Legal Implications of Nursing Practice, Self-Regulation & Professionalism

Question 1

What are the 3 legal limits of nursing?

Answer 1

Sources of law
Professional regulation
Standards of care

Question 2

What type of law uses statutes?

Answer 2

Public law

Question 3

What type of law is practiced in Quebec?

Answer 3

Private, civil law

Question 4

What type of law is practiced in Canada (excluding Quebec)?

Answer 4

Private, common law

Question 5

Who created statute law?

Answer 5

Elective legislative bodies (Parliament, provincial/territorial legislatures)

Question 6

What acts determine how the nursing profession is regulated in Ontario?

Answer 6

Nursing Act (1991)
Regulated Health Professions Act (1991)

Question 7

What act establishes the mandate of the College of Nurses of Ontario?

Answer 7

The Nursing Act

Question 8

What act defines the scope of practice for the nursing profession?

Answer 8

The Nursing Act

Question 9

What is the role of the College of Nurses of Ontario (CNO)?

Answer 9

Accountable to the public for ensuring safe, competent, and ethical nursing care
Grants certificates of registration, offer practice support, ensure the continuing competence of members, investigate complaints, discipline members, develop codes of ethics, set standards of practice & approve nursing education programs

Question 10

What act lists the 14 controlled acts that are considered potentially harmful if performed by someone who isn’t qualified?

Answer 10

RHPA

Question 11

What act authorizes nurses to perform controlled acts when ordered?

Answer 11

Nursing Act

Question 12

What are the 6 classes of registration?

Answer 12

General
Extended class (nurse practitioners)
Non-practicing
Temporary
Special assignment
Emergency assignment

Question 13

What is the foundation for nursing practice?

Answer 13

Entry-to-practice competencies

Question 14

Why were the competencies of entry-level RN practice established?

Answer 14

Protection of the public
Practice reference
Approval of nursing education programs
Registration and membership requirements
Legal reference
Public information
Continuing competence

Question 15

What are the 9 roles that make up the entry to practice competencies?

Answer 15

Clinical
Professional
Communicator
Collaborator
Coordinator
Leader
Advocate
Educator
Scholar

Question 16

What is a tort?

Answer 16

A civil wrong committed by one person against another causing some injury or damage, either to person or property

Question 17

What are intentional torts?

Answer 17

Willful acts that violate a person’s rights
Includes assault, battery, invasion of privacy and false imprisonment

Question 18

What type of legal liability does negligence fall under?

Answer 18

Unintentional torts

Question 19

What is the most common proceeding against nurses?

Answer 19

Negligence

Question 20

What are the criteria for negligence?

Answer 20

Duty of care owed to the plaintiff
Breach of duty of care by the defendant
Harm caused to patient
Harm caused to patient due to breach of duty

Question 21

What does the Health Care Consent Act outline?

Answer 21

Explicit rules for:
- When consent is required
- Who can provide consent
- When a practitioner wants to obtain consent from a substitute decision-maker

Question 22

Is consent required for personal assistance services?

Answer 22

No

Question 23

Emergency treatment can be provided immediately when ___

Answer 23

• Communication barrier d/t language barrier or disability
• Incapable but a substitute is available to give consent
• Incapable and no substitute is available & delay will put the person at risk

Question 24

Crisis administration to a care facility without consent may be authorized if ___

Answer 24

The person who has been deemed incapable requires immediate admission as a result of a crisis and it is not possible to obtain immediate consent

Question 25

What organizations can be used to obtain additional personal liability protection?

Answer 25

RNAO and CNPS

Question 26

Who created the Code of Conduct

Answer 26

CNO

Question 27

What is the Code of Conduct?

Answer 27

Practice standard describing the accountabilities that all nurses registered in Ontario have to clients, employers, colleagues and the public

Question 28

What are the 6 principles of the Code of Conduct?

Answer 28

1. Nurses respect clients’ dignity
2. Nurses provide inclusive and culturally safe care by practicing cultural humility
3. Nurses provide safe and competent care
4. Nurses work respectfully with the health care team to best meet clients’ needs
5. Nurses act with integrity in clients’ best interest
6. Nurses maintain public confidence in the nursing profession

Question 29

What is the ranking of the hierarchy of substitute decision-makers?

Answer 29

1. Guardian appointed by the court
2. Someone who has been named as an attorney for personal care
3. Someone appointed as a representative by the CCB
4. Spouse, partner or relative in the following order:
   - 4a. spouse or partner
   - 4b. child is 16 or older; custodial parent; Children’s Aid Society
   - 4c. parent who has only a right of access
   - 4d. brother or sister
   - 4e. other relative
5. PGT is the substitute decision-maker of last resort

Question 30

When is PGT named as the substitute decision-maker?

Answer 30

Last resort in the absence of any more highly ranked substitute or in the event 2 more equally ranked substitutes cannot agree