LAW AND NURSINGPRACTICEHANNA T. PRIYANKAMATERNITY & CHILDRENHOSPITAL
OBJECTIVE AT THE END OF THISPRESENTATION CANDIDATESSHOULD BECOME FAMILIARWITH THA BASICS OF LEGALASPECTS OF PROFESSIONALNURSING PRACTISE
INTRODUCTIONNursiNg practice is goverNed bymaNy legal coNcepts. KNowledgeof laws that affect NursiNgpractice is Needed to eNsureNurse’s decisioNs aNd actioNs iNworK area aNd also it willprotect the Nurse from liability.
lawdefiNitioN“the sum total of rules aNdregulatioNs by which a society isgoverNed. as such, law is createdby people aNd eXists to regulateall persoNs”( guido, 2001,p.2. )
FUNCTIONS OF LAW INNURSING it provides a frameworK forwhich NursiNg actioNs iN the careof clieNts are legal protect clieNts’ rights it helps to maKe bouNdaries ofiNdepeNdeNt NursiNg actioN. it assists iN maiNtaiNiNg astaNdard of NursiNg practice bymaKiNg Nurses accouNtableuNder the law
how to protect yourself___________________________1. KNow your state lawsaffectiNg NursiNg practice.2. follow your state’s Nursepractice act rules ®ulatioNs.3. deliver safe, competeNtNursiNg care.4. develop & use your criticalthiNKiNg abilities & sKills.
sources of lawSOURCES OF LAWCONSTITUTIONLEGISLATION( STATUTES)ADMINISTRATIVENURSE PRACTICEACTCOMMON LAW
CONSTITUTIONAL LAW it is the supreme law of thecouNtry fuNdameNtal law writteN oruNwritteN, that establishes thecharacter of goverNmeNt bydefiNiNg the basic priNciple towhich a society must coNform.
LEGISLATION ( STATUATORY LAW ) laws eNacted by aNy legislative bodyare called statutory laws. a writteN law passed by alegislature oN the state or federallevel(LEGISLATURE: AN OFFICIALLY ELECTED OROTHERWISE SELECTED BODY OF PEOPLEVESTED WITH THE RESPONSIBILITY & POWERTO MAKE LAWS FOR A POLITICAL UNIT, SUCHAS A STATE OR UNIT.)
Administrative Law When a state legislature passes a statute, anadministrative agency is given authority to createrules & regulations to enforce the statutory laws.e.g.: STATE BOARDS OF NURSINGWRITES RULES AND REGULATIONS TOENFORCE & IMPLEMENT NURSEPRACTICE ACT, WHICH WAS CREATEDBY STATUTORY LAW.
Common law laws evolviNg from courtdecisioNs are referred to ascommoN law. law developed by judgesthrough decisioN of courts aNdsimilar tribuNals.
TYPES OFLAWPUBLIC LAW PRIVATE LAWCRIMINAL LAW CONTRACT LAW TORT LAW
types of law public law: it refers to thebody of law that deals withrelatioNship betweeN iNdividualsaNd the goverNmeNt aNd thegoverNmeNtal ageNcies.Important segment of public law iscriminal law. Which deals withsafety and welfare of the public.E.g.: theft, manslaughter, homicideetc.,
private law or civil law : it is thebody of the law that deals withrelatioNship amoNg privateiNdividuals. it is agaiN classified iNto coNtractlaw aNd tort law Contract law : is the enforcement of agreementsamong private individuals. Tort law: It defines and enforces duties and rightsamong private individuals that are not based on thecontractual agreement. E.g.: INVASION OF PRIVACY,ASSAULT AND BATTERY
Selected Categories of lawaffecting nursesCategoryCONSTITUTIONALSTATUTORY ACTCRIMINALExampleDue ProcessEqual ProtectionNurse Practice ActSexual Harassment lawsTheft, Homicide, SexualassaultActive euthanasiaIllegal Possession ofControlled drugs
CONTRACTSTORTSNurse and clientNurse and employerNurse and insuranceNegligence/malpracticeInvasion of privacyAssault and batteryAbandonment
Regulation of nuRsingpRactice Regulation foR nuRsing pRacticehelps to bRing a standaRd innuRsing caRe and thus to pRotectthe public.1. Nurse Practice act2. Credentialing3. Standards of care
1. NURSE PRACTICE ACTS each state has a nuRse pRacticeact, which pRotects the publicby legally defining anddescRibing the scope of nuRsingpRactice and it is also legallycontRol nuRsing pRacticethRough licensing RequiRements. but acts diffeR fRom countRy tocountRy.
