be able to be cared for at home?
Advanced care planning has several options what are they
there are 5
- Standard representation:
allows the person to name a someone that they want to make personal care decisions. This not allow the named person to refuse life support or life-prolonging medical interventions for you - Advanced representation agreement:
allow a person to name someone to make personal care decisions, some health care decisions (including decisions to refuse life support or life-prolonging medical interventions) - Advanced directives:
allows you to state your decisions about accepting or refusing health care treatments, including life support or life-prolonging medical interventions, directly to a health care provider. The advance directive must be followed when it addresses the health care decision needed at the time. No one will be asked to make a decision for you. - Enduring Power of Attorney:
allows you to appoint someone to make financial and legal decisions on your behalf if you become incapable.
5. Temporary Substitute Decision Maker (TSDM):
a temporary substitute decision maker is chosen if you have not legally named an individual (representative) to make health care decisions for you when you are incapable of making them
yourself.
*Must be 19 or over
*Must have no dispute with the
older person
*Must have had contact in the
past 12 months
*As per the list of people who
will be contacted – the order
cannot be change
For a Temporary Substitute Decision Maker (TSDM) what is the list of people that will be contacted and in what order
(there are 9)
- Your spouse
- A son or daughter (19+)
- A parent
- A brother or sister
- A grandparent
- A grandchild
- Anyone else related to you by
birth or adoption - A close friend
- A person immediately related
to you by marriage (in-laws,
step-parents, step-children,
etc.)
Explain the Health Care Consent and Care Facility Act
- Does not apply to anyone admitted to a care facility under the Mental Health Act
- Under the act every adult is presumed to be capable of given consent for:
*Giving, refusing, revoking
consent to health care
*Deciding to apply, accept
offer, or move out of a
residential care facility
What are the consent rights
there are 6
(a) the right to give consent or to refuse consent on any grounds
(b) the right to select a particular form of available health care
(c) the right to revoke consent
(d) the right to expect that a decision to give, refuse or revoke consent will be respected
(e) the right to be involved to the greatest degree possible in all planning and decision making.
(f) Incapacity is determined
When is consent required
A health care provider must not provide any health care to an adult without the adult’s consent except under sections 11 to 15.
A health care provider must not seek a decision about whether to give or refuse substitute consent to health care under section 11, 14 or 15 unless he or she has made every reasonable effort to obtain a decision from the adult.
What are the parts of a consent (what is a consent made up of)
- Relates to the proposed health
care
- Is given voluntarily
- Not obtained by fraudulent
means
- The adult is deemed capable of
giving consent
- The health care provider gives
the appropriate information –
“informed consent”
- The adult has had the
opportunity to ask questions –
role of nurse or doctor?
- Consent must be expressed
orally, in writing, or inferred by
conduct
- Consent is only for what the
adult has agreed to except
when:
*The adult is unconscious or
semi-conscious
*Medically necessary to
provide additional or
related care that was
unforeseenSection 11 -A health care provider may provide health care to an adult without the adult’s consent if
(a) the health care provider is of the opinion that the adult needs the health care and is incapable of giving or refusing consent, and
(b) the adult’s personal guardian or representative
(i) has authority to consent to
the health care,
(ii) is capable of giving
consent, and
(iii) gives substitute consent.
Section 14 – Major Health Care
what are the 2 points
The ability to give major health care (i.e. surgery) without consent of adult but in consultation with primary relative (if possible) if it is life/death, or if the adult is deemed incapable of consenting or refusing care
Or if the adult has a legally appointed substitute decision maker and is incapable of consenting/refusing
Section 15 – Minor Health Care
- A health care provider may provide minor health care to an adult without the adult’s consent if
(a) the health care provider is of the opinion that the adult is incapable of giving or refusing consent to the minor health care,
(b) the adult does not have a personal guardian or representative or the personal guardian or representative is incapable of giving or refusing consent, and
(c) someone chosen under section 16 gives substitute consent to the minor health care.
How is Incapability Determined?
a health care provider must base the decision on whether or not the adult demonstrates that he or she understands
(a) the information given by the health care provider
(b) that the information applies to the situation of the adult for whom the health care is proposed.
What are the nurse’s responsibilities
- assessing capacity in order to obtain consent (verbally, written, or indicated)
- there is no algorithm for assessing capacity and capacity cannot be globally applied
- know the laws in your province
What are the expectations regarding reporting elder abuse
- Mandatory reporting of suspected abuse or neglect of residents in residential care
- However, if an adult is determined competent then he/she has the right to make decisions about their personal care and can refuse assessment and interventions
