Nurses, especially those employed in community health settings, need to understand public health laws. Malpractice sometimes involves failing to check a patient’s identification correctly before administering blood and then giving the blood to the wrong patient. I) Denial: individuals act as though nothing has happened and may refuse to believe that a loss has occurred. Intentional torts are willful acts that violate another’s rights such as assault, battery, and false imprisonment. CHAPTER 46. Superego- “conscience” performs inhibiting, restraining, and prohibiting actions; derived from the standards of outside social forces (parent, teacher). Assault Battery Malpractice Invasion of privacy Defamation of character Avoid abandonment of clients, even when client goals differ from health care provider goals. Community and public health nurses have the legal responsibility to enforce laws enacted to protect public health (see Chapter 3). To practice responsibly, professional nurses also agree to maintain competence in the application of judgment. Provide two examples each of intentional and unintentional torts in a healthcare setting. Examples are assault, battery, invasion of privacy and defamation of character. Criminal laws protect society as a whole and provide punishment for crimes, which are defined by municipal, state, and federal legislation (Garner, 2006). It identifies advantages for plaintiffs who plead intentional tort claims, including onus of proof, causation, remoteness, the quantum of compensatory damages and the availability of aggravated and exemplary damages. For example, if a driver of a car acts unreasonably in failing to stop at a stop sign, it is negligence. Answer: The nurse admits or denies each allegation in the petition. Examples are assault, battery, invasion of privacy and defamation of character. Does the failure to document an admission nursing assessment equate with the fact that this nurse did no admission nursing … In addition, once you have committed to providing emergency care to a patient, you must stay with that patient until you can safely transfer his or her care to someone who can provide needed care such as emergency medical technicians (EMTs) or emergency department staff. A tort is a civil wrong made against a person or property. The statutes assume that all patients will be resuscitated unless there is a written DNR order in the chart. 7) What are the nurse’s responsibilities and actions after finding a patient injured from a fall? Intentional torts are willful acts that violate another’s rights. A misdemeanor is a less serious crime that has a penalty of a fine or imprisonment for less than 1 year. The use of physical restraints is a safety strategy that has been used in hospitals and long-term care settings to protect patients from injury. The commitment to provide least harmful interventions illustrates the term of nonmalefiencience. The act also protects the donor’s estate from liability for injury or damage that results from the use of the gift. 8) What are the stages of death and dying according to Kubler-Ross? Defamation of character A nurse tells a coworker that she believes a client has been unfaithful to the spouse. Protocols in these instances list specific actions that health care providers will take when providing cardiopulmonary resuscitation (CPR). Quasi-tort is a legal term that is sometimes used to describe unusual tort actions, on the basis of a legal doctrine that some legal duty exists which cannot be classified strictly as negligence in a personal duty resulting in a tort nor as a contractual duty resulting in a breach of contract, but rather some other kind of duty recognizable by the law. Read the case study presented at the end of Chapter 5 (Guido p. 67). 10) What are Erickson’s Stages of Development and how they compare to Freud’s? The nurse’s role in working with hospice agencies emphasizes meeting the primary wishes of the dying client and being open to individual desires of each client. In Quasi intentional torts the accusation is lacking but there is still a volitional act and direct allegations. In contrast, "an intentional tort is a deliberate invasion of someone's legal right. Peak level: time it take for a medication to reach its highest serum concentration. The couple filed a lawsuit. In one case a television crew filmed a married couple who were participating in a hospital program. Describe the legal responsibilities and obligations of nurses regarding the following federal statutes: Americans with Disabilities Act (ADA), Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Patient Self-Determination Act (PSDA).
Issues sometimes arise with regard to celebrities and public figures, who often believe they are defamed by sensationalist “news” organizations that cover celebrity gossip. Considering all consequences. 4) The right route. IV) The person giving consent has the right to have all questions answered satisfactorily and confirm his or her understanding of the treatment given. It is an assault for a nurse to threaten to give a patient an injection or to threaten to restrain a patient for an x-ray procedure when the patient has refused consent. Torts are classified as intentional, quasi-intentional, or unintentional. The complexity of the healthcare delivery system today is such that the roles and responsibilities of the nurse are constantly expanding. The Supreme Court ruled in 1998 in Bragdon v Abbott that even asymptomatic HIV constitutes a disability within the meaning of the ADA. A judge makes the determination of legal competency, and the health care provider and family usually make the determination of decisional capacity. In some situations consent is implied. The Nurse Practice Act, describe and define the legal boundaries of nursing practice within each state. Caroline McGuire received her BSN from the University of Connecticut nursing program in 1985, her first job was working on a surgical unit. For example, the purpose of the preoperative consent that clients must read and sign before surgery is the assurance that the health care team respects the client’s independence by obtaining permission to proceed. The legal guidelines that nurses follow come from statutory law, regulatory law, and common law. Making the choice part of one’s behavior. You need to know the policies, procedures, and protocols of your employing institution so you use the same standard of care as the other nurses in your institution. The health care provider who certifies death is not involved in the removal or transplantation of organs (see Chapter 36). 