SEMINAR ON LEGAL ISSUES IN NURSING INTRODUCTIONIn todays complex o!ld" #t$ ad%anc#n& tec$nolo&#es ' a a!!ay o( soc#etal p!

!o)lems" le&al #ss*es a!e an #mpo!tant aspect o( l#(e+ ,o! n*!ses" #n p!act#ce #t$ #n t$e c*!!ent $ealt$ ca!e system" -no led&e o( )as#c le&al concepts #s %#tal+ Inte!est#n& ' #mpo!tant de%elopments #n t$e system o( la a((ect )ot$ t$e n*!se and $e! p!act#ce+ In t$e $ealt$ ca!e (#eld t$e (*ndamental p!#nc#ple t$at &o%e!ned )e$a%#o! came (!om people s*c$ as .#ppoc!ates" ,lo!ence N#&$t#n&ale" Do!ot$ea D#x" ' Cla!a /*!ton+ T$e#! E((o!ts to assess t$e poo!" t$e s#c- ' t$e #n(#!m )!o*&$t a)o*t s#&n#(#cant c$an&es #n t$e (o!mat#on o( $ealt$ ca!e system t$at )ecame t$e (o*ndat#on (o! t$e standa!ds o( n*!s#n& p!act#ce ' e%ent*ally !e0*#!ement o( la (o! t$e p!otect#on o( t$e cons*me!s+ MEANING O, LA1O!d#na!#ly t$e te!m 2La 3 means a )ody o( !*le to &*#de $*man act#on+ T$e t!m La #s de!#%ed (!om #ts tento!#c !oot 2La&3 $#c$ means somet$#n& $#c$ l#es (#xed+ In En&l#s$ #t means somet$#n& $#c$ #s *n#(o!m+ DE,INITION O, LA12T$e la #s a system o( !#&$ts ' o)l#&at#ons $#c$ t$e state en(o!ces+3 G!een+ 2T$e la #s t$e )ody o( p!#nc#ples !eco&n#4ed ' appl#ed )y t$e state ' t$e adm#n#st!at#on o( 5*st#ce3 LEGAL S6STEM Types o( La T$e la can )e d#%#ded #nto c#%#l la ' c!#m#nal la +A )!#e( desc!#pt#on o( t$ese la s a!e as (ollo s+ 78 C#%#l La -#ncl*des !*les ' !e&*lat#on t$at spec#(y t$e !e0*#!ed co*!se o( act#on to )e (ollo ed )y an #nd#%#d*al #n )*s#ness ' soc#al !elat#ons$#p #t$ ot$e!s+ 98 C!#m#nal la De(#nes o((ences t$at a((ect p*)l#c el(a!e ' #mpose penalt#es +It #ncl*des !*les (o!)#dd#n& cond*ct t$at #s #n:*!#o*s to p*)l#c o!de! ' spec#(y#n& p*n#s$ment to )e adm#n#ste!ed to #nd#%#d*al $o ex$#)#ts #n:*!#o*s cond*ct+ Le&al l#a)#l#ty #n N*!s#n& ;a8 To!ts ;)8 Malp!act#ce+ To!t To!t #s a c#%#l !on& comm#tted a&a#nst a pe!son o! p!ope!ty (o! $#c$ !emedy #s common la act#on (o! dama&es t$at a!e not excl*s#%ely t$e )!eac$ o( cont!act o! t!*st o! a mo!e e0*#ta)le o)l#&at#on+ To const#t*te a to!t" #t #s essent#al t$at t$e (ollo #n& cond#t#on m*st )e sat#s(#ed< 7+Act o! om#ss#on < In o!de! to ma-e a pe!son l#a)le" (o! a to!t " $e m*st $a%e done some act $#c$ $e #s not expected to do o! $e m*st $a%e (a#led #n $#s d*t#es+

9+ 1!on&(*l act o! om#ss#on m*st )e !eco&n#4ed )y la < I( t$e!e #s a me!e mo!al o! soc#al !on&" t$e!e cannot )e a l#a)#l#ty (o! a pe!son+ =+ Le&al dama&e< T$e t$#!d #mpo!tant essent#al #n const#t*t#n& a to!t #s le&al dama&e+ Le&al dama&e a le&al !#&$t means #n(!#n&ement o(+ >+ Le&al !emedy< t$e (o!t$ #mpo!tant essent#al (o! a !on&(*l act o! om#ss#on #n to!t #s t$at m*st &#%e !#se to le&al !emedy #n t$e (o!m o( an act#on o! dama&es+ Class#(#cat#on o( To!t78 Un#ntent#onal to!ts #ncl*de Ne&l#&ence (o! example Malp!act#ce+ 98 Intent#onal to!t a!e #ll(*l acts t$at %#olate anot$e!s !#&$t+ ,o! example assa*lt" )atte!#n&" de(amat#on" #n%as#on o( p!#%acy" (alse #mp!#sonment ' (!a*d+ 7+ Un#ntent#onal To!tsNe&l#&ence-It #s an act o( om#ss#on o! #s t$e (a#l*!e an #nd#%#d*al to do somet$#n& t$at a !easona)ly p!