LAW AND NURSING PRACTICE

1. LAW AND NURSING
PRACTICE
HANNA T. PRIYANKA
MATERNITY & CHILDREN
HOSPITAL

2. OBJECTIVE
AT THE END OF THIS
PRESENTATION CANDIDATES
SHOULD BECOME FAMILIAR
WITH THA BASICS OF LEGAL
ASPECTS OF PROFESSIONAL
NURSING PRACTISE

3. INTRODUCTION

NursiNg practice is goverNed by
maNy legal coNcepts. KNowledge
of laws that affect NursiNg
practice is Needed to eNsure
Nurse’s decisioNs aNd actioNs iN
worK area aNd also it will
protect the Nurse from liability .

4. law
defiNitioN
“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”
( guido, 2001,p.2. )

5. FUNCTIONS OF LAW IN
NURSING
it provides a frameworK for
which NursiNg actioNs iN the care
of clieNts are legal
 protect clieNts’ rights
it helps to maKe bouNdaries of
iNdepeNdeNt NursiNg actioN.
it assists iN maiNtaiNiNg a
staNdard of NursiNg practice by
maKiNg Nurses accouNtable
uNder the law

6. how to protect yourself
___________________________
1.KNow your state laws
affectiNg NursiNg practice.
2.follow your state’s Nurse
practice act rules &
regulatioNs.
3.deliver safe, competeNt
NursiNg care.
4.develop & use your critical
thiNKiNg abilities & sKills.

7. SOURCES OF LAW

8. sources of law
SOURCES OF LAW
CONSTITUTION
LEGISLATION
( STATUTES)
ADMINISTRATIVE
NURSE PRACTICE
ACT
COMMON LAW

9. CONSTITUTIONAL LAW
it is the supreme law of the
couNtry
fuNdameNtal law writteN or
uNwritteN, that establishes the
character of goverNmeNt by
defiNiNg the basic priNciple to
which a society must coNform .

10. LEGISLATION ( STATUATORY LAW )
laws eNacted by aNy legislative body
are called statutory laws.
a writteN law passed by a
legislature oN the state or federal
level
(LEGISLATURE: AN OFFICIALLY ELECTED OR
OTHERWISE SELECTED BODY OF PEOPLE
VESTED WITH THE RESPONSIBILITY & POWER
TO MAKE LAWS FOR A POLITICAL UNIT, SUCH
AS A STATE OR UNIT.)

11. Administrative Law
When a state legislature passes a statute, an
administrative agency is given authority to create
rules & regulations to enforce the statutory laws.

e.g.: STATE BOARDS OF NURSING
WRITES RULES AND REGULATIONS TO
ENFORCE & IMPLEMENT NURSE
PRACTICE ACT, WHICH WAS CREATED
BY STATUTORY LAW.

12. Common law
laws evolviNg from court
decisioNs are referred to as
commoN law.
law developed by judges
through decisioN of courts aNd
similar tribuNals.

13. TYPES OF
LAW
PUBLIC LAW PRIVATE LAW
CRIMINAL LAWCONTRACT LAW TORT LAW

14. types of law
public law: it refers to the
body of law that deals with
relatioNship betweeN iNdividuals
aNd the goverNmeNt aNd the
goverNmeNtal ageNcies .
Important segment of public law is
criminal law. Which deals with
safety and welfare of the public.
E.g.: theft, manslaughter, homicide
etc.,

15. private law or civil law : it is the
body of the law that deals with
relatioNship amoNg private
iNdividuals.
it is agaiN classified iNto coNtract
law aNd tort law
Contract law : is the enforcement of agreements
among private individuals.
Tort law: It defines and enforces duties and rights
among private individuals that are not based on the
contractual agreement. E.g.: INVASION OF PRIVACY,
ASSAULT AND BATTERY

16. Selected Categories of law
affecting nurses
Category
CONSTITUTIONAL
STATUTORY ACT
CRIMINAL
Example
Due Process
Equal Protection
Nurse Practice Act
Sexual Harassment laws
Theft, Homicide, Sexual
assault
Active euthanasia
Illegal Possession of
Controlled drugs

17. CONTRACTS
TORTS
Nurse and client
Nurse and employer
Nurse and insurance
Negligence/malpractice
Invasion of privacy
Assault and battery
Abandonment

18. Regulation of nuRsing
pRactice
Regulation foR nuRsing pRactice
helps to bRing a standaRd in
nuRsing caRe and thus to pRotect
the public.
1. Nurse Practice act
2. Credentialing
3. Standards of care

19. 1. NURSE PRACTICE ACTS
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.

20. 2. CREDENTIALING
cRedentialing is the pRocess of
deteRmining
and maintaining competence in
nuRsing pRactice.

cRedentialing pRocess helps to
maintain standaRds of pRactice &
accountability foR educational
pRepaRation of its membeRs.

