Chapter 45 Fundamentals of Nursing
How is arbitration different from mediation?
Answer: Arbitration is similar to mediation but is different in these ways: Arbitration generally follows a more formal method of evidence presentation. Arbitration is sometimes binding, whereas mediation rarely is.
A registered nurse's primary state of residency is Utah, a compact state. She wants to practice nursing in the state of Nevada, which is a non-compact state. The nurse A) should retake the NCLEX-RN examination for practice in Nevada. B) must apply for licensure by compact endorsement. C) can practice under the mutual recognition agreement. D) must request a permissive license from the Utah Board of Nursing
Answer: B) must apply for licensure by compact endorsement. Rationale: The mutual recognition model of nursing applies to states that have entered into the compact agreement. The agreement does not extend to those states that have not entered into the compact agreement (Nevada).
A new charge nurse is advocating changing the shift report, which currently is the oral communication of patient information between nurses at the nurses' station. What would be the most important reason to make this change? A. Giving the report at the nurse's station causes too much noise. B. Discussing patient information at the desk may violate HIPAA laws. C. If the patient being discussed hears the nurses, he or she may sue the hospital. D. Sharing information about patients at the desk is an invasion of privacy.
Answer: B. Discussing patient information at the desk may violate HIPAA laws. Rationale: The other responses are incorrect because noise would not be the most important issue here; if information is accurate and nonjudgmental, a patient would have no grounds for suing the hospital. This is not an example of invasion of privacy.
A nurse may be convicted of false imprisonment for which behavior? A) Putting the patient in fear of being harmed B) Touching the patient without his/her consent C) Putting a patient in restraints to prevent him from leaving D) Yelling and screaming at the patient for trying to get out of bed without assistance
Answer: C) Putting a patient in restraints to prevent him from leaving Rationale: False imprison is restraining a patient against his/her wishes. This violates the patient's autonomy. Assault is putting the patient in fear of being harmed, such as yelling, screaming, and making threats. Touching a patient without his consent is battery.
A registered nurse administers the wrong medication to a patient. As a result, the patient suffers an injury that requires a longer hospital stay. The patient can sue the hospital under the doctrine of which of the following? A) Battery B) False imprisonment C) Vicarious liability D) Statute of limitations
Answer: C) Vicarious liability Rationale: Vicarious liability is also known as substituted liability, wherein another party is responsible for the negligence or malpractice of another person.
Glenn is a homeless man who is admitted to General Hospital's emergency room for chest pain. He could be having a myocardial infarction (heart attack), but the emergency room is busy and a resident suggests sending Glen to County Hospital. If he is transferred without being stabilized, the hospital is violating which of the following? A. Health Insurance Portability and Accountability Act (HIPAA) B. Americans with Disabilities Act (ADA) C. Emergency Medical Treatment and Active Labor Act (EMTALA) D. Patient Self-Determination Act (PSDA)
Answer: C. Emergency Medical Treatment and Active Labor Act (EMTALA) Rationale: The Emergency Medical Treatment and Active Labor Act (EMTALA) prevents patients from being "shuffled" to another facility because of their inability to pay. There are also other criteria that must be met before a patient such as Glen can be transferred.
Under which type of law (constitutional, statutory, administrative, or common law) does each of the following fall? A defendant claiming the right not to incriminate himself under the Fifth Amendment
Answer: Constitutional, statutory, and case law
Give one example of the duty to advocate for a patient.
Answer: Examples of patient advocacy may include the following duties: -Duty to be knowledgeable about medical prescriptions and to intervene in instances wherein an incorrect prescription has been given, such as a medication that may cause an adverse reaction in the patient -Duty to question incomplete or illegible prescriptions and to question discharge orders when a patient's condition warrants it -Duty to report impaired nurses to the appropriate licensing agency -Duty to report neglect and abuse of patients by relatives and significant others
Nurse practice acts are voluntary professional standards that are used often for peer review.
Answer: False Rationale: Nurse practice acts are mandatory standards.
The state board of nursing is the entity that establishes accreditation requirements for schools of nursing.
