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NRSG 112 - Introduction to the Profession of Nursing I > Week 13 - Legal Aspects > Flashcards

Week 13 - Legal Aspects Flashcards

Introduction to the law and nursing Outline nurses’ legal expectations Discuss tort law

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1
Q

Sources of Law: The Constitution of 1867

A
  • Primary source of Canadian law – supreme law of Canada!
  • Includes the Charter of Rights and Freedoms
  • Divides areas of responsibility: provincial versus federal (s91 and 92)
  • Federal law applies across Canada (e.g., post service, employment insurance, criminal law)
  • The constitution gives provinces authority over matters like: management of hospitals, solemnization of marriage, and civil rights
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2
Q

Private/Common Law

A
  • AKA British common law
  • Followed by provinces other than Quebec
  • Case law: extensive body of legal rules that have been written based on previous cases (precedent)
  • Evolves through the courts
  • Consistency, predictability, reasoning, discretion
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3
Q

Private Civil Law

A
  • Applies in Quebec
  • Based on Roman Law
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4
Q

Statue Law

A
  • Created by elective legislative bodies (parliament, provincial/territorial legislature)
  • Federal statues apply throughout the country; provincial/territory of creation
  • Act or legislation
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5
Q

Court Cases

A
  • Decisions based on statute law or previous course rulings
  • ‘’Precedent’ legal rulings bound in one case in a province/territory must be upheld in similar + subsequent case
  • What if a province/territory does not have a previous ruling/case scenario?
  • Penalties for breaking the law?
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6
Q

The Canadian Court System

A
  • At the top the supreme court of Canada
  • Then the provincial court of appeal and the federal court of appeal
  • Then the provincial/territorial superior court, federal court, and the tax court of Canada
  • Lastly, there is the provincial/territorial lower courts.
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7
Q

Examples of Law in Canada

A
  • Abortion law in Canada
  • 1869 Federal statue (legislation) passed criminalizing abortion in Canada
  • 1960s – Women’s rights movement
  • Roe v. Wade 1972 (US)
  • Morgentaler was tried in Quebec and Ontario
    o Trial court (Provincial)
    o Appeal Court (Provincial)
  • Then Regina versus Morgentaler in 1988 Supreme court of Canada
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8
Q

Who Gets to Make Laws Over Healthcare?

A
  • Both provincial and federal
  • Provincial
    o Establishment, maintenance, and management of hospitals provincial
    o Pay for your healthcare system on certain conditions (Canada Health Act)
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9
Q

Federal Acts that Influence Health

A
  • The Canada Health Act
  • The Food and Drug Act
  • The Controlled Drugs and Substances Act
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10
Q

British Columbia Act

A
  • The Health Professions Act
  • Gunshot and Stab Would Disclosure Act
  • Adult Guardianship Act
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11
Q

Legal Limits on Nursing

A
  • BC statue law = Health Professions Act
  • Delegates regulation to the colleges (BCCNM)
  • Regulates: RNs, RPNs, LPNs, NPs, midwives
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12
Q

Legal Limits on Nursing in BC (top to bottom)

A
  • You
  • Employer policy/Health Agency Policy
  • BCCNM – Standards limits and conditions
  • Health professions act legislation
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13
Q

Regulations

A
  • In British Columbia – BCCNM
  • Controls the standards for entry to practice and advanced practice
  • Sets the standards, limits and conditions
  • Establish education requirements for nursing education programs
  • Maintains quality assurance programs
  • Provides governance to the profession
  • ULTIMATE PURPOSE?? (protecting the public through regulations)
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14
Q

Standards of Nursing Care

A
  • What is a standard of Care? (Standards of care are legal guidelines for nursing practice. Standards establish the expectation that nurses will provide safe and appropriate patient care. If nurses do not meet them, they may face legal action)
  • Aka Nursing practice requirements
  • Health care agencies cannot have policies that do not align with provincial/territorial health legislation
  • Practice standards are essential for self-regulating professions
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15
Q

What is a tort?

A
  • Tort: is a civil wrong committed against a person or person’s property
    o Classified as either interventional or unintentional
    o Unintentional tort – negligence
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16
Q

What is negligence?

A
  • Negligence: consists of conduct and behaviour that falls below the standard expected of an ordinary, reasonable, and prudent nurse
17
Q

Proving Negligence

A
  1. Did the defendant own the plaintiff a duty of care?
  2. Did the Defendant’s behavior breach the standard of care?
  3. Did the plaintiff sustain damage?
  4. Was the plaintiff’s damage caused by the defendant’s breach in fact and in law?
    - Does intent matter? (no it does not)
18
Q

Case in Canada that Led to a Lawsuit

A
  • “Latin v. Hospital for Sick Children” (2007)
  • Incident happened January 98
  • Settled in court January 2007
  • 9 years later
  • Trial lasted ~40 days
  • 8-10 experts
19
Q

Latin Versus Hospital for Sick Kids

A
  • Issue: 14 month old Ryleigh Latin had a cough, high fever and prolonged seizure resulting in profound brain damage.
  • Could brain damage been prevented by more timely intervention i.e., triage at presentation to Emergency Department?
20
Q

How to guard against negligence as a nurse?

