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Page 1: Nursing Jurisprudence
Page 2: Nursing Jurisprudence

NURSING NURSING JURISPRUDENCEJURISPRUDENCE

Page 3: Nursing Jurisprudence

NURSING JURISPRUDENCENURSING JURISPRUDENCE department of law which department of law which

comprise all legal rules and comprise all legal rules and principles affecting the practice principles affecting the practice of nursing.of nursing.

NURSING LEGISLATIONNURSING LEGISLATION the making of laws, or the body the making of laws, or the body

of laws already affecting the of laws already affecting the practice of nursing.practice of nursing.

Page 4: Nursing Jurisprudence

LAWLAW

a rule of civil conduct a rule of civil conduct prescribed by the supreme prescribed by the supreme power in a state commanding power in a state commanding what is right and prohibiting what is right and prohibiting what is wrong.what is wrong.

Sum total of rules and Sum total of rules and regulations by which society is regulations by which society is governedgoverned

Page 5: Nursing Jurisprudence

TYPES OF LAWTYPES OF LAW

PRIVATE OR CIVIL LAWPRIVATE OR CIVIL LAWbody of law that deals with body of law that deals with relationship among private relationship among private individualsindividuals

PUBLIC LAWPUBLIC LAWbody of law for the welfare of the body of law for the welfare of the general public; relationship general public; relationship between individuals and the between individuals and the government and government government and government agenciesagencies

Page 6: Nursing Jurisprudence

LEGAL RIGHTLEGAL RIGHT a claim which can be enforced a claim which can be enforced

by legal means against a by legal means against a person whose duty is to respect person whose duty is to respect it. it.

COURTCOURT An agency in the government An agency in the government

wherein the administration of wherein the administration of justice is delegated.justice is delegated.

Page 7: Nursing Jurisprudence

COURT MECHANISMCOURT MECHANISM

LAWSUIT- proceeding in court LAWSUIT- proceeding in court for a purpose.for a purpose.

Purpose:Purpose:

EEnforce a right nforce a right

RRedress a wrongedress a wrong

Page 8: Nursing Jurisprudence

QUESTIONQUESTION

If you think that a person has done If you think that a person has done something seriously wrong to you, the something seriously wrong to you, the correct action to do get redress for the correct action to do get redress for the injury received is to:injury received is to:

A. systematically plan on how to have a A. systematically plan on how to have a vindication for the damage donevindication for the damage done

B. file a lawsuit against the person for B. file a lawsuit against the person for damagedamage

C. hire someone to take revenge for youC. hire someone to take revenge for you

D. nothing, just forget about itD. nothing, just forget about it

Page 9: Nursing Jurisprudence

PARTIES TO A CASEPARTIES TO A CASE

Complainant VS Defendant: Complainant VS Defendant: Civil caseCivil case

Plaintiff VS Accused: Criminal Plaintiff VS Accused: Criminal casecase

Witness- an individual held upon Witness- an individual held upon to give necessary details either to give necessary details either for the accused or against the for the accused or against the accusedaccused

Page 10: Nursing Jurisprudence

The person who institutes legal The person who institutes legal proceeding is called:proceeding is called:

A. PlaintiffA. Plaintiff

B. RespondentB. Respondent

C. DefendantC. Defendant

D. AccusedD. Accused

QUESTIONQUESTION

Page 11: Nursing Jurisprudence

QUESTIONQUESTION

It is promulgated for the It is promulgated for the common good by one who has common good by one who has legitimate authority:legitimate authority:

A. JurisprudenceA. Jurisprudence

B. DilemmaB. Dilemma

C. LawC. Law

D. EthicsD. Ethics

Page 12: Nursing Jurisprudence

QUESTIONQUESTION

A hospital filed a case of A hospital filed a case of damages against a nurse for damages against a nurse for breach of contract. Who is the breach of contract. Who is the nurse in the case?nurse in the case?

A. complainantA. complainant

B. accusedB. accused

C. defendantC. defendant

D. plaintiffD. plaintiff

Page 13: Nursing Jurisprudence

STATUTE OF LIMITATIONSSTATUTE OF LIMITATIONS

Refers to the length of time Refers to the length of time following the event during which following the event during which the plaintiff may file a suit.the plaintiff may file a suit.

Example: Example:

negligence- filed within 2-3 negligence- filed within 2-3 years from occurrence.years from occurrence.

Page 14: Nursing Jurisprudence

DUE PROCESSDUE PROCESS A fair and orderly process which aims A fair and orderly process which aims

to protect and enforce a person’s to protect and enforce a person’s right.right.

FUNDAMENTAL REQUIREMENTS FUNDAMENTAL REQUIREMENTS OF DUE PROCESS:OF DUE PROCESS:

1. Right to be informed1. Right to be informed

2. Right to remain silent2. Right to remain silent

3. Right to competent counsel3. Right to competent counsel

4. No use of violence, threat, torture4. No use of violence, threat, torture

5. Right to know the witness face to 5. Right to know the witness face to faceface

Page 15: Nursing Jurisprudence

PHASES OF DUE PROCESSPHASES OF DUE PROCESS

PRE-TRIAL- PRE-TRIAL- eliminate matters eliminate matters not in dispute, agree on issues not in dispute, agree on issues or settle procedural matters.or settle procedural matters.

TRIAL-TRIAL- facts are presented and facts are presented and determined; law applied at the determined; law applied at the end.end.

Page 16: Nursing Jurisprudence

WRITTEN ORDERS OF WRITTEN ORDERS OF COURTCOURT WRIT- WRIT- legal notes from courtlegal notes from court

SUBPOENA- SUBPOENA- an order in courtan order in court Duces tecum (papers)Duces tecum (papers) bring bring

documents, objects, materials, chart documents, objects, materials, chart to courtto court

Ad testificandum (person) Ad testificandum (person) testify as testify as witness at a specified time and placewitness at a specified time and place

SUMMONSUMMON- a writ commanding an - a writ commanding an authorized person to notify a party to authorized person to notify a party to appear in court to answer a complaint appear in court to answer a complaint made against him.made against him.