Answer: False Rationale: Accreditation requirements are established by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
If a patient falls while a nurse aide is assisting the patient to ambulate, the registered nurse should make it clear on the incident report that it was the aide's fault.
Answer: False Rationale: No blame should be placed when writing an incident report.
Identify whether the following examples violate state or federal law. A hospital terminates a registered nurse because she has mild cerebral palsy and a weakened left arm.
Answer: Federal Rationale: Termination on these grounds violates the Americans with Disabilities Act.
Which federal law requires healthcare agencies to provide patients with information about advance directives?
Answer: The Patient Self-Determination Act (PSDA) requires that patients be given information about advance directives to promote autonomy in making healthcare decisions.
List the four components of the nurse's legal duty to evaluate.
Answer: The nurse's legal duty to evaluate includes these four components: -Observing for changes -Recognizing the significance of the change -Documenting or reporting symptoms to the appropriate person -Following up
What Are the Main Points in This Chapter?
-The law is a binding practice, rule, or code of conduct that guides a community or society and is enforced by a controlling authority. -Laws are primarily derived from four sources: (1) the Constitution, (2) statutes, (3) administrative bodies, and (4) the courts. -The right of privacy comes from the Bill of Rights. -A living will is prepared by an alert and oriented (competent) individual that gives directions to others about the person's wishes regarding life-prolonging treatments if the person becomes unable to make those decisions. -A durable power of attorney for healthcare identifies a person who will make healthcare decisions in the event the patient is unable to do so. -State laws affecting nursing practice include mandatory reporting laws, Good Samaritan laws, safe harbor laws, and nurse practice acts. -The ANA Code of Ethics describes the standards of professional responsibility for nurses and provides insight into ethical and acceptable behavior. -The ANA Nurses' Bill of Rights identifies the rights nurses should expect from their workplace and work environment that are necessary for sound professional practice. -A primary function of the medical malpractice system is to encourage healthcare providers to adhere to standards of practice and perform their responsibilities in a competent manner. -Standards of practice look to what a reasonable and prudent nurse would do in the same or similar situation -Nurse practice acts are established by state boards of nursing to govern the practice of nursing. -In most states, nurses are obligated legally to report suspected or actual patient abuse, impaired health professionals, and communicable diseases. -State boards of nursing are empowered under the nurse practice act to approve prelicensure nursing education programs, determine the criteria for licensure, define the practice of nursing, and establish grounds for disciplinary actions against nurses. -Criminal law deals with wrongs or offenses against society. Civil law deals with wrongs to individuals. -Intentional torts include assault, battery, false imprisonment, fraud, and invasion of privacy. -Quasi-intentional torts involve those actions that injure a person's reputation. -Unintentional torts that involve healthcare professionals are negligence or malpractice. -Negligence is a wrong committed against an individual by one who has failed to use ordinary care. -Malpractice is negligence committed against an individual by a licensed professional involving a duty, breach of that duty, an injury, and damages. -Litigation is the formal process where the legal issues, rights, and duties between the parties are heard and decided. The stages include: (1) pleading and pretrial motions, (2) discovery, (3) alternative dispute resolution, (4) trial, and (5) appeal. -Malpractice claims, in general, result from failure to maintain the standard of practice, including failure to assess, diagnose, plan, implement, and evaluate patient responses to care. -Nurses can help reduce their legal risks by developing open, honest, respectful, caring relationships with patients and families; observing standards of care; and accurate documentation. -You may witness a patient's signature on a consent form, but you are not legally responsible for explaining the treatments and options, nor for evaluating whether the provider has adequately explained them.
Mutual recognition in nursing benefits which of the following individuals? A) A registered nurse whose primary state of residency is in a compact state and wants to work in a different compact state B) A registered nurse who lives is in a compact state and wants to work in another compact state C) A registered nurse whose primary state of residency is in a non-compact state, but who works in a compact state D) A nursing student who wants to work in a hospital and is attending a university to obtain a bachelor's degree in nursing
Answer: A) A registered nurse whose primary state of residency is in a compact state and wants to work in a different compact state Rationale: The nurse whose state of residency is in a compact state can work in any other state that is a member of the nurse licensure compact without obtaining a new license. It is not enough that the nurse lives in a compact state; it has to be the nurse's state of residency.