*dent pe!son o*ld do o! do#n& somet$#n& t$at $e?s$e o*ld not do+ In #n#t#al sta&e o( ne&l#&ence+ In ot$e! o!ds @ne&l#&ence #s cond*ct t$at (alls )elo t$e standa!d o( ca!e+ It #s esta)l#s$ed )y t$e la (o! t$e p!otect#on o( ot$e! a&a#nst *n!easona)le !#s- o! $a!m+ I( n*!ses &#%e ca!e t$at doesnt meet app!op!#ate standa!ds" t$ey may )e $eld l#a)le (o! ne&l#&ence+ T$e p!o)lem (o! $#c$ n*!ses a!e o(ten (o*nd ne&l#&ent #n d*t#es t$at a!e (ollo #n&< 7+ ,a#l*!e to *se asept#c tec$n#0*e $e!e !e0*#!ed+ 9+ Lea%#n& a (o!e#&n o):ect #n a pat#ents )ody d*!#n& s*!&e!y< #+e+ e!!o! #n spon&e" #nst!*ment o! needle co*nt #n s*!&#cal cases+ =+ ,a#l#n& to !espond p!omptly to pt +symptoms #n pend#n& d#saste!s+ >+ ,a#l*!e to p!otect an #n(#!m pt+ (!om (a#nt#n&" (alls !es*lt#n& #n:*!#es to pts+ A+ Adm#n#ste!#n& !on& med#cat#on to a pt+ B+ Adm#n#ste!#n& med#cat#on #napp!op!#ately" #+e+ #nt!a%eno*s t$e!apy" e!!o!s !es*lt#n& #n(#lt!at#on o! p$le)#t#s+ C+ Adm#n#ste!#n& a ca!e #n s*c$ a manne! t$at a pt+ s*((e!s #n:*!y" e&+ Imp!ope! $andl#n& o( $ot ate! )a&" )*!ns to cl#ents+ N*!ses a!e !espons#)le (o! pe!(o!m#n& all p!oced*!es co!!ectly ' exe!c#s#n& p!o(ess#onal :*d&ement as t$ey ca!!yo*t docto!s o!de!s ' d*t#es not o!de!ed )y (o! $#c$ t$ey $a%e a*t$o!#ty+ Any n*!se $o doesnt meet accepted standa!ds o( p!act#ce o! ca!e o! $o pe!(o!ms d*t#es #n ca!eless manne!" !*ns o( )e#n& (o*nd ne&l#&ent+ .osp#tal a*t$o!#t#es may t!y to d#sp!o%e t$e!e l#a)#l#ty )y ta-#n& t$e plea o( a de(ence o( t o p!#nc#ples7+ Dolent#-non-(#t #n:*!#a 9+ Necess#ty+ 78 Dolenty Non ,#t In:*!#a- It #s a ell esta)l#s$ed p!#nc#ple o( la t$at no man can s*e (o! a to!t to $#c$ $e $ad consented e#t$e! exp!essly o! #mpl#edly+Dolenty non-(#t #n:*!#a means t$at %ol*nta!#ly-s*((e!ed #n:*!y #s not act#ona)le+ 1$en t$e pla#nt#(( %ol*nta!#ly a&!ess to s*((e! some $a!m" $e #s not allo ed to compla#n s*)se0*ently (o! t$at ' $#s consent se!%es as a &ood de(ence to t$e de(endant+e+&+la (*l &ame o! spo!ts o! s*!&#cal ope!at#on+ T$*s" t$e!e a!e t o )as#c !e0*#!ement const#t*t#n& %olent# non-(#t #n:*!#a $#c$ t$e de(endant m*st p!o%e #n o!de! to :*st#(y $#s to!t+ T$ey a!e< ;a8 T$e pla#nt#(( $as t$e -no led&e o( !#s-+ ;)8 T$e pla#nt#((" #t$ $#s (!ee consent" !an t$e !#s- o( $a!m+

T$#s #s t$e !eason t$at a pat#ent o! someone on $#s )e$al( #s as-ed to &#%e $#s consent #n !#t#n& t$at t$ey a!e adm#tt#n& t$e!e pt+ at t$e o n cost ' !#s- so t$at t$ey cant (#le a s*#t a&a#nst t$e docto! o! t$e $osp#tal late! on+ T$e $osp#tal a*t$o!#t#es m*st expla#n t$e extent o( !#s- o! dan&e!+ I( t$e pt+ o! $#s !elat#%es p!o%e at any sta&e t$at t$ey e!e not told t$e extend o( !#s- ' t$e#! consent as not ta-en (!eely" t$en t$e $osp#tal a*t$o!#ty cannot *se t$e de(ense o( %olent# non- (#t #n:*!#a+ Necess#ty- T$e!e a!e cases #n $#c$ t$e de(endant may not )e l#a)le (o! t$e dama&es ca*sed e%en " #ntent#onally" #( $e as act#n& *nde! d#le&mma to p!e%ent a &!eate! e%#l+ A competent s*!&eon can pe!(o!m an eme!&ency ope!at#on on an *nconsc#o*s pat#ent to sa%e $#s l#(e+ It #s o(ten t$e cases t$at st!an&e!s )!#n& an *nconsc#o*s" #n:*!ed pe!son to t$e $osp#tal (!om an acc#dent s#te ' 0*#etly &o a ay+ I( t$e #n:*!ed pe!son #s )leed#n& p!o(*sely ' #s #n an *nconsc#o*s state a s*!