Legal Aspects Of Nursing

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Law

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The sum total of rules and regulations by which a society is governed. As such law is created by people and exists to regulate all persons.

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4 Functions of the Law in Nursing

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· It provides a framework for establishing which nursing actions in the care of clients are legal.

· It differentiates the nurse's responsibilities from those of other health professionals.

· It helps establish the boundaries of independent nurs ing action.

· It assists in maintaining a standard of nursing practice by making nurses accountable under the law.

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Sources of Law

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Nursing derives its legal basis from several sources. This legal basis differs among countries, mostly depending on the NATURE and STRUCTURE of their laws. Regardless of the differences, legal frameworks regulate the practice of the profession.

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Constitutional Law

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Mother Law. A constitution is a collection of statements that embodies the FUNDAMENTALS and PRINCIPLES of a country. It defines the basic rights of its citizens, describes the structures and processes of government organizations, and guides social order.

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Legislation (Statutory Law)

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Laws enacted by any legislative body are called statutory laws. Statutory laws are superior to local or administrative laws.

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Administrative Law

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When a STATE LEGISTATURE passes a statute, an administrative agency is given the authority to create rules and regulations to enforce the statutory laws.

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Commmon Law

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Laws evolving from COURT DECISIONS are referred to common law. In addition to interpreting and applying con stitutional or statutory law, courts also asked resolve disputes between two parties.

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4 Sources of Law

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Constitutional Law

Legislation (Statutory Law)

Administrative Law

Common Law

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2 Types of Laws

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Public law

Private law

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Public law or criminal law

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the body of law that deals with relationships between individuals and the government and governmental agencies.

An important segment of public law is criminal law, which deals with the actions against the safety and welfare of the public.

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Private law or civil law

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The body of law that deals with the relationships among private individuals.

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Contract law

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involves the enforcement of agreements among private individuals or the payment of compensation for failure to fulfill agreements

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Tort law

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defines and enforces duties and rights among private individuals that are not based on contractual agreements.

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2 Kinds of Legal Actions

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Civil actions

Criminal actions

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Civil actions

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deals with the relationships among individuals in society

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Criminal actions

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deals with disputes between an individual and society as a whole

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Litigation

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the action of lawsuit

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The Civil Judicial Process

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The judicial process primarily functions to settle disputes peacefully and in accordance with the law. A lawsuit has strict procedural rules. There are generally five steps:

1. A document, called a complaint, is filed by an individual referred to as the plaintiff, who claims that his or her legal rights have been infringed on by one or more other individuals or entities, referred to as defendants.

2: A written response, called an answer, is made by the defendants.

3. Both parties engage in pretrial activities, referred to as discovery, in an effort to obtain all the facts of the situation.

4. In the trial of the case, all relevant facts are presented to a judge or to a jury.

5. The judge renders a decision, or the jury renders a verdict. If the outcome is not acceptable to one of the parties, an appeal can be made for another trial.

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Regulation of Nursing Practice

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Protection of the public is the legal purpose for defining the scope of nursing practice, licensing requirements, and standards of care.

Nurses who know and follow their nurse practice act and standards of care provide safe, competent nursing care.

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Nurse Practice Acts

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In the united states, each state has a nurse practice act which protects the public by legally defining and describing the SCOPE OF NURSING PRACTICE.

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Credentialing

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process of DETERMINING and MAINTAINING competence in nursing practice.

One way in which the nursing profession maintains standards of practice and accountability for the educational preparation of its members.

Includes licensure, certification, and accreditation.

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Licensure

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A LEGAL PERMIT that a government agency grants to individual to engage in the practice of a profession and to use a particular title.

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Certification

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VOLUNTARY PRACTICE of validating that an individual nurse has met minimum standards of nursing competence in specialty areas such as maternal child health, pediatrics, mental health, gerontology, and school nursing.