For which of the following examples of conduct by nurses would the American Nurses Association recommend disciplinary action by state boards of nursing? Select all that apply. A) Committing a medication error B) Taking excessive sick time or personal leave C) Restraining a patient without obtaining informed consent D) Failing to report a person practicing nursing without a license
Answer: A) Committing a medication error C) Restraining a patient without obtaining informed consent Rationale: The American Nurses Association (ANA) recommends that the following unprofessional conduct result in disciplinary action: violation of the nursing practice act or rules, fraud, deceit, criminal activity, negligence, risk to clients, physical or mental incapacity, disciplinary action by another jurisdiction, incompetence, and unethical conduct. State boards of nursing enforce the requirements of nursing practice by establishing disciplinary actions for unprofessional conduct, including negligence. Restraining a patient without informed consent is considered false imprisonment, which is an intentional tort. Medication administered in error might be the grounds for liability in a nursing lawsuit. However, the error when unintentional is not necessarily the basis for disciplinary action. Nurses must report the unauthorized practice of nursing. Excessive use of sick time and personal leave may result in disciplinary action by the manager but would not warrant action by the state board.
The nurse's legal role in obtaining written consent from a patient for any treatment or procedure includes which of the following? Select all that apply. A) Determining that the elements of a valid informed consent are in place B) Explaining to the patient the treatment and potential complications before he signs the consent C) Communicating the patient's needs for more information to the provider who will perform the procedure D) Evaluating whether the patient's provider has adequately explained the treatment and options before the patient signs the consent
Answer: A) Determining that the elements of a valid informed consent are in place C) Communicating the patient's needs for more information to the provider who will perform the procedure Rationale: As a nurse, your legal role regarding written consent is to collaborate with the provider who will perform the procedure. You may witness a patient's signature on the consent form, but you are not legally responsible for explaining the treatments and options nor for evaluating whether the physician has adequately explained them. You must, however, determine that the elements of a valid informed consent are in place, communicate the patient's need for more information to the physician, and provide feedback to the physician if the patient wishes to change her consent.
The legal criterion against which the nurse's conduct is compared to determine whether a negligent act occurred is called: A) standard of care. B) intentional tort. C) vicarious liability. D) an advance directive.
Answer: A) standard of care. Rationale: The standard of care measures what a reasonable, prudent nurse would have done in the same or similar circumstances. To be successful in a malpractice lawsuit, the plaintiff must prove that the standard of care was breached, in addition to the other elements of malpractice.
An older patient has a known history of peripheral vascular disease. The nurse places a heating pad directly on the patient's lower leg to relieve muscle spasms. The heating pad causes a burn, the area becomes infected, and the patient eventually must have a skin graft. This is an example of which of the following? A. Malpractice B. Assault C. Vicarious liability D. A felony
Answer: A. Malpractice Rationale: The nurse did not follow standards of care, which clearly caused an actual injury to the patient. He should have known the risks of applying heat, especially for a patient with poor circulation.
A nurse having her license revoked by the state board of nursing
Answer: Administrative law
State four ways in which the nurse may fail to implement a plan of care.
