3) What is malpractice? 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. It states that health care providers can use either the cardiopulmonary or the whole-brain definition to determine death. When a patient’s death has occurred under suspicious circumstances or if the patient died within 24 hours of admission to a health care facility, the decision to conduct a postmortem examination is made by the medical examiner (Autopsy Consent, 1998). The opposite of an intentional tort-something that is done on accident that seriously injures or kills another person For example, if a person steals something they can be criminally prosecuted for theft, and found liable in civil court for the tort of conversion. Negligence: ... Common Law Examples: Definition. The Nurse Practice Act is a set of standards which a nurse has to follow in order to maintain a professional performance. * Trust vs. Mistrust (Birth to 1 yr) An individual who is at least 18 years of age has the right to make an organ donation (defined as a “donation of all or part of a human body to take effect upon or after death”). Unintentional tort is negligence or malpractice. The nurse’s signature witnessing the consent means that the client voluntarily gave consent, that the client’s signature is authentic, and that the client appears to be competent to give consent. See also: tort The key component is the patient’s consent. It identifies advantages for plaintiffs who plead intentional tort claims, including onus of proof, causation, remoteness, the quantum of compensatory damages and the availability of aggravated and exemplary damages. Torts can either be intentional (performed purposefully) or negligent (caused by a lack of reasonable care). The nurse should be licensed, have knowledge, be experienced and good attitude. Assault, battery, false imprisonment….these are all examples of intentional torts. The United Network for Organ Sharing (UNOS) has a contract with the federal government and sets policies and guidelines for the procurement of organs. Liability for improper or unlawful restraint and for patient injury from unprotected falls lies with the nurse and the health care institution. Some hospitals are also now using commercially published procedural textbooks to reference the general policies and procedures of the institution. (issues in nursing) How would the student nurse describe a quasi-intentional tort occurring during the practice of nursing a- it is a willful act violating a client's rights b- it is a civil wrong made against a person or property c- it is an act that lacks intent but involves volitional action HIPAA privacy standards have raised awareness of the need for health care professionals to provide confidentiality and privacy. 14) How does the nurse provide care to grieving families? b) Describe specifically what happened in concise, objective terms. Value clarification is an approach to individual appraisal of value. • List the elements needed to prove negligence. The legal guidelines that nurses follow come from statutory law, regulatory law, and common law. The nurse observes the response to loss and then attempts to identify the family’s strengths in dealing with it. Intentional Torts. • Describe the nursing implications associated with legal issues that occur in nursing practice. Even though nurses do not intend to injure patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards. * Intrusion on seclusion Intentional tort: An intentional tort is a legal wrongdoing that is deliberate. If health care workers follow the directions of the living will, they should be immune from liability (, Health care information privacy is also protected by standards set by the Health Care Financing Administration (HCFA) for hospitals and health care providers who participate in Medicare and Medicaid (, Many legal issues surround the event of death, including a basic definition of the actual point at which a person is legally dead. * Receive appropriate supportive therapy in relation to med therapy You’re sitting at a table arguing with your neighbor. Log In or. Intentional torts are willful acts that violate another’s rights such as assault, battery, and false imprisonment. It defines the legal actions a nurse can take. DQ-3 What is the difference between an intentional and a quasi-intentional tort? Development: implies a progressive and continuous process of change leading to a state of organized and specialized functional capacity, for example, a child’s progressions from rolling over to crawling to walking and developmental changes (Haywood, 1993) Describe the nursing implications associated with legal issues that occur in nursing practice. A patient must authorize the release of information and designate to whom the health care information may be released. The use of physical restraints is a safety strategy that has been used in hospitals and long-term care settings to protect patients from injury. Assault and battery give rise to criminal and civil liability. Negligence : Negligence is the failure to act as a reasonable person would. There are two classifications of crimes. The court held that the husband and wife stated a claim for invasion of privacy and that, even though the in vitro fertilization program was of public interest, the identity of the plaintiffs was a private matter (YG v Jewish Hospital, 1990). Nurses, especially those employed in community health settings, need to understand public health laws. Look on pages 158-159 for the comparison. Other witnesses: Factual witnesses, both neutral and biased, including family members on the plaintiff’s side and other medical personnel (e.g., nurses) on the defendant’s side, are deposed to obtain information and their version of the case. An example of a regulatory law is the requirement to report incompetent or unethical nursing conduct to the State Board of Nursing. The complexity of the healthcare delivery system today is such that the roles and responsibilities of the nurse are constantly expanding. Define legal aspects of nurse-patient, nurse–health care provider, nurse-nurse, and nurse-employer relationships. Defamation of character A nurse tells a coworker that she believes a client has been unfaithful to the spouse. * The plaintiff was harmed. