Legal Concepts of Nursing Practice Flashcards
Socio-legal influences that contribute to increased lawsuits
- Forces of consumerism; high expectations, more knowledge, greed mentality, money for mistakes
- Liberal interpretations by the courts
- Better, informed public
Risk factors that put you at risk
- Your name is on the medical incident report or record
- You make a mistake while observing a pt, or someone thinks you did
- Someone claims you made an error in reporting or recording pt care details
- DR claims you misunderstood his directions
- Pt or relative claims you did not provide adequate pt instructions
- Someone under your supervision makes a mistake; CNA, new staff, float
- DR or hospital gets sued and then sues you
- Required to go to court if sued
- Liable for hundreds of thousands of dollars in damages if you lose
How to protect yourself against liability
- Purchase nurse’s liability insurance
- If someone sues you and you are properly insured you will be covered
- You are not alone if you are a part of a professional association; they have their own lawyers
- Be knowledgable about proper nursing procedures and standards of care
What are proper nursing procedures and standards of care?
- Proper nursing procedures are determined from the policies and procedures manual of the hospital
- If a situation is not covered by the manual then deciding what proper procedure is determined by a nurse withness or can be left up to the jury
- You are responsible for all the actions you take
- You are acountable for all the acts you delegate, supervise, perform, or fail to perform when the standard states it should have been done
Who determines standards of care?
- Nurse Practice Act
- Good Samaritan Laws
Who determines professional standards?
- American Nurses Association
- Specialty Nurses Associations
Proper charting to minimize your risk:
- Chart with jury in mind-just the facts
- Do not record opinions
- Include pt’s descriptions of his or her symptoms even if incorrect
- Do not omit the obvious
- Do not delete incorrect entries
- Do not chart for someone else
- Chart as you go and not at the end of the shift
- Notify physician and do appropriate followup if you observe serious changes in a pt’s condition
Statutory Law
Enacted by legislative bodies such as the Nurse Practice Act
Common Law
Stems from previously decided cases such as Roe vs Wade
Criminal Law
Demonstrates intent to do harm-misuse of controlled substance, assisted suicide, etc..not seen as often
Includes:
- Felony-imprisonment and/or death
- Misdemeanor- imprisonment and/or fines
Most medical cases fall under..
- Criminal law- protects private rights (right to health care that meets standard of care)
- Tort- private or civil wrong that is intentional (any action or omission that harms someone)
What are some tort laws affecting nursing?
- Assault- an intentional threat to bring harmful or offensive contact (forcing elder to walk when they don’t want to)
- Battery- an intentional touching without concent (catheter when not needed)
- Invasion of privacy- protects the client’s right to be free from unwanted intrusion into their private affairs (biggest area of concern)
- Right to Confidentiality
- Defamation of character- publication of false statements that result in damage to one’s reputation (charting something told to you as a fact when it might not be)
- False imprisonment- holding someone against their will (restraints)
- Fraud- intent to mislead or misrepresent (incorrect or falsification of med records)
Negligence
An unintentional tort (unreasonable lack of skill/knowledge)
Malpractice
A tort committed by a professional acting in his or her own professional capacity (accidental omission or incorect action)
Nursing Neglicence/Most common breech of duty
An act or omission of an act that a reasonable, prudent nurse would not do
To prove nursing negligence all four of these must be in place:
- Failure to observe/assess
- Failure to monitor/follow up
- Failure to report/notify
- Failure to perform appropriately