&eon #ll not a#t to see- t$e consent o( t$e #n:*!ed o! $#s (am#ly mem)e!s+ .e may ope!ate to stop t$e )leed#n&+ In case t$e pat#ent d#es s*)se0*ently" $osp#tal a*t$o!#t#es may ta-e t$e de(ence o( @necess#ty *nde! t$e la o( to!ts" #( s*ed )y t$e !elat#%es o( t$e deceased+ T$e la o( to!ts #s an *ncod#(#ed la ' #s )ased on common la #+e :*st#ce" e0*#ty ' &ood consc#ence+ It #s ad%#sa)le (o! $osp#tal a*t$o!#t#es to $a%e -no led&e o( t$e la o( to!t" -eep#n& #n %#e t$e t!end o( cases )e#n& (#led )y t$e pat#ents ' t$e#! !elat#%es a&a#nst $osp#tal' docto!s+ T$#s -no led&e #ll sa%e t$em (!om *nnecessa!y $a!assment #( anyone )!#n&s an act#on *nde! t$e la o( to!ts a&a#nst t$e $osp#tal ' #ts pe!sonnel+ Malp!act#ce- Malp!act#ce #s a ne&l#&ence o! ca!elessness )y a p!o(ess#onal pe!son+ So" conce!ns p!o(ess#onal act#ons ' #n t$e (a#l*!e o( a pe!son" #t$ p!o(ess#onal ed*cat#on ' s-#ll to act #n a !easona)le ' p!*dent manne!+ In ot$e! o!ds #t #s p!o(ess#onal cond*ct" *n!easona)le lac- o( s-#ll o! #n(#del#ty #n p!o(ess#onal d*t#es" e%#l p!act#ce o! #mmo!al cond*ct+ Iss*es o( malp!act#ce $a%e )ecome #nc!eas#n&ly mo!e #mpo!tant to t$e n*!se as n*!s#n& a*t$o!#ty" acco*nta)#l#ty ' a*tonomy $a%e #nc!eased+ In malp!act#ce la s*#t" a&a#nst a n*!se" t$e (ollo #n& c!#te!#a m*st )e esta)l#s$ed< 78 t$e n*!se ;de(endant8 o ed a d*ty to t$e cl#ent ;t$e pla#nt#((8 98 T$e n*!se d#d not ca!!yo*t t$e d*t#es+ =8 T$e cl#ent as #n:*!ed+ >8 T$e cl#ents #n:*!y as t$e !es*lt o( t$e n*!ses (a#l*!e to ca!!yo*t t$e d*ty p!ope!ly+ Intent#onal To!tsExamples o( #ntent#onal to!t a!e as (ollo s< ;78Assa*lt #s any #ll(*l attempt o! t$!eat to $a!m anot$e!" co*pled #t$ t$e a)#l#ty to act*ally $a!m t$e pe!son+ T$e %#ct#m )el#e%es t$at $a!m ca*sed as a !es*lt o( t$e t$!eat+ Assa*lt may )e s*)tle+ ,o! e+&+ #n%ol%ement o( a n*!se #n $andl#n& an *ncoope!at#%e cl#ent #n t$e cas*alty !oom+ ;98 /atte!y #s #ntent#onal to*c$#n& o( anot$e!s )ody o! anyt$#n& t$e pe!son #s to*c$#n& o! $old#n& #t$o*t consent+ In:*!y #s not a !e0*#!ement+ In(o!med consent #s necessa!y #n s*c$ cases+ It $as )een allo ed #n mental $ealt$ #nst#t*t#ons+ ;=8 In%as#on o( E!#%acy cl#ent $a%e cla#ms (o! @#n%as#on o( p!#%acy" e+&+ t$e#! p!#%ate a((a#!s #t$ $#c$ t$e p*)l#c $as no conce!n" $a%e )een p*)l#s$ed+ Cl#ents a!e ent#tled to con(#dent#al $ealt$ ca!e+ All aspects o( $ealt$ ca!e s$o*ld )e (!ee (!om *n anted p*)l#c#ty o! expos*!e to p*)l#c sc!*t#ny+ T$e p!eca*t#on s$o*ld )e ta-en somet#me an #nd#%#d*al !#&$t to p!#%acy may con(l#ct t$e p*)l#cs !#&$t to #n(o!mat#on (o! e+&+ #n case o( po#son cases+ ;>8 De(amat#on o( c$a!acte! #s t$e act o( $old#n& *p o( a pe!son to !ed#c*le" sco!n o! contem pt+ #t$#n t$e comm*n#ty+ T$e!e a!e t o types o( de(amat#onF slande! ' l#)el+

