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Health Professionals such as nurses doctors, Pharmacist and many

others are regulated and licensed by regulatory bodies as required by

provincial legislation. All nurses are required to be licensed to practice with

their designated provincial nursing regulatory body. Legal responsibility in

nursing practice is becoming of greater importance as each year passes. In

order to provide safe and competent nursing care an understanding of legal

boundaries is very essential. It is important to know the law in one state and

the authorities enforcing these laws.


 To ensure the public’s light to quality health care service.

 To support and assist professional members.

 Set and enforce standards of nursing practice.

 Monitor and enforce standards for nursing education.

 Monitor and enforce standards of nursing practice.

 Set the requirements for registration of nursing professionals.

Nursing regulatory bodies also known as colleges or associations, are

responsible for the licensing of nurses with in their respective provinces

territory. The Nursing Regulatory bodies receives their authority from




 The central government.

 The state government

 Institutional Rules

 Trained Nurses Association of India

 International council for Nurses

 American Nurses Association

 Canadian Nurses Association

 National League for Nursing


The central government is a source of regulatory body in three ways,


1) Government service conduct rules

2) The Indian Nursing council Act

3) The English law


These are detailed rules of conduct for are government employees.

Examples of these are the requirement to maintain absolute integrity,

devotion to duty and high standards of moral behaviour. Only a few are

applicable to the nursing practice, but all would be applicable to the practice

of a nurse employed by the government.


The Indian Nursing Council, which was authorised by the Indian

Nursing Council Act of 1947, was established In 1949 for the purpose

providing uniform standards in nursing education and reciprocity in nursing

registration throughout the country.

The only national legislation directly related to nursing practice, also

provides a basis from which rules for nursing practice can be developed.

Among other responsibilities, this Act gives authority to the Indian Nursing

Council for prescribing curricula for nursing education and recognising

qualifications of institutions with teaching programmes for nursing. This

means that the INC has authority to control nursing education and what

the nurse is prepared to do. It is important because legal responsibility does

finally depend upon what you should be able to do and how you should do it

as well as what you are not prepared to do. The INC uses this authority in

nursing education but it delegates authority for control of nursing practice to

the State Nurses’ Registration Councils.


The Indian Nursing Council was authorized by the Indian Nursing Act

of 1947. It was established in 1949 to providing uniform standards in nursing

education and reciprocity in nursing registration through out the country.


Nurses registered in one stat were not necessarily recognized for registration

in another state before this time. The Condition of mutual recognition by the

state Nurses Registration Councils, which is called reciprocity, was possible

only if uniform standards of nursing education were maintained.


1) It provide uniform standards of in nursing education and reciprocity in

nursing registration.

2) It has authority to prescribe curriculum for nursing education in all


3) It has authority to recognize programme for nursing education or to

refuse recognition of a programme if it did not meet the standards

required by the council.

4) To provide the Registration of foreign nurses and for the maintance of

the Indian Nurses Register.

5) The INC authorizes State Nurses Registration Council and Examining

Board to issue qualifying certificates.

The INC has been given heavy responsibilities for nursing practice and

nursing education but it has not been able to exert enough power to

support high standards in nursing.


The law based upon the English Pattern is the third way in which the

Central Government is a source of legal authority. These laws are very


specific and make you “liable for negligence” or answerable to the laws

for acts of carelessness. The laws summarised below are given for medical

practitioners including nurses.

1) The right to refuse to the treat a patient expect in an emergency


2) The right to sue for fees. (Applicable only to private duty nurse or

private practitioners: other nurses are salaried.)

3) The right to add a titile descriptions to one’s name. Any title,

description, abbreviation or letter which implies nolding a degree,

diploma, license or certificate showing particular qualifications may

be added. (Improper use of these is often prohibited by State Nurses

Registration Acts.) The right to wear the Red Cross Emblem is

given only to members of the Army medical service.

4) Unregistered practitioners are not allowed to hold positions or

appointments in public and local hospitals

5) Fundamental duties.

a) To exercise a reasonable degree of skill and knowledge in

treating patients. The standard held is that exercised by other

reputable members of the same profession in similar


b) Once a relationship to a patient has been established, there is

an obligation to attend the patient as long as necessary unless


the patient requests withdrawal or notice is given of intention

to withdraw.

c) A practitioner must give personal attention to his cases and

answer calls with reasonable promptness.

d) Children must be protected from harming themselves.

e) Special precautions must be taken in the case of adults who

are incapable of taking care of themselves.