1. licensuRe
2.ceRtification
3. accReditation

21. Licensure
A license is a legal permit that a government
agency grants to individual to engage in the
practice of profession & to use a particular
title.
Each country has its own method to grant or
maintain and revoke the licensure.
However a nurse can practice any where
within the country with her state’s licensure.
This is known as mutual recognition model.

22. Certification
Certification is the voluntary practice
of validating that an individual nurse
has met minimum standards of nursing
competence in specialty areas such as
maternal-child health nursing,
pediatrics, school nursing etc.,

23. Accreditation
It is the function of a state board of
nursing is to ensure that schools
preparing nurses maintain minimum
standard of education.

24. 3.STANDARD OF CARE
Standard of care are the skills and learning commonly
possessed by members of a profession.
These standards are used to evaluate the quality of care nurses
provide and, therefore, become legal guidelines for nursing
practice.
It can be internal – job description, education,
policy & procedures
external – Nurse practice act,
Professional organizations
It is important for a nurse remain competent
through reading professional journals and attending
continuing education and in-service programs.

25. legal Role of nuRse

26. legal Roles of nuRses
1. pRovideR of seRvice
2. employee oR contRactoR foR
seRvice
3. citizen

27. 1. pRovideR of seRvice
The nurse is expected to provide safe & competent
care.
Nurse is liable to his/her action. Liability is the
quality or state of being legally responsible for
one’s obligations and to make financial restitution
for wrongful act.
For example: A nurse can refuse a task if the nurse
will feel that it may harm the client and it can be
reported to the supervisor

28. 2. employee oR contRactoR
foR seRvice
It vary among practice settings.
A independent nurse practitioner has an
independent contractual relationship with the
client.
Nurse who is employed by an agency works as an
representative of the agency.
cont…

29. The nurse in the role of employee or contractor for
service has obligations to the employer, the client,
and other personnel.
Nursing care provided must be within the limitations
and term specified.

30. 3. citizen
The rights & responsibilities of a nurse in the role of
citizen are the same as those of any individual
under legal the system.
A right is a privilege or fundamental power
A responsibility is the obligation associated with the
right

31. SELECTED LEGAL ASPECT OF
NURSING PRACTICE
INFORMED CONSENT
DELEGATION
VIOLENCE, ABUSE & NEGLECT
CONTROLLED SUBSTANCES
ABORTIONS
DEATH & REALTED ISSUES
SEXUAL HARASSEMENT

32. INFORMED CONSENT
It is 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, alternative to the
treatment, and prognosis if not
treated by a health care provider.

33. Obtaining informed consent is a
responsibility of the person performing
the procedure. Nurse is a witness.
Witnessing with a signature it shows
that client gave consent voluntarily,
signature authentic, client appears
competent to give signature.

34. DELEGATION
Delegation is defined as “ transferring
a competent individual the authority to
perform a selected nursing task in a
selected situation”.

35. VIOLENCE, ABUSE & NEGLECT
Violent behavior can include domestic
violence, child abuse, elder abuse, and
sexual abuse.
Neglect is the absence of care necessary to
maintain the health & safety of a vulnerable
individual such as a child or elder.
To use wrongly or improperly or to hurt or
injure someone.

36. CONTROLLED SUBSTANCES
Controlled substances mainly include
stimulants, depressants, narcotics,
hallucinogens etc.,
Misuse of these leads to criminal penalties.

37. ABORTIONS
To save the life of the womanYes
To preserve physical healthYes
To preserve mental health Yes

38. The Qur'an clearly disapproves of killing other humans:
Take not life which Allah has made sacred (6:151; see
also 4:29  If a man kills a believer intentionally, his
recompense is Hell, to abide therein (for ever) (4:93).
Allah (SWT) went even further, making unlawful killing of
a single individual human being equal to mass murder of
the whole of mankind: "Because of that, We ordained for
the children of Israel that if anyone killed a person not in
retaliation for murder or for spreading mischief on earth,
it would be as if he killed all mankind. And who saved a
life, it would be as if he saved all mankind." (Al-Maidah,
5:32)

39. DEATH & REALTED ISSUES
NURSES ROLE IN LEGAL ISSUES
RELATED TO DEATh IS PRESCRIbED
by ThE LAwS OF ThE REGION AND
ThE POLICIES OF ThE hEALTh CARE
INSTITUTION.
bELIEFS AND ATTITUDES AbOUT
DEAThS, ITS CAUSES AND ThE SOUL
ALSO vARy AmONG CULTURES

40. SEXUAL HARASSEMENT
SExUAL hARASSmENT IS DEFINED AS
“UNwELCOmE SExUAL ADvANCES,
REqUESTS FOR SExUAL FAvORS, AND
OThER vERbAL OR PhySICAL
CONDUCT OF A SExUAL NATURE.”

41. Areas of potential liability in
nursing
NURSING LIAbILITy IS USUALLy
INvOLvED wITh TORT LAw.
IT IS ImPORTANT FOR A NURSE TO
kNOw ThE DIFFERENCES bETwEEN
mALPRACTICE (UNINTENTIONAL
TORTS) AND INTENTIONAL TORTS.