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Accreditation and Approval of Basic Nursing Education Programs

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APPROVAL of NURSING education programs offered by colleges and universities entails ensuring that the contents, methods of teaching, methods of assessing and evaluating student' progress, and overall curricular meet nationally set standards.

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Accreditation

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process to evaluate whether a nursing education program maintains the LEVEL OF QUALITY, determined by current evidence and policies, set by accrediting body.

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Contractual Arrangements in Nursing

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A contract is the basis of the relationship between a nurse and an employer.

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Contract

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an ARRANGEMENT between 2 or more competent individuals, on sufficient consideration, to do or not some lawful act. May be written or oral.

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Implied contract

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one that has NOT BEEN AGREED to by the parties but that the law nevertheless considers to exist.

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4 Features of a Lawful Contract

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1. Promise or agreement between 2 or more individuals for the performance of an action or restraint from certain actions.

2. Mutual undrstanding of the terms and meaning of the contract

3. A lawful purpose

4. Compensation in the form of something of value in most cases compensation is monetary.

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Legal roles of nursing

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Nurses have 3 separate interdependent legal roles each with right and associated responsibilities: provider of service, employee or contractor for service, employee or contractore for service, and citizen.

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Provider of Service

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Nurse is expected to provide safe and competent care. Implicit in this role are several legal concepts: liability, standards of care, and contractual obligations.

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Standards of care

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a nurse acts or fails to act are legally defined by nurse practice acts and by the rule of reasonable and prudent action.

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Selected Legal Aspects of Nursing Practice

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Nurses need to know and apply legal aspects in their many different roles.

Example: As client advocates, nurses ensure the client's right to informed consent or refusal, and they identify and report violent behavior, and neglect of vulnerable clients.

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3 major Elements of informed Consent

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1. The consent must be given voluntarily.

2. The consent must be given by a client or individual with the capacity and competence to understand.

3. The client or individual must be given enough information to be the ultimate decision maker.

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Informed Consent

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an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment, alternatives to the treatment, and prognosis of not treated by a healthcare provider.

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2 types of consent

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Express consent

Implied consent

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Express consent

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may take the form of either oral or written agreement.

The more invasive a procedure or the greater the potential for risk to the client, the greater the need for written permission.

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Implied consent

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exists when the individual's nonverbal behavior indicates agreement.

Example: client's who position their bodies for an injection or cooperate with the taking of vital signs.

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Advance Healthcare Directives

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include a variety of legal and lay documents that allow individuals to specify aspects of care they wish to receive should they become unable to make or communicate their preferences.

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2 types of Advance healthcare directives

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Living will

Healthcare proxy

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Living will

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provides specific instructions about what medical treatment the client chooses to omit or refuse in the event that the client is unable to make the decisions.

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Healthcare proxy

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also referred to as a DURABLE POWE OF ATTORNEY FOR HEALTHCARE, a notarized or witnessed statement appointing soemone else to manage healthcare treatment decisions when the client is unable to do so.

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Autopsy or postmortem examination

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an EXAMINATION OF THE BODY AFTER DEATH. The law describes under what circumstances an autopsy must be performed when death is sudden or occurs within 48 hrs of admission.

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Certification of Death

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The formal determination of death must be performed by a primary care provider, a coroner, or a nurse.

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Euthanasia

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act of painlessly putting to death people suffering from incurable or distressing disease. "Mercy killing"

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Inquest

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a legal inquiry into the cause or manner of a death. When a death is the result of an accident. Is held into the circumstances of the accident to determine and blame.

Next is autopsy.

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Coroner

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a public official appointed or elected to inquire into the cause of death, when appropriate.

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Medical examiner

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a physician and usually has advanced education in pathology or forensic medicine.

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Organ Donation

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Under the Uniform Anatomical Gift Act and the National Organ Transplant Act (NOTA) in the US. People 18 years or older and of sound mind may make a gift of all or any part of their own bodies for the following purposes: for medical or dental education