Nursing-Jurisprudence_ affecting the practice of nursing.

department of law which comprise all legal rules and principles affecting the practice of nursing.

1. NURSING JURISPRUDENCE

2. NURSING JURISPRUDENCE department of law which comprise all legal rules and principles affecting the practice of nursing. NURSING LEGISLATION the making of laws, or the body of laws already affecting the practice of nursing.

3. LAW a rule of civil conduct prescribed by the supreme power in a state commanding what is right and prohibiting what is wrong. Sum total of rules and regulations by which society is governed

4. LEGAL RIGHT a claim which can be enforced by legal means against a person whose duty is to respect it. COURT An agency in the government wherein the administration of justice is delegated.

5. COURT MECHANISM

6. PARTIES TO A CASE Complainant VS Defendant: Civil case Plaintiff VS Accused: Criminal case Witness- an individual held upon to give necessary details either for the accused or against the accused

7. STATUTE OF LIMITATIONS

8. DUE PROCESS A fair and orderly process which aims to protect and enforce a person’s right. FUNDAMENTAL REQUIREMENTS OF DUE PROCESS: 1. Right to be informed 2. Right to remain silent 3. Right to competent counsel 4. No use of violence, threat, torture 5. Right to know the witness face to face

9. WRITTEN ORDERS OF COURT WRIT- legal notes from court SUBPOENA- an order in court Duces tecum (papers) bring documents, objects, materials, chart to court Ad testificandum (person) testify as witness at a specified time and place SUMMON- a writ commanding an authorized person to notify a party to appear in court to answer a complaint made against him.

10. WARRANT- a writing from a competent authority in pursuance of law, directing the doing of an act addressed to a person competent to do it Warrant of arrest - a court order to arrest or detain a person Search warrant- a court order to search for properties

11. LAWS THAT PROMOTE THE WELFARE AND WELL-BElNG OF NURSES P.D. 442- Labor Code Defines among other things, hours of work, contract and nurse staffing in industrial clinics P.D. 807- Civil Service Law Provide for the recruitment and selection of employees in government service; qualification standards; personnel evaluation system; and personnel discipline

12. R.A. 7305- Magna Carta for Public Health Workers Has provisions on benefits, rights and responsibilities of public health workers R.A. 8344 “No Deposit Policy” Prohibits hospitals and clinics from demanding advance payments/cash deposits before patients are admitted or treated

13. LEGAL CONCEPTS AND ISSUES IN NURSING LIABILITY: is an obligation or debt that can be enforced by law A person who is liable for malpractice is usually required to pay for damages. DAMAGES: refer to compensation in money recoverable for a loss of damage

14. PROFESSIONAL NEGLIGENCE Negligence – failure to do something which a reasonable & prudent person should have done. 2 types: 1. Commission – wrong- doing 2. Omission – total neglect of care – didn’t do anything

15. ELEMENTS OF NEGLIGENCE 4D’S D uty for nurse D ereliction (breach of duty) D amages as result D irect result (injury, harm or death)

16. SPECIFIC EXAMPLES Burns resulting from hot water bags, heat lamps, vaporizers, sitz bath Objects left inside the patient’s body; sponges suction tips Falls of the elderly, confused, unconscious, sedated patients Falls of children whose bed rails were not pulled up and locked Mistaken identity- drug given to the wrong patient Wrong medicine, wrong concentration, wrong route, wrong dose Defects in the equipment

17. DOCTRINES OF NEGLIGENCE 1. RES IPSA LOQUITOR - “the things speak for itself” - the injury is enough proof of negligence 2. RESPONDEAT SUPERIOR - Let the master answer for the acts of the subordinate - The liability is expanded to include the master as well as the employee

18. 3. FORCE MAJEURE - Irresistible force; unforeseen or inevitable event - No person shall be responsible for those events which cannot be foreseen Ex. Flood, fire, earthquake INCOMPETENCE : lack of ability, legal qualifications or fitness to discharge the required duty

19. MALPRACTICE Doing acts or conducts that are not authorized or licensed or competent or skilled to perform, resulting to injuries or non-injurious consequences Stepping beyond one’s authority Negligent act committed in the course of professional performance RN exceeding the scope of nursing practice & does an MD’s job.