6) The Indian Penal Code demands that poisonous drugs be kept in

separate containers properly labeled and marked. Care must be

taken not to mix with nonpoisonous drugs.

7) There is a duty of secrecy to the patients. Records must be treated

as confidential unless the practitioner is called upon to give

evidence in court.

8) Dangerous diseases must be reported. (Theses will vary in

different parts of the country.)

9) Nurses as considered solely responsible for their own

professional acts irrespective of the employing authority.

A fine is the usual penalty imposed for disobeying the law stated

above, although imprisonment is also possible.

The central responsibility consists mainly of Policy making, palnning,

guiding, assisting evaluating and Co. ordinating the work.




 Ministry of health and family welfare

 The directorate general of health service

 The central council of health and family welfare.


 International health relations and administration of port quarantine

 Administration of the central institute such as All India Institute of

hygiene and public health, Kolkata, National institute for the control of

communicable disease, Delhi

 Promotion and development of medical, pharmaceutical, dental and

nursing professions

 Establishment and maintenance of drug standards

 Census, and collections and publication of other statistical data

 Immigration and emigration

 Regulation of labour in the working of mines and oil fields

 Co. ordination with states and with other ministry for the promotion of



The functions listed under this are the responsibility of both ccentral

and state government.


1) Prevention of extension of communicable disease from one unit to


2) Prevention of adulteration of food stuffs

3) Control of rugs and poisons

4) Vital statistics

5) Labour welfare

6) Ports other their major

7) Economic and social planning

8) Population control and Family planning



1) International health relations and quarantine of all major ports in the

country and international airport

2) Control of drug standards

3) Medical stone depots are maintained

4) Administration of post graduate training programes

5) Administration of certain medical colleges in India

6) Conducting Medical Research through Indian council of medical


7) Central Government health schemes

8) Implementation of national health programs

9) Maintaing the central health education Bureau


10) Health intelligence to centralize collection compilation, analysis,

evaluation and dissemination of all information on health statistics for the

nation as a whole

11) Maintaining and Administering the National Medical Library.



1) To consider and recommend broad outline of policy regard to matters

concerning health like environmental hygiene, nutrition and health

Education, provision of remedical and preventive care.

2) To make proposals for legislation relating to medical and public health


3) To make recommendation to the central government regarding

distribution of available grants-in-aid for health purposes


The state government controls nursing practice through the state

Nurses Registration Acts. The state Nurses Registration Councils have

authority to prescribe rules of conduct, to take disciplinary action and to

maintain registers of nurses. Except for the uniform standards given by the

INC, the state nurse practice act is the important law affecting one nursing

practice act that protect the public by broadly defining the legal scope of

nursing practice.


1) It registers Nurse / Midwives

2) It serves as legal protections to the nurse

3) It protect the public from incompetent nursing practice or poor nursing


4) It accredits and inspects schools of nursing and college of nursing

5) It prescribes the rules of conduct, table disciplinary action

6) It takes united efforts to elevate the standards of nursing

7) It works for the welfare of the members


 The dishonest use of certificate

 Procuring registration by false means

 Falsification of the register

 Representation of registration by an unrecognised person

 Representation of a registrant as a medical practitioner

Many states prohibit an unregistered person from holding a nursing

position in an institution wholly or partially supported by government funds.

Some states prohibit practice of any unregistered nurse.

A fine is the usual penalty imposed for disobeying the laws stated

above although imprisonment is also possible. In actual practice, the state

Council often delegates responsibility for the supervision of nurses to local


authorities such as the District Civil Surgeon or a board appointed for this


The Trained Nurses’ Association of India bases its standards for

conduct of professional nurses upon the International Code for Nurses.


Institution acts as a regulatory body for all employees by formulating

some rules and regulation Professional rules of conduct may be stated by the

institution regarding conditions of agreement for employment such as periods

of time needed when giving notification of registration.


