Deck 0 Chapter 23: Legal Implications in Nursing Practice

Question 1

A nurse gives an incorrect medication to a patient without doing all of the mandatory checks, but the patient has no ill effects from the medication. What actions should the nurse take after reassessing the patient? (Select all that apply.)

1. Notify the health care provider of the situation.
2. Document in the patient’s medical record that an occurrence report was filed.
3. Document in the patient’s medical record why the omission occurred.
4. Discuss what happened with all of the other nurses and staff on the unit.
5. Continue to monitor the patient for any untoward effects from the medication.
6. Send an occurrence report to risk management after completing it.

Answer 1

1. Notify the health care provider of the situation.
2. Continue to monitor the patient for any untoward effects from the medication.
3. Send an occurrence report to risk management after completing it.

Rationale:

Examples of an occurrence include an error in technique or procedure such as failing to properly identify a patient. Institutions generally have specific guidelines to direct health care providers how to complete the occurrence report. The report is confidential and separate from the medical record. The nurse is responsible for providing information in the medical record about the occurrence. It is also best for the nurse to discuss the occurrence with nursing management only. The risk management department of the institution also requires complete documentation. The fact that an occurrence report was completed is not documented in the patient’s medical record. No discussion of why the omission in procedure occurred should be documented in the patient’s medical record. Errors should be discussed only with those who need to know such as the health care provider, appropriate administrative personnel, and risk management.

Question 2

The nurse hears a physician say to the charge nurse that he doesn’t want that same nurse caring for his patients because she is stupid and won’t follow his orders. The physician also writes on his patient’s medical records that the same nurse, by name, is not to care for any of his patients because of her incompetence. What component(s) of defamation has the physician committed? (Select all that apply.)

1. Slander
2. Invasion of privacy
3. Libel
4. Assault
5. Battery

Answer 2

1. Slander
2. Libel

Rationale:

Slander occurred when the physician spoke falsely about the nurse, and libel occurred when the physician wrote false information in the chart. Both of these situations could cause problems for the nurse’s reputation. Invasion of privacy is the release of a patient’s medical information to an unauthorized person such as a member of the press, the patient’s employer, or the patient’s family. Assault is any action that places a person in apprehension of a harmful or offensive contact without consent. No actual contact is necessary. Battery is any intentional touching without consent.

Question 3

A patient’s condition is slowly deteriorating. What actions should the nurse take to provide the best care possible? (Select all that apply.)

1. Allow the nursing student to receive verbal orders from the physician in the room while the nurse is in the medication area down the hall.
2. Document the patient’s status changes in the medical record in a timely manner.
3. Document that the health care provider has been notified of the specific patient status, including date and time that messages were left.
4. Check the chart for frequent orders.
5. Omit charting what the health provider’s response is to notification of the patient’s status change.

Answer 3

2. Document the patient’s status changes in the medical record in a timely manner.
3. Document that the health care provider has been notified of the specific patient status, including date and time that messages were left.

Rationale:

Clear, concise, and timely communication is essential whenever charting in the patient’s medical record occurs. Nursing students are not permitted to receive verbal orders. Documentation regarding communication with the health care provider must contain what was communicated by the nurse and the health care provider, orders if given, date, time, and identification of who is documenting the situation.