Answer: Answers may include any four of these failures to implement a plan of care: -Failure to respond means, for example, not intervening to care for the patient's specific symptoms or not responding to an expressed request for care. -Failure to educate means, for example, not answering questions, not teaching self-care measures, or not explaining procedures or equipment adequately on discharge. -Failure to follow standards of care and institutional policies and procedures most commonly occurs in the form of medication errors and failure to follow a physician's prescriptions. It also frequently occurs because equipment has not been used responsibly. Failure to follow standards of care may also occur when the unit is understaffed or the nurse is inexperienced. -Failure to communicate often takes the form of failing to seek medical authorization for a treatment or failing to notify a physician in a timely manner when the patient's condition warrants doing so. -Failure to document the following in the patient's record may break down implementation of a plan of care: assessment data (e.g., drug allergies), patient injuries, medication administration details, patient progress and response to treatment, physicians' orders, and telephone conversations with physicians. -Failure to act as an advocate is another way that implementation of a plan of care may break down. Nurses must frequently intervene to prevent harm to the patient by other healthcare providers and by relatives and significant others. The following are examples of advocacy duties: Medical and discharge prescriptions. To act as an advocate, you must be knowledgeable about medical prescriptions. You must intervene when you believe an incorrect prescription has been given, for example, when a medication may cause an adverse reaction in the patient. You have a duty to question incomplete or illegible prescriptions and discharge orders when you believe the patient is not well enough to be discharged. Impaired nurses. You have a duty under most state nursing practice acts to advocate for patients by reporting an impaired nurse's practice (e.g., as a result of alcoholism or mental illness) to the appropriate licensing agency. This will be discussed more in a following section. Family and significant others. Advocacy includes reporting neglect and intentional injuries to patients who are children, older adults, or disabled. Failure to do so may constitute negligence.
A 67-year-old man has been admitted to the hospital for a surgical procedure. During the admission process, the nurse asks whether he has a living will or a durable power of attorney. The patient asks, "What is a living will?" The best response by the nurse would be which of the following? A) "A living will and a durable power of attorney are both advance directives." B) "A living will states your wishes regarding future healthcare if you become unable to give instructions." C) "A living will identifies a person who will make healthcare decisions in the event you are unable to do so." D) "I will tell a case manager that you would like additional information."
Answer: B) "A living will states your wishes regarding future healthcare if you become unable to give instructions." Rationale: Generally, there are two types of advance directives: a living will and a durable power of attorney. A living will is a directive that declares the patient's wishes should the patient become unable to give instruction. A durable power of attorney identifies a person who will make healthcare decisions in the event the patient is unable to do so. Simply saying a living will and durable power of attorney are both advance directives is broadly stated and does not give as much information to the patient.
A nurse carried her own professional liability, a claims-made policy, from May 1, 2011, until April 30, 2012. She did not renew her professional liability policy, but purchased the tail coverage because she was starting law school on July 15, 2012, and did not plan to work as a nurse. A malpractice lawsuit was filed against her on July 3, 2012, arising out of an incident that occurred in December 2011. The plaintiff won the lawsuit. The statement that best describes the nurse's situation is that her insurance policy will A) not cover her. B) cover her. C) cover her only if she is working as a nurse. D) cover her if she renews her policy within 3 months.
Answer: B) cover her. Rationale: A claims-made policy covers claims that were made and reported during the policy period. The purchase of the tail insurance extended the coverage of the policy. If the nurse had not purchased the tail insurance, she would not have been covered.
A patient tells you that chart entries made by the nurse from the previous day indicate he was uncooperative when asked to ambulate. He says this is not true and asks that his record be corrected. You understand that if what he says is accurate, he has the right to have the documentation error corrected based on which of the following regulations? A) Americans with Disabilities Act (ADA) B) Patient Self-Determination Act (PSDA) C) Health Insurance Portability and Accountability Act (HIPAA) D) Health Care Quality Improvement Act (HCQIA)
Answer: C) Health Insurance Portability and Accountability Act (HIPAA) Rationale: The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule of 2004 provides comprehensive protection for the privacy of protected health information (confidentiality of patient records). In addition, patients have the right to see and copy their medical records and to reconcile incorrect information.
Two student nurses in the elevator are discussing the HIV-positive status of a client. One of the clients' family members is in the elevator and overhears the conversation between the student nurses. Which of the following statements is true? A) The state board of nursing can discipline the students' license. B) The client can sue the student nurses for slander and libel. C) The students have violated the Health Insurance Portability and Accountability Act. D) The students have violated the Emergency Medical Treatment and Active Labor Act.
Answer: C) The students have violated the Health Insurance Portability and Accountability Act. Rationale: The students have released the client's protected personal information to a third party without the patient's consent and to those who do not have a medical or business need to know. This is a HIPAA violation.