2. CREDENTIALING cRedentialing is the pRocess ofdeteRminingand maintaining competence innuRsing pRactice.cRedentialing pRocess helps tomaintain standaRds of pRactice &accountability foR educationalpRepaRation of its membeRs.1. licensuRe2.ceRtification
Licensure A license is a legal permit that a governmentagency grants to individual to engage in thepractice of profession & to use a particulartitle. Each country has its own method to grant ormaintain and revoke the licensure. However a nurse can practice any wherewithin the country with her state’s licensure.This is known as mutual recognition model.
CertificationCertification is the voluntary practiceof validating that an individual nursehas met minimum standards of nursingcompetence in specialty areas such asmaternal-child health nursing,pediatrics, school nursing etc.,
AccreditationIt is the function of a state board ofnursing is to ensure that schoolspreparing nurses maintain minimumstandard of education.
3.STANDARD OF CARE Standard of care are the skills and learning commonlypossessed by members of a profession. These standards are used to evaluate the quality of care nursesprovide and, therefore, become legal guidelines for nursingpractice. It can be internal – job description, education,policy & proceduresexternal – Nurse practice act,Professional organizationsIt is important for a nurse remain competentthrough reading professional journals and attendingcontinuing education and in-service programs.
legal Roles of nuRses1. pRovideR of seRvice2. employee oR contRactoR foRseRvice3. citizen
1. pRovideR of seRvice The nurse is expected to provide safe & competentcare. Nurse is liable to his/her action. Liability is thequality or state of being legally responsible forone’s obligations and to make financial restitutionfor wrongful act.For example: A nurse can refuse a task if the nursewill feel that it may harm the client and it can bereported to the supervisor
2. employee oR contRactoRfoR seRvice It vary among practice settings. A independent nurse practitioner has anindependent contractual relationship with theclient. Nurse who is employed by an agency works as anrepresentative of the agency.cont…
The nurse in the role of employee or contractor forservice has obligations to the employer, the client,and other personnel. Nursing care provided must be within the limitationsand term specified.
3. citizen The rights & responsibilities of a nurse in the role ofcitizen are the same as those of any individualunder legal the system. A right is a privilege or fundamental power A responsibility is the obligation associated with theright
INFORMED CONSENTIt is an agreement by a client toaccept a course of treatment or aprocedure after being providedcomplete information, includingthe benefits and risks oftreatment, alternative to thetreatment, and prognosis if nottreated by a health care provider.
Obtaining informed consent is aresponsibility of the person performingthe procedure. Nurse is a witness.Witnessing with a signature it showsthat client gave consent voluntarily,signature authentic, client appearscompetent to give signature.
DELEGATIONDelegation is defined as “ transferringa competent individual the authority toperform a selected nursing task in aselected situation”.
VIOLENCE, ABUSE & NEGLECT Violent behavior can include domesticviolence, child abuse, elder abuse, andsexual abuse. Neglect is the absence of care necessary tomaintain the health & safety of a vulnerableindividual such as a child or elder. To use wrongly or improperly or to hurt orinjure someone.
CONTROLLED SUBSTANCES Controlled substances mainly includestimulants, depressants, narcotics,hallucinogens etc., Misuse of these leads to criminal penalties.
ABORTIONS To save the life of the woman Yes To preserve physical health Yes To preserve mental health Yes
The Quran clearly disapproves of killing other humans:Take not life which Allah has made sacred (6:151; seealso 4:29 If a man kills a believer intentionally, hisrecompense is Hell, to abide therein (for ever) (4:93).Allah (SWT) went even further, making unlawful killing ofa single individual human being equal to mass murder ofthe whole of mankind: "Because of that, We ordained forthe children of Israel that if anyone killed a person not inretaliation for murder or for spreading mischief on earth,it would be as if he killed all mankind. And who saved alife, it would be as if he saved all mankind." (Al-Maidah,5:32)
DEATH & REALTED ISSUES NURSES ROLE IN LEGAL ISSUESRELATED TO DEATh IS PRESCRIbEDby ThE LAwS OF ThE REGION ANDThE POLICIES OF ThE hEALTh CAREINSTITUTION. bELIEFS AND ATTITUDES AbOUTDEAThS, ITS CAUSES AND ThE SOULALSO vARy AmONG CULTURES
SEXUAL HARASSEMENT SExUAL hARASSmENT IS DEFINED AS“UNwELCOmE SExUAL ADvANCES,REqUESTS FOR SExUAL FAvORS, ANDOThER vERbAL OR PhySICALCONDUCT OF A SExUAL NATURE.”
