Legal Responsibilities BSN PDF

LEGAL RESPONSIBILIT Y NURSING LEGISLATIONS  LAW THE SUM TOTAL OF RULES & REGULATIONS BY WHICH SOCIETY IS GOVERNED. MAY BE DEFINED AS A RULE OF CONDUCT PRONOUNCED BY CONTROLLING AUTHORITY, WHICH MAY BE ENFORCED. THERE ARE THREE ESSENTIAL CHARACTERISTICS OF E...

LEGAL RESPONSIBILIT Y NURSING LEGISLATIONS  LAW THE SUM TOTAL OF RULES & REGULATIONS BY WHICH SOCIETY IS GOVERNED. MAY BE DEFINED AS A RULE OF CONDUCT PRONOUNCED BY CONTROLLING AUTHORITY, WHICH MAY BE ENFORCED. THERE ARE THREE ESSENTIAL CHARACTERISTICS OF EVERY LAW: 1. THE FIRST ONE IS THE AUTHORITY OR THE RIGHT TO DECLARE THE RULE EXISTS. 2. THE SECOND IS THAT SUCH RULE IS PRONOUNCED OR EXPRESSED AND THAT ITS SOURCE CAN BE IDENTIFIED. 3. LASTLY, A RIGHT TO ENFORCE THE SAME MUST BE PROVIDED.  NURSING JURISPRUDENCE DEPARTMENT OF LAW WHICH COMPRISES ALL LEGAL RULES AND PRINCIPLES EFFECTING THE PRACTICE OF NURSING. INCLUDES THE STUDY AND INTERPRETATION OF RULES AND PRINCIPLES AND THEIR APPLICATION IN THE REGULATION OF THE PRACTICE OF NURSING.  FUNCTIONS OF LAW IN NURSING A FRAMEWORK FOR ESTABLISHING WHAT NURSING ACTIONS IN THE CARE OF PATIENTS ARE LEGAL DELINEATES THE NURSE’S RESPONSIBILITIES FROM THOSE OF OTHER PROFESSIONALS HELPS TO ESTABLISH THE BOUNDARIES OF INDEPENDENT NURSING ACTIONS ASSISTS IN MAINTAINING A STANDARD OF NURSING PRACTICE BY MAKING NURSES ACCOUNTABLE TO THE LAW  PHILIPPINE NURSING LAW ACT NO. 2493 (1915) REGULATED THE PRACTICE OF MEDICINE PROVIDED FOR THE EXAMINATION & REGISTRATION OF NURSES IN THE PHILIPPINES. ACT 2808 (1919) FIRST TRUE NURSING LAW CREATED BOARD OF EXAMINERS FOR NURSES FIRST BOARD OF EXAMINATION WAS GIVEN IN 1920  PHILIPPINE NURSING LAW R.A. 877- THE PHILIPPINE NURSING LAW (JUNE 19, 1953) ORGANIZATION OF THE BOARD OF EXAMINERS FOR NURSES PROVISIONS REGARDING NURSING SCHOOLS & COLLEGES EXAMINATIONS, REGISTRATION OF NURSES  PHILIPPINE NURSING LAW UNDER PROCLAMATION NO. 539DATED OCTOBER 17, 1958 THE PRESIDENT OF THE PHILIPPINES DESIGNATED THE LAST WEEK OF OCTOBER EVERY YEAR BEGINNING IN 1958 AS NURSES' WEEK. REPUBLIC ACT 7164 INTRODUCED BY SENATOR HEHERSON ALVAREZ, CODIFIED AND REVISED ALL THE LAWS REGULATING THE PRACTICE OF NURSING IN THE PHILIPPINES. IT WAS KNOWN AS THE PHILIPPINE NURSING ACT OF 1991. HEALTH RELATED LAWS AFFECTING NURSING AND HEALTH R.A. 2382 – PHILIPPINE MEDICAL ACT DEFINES THE PRACTICE OF MEDICINE IN THE PHILIPPINES. R.A. 6425- DANGEROUS DRUG ACT ACT NO. 3573 IN 1929- ALL COMMUNICABLE DISEASES SHALL BE REPORTED TO THE NEAREST HEALTH STATION. R.A. 1082- CREATION OF RURAL HEALTH UNITS. R.A. 4073- TREATMENT OF LEPROSY PRESIDENTIAL DECREE 996- COMPULSORY IMMUNIZATION FOR ALL CHILDREN BELOW 8 Y/O AGAINST COMMUNICABLE DISEASES. HEALTH RELATED LAWS AFFECTING NURSING AND HEALTH PRESIDENTIAL DECREE 825- PENALTY FOR IMPROPER DISPOSAL OF GARBAGE & OTHER FORMS OF CLEANLINESS PRESIDENTIAL DECREE 856- CODE OF SANITATION, CONTROL OF ALL FACTORS IN ENVIRONMENT THAT AFFECT HEALTH INCLUDES QUALITY OF WATER, FOOD, MILK, CONTROL OF INSECTS, ANIMAL CARRIERS, TRANSMITTERS OF DISEASE, SANITARY & RECREATION FACILITIES, NOISE, UNPLEASANT ODORS. PRESIDENTIAL DECREE 148- MINIMUM EMPLOYABLE AGE (16Y/O) AND PRIVILEGES OF WORKING WOMEN. R.A. 6365- ESTABLISHED A NATIONAL POLICY ON POPULATION & CREATED COMMISSION ON POPULATION. PRESIDENTIAL DECREE 166- STRENGTHEN FAMILY PLANNING PROGRAMS. HEALTH RELATED LAWS AFFECTING NURSING AND HEALTH R.A. 4226- HOSPITAL LICENSURE ACT, REQUIRES ALL HOSPITALS TO BE LICENSED BEFORE THEY CAN OFFER TO SERVE COMMUNITY. PRESIDENTIAL DECREE 442- LABOR CODE OF THE PHILIPPINES PROVIDES WORKERS THE RIGHT TO SELF-ORGANIZATION/PROMOTES THE RIGHT & WELFARES OF WORKERS. PRESIDENTIAL DECREE 1519- MEDICARE BENEFITS TO ALL GOVERNMENT EMPLOYEES REGARDLESS OF STATUS OF APPOINTMENT. R.A. 7600- ROOMING IN & BREASTFEEDING ACT OF 1992. R.A. 7432- SENIOR CITIZEN’S ACT. HEALTH RELATED LAWS AFFECTING NURSING AND HEALTH PRC RESOLUTION NO 2004-17 SERIES OF 2004- RE IMPLEMENTED CONTINUING PROFESSIONAL EDUCATION REQUIRING 60 CREDIT UNITS FOR 3 YEARS FOR PROFESSIONALS WITH BACHELOR’S DEGREE.  