Nurse practice act

The state Nurse Practice Act defines nursing practice and establishes standards for nurses in your state. Ignorance of your state’s Nurse Practice Act is never a valid defense against any legal proceeding regarding your license.

State board of nursing

All states and provinces have examining councils that provide nursing examinations for licensure and review complaints that can lead to revocation of a license.

Disciplinary process and action

The disciplinary process is based on law and follows the rules of law. See Box 12-3 for the steps of a disciplinary process.

Nursing standard of care

The nursing standard of care is your guideline for good nursing care. The phrase “You are held to the nursing standard of care” has important legal implications. The standard is based on what an ordinary, prudent nurse with similar education and nursing experience would do in similar circumstances. Resources for the nursing standard of care are found in Box 12-4. Note that unit routine (“I know you studied how to do this in nursing school, but this is how we do it here.”) is not on the list.

The legal system in both the United States and Canada originates from English common law. Common law is called judge-made law because it originates in the courts. Common law is one way of establishing standards of legal conduct and is useful in settling disputes. Once the judge has made a decision, this decision sets the precedent for a ruling on a case with similar facts in the future. Informed consent and a patient’s right to refuse treatment are examples of common law.

Statutory law is law developed by the legislative branch of the state and the U.S. Congress of the federal government. The Nurse Practice Act, which governs the practice of nursing, is an example of a statutory law. State boards of nursing can make nursing laws as long as the items in their laws do not conflict with any federal statutes.

Criminal versus civil action

The two classifications of legal action are criminal action and civil action. A criminal action involves people and society as a whole. It involves relationships between individuals and the government. A criminal action is classified as follows:

Guilt on the part of the nurse needs to be established by producing proof beyond a reasonable doubt. Regardless of the outcome of the criminal case, when a criminal case is completed, it is possible to be sued in a civil court.

A civil action protects individual rights and results in payment of money to the injured person (e.g., a back injury was sustained during a fall because spilled urine was not wiped up. This injury caused the patient additional treatment time, including physical therapy, pain, suffering, and loss of time from work). A civil action involves a relationship between individuals and the violation of those rights. A tort is a civil wrong. The two kinds of torts are intentional and unintentional, which are described as follows:

Guilt on the part of the nurse can be established by a preponderance (majority) of the evidence. Table 12-1 provides a comparison of criminal and civil law.

Intentional torts

Tort law is based on the premise that in the course of relationships with one another there is a general duty to avoid injuring one another. A tort is a wrong or injury done to someone that violates his or her rights.

Intentional torts require a specific state of mind—that is, that the nurse intended to do the wrongful act. Assault and battery, false imprisonment and use of restraints, defamation that includes both libel and slander (discussed later), and physical and emotional abuse are examples of intentional torts. Not all insurance companies cover intentional torts in their malpractice insurance policies, so you should check your policy.

Assault and Battery

Assault is an unjustified attempt or threat to touch someone. Battery means to cause physical harm to someone. When a patient refuses a treatment or medication, forcing the patient to take medication could result in an assault and battery charge against you. The patient gives implied consent (permission) for certain routine treatments when entering the institution. Patients retain the right to refuse any treatment verbally and may leave the institution when they choose, unless they are there for court-ordered treatment. Nurses can also protect themselves from assault by a patient but can use only as much force as is considered reasonable for self-protection.

Treating a patient without consent is battery even if the treatment is medically beneficial. A physician might go to the court to attempt to get a court order to allow a blood transfusion for someone who opposes it on religious grounds. If the patient is fully competent, is not pregnant, and has no children, the court is likely to rule for the patient even if a blood transfusion would save his or her life. When faced with a similar situation, the practical/vocational nurse respects the patient’s belief system and notifies the supervisor for further advice or interpretation.

False Imprisonment and Use of Restraints

False imprisonment is keeping someone detained against his or her will. It can include the use of restraints or seclusion in a room without cause and without a physician’s order. Restraint by verbal threats of physical harm is also included in this category. Chemical restraint (with medication) is defined as administering a PRN medication with a sedating side effect every 4 hours to keep the patient tired and in his or her room. In this situation,the intent is to keep the patient quiet and out of the way. The intended use of the medication has been circumvented to meet the nurse’s need.

Defamation

Defamation means damage to someone’s reputation through false communication or communication without their permission. Libel and slander are included in this category and are described as follows:

• Libel is defamation through written communication or pictures.

• Slander is defamation by verbalizing untrue or private information (gossip) to a third party.

Only gold members can continue reading. Log In or Register to continue

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)

Related

Related posts:

1. Critical Thinking: A Lifelong Journey
2. Time Management: Making Time Work for You
3. The NCLEX-PN® Examination
4. Assertiveness: Your Responsibility

Stay updated, free articles. Join our Telegram channel

Join