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. Describe the legal responsibilities and obligations of nurses regarding the following federal statutes: Americans with Disabilities Act (ADA), Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Patient Self-Determination Act (PSDA). Health care providers agree to strive for justice in health care. * Initiative vs. Negligence is defined as the failure to use proper care, which results in damage or injury to another. * Phallic or Oedipal complex (3 to 6 yrs) -sexual organ gains prominence. He believed that the maturation of bodily functions was linked with expectations of society and culture in which the person live. Although the HIPAA does not require such measures as soundproof rooms in hospitals, it does mean that nurses and all health care providers need to avoid discussing patients in public hallways and provide reasonable levels of privacy in communicating with and about patients in any manner. The tort of nuisance, for example, involves strict liability for a neighbor who interferes with another's enjoyment of his real property. As patient care practice innovations and new health care technologies emerge, the principles of negligence and malpractice liability are being applied to challenging new situations. There are also cases in which information about a scientific discovery or a major medical breakthrough is newsworthy, as with the first heart transplant case or the first artificial heart recipient. d) Report any measures taken by oneself, other nurses, or physicians at the time of the incident. CHAPTER 46. Each state providing for living wills has its own requirements for executing them. * Integrity vs. The State Board of Nursing suspends or revokes a license if a nurse’s conduct violates provisions in the licensing statute based on administrative law rules that implement and enforce the statute. As a standard in ethics, autonomy represents an agreement to respect another’s right to determine a course of action. * The breach of duty caused the harm. No actual contact is necessary. That fear is something we expect to never have to feel, and that fear creates the basis for the tort of assault.An assault is an intentional, unexcused act that creates in another person a reasonable apprehension or fear of immediate harmful or offensive contact. 11) What are the physiological signs and symptoms of death? I) Denial: individuals act as though nothing has happened and may refuse to believe that a loss has occurred. State legislatures enact statutes under health codes, which describe the reporting laws for communicable diseases and school immunizations and those intended to promote health and reduce health risks in communities. Some State Boards of Nursing define the registered nurse’s responsibilities specifically and develop position statements and guidelines to help licensed nurses delegate safely to NAP (National Council of State Boards of Nursing [NCSBN], 2005). There are 3 steps for value clarification: I) Choosing one’s beliefs and behaviors. Libel is the written defamation of character (e.g., charting false entries in a medical record). The emergency department physician applied a cast with insufficient padding. Torts are classified as intentional, quasi-intentional, or unintentional. III) The person giving the consent must thoroughly understand the procedure, its risks and benefits, and alternative procedures. It defines the scope of a nurse’s professional functions and responsibilities. What does the Food and Drug Administration do? In addition to federal statutes, the ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. Nurses help organizations protect patients’ rights to confidentiality. An autopsy or postmortem examination may be requested by the patient or patient’s family, as a part of an institutional policy; or it may be required by law. To administer medication safely to clients certain cognitive skills are essential. Examples of such laws include malpractice, invasion of privacy, assault, battery, libel, slander, and false imprisonment. One of the first and most important cases to discuss a nurse’s liability was Darling v Charleston Community Memorial Hospital. This, along with good judgment and sound decision making, ensures that your patients receive safe and appropriate nursing care. For example, if a nurse tells people erroneously that a client has a venereal disease, and the disclosure affects the client’s business, the nurse could be held liable for slander. • Explain the legal concept of standard of care. Three states (Louisiana, Minnesota, and Vermont) have enacted “failure-to-act” laws that make it a crime not to provide Good Samaritan care (Dachs and Elias, 2008). In many states adults sign the back of their driver’s license, indicating consent to organ donation. V) Acceptance: Physiological reactions cease, and social interactions resume. n. French for wrong, a civil wrong, or wrongful act, whether intentional or accidental, from which injury occurs to another. However, the Centers for Medicare and Medicaid Services (2007) and The Joint Commission (2011a) have set standards for reducing the use of restraints in health care settings and for using them only with extreme caution. Which examples mentioned by the nursing student need correction? 8) What are the stages of death and dying according to Kubler-Ross? Christian Scientists may refuse medical treatment based on religious beliefs, and Jehovah’s Witnesses may accept medical treatment but may refuse blood transfusions based on personal religious beliefs. * Assault -verbal or offensive contact i.e. V) Fidelity: refers to the agreement to keep promises. Pharmacodynamics: the study of how long a drug acts on a living organism, including pharmacologic response and the duration and magnitude of response observed, relative to the concentration of the drug at the active site in the organism. Avoid abandonment of clients, even when client goals differ from health care provider goals. The third classification of tort is the unintentional tort, which includes negligence or malpractice. 3. explain a recent case involtional or quasi-intentional torts? 4. analyze the ethical implications of committing an intentioal or quasi- intentional tort? Unintentional Tort: A type of unintended accident that leads to injury, property damage or financial loss. Involuntary detention occurs when an individual files with the court within 96 hours of the patient’s initial detention. For example, if a nurse assesses a client for pain and then offers a plan to manage the pain, the standard of fidelity encourages monitoring the client’s response to the plan. Donors need to make the gift in writing with their signature. Which examples mentioned by the nursing stud… Get the answers you need, now! Growth refers to the quantitative changes that can be measured and compare to norms. In addition to the physical pain that accompanies being strangled by a coworker, the victim may also feel a great deal of fear. They are based on values of informed consent, patient autonomy over end-of-life decisions, truth telling, and control over the dying process. Erickson defined 8 stages of life, first five coinciding with Freud’s stages. This stage provides the opportunity to work trough the loss and to begin solving problems. So, if a patient flat out refuses an injection, and you still give it to them, that’s assault…which leads us into the last thing we’re gonna talk about, which is criminal and civil law. If a patient does not have a DNR order, health care providers need to make every effort to revive the patient. The positions of these two national organizations are not contradictory and require nurses to approach a patient’s end of life with openness to listening to the patient’s expressions of fear and to attempt to control the patient’s pain. These changes can be measured quantitatively but are more distinctly measured in qualitative changes. Hearings for suspension or revocation of a license do not occur in court. 