20. ELEMENTS OF MALPRACTICE D uty of the nurse D ereliction or breach of duty D irect result (injury or harm) D amages E xceeds the limits of the standards of care F oreseability of harm

21. MEDICATIONS & PRESCRIPTIONS 1. Only registered medical, dental and veterinary practitioners are authorized to prescribe drugs. 2. Prescription information (based on R.A. 5921 of the Pharmacy Act)- all prescriptions must contain the following information: Name of MD, PTR, PRC#, location of clinic/ hospital Name of patient, age, sex Information about drug – frequency duration Generic & brand name in prescription

22. R.A. 6675- Generics Act of 1988 All prescribed drug must be written in generic and brand names or generic name but never the brand name alone Purpose: for the pt. to choose what brand they want 3. Know rights in giving meds 4. Proper identification of pt.'s name 5. In cases of doubts and errors in medication, refer to the physician. 6. Special training is required before a nurse can administer IV injection. BON Resolution No. 8 states that who administers IV injection without training shall be held liable whether causing or not an injury or death to the patient)

23. 7. Verbal or telephone order General rule: as possible avoid T.O. “whatever is not written is not an order” Exception: During extreme emergency only! What to do? Nurse should read back such order to the physician to make certain the order has been correctly written. Such order should be signed by the physician within 24 hours. The nurse should sign the physician’s name per her own and note the time and order was received.

24. LEGAL WRONGS TORTS : A legal wrong, committed against a person or property TYPES: 1. Unintentional- do not require intent but do require the element of harm. Ex. Negligence and malpractice

25. 2. Intentional- the act was done on purpose or with intent; no harm, injury or damage is needed to be liable. ASSAULT AND BATTERY ASSAULT - an attempt or threat to touch another person unjustifiably; mental or physical threat Ex.- forcing a pt. to take his medication or treatment

26. BATTERY - physical harm through willful touching of person or clothing without consent. Ex. – giving of injection without pt’s consent B. FALSE IMPRISONMENT - Unjustifiable detention of a person without a legal warrant - occurs when the person is not allowed to leave a health care facility when there is no legal justification to detain the client. - occurs when restraining devices are used without an appropriate clinical need.

27. Exceptions: Confidential information can be revealed! P t. consent, I nform HCT for precautionary measures C rimes, child abuse, BWS C ommunicable disease- R.A. 3573 (Law on Notifiable Diseases) E thics

28. D. DEFAMATION Character assassination There must be a third person who hears or read the comment before it can be considered defamation TYPES: Slander-oral defamation Libel-written words

29. RESTRAINTS Restraints are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity. TYPES: Physical restraints: restrict client’s movement through the application of a device e.g. restraint jacket, straps, Chemical restraints: Medications given to inhibit a specific behavior or movement. e.g. sedation, psychotrophic drug

30. RESTRAINTS SHOULD NOT BE USED PRN!!! R- equires physician’s order; consent E- mergency , get MD’s order ASAP S- hortest duration, least restrictive type T-o protect pt. and others R- enew order every 24 hours A- ssess every 15 to 30 minutes and document I- ndividualized supervision N-ever used as a punishment T- otal documentation S- eclusion as last step

31. CRIMES & OTHER ACTS CRIME: An act committed or omitted in violation of the law Two elements: Criminal act Evil/criminal intent Criminal Actions Acts or offenses against public welfare Misdemeanor- offenses or acts less than a felony Felony- a public offense committed with deceit and fault

32. CLASSIFICATION 1 . Manner of commission: Deceit ( dolo ) with criminal intent Fault (culpa) without; negligence Criminal negligence Reckless imprudence- person does an act from which damage results immediately Simple imprudence- did not use precaution and the damage was not immediate

33. 2. Stages of Execution 1. Consummated all elements executed, with successful result 2. Frustrated all elements executed but no successful result 3. Attempted not all elements executed, no successful result

34. 3. Degree of penalty and fine grave Capital punishment or 6 years & 1 day not exceed P6k Less grave 1 month and 1 day to 6 years not exceed P 6 K but not less than P200 Light felony 1 day to 30 days fine not exceed P 200

