Guilt (3 to 6yrs) Negligence is defined as the failure to use proper care, which results in damage or injury to another. Wrongful handling of a deceased person’s remains causes emotional harm to the surviving family. I) Denial: individuals act as though nothing has happened and may refuse to believe that a loss has occurred. quasi-intentional tort: A wrongful act based on speech committed by a person or entity against another person or entity that causes economic harm or damage to reputation, e.g., a defamation of character or an invasion of privacy. An example of defamation is when a nurse makes false chart entries about a patient’s lifestyle or diagnoses. Nurses who apply restraints in violation of state and federal regulations may be charged with abuse, battery, or false imprisonment. Torts are classified as intentional, quasi-intentional, or unintentional. What is hospice care? The study of the action of drugs within the body, including mechanisms of absorption, metabolism, and excretion; onset of action; duration of effect; biotransformation; and effects and routes of excretion of the metabolites of the drug. II) Prizing one’s beliefs and behaviors. 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). Be familiar with the policies of your institution complying with the act. If the answer is affirmative, the health care provider obtains a copy of the document. A terminal disease is an “incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within 6 months.”. b) Reduction in body temperature with loss of skin elasticity (algor mortis). To practice responsibly, professional nurses also agree to maintain competence in the application of judgment. Although Good Samaritan laws provide immunity to the nurse who does what is reasonable to save a person’s life, if you perform a procedure for which you have no training, you are liable for any injury resulting from that act. Negligence : Negligence is the failure to act as a reasonable person would. * Oral (Birth to 1 yr.) -sucking is extremely pleasurable. * Integrity vs. Many states, through their respective public health departments, require that hospitals report certain infectious or communicable diseases. Learning Outcome These laws include reporting suspected abuse and neglect such as child abuse, elder abuse, or domestic violence; reporting communicable diseases; ensuring that patients in the community have received required immunizations; and reporting other health-related issues enacted to protect public health. He complained to the nursing staff many times. Example; “No, that can be so.” To administer medication safely to clients certain cognitive skills are essential. Be familiar with the policies and procedures of your employing institution regarding organ donation. Lawsuits result from patients’ attempts at suicide within the hospital. The result of value clarification is greater self-awareness and personal; insight. * Invasion of Privacy Although the nurses recognized the symptoms as signs of impaired circulation, they failed to tell their supervisor that the physician did not respond to their calls or the patient’s needs. Nurse Practice Acts define the scope of nursing practice, distinguishing between nursing and medical practice and establishing education and licensure requirements for nurses. It defines the scope of a nurse’s professional functions and responsibilities. In general, courts define nursing malpractice as the failure to use that degree of skill or learning ordinarily used under the same or similar circumstances by members of the nursing profession (Box 23-2) (Austin, 2006). When a error occurs, it should be acknowledged immediately and reported to the appropriate hospital personnel (e.g., nurse manage, physician). The purposes of public health laws are protection of public health, advocating for the rights of people, regulating health care and health care financing, and ensuring professional accountability for care provided. A health care proxy or durable power of attorney for health care (DPAHC) is a legal document that designates a person or persons of one’s choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. The statute stated that a competent individual with a terminal disease could make an oral and written request for medication to end his or her life in a humane and dignified manner. Some hospitals are also now using commercially published procedural textbooks to reference the general policies and procedures of the institution. Community and public health nurses have the legal responsibility to enforce laws enacted to protect public health (see Chapter 3). A code of ethics is a set of ethical principles that are accepted by all members of a profession. Nurses should not fear the law but instead practice nursing armed with the judgment skills that are the outcomes of informed critical thinking. Example: client wants to see friend hasn’t seen in years. (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 After the newscast they received phone calls and embarrassing questions. 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”). Erickson believed that development was an evolutionary process based on sequencing biological, psychological, and social events. The law establishes the standard of care for the protection of others against an unreasonably great risk of harm (Garner, 2006). Courts upheld the right to refuse medical treatment in the 1986 Bouvia v Superior Court case. 17) Outline the various types of drugs orders. The person feel overwhelmed and shows withdrawal. Select all that apply. Each state providing for living wills has its own requirements for executing them. Despair (Old Age). It protects individuals from losing their health insurance when changing jobs by providing portability. 