Nurse’s Responsibilities Under the Law - Lecture 3 PDF

- Nurse’s responsibilities under the Law Legal issues and legal safeguards in nursing practice Dr Enas Mohamed Lofty Associated Professor In Nursing Administration College Of Nursing, PNU Lecture 3 2 Intended...

- Nurse’s responsibilities under the Law Legal issues and legal safeguards in nursing practice Dr Enas Mohamed Lofty Associated Professor In Nursing Administration College Of Nursing, PNU Lecture 3 2 Intended 1 2 leaning Outcomes (ILOs) Recognize the nurse's legal Describe the legal responsibilities with selected safeguards in Nursing aspects of nursing practice practice  SELECTED LEGAL ASPECT OF NURSING PRACTICE 1.Informed Consent 6. Controlled Substances 2.Delegation 7.Advance Directives 3.Confidentiality 8.Death & Related Issues 4. Liability 9. Sexual Harassment 5. Violence, Abuse & Neglect 10. Organ Donation 1- Informed Consent Purposes: Provides client with complete ,enough information prior to obtaining agreement by client to accept a course of treatment (Based upon principle of autonomy) - Must be given voluntarily—freedom to accept or reject -Must be given by a competent person with capacity to understand  Informed Consent CONT. The following individuals cannot provide informed consent Minors, under influence of drugs/alcohol, person 18 years or younger The unconscious ,mentally ill person judged by professionals to be incompetent Parent, legal guardian,or representativeprovidesor refusesconsentfortheseabove individuals 2-DELEGATION Delegation is defined as health professional (delegator) who is legally authorized and competent transferring his task to another individual (delegate) but still responsible for acts he/she delegates RNs delegate care (tasks) e.g, assign unlicensed nurse to take vital signs under RNscare, but not: - Assessment & evaluation - Medication administration to unlicensed assistive personnel. 5 RIGHTS OF DELEGATION 1. Right task 2. Right circumstances 3. Right person 4. Right direction/communication 5. Right supervision/evaluation  3-CONFIDENTIALITY Code of Ethics for nurses: “the nurse has a duty to maintain confidentiality of all patient information. ” Exceptions: Discussing with others involved in patient care, quality assurance Privileged communication: lawyers, clergy ‫رجال الدين‬ Duty to report: child abuse, gunshot wounds, threats to another, vulnerable adult abuse, certain communicable diseases  4-LIABILITY‫مسئولية قانونية‬ It is state of being legally responsible for one's obligations and actions and to make financial restitution ‫ تعويض‬for wrongful acts. for example, A nurse, has an obligation to practice and direct the practice of others under the nurse's supervision so that harm or injury to the client is prevented and standards of care are maintained Reported problem areas of liability for nurses Monitoring patients Implementing treatments Medication problems MINIMIZING CHANCE OF LIABILITY Function within scope of education, job description and nurse practice act Follow procedures and policies - Perform procedures correctly and appropriately Build and maintain good rapport (ask them how the recovery is going) Always check the client’sidentity - Observe and monitor Accurately communicate and record significant changes Promptly and accurately document all assessments and care Administer the right medication, in the right dose, via the right routes, at the right time, to the right client 5- VIOLENCE, ABUSE & NEGLECT Violent behaviour caninclude domesticviolence ‫العنف المنزلي‬, child abuse,elder abuse,and sexual abuse. Violence in the workplace may include the following: Physical Abuse: Hitting, forcing people against their will, restraining movement, depriving people of food or water, not providing physical care Verbal Abuse : Speaking harshly, swearing, shouting, using inappropriate words to describe a person’s race or nationality Neglect is the absence of care necessary to maintain the health & safety of a vulnerable individual such as a child or elder.. SUGGESTIONS FOR NURSES TO IMPROVE WORKPLACE SAFETY Nurses have been identified as a group at risk for violence from patients, family members, and other staff members 1. Participate in workplace assessments(identify unsafe areas as well as f factors that might contribute to violent behaviors) 2.Always be alert for suspicious behavior (threatening body language, drug/alcohol use, a weapon) 3. Maintain behavior that de-fuses anger‫( ينزع فتيل الغضب‬acknowledge the person’s feelings, remain calm) 4. If the situation cannot be de-fused, quickly leave and call security 6- CONTROLLED SUBSTANCES Controlled substances mainly include stimulants, depressants, narcotics, etc., Example: Misuse of these leads to criminal penalties. 7- ADVANCE DIRECTIVES ‫توجيهات مسبقة‬ are known as legal directives that allow individuals to state what medical treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care. There are two types of advanced directives: Living Will : Documents that allow individuals to state what measures should or should not be taken to prolong life when their condition is terminal (death expected) Example: May include a DNR order Do-not-resuscitate order Durable Power of Attorney‫ الوكالة الدائمة‬: This document permits: individual to appoint another person (agent) to make any health care decisions for them if they are unable to make their own decisions 8- DEATH & REALTED ISSUES Nursesrole in legal issuesrelated to death isprescribed by the laws of the region and the policies of the health care institution. Beliefs and attitudes about deaths are vary among cultures DNR (do not resuscitate) orders or no code orders are a form of withholding treatment Only physicians can write a DNR, usually after consulting with the patient (when possible) and the family. All members of the health care team are expected to comply with the order!!!  