42. CRIMES & TORTS
A CRImE IS AN ACT COmmITTED IN
vIOLATION OF PUbLIC (CRImINAL) LAw AND
PUNIShAbLE by A FINE OR ImPRISONmENT.
CRImES ARE PUNIShED ThROUGh CRImINAL
ACTION by ThE STATE AGAINST AN
INDIvIDUAL.
CRImES ARE PUNIShED ThROUGh CRImINAL
ACTION by ThE STATE AGAINST AN
INDIvIDUAL. IT mAy bE IN TERmS OF
ImPRISONmENT OR by A FINE.

43. CRImES AGAIN CLASSIFIED INTO
FELONy AND mISDEmEANOR
FELONy IS A CRImE OF A SERIOUS
NATURE, SUCh AS mURDER, PUNIShED
by A TERm IN PRISON.
A mISDEmEANOR IS AN OFFENSE OF A
LESS SERIOUS NATURE AND IS
USUALLy PUNIShAbLE by A FINE OR
ShORT TERm jAIL SENTENCE, OR
bOTh.

44. A TORT IS A CIvIL wRONG COmmITTED
AGAINST A PERSON OR A PERSON’S
PROPERTy.
IN OThER wORDS, ThE PERSON OR PERSONS
CLAImED TO bE RESPONSIbLE FOR ThE
TORT ARE SUED FOR ThE DAmAGES.
TORTS ARE AGAIN CLASSIFIED INTO
UNINTENTIONAL TORT AND INTENTIONAL
TORT.

45. UNINTENTIONAL TORT
NEGLIGENCE AND mALPRACTICE ARE
ExAmPLES OF UNINTENTIONAL
TORTS.
NEGLIGENCE IS mISCONDUCT OR
PRACTICE ThAT IS bELOw ThE
STANDARD ExPECTED OF AN
ORDINARy, REASONAbLE, AND
PRUDENT PERSON. SUCh CONDUCT
PLACES ANOThER PERSON AT RISk
FOR hARm.

46. Malpractice is “professional
negligence” that is, negligence that
occurred while the person was
perforMing as a professional.
there are 6 eleMents Must be
present for a case of nursing
Malpractice to be proven.
1. duty: the nurse Must have a
relationship with the client that
involves providing care and
following an acceptable standard
of care.

47. 2. breach of duty: standard of care
that is expected in the specific
situation but that the nurse did
not observe.
3. foreseeability: a link Must exist
between the nurse’s act and the
injury occurred.
4. causation: it Must be proved that
harM occurred as a direct result
of nurse’s failure to follow the
standard of care.

48. 5. harM or injury: the client Must
deMonstrate soMe type of harM
or injury ( physical, financial,
or eMotional)
6. daMages: if Malpractice caused
the injury, the nurse is held
liable for daMages that May be
coMpensated.

49. INTENTIONAL TORTS
the defendant executed the act on
purpose or with intent.
there are Mainly 5 intentional torts
which is related with nursing
1.assault
2.battery
3.false iMprisonMent
4. invasion of privacy
5.defaMation

50. 1.assault: it is an atteMpt or threat
to touch another person
unjustifiably.
e.g.: a nurse who threatens a client
with an injection for refusing an
oral Medicine.
2.battery: is the willful touching of a
person that May or May not harM.
e.g.: a nurse threatens an gives an
injection without consent .

51. 3. false iMprisonMent: it is the
unjustifiable detention of a person
without legal warrant or confine
the person.
e.g.: not allowing a person to go laMa
or insisting a client to confine on
bed
4. invasion of privacy: it injures the
feeling of a person and does not
take into account the effect of
revealed inforMation on the
standing of the person in the
coMMunity.

52. 5. defaMation: it is a coMMunication
that is false, or Made with a
careless disregard for the truth.
e.g.: a nurse writes in her nurse’s
notes that a physician is
incoMpetent or telling a client that
her colleague is incoMpetent.

53. LOSS OF CLIENT PROPERTY
loss of client property,
dentures, jewelry, Money etc.,
nurses are expected to take
reasonable precautions to
safeguard client’s property

54. UNPROFESSIONAL CONDUCT
it includes incoMpetence or
gross negligence, conviction for
practicing without a license,
falsification of client record,
and illegally obtaining, using,
or possessing controlled
substances.

55. LEGAL PROTECTION IN NURSING
PRACTICE
1.good saMaritan act
2.professional liability
insurance
3.carrying out a physician order
- Question any order a if the
client’s condition has changed
- Question any order that is
illegal, unclear, or incoMplete .

56. 4. providing coMpetent nursing
care
5. record keeping
6. the incident report

57. REPORTING, CRIMES, TORTS, AND
UNSAFEPRACTICES
nurses May need to report
nursing colleagues or other
health professional for
practices that endanger the
health and safety of clients .

58. Questions????????????

59. THANK YOU