Exam 2 Legal issues Nursing

When can physical restraints be used

-Patient is a threat to self or others -Restraint is the least intrusive to control the patient -Regular reassessment according to policy -Physician order -Restraint is discontinued as soon as possible -Many facilities have a no restraint policy

List the Five Intentional Torts Laws and Describe each one.

1) Assault- Saying or doing something to harm someone without consent 2) Battery - un-consented touching of a person without permission. Does not have to cause injury. 3) Invasion of Privacy (publishing photos, disclosing confidential information) 4) Defamation of Character (false statements that result in damage to a person's reputation) 5) False Imprisonment- making a person stay in a place against his or her wishes; can be verbal, physical, or chemical

List and Describe two types of legal Damages

1) Compensatory damages - the actual cost incurred because of the negligent act. 2) Punitive damages- money awarded beyond the compensatory damages to "punish" the violator and send a message that this behavior is unacceptable; tend to much greater amounts of money

List Two Unintentional Torts laws

1) Negligence 2) Malpractice

What is Patient Self Determination Act

Act-encourage people to discuss and document their wishes concerning the type of treatment and care they want so it will ease the burden on their families and providers when it comes time to make a decision.

Threat against a patient or a coworker is an example of _____________ Intentional tort law

Assault

Personal Liability

Each professional is responsible for his or her own actions

Employer Liability

Employers can be held responsible for actions committed by employees

What are some traits of Suit-Prone Nurses

Insensitive to patient needs Undereducated Overconfident Authoritarian Inflexible Pre-occupied with personal issues

What is Informed Consent?

Law that requires that patients receive adequate information concerning the proposed treatment, the material risks and benefits of the proposed treatment, the risks of doing nothing, and the right to accept or refuse.

Define Legal Damages

Occurs if a person is found guilty of any tort; generally results in the payment of money.

Define Malpractice

Professional negligence.

Criminal Laws consist of ___________ law and __________ law and Define criminal law.

Statutory/Common Written to prevent harm to society and provide punishment for crimes. *Felony or Misdemeanor*

What is the Good Samaritan Law

This protects health care providers in emergency situations if care is given according to established guidelines and within the scope of practice for that professional.

Felony

a crime of a serious nature: rape, theft, kidnap, murder

Misdemeanor

a lesser crime with a penalty of a fine of less than 1 year in prison (petty theft)

Acts such as hanging the wrong intravenous solution for a patient or allowing a NAP to administer a medication is an example of __________ Unintentional Tort law.

Negligence

If the nurse is sued for negligence after the administration of an injection, which one of the following persons will most likely be asked to serve as an expert witness to describe standards of care? A. An experienced nursing supervisor or instructor. B. A lawyer who has successfully defended another nurse sued for negligence. C. A judge who is considered to be an expert in the field of professional negligence. D. Another patient who had received an injection by the same nurse but without complications.

A. An experienced nursing supervisor or instructor.

An obstetrical nurse comes across an automobile accident. The patient seems to have a crushed upper airway, and while waiting for emergency medical services to arrive, the nurse makes a cut in the trachea and inserts a straw from her purse to provide an airway. The patient survives and has a permanent problem with his vocal cords, making it difficult to talk. Which statement is true regarding the nurse's performance? a. The nurse acted appropriately and saved the patient's life. b. The nurse acted within the guidelines of the Good Samaritan Law. c. The nurse took actions beyond those that are standard and appropriate. d. The nurse should have just stayed with the patient and waited for help

ANS: C An obstetric nurse would not have been trained in performing a tracheostomy or a cricotomy, and doing so would be beyond what she has been trained or educated to do. The nurse did not do what another nurse would have done in the same situation. The nurse is not protected by the Good Samaritan Law because she acted outside of her scope of practice and training. The nurse should have acted within what she was trained and educated to do in this circumstance, not just stay with the patient.

Touching someone without consent is an example of _____________ under Intentional tort law

Battery

Under which category are nursing licensure laws included? A. Contract Laws B. Federal Laws C. Civil Laws D. Natural Laws

C. Civil Laws

A recent immigrant who does not speak English is alert and requires hospitalization. What is the initial action that the nurse must take to enable informed consent to be obtained? A. Ask a family member to translate what the nurse is saying. B. Notify the health care provider that the patient doesn't speak English. C. Request an official interpreter to explain the terms of consent. D. Use hand gestures and medical equipment while explaining in English.

C. Request an official interpreter to explain the terms of consent.

Define Negligence

Conduct that falls below the standard of care: "Failure to use that degree of care that an ordinarily CAREFUL and PRUDENT person would use under the same or similar circumstances."