1. explain the intent required to commot an intentional tort? An unconscious patient has not been falsely imprisoned (Guido, 2010). The tort of invasion of privacy protects the patient’s right to be free from unwanted intrusion into his or her private affairs. Parties’ depositions: The plaintiff and defendants (physician, nurse, hospital personnel) are almost always deposed. Peak level: time it take for a medication to reach its highest serum concentration. Involving the family in the care of the dying client may help the family feel a sense of participation and decrease their sense of helplessness during the dying process. Usual questions concern witnesses, insurance experts, and which health care providers the plaintiff has seen before and after the incident. This article explores the potential application of intentional torts claims in a medical context in light of recent case law. 7) What are the nurse’s responsibilities and actions after finding a patient injured from a fall? * Assault -verbal or offensive contact i.e. Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. Intentional Torts Intentional torts, on the other hand, occur when a person intentionally acts in a certain way that leads to another person's injury. Any health care professional who does not report suspected child abuse or neglect may be liable for civil or criminal legal action. 17) Outline the various types of drugs orders. The ADA regulations protect the privacy of infected people by giving individuals the opportunity to decide whether to disclose their disability. The man’s toes became swollen and discolored, and he developed decreased sensation. The Florence Nightingale Pledge Be familiar with the policies and procedures of your employing institution regarding organ donation. In general, courts define negligence in car accident cases and other negligence cases as that degree of care that an ordinarily careful and prudent person would use under the same or similar circumstances. Quasi intentional torts include intrusion of privacy and defamation. b) Nurses in charge carry a set of keys (or a special computer entry code) for narcotics cabinet. The defendant. Torts are classified as intentional, quasi-intentional, or unintentional. 2. DNR means “do not resuscitate” or “no code.” Documentation that the health care provider has consulted with the patient and/or family is required before attaching a DNR order to the patient’s medical record (Guido, 2010).The health care provider needs to review DNR orders routinely in case the patient’s condition demands a change. Be familiar with the policies of your institution complying with the act. threaten to give injection w/o consent. The procedure, however, may require long periods of pain and suffering. b) prn Orders: the prescriber may order a medication when a client requires it. List the elements needed to prove negligence. Common law results from judicial decisions made in courts when individual legal cases are decided. Answer: The nurse admits or denies each allegation in the petition. Is coming to terms with the situation, rather than submitting to resignation or hopelessness. HIPAA violations have civil and criminal sanctions. Although the physician was held liable for incorrectly applying the cast, the nursing staff was also held liable for failing to adhere to the standards of care for monitoring and reporting the patient’s symptoms. The American Nurses Association (ANA) (2008) has held that nurses’ participation in assisted suicide violates the code of ethics for nurses. Id- primitive part, basic instinctual impulses driven to achieve pleasure. In this case: The person intended to make a fist and slam it into the victim's face; The person also intended to harm the victim; This law can be tricky, however. Assault is any action that places a person in apprehension of a harmful or offensive contact without consent. Most states have adopted the, An individual’s right to privacy sometimes conflicts with the public’s right to know. • Describe the nurse’s role regarding a “do not resuscitate” (DNR) order. b) Reduction in body temperature with loss of skin elasticity (algor mortis). When supporting the grieving family, the nurse must acknowledge their grief, understand the value of the client to the family, and assist them through the dying process. c) During institutions change of shift the nurse going off duty counts all the narcotics with the nurse coming on duty. 4) The right route. II) Prizing one’s beliefs and behaviors. For example, treating clients at greater risk firt. If the answer is negative, the health care provider discusses the option to make or refuse an organ donation and places such documentation in the patient’s medical record. Part 2 . Hospice Care: generally clients that are accepted into hospice have less than 6 months to live and are considered terminal. Medical records: The defendant obtains all of the plaintiff’s relevant medical records for treatment before and after the incident. Realize mom/parent is separate from self. CPR is an emergency treatment provided without patient consent. Health care providers perform CPR on an appropriate patient unless there is a DNR order in the patient’s chart. Four factors must be verified for a consent to be valid: I) The person giving consent must be mentally and physically competent and be legally an adult (over 18 yrs of age or emancipated). Federal medication law has extended and refined controls on medication sales and distribution: medication testing, naming and labeling: and the regulation of controlled substances. Guilt (3 to 6yrs) Nurse is held accountable for all actions that are performed incorrectly. Courts upheld the right to refuse medical treatment in the 1986 Bouvia v Superior Court case. Gangrene developed, and the man’s leg was amputated. What are side effects? 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