Page 17: Nursing Jurisprudence

WARRANT- WARRANT- a a writing from a writing from a competent authority in pursuance of competent authority in pursuance of law, directing the doing of an act law, directing the doing of an act addressed to a person competent to addressed to a person competent to do it do it

Warrant of arrestWarrant of arrest-- a court order to a court order to arrest or detain a personarrest or detain a person

Search warrant-Search warrant- a court order to a court order to search for propertiessearch for properties

Page 18: Nursing Jurisprudence

QUESTIONQUESTION

A process whereby the BON only A process whereby the BON only compel the personal attendance of a compel the personal attendance of a witness to bring with him to the court witness to bring with him to the court books, papers and the like to books, papers and the like to elucidate the matters in issue:elucidate the matters in issue:

A. WarrantA. Warrant

B. SubpoenaB. Subpoena

C. Subpoena duces tecumC. Subpoena duces tecum

D. SummonsD. Summons

Page 19: Nursing Jurisprudence

LAWS THAT PROMOTE THE LAWS THAT PROMOTE THE WELFARE AND WELL-BElNG WELFARE AND WELL-BElNG OF NURSESOF NURSES

P.D. 442- Labor Code P.D. 442- Labor Code

Defines among other things, hours of Defines among other things, hours of work, contract and nurse staffing in work, contract and nurse staffing in industrial clinicsindustrial clinics

P.D. 807-P.D. 807- Civil Service LawCivil Service Law

Provide for the recruitment and Provide for the recruitment and selection of employees in government selection of employees in government service; qualification standards; service; qualification standards; personnel evaluation system; and personnel evaluation system; and personnel disciplinepersonnel discipline

Page 20: Nursing Jurisprudence

R.A. 7305- R.A. 7305- Magna Carta for Public Magna Carta for Public Health WorkersHealth Workers

Has provisions on benefits, rights and Has provisions on benefits, rights and responsibilities of public health responsibilities of public health workersworkers

R.A. 8344 “No Deposit Policy”R.A. 8344 “No Deposit Policy”

Prohibits hospitals and clinics from Prohibits hospitals and clinics from demanding advance payments/cash demanding advance payments/cash deposits before patients are admitted deposits before patients are admitted or treated or treated

Page 21: Nursing Jurisprudence
Page 22: Nursing Jurisprudence

LEGAL CONCEPTS AND LEGAL CONCEPTS AND ISSUES IN NURSINGISSUES IN NURSING

LIABILITY: LIABILITY: is an obligation or debt is an obligation or debt that can be enforced by lawthat can be enforced by law

A person who is liable for malpractice A person who is liable for malpractice is usually required to pay for is usually required to pay for damages.damages.

DAMAGES: DAMAGES: refer to compensation in refer to compensation in money recoverable for a loss of money recoverable for a loss of damage damage

Page 23: Nursing Jurisprudence

PROFESSIONAL PROFESSIONAL NEGLIGENCENEGLIGENCE

Negligence Negligence – failure to do – failure to do something which a reasonable & something which a reasonable & prudent person should have prudent person should have done. done.

2 types: 2 types:

1. Commission – wrong doing1. Commission – wrong doing

2. Omission – total neglect of 2. Omission – total neglect of care – didn’t do anything care – didn’t do anything

Page 24: Nursing Jurisprudence

ELEMENTS OF ELEMENTS OF NEGLIGENCENEGLIGENCE

4D’S4D’S

DDuty for nurseuty for nurse

DDereliction (breach of duty)ereliction (breach of duty)

DDamages as resultamages as result

DDirect result (injury, harm or irect result (injury, harm or death)death)

Page 25: Nursing Jurisprudence

OR…OR…

AAn injury incurred within then injury incurred within the

BBreadth of duty of the nurse readth of duty of the nurse wherewhere

CCause of injury is the failure to ause of injury is the failure to perform theperform the

DDuty!uty!

Page 26: Nursing Jurisprudence

SPECIFIC EXAMPLESSPECIFIC EXAMPLES

Burns resulting from hot water bags, heat Burns resulting from hot water bags, heat lamps, vaporizers, sitz bathlamps, vaporizers, sitz bath

Objects left inside the patient’s body; Objects left inside the patient’s body; sponges suction tipssponges suction tips

Falls of the elderly, confused, unconscious, Falls of the elderly, confused, unconscious, sedated patients sedated patients

Falls of children whose bed rails were not Falls of children whose bed rails were not pulled up and lockedpulled up and locked

Mistaken identity- drug given to the wrong Mistaken identity- drug given to the wrong patientpatient

Wrong medicine, wrong concentration, Wrong medicine, wrong concentration, wrong route, wrong dosewrong route, wrong dose

Defects in the equipment Defects in the equipment

Page 27: Nursing Jurisprudence

QUESTIONQUESTION Which of the following situations would Which of the following situations would

possibly cause a nurse to be sued due to possibly cause a nurse to be sued due to negligence? negligence? A. Nurse gave a client wrong medication, A. Nurse gave a client wrong medication, and an hour later, client complained of and an hour later, client complained of dyspnea dyspnea B. While preparing a medication, the nurse B. While preparing a medication, the nurse notices that instead of 1 tablet, she put two notices that instead of 1 tablet, she put two tablets into the client’s medicine cup tablets into the client’s medicine cup C. As the nurse was about to administer C. As the nurse was about to administer medication, the client questioned why the medication, the client questioned why the medication is still given when in fact the medication is still given when in fact the physician discontinued it. physician discontinued it. D. Nurse administered 2 tablets of D. Nurse administered 2 tablets of analgesic instead of 1 tablet as prescribed. analgesic instead of 1 tablet as prescribed. Patient noticed the error and complained. Patient noticed the error and complained.

Page 28: Nursing Jurisprudence

QUESTIONQUESTION Wilfred, 30 years old male, was brought to the Wilfred, 30 years old male, was brought to the

hospital due to injuries sustained from a hospital due to injuries sustained from a vehicular accident. While being transported to vehicular accident. While being transported to the X-ray department, the straps accidentally the X-ray department, the straps accidentally broke and the client fell to the floor hitting to broke and the client fell to the floor hitting to his head. In this situation, the nurse is: his head. In this situation, the nurse is:

A. not responsible because of the doctrine of A. not responsible because of the doctrine of respondent superior respondent superior

B. free from any negligence that caused harm B. free from any negligence that caused harm to pt.to pt.

C. liable along with the employer for the use of C. liable along with the employer for the use of a defective equipment that harms the client a defective equipment that harms the client

D. totally responsible for the negligence D. totally responsible for the negligence

Page 29: Nursing Jurisprudence

QUESTIONQUESTION

Which of the following statements if made by Which of the following statements if made by the nurse, would you consider him/her as a the nurse, would you consider him/her as a prudent nurse?prudent nurse?

