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NURS2512 > Legal Implications in Nursing (WK9) > Flashcards

Legal Implications in Nursing (WK9) Flashcards

1
Q

What is a fiduciary relationship and how does it apply to nursing?

A

fiduciary relationship = trusting relationship;

One in which the nurse provides services that, by their nature, cause the recipient to trust in the specialized knowledge and integrity of the professional

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2
Q

Which government regulates the nursing profession? And how are they involved?

A

the provincial or territorial government

Regulatory bodies are responsible for:

  • granting certificates of registration
  • offering practice support
  • ensuring continuing competence of their members
  • investigating complaints
  • disciplining members when necessary
  • develop a code of ethics
  • set standards of practice
  • approve nursing programs
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3
Q

What are ‘standards of care’ and where do they arise from?

A

legal guidelines for nursing practice

come from a variety of sources:

  • statutes
  • case laws
  • regulations
  • practice standards
  • code of ethics
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4
Q

How are standards of care used in a negligence lawsuit?

A

the standards are used to determine whether the nurse has acted as any reasonably prudent nurse in a similar setting w/ the same credentials would act

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5
Q

What is a ‘tort’?

A

a civil wrong committed against a person or property

can be intentional or unintentional

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6
Q

Intentional tort

A

willful acts that violate another person’s rights

- ex. assault, battery, invasion of privacy, false imprisonment

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7
Q

Unintentional tort

A

negligence

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8
Q

What is ‘Assault’?

Give a nursing example

A
  • conduct that creates in another person apprehension of fear or imminent harmful or offensive contact

Ex.

  • Threatening to give a pt an injection
  • restraining a pt when pt refused consent
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9
Q

What is ‘Battery’?

Give a nursing example

A
  • intentional physical contact w/o consent
  • can be harmful, cause injury, or merely offensive to the pt’s dignity

Ex.
- giving an injection that was refused

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10
Q

What is ‘Invasion of Privacy?

A
  • ex. releasing a pt’s medical info to an unauthorized person (ex. the pt’s employer, the press)
  • tort of invasion of privacy protects the pt’s right to be free from unwanted intrusion into his/her private affairs

nurses have the duty to keep PHI confidential

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11
Q

When is it ok to breach confidentiality?

A
  • when you suspect child abuse
  • when there is a gunshot or stab wound
  • when you receive a legal order to testify in court
  • when the life, safety, or health of the pt or an innocent third party is in jeopardy (before releasing info to police, report to admin)
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12
Q

What should you do if your HIV-positive patient refuses to disclose this information to a blood bank where they recently donated blood?

A

Need to carefully weigh the need for privacy and confidentiality and the need for public safety

1) suggest and strongly encourage the pt to disclose this info
2) if refuses, seek consultation w/ professional colleagues and supervisors

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13
Q

What are ways in which you can avoid unintentional disclosure of confidential information about patients

A
  • maintain professional boundaries
  • follow employers’ policies
  • do not post or share any patient-related info online
  • do not make disparaging comments about employers or colleagues –> can be viewed as defamatory
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14
Q

What is ‘False Imprisonment’

Give a nursing example

A
  • preventing a pt from leaving the health care facility voluntarily
  • inappropriate/unjustified use of restraints

tort of false imprisonment serves to protect a person’s individual liberty and basic rights

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15
Q

What is Negligence

A

Harm resulting from inadvertence, thoughtlessness, inattention

the tort of negligence = MALPRACTICE

negligence in nursing is conduct that does not meet a standard of care established by law

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16
Q

What are some examples of negligence in nursing?

A
  • medication errors resulting in harm
  • IV therapy errors resulting in infiltrations or phlebitis
  • burns caused by equipment, bathing, or spills of hot food
  • falls
  • failure to use aseptic technique
  • failure to monitor a pt’s condition adequately
  • failure to notify a physician of a significant change in a pts ststus
  • failure to delegate properly or supervise
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17
Q

Can you be careful and still be negligent?

A

YES
- doing a procedure you haven’t done before and lack skills in is negligent

  • courts define nursing negligence as the failure to use the degree of skill or learning ordinarily used under the same or similar circumstances by members of the nursing profession.
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18
Q

Criteria for negligence

A

Nurses can be found liable for negligence if:

  • the nurse owed duty of care to the pt
  • the nurse did not carry out that duty
  • the pt was injured
  • the nurse’s inaction caused the injury
19
Q

How can you prevent negligence?

A
  • follow the standards of care
  • give competent health care
  • insist on appropriate orientation, continuing education, and adequate staffing
  • communicate w/ other HCPs
  • develop a caring rapport w/ the pt
  • document everything!!
20
Q

What is the best defense against allegations of negligence?