Areas of potential liability innursing NURSING LIAbILITy IS USUALLyINvOLvED wITh TORT LAw. IT IS ImPORTANT FOR A NURSE TOkNOw ThE DIFFERENCES bETwEENmALPRACTICE (UNINTENTIONALTORTS) AND INTENTIONAL TORTS.
CRIMES & TORTS A CRImE IS AN ACT COmmITTED INvIOLATION OF PUbLIC (CRImINAL) LAw ANDPUNIShAbLE by A FINE OR ImPRISONmENT. CRImES ARE PUNIShED ThROUGh CRImINALACTION by ThE STATE AGAINST ANINDIvIDUAL. CRImES ARE PUNIShED ThROUGh CRImINALACTION by ThE STATE AGAINST ANINDIvIDUAL. IT mAy bE IN TERmS OFImPRISONmENT OR by A FINE.
CRImES AGAIN CLASSIFIED INTOFELONy AND mISDEmEANOR FELONy IS A CRImE OF A SERIOUSNATURE, SUCh AS mURDER, PUNIShEDby A TERm IN PRISON. A mISDEmEANOR IS AN OFFENSE OF ALESS SERIOUS NATURE AND ISUSUALLy PUNIShAbLE by A FINE ORShORT TERm jAIL SENTENCE, ORbOTh.
A TORT IS A CIvIL wRONG COmmITTEDAGAINST A PERSON OR A PERSON’SPROPERTy. IN OThER wORDS, ThE PERSON OR PERSONSCLAImED TO bE RESPONSIbLE FOR ThETORT ARE SUED FOR ThE DAmAGES. TORTS ARE AGAIN CLASSIFIED INTOUNINTENTIONAL TORT AND INTENTIONALTORT.
UNINTENTIONAL TORT NEGLIGENCE AND mALPRACTICE AREExAmPLES OF UNINTENTIONALTORTS. NEGLIGENCE IS mISCONDUCT ORPRACTICE ThAT IS bELOw ThESTANDARD ExPECTED OF ANORDINARy, REASONAbLE, ANDPRUDENT PERSON. SUCh CONDUCTPLACES ANOThER PERSON AT RISkFOR hARm.
Malpractice is “professionalnegligence” that is, negligence thatoccurred while the person wasperforMing as a professional. there are 6 eleMents Must bepresent for a case of nursingMalpractice to be proven.1. duty: the nurse Must have arelationship with the client thatinvolves providing care andfollowing an acceptable standard
2. breach of duty: standard of carethat is expected in the specificsituation but that the nurse didnot observe.3. foreseeability: a link Must existbetween the nurse’s act and theinjury occurred.4. causation: it Must be proved thatharM occurred as a direct resultof nurse’s failure to follow thestandard of care.
5. harM or injury: the client MustdeMonstrate soMe type of harMor injury ( physical, financial,or eMotional)6. daMages: if Malpractice causedthe injury, the nurse is heldliable for daMages that May becoMpensated.
INTENTIONAL TORTS the defendant executed the act onpurpose or with intent. there are Mainly 5 intentional tortswhich is related with nursing1.assault2.battery3.false iMprisonMent4. invasion of privacy5.defaMation
1. assault: it is an atteMpt or threatto touch another personunjustifiably.e.g.: a nurse who threatens a clientwith an injection for refusing anoral Medicine.2.battery: is the willful touching of aperson that May or May not harM.e.g.: a nurse threatens an gives aninjection without consent.
3. false iMprisonMent: it is theunjustifiable detention of a personwithout legal warrant or confinethe person.e.g.: not allowing a person to go laMaor insisting a client to confine onbed4. invasion of privacy: it injures thefeeling of a person and does nottake into account the effect ofrevealed inforMation on thestanding of the person in the
5. defaMation: it is a coMMunicationthat is false, or Made with acareless disregard for the truth.e.g.: a nurse writes in her nurse’snotes that a physician isincoMpetent or telling a client thather colleague is incoMpetent.
LOSS OF CLIENT PROPERTY loss of client property,dentures, jewelry, Money etc., nurses are expected to takereasonable precautions tosafeguard client’s property
UNPROFESSIONAL CONDUCT it includes incoMpetence orgross negligence, conviction forpracticing without a license,falsification of client record,and illegally obtaining, using,or possessing controlledsubstances.
LEGAL PROTECTION IN NURSINGPRACTICE1. good saMaritan act2. professional liabilityinsurance3. carrying out a physician order- Question any order a if theclient’s condition has changed- Question any order that isillegal, unclear, or incoMplete.
4. providing coMpetent nursingcare5. record keeping6. the incident report
REPORTING, CRIMES, TORTS, ANDUNSAFEPRACTICES nurses May need to reportnursing colleagues or otherhealth professional forpractices that endanger thehealth and safety of clients.