35. 4. Degree of participation PRINCIPAL Primary author a. By direct participation- doer of the act b. By inducement-directly force or induce others c. By cooperation- indispensable ACCOMPLICE A person who cooperates “cooperates before the fact”- absent at the time crime is committed. ACCESSORY “cooperates after the fact” P rofits C onceals/ destroys evidence A ssists in the escape of the principal

36. Circumstances affecting criminal liability J-E-M-A-A

37. JUSTIFYING SELF-DEFENSE Unlawful aggression Reasonable necessity Lack of sufficient provocation Fulfillment of Duty Obedience to an order from superior Order must be lawful Superior acting within the scope of practice

38. EXEMPTING I nsane/imbecile P erformance of a lawful act causes injury by mere accident U nder 9 y/o U nder compulsion of uncontrollable force U nder impulse of uncontrollable fear F ailure to perform an act required by law when prevented by some lawful cause

39. MITIGATING U nder 18y/o or over 70 y/o N o intention to commit so grave a wrong S ufficient provocation/threat preceding the act I mmediate vindication of a grave offense V oluntary surrender D eaf & dumb/ with physical defect S uffer from such illness that diminishes willpower

40. AGGRAVATING T reachery/taking advantage of superior strength or position P rice, reward, promise U se of fire, poison, explosion C alamities C raft, fraud or disguise employed E vident Premeditation C ruelty

41. ALTERNATIVE May increase/ decrease criminal liability depending on the nature and effects of the crime R elationship I ntoxication D egree of instruction/ education

42. CRIMES CONCERNING THE NURSE

43. MORAL TURPITUDE Are acts contrary to the accepted and customary rule of right 1. RAPE: a.) Ordinary rape – forcible penetration of sex organ to a sex organ b.) Sexual assault – anything forcibly inserted to any orifice. Intervention S afety (emotional and physical) R eport the incidence R eferral (if the father is the rapist, refer to DSWD)

44. ANTI- RAPE LAW (RA 8353) R.A . 7877 – Anti-sexual Harassment Act Any person who exercises authority Asking sexual favors in exchange of another favor

45. 2.MURDER- killing of another with intent 3. HOMICIDE- unintentional killing of another person 4. PARRICIDE Killing of a person to whom you have a relationship 1. father 2. mother 3. brothers/sisters 4. ascendants 5. descendants 6. spouse

46. 5. ABORTION- termination of product of conception before the age of viability. 6. INFANTICIDE - the killing of an infant less than three days or 72 hours.

47. 8. THEFT- anyone who gets the personal property of another without the latter’s permission. 7. ROBBERY Anyone who gets the personal property of another with the use of force, violence or intimidation.

48. 9. SIMULATION OF BIRTH 1. Pretend that a woman gave birth 2. Substitution or exchanging of babies in the nursery 3. Intentionally putting wrong information in the birth registration form P.D. 651 – Birth Registration Act - requires any person (RN,OB, midwife) who shall assist in giving birth to report within 30 days without penalty any live birth at Local Civil Registrar’s Office.

49. 10. DISPENSING OF PROHIBITED DRUGS R.A. 6425 (1965) – Dangerous Drugs Act A. Prohibited – chemicals or substances that are totally and absolutely can’t be consumed by human being. Ex. Shabu, cocaine, cannabis B. Regulated – can use this drug - with appropriate prescription - MD with appropriated license Ex.- Valium, dormicum

50. PENALTY FOR VIOLATING THE ACT For licensed health care providers F ines I mprisonment Automatic revocation of license

51. GUIDELINES TO PREVENT CRIMINAL LIABILITY

52. TIPS FOR AVOIDING LEGAL PITFALLS:

53. 2 . Medication errors observe the rights of drug administration Check dr’s order Understand the medication you will administer Consult drug handbook/ pharmacy Not exempt from liability for following wrong Dr.’s order 3. Equipment injuries refuse to use a device you do not know how to operate report adverse events to superiors monitor patient regularly bring questionable orders to the attention of the doctor or superior

54. -END-