A. careful giving of medication in a central A. careful giving of medication in a central lineline

B. very cautiously asks supervision all the B. very cautiously asks supervision all the timetime

C. follows the doctor’s order even when she C. follows the doctor’s order even when she thinks it is wrongthinks it is wrong

D. questions wrong order of the doctorD. questions wrong order of the doctor

Page 30: Nursing Jurisprudence

QUESTIONQUESTION

Which of the following actions by a Which of the following actions by a nurse would be considered nurse would be considered negligence?negligence?A. Playing cards with an 8 y/o boy A. Playing cards with an 8 y/o boy with diabeteswith diabetesB. Instructing a 6 y/o asthmatic to B. Instructing a 6 y/o asthmatic to blow on a pin wheelblow on a pin wheelC. Massaging the abdomen of a 5 C. Massaging the abdomen of a 5 y/o with Wilm’s tumory/o with Wilm’s tumorD. Obtaining a blood test on a 6 day D. Obtaining a blood test on a 6 day old infantold infant

Page 31: Nursing Jurisprudence

QUESTIONQUESTION

A nurse may be found negligent if:A nurse may be found negligent if:

1. a patient is injured1. a patient is injured

2. the nurse did not follow the 2. the nurse did not follow the standardstandard

3. failure to do the duty3. failure to do the duty

4. the injury incurred by the pt. is 4. the injury incurred by the pt. is foreseeableforeseeable

A. 1,2,3A. 1,2,3 C. 1,2,4C. 1,2,4

B. All of the aboveB. All of the above D. 2,3,4D. 2,3,4

Page 32: Nursing Jurisprudence

QUESTIONQUESTION

Monica shared with the interviewer Monica shared with the interviewer her most recent experiences about a her most recent experiences about a restless pediatric patient whom she restless pediatric patient whom she puts up the side rails of the bed to puts up the side rails of the bed to prevent accidental falls. Which of the prevent accidental falls. Which of the following attributes is shown by following attributes is shown by Monica? Monica? A. Resourcefulness A. Resourcefulness B. PrudenceB. PrudenceC. Honesty C. Honesty D. Reliability D. Reliability

Page 33: Nursing Jurisprudence

DOCTRINES OF DOCTRINES OF NEGLIGENCENEGLIGENCE

1. RES IPSA LOQUITOR1. RES IPSA LOQUITOR- “the things speak for itself” - “the things speak for itself” - the injury is enough proof of - the injury is enough proof of negligencenegligence

2. RESPONDEAT SUPERIOR2. RESPONDEAT SUPERIOR- - Let the master answer for the acts Let the master answer for the acts of the subordinateof the subordinate- The liability is expanded to - The liability is expanded to include the master as well as the include the master as well as the employeeemployee

Page 34: Nursing Jurisprudence

3. 3. FORCE MAJEUREFORCE MAJEURE

- - Irresistible force; unforeseen or Irresistible force; unforeseen or inevitable eventinevitable event

- No person shall be responsible for - No person shall be responsible for those events which cannot be those events which cannot be foreseenforeseen

Ex. Flood, fire, earthquakeEx. Flood, fire, earthquake

INCOMPETENCEINCOMPETENCE: : lack of ability, lack of ability, legal qualifications or fitness to legal qualifications or fitness to discharge the required dutydischarge the required duty

Page 35: Nursing Jurisprudence

QUESTIONQUESTION

One of the important conditions One of the important conditions that must be present in a negligent that must be present in a negligent act to be considered as force act to be considered as force majeure is:majeure is:

A.A. The nurse is unable to predict the The nurse is unable to predict the possible occurrence of the action possible occurrence of the action hence, she cant prevent ithence, she cant prevent it

B.B. The injury is within the domain of The injury is within the domain of nursing practicenursing practice

C.C. The patient did not voluntarily The patient did not voluntarily participate in the actionparticipate in the action

D.D. The superior is also accountable for The superior is also accountable for the actionthe action

Page 36: Nursing Jurisprudence

QUESTIONQUESTION

When a staff nurse gives the wrong When a staff nurse gives the wrong medication to her patient, the head medication to her patient, the head nurse and supervisor are also nurse and supervisor are also made responsible for the error. made responsible for the error. This is based on what doctrine?This is based on what doctrine?

A.A. Respondent superiorRespondent superior

B.B. Good Samaritan ActGood Samaritan Act

C.C. Res ipsa loquiturRes ipsa loquitur

D.D. Force majeureForce majeure

Page 37: Nursing Jurisprudence

QUESTIONQUESTION

When a nurse causes an injury When a nurse causes an injury to the patient and the injury to the patient and the injury caused becomes the proof of caused becomes the proof of the negligent act, the presence the negligent act, the presence of the injury is said to exemplify of the injury is said to exemplify the principle of: the principle of: A. Force majeure A. Force majeure B. Respondeat superior B. Respondeat superior C. Res ipsa loquiturC. Res ipsa loquiturD. Holdover doctrine D. Holdover doctrine

Page 38: Nursing Jurisprudence

MALPRACTICEMALPRACTICE

Doing acts or conducts that are not Doing acts or conducts that are not authorized or licensed or competent authorized or licensed or competent or skilled to perform, resulting to or skilled to perform, resulting to injuries or non-injurious injuries or non-injurious consequences consequences

Stepping beyond one’s authorityStepping beyond one’s authority Negligent act committed in the Negligent act committed in the

course of professional performancecourse of professional performance RN exceeding the scope of nursing RN exceeding the scope of nursing

practice & does an MD’s job.practice & does an MD’s job.

