1. Legal Aspects of Nursing Part 2 Dr. Belal Hijji, RN, PhD December 20, 2011

2. 2 Learning Outcomes At the end of this lecture, students will be able to: Discuss some selected legal aspects related to nursing practice.

3. 3 Selected Legal Aspects of Nursing Practice Continuing from the last session, nurses need to identify and report the impaired nurse, violent behaviour and neglect of vulnerable clients, and sexual harassment. Nurses need also to recognise the importance of the confidentiality of patient information and identify some important aspects of unprofessional behaviour.

4. 4 Controlled Substances Laws in the USA regulate the distribution of controlled drugs such as narcotics, depressants [drugs that temporarily reduce the function or activity of a specific part of the body or mind, such as alcohol and morphine], and stimulants [such as caffeine, cocaine, and amphetamines (Levoamphetamine, dextroamphetamine].

5. 5 The Impaired Nurse This term (impaired nurse) refers to a nurse whose ability to perform nursing functions is diminished by chemical dependency on drugs, alcohol, or mental illness. Chemical dependence is a real problem caused by high levels of stress in health care settings, increased workloads, decreased staffing, fatigue, isolation, and access to addictive drugs. In the US, more than 50% of impaired nurses started abusing drugs including alcohol before they finished their nursing education. In the US, these nurses and student nurses receive treatment and support, not discipline.

6. 6 Sexual Harassment Sexual harassment is defined as “unwelcome sexual advances, requests for sexual favors, and other verbal of physical conduct of a sexual nature”; it is a violation of the individual’s rights and a form of discrimination. Sexual harassment occurs when submission to such conduct is considered a condition of an employment, when submission or rejection of such conduct is used as the basis for employment decisions affecting the person, and when such a conduct interferes with a person’s work performance. Nurses must develop skills to deter sexual harassment in workplace and must be familiar with existing policies and procedures related to sexual harassment that must be enacted in every institution.

7. 7 Privacy of Client ’ s Health Information It is a nursing responsibility to protect client’s confidentiality. By this, we mean health and identifying information including diagnosis, social security number, name, address, phone number, and website address. The American Health Insurance Portability and Accountability Act of 1996 (HIPPA) protects the privacy of client’s information.

8. 8 Examples of HIPPA Compliance and Nursing Practice A client’s name cannot appear near or on the room door. Client’s medical records should be kept in safe, secure, and non-public location to prevent unauthorised access. Printed copies of protected health information should not be left unattended near fax machines or printers. Access to protected information is permitted for authorised personnel. Voice levels should be lowered, and a notice informing clients of their rights about privacy, should be provided.

9. 9 Unprofessional Conduct Unprofessional conduct is one of the grounds for action against the nurse’s license. Unprofessional conduct includes incompetence, gross negligence, conviction of practicing without license, falsification of client’s records, and illegally obtaining controlled substances. An example of falsification of a client’s record is what some nurses do sometimes when they enter the vital signs of a patient without actually measuring them. Having personal relationship with a vulnerable client may be considered unprofessional conduct, because nurses are responsible for retaining professional boundaries. Unethical conduct includes violation of ethical codes, breach of confidentiality, or discrimination in the provision of care.

10. 10 What You Should Do Next Based on this teaching session and supported by your clinical instructor, find out whether the hospital you are assigned to has policies to handle issues related to impaired nurse, falsification of patient’s records, and sexual harassment.