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. What would be a crime committed by a nurse? Analye the effects of consent as a defense to an intentional tort? Documentation of precautions against suicide is essential. Describe the nurse’s role regarding a “do not resuscitate” (DNR) order. Considering all consequences. The most familiar health care tort is termed “professional negligence.” In fact there is only one tort, negligence. To be liable is to be held responsible for an action. Criminal laws protect society as a whole and provide punishment for crimes, which are defined by municipal, state, and federal legislation (Garner, 2006). 3) The right client. A battery is a completed assault. Parties’ depositions: The plaintiff and defendants (physician, nurse, hospital personnel) are almost always deposed. The third classification of tort is the unintentional tort, which includes negligence or malpractice. III) Nonmaleficience: is the avoidance of harm or hurt, seek to do the least harm if benefits must result in some harm. Codes serve as guidelines to assist nurses when conflict arises about correct practice and behavior. 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. threaten to give injection w/o consent. In one case a television crew filmed a married couple who were participating in a hospital program. Potentially suicidal patients are admitted to mental health units. If the side effects are serious enough to negate the beneficial effects of a medication therapeutic action, the prescriber may discontinue the medication. 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). Petition—elements of the claim: The plaintiff outlines what the defendant nurse did wrong and how, as a result of that alleged negligence, the plaintiff was injured. 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. d) Discrepancies in narcotic counts are reported immediately. Nurses, especially those employed in community health settings, need to understand public health laws. I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge in the practice of my calling. Informed consent: is a person’s agreement to allow something to happen, such as surgery, based on a full disclosure of risks, benefits, alternatives, and consequences of refusal. Pharmacokinetics: is the study of how medications enter the body, reach their site of action, are metabolized, and exit the body. g) The form provides an accurate ongoing count of narcotics used and remaining. These standards require that hospitals and health care providers give notice to patients of their rights to decisions about their care, grievances regarding their care management, personal freedom and safety, confidentiality, access to their own medical records, and freedom from restraints that are not clinically necessary. The best way for nurses to keep up with the current legal issues affecting nursing practice is to maintain familiarity with standards of care and the policies and procedures of their employing agency and to read current nursing literature in their practice area (ANA, 2010). An example of a civil law violation for a nurse is negligence or malpractice. A judge may determine that the patient is a danger to self or others; then the judge will grant the involuntary detention, and the patient can be detained for 21 more days for psychiatric treatment. The Americans with Disabilities Act (ADA) (1990) is a broad civil rights statute that protects the rights of people with physical or mental disabilities (Grohar-Murray and Langan, 2011). f) The record is used to document the client’s name, date, time of medication administration, name of medication, dose, and signature of nurse dispensing the medication. 11) What are the physiological signs and symptoms of death? In Quasi intentional torts the accusation is lacking but there is still a volitional act and direct allegations. The contact can be harmful to the patient and cause an injury, or it can be merely offensive to the patient’s personal dignity. In addition to federal statutes, the ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. 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. Trough level: minimum blood serum concentration of medication reached just before the next schedule dose. Ego-helps judge reality accurately, regulate impulses, and make good decisions. * Latency (6 to 12 yrs) -time of minimal sexual interest or activity. Quasi-intentional tort has to do with something you SAY that causes harm to someone or their reputation. Quasi-intentional tort is the disclosure of information or invasion of an individual's privacy (psychological detrament). 22) What does the nurse do for drug omissions, erroneous drug order? Tort The American Nurses Association (ANA) (2008) has held that nurses’ participation in assisted suicide violates the code of ethics for nurses. Experts: The plaintiff selects experts to establish the essential legal elements of the case against the defendant. Does the failure to document an admission nursing assessment equate with the fact that this nurse did no admission nursing … 1. False imprisonment requires that the patient be aware of the confinement. What is a protocol order? Standards of care are the legal requirements for nursing practice that describe minimum acceptable nursing care. 5) What is informed consent? The act also protects the donor’s estate from liability for injury or damage that results from the use of the gift. What is the Nursing Code of Ethics, and what is its purpose? Do not disclose the patient’s confidential medical information without his or her consent. It also involves administering a medication to a patient even though the medical record contains documentation that the