Page 39: Nursing Jurisprudence

ELEMENTS OF ELEMENTS OF MALPRACTICEMALPRACTICE

DDuty of the nurseuty of the nurse

DDereliction or breach of dutyereliction or breach of duty

DDirect result (injury or harm)irect result (injury or harm)

DDamagesamages

EExceeds the limits of the xceeds the limits of the standards of carestandards of care

FForeseability of harmoreseability of harm

Page 40: Nursing Jurisprudence

MEDICATIONS & MEDICATIONS & PRESCRIPTIONSPRESCRIPTIONS1. Only registered medical, dental and 1. Only registered medical, dental and

veterinary practitioners are veterinary practitioners are authorized to prescribe drugs.authorized to prescribe drugs.

2. Prescription information (based on 2. Prescription information (based on R.A. 5921 of the Pharmacy Act)- all R.A. 5921 of the Pharmacy Act)- all prescriptions must contain the prescriptions must contain the following information:following information: Name of MD, PTR, PRC#, location of Name of MD, PTR, PRC#, location of

clinic/ hospital clinic/ hospital Name of patient, age, sex Name of patient, age, sex Information about drug – frequency Information about drug – frequency

durationduration Generic & brand name in prescriptionGeneric & brand name in prescription

Page 41: Nursing Jurisprudence

R.A. 6675- Generics Act of 1988R.A. 6675- Generics Act of 1988 All prescribed drug must be written in generic and All prescribed drug must be written in generic and

brand names or generic name but never the brand names or generic name but never the brand name alonebrand name alone

Purpose: for the pt. to choose what brand they Purpose: for the pt. to choose what brand they wantwant

3. Know rights in giving meds 3. Know rights in giving meds 4. Proper identification of pt’s name4. Proper identification of pt’s name5. In cases of doubts and errors in medication, 5. In cases of doubts and errors in medication,

refer to the physician.refer to the physician.6. Special training is required before a nurse 6. Special training is required before a nurse

can administer IV injection.can administer IV injection.BON Resolution No. 8 states that who BON Resolution No. 8 states that who administers IV injection without training shall administers IV injection without training shall be held liable whether causing or not an be held liable whether causing or not an injury or death to the patient)injury or death to the patient)

Page 42: Nursing Jurisprudence

7. Verbal or telephone order7. Verbal or telephone orderGeneral rule:General rule: as possible avoid T.O. as possible avoid T.O.

““whatever is not written is not an order”whatever is not written is not an order”

Exception:Exception: During extreme emergency only! During extreme emergency only!

What to do?What to do?

1.1. Nurse should read back such order to the Nurse should read back such order to the physician to make certain the order has physician to make certain the order has been correctly written.been correctly written.

2.2. Such order should be signed by the Such order should be signed by the physician within 24 hours.physician within 24 hours.

3.3. The nurse should sign the physician’s The nurse should sign the physician’s name per her own and note the time and name per her own and note the time and order was received.order was received.

Page 43: Nursing Jurisprudence

QUESTIONQUESTION A telephone order is given for a client in A telephone order is given for a client in

your ward. What is your most appropriate your ward. What is your most appropriate action? action? A. Copy the order on to the chart and sign A. Copy the order on to the chart and sign the physician’s name as close to his the physician’s name as close to his original signature as possible original signature as possible B. Repeat the order back to the physician, B. Repeat the order back to the physician, copy onto the order sheet and indicate that copy onto the order sheet and indicate that it is a telephone order it is a telephone order C. Write the order in the client’s chart and C. Write the order in the client’s chart and have the head nurse co-sign it have the head nurse co-sign it D. Tell the physician that you can not take D. Tell the physician that you can not take the order but you will call the nurse the order but you will call the nurse supervisor supervisor

Page 44: Nursing Jurisprudence

QUESTIONQUESTION

In an extreme situation and In an extreme situation and when no other resident or intern when no other resident or intern is available, should a nurse is available, should a nurse receive telephone orders, the receive telephone orders, the order has to be correctly written order has to be correctly written and signed by the physician and signed by the physician within: within: A. 24 hours A. 24 hours C. 48 hours C. 48 hours B. 36 hours B. 36 hours D. 12 hours D. 12 hours

Page 45: Nursing Jurisprudence

INTENTIONAL WRONGSINTENTIONAL WRONGS

TORTS: A legal wrong, TORTS: A legal wrong, committed against a person or committed against a person or propertyproperty

TYPES:TYPES:1. Unintentional- do not require 1. Unintentional- do not require intent but do require the element intent but do require the element of harm.of harm.Ex. Negligence and malpracticeEx. Negligence and malpractice

Page 46: Nursing Jurisprudence

2. Intentional- the act was done on 2. Intentional- the act was done on purpose or with intent; no purpose or with intent; no harm, injury or damage is harm, injury or damage is needed to be liable. needed to be liable.

A.A. ASSAULT AND BATTERYASSAULT AND BATTERYASSAULTASSAULT- an attempt or threat to - an attempt or threat to

touch another person touch another person unjustifiably; mental or unjustifiably; mental or physical threat physical threat Ex.- forcing a pt. to take his Ex.- forcing a pt. to take his medication or treatment medication or treatment

Page 47: Nursing Jurisprudence

BATTERYBATTERY- physical harm through - physical harm through willful touching of person or clothing willful touching of person or clothing without consent. without consent. Ex. – giving of injection without pt’s Ex. – giving of injection without pt’s consentconsent

2. 2. FALSE IMPRISONMENTFALSE IMPRISONMENT- - Unjustifiable detention of a person Unjustifiable detention of a person without a legal warrant without a legal warrant - occurs when the person is not - occurs when the person is not allowed to leave a health care facility allowed to leave a health care facility when there is no legal justification to when there is no legal justification to detain the client.detain the client.- occurs when restraining devices - occurs when restraining devices are used without an appropriate are used without an appropriate clinical need.clinical need.

Page 48: Nursing Jurisprudence

3. 3. INVASION OF PRIVACYINVASION OF PRIVACY Right to privacy is the right to be Right to privacy is the right to be

left aloneleft alone Right to be free from unwarranted Right to be free from unwarranted

publicity publicity Exposure to public viewExposure to public view Divulge information from patient’s Divulge information from patient’s

chart to improper sources or chart to improper sources or unauthorized personunauthorized person

PRIVILEGEDPRIVILEGED COMMUNICATION: COMMUNICATION: Statements uttered in good faith; not Statements uttered in good faith; not permitted to be divulged in court of permitted to be divulged in court of justicejustice

Page 49: Nursing Jurisprudence

Exceptions: Exceptions: Confidential Confidential information can be revealed!information can be revealed!

