Contracts pertinent to Nursing practice

1. CONTRACTUAL
ARRANGEMENTS IN NURSING
Muhammad Fatimah
AFE BABALOLA UNIVERSITY, ADO-EKITI

2. OUTLINE
 Definition of a contract
 Types of contract
 Elements of a contract
 Contractual relationships pertinent to nursing
 Breach of contract
 Remedies for breach of contract

3. WHAT IS A CONTRACT?
 Contract may be defined as a legally binding
agreement that recognizes and governs the rights
and duties of the parties to the agreement.
 A contract is an agreement between two or more
competent persons, on sufficient consideration
(remuneration), to do or not to some lawful act.

4. WHAT IS A CONTRACT?
 In healthcare a contract is a mutual arrangement
between a patient and a nurse concerning their
expectations of each other during a hospital stay.
 A contract is the basis of the relationship between a
nurse and an employer
 For example, a contract exists between a nurse and
a hospital/ healthcare setting.

5. TYPES OF CONTRACT
Verbal contract Written contract

6. WRITTEN CONTRACTS
 This is an agreement made on printed document
that has been signed by parties to a contract
 Written contracts provide more certainty for parties
than verbal contracts.
 Written contracts help prevent misunderstandings
by stating clear terms of the agreement
 An example of a written contract in nursing is a
contract between a nurse and a client before care is
commenced.

7. VERBAL CONTRACTS
 Verbal contract is a contract in which the terms are
agreed by spoken communication.
 A verbal contract has no legal document binding it
however has been discussed and agreed upon by
the parties involved
 An oral contract is equally binding as a written
contract.
 However it is difficult to prove an oral contract in a
court of law

8. CHANGING/ AMENDING A CONTRACT
 A written contract cannot be changed legally by an
oral agreement.
 If two people want to change some aspects of a
written contract, the change must be written into the
contract.

9. EXPRESSED VS IMPLIED CONTRACTS
 A contract is expressed when two parties discuss
and agree orally or in writing to its terms. For
example a contract between a nurse and an
employer.
 A contract is implied when it has not been explicitly
agreed upon by the parties but considered to exists
by the law. For example in a contractual
relationships between a nurse and a client, the
client expects that the nurse has the competence to
meet to his/her needs.

10. EXPRESSED VS IMPLIED CONTRACTS
 Likewise, in a contract between the nurse and the
agency the hospital is expected to provide the
necessary supplies and equipments needed to
provide competent nursing care.

11. CONTRACTUAL ARRANGEMENTS IN NURSING
 Contractual obligations refer to the nurses’ duty to
render care established by the presence of an
expressed or implied contract.
 A nurse who is employed by an agency works as a
representative of the agency, and the nurses'
contracts with clients is an implied one.
 A nurse employed directly by a client (e.g. private
nurse), may have a written contract with a client , in
which the nurse agrees to provide professional
service for a certain fee

12. CONTRACTUAL ARRANGEMENTS IN NURSING
NOTE! Personal inconvenience and
personal problems such as nurses’ car
failure, are not legitimate reasons for
failing to fulfill a contract.

13. ELEMENTS OF A CONTRACT

14. ELEMENTS OF A CONTRACT
 Offer and acceptance: a contract is formed when an
offer by one party is accepted by the other party
 Intent: The parties to the agreement must intend to
enter into a legally binding agreement
 Consideration: This is the price paid for a promise
made by one party to the other party.

15. ELEMENTS OF A CONTRACT
 Legal capacity :People entering into a contract must
have the legal capacity to do so. Some people not
free to go into a valid contract include
 Mentally ill people, Minors, Prisoners e.t.c
 Consent: There must be consent of each of the
parties to a contract in order for the contract to be
genuine.

16. CONTRACTUAL RELATIONSHIPS PERTINENT TO
NURSES
Contracts may exists between
 Nurse and client
 Nurse and employer
 Nurse and insurance
 Client and agency

17. NURSE AND CLIENT CONTRACT
 A Nurse-client contract assists in
establishing the terms, goals and
expectations of both parties to the contract.
 In the contract one or both parties commit
to a set of behaviors related to the care of
the patient
 Contracts may be written or verbal

18. NURSE AND CLIENT CONTRACT
 The nursing contract can help clarify differences
and clear up assumptions.
 For example in the case of a home care nurse, a
contract identifies the roles and responsibilities of
the nurse and the client.
 Contract litigations may arise if there is a breach of
contractual duties

19. ADVANTAGES OF NURSE-CLIENT CONTRACTS
 Contracts between nurses and clients help
to improve the patient’s adherence to
treatments.
 The nursing contract can help clarify
differences and clear up assumptions
related to care of the patient.
 Nursing contracts ensure that the nurse and
the patient share a sense of purpose and
ensure ultimate achievement of goals.