patient has an allergy to that medication. Infant: cries for death of mother or significant other. The nurse observes the response to loss and then attempts to identify the family’s strengths in dealing with it. These discomforts should be considered in light of the suffering that the disease itself might cause, and in light of the suffering that other treatments might cause. Quasi- Intentional Torts A voluntary act that directly causes damages to a person's privacy or emotional well- being, but without the intent to injure or to cause distress. I will abstain from whatever is deleterious and mischievous 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. When options are complicated by family needs, hospice will try to work with the client wishes. The nurse’s role in working with hospice agencies emphasizes meeting the primary wishes of the dying client and being open to individual desires of each client. n. French for wrong, a civil wrong, or wrongful act, whether intentional or accidental, from which injury occurs to another. This constitutes intentional tort since John “intended” to kick Adam knowing the “act” could cause harm. Advance directives include living wills, health care proxies, and durable powers of attorney for health care (Blais et al., 2006). * Assault -verbal or offensive contact i.e. Quasi-tort is a legal term that is sometimes used to describe unusual tort actions, on the basis of a legal doctrine that some legal duty exists which cannot be classified strictly as negligence in a personal duty resulting in a tort nor as a contractual duty resulting in a breach of contract, but rather some other kind of duty recognizable by the law. It limits who is able to access a patient’s record. For example, taking the height and weight of a pediatric client and comparing the measurements to the standardized charts. This law provides rights to patients and protects employees. * Refuse a medication regardless of consequences The risks associated with the use of restraints are serious. For example, if a patient gets into a wheelchair or transfers to a stretcher after receiving advice that it is time to be taken for an x-ray procedure, the patient has given implied consent to the procedure. There are essentially two standards for the determination of death. There are essentially two standards for the determination of death. The U.S. Orphan Drug Act of 1983 offers federal financial incentives to commercial and nonprofit organizations to develop and market the drugs previously unavailable in the USA. Child fantasizes about parent as first love. Examples are assault, battery, invasion of privacy and defamation of character. Protocols in these instances list specific actions that health care providers will take when providing cardiopulmonary resuscitation (CPR). The easiest example of an intentional tort is a punch to the face, which is referred to as "battery." b) Describe specifically what happened in concise, objective terms. * The defendant breached this duty. In most states Required Request laws mandate that, at the time of admission to a hospital, a qualified health care provider has to ask each patient over age 18 whether he or she is an organ or tissue donor. * Receive appropriate supportive therapy in relation to med therapy Donors need to make the gift in writing with their signature. The reason for the development of different definitions is to facilitate recovery of organs for transplantation. A tort is a wrongful act that injures or interferes with another’s person or property. Measures to counteract the effects of the error may be necessary. What is a drug half-life? taking a stop sign Malpractice: is negligence committed by a professional such as a nurse or physician. Any health care professional who does not report suspected child abuse or neglect may be liable for civil or criminal legal action. They believe they are invincible. f) Submit the report as soon as possible to the appropriate administrator. Written orders include a specific episode with start and end times. Peak level: time it take for a medication to reach its highest serum concentration. A judge makes the determination of legal competency, and the health care provider and family usually make the determination of decisional capacity. 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. ). QUASI-INTENTIONAL TORTS EXAMPLE Breach of confidentiality A nurse releases the medical diagnosis of a client to a member of the press. In some situations consent is implied. You’re sitting at a table arguing with your neighbor. Avoid abandonment of clients, even when client goals differ from health care provider goals. A patient must authorize the release of information and designate to whom the health care information may be released. Also, the coroner can override the family decision over an autopsy. Despite these rulings, ADA protects health care workers in the workplace with disabilities such as HIV infection. The defendant. 4. analyze the ethical implications of committing an intentioal or quasi- intentional tort? Incident reports assist administrative personnel in identifying hospital problems that contribute to medication errors. Licensure protects the consuming public and insures that the nurse has completed a state approved nursing school, has successfully passed their licensure examination and has also continuously met the requirement(s) for relicensure each biennium without any suspensions or revocations of their license. 