PRESIDENTIAL DECREE 442 KNOWN AS THE LABOR CODE OF THE PHILIPPINES PROVIDES WORKERS FOR THE RIGHT TO SELF ORGANIZATION AND COLLECTIVE BARGAINING THAT PROMOTES THE RIGHTS & WELFARE OF THE WORKERS. R.A. 7305  REPUBLIC ACT NO. 9173 AN ACT PROVIDING FOR A MORE RESPONSIVE NURSING PROFESSION. LEGAL ASPECTS AND THE NURSE AS NURSES BEGIN THEIR PROFESSIONAL OBLIGATIONS, THEIR LEGAL RESPONSIBILITIES BEGIN AS WELL. THEIR LICENSE TO PRACTICE ATTESTS THAT THEY ARE QUALIFIED UNDER THE LAW TO PRACTICE THEIR PROFESSION. THE PHILIPPINE NURSING ACT OF 1992 IS THE BEST GUIDE THE NURSE CAN UTILIZE AS IT DEFINES THE SCOPE OF NURSING PRACTICE. THE NURSES ARE ENJOINED TO BE FAMILIAR WITH THE PHILIPPINE NURSING LAW, AND THE STANDARDS OF NURSING CARE, OTHER LAWS WHICH AFFECT NURSING PRACTICE AND THEIR CODE OF ETHICS  RESPONSIBILITY AND ACCOUNTABILITY FOR THE PRACTICE OF PROFESSIONAL NURSING RESPONSIBILITY-REFERS TO THE EXECUTION OF DUTIES ASSOCIATED WITH A NURSE’S PARTICULAR ROLE. THAT IS, THE NURSE IS RESPONSIBLE FOR PROVIDING CARE WITHIN ESTABLISHED STANDARDS OF THE PROFESSION. THE RESPONSIBLE NURSE DEMONSTRATES CHARACTERISTICS OF RELIABILITY AND DEPENDABILITY. ACCOUNTABILITY-REFERS TO THE ABILITY TO ANSWER FOR ONE’S OWN ACTIONS. THE NURSE IS ACCOUNTABLE TO HERSELF MOST OF ALL. HE/SHE ALSO BALANCES ACCOUNTABILITY TO THE PATIENT, THE PROFESSION, THE EMPLOYING INSTITUTION, AND SOCIETY. LIABILITY-AN OBLIGATION ONE HAS INCURRED OR MIGHT INCUR THROUGH ANY ACT OR FAILURE TO ACT.-WHEN THE NURSE FAILS TO MEET THE LEGAL EXPECTATIONS OF CARE, THE CLIENT CAN INITIATE ACTION IF HARM OR INJURY IS INCURRED BY THE CLIENT BREACH OF CONTRACT FAILURE TO PERFORM AN AGREEMENT, WHETHER EXPRESSED OR IMPLIED, WITHOUT CAUSE. THE FOLLOWING CONSTITUTE BREACH OF CONTRACT FOR NURSING SERVICES: 1. PREVENTION OF PERFORMANCE. 2. FAILURE TO PERFORM BECAUSE OF INCONVENIENCE OR DIFFICULTY. 3. FAILURE OF COOPERATION IN PERFORMANCE. 4. ABANDONMENT OF DUTY (I.E. LEAVING UNCONSCIOUS PATIENTS, GOING OFF DUTY WITHOUT ENDORSEMENT 5. SUBSTITUTION OF PERFORMANCE. 6. FAILURE TO USE DUE CARE. PROFESSIONAL NEGLIGENCE NEGLIGENCE REFERS TO THE OMISSION OF AN ACT, PURSUANT TO DUTY, THAT A REASONABLY PRUDENT PERSON IN THE SAME OR SIMILAR CIRCUMSTANCE WOULD OR NOT DO. ACTING OR THE NON ACTING OF WHICH IS THE PROXIMATE CAUSE OF INJURY TO ANOTHER PERSON OR HIS PROPERTY.  SPECIFIC SAMPLES OF NEGLIGENCE 1. FAILURE TO REPORT OBSERVATIONS TO ATTENDING PHYSICIANS. 2. FAILURE TO EXERCISE THE DEGREE OF DILIGENCE WHICH THE CIRCUMSTANCES OF THE PARTICULAR CASE DEMANDS. 3. MISTAKEN IDENTITY. 4. WRONG MEDICINE, WRONG CONCENTRATION, WRONG ROUTE, WRONG DOSE. 5. DEFECTS IN THE EQUIPMENT SUCH AS THE STRETCHERS & WHEELCHAIRS MAY LEAD TO FALLS THUS INJURING THE PATIENTS. 6. ERRORS DUE TO FAMILY ASSISTANCE. 7. ADMINISTRATION OF MEDICINE WITHOUT A DOCTOR’S PRESCRIPTION.  DOCTRINE OF RES IPSA LOQUITOR MEANS THE THING SPEAKS FOR ITSELF. THE INJURY COULD NOT HAVE HAPPENED IF SOMEONE WAS NOT NEGLIGENT THAT NO FURTHER PROOF IS REQUIRED. EX: PRESENCE OF SPONGES IN THE PATIENT’S ABDOMEN AFTER AN OPERATION. FRACTURE ON A NEWLY DELIVERED BABY BORN BY BREECH PRESENTATION.  