Legal Implications and Issues Associated with Nursing Practice Flashcards
Torts
Torts are civil wrongful acts or omissions made against a person or property. They are classified as intentional, quasi-intentional, or unintentional.
Intentional Torts
deliberate acts against a person or his or her
property that may result in both civil and criminal actions. No actual contact is required for an assault to occur. Assault is the intentional act of making someone fear that you will cause them harm. You do not have to actually harm them to commit assault. Likewise, assault occurs when a patient threatens a nurse. Battery is any intentional offensive touching
without consent or lawful justification.
In the example of a nurse
threatening to give a patient an injection without the patient’s consent, if
the nurse gives the injection, it is battery. Battery also results if the health care provider performs a procedure that goes beyond the scope of a
patient’s consent.False imprisonment occurs when a patient is restrained without a legal reason e.g. restrain a patient in a confined area,
preventing the ability to move freely in a bed, chair, room, or other area in which the patient wishes to be.
Quasi-intentional torts
are acts in which a person may not intend to cause
harm to another but does. Typically, the person invades another’s privacy
or in some way defames his or her character. Defamation of character is the publication of false statements that result
in damage to a person’s reputation. Slander occurs when one speaks
falsely about another. For example, if a nurse tells people erroneously that
a patient has gonorrhea and the disclosure affects the patient’s business,
the nurse is liable for slander. Libel is the written defamation of character
(e.g., charting false defamatory entries in a medical record).
Unintentional torts
arise when a person is harmed and the person inflicting the harm knew, or should have known, that his or her actions were less than the accepted scope and standard of practice. Negligence is conduct that falls below the generally accepted standard
of care of a reasonably prudent person. A nurse is negligent when he or she had a duty of care that is breached and a patient is physically harmed. A reasonably prudent nurse under similar
circumstances would have provided care differently. Malpractice is a type of negligence. A person being held liable for malpractice must be a professional. (1) the nurse (defendant) owed a duty of care to the patient (plaintiff), (2) the nurse did not carry out or breached that duty, (3) the patient was injured due to the breach in duty, and (4)
damages or remedies are allowed under state law to “make the person
whole” in the eyes of the court. Even though nurses do not intend to injure
patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards.
Beginning- and End-of-Life Nursing Issues
Termination of Pregnancy
right to privacy, which includes a woman’s decision to terminate a pregnancy. The court ruled that during the first trimester a woman could end her pregnancy without state regulation. During the second trimester the state has an interest in protecting maternal
health, and it enforces regulations regarding the person terminating the
pregnancy and the agency where it is done. By the third trimester, when
the fetus becomes viable, the interest of the state is to protect the fetus;
therefore, it prohibits termination except when necessary to save the
mother.
Death With Dignity or Physician-Assisted Suicide
competent individual with a
terminal disease could make an oral and written request for medication to end his or her life in a humane and dignified manner. A terminal disease is
defined as an incurable and irreversible disease that has been medically confirmed.
Nursing Assignments
often called “floating,” nurses
temporarily work in another area because there are not enough nurses to
care for the number of patients and the acuity of the patients’ needs on
that unit at that time.
Patient Abandonment
Patient abandonment occurs when a nurse refuses to provide care for a
patient after having established a patient-nurse relationship. Before having
established that relationship, a nurse may refuse an assignment when (1)
the nurse lacks the knowledge or skill to provide competent care; (2) care
exceeding the Nurse Practice Act is expected; (3) health of the nurse or the
nurse’s unborn child is directly threatened by the type of assignment; (4)
orientation to the unit has not been completed and safety is at risk; (5) the
nurse clearly states and documents a conscientious objection on the basis
of moral, ethical, or religious grounds; or (6) the nurse’s clinical judgment
is impaired as a result of fatigue, resulting in a safety risk for the patient
Risk Management and Performance/Quality
Improvement
Risk-management and performance improvement (PI) and quality improvement (QI) programs help to reduce a nurse’s legal risk for
malpractice and negligence because they help to identify potential hazards
and eliminate them before harm occurs. The two processes are similar, but
PI places more emphasis on human performance, whereas QI focuses on
work processes.Risk management involves several components, including identifying possible risks, analyzing them, acting to reduce the risks, and
evaluating the steps taken to reduce them (TJC, 2019). QI, PI, and riskmanagement
procedures are essential; they require documentation of information to facilitate resolution of questions regarding care.
Proof of Negligence
The nurse owed a duty of care to the patient.
• The nurse did not carry out the duty or breached it (failed to use that
degree of skill and learning ordinarily used under the same or similar
circumstances by members of the profession).
• The patient was physically injured or harmed because the nurse
breached the duty.
• The patient’s injury resulted in compensable damages that can be
qualified as medical bills, lost wages, and pain and suffering.