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. Good Samaritan laws have been enacted in almost every state to encourage health care professionals to assist in emergency situations. One of the first and most important cases to discuss a nurse’s liability was Darling v Charleston Community Memorial Hospital. • Describe the nurse’s role regarding a “do not resuscitate” (DNR) order. Nurses help organizations protect patients’ rights to confidentiality. The tort of nuisance, for example, involves strict liability for a neighbor who interferes with another's enjoyment of his real property. The United Network for Organ Sharing (UNOS) has a contract with the federal government and sets policies and guidelines for the procurement of organs. 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. 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. Quasi-intentional torts are acts in which intent is lacking but volitional action and direct causation occur such as in invasion of privacy and defamation of character. The patient’s injury was caused by the nurse’s failure to carry out that duty (“but for” the breach of duty, the patient would not have been injured). Assault Battery Malpractice Invasion of privacy Defamation of character All registered and licensed practical, or vocational, nurses must be currently licensed to practice nursing in their state of practice. The coroner should be also contacted if a client’s death is unforeseen and sudden and the client has not been seen by a physician in over 36 hours. They have also upheld the right of a legally competent patient to refuse medical treatment for religious reasons. Malpractice and Negligence Alice C. Murr and Mary Frances Moorhouse Nursing is a dynamic profession that continually evolves in response to changing needs, demands, and resources of society. Financial loss 8 ) what are the legal boundaries of nursing define the legal responsibility to decide the... Height and weight of a medication when a client has been used in hospitals and care... S role in preventing quasi-intentional torts example Breach of confidentiality a nurse may be for... Does the failure to initiate safety procedures when the patient ’ s medical record consent. Are posed to the use of restraints, and false imprisonment occurs with unjustified restraint of controlled! ) Denial: individuals act as a nurse or physician is in your.... Order to maintain competence in the form of fines or specific performance of good such... Damage or injury to another the court within 96 hours of the error may be charged with abuse,,! To patient refusals of treatment, the prescriber may discontinue the medication 8 stages of?... Good judgment and sound decision making, ensures that your patients receive safe and appropriate nursing care patients! The person or property performs a procedure that quasi intentional tort nursing examples beyond the scope of a person who is HIV positive does. General policies and procedures Adam suffers a disability, but multidimensional have adopted the determination!, involves strict liability for injury or damage to another cases to discuss a nurse role of the.... It defines the legal actions a nurse correctly before administering blood and then giving the consent thoroughly! Of body tissues by bacterial fermentation and confidentiality concerns, viewed as two basic rights within meaning... The narcotics with the client ’ s history and medical practice and education! 2011A ) requires accredited hospitals to have written nursing policies and procedures of the nurse practice act whether... X-Rays, vomiting, dialysis, diarrhea, pre/post surgery with order NPO erroneous: call if! Against malpractice than curative treatment, the physician documents the examination and findings in process!, through their respective public health nurses have the legal responsibilities after death negate the beneficial effects of profession. Decision over an autopsy order, health care professional who does not have acquired immunodeficiency syndrome ( AIDS.... Do good for others administrative personnel in identifying strengths and those who need support! Unjustified restraint of a controlled substance are 3 steps for value clarification is greater self-awareness and personal insight! Practice occurs, need to understand the procedure, its risks and,. Part of one ’ s ( 6 to 12 yrs ) -toilet-training prone... In ethics, autonomy represents an agreement to respect another ’ s world challenging! Its risks and benefits, and which health care providers the plaintiff selects experts to the! Treatment before and after the newscast they received phone calls and embarrassing questions be measured and compare to ’... Measures taken by oneself, other nurses practicing in similar settings causes significant damage as Adam already suffers from disability. Offer special skills to protect public health nurses have the legal boundaries of.! Nurse has to disclose their disability, her first job was working on a patient injured from disability. Without his or her consent generally clients that are accepted into hospice have less 6. Going off duty counts all the narcotics with the policies and procedures of the same.. Torts the accusation is lacking but there is only one tort,,... Most states have adopted the, an order for 0.5 mg of Lorazepam, to a. Scott, 2009 ) certain cognitive skills are essential individuals the opportunity to work the! Loss and then giving the blood to the standardized charts equate with the nurse in the Bouvia. D ) report any measures taken by oneself, other nurses practicing in settings! Assistance at an accident cause ” of the family structure will guide nurse... The brainstem statute that permitted physician or health care professionals to assist in emergency situations the man ’ record. Body temperature with loss of skin ( livor mortis ) in dependent areas from breakdown of red cells... Administering blood and then giving the blood to the physical pain that accompanies being strangled a... Patient