MALPRACTICE THE TERM FOR NEGLIGENCE OR CARELESSNESS OF PROFESSIONAL PERSONNEL. NEGLIGENT ACT COMMITTED IN THE COURSE OF PROFESSIONAL PERFORMANCE. MALPRACTICE IN THE USUAL SENSE IMPLIES THE IDEA OF IMPROPER OR UNSKILLFUL CARE OF A PATIENT BY A NURSE. IT WOULD ALSO SEE THAT MALPRACTICE ALSO DENOTES STEPPING BEYOND ONE'S AUTHORITY WITH SERIOUS CONSEQUENCES. EX; GIVING OF ANESTHESIA BY A NURSE OR PRESCRIBING MEDICINE.  DOCTRINE OF FORCE MAJEURE FORCE MAJEURE MEANS AN IRRESISTIBLE FORCE, ONE THAT IS UNFORESEEN OR INEVITABLE. CIRCUMSTANCES SUCH AS FLOODS, FIRE, EARTHQUAKES & ACCIDENTS FALL UNDER THIS DOCTRINE AND NURSES WHO FAIL TO RENDER SERVICE DURING THESE CIRCUMSTANCES ARE NOT HELD NEGLIGENT. HABITUAL TARDINESS DUE TO HEAVY TRAFFIC IS NOT CONSIDERED AN EXCUSE FOR FORCE MAJEURE.  DOCTRINE OF RESPONDENT SUPERIOR THE LIABILITY IS EXPANDED TO INCLUDE THE NASTER AS WELL AS THE EMPLOYEE AND NOT SHIFT OF LIABILITY FROM THE SUBORDINATE TO THE MASTER. WHEN A PERSON THROUGH HIS NEGLIGENCE, INJURES ANOTHER, HE REMAINS FULLY RESPONSIBLE. EX; HOSPITAL WILL BE HELD LIABLE, IF, IN AN EFFORT TO CUT DOWN ON EXPENSES, IT DECIDES TO HIRE UNDERBOARD NURSES OR MIDWIVES IN PLACE OF PROFESSIONAL NURSES, AND THESE PERSONS PROVE TO BE INCOMPETENT. EX; THE SURGEON WILL BE HELD RESPONSIBLE IN CASE A LAPAROTOMY PACK IS LEFT IN A PATIENT’S ABDOMEN. MEDICAL ORDERS, DRUGS, AND MEDICATIONS R.A. 6675 STATES THAT ONLY VALIDLY REGISTERED MEDICAL, DENTAL AND VETERINARY PRACTITIONERS, WHETHER IN PRIVATE INSTITUTION/ CORPORATION OR IN THE GOVERNMENT, ARE AUTHORIZED TO PRESCRIBE DRUGS. PRESCRIPTIONS MADE BY UNAUTHORIZED PERSONS CONSTITUTE ILLEGAL PRACTICE OF MEDICINE, DENTISTRY OR VETERINARY MEDICINE AND IS PUNISHABLE UNDER R.A. 2832 OF THE MEDICAL ACT OF 1959, R.A. 4419 OF THE DENTAL ACT, AND R.A. 382 OR THE VETERINARY ACT IN ACCORDANCE WITH R.A. 5921, OR THE PHARMACY ACT AS AMENDED, ALL PRESCRIPTIONS MUST CONTAIN THE FOLLOWING INFORMATION: NAME OF THE PRESCRIBER, OFFICE ADDRESS, PROFESSIONAL REGISTRATION NUMBER, PROFESSIONAL TAX RECEIPT NUMBER, PATIENT’S/CLIENT’S NAME, AGE AND SEX, AND DATE OF PRESCRIPTION. R.A. 6675 REQUIRES THAT THE DRUGS BE WRITTEN IN THEIR GENERIC NAMES. MEDICAL ORDERS, DRUGS, AND MEDICATIONS THE DEPENDENT AND COORDINATED FUNCTION OF THE NURSE PERTAINS TO THE APPLICATION AND EXECUTION OF WRITTEN LEGAL ORDERS OF PHYSICIANS CONCERNING TREATMENT AND MEDICATIONS. ONLY WHEN THESE ORDERS ARE LEGAL IN WRITING AND BEAR THE DOCTOR’S SIGNATURE DOES THE NURSE HAVE THE LEGAL RIGHT TO FOLLOW THEM. WRITTEN ORDERS ARE BETTER UNDERSTOOD AND CHANCES OF ERROR ARE MINIMIZED IF THEY ARE CLEAR, SPECIFIC, COMPLETE AND LEGIBLE. VERBAL ORDERS CAN BE MINIMIZED IF THE NURSE SEEKS A CLEAR UNDERSTANDING FROM THE PHYSICIANS IN ESTABLISHING A POLICY CONCERNING THE IMPORTANCE OF WRITTEN ORDERS. THE GENERAL RULE REQUIRING A NURSE TO EXECUTE ALL LAWFUL ORDERS OF A PHYSICIAN IS TEMPERED BY COMMON SENSE. THE NURSE MUST NOT EXECUTE AN ORDER IF SHE IS REASONABLY CERTAIN IT WILL RESULT IN HARM TO THE PATIENT. IN SUCH CASE SHE MUST SPEAK OUT AND RISK INCURRING THE PHYSICIAN’S RESENTMENT OR IRE RATHER THAN A LAWSUIT MEDICAL ORDERS, DRUGS, AND MEDICATIONS IT IS PREFERABLE TO RAISE THE MATTER OF CARRYING OUT THE PROCEDURE AS A POINT OF CLARIFICATION IN A TACTFUL, ACCEPTABLE MANNER. A NURSE MUST SEE TO IT THAT SHE UNDERSTANDS THE ACTION OF A DRUG, ITS MINIMUM AND MAXIMUM DOSAGES, ROUTE OF ADMINISTRATION, AND UNTOWARD EFFECTS SO THAT SHE MAY SKILLFULLY, SAFELY, AND EFFECTIVELY CARRY THEM OUT. SHE SHOULD BE ABLE TO REPORT AND RECORD THE EFFECTS ON THE PATIENT SO THAT THE DOCTOR CAN JUDGE ITS THERAPEUTIC VALUE AND KNOW WHEN TO DISCONTINUE ITS USE. TESTS AND TREATMENTS SHOULD BE EXPLAINED TO THE PATIENT IN ACCORDANCE WITH THE GENERAL PLAN OF HIS CARE SO THAT THE PATIENT CAN