A registered nurse on active duty in the army is licensed in the state of Texas. She is assigned to work as a nurse in the military hospital located in Nevada. The nurse will: A) need to obtain a license through the endorsement process. B) need to obtain a license through the mutual recognition process. C) not need to obtain a new license in the state of Nevada. D) not need a license for Nevada if she gets a guest license from the state of Texas.
Answer: C) not need to obtain a new license in the state of Nevada. Rationale: A nurse who works for the federal government does not need a new license to work in other federal government facilities.
A registered nurse is giving an end-of-shift report on her patient with hepatitis B, which he acquired through IV drug use. She tells the nurse coming on to the shift that the patient is nasty and uncooperative and that she's not surprised he has hepatitis, given his lifestyle. The nurse's behavior is consistent with which of the following? A. Battery B. An appropriate shift report C. Slander D. Malpractice
Answer: C. Slander Rationale: Slander is a verbal form of defamation of character. The other responses are incorrect because the nurse is not performing a procedure or otherwise touching the patient, there is no evidence that the nurse is not implementing a plan of care, and there has been no breach of duty.
For the patient with no healthcare coverage who is seeking medical care, the emergency department staff members decide whether to provide care or transport to a public facility based on which law, enacted by Congress in 1986 and updated in 2003? A) Health Insurance Portability and Accountability Act (HIPAA) B) Patient Self-Determination Act (PSDA) C) Newborns' and Mothers' Health Protection Act (NMHPA) D) Emergency Medical Treatment and Active Labor Act (EMTALA)
Answer: D) Emergency Medical Treatment and Active Labor Act (EMTALA) Rationale: The intent of the Emergency Medical Treatment and Active Labor Act (EMTALA) is to ensure public access to emergency services regardless of ability to pay. The EMTALA prohibits "patient dumping," which is transferring indigent or uninsured patients from a private hospital to a public hospital without appropriate screening and stabilization. An exception is made if a hospital does not have the capability to stabilize a patient or if the patient requests a transfer. However, the hospital has to ensure that the patient is released to or transported with proper medical personnel.
An 82-year-old patient with terminal metastatic breast cancer is confused and not eating well. However, she has in her chart documentation that instructs healthcare providers not to insert a feeding tube. This documentation would be which of the following? A. Do not attempt resuscitation order B. Durable power of attorney C. Patient Care Partnership D. Living will
Answer: D. Living will Rationale: The other responses are incorrect because a do not attempt resuscitation order instructs nurses and other providers to not initiate cardiopulmonary resuscitation; a Patient Care Partnership speaks to what patients can expect during their treatment in general; and a durable power of attorney is a document that identifies a person who will make healthcare decisions for someone else if that person becomes incapacitated.
A nursing instructor copies a patient's lab results to use in class for teaching purposes.
Answer: Federal Rationale: This violates HIPAA.
Define plaintiff and defendant in the context of civil law.
Answer: In the context of civil law, these terms have the following definitions: A plaintiff is the person bringing a lawsuit seeking damages or other relief. The defendant is the person who is being sued or accused of wrongdoing.
The emergency room nurse fails to report a case in which an older patient, who lives with a young nephew, has suspicious bruises.
Answer: State Rationale: This violates the mandatory reporting law.
A graduate nurse (GN) continues to work in a GN position even though she has not passed the state board examination (NCLEX-RN).
Answer: State Rationale: This violates the nurse practice act regulation on licensing.
The wording of a state nurse practice act
Answer: Statutory law
Which federal law ensures that patients can receive emergency treatment regardless of their ability to pay?
Answer: The Emergency Medical Treatment and Active Labor Act (EMTALA), enacted by Congress, ensures public access to emergency services regardless of the client's ability to pay. EMTALA prohibits "patient dumping"—transferring indigent or uninsured patients from a private hospital to a public hospital without appropriate screening and stabilization. When a client comes to the emergency department requesting examination or treatment for an emergency medical condition (including labor), the hospital must provide stabilizing treatment; the client cannot be transferred until he is stable. An exception is made when a hospital does not have the capability to stabilize a patient or when the patient requests a transfer. In those circumstances, qualified personnel and equipment must be made available to transport the patient, and his medical records must be forwarded to the receiving hospital.
