Lecture 7 - Legal Limits and Self-regulation Flashcards
Which three things govern legal limits of nursing?
- Sources of law
- Professional regulation
- Standards of Care
What are sources of law that govern nurses?
Civil law governs Quebec
Common Law governs the rest of Canada
What is civil law?
A clear statement of broad rules and principles that are applied if a situation arises
What is common law?*
Based upon British Common Law
–> A system of rules based on precedent
–> Decisions made based on previous similar cases
–> Usually based in payment
–> Adapts to change
What is statute law?
Statutes are created by elected official body
e.g., Federal statute that murder is illegal (criminal code), charter of rights and freedoms
What grants authority to a nursing regulatory body?
A statute law decided by the provincial government.
In Ontario, The Nursing Act of 1991, and the Regulated Health Professions Act of 1991 establishes the mandate of the CNO and defines the scope of practice for the nursing profession
What code of conduct does the CNO use?
The six part of they developed.
Who grants certificates of registration, offer practice support, ensures continuing competence of members, investigates complaints, disciplines members and sets the standards of practice and approves nursing education programs?
The College of Nurses of Ontario (CNO)
What are the controlled acts listed by the RHPA that nurses are authorized to perform by the Nursing Act?
- Psychotherapy delivered through a therapeutic nurse-client relationship
- Dispensing a drug, administering a substance by injection or inhalation
- Placing anything beyond a natural or artificial orifice, or beyond the dermis or a mucous membrane
What might count as initiation to perform a controlled act?
A physician order or medical emergency
What are the six classes of nurse registration?
- General
- Extended Class
- Non-Practicing
- Temporary
- Special Assignment
- Emergency Assignment
Who does the general class of nurse registration apply to?
RNs, RPNs, and educators
Who does the extended class of nurse registration apply to?
NPs
Who does the temporary class of nurse registration apply to?
Applicants who met all requirements for general, with exception of education & registration - new grads
Who does the special assignment class of nurse registration apply to?
Those who are in the process of immigrating - will be given an assignment with specific scope in specific facility
When is an emergency assignment nursing registration issued?
When the government declares an emergency and allows people to practice with specific training for a specific role
what are the foundational competencies of nursing?
The 101 competencies outlines in the CNO’s Entry-to-Practice Competencies for Registered Nurses
For what purposes are the entry-level RN practices established? (7)
–> Protect public
–> Practice reference
–> Approval of nursing education programs
–> Registration and membership requirements
–> Legal references
–> Public information
–> Continuing competence
The 101-competencies outlines in the entry-level RN competencies are organized thematically under which nine roles?
- Clinician
- Professional
- Communicator
- Collaborator
- Coordinator
- Leader
- Advocate
- Educator
- Scholar
What is a tort?
A civil wrong committed by one person against another causing that other some injury or damage, either to person or property.
Can be intentional or unintentional (negligence)
What might be considered assault to a patient?
Witholding care, service, or medication
What might be considered battery to a patient?
Not obtaining consent before performing a procedure, or not honoring an advanced directive
What is negligence?
Conduct that does not meet standard of care
–>Malpractice, also considered unintentional tort if someone if harmed
What are the specific criteria for negligence to occur?
- Duty of care owed to plaintiff
- Breach of duty of care by defendant
- Harm caused to patient
- Harm caused to patient due to a breach of duty
Does tort fall under criminal or private law?
Generally speaking, negligent claims fall under private law.
Consent is required for all situations except ____
In certain emergency situations
In order for consent to be legally valid:
–> Person must have legal and mental capacity to make a treatment decision
–> Language/communication barriers must be addressed
–> Understand risks and benefits
–> Voluntary and without coercion
–> Must be sensitive to cultural values of patient/family
What are the rules for obtaining consent to admission to a care facility?
Consent to admission is required by law, except in crisis situations
What are the rules for obtaining personal assistance services?
Not legally required, however it can be obtained from a substitute decision maker if the person is deemed incompetent and the care-taker wants to obtain consent.
What are the five aspects of informed consent?
- Nature of treatment
- Expected benefits
- Material risks and side effects
- Alternative courses of action/options
- Likely consequences of not having the treatment
What is the hierarchy of substitute decision-making?
- Guardian of the person - court appointed
- Someone named as an attorney for personal care
- Someone appointed as a representative by the CCB
- Family member
- PGT
When can emergency treatment be provided?
When communication is impossible, and a substitute not is not available and delaying treatment will put the person at risk.
The general assumptions is that if they were able to communicate, this person would want care and reasonable efforts to find a substitute are being made.
Consent to treatment must:
- Relate to the treatment being proposed
- Be informed
- Be voluntary
- Not have been obtained through misrepresentation or fraud
check textbook for legal issues in nursing practice
What are the six principles outlined in the CNO Code of Ethics?
- Respect client dignity
- Inclusive and culturally safe care by practicing cultural humility
- Safe and competent care
- Respectful teamwork to best meet client needs
- Act with integrity and in client’s nest interest
- Nurses maintain public confidence in the nursing profession.