Writing something about someone that you know is false is an example of _____________ under Quasi-Intentional Tort law

Libel

What is the purpose of a Expert Witness

a person called to provide special information or opinions in cases that require special study or experience.

Define Statute of limitation

a time period after which a malpractice suit cannot be filed. -Generally 2 years after the discovery of injury

While recovering from a severe illness, a hospitalized patient states that he wants to change his living will, which he signed nine months ago. Which response by the nurse is most appropriate? a. "Check with your admitting health care provider whether a copy is on your chart." b. "Have you talked with your attorney recently about a living will?" c. "Your living will can be changed only once each calendar year." d. "Let me check with someone here in the hospital who can assist you."

d. "Let me check with someone here in the hospital who can assist you." Each health care facility has personnel who are familiar with the state laws and can assist the patient in revising a living will. They may be in the admissions or risk management department. Checking with the health care provider about the presence of a living will on the chart has nothing to do with the patient's desire to change the living will. The question states that the patient wants to change his living will. Asking whether he has talked to his lawyer recently is a closed-ended question that passes the responsibility to someone else, that is, the attorney, and does not address the patient's current desire to change the living will. It is the nurse's responsibility to find an appropriate person in the facility to assist the patient. A living will can be changed whenever the patient decides to change it, as long as the patient is competent.

List the Quasi-Intentional Torts Laws and Describe each one.

-Defamation of character - the sharing of information that unintentionally harms a person's reputation -Invasion of privacy - violation of a person's right to keep information about self, family, and property from public scrutiny

List 3 types of Advance Directives

-Directive to Physicians -Medical Power of Attorney -Living wills

List and describe two types of Defamation of character.

-Slander - oral defamation of character that is intentional and malicious -Libel - written defamation of character that is intentional and malicious

Statutory laws are created by what two legislative bodies?

-U.S. Congress (Federal Laws) -State Legislature (State Laws)

What are some traits of Suit-Prone Patients

-Very demanding -Very critical of all aspects of the hospital experience -Very dependent -Critical of other nurses -Has filed a lawsuit before

List two policies for Malpractice Insurance and describe each one.

1) Claims-made: protect you only while your policy is in effect -Can purchase "tails" that expand the policy -Usually a little cheaper 2) Occurrence polices: protect against any claims that occurred during the policy period no matter when it was made. An occurrence policy will respond to claims that come in even after the policy has been canceled so long as the incident occurred during the period in which coverage was in force.

List and define the three Tort laws

1) Intentional Tort - willful acts that violate another persons rights or property. 2) Unintentional Tort - A wrong occurring to another person leading to injury even through it was not intended. 3) Quasi-intentional Tort - Have characteristics of both intentional and unintentional torts. Violation of a person's reputation, personal privacy, or freedom from malicious or unfounded legal prosecution

A malpractice case is won by the plaintiff when:

1) It is determined that the standard of care that any reasonable and prudent nurse in a similar setting with the same credentials would deliver, has been violated or omitted. 2) Nurse violated policy and/or procedures

Four ways to legally protect myself?

1) Know your state laws affecting nursing practice. 2) Follow your state's nursing practice act rules and regulations. 3) Deliver safe, competent nursing care. 4) Develop and use your critical thinking abilities and skills.

List Examples of Negligence:

1) Leaving a patient in a wet bed 2) Not turning every 2 hours 3) Meds to the wrong patient 4) Giving too many doses of a med 5) Incorrect surgical site 6) Seeing a downward trend of vitals and doing nothing

List two exceptions to Privacy Rights and describe them

1) Not an absolute right — can and may be required by law to be breached in certain situations such as child, spousal, or elder abuse; gunshot wounds; knife wounds; rape; communicable diseases; suspected crimes 2) Privileged communication - a special type of privacy that exists in certain professional relationships where its violation would destroy trust and confidence in the professional

List 3 Types of Liability

1) Personal Liability 2) Supervisor Liability 3) Corporate Liability

Two Major Legal Focuses of the R.N.

1) Protect my clients' rights 2) Protect myself from legal liability

Malpractice involves substandard care and the following four criteria:

1) The nurse (defendant) owed a duty to the patient (plaintiff) 2) The nurse did not care out that duty. 3) The client was injured 4) The nurse's failure to carry out the duty are is both the actual and proximate causes of the injury.