What protections are provided to patients by the Department of Health and Human Services "privacy rule" of HIPAA?
Answer: The Health Insurance Portability and Accountability Act (HIPAA) provides patients the following protections: -Prevent discrimination. Initially intended to keep health plans from discriminating against people on the basis of their medical condition. In most cases, HIPAA allows insurers to limit coverage for a preexisting condition for only 12 months. -Protect privacy. The privacy regulations provide comprehensive protection for the privacy of patients' health information. Healthcare agencies must provide reasonable safeguards to protect the confidentiality of records. -Ensure access. Patients have the right to see and copy their medical records and to correct mistaken information.
State the four elements of malpractice.
Answer: The four elements of malpractice are existence of a duty, breach of a duty, causation, and damages. -Existence of a duty. A duty is created, by the nurse to the patient, through the nurse-patient relationship. As a nurse, you have a duty to assess, plan, implement, and evaluate care for your patients. Duty also arises when you see a patient in need or when you observe another provider committing malpractice. -Breach of the duty. The plaintiff may establish a breach of duty by proving that nursing actions failed to meet the standards of care. The standard of care will be established by a testifying expert, based on the state nursing practice act and a combination of any of the following sources of nursing and patient care standards: The nurse's job description Clinic or hospital policies, procedures, and protocols Standards and guidelines adopted by professional organizations to which the nurse may belong Nursing textbooks -Causation. The breach of duty must be the direct and proximate cause of the patient's injury. The plaintiff must establish that no other factor in the scenario could have caused the injury. -Damages. The plaintiff must also prove that there has been an actual injury, which is compensable in damages (money). For example, even though a nurse administers the wrong medication, if no injury occurred to the patient, then he will not be able to prove a negligence case and recover damages under civil law. However, the patient may file a complaint before the board of nurse examiners to obtain sanctions against the nurse under administrative law.
State the four requirements of the nurse's duty to assess.
Answer: The nurse's duty to assess has these four requirements: -The nurse must have the necessary knowledge and skills to observe the patient and interpret the symptoms in the form of a nursing diagnosis. -The nurse must actually carry out the assessment. -The nurse must perform an admission or shift assessment. When the assessment reveals adverse symptoms, the nurse must report the symptoms to the appropriate provider and carry out the standard nursing care and ordered interventions. -The nurse must continue to assess and monitor until the patient is stable.
Identify the phases of the trial process.
Answer: The phases of the trial process are pretrial, discovery, alternate dispute resolution, trial, and appeal. -Pretrial processes. The plaintiff files a petition or complaint outlining what the nurse did wrong and how the plaintiff was injured. The defendant then files an "answer," admitting or denying each allegation (unproven accusation). If any of the four elements of malpractice are missing, the defendant may file a motion with the court to dismiss the lawsuit. If you are a defendant, cooperate fully and be honest with your attorney. Do not discuss the case with anyone (not even coworkers) other than your attorney and the risk manager at your agency. Do not alter the patient records in any way, even if the documentation seems unfavorable to you in some way. This can seriously compromise your defense. -Discovery phase. The discovery process consists of pretrial activities designed to provide both parties with knowledge of any facts and evidence of the case. Discovery is designed to make sure there are no "surprises" during the trial. Discovery may be obtained through written questions, requests for documents and other evidence, and by deposition (counselors orally question parties to the suit under oath, as though the person were testifying in a courtroom). You may be deposed as a party to the lawsuit, as a fact witness, or as an expert witness. Prior to the deposition, you should review all pertinent medical records and other information. Keep in mind the opposing counsel can request a copy of anything you use in your preparation. If you are deposed, do not volunteer information; answer questions factually—if they can be answered "yes" or "no," then do so. Take your time before answering a question; this allows your attorney time to make any necessary objections. Tell the truth, but base your answers on facts; do not speculate. Remain calm; do not get angry, argue, or be sarcastic. -Alternate dispute resolution. Lawyers and involved parties typically seek to resolve disputes before going to trial. The three most common methods of alternative dispute resolution are negotiation, mediation, and arbitration. Negotiation takes place informally between the parties through their lawyers. Mediation is the attempt to resolve the dispute through a neutral party; it is usually not binding. Arbitration involves a third party making a decision after hearing the evidence and information from both parties. -Trial process. If the dispute cannot be resolved during the discovery process and subsequent dispute resolution, the case proceeds to trial. Facts are presented and arguments made to a judge, and sometimes a jury. -Appeal. After the judge or jury has rendered a decision, either party has the opportunity to (a) present post-trial motions, (b) move for a new trial, or (c) appeal the verdict and/or damages to an appellate court.
