Legal Issues

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What is the concept of Legal Issues?

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Encompasses the rights, responsibilities, and scope of nursing practice as defined by state Nurse Practice acts and as legislated through criminal and civil laws.

Front 2

What are some Liability Risks for Nurses?

Back 2

Supervision/Delegation, Early client discharge, Nursing shortage, Hospital downsizing, Increased autonomy, and Advanced technology.

Front 3

Law?

Back 3

The sum total of the rules and regulations by which a society is governed. Laws are made at the Federal, State, and Local levels.

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Statutory Laws?

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Made by any legislative branks of the government, including U.S. Congress, State Legislatures, and City & County governments.

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Nursing Laws?

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They are examples of state statutory laws Each state has a NS practice act.

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Statutory Laws that affect NS practice?

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Statutes of Limitation, Protection and Reporting Laws, Natural Death Acts, and Informed Consent Laws.

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Administrative Agencies

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State Boards of Nursing are examples; They are delegated the power to interpret and enforce law by the legislatures that govern them.

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Criminal Law

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Defines conduct that is harmful to another individual or to society as a whole and that may be punishable by fines or imprisonment.

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Crime

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An act prohibited by statute or by common law principles; Felonies vs. misdemeanors. Misdemeanor usually punishable by a fine or short-term jail sentence or both.

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Civil Law

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Deals with the rights and duties of private persons or citizens and is most often enforced through the awarding of damages or compensation.

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Tort

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A civil wrong committed against a person or a person's property; May be intentional or unintentional. Violator may be sued and compensation is usually awarded to the victim.

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Sources of Law

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Constitution, Administrative Law, Legislative (statutes) - NS practice act, and Common Law.

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Constitutional Law Category Examples

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Due Process, Equal Protection

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Statutory (Legislative) Law Category Examples

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NS Practice acts, Good Samaritan laws, Child & adult abuse laws, Advance directives, Sexual harassment laws, Americans with disabilities act.

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Criminal (Public) Law Category Examples

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Homicide, Manslaughter; Theft, Arson, Active euthanasia, Sexual assault, Illegal possession of controlled drugs.

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Contracts (Private/Civil) Laws Category Examples

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Nurse and client, Nurse and employer, Nurse and insurance, Client and agency.

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Torts (Private/Civil) Laws Category Examples

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Negligence/Malpractice, Libel and Slander, Invasion of Privacy, Assault and Battery, False Imprisonment, Abandonment.

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Unintentional Tort

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Include Negligence and Malpractice.

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Intentional Tort

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Include Assault, Battery, and False Imprisonment.

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Tort Law

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Defines and addresses both unintentional and intentional actions or omissions that result in harm to another person or persons or harm to another's personal property.

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Negligence

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Denotes conduct that deviates from what a reasonable person would perform in a particular circumstance. Term used in NS is the reasonable professional NS standard.

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Negligence Cont.

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Driver is talking on cell phone and accidently causes an accident.

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Negligence Legal Action

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Injured party must prove that the other party had a "duty of reasonable care, did not maintain reasonable care, and that the failure to maintain reasonable care resulted in injuries."

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Negligence - Nursing Student

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A Nursing Student is held to the same standard as a licensed RN.

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Malpractice

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Refers to conduct deviating from the standard of practice dictated by the profession. Includes acts and omissions committed by a professional in the course of performing his or her professional duties.

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Elements of Professional Negligence or Malpractice

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5 elements are needed to establish Liability.

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Liability

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The state of being legally obliged and responsible, on the part of the defendant.

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First Element

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There must be a DUTY, a legally enforceable obligation to conform to a particular standard of conduct, owed the client. EX: Ns-Pt relationship, accepting duty of care.

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Second Element

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Breach of Duty; A deviation from the standard of care owed the pt. Must occur either by commission or omission. EX: Giving pt wrong dose.

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Third Element

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Forseeability; Certain events may reasonably be expected to cause specific results.

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Fourth Element

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Causation; Injury must've resulted as a direct result of the nurse's breach of duty. PT must be able to show that specific nurse caused injury.

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Fifth Element

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The patient must be able to show that some type of emotional injury or harm resulted from breach of owed duty.

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The purpose of Malpractice Suits

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To award damages sufficient to restore the plaintiff to his or her original position, as far as financially possible.

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Related Doctrines

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Respondent Superior; Employers may be held liable if they fail to properly educate nurses, fail to provide proper resources.

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Related Doctrines

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Res Ipsa Loquitur "The thing speaks for itself". Example is surgical instruments being left inside patients... cannot technically trace back.

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Cat. of Negligence that result in Malpractice

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Failure to follow standards of care: EX - Failure to follow doctors verbal or written orders.

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Cat. of Negligence that result in Malpractice

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Failure to use equipment in a responsible manner: EX - Failure to check equipment safety before use.

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Cat. of Negligence that result in Malpractice

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Failure to communicate: EX - Failure to seek clarification for orders for tx when necessary.

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Cat. of Negligence that result in Malpractice

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Failure to document: EX - Failure to document a patients drug allergies.

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Cat. of Negligence that result in Malpractice

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Failure to Assess and Monitor: EX - Failure to complete a shift assessment.

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Cat. of Negligence that result in Malpractice

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Failure to act as a client advocate: EX - Failure to question incomplete or illegible medical orders.

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Statute of Limitations

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Plaintiffs have 1-2 years to file a malpractice suit; some states have different rules on time limits for specific injuries.