PPt. consent, if there ist. consent, if there isIInform HCT for precautionary nform HCT for precautionary

measuresmeasuresCCrimes, child abuse, BWSrimes, child abuse, BWSCCommunicable disease- R.A. ommunicable disease- R.A.

3573 (Law on Notifiable 3573 (Law on Notifiable Diseases)Diseases)

EEthicsthics

Page 50: Nursing Jurisprudence

4. 4. DEFAMATIONDEFAMATION Character assassinationCharacter assassination There must be a third person who There must be a third person who

hears or read the comment before it hears or read the comment before it can be considered defamationcan be considered defamation

TYPES:TYPES: Slander-oral defamationSlander-oral defamation Libel-written wordsLibel-written words

Page 51: Nursing Jurisprudence

QUESTIONQUESTION

The nurse writes the following The nurse writes the following note in the client’s chart, “the note in the client’s chart, “the physician is incompetent physician is incompetent because he ordered the wrong because he ordered the wrong drug dosage.” This statement drug dosage.” This statement may lead to a charge of:may lead to a charge of:

A. AssaultA. AssaultB. SlanderB. SlanderC. LibelC. LibelD. Invasion of privacyD. Invasion of privacy

Page 52: Nursing Jurisprudence

QUESTIONQUESTION

Doing a nursing procedure Doing a nursing procedure without the patient’s informed without the patient’s informed consent may bring the health consent may bring the health professional to the court of law professional to the court of law for what violation?for what violation?

A. TortA. Tort C. NegligenceC. Negligence

B. AssaultB. Assault D. BatteryD. Battery

Page 53: Nursing Jurisprudence

QUESTIONQUESTION

Two janitors are having a heated Two janitors are having a heated argument as to who shall dispose argument as to who shall dispose the waste of a patient with typhoid the waste of a patient with typhoid fever. The first one called the other fever. The first one called the other “lazybone” and “pain in the neck” “lazybone” and “pain in the neck” within the hearing of the rest of the within the hearing of the rest of the nurses. The case is:nurses. The case is:A. LibelA. LibelB. SlanderB. SlanderC. Invasion of privacyC. Invasion of privacyD. NegligenceD. Negligence

Page 54: Nursing Jurisprudence

QUESTIONQUESTION

Allowing a person who is in no Allowing a person who is in no way involved in the care of the way involved in the care of the patient to read the patient’s patient to read the patient’s chart constitutes which of the chart constitutes which of the following violations:following violations:A. Invasion of pt’s privacyA. Invasion of pt’s privacyB. Breach of trustB. Breach of trustC. MalpracticeC. MalpracticeD. Violation of pt’s dignityD. Violation of pt’s dignity

Page 55: Nursing Jurisprudence

QUESTIONQUESTION

Which of the following persons Which of the following persons cannot have the access to the cannot have the access to the patient record? patient record?

A. physical therapistA. physical therapist

B. lawyer of the familyB. lawyer of the family

C. the patient C. the patient

D. speech therapist D. speech therapist

Page 56: Nursing Jurisprudence

QUESTIONQUESTION

It is unethical to tell one’s friends It is unethical to tell one’s friends and family members data about and family members data about the patient because doing so is the patient because doing so is a violation of patients’ rights to: a violation of patients’ rights to:

A. A. Informed consent Informed consent

B. B. Confidentiality Confidentiality

C. Least restrictive environment C. Least restrictive environment

D. Civil liberty D. Civil liberty

Page 57: Nursing Jurisprudence

QUESTIONQUESTION

Should the accusation be written Should the accusation be written in the newsletter of the hospital, in the newsletter of the hospital, such liability is a/an:such liability is a/an:

A. AssaultA. Assault

B. LibelB. Libel

C. SlanderC. Slander

D. BatteryD. Battery

Page 58: Nursing Jurisprudence

QUESTIONQUESTION

Confidentiality of patient’s identity Confidentiality of patient’s identity and condition is one of the nursing and condition is one of the nursing responsibilities in the hospital. responsibilities in the hospital. Which of the following reasons can Which of the following reasons can information be given without patient information be given without patient consent EXCEPT:consent EXCEPT:

A.A. Patient is charged with a crimePatient is charged with a crime

B.B. Patient has a TBPatient has a TB

C.C. Patient is a victim of child abusePatient is a victim of child abuse

D.D. Patient with cancerPatient with cancer

Page 59: Nursing Jurisprudence

RESTRAINTSRESTRAINTS

Restraints are protective devices Restraints are protective devices used to limit the physical activity of a used to limit the physical activity of a client or to immobilize a client or an client or to immobilize a client or an extremity.extremity.

TYPES:TYPES: Physical restraints: restrict client’s Physical restraints: restrict client’s

movement through the application of movement through the application of a devicea devicee.g. restraint jacket, straps, e.g. restraint jacket, straps,

Chemical restraints: Medications Chemical restraints: Medications given to inhibit a specific behavior or given to inhibit a specific behavior or movement.movement.e.g. sedation, psychotrophic druge.g. sedation, psychotrophic drug

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RESTRAINTS SHOULD NOT RESTRAINTS SHOULD NOT BE USED PRN!!!BE USED PRN!!!

R-equires physician’s order; consentR-equires physician’s order; consentE-mergency, get MD’s order ASAPE-mergency, get MD’s order ASAPS-hortest duration, least restrictive typeS-hortest duration, least restrictive typeT-o protect pt. and othersT-o protect pt. and othersR-enew order every 24 hoursR-enew order every 24 hoursA-ssess every 15 to 30 minutes and A-ssess every 15 to 30 minutes and

documentdocumentI-ndividualized supervisionI-ndividualized supervisionN-ever used as a punishmentN-ever used as a punishmentT-otal documentationT-otal documentationS-eclusion as last stepS-eclusion as last step

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ALTERNATIVES TO ALTERNATIVES TO RESTRAINTS RESTRAINTS Before restraints offer explanations, ask Before restraints offer explanations, ask

someone to stay with the client, use clocks, someone to stay with the client, use clocks, calendars, TV & radio (to decrease calendars, TV & radio (to decrease disorientation) or any relaxation disorientation) or any relaxation techniques. techniques.