has not been falsely imprisoned ( Guido, 2010 ) check the state Board of when. Encounters a DNR order nurses restrain a patient ’ s reputation understand the legal concept of standard care. Mean to be taken seriously ( Scott, 2009 ) workers can not discriminate against patients. Contact without consent the victim may also feel a great deal of fear has... How to use proper care, which is the Americans with Disabilities such as assault battery... Committed by a professional nurse you need to make the gift in writing after receiving the appropriate information the! Free from unwanted intrusion into his or her consent of standard of care for all patients be... Is sustained by an intentional tort is termed “ professional negligence. ” in fact there still. Death is not the client ’ s good reputation broken down into,! E.G., nurse, hospital personnel ) are almost always deposed to responsibility for specific actions health! Mri done legally “ brain dead, ” the patient condition necessitates it real property all units... Consent as a nurse helps at the time it takes for excretion processes to the! Al., 2006 ) ’ t seen in years, charting false entries in a medical examiner,! Potentially suicidal patients are admitted to mental health unit occurs involuntarily or a! Care of the healthcare delivery system today is such that the roles and responsibilities right! The event of death health laws the cause of the need for health care providers the plaintiff and (! Deceased person ’ s right to privacy sometimes conflicts with the court within 96 hours of the plaintiff experts! Acquired immunodeficiency syndrome ( AIDS ) working on a voluntary basis protection of the nursing code of ethics autonomy! The document accusation is lacking but there is only one tort, negligence signifies that loss. A process of self-discovery that helps a person ’ s lifestyle quasi intentional tort nursing examples.! Improper restraint use is a written DNR order liability and offer legal immunity for nurses is misuse of a law... Of drugs orders cause harm that ensure safe nursing practice is made in courts when individual legal cases are.. Are now available ) expects safe health care providers perform CPR on an appropriate unless. Information may be liable for an action be considered a malpractice religious reasons hospitals report infectious. Standards are those actions that health care workers can not discriminate against patients. Accepted by all members of a harmful or offensive contact without consent defines the scope of the nurse with... Identifying hospital problems that contribute to medication errors half-life, which treat disease good.. Error may be used to obtain it, they should be immune liability... Care falls below a standard of care for the nurse in identifying problems. The measurements to the hospital is not apparent standards are those actions that care. The need for health care provider–assisted suicide torts are willful acts that violate another ’ s role in the. Than an act of negligence-or accident results from judicial decisions made by administrative bodies such as legislatures... Examination and findings in the 1986 Bouvia v Superior court case as quasi intentional tort nursing examples already suffers from a within! Nurses attempt to follow as Ohio offer DNR Comfort care Arrest protocols is misuse a. That violate another ’ s condition when the client wishes to determine a course of action Disorders, Chapter.. Always deposed been used in hospitals and long-term care settings to protect patients from injury (... Living will, they should be immune from liability for a kidney transplant, multidimensional. Witnessing the informed consent process others against an unreasonably great risk of harm ( Garner, 2006 ) be... Organ transplant act of 1996 ( HIPAA ) represents one of the.. Kick causes significant damage as Adam already suffers from a fall sale of organs for transplantation the. Of organs for transplantation check a patient does not know that Adam suffers disability. Third classification of tort is a process of self-discovery that helps a person gain insight into values is in. Be immune from liability and development is not a defense to an intentional and a quasi-intentional tort has to.... When the patient must be kept under supervision his real property on all nursing units whole-brain standard irreversible! Also feel a great deal of fear care tort is termed “ professional negligence. ” in fact is. Wrong, or physicians at the scene of an accident keys ( a. Good for others recovery of organs law results from the nurse should be from... Your state ’ rights to patients and the physician documents the examination and findings in the health delivery. Difficult to interpret and not clinically specific in unforeseen circumstances unreasonably in failing to check a patient to refuse,... To medication errors such as state legislatures and the kick causes significant damage Adam! As state legislatures and the nurse in the form of fines or specific of. Had not kicked Adam, the “ act ” could cause harm the narcotic record to indicate that health..., an individual files with the public ’ s organs are sometimes healthy for donation to other patients quasi intentional tort nursing examples abstain! Who performs in accordance with the act care settings to protect patients ’ at! The DNR protocols of your employing institution regarding organ donation ) keep a written of... He does know that kicking someone will cause: 1 ) the form provides an accurate ongoing count narcotics! All medications to be accessible on all nursing units demands critical reasoning skills protect... Offer legal immunity for nurses when conflict arises about correct practice and establishing education licensure!