In which situation would an emergency room nurse be justified in proceeding without obtaining consent, verbal or otherwise? A. A 15 year old girl brought to the emergency department in respiratory distress B. An unconscious, bleeding victim brought in via ambulance C. A construction worker comes in to the emergency department with a fractured femur D. An infant with a febrile seizure brought in by the child's grandmother

B. An unconscious, bleeding victim brought in via ambulance

Which type of tort may occur if a client is not allowed to leave the hospital after receiving emergency care until the bill is paid? A. Battery B. False Imprisonment C. Assault D. Slander

B. False Imprisonment

Which statement is most accurate regarding nursing students and the legal responsibilities they incur? A. Student nurses are accountable for their actions B. Student nurses practice under the license of their instructors C. Student nurses are allowed to perform any nursing skill that they are comfortable performing D. Student nurses do not need to carry malpractice insurance

A. Student nurses are accountable for their actions

The newborn nursery is desperately short of staff. A nurse agrees to work an extra shift. During the 14th hour on duty, the nurse makes a medication error. Because the nurse was filling a "desperate" staffing need, and therefore was fatigued, what is the legal responsibility of the nurse? A. The hospital accepts responsibility for the error B. The nurse is held to the same standards as any nurse with the same experiences and education C. The nurse's legal responsibility is met if an incident report is completed D. No legal action can be brought against the nurse because of the extreme shortage of nursing personnel

B. The nurse is held to the same standards as any nurse with the same experiences and education

A nurse preceptor is working with a student nurse. Which behavior by the student nurse will require the nurse preceptor to intervene? A. The student nurse reviews the patient's medical record. B. The student nurse reads the patient's plan of care. C. The student nurse shares patient information with a friend. D. The student nurse documents medication administered to the patient.

C. The student nurse shares patient information with a friend.

A nurse is accused of professional negligence. In determining if he or she is guilty, a jury would compare the nurse to what standard? A. What a physician would have done in the same situation B. What a well educated lay-person would have done in the same situation C. What a prudent and reasonable nurse would have done in the same situation D. What an attorney with knowledge of the Nurse Practice Act would have done in the same situation

C. What a prudent and reasonable nurse would have done in the same situation

Civil Law

Protects the rights of the individual in our society; encourages fair and equitable treatment among people

Verbally saying something about a person that is damaging to them is an example of _____________ under Quasi-Intentional Tort law

Slander

Supervisor Liability

Supervisors are responsible for the actions of those working under their direction

A patient has just been told that he has approximately six months to live and asks about advance directives. Which statements by the nurse give the patient correct information? (Select all that apply.) A. "You have the right to refuse treatment at any time." B. "If you travel to another state your living will covers your wishes." C. "You might want to consider choosing someone who can make medical decisions for you in the event you cannot make them for yourself." D. "You will be resuscitated at any time to allow you the longest length of survival." E. "We can find someone to explain to you the state's guidelines in setting up an advance directive."

The ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. Living wills are written documents that direct treatment in accordance with a patient's wishes in the event of a terminal illness or condition. With this legal document, the patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Each state providing for living wills has its own requirements for executing the health care proxy or durable power of attorney for health care (DPAHC). This is a legal document that designates a person or persons of one's choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. This agent makes health care treatment decisions based on the patient's wishes. Cardiopulmonary resuscitation (CPR) is an emergency treatment provided without patient consent. Health care providers perform CPR on an appropriate patient unless a do not resuscitate (DNR) order has been placed in the patient's chart. The statutes assume that all patients will be resuscitated unless a written DNR order is found in the chart. Legally competent adult patients can consent to a DNR order verbally or in writing after receiving appropriate information from the health care provider. Differences among the states have been noted regarding advance directives, so the patient should check state laws to see if a state will honor an advance directive that was originated in another state.

Describe Delegation of nursing

by establishing a clear distinction of responsibility for RNs, LVNs, and UAPs (unlicensed assistive personnel). Helps nurses work within there scope of practice and is less likely to get into potentially litigious situations.

What is Malpractice insurance

is a contract between the nurse and the insurance company. Malpractice insurance pro- vides for a defense when a nurse is in a lawsuit involving profes- sional negligence or medical malpractice. As part of the insurance contract, the insurance company pays for any judgment or settle- ment of the case and for the attorney's fees generated in the repre- sentation of the nurse.

What is the Emergency Medical Treatment and Active Labor act (also called the patient dumping act)?

requires all hospitals (public and private) to provide appropriate medial screening within the capacity of the hospital. If an emergency condition exists, the hospital can not discharge or transfer the patient until the condition stabilizes.

Define Natural law

the inherent tendency that humans have to take actions that follow our nature and purpose as human beings; based on the idea to promote good and avoid evil -Aimed at the preservation of society -Basic concepts similar to those found in the deontological ethical system