Use LESS restrictive methods first. Use LESS restrictive methods first. RESTRAINTS should always be the last.RESTRAINTS should always be the last.

Assign confuse and disoriented clients to Assign confuse and disoriented clients to rooms near the nurserooms near the nurse’’s station.s station.

Maintain toileting routines & institute Maintain toileting routines & institute exercise and ambulation schedules as the exercise and ambulation schedules as the client condition allows. client condition allows.

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QUESTIONQUESTION

The nurse noticed that restraining The nurse noticed that restraining patients is a common practice. Which of patients is a common practice. Which of the following should she remember?the following should she remember?A. Restraints are necessary so that the A. Restraints are necessary so that the nurse could do more work for patientsnurse could do more work for patientsB. Use of restraints is an effective B. Use of restraints is an effective interventioninterventionC. Restraints require a physician’s C. Restraints require a physician’s orderorderD. Refusal to be restrained is a ground D. Refusal to be restrained is a ground for terminating the nurse-patient for terminating the nurse-patient relationshiprelationship

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CRIMES & OTHER ACTSCRIMES & OTHER ACTS

CRIME: An act committed or omitted CRIME: An act committed or omitted in violation of the lawin violation of the law

Two elements:Two elements: Criminal actCriminal act Evil/criminal intentEvil/criminal intent

Criminal ActionsCriminal Actions Acts or offenses against public welfareActs or offenses against public welfare Misdemeanor- offenses or acts less Misdemeanor- offenses or acts less

than a felonythan a felony Felony- a public offense committed with Felony- a public offense committed with

deceit and faultdeceit and fault

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Criminal negligenceCriminal negligence Reckless imprudence- person does an act Reckless imprudence- person does an act

from which damage results immediatelyfrom which damage results immediately Simple imprudence- did not use Simple imprudence- did not use

precaution and the damage was not precaution and the damage was not immediateimmediate

CLASSIFICATIONCLASSIFICATION

1. Manner of commission:1. Manner of commission: Deceit (dolo) with criminal intentDeceit (dolo) with criminal intent Fault (culpa) without; negligenceFault (culpa) without; negligence

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2. Stages of Execution2. Stages of Execution

1. Consummated1. Consummated all elements all elements executed, with executed, with successful resultsuccessful result

2. Frustrated2. Frustrated all elements all elements executed but no executed but no successful resultsuccessful result

3. Attempted3. Attempted not all elements not all elements executed, no executed, no successful resultsuccessful result

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3. Degree of penalty and fine3. Degree of penalty and fine

gravegrave Capital Capital punishment or punishment or >>6yrs & 1 day6yrs & 1 day

above P6kabove P6k

Less Less gravegrave

1 month and 1 1 month and 1 day to 6 yearsday to 6 years

not > P 6 K not > P 6 K but not but not <P200 <P200

Light Light felonyfelony

1 day to 30 1 day to 30 daysdays

fine not > fine not >

P 200 P 200

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4. Degree of participation4. Degree of participation

PRINCIPALPRINCIPAL

Primary authorPrimary author

a. By direct participation- doer of a. By direct participation- doer of the actthe act

b. By inducement-directly force or b. By inducement-directly force or induce othersinduce others

c. By cooperation- indispensablec. By cooperation- indispensable

ACCOMPLICEACCOMPLICEA person who A person who cooperates cooperates

““cooperates before the fact”-cooperates before the fact”- absent at the time crime is absent at the time crime is committed.committed.

ACCESSORYACCESSORY ““cooperates after the fact”cooperates after the fact”

PProfitsrofits

CConceals/ destroys evidence onceals/ destroys evidence AAssists in the escape of the ssists in the escape of the principalprincipal

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QUESTIONQUESTION

A crime can be committed with the A crime can be committed with the element of culpa if:element of culpa if:

A. the person committed the crime A. the person committed the crime because of ignorance of the lawbecause of ignorance of the law

B. the person knows the action is a B. the person knows the action is a crime and he chooses to do itcrime and he chooses to do it

C. the person committed the crime C. the person committed the crime because he lacked the competency to because he lacked the competency to act correctlyact correctly

D. all of theseD. all of these

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QUESTIONQUESTION

The nurse out of pity unhooked The nurse out of pity unhooked the patient from a respirator. the patient from a respirator. The patient died after 15 The patient died after 15 minutes. This type of felony is:minutes. This type of felony is:

A. ConsummatedA. Consummated

B. FrustratedB. Frustrated

C. AttemptedC. Attempted

D. MurderD. Murder

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QUESTIONQUESTION

If the penalty is death, what is the If the penalty is death, what is the degree of the felony?degree of the felony?

A. graveA. grave

B. less graveB. less grave

C. light felonyC. light felony

D. none of the aboveD. none of the above

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SITUATIONSITUATION

Danaya is two-months pregnant. Her Danaya is two-months pregnant. Her parents do not know this. She parents do not know this. She informed her friend Alena about the informed her friend Alena about the problem. Alena then referred Danaya problem. Alena then referred Danaya to Pirena, an abortionist. Danaya to Pirena, an abortionist. Danaya had an abortion. had an abortion.

If those involved will be charge If those involved will be charge legally, who is considered the legally, who is considered the principal?principal?A. PirenaA. Pirena C. AlenaC. AlenaB. DayanaB. Dayana D. None of themD. None of them

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If during the investigation, the pieces If during the investigation, the pieces of evidence were not found because of evidence were not found because Gurna, the maid of Pirena burned it. Gurna, the maid of Pirena burned it. Gurna is considered as:Gurna is considered as:A. AccompliceA. AccompliceB. AccessoryB. AccessoryC. PrincipalC. PrincipalD. Co-principalD. Co-principal

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QUESTIONQUESTION

A nurse is liable as an accomplice A nurse is liable as an accomplice in an abortion if she;in an abortion if she;

A. Assist in the escape of the A. Assist in the escape of the offenderoffender

B. Refers the pregnant mother to B. Refers the pregnant mother to the abortionistthe abortionist

C. Conceals the evidence of the C. Conceals the evidence of the crimecrime

D. None of theseD. None of these

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QUESTIONQUESTION

A person uses the license of A person uses the license of another person to practice another person to practice nursing is liable for what?nursing is liable for what?