GIVE FULL CONSENT AND COOPERATE IN ITS IMPLEMENTATION. ANY UNFAVORABLE PSYCHOLOGIC OR PHYSICAL REACTION SHOULD BE LIKEWISE REPORTED SO THAT THE PROPER ACTION MAYBE TAKEN. SOMETIMES, HOWEVER, REFUSAL MAY BE DUE TO INACCURATE PRESENTATION OF FACTS. PATIENTS MUST RECEIVE SPECIAL SYMPATHETIC ATTENTION FROM THE NURSES. EVERY EFFORT SHOULD BE MADE TO CORRECT INACCURATE VIEWS AND MODIFY SUPERFICIALLY-HELD BELIEFS. INTRAVENOUS THERAPY AND LEGAL IMPLICATIONS NURSES NOW PARTICIPATE IN COMPLEX INTRAVENOUS THERAPY PROCEDURES THAT WERE ONCE PERFORMED ONLY BY DOCTORS. BECAUSE OF THIS CHANGE, NURSES MUST REMEMBER THAT THEIR LEGAL RIGHT TO GIVE INTRAVENOUS INJECTIONS IS BASED ON THE PHILIPPINE NURSING ACT OF 1991 SECTION 28 WHICH STATE THAT "IN THE ADMINISTRATION OF INTRAVENOUS INJECTIONS, SPECIAL TRAINING SHALL BE REQUIRED ACCORDING TO PROTOCOL ESTABLISHED. "THEREFORE, NURSES HAVE TO UNDERTAKE A CERTIFIED TRAINING COURSE ON INTRAVENOUS THERAPY. IN GIVING INTRAVENOUS INJECTIONS, NURSES SHOULD ALSO FOLLOW THE POLICIES OF THEIR AGENCIES. EVEN IF NURSES HAVE FORMAL TRAINING ON IV THERAPY, IF THE HOSPITAL DOES NOT ALLOW THEM TO DO SO, THEN THEY MAY NOT DO THE PROCEDURE. BOARD OF NURSING RESOLUTION NO. 8 STATES THAT ANY REGISTERED NURSE WITHOUT SUCH TRAINING AND WHO ADMINISTERS IV INJECTIONS TO PATIENTS, SHALL BE HELD LIABLE, EITHER CRIMINALLY UNDER SEC. 30 ( C) ART. VII OF SAID LAW OR ADMINISTRATIVELY UNDER SEC. 21 ART. III OR BOTH (WHETHER CAUSING OR NOT INJURY OR DEATH TO THE PATIENT)  TELEPHONE ORDERS THERE ARE LEGAL RISKS BY TELEPHONE ORDERS. THESE MAY BE MISUNDERSTOOD OR MISINTERPRETED BY THE RECEIVING NURSE. SOMETIMES TOO, MESSAGES FROM TELEPHONES MAY SOUND UNCLEAR OR GARBLED BECAUSE OF SOME TROUBLE IN THE TELEPHONE LINES. MOST IMPORTANTLY, THE SIGNATURE OF THE ORDERING PHYSICIAN IS NOT PRESENT AND THIS ORDER MAY LATER BE DENIED INCASE ERRORS EXIST OR COURT LITIGATIONS ARISE. CONSENT TO MEDICAL & SURGICAL PROCEDURES CONSENT IS DEFINED AS A “FREE AND RATIONAL ACT THAT PRESUPPOSES KNOWLEDGE OF THE THING TO WHICH CONSENT IS BEING GIVEN BY A PERSON WHO IS LEGALLY CAPABLE TO GIVE CONSENT.” THE CONSENT SIGNED BY THE PATIENT OR HIS AUTHORIZED REPRESENTATIVE/LEGAL GUARDIAN UPON ADMISSION IS FOR THE INITIAL DIAGNOSIS AND TREATMENT. SUBSEQUENT TREATMENTS/OPERATIONS REQUIRE INDIVIDUAL, INFORMED CONSENT. BEFORE ANY MEDICAL OR SURGICAL PROCEDURE CAN BE PERFORMED ON A PATIENT, CONSENT MUST BE OBTAINED FROM THE PATIENT OR HIS AUTHORIZED REPRESENTATIVE WHO MAY BE HIS PARENT OR GUARDIAN. IT IS ONLY IN CASE OF EMERGENCY WHERE THE CONSENT REQUIREMENT DOES NOT APPLY. THE PHYSICIAN SHOULD GIVE AS MUCH INFORMATION ABOUT A CONTEMPLATED PROCEDURE AND THE PATIENT SHOULD RECEIVE ENOUGH INFORMATION TO ALLOW HIM TO GIVE AN INFORMED CONSENT FOR SUCH PROCEDURE OR TREATMENT.  NATURE OF CONSENT CONSENT IS AN AUTHORIZATION, BY A PATIENT OR A PERSON AUTHORIZED BY LAW TO GIVE THE CONSENT ON THE PATIENT'S BEHALF THAT CHANGES A TOUCHING FROM NON-CONSENSUAL TO CONSENSUAL. IT IS THE NURSE WHO ACTUALLY SECURES THE CONSENT OF THE PATIENT UPON ADMISSION. THIS CONSENT IS USUALLY FOR DIAGNOSTIC PROCEDURES AND INITIAL TREATMENT DEEMED NECESSARY BY THE MEDICAL STAFF. TO SUBSTANTIATE THE PATIENT’S CONSENT, A WRITTEN AUTHORIZATION IS NEEDED AS PROOF AGAINST ANY LIABILITY THAT MAY ARISE DUE TO AN ALLEGED UNLAWFUL TOUCHING OF A PATIENT  INFORMED CONSENT IT IS ESTABLISHED PRINCIPLE OF LAW THAT EVERY HUMAN BEING OF ADULT YEARS AND SOUND MIND HAS THE RIGHT TO DETERMINE WHAT SHALL BE DONE WITH HIS OWN BODY. HE MAY CHOOSE WHETHER TO BE TREATED OR NOT AND TO WHAT EXTENT, NO MATTER HOW NECESSARY THE MEDICAL CARE, OR HOW IMMINENT THE DANGER TO HIS LIFE OR HEALTH IF HE FAILS TO SUBMIT TO TREATMENT.  