G Slande! De(amat#on #s #n t$e (o!m o( spo-en o!ds (o!" e+&+ #( a n*!se tells a cl#ent t$at $#s docto! #s #ncompetent" (o! $#c$ n*!se co*ld )e $eld l#)el (o! slande!+ G L#)el De(amat#on #s #n t$e (o!m o( !#tten o!ds" e+&+ t$e n*!se $o !#tes s*c$ a comment co*ld )e $eld (o! l#)el+ Le&al Iss*es #n Spec#al#ty E!act#ce A!eaMate!nal and C$#ld .ealt$ N*!s#n& Many le&al #ss*es a!e #n%ol%ed #n t$e ca!e o( mot$e! ' $e! #n(ant+ Gene!ally ca*ses o( la s*#ts (o! malp!act#ce #n t$#s a!ea may )e d#%#ded #nto t o cate&o!#es $o $andl#n& t$e mot$e! ' c$#ld+ T$e common ca*ses o( la s*#ts a&a#nst a n*!se #ll #ncl*de t$e (ollo #n&< a8 E!o)lem o( med#cat#on< Many alle&at#ons a&a#nst n*!ses #t$ !e&a!d to med#cat#on a!e #mp!ope! cl#ent pat#ent #dent#(#cat#on" !on& med#cat#on dosa&e" (o! e+&+ n*!ses a!e o(ten #n%ol%ed #n t$e adm#n#st!at#on o( oxytoc#n (o! t$e a*&mentat#on o( la)o*!+ )8 ,a#l*!e #n ade0*ate cl#ent mon#to!#n&- La)o! ' del#%e!y poses a *n#0*e mon#to!#n& c$allen&es" #n t$at t$e!e a!e t o cl#ents to mon#to!" t$e mot$e! ' )a)y+ T$e del#%e!#n& m*st )e ade0*ately mon#to!ed to p!e%ent any mate!nal compl#cat#on d*!#n& p!enatal pe!#od+ N*!ses $a%e le&al !espons#)#l#ty !e&a!d#n& (etal mon#to!#n& d*!#n& la)o!+ And p!ompt mon#to!#n& #ll )e cont#n*ed d*!#n& natal pe!#od" postnatal pe!#od to p!e%ent compl#cat#on !elated to mot$e! ' c$#ld #n !espect#%e pe!#od+ c8 ,a#l*!e to ade0*ately assess t$e cl#ent- T$e n*!se #s an #mpo!tant mem)e! o( t$e $ealt$ ca!e team $o #s #t$ t$e cl#ent constantly" ' !espons#)le (o! t$e m#n*te e%al*at#on o( t$e cl#ent p!o&!ess+ N*!ses #n all spec#alty a!eas m*st ma#nta#n $#&$e! le%el o( assessment s-#ll+ d8 ,a#l*!e to !epo!t t$e c$an&es #n t$e cl#ent- 1$ene%e! t$e n*!se assessment #nd#cates t$at t$e cl#ents cond#t#on $as c$an&ed" t$e n*!se m*st not#(y t$e conce!ned p$ys#c#an+ As a pat#ent ad%ocate" n*!se m*st *nde!stand t$at (a#l#n& to not#(y a docto! o( a p!o)lem o(ten leads to a delay #n app!op!#ate med#cal ca!e )e#n& #mplemented+ T$#s #n t*!n can lead to an #n:*!y to t$e cl#ent ' a la s*#t+ e8 A)o!t#on- A)o!t#on #s a one o( t$e emot#onally c$a!&ed #ss*es con(!ont#n& n*!ses+ N*!ses cannot )e (o!ced to pa!t#c#pate #n p!oced*!es t$ey (#nd mo!ally o((ens#%e+ S$e can ass#st #t$ a)o!t#ons #( #t #s pe!(o!med *nde! Med#cal te!m#nat#on o( p!e&nancy Act ;MTE ACT8 (8 N*!s#n& ca!e o( ne )o!n- t$e!e a!e ce!ta#n le&al !e0*#!ement #n p!o%#d#n& n*!s#n& ca!e o( ne )o!ns" s*c$ as p!ope!ty #dent#(y#n& t$e #n(ant-mot$e! pa#! as soon as poss#)le #t$ (#n&e! p!#nts" (oot p!#nts ' !#st )and o! o)ta#n#n& )lood sample (o! p$enyl-eton*!#a+ Test#n&+ 1$en !e0*#!ed )y la + T$e n*!se m*st complete le&al !e0*#!ement )y ca!e(*l doc*mentat#on+ Eed#at!#c N*!s#n&Eed#at!#c n*!ses a!e !espons#)le (o! p!e%ent#n& c$#ld!en" #n t$e!e ca!e" (!om acc#dently $a!m#n& t$emsel%es+ C!#)s $#c$ somet#mes $a%e a !est!a#n#n& de%#ce at t$e top" a!e des#&ned to -eep #n(ant ' toddle!s (!om cl#m)#n& o*t o( )ed ' #n:*!#n& t$emsel%es+ All po#sono*s s*)stance ' s$ape o):ects s$o*ld )e -ept o*t o( t$e !eac$ o( c$#ld!en+ C$#ld!en s$o*ld )e -ept *nde! constant s*!%e#llance to m#n#m#4e oppo!t*n#t#es (o! acc#dental $a!m+ Med#cal s*!&#cal N*!s#n&N*!ses a!e !espons#)le (o! pe!(o!m#n& all p!oced*!es co!!ectly ' exe!c#s#n& p!o(ess#onal :*d&ement as t$ey ca!!yo*t docto!s o!de! ' d*t#es+ Some common act o( ne&l#&ence #n med#cal s*!&#cal n*!s#n& a!e as (ollo s< a8 O%e!loo-ed spon&es" #nst*ments" needles< #n t$e ope!at#on t$eate!" #t a !espons#)#l#ty o( a n*!se to co*nt t$e spon&es" #nst!*ments" needles" )e(o!e t$e clos*!e o( t$e a)domen o! any ca%#ty+

