1. Chapter 11 Legally Responsible Nursing Practice

2. Legally Responsible Nursing Practice
A nurse’s duty is to do good and to avoid harm in accordance with the law.
Laws are rules of conduct derived from:
Cultural values
Moral practices
Ethical beliefs

3. Good Samaritan Statutes
Protect people from prosecution who voluntarily aid others in an emergency.
Intend to encourage giving emergency care outside the hospital or health care facility.
Some states require people to help strangers in distress.
To act or not act is an ethical decision.

4. Sources of Laws Public (federal, state, and local government)
Constitutional law
Administrative law
Criminal law
Private
Contract law
Laws of torts

5. Regulation of Nursing Practice
Administrative Law—The Nurse Practice Act
Defines legal functions, powers, and duties of the state board of nursing
Enforces the Nurse Practice Act
Holds disciplinary hearings
Identifies membership of the board and how to become a board member
Defines terms
Includes laws governing licensure and legal titles

6. Responsibility and Liability
Responsibility is being accountable for your actions.
Explain the action and accept any consequences.
Liability is the legal obligation to make good for the loss of, or damage to, something for which he or she is responsible.
Nurses are personally and legally responsible for their nursing actions.
Best protection against charges:
Carry out duties at or above the standard expected

7. Legal Relationships Between Employer and Employee
Employer has right to hire employees, direct, and control performance of work.
Employee accepts wages, provides service to employer.
Respondeat superior
Both the nurse and the employer can be held liable for nurse’s acts.
Employer’s guidelines (policies and procedures) state what action is expected in a specific situation.

8. Standards of Care
Guidelines to identify appropriate levels of professional care
Rules and regulations defining care expected of professional and practical/vocational nurses
Accrediting agencies and organizations develop standards of care
Employer policy and procedure manuals

9. Legal Issues for Nurses #1
Contracts
An agreement between two or more parties
Written or verbal promises with exchange of something of value
Breach of contract
Failure to fulfill any or all parts of a contractual obligation

10. Legal Issues for Nurses #2
Torts
An injury or wrong committed by one person, group, or organization against another person, group, or organization
Strict Liability
Describes actions that cause injury to others
Intentional
Injuries caused by willful, forceful, and aggressive behavior

11. Legal Issues for Nurses #3
False imprisonment-confining or restricting someone to a place
Restraint
Violation of confidentiality
Defamation of character
Violating informed consent-Patients have the right to choose to receive treatment
Assault and battery-threatening to touch someone without touching; touching someone without permission
Fraud

12. Legal Issues for Nurses #4
Negligence
Failure of a reasonable person to do something or not do something that a reasonable person in the same circumstances would or would not do
General term describing neglect by a physician or nurse to apply education and skills which other physicians or nurses apply in similar circumstances

13. Legal Issues for Nurses #5
Gross Negligence
Human life endangered or lost
Often tried under Criminal law

14. Legal Issues for Nurses #6
Malpractice Claims
Patients’ perceptions
Impersonality of the American health care system
Health care is big and profitable business
Liability insurance justifies making claims
Frequent new stories of enormous judgments encourage lawsuits

15. Legal Issues for Nurses #7
Traits of “suit-prone” patients
High levels of criticism
Fault-finding
Hostility
Uncooperativeness
Sensitivity to being offended
Successful prior lawsuits

16. Legal Issues for Nurses #8
Prevention of or discouraging lawsuits
Strict personal and institutional adherence to high standards of care
Attention to accurate documentation
Being aware of areas where nurses are often found negligent

17. Legal Issues for Nurses #9
Documentation
Patient’s medical record is a legal document.
Entries must be factual, to the point, accurate, legible, related to patient’s needs or plan of treatment, objective, consistent.
Use agency-approved abbreviations and chart correction procedures.
Computer charting confidentiality.

18. Legal Issues for Nurses #10
Delegation of Nursing Duties
Licensed nurse is accountable for the appropriateness of delegated nursing tasks
The best way for a nurse to avoid being sued for negligence is to constantly look for and correct situations in which a patient may suffer an injury.

19. Legal Issues for Nurses #11
Malpractice Insurance
Institutional employers carry malpractice liability insurance to protect employees and themselves.
Personal malpractice liability insurance policy is a wise investment.
Settlements may exceed employer’s policy limits.
Employer’s insurance company may sue you.
Claims-based rather than occurrence-based policies.

20. Legal Issues for Nurses #12
Wills
Legal statement of a person’s wishes regarding disposition of property after death.
Attorney is most appropriate to help write a will.
Follow institutional guidelines regarding witnessing a will.

21. Legal Issues for Nurses #13
Gifts
Don’t accept gifts or money.
It is legal but not ethical to accept or solicit gifts.

22. Criminal Law and Nursing #1
A crime is an offense committed against the public welfare or safety.
The state prosecutes criminal acts:
Minor offenses
Misdemeanors
Felonies
Practicing without a nursing license is a felony.

23. Criminal Law and Nursing #2
Grossly negligent acts are considered crimes. Example is restraining a patient and there is injury
Criminal background, patient abuse, elder abuse, and child abuse checks done prior to being hired.
Drug and alcohol screening prior to hire.

24. Criminal Law and Nursing #3
Other crimes in which nurses may become directly or indirectly involved:
Right -to-die situations
Violations of federal and state narcotic and controlled substance laws
Fraud
Robbery
Death due to lack of or incorrect nursing care
Murder