2) The right dose. ). For example, respect the wish not to inform the patient’s family of a terminal illness. A breach of the nursing standard of care is one element that must be proven in the tort of nursing negligence or malpractice (Daller, 2010). Federal medication law has extended and refined controls on medication sales and distribution: medication testing, naming and labeling: and the regulation of controlled substances. Intentional torts are things you knowingly and willfully do to … threaten to give injection w/o consent. The practice of beneficence encourages the urge to do good for others. What are peak and through level? Negligence : Negligence is the failure to act as a reasonable person would. A battery is a completed assault. Torts may be classified as unintentional or intentional. All nurses are responsible for knowing the provisions of the Nurse Practice Act of the state in which they work and the rules and regulations enacted by the State Board of Nursing and other regulatory administrative bodies. Growth refers to the quantitative changes that can be measured and compare to norms. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) represents one of the more recent federal statutory acts affecting nursing care. To be liable is to be held responsible for an action. The whole-brain standard requires irreversible cessation of all functions of the entire brain, including the brainstem. * Intimacy vs. If you leave the patient without properly transferring or handing him or her off to a capable person, you may be liable for patient abandonment and responsible for any injury suffered after you leave him or her (Dachs, 2008). II) Beneficence (advocacy): refers to taking positive actions to help other. * Be informed of med’s name, purpose, action, and potential undesired effects threaten to give injection w/o consent. Informed consent not only requires that a person be given all relevant information required to reach a decision regarding treatment, but also requires that the person be capable of understanding the relevant information and does in fact give consent. An example of a civil law violation for a nurse is negligence or malpractice. Definition. Usual questions concern witnesses, insurance experts, and which health care providers the plaintiff has seen before and after the incident. A health care proxy or durable power of attorney for health care (DPAHC) is a legal document that designates a person or persons of one’s choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. * Latency (6 to 12 yrs) -time of minimal sexual interest or activity. With this legal document the patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Intentional Torts. Standards are those actions that ensure safe nursing practice. An intentional tort is when an individual or entity purposely engages in conduct that causes injury or damage to another. reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. Even though nurses do not intend to injure patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards. n. French for wrong, a civil wrong, or wrongful act, whether intentional or accidental, from which injury occurs to another. * Must have a License Be aware of legal definitions of death because you need to document all events that occur when the patient is in your care. * The breach of duty caused the harm. Value clarification is a process of self-discovery that helps a person gain insight into values. Battery is any intentional touching without consent. Exceptions to the ability to access medical records apply to psychotherapy notes or when the health care provider has determined that access would result in harm to the patient or another party (Privacy Rights Clearinghouse, 2011). The ADA prohibits discrimination and ensures for persons with disabilities equal opportunities in employment, state and local government services, public accommodations, commercial facilities, and transportation. Unintentional tort is negligence or malpractice. Likewise, check the state laws to see if a state honors an advance directive that originates in another state. The nurse should be licensed, have knowledge, be experienced and good attitude. d) STAT order: signifies that a single dose of a medication is to be given immediately and only once. Erroneous: call Dr if illegible handwriting. * Autonomy vs. Shame and Doubt (1 to 3yrs) Many legal issues surround the event of death, including a basic definition of the actual point at which a person is legally dead. A code of ethics is a set of ethical principles that are accepted by all members of a profession. Confidentiality protects private patient information once it has been disclosed in health care settings. He believed that the maturation of bodily functions was linked with expectations of society and culture in which the person live. Hospice Care: generally clients that are accepted into hospice have less than 6 months to live and are considered terminal. An individual who is at least 18 years of age has the right to make an organ donation (defined as a “donation of all or part of a human body to take effect upon or after death”). * Appropriation of name f) Submit the report as soon as possible to the appropriate administrator. Although the courts will not force adults to undergo treatment refused for religious reasons, they will grant an order allowing hospitals and health care providers to treat children of Christian Scientists or Jehovah’s Witnesses who have denied consent for treatment of their minor children. What are side effects? The procedure, however, may require long periods of pain and suffering. Because a license is a property right, the State Board has to follow due process before revoking or suspending a license. What is the Nursing Code of Ethics, and what is its purpose? Those laws limit liability and offer legal immunity for nurses who help at the scene of an accident. Adult: are confronted with the death of family members and friends of the same age. Malpractice is negligence committed by a professional such a nurse or physician. 