)8 /*!ns< T$e p!o(ess#onal n*!se #s !e0*#!ed to -no t$e ca*ses ' e((ect o( any $eat appl#cat#on so as to a%o#d )*!ns+ Some o( t$e common $eat appl#cat#ons a!e o( $ot ate! )a&s" $eat#n& pads" s#t4)at$ etc+ c8 ,alls< T$e n*!se co*ld )e $eld l#)el o( a pt+ (alls (!om t$e )ed o! d*e to #mp!ope! se0*#!#n& o( pt+ on exam#nat#on ta)le o! #mp!ope! appl#cat#on o( !est!a#ns o! p!o%#s#on o( an #mp!ope! )ed (o! an *nconsc#o*s pt+ o! a c$#ld+ d8 In:*!y d*e to t$e *se o( de(ect#%e appa!at*s o! s*ppl#es< T$e n*!se co*ld )e $eld l#)el #( s$e *ses e0*#pment o! s*ppl#es t$em $#c$ s$eH$e -no s to )e (a*lty" e+&+ t$e *se o( *nste!#l#4ed &a*4e o( s*!&#cal d!ess#n&s+ e8 In:*!y d*e to adm#n#st!at#on o( !on& med#c#ne" !on& dosa&e ' !on& concent!at#on< adm#n#st!at#on o( med#c#ne #t$o*t p!esc!#pt#on )y t$e conce!ned a*t$o!#ty" m#x#n& o( po#sono*s ' nonpo#sono*s d!*& #n c*p)oa!ds lead#n& to e!!o!s" (a#l#n& to #dent#(y C !#&$ts o( pat#ent d*!#n& med#cat#on+ (8 Loss o! dama&e< T$e n*!se #s $eld l#a)le #( a pt+s p!ope!ty #s lost $en #t $as )een ent!*sted to $e!H$#s ca!e+ &8 Assa*lt ' )atte!y< (a#l*!e to ta-e t$e #n(o!med consent o( t$e pat#ent p!#o! to any p!oced*!e" t!eatment" #n%est#&at#on o! ope!at#on" t$e n*!se )e $eld l#a)le+ $8 ,a#l*!e to !epo!t acc#dents< t$e n*!se $as t$e mo!al ' le&al !espons#)#l#ty to !epo!t to t$e conce!ned a*t$o!#ty any acc#dents" losses o! *n*s*al occ*!!ences+ ,a#l*!e to do t$#s #s an act o( ne&l#&ence+ #8 Ma#ntenance o( !eco!ds ' !epo!ts< (a#l*!e to ma#nta#n acc*!ate !eco!d ' !epo!ts o! !emo%#n& a pos#t#on o( !eco!d may also ma-e a n*!se l#a)le+ N*!ses o!-#n& #n c!#t#cal ca!e *n#ts a!e also le&ally acco*nta)le (o! pe!(o!m#n& t$e#! d*t#es+ T$e poss#)le le&al p!o)lems (o! c!#t#cal ca!e n*!ses a!e assoc#ated #t$ *se o( elect!on#c mon#to!#n& de%#ces+ No mon#to! can )e cons#de!ed totally !el#a)le ' n*!se m*st not completely depend on #t+ T$ese may )e elect!#cal $a4a!ds+ T$e e0*#pment s$o*ld )e c$ec-ed !o*t#nely )y en&#nee!s to ens*!e t$at a pat#ent #ll not !ece#%e any elect!#cal s$oc-+ Esyc$#at!#c N*!s#n& T$e p!act#ce o( psyc$#at!#c n*!s#n& #s #n(l*enced )y t$e la " pa!t#c*la!ly #n conce!n (o! t$e !#&$t o( pat#ents ' t$e 0*al#ty o( ca!e t$ey a!e !ece#%#n&+ In t$e past 9Iy!s+ C#%#l" c!#m#nal ' cons*me! !#&$ts $a%e )een esta)l#s$ed ' expanded t$!o*&$ :*d#c#al dec#s#on+ E!e%#o*sly po e!less ' ne&lected &!o*ps s*c$ as t$e mentally #ll a!e no *s#n& t$e le&al system as )ot$" a (o!m (o! t$e exp!ess#on o( le&#t#mate &!#e%ances ' as a %e$#cle (o! soc#al c$an&e+ Many o( t$e la s %a!y (!om state to state" ' p!o(ess#onals a!e !e0*#!ed to )ecome (am#l#a! #t$ t$e le&al p!o%#s#ons o( t$e#! o n state )eca*se -no led&e o( t$e la en$ances t$e (!eedom o( )ot$ t$e n*!se ' pt+ A psyc$#at!#c n*!se s$o*ld )e s*((#c#ently ac0*#nted #t$ t$e le&al aspect o( psyc$#at!y so t$at s$eH$e can )e a a!e o( t$e pts+ !#&$ts ' can a%o#d &#%#n& poo! ad%#ce o! #nnocently #n%ol%#n& $e!sel(H$#msel( #n a le&al #ntan&lement+ S$e m*st )e (am#l#a! #t$ t$e adm#ss#on" d#sc$a!