A

careful, complete, and thorough documentation

if lost or incomplete; care is presumed to have been negligent

incomplete or illegible records undermine the credibility of the HCP

21
Q

When is consent required

A

required for ALL routine treatment and procedures.

  • General consent upon admission to the hospital
  • special consent for specialized treatments or procedures
22
Q

What factors make consent legally valid?

A
  • must have the legal and mental capacity
  • given voluntarily w/o coercion
  • understand the risks and benefits of the procedure
  • understand the risks of not undergoing the procedure
  • aware of the alternatives to the procedure
23
Q

Can family members help give consent when there is a communication barrier?

A

Technically yes, but should be the last resort

official interpreter should be used instead

24
Q

What is Informed consent?

A

A person’s agreement to allow a medical action to happen, based on full disclosure of the likely risks and benefits of the action, alternatives to the actin, and the consequence of refusal

25
Q

Do you need consent during emergencies?

A

No

26
Q

What happens when you do something w/o obtaining consent?

A

Can be sued for battery and negligence; even if the procedure or treatment was done competently

27
Q

What needs to be included in informed consent?

A
  • brief, complete explanation of the procedure or treatment
  • name and qualifications of people performing and assisting the procedure
  • description of any possible harm due to procedure
  • explanation of therapeutic alternatives as well as the risks of doing nothing
28
Q

Do nursing students have legal liability too?

A

YES
- if a student nurse performs a nursing action an RN would perform, they will be held to the standard of an RN

In the case that a pt is harmed as a direct result of a nursing student’s actions or lack of action, the liability is generally shared by the student, the instructor, the hospital, and the university

29
Q

What is the Canadian Nurses Protective Society?

A
  • nonprofit society

- provide legal support and liability protection to nurses

30
Q

Is it okay to walk out when staffing is inadequate?

A

NO

- charges of abandonment can be made

31
Q

If a pt’s condition suddenly changes, what do you do?

A

Document AND notify the physician

- if you just document and don’t notify, you can be charged w/ negligence

32
Q

When is it ok for nurses to withdraw from care provision?

A

when there is an ‘unreasonable burden’
- exists when your ability to provide safe care and meet the standards of practice is compromised by unreasonable expectations, lack of resources, or ongoing threats to personal well being

33
Q

Is it okay to refuse care for pt’s with communicable diseases (ex. AIDS)

A

NO - you can be fired or reprimanded for insubordination

Code of Ethics for RNs - nurses do NOT discriminate

34
Q

Can you refuse care to a pt when the pt’s wishes go against your values? Ex. assistance in MAID, abortion, etc.

A

YES… BUT

- provide appropriate care until alternative care arrangements are made

35
Q

What is an advanced directive?

- 2 types

A

Enables a mentally competent person to plan for a time when he/she may lack the mental capacity to make medical treatment decisions.

  • takes into effect as soon as the person becomes incompetent
  • focus is on treatment preferences

INSTRUCTIONAL DIRECTIVE
- detailed document w/ directions for governing care

PROXY DIRECTIVE
- person appoints someone as a health care agent to make decisions on his/her behalf

36
Q

What is a living will?

A

A document in which the person makes an ANTICIPATORY REFUSAL of life-prolonging measures during a future state of mental incompetence

37
Q

What do you do when the physician ignores the advanced directive

A
  • bring the advanced directive to the physician’s attention
  • document that you did so and their response to this info
  • notify the nursing supervisor
38
Q

What is Euthanasia

A

Act is undertaken by one person w/ the motive of relieving another person’s suffering and the knowledge that the act will end the life of that person

39
Q

Which bill legalized Medical assistance in dying (MAID)?

A

Bill C-14

40
Q

Criteria for MAID

A
  • eligible for free health care in Canada
  • > 18 yrs of age
  • capable of making health care decisions
  • has a grievous and irremediable medical condition
  • voluntary request in writing, no coercion, signed and dated in the presence of 2 witnesses
  • able to provide informed consent after being informed of all therapeutic options available to relieve their suffering
41
Q

Criteria for a “grievous” and “irremediable” medical condition

A
  • serious, incurable illness, disease, or disability
  • in an advanced state of irreversible decline
  • physical or psychological suffering is intolerable and cannot be relieved under conditions considered acceptable to the pt
  • natural death is reasonably foreseeable
42
Q

What is risk management in nursing care?

What are the steps involved?

A

a system of ensuring appropriate nursing care by identifying potential hazards and preventing harm.

STEPS

  • identify possible riss
  • analyze risks
  • act to reduce them
  • evaluate steps taken
43
Q

What is an incident report

A

completed when a pt is harmed or endangered by incorrect care

NURS2512 (5 decks)

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