A. negligenceA. negligence

B. malpracticeB. malpractice

C. misdemeanorC. misdemeanor

D. invasion of privacyD. invasion of privacy

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QUESTIONQUESTION

The receptionist of a clinic was The receptionist of a clinic was asked by police if a certain doctor asked by police if a certain doctor charged with murder was hiding in charged with murder was hiding in the premises of the clinic. She lied the premises of the clinic. She lied about it but unfortunately the doctor about it but unfortunately the doctor was discovered inside the clinic. was discovered inside the clinic. She could be charged with:She could be charged with:

A.A. PrincipalPrincipalB.B. AccessoryAccessoryC.C. AccompliceAccompliceD.D. AssistantAssistant

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Circumstances Circumstances affecting criminal affecting criminal

liabilityliability

J-E-M-A-AJ-E-M-A-A

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JUSTIFYINGJUSTIFYING SELF-DEFENSESELF-DEFENSE

Unlawful aggressionUnlawful aggression Reasonable necessityReasonable necessity Lack of sufficient provocationLack of sufficient provocation

Fulfillment of DutyFulfillment of Duty Obedience to an order from Obedience to an order from

superiorsuperior Order must be lawfulOrder must be lawful Superior acting within the Superior acting within the

scope of practicescope of practice

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EXEMPTINGEXEMPTINGIInsane/imbecilensane/imbecile

PPerformance of a lawful act causes erformance of a lawful act causes injury by mere accidentinjury by mere accident

UUnder 9 y/onder 9 y/o

UUnder compulsion of uncontrollable nder compulsion of uncontrollable forceforce

UUnder impulse of uncontrollable nder impulse of uncontrollable fearfear

FFailure to perform an act required ailure to perform an act required by law when prevented by some by law when prevented by some lawful causelawful cause

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MITIGATINGMITIGATINGUUnder 18y/o or over 70 y/onder 18y/o or over 70 y/o

NNo intention to commit so grave a o intention to commit so grave a wrongwrong

SSufficient provocation/threat ufficient provocation/threat preceding the actpreceding the act

IImmediate vindication of a grave mmediate vindication of a grave offenseoffense

VVoluntary surrenderoluntary surrender

DDeaf & dumb/ with physical defecteaf & dumb/ with physical defect

SSuffer from such illness that uffer from such illness that diminishes willpowerdiminishes willpower

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AGGRAVATINGAGGRAVATINGTTreachery/taking advantage of reachery/taking advantage of

superior strength or positionsuperior strength or position

PPrice, reward, promiserice, reward, promise

UUse of fire, poison, explosionse of fire, poison, explosion

CCalamitiesalamities

CCraft, fraud or disguise employedraft, fraud or disguise employed

EEvident Premeditationvident Premeditation

CCrueltyruelty

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ALTERNATIVEALTERNATIVE May increase/ decrease May increase/ decrease

criminal liability depending on criminal liability depending on the nature and effects of the the nature and effects of the crimecrime

RRelationshipelationship

IIntoxicationntoxication

DDegree of instruction/ egree of instruction/ educationeducation

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DRILLSDRILLS

1. Under compulsion of 1. Under compulsion of uncontrollable force uncontrollable force

2. There is sufficient 2. There is sufficient provocationprovocation

3. Act is committed with abuse 3. Act is committed with abuse of confidence of confidence

4. Fulfillment of a duty4. Fulfillment of a duty

5. Offender is over 70 years old5. Offender is over 70 years old

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6. Voluntary surrender6. Voluntary surrender

7. Disguise in being employed7. Disguise in being employed

8. Defense of a stranger8. Defense of a stranger

9. Acts under the impulse of an 9. Acts under the impulse of an uncontrollable fearuncontrollable fear

10. Offender is insane10. Offender is insane

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QUESTIONQUESTION

Premeditating to commit a crime Premeditating to commit a crime is considered as:is considered as:

A. justifyingA. justifying

B. mitigatingB. mitigating

C. aggravatingC. aggravating

D. exemptingD. exempting

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QUESTIONQUESTION

All of the following are All of the following are exempting circumstances exempting circumstances except:except:

A. ImbecileA. Imbecile

B. 8 year oldB. 8 year old

C. performance of a lawful actC. performance of a lawful act

D. offender is deaf and dumbD. offender is deaf and dumb

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QUESTIONQUESTION

When a politician takes advantage When a politician takes advantage of his power in the performance of of his power in the performance of unlawful actions, this is considered unlawful actions, this is considered as:as:

A. justifying circumstanceA. justifying circumstance

B. exempting circumstanceB. exempting circumstance

C. mitigating circumstanceC. mitigating circumstance

D. aggravating circumstanceD. aggravating circumstance

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QUESTIONQUESTION

When the defendant kills When the defendant kills someone accidentally:someone accidentally:

A. justifyingA. justifying

B. exemptingB. exempting

C. aggravatingC. aggravating

D. mitigatingD. mitigating

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CRIMES CRIMES CONCERNING CONCERNING THE NURSE THE NURSE

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MORAL TURPITUDEMORAL TURPITUDE Are acts contrary to the accepted Are acts contrary to the accepted

and customary rule of rightand customary rule of right

1. Rape: 1. Rape: a.) Ordinary rape – forcible penetration of a.) Ordinary rape – forcible penetration of sex organ to a sex organ sex organ to a sex organ b.) Sexual assault – anything forcibly b.) Sexual assault – anything forcibly inserted to any orifice.inserted to any orifice.

InterventionInterventionSSafety (emotional and physical)afety (emotional and physical)RReport the incidenceeport the incidenceRReferral (if the father is the rapist, refer to eferral (if the father is the rapist, refer to

DSWD)DSWD)

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ANTI- RAPE LAWANTI- RAPE LAW (RA 8353) (RA 8353)

R.A. 7877 – Anti-sexual Harassment Act 1. Any person who exercises authority 2. Asking sexual favors in exchange of

another favor

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2.MURDER- killing of another with intent2.MURDER- killing of another with intent3. HOMICIDE- unintentional killing of another 3. HOMICIDE- unintentional killing of another

personperson

4. PARRICIDE4. PARRICIDE Killing of a person to whom you have a Killing of a person to whom you have a

relationshiprelationship1. father1. father2. mother2. mother3. brothers/sisters3. brothers/sisters4. ascendants4. ascendants5. descendants5. descendants6. spouse6. spouse

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5. ABORTION- termination of product 5. ABORTION- termination of product of conception before the age of of conception before the age of viability.viability.