&e" med#cat#on p!oced*!e ' also t$e !#&$t o( mentally #ll pt+ ' !eco!d#n& ' !epo!t#n&+ LEGAL RESEONSI/ILIT6 O, NURSE 7+ Respons#)#l#ty O( Appo#nt#n& ' Ass#&n#n& N*!s#n& adm#n#st!ato!s a!e expected to )e a a!e o( le&al !est!#ct#ons a((ect#n& pe!sonnel appo#ntment ' ass#&nment+ A mana&e! $o depa!ts (!om a&encys $#!#n& pol#c#es can )e $eld ne&l#&ence #( s$eH$e appo#nts an employee #t$o*t app!op!#ate sc!een#n& ' t$at employee late! #n:*!es a pat#ent+

In (loat#n& n*!ses to an #ntens#%e ca!e *n#t to compensate (o! *nde!sta((#n&" t$e mana&e! s$o*ld !eass#&n only t$ose n*!ses $ose ed*cat#on ' expe!#ence $a%e p!epa!ed t$em to pe!(o!m all t$e n*!s#n& (*nct#ons common to an #ntens#%e ca!e *n#t+ Eac$ n*!se $as le&al !espons#)#l#ty to ma-e (*ll d#sclos*ce!e o( $e! o! $#s )ac-&!o*nd -no led&e ' s-#ll ' not#(y t$e n*!se mana&e! $en &#%en an ass#&nment (o! $#c$ s$eH$e #s not 0*al#(#ed+ T$e mana&e! #s also o)l#&ed to ad:*st t$e amo*nt ' type o( s*pe!%#s#on to (#t an employees le%el o( mat*!#ty ' expe!#ence+ Less expe!#enced o! less s-#lled employees need mo!e p!o(ess#onal s*ppo!t ' ad%#ce (!om t$e mana&e!+ 9+ Respons#)#l#ty #n J*al#ty Cont!ol A n*!se mana&e!s le&al !espons#)#l#ty (o! 0*al#ty cont!ol o( N*!s#n& se!%#ce #mpose a d*ty to o)se!%e !epo!t ' co!!ect t$e #ncompetence o( any pat#ent ca!e p!o%#de!+ Us*ally t$e $ead n*!se o! a!d #nc$a!&e #s !espons#)le (o! 0*al#ty o( pat#ent ca!e &#%en )y all pe!sonnel #ncl*d#n& med#cal on n*!s#n& *n#t+ =+ Respons#)#l#ty (o! e0*#pment To p!otect pat#ent ' employees (!om #n:*!y" a n*!se mana&e! m*st ens*!e t$at all pat#ent ca!e e0*#pment a!e (*lly (*nct#onal ' t$at de(ect#%e e0*#pment #s p!omptly !epa#!ed ' !eplaced+ N*!se also $as d*ty to !e(*se to *se e0*#pment -no n to )e (a*lty o! t$at as not des#&ned (o! *se #n t$e s#t*at#on $e!e #t as o!de!ed+ >+ Respons#)#l#ty (o! o)se!%at#on ' !epo!t#n& N*!s#n& pe!sonnel $a%e mo!e (!e0*ently ' p!olon&ed pat#ent contact t$en ot$e! ca!e &#%e!+ N*!ses $a%e a le&al d*ty to o)se!%e pat#ent (!e0*ently ' !epo!t (#nd#n&s t$at $a%e d#a&nost#c o! t!eatment %al*e (o! t$e pat#ents p$ys#c#an ' ot$e! mem)e!s o( t$e pts t!eatment team+ T$e n*!se $as t$e d*ty to !eco!d ' !epo!t o)e!%at#on o( t$e pat#ents cond#t#on p!omptly so t$at t$e p$ys#c#an can )ase t!eatment" dec#s#on on *p-to-date #n(o!mat#on a)o*t t$e pat#ents $ealt$ needs+ >+ Respons#)#l#ty to p!otect p*)l#c T$e n*!se $as a le&al d*ty to p!otect t$e p*)l#c (!om #n:*!y )y dan&e!o*s pt+ eac$ n*!se mana&e! o! adm#n#st!ato! s$o*ld ens*!e t$e pol#cy desc!#)#n& t$e p!oced*!e to )e (ollo ed $en a pat#ent #t$ %#olent tendenc#es+ A+ Respons#)#l#ty (o! !eco!d -eep#n& ' !epo!t#n& N*!ses $a%e le&al !espons#)#l#ty (o! acc*!ately !epo!t#n& ' !eco!d#n& pat#ents cond#t#on t!eatment ' !esponses to ca!e+ Eat#ents !eco!d #s essent#al (o! p!ope! ca!e ' #t #s t$e p!ope!ty o( $ealt$ ca!e a&ency+ ,a#l*!e to !eco!d s#&n#(#cant pt+ #n(o!mat#on #n t$e med#cal !eco!d ma-es a n*!se &*#lt o( ne&l#&ence+ T$e med#cal !eco!d m*st )e acc*!ate" e!!o!s #n n*!ses c$a!t#n& m*st )e co!!ected p!omptly #n a manne! t$at lea%es no do*)t a)o*t t$e (act+ B+ Respons#)#l#ty (o! Deat$ ' Dy#n& N*!ses m*st )e a a!e o( le&al de(#n#t#on o( deat$ )eca*se t$ey m*st doc*ment all e%ents t$at" $en t$e pat#ent #s #n t$e#! ca!e+ In add#t#on" n*!ses $a%e ot$e! spec#(#c