TNAI means Trained Nurses Association of India, is a national

professional association of nurses. The level of organization moves to the

district, state and national levels. Members of TNAI are usually most active

on the level of the local unit. Activities and conference however are planned

regularly by the state branches and provide opportunities for valuable

professional participation and development of the individual member.


 Up grading development and standardization of nursing education

 Improvement of living and working condition for nurses in India

 Registration for qualified nurses


 It has promoted the development of courses in higher education for


 It gives scholarships for nurses who wish to go on for advanced study

 Helped to organize the state nurse and midwives Registration Council

 Helps to develop leadership ability

 Helps to share and solve professional problems

 Helped to remove discrimination against male nurses

 Helped to improve economic conditions for nurses

 The official organ of TNAI is the Nursing journal of India which is

published monthly


The International council of nurses, founded in 1899 by Mrs.Bedford

Fenwick, is a federation of non-political and self- governing national nurses

association. The head quarters are in Geneva, Switzerland.

The main purpose of the ICN is to provide a mean through which the

national associations can share their interest in the promotion of health and

care of the sick.


1) To promote the development of strong national nurses associations

2) To assist national nurses association to improve the standards of

nursing and the competencies of nurses


3) To assist national nurses associations to improve the status of nurses

within their countries.

4) To serve as the authoritative voice for nurse and nursing


The international council of nurses is the global voice of nursing. The

governing body of the ICN is the council of national representative which is

made up of the ICN Honorary officers and the presidents of the national

members associations.

The ICN code of ethics for nurses has four principles elements.

Elements of the code:


The nurses primary responsibility is to people requiring nursing care.

In providing care, the nurse promotes an environment in which the human

rights, values customs and spiritual belief of the individual, family and

community are respected.

The nurse ensures that the individual receives sufficient information on

which to base consent for care and related treatment.

The nurse hold in confidence personal information and uses judgement

in sharing this information.

The nurse shares with society the responsibility for initiating and

supporting action to meet the health and social needs of the public in

particular those of vulnerable populations.


The nurses also hares responsibility to sustain and protect the natural

environment from depletion, pollution, degradation and destruction.


The nurse carries personal responsibility and accountability for nursing

practice, and for maintaining competence by continual learning.

The nurse maintains a standard of personal health. Such that the

ability to provide care is not compromised.

The nurse uses judgments regarding individual competence when

accepting and delegating responsibility.

The nurses at all times maintains standards of personal conduct which

respect well on the profession and enhance public confidence.

The nurse, in providing care ensures that uses of technology and

scientific advances are compatible with safety, dignity and rights of people.


The nurses assumes the major role in determining and implanting
acceptable standards of clinical nursing practice, managent research and
The nurse is active is developing a core of research-based professional
The nurse, acting through the professional organization, participate in
creating and maintaining safe, equitable social and economic working
conditions in nursing.

The nurse sustains a co operative relationship with co-workers in

nursing and other field.
The nurse takes appropriate action to safeguard individuals, families
and communities when their health is endangered by a co-workers or any
other person.
The ANA is the professional organization for registered nurses in the
united states to advance and protect the profession of nursing the purpose of
ANA are;
- To work for the improvement of health standards and the
availability of health care services for all people.
- To foster high standards of nursing and to stimulate and
promote the professional development of nurses and advances
their economic and general welfare.
• Accredits containing education programs
• Provide certification for individual registered nurse
• Supplies data for research analysis.
• Provide public policy analysis and political education and maintains
government relations and political action activities.
• Implements an economic and general welfare program.
• Publishes a variety of publications including the American Nurses
• Holds conferences and a biennial convention.
• They are responsible for creating code of ethics for nurses.
1. The nurse, in all professional relationships, practice with compassion
and respect for the inherent dignity, worth and uniqueness of every
individuals, unrestricted by considerations of social or economic
status, personal attributes or the nature of health problems.