9-SEXUAL HARASSEMENT Is defined as “unwelcome sexual advances,and other verbal or physical conduct of a sexual nature.” Nurses who engage in sexual harassment of others are guilty of intentional torts and civil rights claims. They are guilty of intentional infliction of emotional distress. ‫ انهم مذنبون بالتسبب المتعمد في االضطراب الوجداني‬,. IF THE NURSE IS A VICTIM OF SEXUAL HARASSMENT The ANA (American Nurses Association) suggests four actions: (1)Confront the harasser‫مواجهة المتحرش‬ (2)Report to the supervisor (file a formal complaint) (3)Document the incident (name any witnesses) ‫توثيق الحادث‬ (4)Seek support from friends, family, and organizations (such as the ANA) 10-ORGAN DONATION The Uniform Anatomical Gift Act ‫(قانون الهبات التشريحية الموحدة‬1968, 1987) Allows people 18 years of age or older and of sound mind to make a gift of all or any part of their own bodies for medical education, research, or transplantation. It also provides a list of relatives who can authorize organ donation in the absence of donation arrangements made before death. 10-ORGAN DONATION- Contd… Some patients carry a card they have signed stating they wish to be an organ donor Some have indicated they wish to be an organ donor on their driving license. Nurses may serve as a witness for patients consenting to donate organs Patients may revoke their decision by (1) destroying the card or (2) orally retracting their desire to be a donor in the presence of two witnesses  INCIDENT REPORTS Incident Reports ‫ تقارير الحادث‬: Agency record of an incident or unusual occurrence (also called unusual occurrence report) Make all the facts available to agency personnel Contribute to statistical data about incidents Help health personnel prevent future incidents Filed according to agency policy INFORMATION INCLUDED ON INCIDENT REPORT Identification of the client by name, initials, and hospital or identification number -Date, time, and place of the incident Description of the facts of the incident (no conclusionsor blame) Incorporation of the client’s account of the incident ‫إدراج رواية العميل عن الحادثة‬ Identification of all witnesses Identification of any equipment by number and any medication by name and dosage REGULATION OF NURSING PRACTICE-‫تنظيم ممارسة التمريض‬ Legal Safe Guards Regulation for nursing practice helps to bring a standard in nursing care and thus to protect the public. 1.Nurse Practice act ‫قانون ممارسة التمريض‬ 2. Credentialing ‫االعتماد‬ 3. Standards of care ‫معايير الرعاية‬  1-NURSE PRACTICE ACTS ‫قانون ممارسة التمريض‬ Each state has a nurse practice act, which protects the public by legally defining and describing the scope of nursing practice and it is also legally control nursing practice through licensing Requirements. But acts differ from country to country.  2- CREDENTIALING Credentialing is the process of determining and maintaining competence in nursing practice ,accountability for educational preparation of its members. a)Licensure ‫الترخيص‬ Licensing is intended to ensure that only competent and ethical individuals practice in an occupation. Examples of occupations licensed include: teachers, doctors, lawyers,, nurses, building contractors, counselors, therapists, licensure must be issued by a government agency or entity. a) Certification ‫شهادة‬ It is an acknowledgment by a medical specialty board of successful completion of requirements for recognition as a specialist. Certification is may issued by a non-governmental agency, entity, or organization, for example, an association of nurses 3- STANDARDS OF CARE These standards are used to evaluate the quality of care nurses provide and, therefore, become legal guidelines for nursing practice. TYPES OF STANDARDS OF CARE External Standards : Nurse practice acts Professional organizations Nursing specialty-practice organizations Internal Standards : Job description Education Expertise Institutional policies and procedures MAINTAINING THE STANDARDS OF CARE 1. Accountability ensure that clients receive competent, safe and ethical care 2. Continuing competence relevant to their own scope of nursing practice 3. Application of knowledge, skills and judgement relevant to their own scope of practice  MAINTAINING THE STANDARDS OF CARE- CONTD.. 4.Professional relationships and advocacy Establish professional therapeutic relationship and act as an advocate for clients 5.Professional leadership Whenproviding quality nursingcare and health care service to clients 6.Self-regulation To practice nursing in a competent and ethical manner  LEGAL RESPONSIBILITIES OF THE NURSE Ensure that client receives competent, safe, & holistic care Supervise/evaluate the care provider. Documentation of care. Maintain clinical quality of care. Responsibility for equipment REFERENCES Patricia Stauton &Mary Chiarella (2020). Law for Nurses and Midwives,(9th ed).Elsevier Black, B. (2016) Professional Nursing: Concept & Challenges. 8th ed. USA: SaundersPublishing.