le&al d*t#es $#c$ #ncl*de t!eat a deceased pe!son #t$ d#&n#ty ; !on&(*l $andl#n& #s a &!o*nd (o! la s*#t8 R*les and ,*nct#ons o( N*!se Mana&e! In Le&al Iss*es T$e (ollo #n& a!e t$e leade!s$#p !oles ' mana&e!#al (*nct#ons o( a n*!se mana&e! #n le&al ' le&#slat#%e #ss*es" $#m o! $e!F 78 Se!%e as a !ole model )y p!o%#d#n& n*!s#n& ca!e t$at meets o! exceeds accepted standa!ds o( ca!e+ 98 See- p!o(ess#onal ce!t#(#cat#on to #nc!ease expe!t#se #n a spec#(#c (#eld+ =8 ,oste! n*!se-pt+ !elat#ons$#p t$at a!e !espect(*l" ca!#n& ' $onest" t$*s !ed*c#n& t$e poss#)#l#ty o( (*t*!e la s*#ts+ >8 Repo!t s*)standa!d n*!s#n& ca!e to app!op!#ate a*t$o!#ty+ A8 5o#ns ' act#%ely s*ppo!ts p!o(ess#onal o!&an#4at#ons to st!en&t$en t$e lo))y#n& e((o!ts o( n*!ses #n $ealt$ ca!e le&#slat#on+ B8 E!act#ce n*!s#n& #n t$e a!ea o( #nd#%#d*al competence+ C8 E!#o!#t#4es pat#ents !#&$ts ' el(a!e (#!st #n dec#s#on ma-#n&+ K8 Demonst!ate %#s#on" !#s- ta-#n&" ' ene!&y #n dete!m#n#n& app!op!#ate le&al )o*nde!#es (o! n*!s#n& p!act#ce" t$*s de(#n#n& $at n*!s#n& #s ' s$o*ld )e #n (*t*!e+ L8 Mno led&ea)le !espond#n& so*!ces o( la ' le&al doct!#nes t$at a((ects n*!s#n& p!act#ce+ 7I8 Del#&ates to s*)o!d#nates #sely+ 778 Unde!stand ' ad$e!es to #nst#t*t#onal pol#c#es ' p!oced*!es+ 798 E!act#ce n*!s#n& #t$#n t$e scope o( t$e state n*!se p!act#ce act+ 7=8 Mon#to!s s*)o!d#nates to ens*!e t$at t$ey $a%e a %al#d" c*!!ent ' app!op!#ate l#cense to p!act#ce n*!s#n&+ 7>8 Uses (o!esee a)#l#ty to $a!m #n del#&at#on ' sta((#n& dec#s#ons+ 7A8 Inc!eases sta(( a a!eness o( #ntent#onal to!ts ' ass#st t$em #n de%elop#n& st!ate&#es to !ed*ce t$e#! l#a)#l#ty t$ese a!eas+ 7B8 E!o%#des ed*cat#onal ' t!a#n#n& oppo!t*n#t#es (o! sta(( on le&al #ss*es a((ect#n& n*!s#n& p!act#ce+ L#st o( Dos ' Donts as &*#del#nes (o! sa(e p!act#ce+ Dos 7+ doc*mentat#on o( all *n*s*al #nc#dences+ 9+ Repo!t all *n*s*al #nc#dences+ =+ -no yo*! :o) desc!#pt#on+ >+ ,ollo pol#ces ' p!oced*!es as esta)l#s$ed )y yo*! employ#n& a&ency+ A+ Meep yo*! !e&#st!at#on *pdated+ B+ pe!(o!m p!oced*!es t$at yo* $a%e )een ta*&$t ' t$at a!e #t$#n t$e standa!d scope o( yo*! p!act#ce+ C+ E!otect pat#ents (!om #n:*!#n& t$emsel%es+ K+ Rema#n ale!t ' (oc*sed+ L+ esta)l#s$ ' ma#nta#n t$e !appo!t #t$ t$e pt+ 7I+ See- ' cla!#(y o!de!s $en pat#ents med#cal cond#t#on c$an&es+ 77+ E!act#ce sa(ety #t$ p$ys#c#ans %e!)al o!de!s+ Donts 7+ Remo%e s#de !a#ls (!om pts )ed *nless t$e!e #s an o!de! o! $osp#tal pol#cy to do so+ 9+ Allo t$e pt+ to lea%e t$e $osp#tal o! n*!s#n& $ome *nless t$e!e #s an o!de! o! s#&ned !elease+ =+ accept money o! &#(ts (!om pat#ents >+ G#%e ad%#ce t$at #s cont!a!y to p$ys#c#an o!de! o! t$e n*!s#n& ca!e plan+