20. NURSE AND EMPLOYER CONTRACT
 An employment contract states the terms and
conditions of an employment offer.
 Contract basics are stated in an appointment letter,
and the employee is expected to sign and agree to
the terms of the contract
 It is important to go through contracts thoroughly
before signing or agreeing to the terms.
 When a nurse refuses to show up for work she can
be found in breach of a contract.

21. NURSE AND EMPLOYER CONTRACTS
 The contract may contain the following details
 Duties to be performed by the nurse
 Details of remuneration
 Termination of appointment clause
 Leave policy
 Promotion policy

22. WHAT IS BREACH OF CONTRACT?
 Breach of a contract occurs when one or more
parties to a contract fail to meet up with obligations/
responsibilities
 It also means a violation of
contract through failure to
perform contractual obligations
whether partially, or wholly or
as described in the contract

23. BREACH OF CONTRACT
 In breach of contract cases, the plaintiff may be
able to recover as damages, the cost of the
procedure, nursing care and other monetary
expenses that may result from the breach of
contract.
 Where there is breach of contract, the resulting
damages will have to be paid by the party
breaching the contract to the aggrieved party.

24. WAYS OF BREACHING A CONTRACT
A breach of contract may take place when a party to a
contract:
 Fails to perform their obligations under the contract
in whole or in part.
 Behaves in manner that shows an intention not to
perform their obligations.
 The contract becomes impossible to perform as a
result of defaulting party’s own act.

25. TYPES OF BREACH OF CONTRACT
 Actual breach
 Anticipatory breach

26. ACTUAL BREACH
 Actual breach of contract occurs when one party
fails or refuses to perform his promise under the
contract
 EXAMPLE : An employer agrees to pay the salary
of a nurse monthly. An actual breach occurs if the
employer fails to pay the agreed salary

27. ANTICIPATORY BREACH
 It is also known as renunciatory breach
 This occurs when a party demonstrates his
intention to breach a contract
 EXAMPLE: Nurse K agrees to care for Mrs. J from
Monday to Friday from 1st till 30th June. By the
second week of June Nurse K starts to visit only
once a week

28. REMEDIES FOR BREACH OF CONTRACT
 DAMAGES
 Damages means money compensation allowed to
an injured party for the injury suffered by him by the
breach of contract. Damages may be compensatory
or punitive
 Compensatory damages are awarded to make up
for the losses incurred by the breached party.
 Punitive damages are given to punish the
wrongdoer, they are usually awarded along with
compensatory damages

29. REMEDIES FOR BREACH OF CONTRACT
 Specific performance is a court ordered action,
forcing the breaching party to perform or provide
exactly what was agreed to in the contract.

30. CASE LAW
 In Moore v. Talbot (2009), an advanced practice
nurse discontinued her employment with a practice
group and closed her clinic to accept a position with
Dr. Talbot
 She sold her office supplies and medical
equipments to Talbot and agreed to accept wages
of $60 an hour.
 After one week of work Talbot informed more that
he was going in a different direction and intended to
pay her $30 per hour rather than the $60 per hour
as agreed.

31. CASE LAW
 Moore filed a breach of contract claim and was
awarded penalties, costs and expenses and
attorney’s fees.
 The court found Talbot guilty of breach of contract
as he and Moore had entered into an oral
employment agreement.
 Talbot was obligated to pay Moore the wages due.

32. REFERENCES
 Berman, A., Snyder, S., & Frandsen, G. (2016).
Fundamentals of Nursing (10th ed) Pearson Education,
Inc.
 Harris, J. (1978). Advantages of the Nurse-Patient
Contract. Canadian Journal of Nursing Research
Archive, 10(2).
 Kjervik, D., Brous, E. (2010). Law and Ethics For Advanced
Practice Nursing. Springer Publishing Company.
 Peterson, M, A., & Kopishke, L. (2010). Legal Nurse
Consulting Principles (3rd ed.).
 Wishnia, J. (2020). Breach of contract Lawsuit: Suing for
breach of Contract. Retrieved from
https://www.legalmatch.com/law-library/article/breach-of-
contract.html Accessed on, June, 21, 2020.

33. TABLE OF CASE
 Moore v. Talbot, 5 So 3d 313 (La. App. 1 Cir.
2/13/09).

34. Thank you
for
listening!!!