Distinguish civil law from criminal law.
Answer: These laws differ as follows: Under civil law, the courts seek to resolve a dispute between private parties, which may result in damages or payment of money by the losing party. Tort law and contract law are types of civil law. Under criminal law, the federal or state government seeks to penalize the accused for an offense against society.
How does each of the following protect patients? 1. The Patient Care Partnership (PCP) 2. Nursing codes of ethics 3. Mandatory reporting laws
Answer: These standards protect patients as follows: 1. Patient Care Partnership. The American Hospital Association Patient Care Partnership identifies some rights that are guaranteed to a patient while in the healthcare setting. Although not all of the rights are legally binding, some courts look to such documents as part of the overall picture to decide whether patient care has met the applicable standard. 2. Nursing codes of ethics. Although they are not laws, nursing codes of ethics specify duties of the nurse to the patient, with corresponding patient rights. The ANA Code guarantees: The patient the right to dignity (including the right to self-determination), privacy, and safety That the nurse will be accountable and competent, use informed judgment, maintain employment conditions conducive to quality patient care, protect the client from misinformation and misrepresentation, and collaborate with other healthcare professions to meet the patient's healthcare needs In a negligence or malpractice suit, these guarantees may be used as standards for judging the nurse's actions. For more information on the ANA Code of Ethics, Refer to Chapter 44 in your textbook. 3. Mandatory reporting laws. Most states have mandatory reporting laws related to abuse of children and older adults. Elder abuse laws provide protection to those persons over age 60 from actions that cause serious physical or emotional injury, caretaker neglect, and financial exploitation. The same protections are provided to children under the child abuse laws. The states vary in their requirements for mandatory reporting of abuse to the disabled, sexual assaults, and specific traumatic injuries. Laws requiring the reporting of communicable diseases help prevent spread of diseases.
Distinguish negligence from malpractice.
Answer: These terms differ as follows: Negligence is a wrong committed against an individual by one who has failed to use ordinary care. Malpractice is a subset of negligence: a wrong committed against an individual by a licensed professional.
Define these terms: assault, battery, fraud, slander, libel, negligence, malpractice.
Answer: These terms may be defined as follows: -Assault occurs when a nurse intentionally places a patient in a position of apprehension or fear that he will suffer harmful or offensive contact (e.g., "Stop that or I will restrain you"). -Battery occurs when physical contact occurs with the intent to cause harm or offense. It also occurs when the patient did not consent to be touched (e.g., performing a procedure without consent). -Fraud is a tort (wrongful act) that is a "willful" or intentional misrepresentation designed to deprive another person of a right. Because actual fraud requires intent, it can never be the result of accident or negligence. -Slander is oral defamation in which a false communication is made to a third person that is harmful and that holds the plaintiff up to hatred, contempt, or ridicule or causes the plaintiff to be shunned or avoided. -Libel is written defamation. -Negligence is simply the failure to use ordinary care. -Intent is not a necessary element of negligence. -Ordinary care is the degree of care a reasonable and prudent person would exercise under the same or similar circumstances. -Malpractice occurs when a nurse or other licensed provider is negligent and fails to use ordinary care. It is professional negligence.
Telling an agitated patient that an oral sedative is a medication for his headache would be considered fraud.
Answer: True. Rationale: Fraud is the false representation of significant facts by words or by conduct. It can occur through making false statements, falsifying documentation, or concealing information that should have been disclosed. It is intentionally misleading or deceiving another person to act (or not act) for the personal gain of the one committing the fraud.