A+ G#%e med#cal ad%#ce to (!#ends ' ne#&$)o*!s+ B+ Attempt to p!act#ce med#c#ne+ C+ #tness a pts #ll+ K+ Ta-e med#cat#ons t$at )elon&s to pat#ents L+ 1o!- as a l#censed p!act#calH%ocat#onal n*!se #n a state #n $#c$ yo* a!e not l#censed+ LIA/ILIT6< EERSONAL" DICARIOUS AND COREORATE Ee!sonal l#a)#l#ty de(#nes eac$ pe!sons !espons#)#l#ty ' acco*nta)#l#ty (o! #nd#%#d*al act#on o! om#ss#on+ E%en #( ot$e!s can )e s$o n to )e l#a)le (o! a pat#ent #n:*!y" eac$ #nd#%#d*al !eta#n pe!sonal acco*nta)#l#ty (o! $#sH$e! act#on+ D#ca!#o*s o! s*)st#t*ted" l#a)#l#ty" t$e doct!#ne o( !espondent s*pe!#o! ma-es employe!s acco*nta)le (o! t$e ne&l#&ence o( t$e#! employees+ T$e !at#onale *nde!ly#n& t$e doct!#ne #s t$at t$e employee o*ld $a%e not )een #n a pos#t#on to $a%e ca*sed t$e !on&do#n& *nless $#!ed )y t$e employe! ' t$at t$e #n:*!ed pa!ty #ll )e allo ed to s*((e! a do*)le !on& me!ely )eca*se most employees *na)le to pay dama&es (o! t$e#! !on&do#n&s+ N*!se Mana&e!s can )est a%o#d t$ese #ss*es )y ens*!#n& t$at t$e sta(( t$ey s*pe!%#se -no ' (ollo $osp#tal pol#cy ' p!oced*!e ' del#%e! competent n*!s#n& ca!e+ N*!ses o(ten )el#e%e t$at t$e doct!#ne o( %#ca!#o*s l#a)#l#ty s$#elds t$em (!om pe!sonal l#a)#l#ty" t$e #nst#t*t#on may )e s*ed" )*t not t$e #nd#%#d*al n*!se o! n*!ses+ .o e%e! pat#ents #n:*!ed )eca*se o( s*)standa!d ca!e $a%e t$e !#&$t to s*e )ot$ t$e #nst#t*t#on ' n*!se+ In add#t#on t$e #nst#t*t#on $as t$e !#&$t *nde! 2#ndemn#(#cat#on3 to s*e t$e n*!se (o! t$e dama&es pa#d an #n:*!ed pat#ent+ t$e p!#nc#ple o( #ndemn#(#cat#on #s appl#ca)le $en t$e employe! #s $eld l#a)le )ased solely on t$e act#on o( t$e sta(( mem)e!s ne&l#&ence ' t$e employe! pays moneta!y dama&es )eca*se o( t$e employees ne&l#&ent act#on+ Co!po!ate l#a)#l#ty #s ne e! t!end #n t$e la ' essent#ally $olds t$at t$e #nst#t*t#on $as t$e !espons#)#l#ty ' acco*nta)#l#ty (o! ma#nta#n#n& an en%#!onment t$at ens*!es 0*al#ty $ealt$ ca!e del#%e!y (o! cons*me!s+ Co!po!ate l#a)#l#ty #ss*es #ncl*de ne&l#&ent $#!#n& ' (#!#n& #ss*es" (a#l*!e to ma#nta#n sa(ety #n p$ys#cal en%#!onment" ' lac- o( 0*al#(#ed" competent ' ade0*ate sta((+ N*!se mana&e! play a -ey !ole #n ass#st#n& t$e #nst#t*t#on to a%o#d co!po!ate l#a)#l#ty+ Concl*s#onT$e!e a!e many le&al #ss*es con(!ont#n& p!act#c#n& n*!se todayF )*t n*!ses s$o*ld %#e t$e la " not #t$#n app!e$ent#on" )*t as a $elp(*l pa!tne! #n de(#n#n& n*!s#n& p!act#ce+ N*!ses $o a!e a a!e o( le&al !#&$ts ' o)l#&at#ons a!e )ette! p!epa!ed to ta-e &ood ca!e o( pat#ents+ Some le&al #ss*es " s*c$ as t$e necess#ty o( #n(o!med consent ' a%o#d#n& ne&l#&ence a!e #n%ol%ed #n almost e%e!y )!anc$ o( n*!s#n&+ N*!ses a!e !espons#)le (o! -no #n& t$e la t$at apply to t$e#! a!eas o( n*!s#n& p!act#ce+

/I/LIOGRAE.6 78 /asa%ant$appa /+T+< N*!s#n& Adm#n#st!at#onF 9nd ed#t#onF 5aypee E*)l#cat#onF Ea&e noKI=-K9C+ 98 Ma!y L*c#ta< n*!s#n& p!act#ce ' p*)l#c $ealt$ adm#n#st!at#onF 9nd ed#t#onF Else%#e! p*)l#cat#onF pa&e no+ 7LL+ =8 Maste!s< Role De%elopment In E!o(ess#onal N*!s#n& E!act#ceF 5ones ' /a!tlett E*)l#s$e!F Ea&e no+ 99C-9=I+ >8 Cla!-< c!eat#%e n*!s#n& leade!s$#p ' mana&ementF 5ones ' /atlett E*)l#s$e!F pa&e no+ 7LK-9I9+ A8 Tappen< N*!s#n& Leade!s$#p ' Mana&ement Concepts ' E!act#cesF >t$ ed#t#onF ,+A+Da%#s E*)l#cat#onF Ea&e no+>>I->>7+ B8 6ode!- #se< Lead#n& ' Mana&#n& In N*!s#n&F =!d ed#t#onF E%ol%e E*)l#cat#on F Ea&e no+A=-AC+