6. INFANTICIDE6. INFANTICIDE

- the killing of an infant less than - the killing of an infant less than three days or 72 hours.three days or 72 hours.

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8. THEFT- 8. THEFT- -anyone who gets the -anyone who gets the personal property of another without personal property of another without the latter’s permission.the latter’s permission.

7. ROBBERY7. ROBBERY- Anyone who Anyone who

gets the gets the personal personal property ofproperty of

another with the another with the use of use of force,violence orforce,violence or

intimidation.intimidation.

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9. SIMULATION OF BIRTH9. SIMULATION OF BIRTH

1. Pretend that a woman gave birth1. Pretend that a woman gave birth2. Substitution or exchanging of babies 2. Substitution or exchanging of babies

in the nurseryin the nursery3. Intentionally putting wrong 3. Intentionally putting wrong

information in the birth registration information in the birth registration formform

P.D. 651 – Birth Registration Act - requires P.D. 651 – Birth Registration Act - requires any person (RN,OB, midwife) who shall any person (RN,OB, midwife) who shall assist in giving birth to report within 30 days assist in giving birth to report within 30 days without penalty any live birth at Local Civil without penalty any live birth at Local Civil Registrar’s Office. Registrar’s Office.

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10. DISPENSING OF 10. DISPENSING OF PROHIBITED PROHIBITED DRUGSDRUGS

R.A. 6425 (1965) – Dangerous Drugs Act R.A. 6425 (1965) – Dangerous Drugs Act

A. Prohibited – chemicals or substances that A. Prohibited – chemicals or substances that are totally and absolutely can’t be are totally and absolutely can’t be consumed by human being. consumed by human being.

Ex. Shabu, cocaine, cannabis Ex. Shabu, cocaine, cannabis

B. Regulated – can use this drug - with B. Regulated – can use this drug - with appropriate prescription - MD with appropriate prescription - MD with appropriated license appropriated license

Ex.- Valium, dormicum Ex.- Valium, dormicum

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For licensed health care providersFor licensed health care providers

FFines ines

IImprisonment mprisonment

AutomaticAutomatic revocation of license revocation of license

PENALTY FOR VIOLATING PENALTY FOR VIOLATING THE ACTTHE ACT

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GUIDELINES TO PREVENT GUIDELINES TO PREVENT CRIMINAL LIABILITY:CRIMINAL LIABILITY:

1. Be very familiar with the Philippine 1. Be very familiar with the Philippine Nursing lawNursing law

2. Be familiar with the laws affecting 2. Be familiar with the laws affecting nursing practicenursing practice

3. Know agency rules, regulations, 3. Know agency rules, regulations, policiespolicies

4. Upgrade skills and competence4. Upgrade skills and competence

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5. Develop good IPR with co-workers5. Develop good IPR with co-workers6. Consult superior as needed6. Consult superior as needed7. Verify vague/ erroneous orders7. Verify vague/ erroneous orders8. Always keep doctor updated 8. Always keep doctor updated

regarding patientregarding patient9. Ensure accurate recording and 9. Ensure accurate recording and

reportingreporting10. Get informed consent10. Get informed consent11. Do not delegate responsibilities to 11. Do not delegate responsibilities to

othersothers

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TIPS FOR AVOIDING LEGAL TIPS FOR AVOIDING LEGAL PITFALLS:PITFALLS:

1. Patient Falls1. Patient Falls do proper do proper

assessmentassessment appropriate appropriate

assistance assistance use protective use protective

measuresmeasures document all document all

nursingnursing

interventionsinterventions

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2. Medication errors2. Medication errors observe the rights of drug administrationobserve the rights of drug administration Check dr’s orderCheck dr’s order Understand the medication you will administerUnderstand the medication you will administer Consult drug handbook/ pharmacyConsult drug handbook/ pharmacy Not exempt from liability for following wrong dr’s Not exempt from liability for following wrong dr’s

orderorder

3. Equipment injuries3. Equipment injuries refuse to use a device you do not know how to refuse to use a device you do not know how to

operateoperate report adverse events to superiorsreport adverse events to superiors monitor patient regularlymonitor patient regularly bring questionable orders to the attention bring questionable orders to the attention

of the doctor or superiorof the doctor or superior

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DRILLSDRILLS

1. A student nurse is overheard 1. A student nurse is overheard talking in the cafeteria about a talking in the cafeteria about a client and his suicidal client and his suicidal tendencies.tendencies.

2. A nurse asks a client why he 2. A nurse asks a client why he chose Dr. Smith for her chose Dr. Smith for her physician when this doctor is physician when this doctor is always rude to the staff.always rude to the staff.

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3. A client is told he must pay the 3. A client is told he must pay the remainder of his medical bill remainder of his medical bill before he can leave the facility.before he can leave the facility.

4. A nurse told the client that she 4. A nurse told the client that she will inject her with sedatives if he will inject her with sedatives if he does not cooperate.does not cooperate.

5. A nurse forcibly opened the 5. A nurse forcibly opened the mouth of a pedia patient and mouth of a pedia patient and gave his medication.gave his medication.

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6. A nurse takes the wallet of the 6. A nurse takes the wallet of the patient while the latter is patient while the latter is sleeping.sleeping.

7. A nurse takes the wallet of the 7. A nurse takes the wallet of the patient with the use of violence patient with the use of violence and intimidation.and intimidation.

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8. A nurse gives a potent injection 8. A nurse gives a potent injection of morphine to a patient causing of morphine to a patient causing his death.his death.

9. A nurse poisons his client to 9. A nurse poisons his client to end his life.end his life.

10. A patient died because of 10. A patient died because of wrong medication given.wrong medication given.

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SEE SEE YOU YOU ALL ALL

AGAIN AGAIN TOMORROW…TOMORROW…