INFORMED CONSENT THE ESSENTIAL ELEMENTS OF INFORMED CONSENT INCLUDE : (1) THE DIAGNOSIS AND EXPLANATION OF THE CONDITION; (2) A FAIR EXPLANATION OF THE PROCEDURES TO BE DONE AND USED AND THE CONSEQUENCES; (3) A DESCRIPTION OF ALTERNATIVE TREATMENTS OR PROCEDURES; (4) A DESCRIPTION OF THE BENEFITS TO BE EXPECTED; (5) MATERIAL RIGHTS IF ANY; AND (6) THE PROGNOSIS, IF THE RECOMMENDED CARE, PROCEDURE, IS REFUSED  PROOF OF CONSENT A WRITTEN CONSENT SHOULD BE SIGNED TO SHOW THAT THE PROCEDURE WAS THE ONE CONSENTED TO AND THAT THE PERSON UNDERSTOOD THE NATURE OF THE PROCEDURE, THE RISKS INVOLVED AND THE POSSIBLE CONSEQUENCES. A SIGNED SPECIAL CONSENT IS NECESSARY BEFORE ANY MEDICAL OR SURGICAL TREATMENT IS DONE SUCH AS X-RAYS, SPECIAL LABORATORY TESTS, BLOOD TRANSFUSIONS, OPERATIONS, COBALT THERAPY, OR CHEMOTHERAPY AND THE LIKE.  CONSENT WHO MUST CONSENT ORDINARILY, THE PATIENT IS THE ONE WHO GIVES THE CONSENT IN HIS OWN BEHALF. HOWEVER, IF HE IS INCOMPETENT (SUCH AS IN THE CASE OF MINORS OR THE MENTALLY ILL) OR PHYSICALLY UNABLE AND IS NOT AN EMERGENCY CASE, CONSENT MUST BE TAKEN FROM ANOTHER WHO IS AUTHORIZED TO GIVE IT IN HIS BEHALF. CONSENT OF MINORS. PARENTS, OR SOMEONE STANDING IN THEIR BEHALF, GIVE THE CONSENT TO MEDICAL OR SURGICAL TREATMENT OF A MINOR. PARENTAL CONSENT IS NOT NEEDED HOWEVER, IF THE MINOR IS MARRIED OR OTHERWISE EMANCIPATED. CONSENT OF MENTALLY ILL A MENTALLY INCOMPETENT PERSON CANNOT LEGALLY CONSENT TO MEDICAL OR SURGICAL TREATMENT. THE CONSENT MUST BE TAKEN FROM THE PARENTS OR LEGAL GUARDIAN.  EMERGENCY SITUATION WHEN AN EMERGENCY EXISTS, NO CONSENT IS NECESSARY BECAUSE INACTION AT SUCH TIME MAY CAUSE GREATER INJURY. EX; A MOTHER WHO IS ON THE ADVANCED STAGE OF LABOR OR A PATIENT WHO GOES TO THE EMERGENCY ROOM GIVES AN IMPLIED CONSENT TO AN IMMEDIATE TREATMENT OR ATTENDANCE. HOWEVER, IF TIME IS AVAILABLE AND AN INFORMED CONSENT IS POSSIBLE, IT IS BEST THAT THIS BE TAKEN FOR THE PROTECTION OF ALL PARTIES CONCERNED.  REFUSAL TO CONSENT A PATIENT WHO IS MENTALLY AND LEGALLY COMPETENT (SANE MIND AND OF LEGAL AGE) HAS THE RIGHT TO REFUSE TO PERMIT TOUCHING OF HIS BODY OR TO SUBMIT TO A MEDICAL OR SURGICAL PROCEDURE NO MATTER HOW NECESSARY, NOR HOW IMMINENT THE DANGER TO HIS LIFE OR HEALTH IF HE FAILS TO SUBMIT TO TREATMENT. EX; PATIENTS WHO, BECAUSE OF THEIR RELIGIOUS BELIEFS, MAY REFUSE BLOOD TRANSFUSION. A PATIENT MAY REFUSE TO CONSENT DUE TO INADEQUATE INFORMATION REGARDING THE PROCEDURE TO BE DONE. IF AFTER THE EXPLANATION, HE STILL REFUSES TO SIGN THE CONSENT FORM, HE SHOULD BE MADE TO FILL OUT THE RELEASE FORM TO PROTECT THE HOSPITAL AND/OR AGENCY AND ITS PERSONNEL FROM ANY LIABILITY THAT MAY RESULT FROM HIS REFUSAL. IF HE REFUSES TO SIGN THE RELEASE FORM, THIS SHOULD BE NOTED IN HIS CHART. THE COMPETENT PERSON HAS A LEGAL AND ETHICAL RIGHT TO REFUSE TREATMENT, AND THIS RIGHT IS FORMALLY ESTABLISHED  CONSENT FOR STERILIZATION STERILIZATION IS THE TERMINATION OF THE ABILITY TO PRODUCE OFFSPRINGS. THE HUSBAND AND THE WIFE MUST CONSENT TO THE PROCEDURE IF THE OPERATION IS PRIMARILY TO ACCOMPLISH STERILIZATION. WHEN THE STERILIZATION IS MEDICALLY NECESSARY, THE STERILIZATION IS AN INCIDENTAL RESULT SUCH AS IN CASES OF ABRUPTIO PLACENTA, ECTOPIC PREGNANCIES OR RUPTURED UTERUS, THE PATIENT'S CONSENT ALONE IS SUFFICIENT.  