21) How does the nurse works with narcotics? For example, taking the height and weight of a pediatric client and comparing the measurements to the standardized charts. Providing end-of-life care in today’s world is challenging for health care professionals because people are living longer. In one case a television crew filmed a married couple who were participating in a hospital program. The rules and regulations enacted by a State Board of Nursing define the practice of nursing more specifically. In many states adults sign the back of their driver’s license, indicating consent to organ donation. * Invasion of Privacy To illustrate these differences, let’s look at two scenarios. Living wills represent written documents that direct treatment in accordance with a patient’s wishes in the event of a terminal illness or condition. These rules create patient rights to consent to the use and disclosure of their protected health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information. Toddler: think that death is reversible. Involuntary detention occurs when an individual files with the court within 96 hours of the patient’s initial detention. As a professional nurse you need to understand the legal limits influencing your practice. Torts include all negligence cases as well as in Check your understanding of unintentional torts with an interactive quiz and printable worksheet. This constitutes intentional tort since John “intended” to kick Adam knowing the “act” could cause harm. Health insurance plans are free to eliminate coverage for certain specialties and impose limits on the amount of coverage that they will pay for certain illnesses. All medications have a serum half-life, which is the time it takes for excretion processes to lower the serum medication concentration by half. * Advised of experimental nature of med and give consent If health care workers follow the directions of the living will, they should be immune from liability (, Health care information privacy is also protected by standards set by the Health Care Financing Administration (HCFA) for hospitals and health care providers who participate in Medicare and Medicaid (, Many legal issues surround the event of death, including a basic definition of the actual point at which a person is legally dead. Examples of such laws include malpractice, invasion of privacy, assault, battery, libel, slander, and false imprisonment. An example of state statutes are the Nurse Practice Acts found in all 50 states (see Chapter 1). Intentional Tort Example. b) prn Orders: the prescriber may order a medication when a client requires it. They have also upheld the right of a legally competent patient to refuse medical treatment for religious reasons. An example of a regulatory law is the requirement to report incompetent or unethical nursing conduct to the State Board of Nursing. An intention tort is an injury that is sustained by an intentional act rather than an act of negligence-or accident. * Refuse a medication regardless of consequences What does the Food and Drug Administration do? A value is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behaviors. h) If only one part of a pre-measured dose of a controlled substance is given, a second nurse witnesses’ disposal of the unused portion and documents such on the record. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. * Battery -any intentional touching w/o consent i.e. An unintentional tort is what most torts are. The nurse did not carry out the duty or breached it (failure to use the degree of skill and learning ordinarily used under the same or similar circumstances by members of his or her profession). ( Anal (1 yr to 3 yrs) -toilet-training, prone to child abuse. e) A special inventory record is used each time a narcotic is dispensed. The statute stated that a competent individual with a terminal disease could make an oral and written request for medication to end his or her life in a humane and dignified manner. That fear is something we expect to never have to feel, and that fear creates the basis for the tort of assault.An assault is an intentional, unexcused act that creates in another person a reasonable apprehension or fear of immediate harmful or offensive contact. The man’s toes became swollen and discolored, and he developed decreased sensation. The American Nurses Association (ANA) (2008) has held that nurses’ participation in assisted suicide violates the code of ethics for nurses. In general, courts define negligence in car accident cases and other negligence cases as that degree of care that an ordinarily careful and prudent person would use under the same or similar circumstances. Value clarification is an approach to individual appraisal of value. The allegations in the lawsuits are that the health care provider failed to provide adequate supervision and safeguard the facilities. The most familiar health care tort is termed “professional negligence.” In fact there is only one tort, negligence. The patient’s injury was caused by the nurse’s failure to carry out that duty (“but for” the breach of duty, the patient would not have been injured). Elected legislative bodies such as state legislatures and the U.S. Congress create statutory law. 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