Legal and Ethical Concepts Nancy Pares RN, MSN Metro Community College.
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Transcript of Legal and Ethical Concepts Nancy Pares RN, MSN Metro Community College.
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NURS 2210 Roles II: Unit II
Legal and Ethical ConceptsNancy Pares RN, MSN
Metro Community College
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http://www.youtube.com/watch?v=n5Zw4ZARvNg
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Laws define and limit relationships Sources of public law
◦ Constitutional◦ Administrative◦ Criminal
Civil Law◦ Contract◦ Tort◦ Protective/reporting
Obj 1: Review legal standards
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State◦ Unintentional torts
Negligence Duty Breach of Duty Injury Causation
Malpractice
Tort law
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Assault Battery False imprisonment
Restraints (OBRA) Invasion of privacy Defamation fraud
Intentional Torts
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Defined by Practice Acts and Standards of Care
RN is legally responsible to ensure that the client receives competent, safe and holistic care.
Best Defense ◦ Actively participate in NNA◦ Attend continuing ed on legal issues◦ Call State Board with any questions about
practice◦ Stay current in hospital policies and procedures
Legal responsibilities of RN
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Unprofessional conduct
Impaired Nurse
Safety◦ Understaffing◦ Mandatory overtime◦ Reassignment
Executing prescribed orders
Responsibilities
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Whistle blowing
Nursing students
Professional liability insurance
Advance Directives
Other legal issues
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DNR orders Euthanasia Wills Pronouncement of Death Care of the deceased Organ donation autopsies
Legal issues related to death
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Ethics◦ Study of rightness of conduct◦ Vs. morality?
Relationship between ethics and legal◦ Ethical opinions reflect individual differences◦ Human behavior and motivation are too complex
to be accurately reflected in law◦ The legal system judges action rather than
intention◦ Laws change according to social and political
influences
Obj 2 Review ethical principles
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Working in a clinic that performs abortions
Honoring a terminally ill client request for no heroic actions
d/c a comotose client life support at the request of the family
Diverting meds from a client for your own use
Ethical vs. Legal…or both
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Autonomy Beneficience Confidentiality Double effect Fidelity Justice Nonmaleficence Paternalism Sanctity of life veracity
Ethical Principles
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Human caring should guide the practice Confidentiality
◦ Privacy, misuse of information Restraints Trust Refusing to provide care Food and fluid
Basics of nursing ethics
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Nancy Cruzan
Terri Shiavo
Preventative ethics
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Practice with compassion and respect Nurses primary commitment is to the
patient Nurse advocates, protects the patient Nurse is responsible and accountable for
actions Nurse must maintain competence and
professional growth Nurse participates in improving health Nurse contributes to profession thru
community, educational and social situations
Code of Ethics (pg 31 Brunner)
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Dx: missed abortion—client hospitalized, D&C was scheduled—client discussed with MD
Nurse administered preop meds then noted that there was no consent signed. Surgery was postponed awaiting MD. MD arrived and had pt sign and husband also-witnessed by RN.
Procedure resulted in perforation, OB attempted to repair—called in general surgeon-- required removal of 1 ft of bowel
Result: likely to have higher incidence of SBO
Case 1
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Was the hospital liable to obtain informed consent?
Issue:
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1985- Nurse Midwife advertised ‘Family Birth’
Hospital Chief of Staff – OB wrote a letter to the administration of two hospitals stating that home deliveries were being done without qualified supervision.
Same MD confronted nurse midwife at L&D Nurse midwife was prohibited from the
hospital.
Case 2
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Was the slander actionable?
Issue
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Client with fx leg—cast applied; orders to have nursing check hourly and call with concerns
Charting notes gap from 4am to 830 am. MD examines at 830—compartment
syndrome and identification of tissue death—leg amputated
Case 3
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Was documentation considered substandard and cause for patient to suffer injury?
Issue
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Female patient admitted to LTC—noted large diamond ring and informed that she should not keep in her room. Pt kept the ring.
Ring disappeared—investigation proved fruitless—thru a ‘tip’ a nurse aid was implecated—arrested and pled guilty
Case 4
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Was the nursing home responsible for the property damage sustained by the resident?
Issue:
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Male was admitted to psych unit on Nov 21due to being a threat to himself and others. Meeting held on Nov 23 determined that he was able to be released. (Thanksgiving holiday)
Male entered house on Dec 5 and killed one individual and wounded two others, then shot himself.
Case 5
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Was the institution liable for discharging the patient and the subsequent deaths?
Issue