MEDICAL RECORDS IT SERVES AS A LEGAL PROTECTION FOR THE HOSPITAL, DOCTOR AND NURSE BY REFLECTING THE DISEASE OR CONDITION OF THE PATIENT AND HIS MANAGEMENT. NURSES MUST REMEMBER THE RULE. "IF IT WAS NOT CHARTED, IT WAS NOT OBSERVED OR DONE. ” NURSES ARE EXPECTED TO RECORD FULLY, ACCURATELY, LEGIBLY, AND PROMPTLY THEIR OBSERVATIONS FROM ADMISSION TO THE TIME OF THE PATIENT’S DISCHARGE. DAILY NOTES SHOULD INCLUDE NOT ONLY MEDICATIONS AND TREATMENTS GIVEN OR RENDERED BUT ALSO THE PHYSICAL AND EMOTIONAL SYMPTOMS EXHIBITED BY THE PATIENT. THE NURSES’ NOTES ARE AIDS TO MEDICAL DIAGNOSIS AND IN UNDERSTANDING THE PATIENT’S BEHAVIOR. SINCE PATIENTS HAVE THE RIGHT TO CONFIDENTIALITY OF THESE RECORDS, NURSES ARE LEGALLY AND ETHICALLY BOUND TO PROTECT THE PATIENT’S CHART FROM UNAUTHORIZED PERSONS. PERMISSION HAS TO BE TAKEN FROM THE HOSPITAL AUTHORITIES FOR AUTHORIZATION TO SECURE ANY INFORMATION FROM THE PATIENT’S CHART NURSES ARE RESPONSIBLE FOR SAFEGUARDING THE PATIENT’S RECORD FROM LOSS OR DESTRUCTION OR FROM ACCESS BY PERSONS WHO ARE NOT LEGALLY AUTHORIZED TO READ SUCH  LEGAL RESPONSIBILITIES OF STUDENTS NURSING STUDENTS ARE RESPONSIBLE FOR ACQUIRING THE KNOWLEDGE AND SKILLS NECESSARY TO BECOME A SAFE PRACTITIONER. INCLUDED IN THIS KNOWLEDGE AND SKILL DEVELOPMENT IS THE AWARENESS OF ETHICAL PRINCIPLES AND THE PROCESS OF ETHICAL DECISION MAKING. NURSING STUDENTS MUST ACT AS REASONABLY PRUDENT PERSONS, EQUIVALENTLY WITH EDUCATION AND EXPERIENCE, WHEN PERFORMING NURSING DUTIES. THEY MUST PERFORM ONLY THOSE TASKS THAT THEY ARE COMPETENT TO PERFORM.  LIABILITY FOR THE WORK OF NURSING STUDENTS UNDER THE PHILIPPINE NURSING ACT OF 2002 R.A. 9173 NURSING STUDENTS DO NOT PERFORM PROFESSIONAL NURSING. THEY ARE TO BE SUPERVISED BY THEIR CLINICAL INSTRUCTORS. IN ORDER THAT THE ERRORS COMMITTED BY NURSING STUDENTS WILL BE AVOIDED/MINIMIZED, THE FOLLOWING MEASURES SHOULD BETAKEN: 1. NURSING STUDENTS SHOULD ALWAYS BE UNDER THE SUPERVISION OF THEIR CLINICAL INSTRUCTORS. 2. THEY SHOULD BE GIVEN ASSIGNMENTS THAT ARE IN LEVEL OF THEIR TRAINING, EXPERIENCE AND COMPETENCY. 3. THEY SHOULD BE ADVISED TO SEEK GUIDANCE SPECIALLY IF THEY ARE PERFORMING A PROCEDURE FOR THE FIRST TIME. 4. THEY SHOULD BE ORIENTED TO THE POLICIES OF THE NURSING UNIT WHERE THEY ARE ASSIGNED. 5. THEIR PERFORMANCE SHOULD BE ASSESSED FREQUENTLY TO DETERMINE THEIR STRENGTHS AND THEIR WEAKNESSES. 6. FREQUENT CONFERENCES WITH THE STUDENTS WILL REVEAL THEIR PROBLEMS, WHICH THEY MAY WANT TO BRING TO THE ATTENTION OF THEIR INSTRUCTORS OR VICE-VERSA. DISCUSSIONS OF THESE PROBLEMS WILL IRON OUT DOUBTS AND POSSIBLE SOLUTIONS MAY BE PROVIDED.  CHARTING DONE BY NURSING STUDENTS WHEN A NURSE OR A CLINICAL INSTRUCTOR COUNTERSIGNS THE CHARTING OF A NURSING STUDENT, SHE ATTESTS THAT SHE HAS PERSONAL KNOWLEDGE OF INFORMATION AND THAT SUCH IS ACCURATE AND AUTHENTIC. ANYONE WHO COUNTERSIGNS WITHOUT VERIFICATION COMMITS HERSELF TO POSSIBLE LEGAL RISK  WILLS TESTATE- A PERSON WHO DIES LEAVING A WILL. INTESTATE- ONE WHO DIES WITHOUT A WILL. HOLOGRAPHIC WILL- WILL WHICH IS WRITTEN, DATED & SIGNED BY THE TESTATOR. NUNCUPATIVE WILL OR NUNCUPATION- ORAL WILL NURSE’S OBLIGATION IN THE EXECUTION OF A WILL NURSE SHOULD NOTE THE SOUNDNESS OF THE PATIENT’S MIND (HE/SHE UNDERSTOOD THE ACT OF MAKING A WILL) THERE WAS FREEDOM FROM FRAUD OR UNDUE INFLUENCE (WAS NOT INDUCED TO MAKE SOMEONE THE BENEFICIARY OF THE WILL) PATIENT WAS ABOVE 18 Y/O. PATIENT SHOULD NOTE THAT THE WILL WAS SIGNED BY THE TESTATOR, THAT THE WITNESS WERE ALL PRESENT AT THE SAME TIME & SIGNED THE WILL IN THE PRESENCE OF THE TESTATOR. FOR PROTECTION OF THE NURSE, SHE SHOULD MAKE NOTATION ON THE PATIENT’S CHART OF THE APPARENT MENTAL & PHYSICAL CONDITION OF THE PATIENT AT TIME OF MAKING THE WILL. CRIMES RELATED TO NURSING PRACTICE LEGAL RISKS FOR DEFECTIVE EQUIPMENT TORTS- LEGAL WRONG COMMITTED AGAINST A PERSON OR PROPERTY INDEPENDENT OF A CONTRACT WHICH RENDERS THE PERSON WHO COMMITS IT LIABLE FOR DAMAGES IN CIVIL ACTION. CRIMES RELATED TO NURSING PRACTICE EXAMPLE OF TORTS: 1.ASSAULT & BATTERY ASSAULT- IMMINENT THREAT OF HARMFUL OR OFFENSIVE BODILY CONTACT. IT IS UNJUSTIFIABLE TO TOUCH ANOTHER PERSON, OR TO THREATEN TO DO SO IN SUCH CIRCUMSTANCES AS TO CAUSE THE OTHER TO REASONABLY BELIEVE THAT IT WILL BE CARRIED OUT. BATTERY- INTENTIONAL, UNCONSENTED TOUCHING OF ANOTHER PERSON. IF CONSENT HAS NOT BEEN SECURED, THE PERSON PERFORMING THE PROCEDURE MAY BE LIABLE FOR BATTERY. 