A
  • Common reasons that nurses are sued for negligence in Canada?: Failure to communicate adequate information to the physician/MRP
  • Inadequate nursing assessment, intervention, care (i.e., the care did not meet the minimum standard of a reasonable nurse)
  • Medication errors
  • Inadequate infection control**
  • Unsafe or improper use of medical equipment
  • How do nurses protect themselves legally?
21
Q

What are Intentional Torts?

A
  • Willful acts that violate a person’s rights:
    o Assault
    o Battery
    o Invasion of privacy
    o False Imprisonment
22
Q

Legal Liability Issues in Nursing

A
  • CONSENT ISSUES
  • INFORMED CONSENT: the right to make a decision that is well informed (grounded in autonomy)
  • DISCLOSURE: the patient must have received all the information necessary to make an informed decision
  • CAPACITY: the patient must be capable of understanding the information being provided
  • VOLUNTARY: the patient cannot be coerced or manipulated into a making a decision
23
Q

Requirements of Consent

A
  • Consent is required for all medical/surgical procedures – by a physician
  • Consent for any nursing procedure also required – taken by a nurse
  • Consent must be voluntarily given (or implied)
  • The pt must be told all the potential risks, benefits, and be provided the right to refuse the procedure
  • Consent must be specific to the proposed treatment/procedure (i.e., general consent to treatment would not cover a surgical procedure)
  • The person performing the procedure must be identified (how do students fit in?) (must ask before students take a part)
  • Must be legally able to do the procedure (scope of practice/standard of care)
  • Must be mentally competent to give consent
  • The pt has the right to ask questions, seek a second opinion etc.
24
Q

Consent and the nurse

A
  • Nurses have both a legal and ethical obligation to ensure that patients/clients make a fully informed decision when it comes to their care.
25
Q

Consent and the nurse- people under 19

A
  • According to the Infant Act:
    o Infants are defined as individuals under 19 years of age
    o A child may consent to their own health care if they are capable
    o A capable child does not need parent/guardian to consent to healthcare
    o The healthcare has to be in the child’s best interest
    o Consent to health care in a medical emergency
    o A child’s health care is confidential
26
Q

What happens when you cannot get informed consent?

A
  • Representation Agreement Act (2013): Legal Contract
  • Designed to allow adults to arrange in advance who may make decisions about their healthcare (and other personal affairs) if person becomes no longer capable of making decisions independently.
  • Duties of a clients’ representative: Act honestly, take into account the wishes and instructions of the client, act within authority granted, keep proper records of properties and liabilities.
  • Different from a Power of Attorney
27
Q

What happens when you cannot get informed consent?

A
  • Advanced Directive: “… a capable adult may make an advance directive. An advance directive is a written instruction that gives or refuses consent to health care in the event the adult later becomes incapable of giving the instruction at the time the health care is required.”
  • “…a [HCP] may provide health care to an adult if they consented to the health care in an advance directive, but must not provide health care to an adult if the adult refused consent to the health care in an advance directive.”
28
Q

Temporary Substitute Decision-Maker

A
  • In this order:
  • (a) the adult’s spouse
  • (b) the adult’s child
  • (c) the adult’s parent
  • (d) the adult’s brother or sister
    o (d.1) the adult’s grandparent
    o (d.2) the adult’s grandchild
  • (e) anyone else related by birth or adoption to the adult
  • (f) a close friend of the adult
    - (g) a person immediately related to the adult by marriage.
29
Q

Legal liability issues in nursing

A
  • Confidentiality and Privacy Issues
30
Q

What is confidential information and confidentiality?

A
  • Confidential Information: “intimate or private knowledge” (p. 109)
  • Confidentiality:
    o Duty to protect private information
    o Privacy is the right to disclose or withhold private information
31
Q

What is privacy?

A
  • Privacy: “Person’s right to control the intrusion of others into his/her life” (p. 110)
32
Q

What to do if you made a mistake?

A
  • Recognizing and responding to hazards, near misses and adverse events
  • Immediate management of an adverse event
  • Ongoing management of adverse events
  • Disclosure of harm
  • Patient safety alerts
    o Identification of the client by name, initials, and hospital or identification number
    o Date, time, and place of the incident
    o Description of the facts of the incident (no conclusions or blame)
    o Incorporation of the client’s account of the incident in quotes
    o Identification of all witnesses
    o Identification of any equipment by number and any medication by name and dosage
33
Q

Reporting unsafe practice

A
  • Recognizing and responding to hazards, near misses and adverse events
  • Whistleblowers: people who expose negligence, abuse, and/or dangers like misconduct or incompetence in the organization

NRSG 112 - Introduction to the Profession of Nursing I (4 decks)

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