Legal Issues Outline It is important for nurses to recognize that nursing practice is g Guided by: o Legal restrictions o Professional

al Obligations Regulated by: o State Nurse- Practice Acts o May vary from State to State The State practice act general standard have been developed and published by: o American Nursing Association which developed Code of ethics (general standards) Ethics: rules and principals that guide nursing decision (wrong from right) Morals: personal beliefs, opinions that guide our actions Values: what we perceive as good Ethical dilemma: problem in which there is no right or wrong decision Decision may violate ones own principals or values in order to promote another Autonomy: right to make own decisions Paternalism: another making decision about what is best for an individual Beneficence: for the interest of the patient Right to know: patient must be informed to make proper decision in about own health Principal of promoting good: necessary medication may result in adverse effects Allocation of goods and service and how or to whom they are distributed: Everyone gets the same services Critically ill receive greater services Merit : services go to more deserving ( used as criterion for transplant recipients) Standards: o Identify minimal knowledge and conduct expected from a professional. Standards are applied as they R/T practitioners experience and education ( all nurses with same education are expected to show level of equal competence in practice)

Nursing license: o A legal document that: o permits a person to offer his or her special skills and knowledge to the public o in a particular jurisdiction, o where such practice would be unlawful without a license o A nurse is accountable for his/her own actions o Must practice within definition stated in Nursing Practice Act o Must provide quality care according to Standards of Care o License May be Revoked or Coded Licensure: o Granted to protect the public o Standards for entry into practice o Defines what licensed person can do o Nurse disciplined in one state may be disciplined in state where they hold license Legal responsibility of the nurse: o Responsible for own actions o Protect rights and safety of patients o Nurse may witness but not obtain consent for medical procedures o Proper documentation o Refuse to carry out treatment deemed harmful to patient o Follow the nurse practice act o Reveal confidential information to appropriate persona o Perform only acts in which the nurse is qualified by education or experience o Restraint clients only in emergency situation Torts: o o o o o o

Civil wrong against a person No contract necessary Must be harm resulting from action Person who commits a tort is liable for damages in civil action Negligence and malpractice are torts Victims of malpractice are entitled to monetary compensation

Assault: unjustifiable threat or attempt to touch or injure others Battery: unjustifiable touching or injury Crime: act that is a violation of duty or breach of law Negligence: o failure to act as a reasonably prudent person would in the same situation o injury caused by failure to use such care as a reasonable person would in similar situation

Malpractice: o Applies to licensed professionals who do not apply degree of skills while providing service, resulting in loss or damage to the person receiving service o Claims evaluated by comparing with the standard of care for that situation

Most malpractice suits: o Carelessness o Forgetfulness o Failure to communicate Competence: Is the ability or qualifications to make informed decision Informed consent: An agreement to the performance of a procedure and treatment based of knowledge of facts, risks and alternatives. o Must be voluntary o Clear understanding what they are consenting to o Must include risk of procedures, alternatives and prognosis o If person cannot sign there must be 2 witnesses o Minors consent given by legal guardian o Telephone consent- nurse and 2nd witness listen at same time both sign consent form Living will: o Stipulates to what extent the individual wants medical treatment o Not recognized in all sates Expert witness: member of a profession who can assist in making better decision Reporting: o The nurses legal right to report incompetent nurse o The must report chemically impaired nurse Voluntary commitment: client must be released when he/she no longer chooses to remain in the hospital o Most states require individual to be mentally ill and danger to self or others o In most states may not refuse treatment Involuntary commitment: hospitalized w/out consent o In some states may not refuse treatment

Insanity: when an individual cannot be held accountable for their actions Irresistible impulse: due to mental illness an individual does not have the will to resist an impulse, even though able to differentiate between right and wrong

Rights of clients: o Have the right to receive treatment not just be confined o Right to least restrictive alternative o Right to individualized treatment plan and explanation of treatment Right to confidentiality o Right to visitors, mail and use the phone o Right to refuse experimental treatment o Right to freedom from restraints Consent: having capacity and demonstrates understanding of treatment both good and bad effects and given alternative treatments Legal responsibility of the nurse: o Responsible for own actions o Protect rights and safety of patients o Nurse may witness but not obtain consent for medical procedures o Proper documentation o Refuse to carry out treatment deemed harmful to patient o Follow the nurse practice act o Reveal confidential information to appropriate persona o Perform only acts in which the nurse is qualified by education or experience o Restraint clients only in emergency situation Professional Insurance o Many employers supply it o It is better to have duplicate coverage o Personal insurance always available o Know your contract. Limits