2. FALSE IMPRISONMENT OR ILLEGAL DETENTION UNJUSTIFIABLE DETENTION OF A PERSON WITHOUT A LEGAL WARRANT WITHIN BOUNDARIES FIXED BY THE DEFENDANT BY AN ACT OR VIOLATION OF DUTY INTENDED TO RESULT IN SUCH CONFINEMENT. CRIMES RELATED TO NURSING PRACTICE 3. INVASION OF RIGHT TO PRIVACY & BREACH OF CONFIDENTIALITY NURSES MAY BECOME LIABLE FOR INVASION OF RIGHT TO PRIVACY IF THEY DIVULGE INFORMATION FROM A PATIENT’S CHART TO IMPROPER SOURCES OR UNAUTHORIZED PERSONS. EX; PUBLICATION OF ANY PICTURE OF A PATIENT OR A MALFORMED BABY WITHOUT THE CONSENT OF THE PARENTS OR REVELATION OF THE CONTENTS OF THE RECORDS OF THE PATIENT WITHOUT HIS CONSENT EX; WHEN A NURSE PERMITS A NON-PROFESSIONAL PERSON(USUAL A MALE HELPER) TO VIEW A WOMAN IN LABOR INSIDE THE DELIVERY ROOM. CRIMES RELATED TO NURSING PRACTICE 4. DEFAMATION CHARACTER ASSASSINATION, WRITTEN OR SPOKEN. SLANDER- ORAL DEFAMATION OF A PERSON BY SPEAKING UNPRIVILEGED OR FALSE WORDS BY WHICH HIS REPUTATION IS DAMAGED. LIBEL- DEFAMATION BY WRITTEN WORDS. THERE MUST BE A THIRD PERSON WHO HEARS OR READS THE COMMENT BEFORE IT CAN BE CONSIDERED DEFAMATION. * CRIMES, MISDEMEANORS & FELONIES CRIME- DEFINED AS AN ACT COMMITTED OR OMITTED IN VIOLATION OF THE LAW. 2 ELEMENTS 1. CRIMINAL ACT 2. EVIL/CRIMINAL INTENT CRIMES RELATED TO NURSING PRACTICE CONSPIRACY TO COMMIT CRIME WHEN 2 OR MORE PERSONS AGREE TO COMMIT A FELONY & DECIDE TO DO IT. EITHER PRINCIPALS, ACCOMPLICES, ACCESSORIES. PRINCIPALS- THOSE WHO TAKE A DIRECT PART IN THE EXECUTION OF THE ACT. ACCOMPLICES- THOSE WHO COOPERATE IN THE ACT ACCESSORIES- THOSE WHO HAVING THE KNOWLEDGE OF THE COMMISSION OF THE CRIME, TAKE PART OR ASSISTING THE OFFENDER TO PROFIT FROM THE EFFECTS OF THE CRIME BY CONCEALING OR DESTROYING THE BODY OF THE CRIME, OR THE EFFECTS OR INSTRUMENTS THEREOF, IN ORDER TO PREVENT ITS DISCOVERY OR BY HARBORING, CONCEALING OR ASSISTING THE ESCAPE OF THE PRINCIPAL OF THE CRIME. CRIMES RELATED TO NURSING PRACTICE CRIMINAL ACTIONS DEAL WITH ACTS OR OFFENSES AGAINST PUBLIC WELFARE. MISDEMEANOR- IS A GENERAL NAME FOR A CRIMINAL OFFENSE WHICH DOES NOT IN LAW AMOUNT TO FELONY. FELONY- IS A PUBLIC OFFENSE FOR WHICH A CONVICTED PERSON IS LIABLE TO BE SENTENCED TO DEATH OR TO BE IMPRISONED IN A PENITENTIARY OR PRISON. IT IS COMMITTED WITH DECEIT & FAULT. A DECEIT EXISTS WHEN THE ACT IS PERFORMED WITH DELIBERATE INTENT AND THERE IS A FAULT WHEN THE WRONGFUL ACTS RESULT FROM IMPRUDENCE, NEGLIGENCE, OR LACK OF SKILL OR FORESIGHT. CRIMES RELATED TO NURSING PRACTICE CRIMINAL NEGLIGENCE- MAY BE CLASSIFIED INTO RECKLESS IMPRUDENCE & SIMPLE IMPRUDENCE. RECKLESS IMPRUDENCE- WHEN A PERSON DOES AN ACT OR FAILS TO DO IT VOLUNTARILY BUT WITHOUT MALICE, FROM WHICH DAMAGE RESULTS IMMEDIATELY. SIMPLE IMPRUDENCE- THE PERSON OR NURSE DID NOT USE PRECAUTION AND THE DAMAGE WAS NOT IMMEDIATE OR THE IMPENDING DANGER WAS NOT EVIDENT. CRIMES RELATED TO NURSING PRACTICE CRIMINAL INTENT THE STATE OF MIND OF A PERSON AT THE TIME THE CRIMINAL ACT IS COMMITTED, THAT IS HE KNOWS THAT AN ACT IS NOT LAWFUL & STILL DECIDED TO DO IT ANYWAY. TO BE CRIMINAL, AN ACT MUST BE DEFINED AS A CRIME. CRIMES RELATED TO NURSING PRACTICE MURDER- UNLAWFUL KILLING OF A HUMAN BEING WITH INTENT TO KILL. NURSES SHOULD KEEP IN MIND