2. The nurse’s primary commitment is to patient whether an individual,

family, group or community.
3. The nurse promotes advocates for and strives to protect the health,
safety and rights of the patient.
4. The nurse is responsible and accountable for individual nursing
practice and determines the appropriate delegation of tasks consistent
with the nurses obligation to provide optimum patient care.
5. The nurse owes the same duties to self as to other including the
responsibility to preserve integrity, to maintain competence, and to
continue personal and professional growth.
6. The nurse participates in establishing maintaining and improving
health care environment and improving health care environment and
conditions of employments conducive to the provision of quality
health care and consistent with the values of the profession through
individual and collective action.
7. The nurse participates in the advancement of the profession through
contributions to practice, education, administration and acknowledge
8. The nurse collaborates with other health professionals and with the
public in promoting community, national and international efforts to
meet health needs.
9. The profession of nursing as represented by associations and their
members is responsible for the articulating of nursing values, for
maintaining the integrity of the profession and its practice, and for
shaping social policy.
It is the national nursing association of Canada. The Canadian Nurses
Association has developed national standards and a code of ethics and it

offers support to all professional associations. Though this foundation

research grants, fellowships and scholarships and offered to Canadian Nurses.
The nursing profession in Canada is regulated in the public interest
meaning that a person is not allowed to work in a nursing job or even use the
little “nurse” unless he/she is registered with a provincial regulatory
• Regulating nursing education standards for nursing programs.
• Setting criteria for admission to the professional
• Setting standards for practice
• Acting on complaints from the public
• Disciplining members who fail to meet the necessary standards of life
• Providing support for nursing practice to registered members.
The mission of the national league for nursing is to advance the
promotion of health and the provision of quality health care within a
changing health care environment by promoting and monitoring effective
nursing education and practice through collaborative efforts of nursing
leaders, representatives of relevant agencies, and the general public.
• Strengthen nursing’s role in the promotion of quality health care that is
both accessible and affordable.
• Promote quality in nursing practice.
• Assure quality in nursing education.
• Enhance the consumer involvement in attaining the goals of the

• Develop creative and collaborative approaches to the resolution of

health care problems.
• Restructure the organization to provide flexibility for fixture growth
and development.
• Ensure the financial solvency of the organization.
The NLN is recognized in the united states as the national accrediting
body for all basic nursing education, programs, as well as for masters degree
nursing programs.
Provide peers-review accreditation programs for home health agencies
and community nursing service.
Provide consultation services, continuing education, programs,
analysis of statistical data related to nursing education and a variety of
information package to affect recruitment image and legislative affairs.

The provincial regulatory bodies have responsibility for monitoring
and approving nursing education. All nursing education programs must
prove that their nursing curriculum. Prepares graduates to practice
professionally and meet the required standards and competencies. The
government sets out the legislation for the protection of the public it is the
nurses themselves who carry out this legislation under the specific mandate
and structure required by the law.
Power point, OHP, Chart.
• Ann. J. Zwemer (1995), Text Book of Professional Adjustments
and Ethics for Nurses In India, Sixth edition, B.I. Publications,
Madras, p.no: 139 – 147.
• Grace L. Deloughery ( ), Issue and Trends in Nursing, third
edition Mos by company publications, p.no.91-92.
• Joanne Come Mecloskey, Helan Kennedy, ( ), Current Issues in
Nursing, third edition, C.V. Mosby company publications, p.no. 45,
116, 472-476.
• K. Park, (2002), Text Book of Preventive and Social Medicine,
Seventh edition Banarsidas Bhanot Publication, p.no. 640.
• Mary Lucita, ( ), Nursing Practice and Public Health
Administration Current Concepts and Trends, Second edition,
Elsevier publications, New Delhi, p.no.169.
• Susan Leddy J. Mae, ( ), Conceptual Basis of Professional
Nursing, Second edition, J.B. Company publication, p.no.31-34.

• Taylor Carol (2008), Text Book of Fundamentals of Nursing /

The Art and Science of Nursing Care, Vol. 1, Sixth edition,
Lippin Cott Williams and Wilkins Publications, Philadelphia, p.no.
• Regulatory Model on Transitioning Nurses From Education to
practice, Nancy Spector, Sulling Li, Joan’s Health Care Law, ethics
and Regulation / volume 9 No.1 January – March, 2007, p.no.19 – 22.
• Issues of Accreditation, A Deans Perspective, Collins, online journal
of issues in nursing volume 2, No.3.
• The Tri Council for Nursing: Barbara, K. Redman, Geradline, 15
Years of Fruitful Co-operation Nursing Outlook, Vol. 39, No.3, p.128-