THAT DEATH RESULTING FROM A CRIMINAL ABORTION IS MURDER. EUTHANASIA IS ALSO CALLED A MURDER. HOMICIDE- IS THE KILLING OF HUMAN BEING BY ANOTHER. IT MAYBE COMMITTED WITHOUT CRIMINAL INTENT, BY ANY PERSON WHO KILLS ANOTHER, OTHER THAN HIS FATHER, MOTHER, OR CHILD OR ANY OF HIS ASCENDANTS OR DESCENDANTS, OR HIS SPOUSE, WITHOUT ANY OF THE CIRCUMSTANCES ATTENDANT THE CRIME OF MURDER ENUMERATED ABOVE BEING PRESENT. CRIMES RELATED TO NURSING PRACTICE ABORTION- MEANS THE EXPULSION OF THE PRODUCT OF CONCEPTION BEFORE THE AGE OF VIABILITY. INFANTICIDE- KILLING OF A CHILD LESS THAN 3 DAYS OF AGE. CONTROLLED SUBSTANCES- R.A. 6425 KNOWN AS THE DANGEROUS ACT OF 1972 COVERS THE ADMINISTRATION & REGULATION OF THE MANUFACTURE, DISTRIBUTION & DISPENSING OF CONTROLLED DRUGS. PERSONS AUTHORIZED TO PRESCRIBE OR DISPENSE THESE DRUGS ARE REQUIRED TO REGISTER & HAVE A SPECIAL LICENSE FOR THIS PURPOSE. DOCTORS WITH SUCH LICENSE PRESCRIBE THESE DRUGS IN A YELLOW FORM. NURSES MAY ADMINISTER THESE DRUGS ONLY UPON THE WRITTEN ORDER OF A PHYSICIAN DULY LICENSED TO PRESCRIBE SUCH. CONTROLLED DRUGS ARE KEPT LOCKED IN CABINETS & ONLY AUTHORIZED PERSONS SHALL ACCESS TO THEM. THESE ARE COUNTED & ENDORSED EVERY SHIFT. NURSES WHO VIOLATE THIS LAW ARE IN DANGER OF HAVING THEIR LICENSES REVOKED ASIDE FROM THE IMPOSED FINE AND IMPRISONMENT. SIMULATION OF BIRTH, SUBSTITUTION OF ONE CHILD FOR ANOTHER, OR ABANDONMENT OF A LEGITIMATE CHILD SIMULATION OF A BIRTH IS A CRIME COMMITTED BY ONE WHO ENTERS IN A BIRTH CERTIFICATE A BIRTH THAT DID NOT OCCUR. IT IS A CRIME AGAINST THE CIVIL STATUS OF A PERSON. SUBSTITUTION OF ONE CHILD FOR ANOTHER OR CONCEALING OR ABANDONING ANY LEGITIMATE CHILD WITH INTENT TO CAUSE SUCH CHILD TO LOSE CIVIL STATUS SHALL BE PUNISHABLE. POINTS TO REMEMBER IN AVOIDING CRIMINAL LIABILITY BE FAMILIAR WITH THE PHILIPPINE NURSING LAW. BE AWARE OF LAWS THAT AFFECT NURSING PRACTICE. AT THE START OF EMPLOYMENT, GET A COPY OF YOUR JOB DESCRIPTION, AGENCY’S RULES, REGULATIONS AND POLICIES. UPGRADE SKILLS & COMPETENCE. ACCEPT ONLY RESPONSIBILITY THAT IS WITHIN THE SCOPE OR EMPLOYMENT & JOB DESCRIPTION. DO NOT DELEGATE RESPONSIBILITY TO OTHERS. DETERMINE WHETHER YOUR SUBORDINATES ARE COMPETENT IN THE WORK YOU ARE ASSIGNING TO THEM. POINTS TO REMEMBER IN AVOIDING CRIMINAL LIABILITY DEVELOP GOOD INTERPERSONAL RELATIONSHIPS WITH YOUR CO- WORKERS. CONSULT SUPERIORS FOR PROBLEMS THAT MAY TOO BIG FOR YOU TO HANDLE. VERIFY ORDERS THAT ARE NOT CLEAR TO YOU OR THOSE THAT SEEM TO BE ERRONEOUS. DOCTORS SHOULD BE INFORMED ABOUT PATIENT’S CONDITION. KEEP IN MIND THE VALUE & NECESSITY OF KEEPING ACCURATE & ADEQUATE RECORDS. PATIENTS ARE ENTITLED TO AN INFORMED CONSENT. NURSES AND EVIDENCE ANTI MORTEM STATEMENTS OR DYING DECLARATIONS CONSIDERED HEARSAY EVIDENCE EXCEPT WHEN MADE BY A VICTIM OF A CRIME. IF A NURSE RECEIVES A DYING DECLARATION SHE SHOULD WRITE DOWN THE PERSON’S ACTUAL WORDS. IF POSSIBLE, THESE STATEMENTS ARE TO BE SIGNED BY THE PERSON MAKING THE DECLARATION. NURSES AS WITNESS WHEN A NURSE IS INVITED TO BECOME A WITNESS, SHE SHOULD ALSO SEEK THE AID OR COUNSEL OF A LAWYER SO THAT SHE MAY BE GUIDED ACCORDINGLY. IN THE WITNESS STAND, SHE SHOULD FACE THE JUDGE OR JURY & SPEAK CLEARLY, ADEQUATELY & INTELLIGENTLY. SHOULD TESTIFY ONLY ON WHAT SHE KNOWS BASED ON FACTS OR TESTIMONY OF FACTS. SHOULD USE WORDS AND TERMS THAT AVERAGE PERSON WILL UNDERSTAND. SHOULD SPEAK ONLY THE TRUTH, OTHERWISE WILL BE LIABLE FOR PERJURY OR FALSE SWEARING UNDER OATH. SHOULD NEITHER HESITATE TO SAY SHE DOES NOT KNOW, NOR ANSWER ANY QUESTION THAT MIGHT INCRIMINATE HER. (KNOWN AS THE PRIVILEGE AGAINST SELF INCRIMINATION.) THANK YOU CYNTHIA P. HERNANDEZ, RN, MAN