LEC 2.4 (Part 1): Crimes Affecting the Nursing Profession

Felony

• Act or omission punishable by law (delitos)

• Committed not only by means of deceit (dolo) but also by means of fault (culpa)

• There is deceit when the act is performed with deliberate intent, and there is fault when the wrongful act results from imprudence, negligence, lack of foresight, or lack of skill

• Include all crimes punishable under the Revised Penal Code (murder, r_pe, homicide)

Law (Delitos)

A felony is punishable by…

Offense

Crimes punishable under special laws (dangerous drugs act, law on anti-violence on women and children)

Misdemeanor

Minor infraction of the law, involving crimes that carry a less severe punishment than a felony, like violation of a city ordinance

Tort

Act or omission that gives rise to injury or harm to another, and amounts to a civil wrong for which courts impose liability

1. Deceit (Dolo)

2. Fault (Culpa)

Felonies are committed by means of:

Deceit (Dolo)

Classification of Felonies

• act is performed with deliberate intent.

Fault (Culpa)

Classification of Felonies

• when the wrongful act results from imprudence, negligence, lack of foresight, or lack of skill.

1. According to Stages of Execution

2. According to Gravity of Offense

3. According to Degree of Participation

Classification of Felonies

1. Consummated

2. Frustrated

3. Attempted

3 Stages of Execution

Consummated

Stage of Execution

• when all the elements necessary for its execution and accomplishment are present.

Frustrated

Stage of Execution

• The offender performs all the acts of execution which would produce the felony as a consequence, but which nevertheless do not produce it by reason of causes independent of the will of the perpetrator.

Attempted

Stage of Execution

• When the offender commences the commission of a felony directly by overt acts and does not perform all the acts of execution which should produce the felony by reason of some cause or accident other than his own spontaneous desistance.

1. Grave Felony

2. Less Grave Felony

3. Light Felony

3 Gravity of Offense

Grave Felony

Gravity of Offense

• Those to which the law attaches the capital punishment or penalties which in any of their periods are afflictive, in accordance with Article 25 of the Revised Penal Code.

Less Grave Felony

Gravity of Offense

• Those which the law punishes with penalties which in their maximum period are correctional, in accordance with the above-mentioned article.

Light Felony

Gravity of Offense

• Those infractions of law for the commission of which the penalty of arresto menor or a fine not exceeding 200 pesos, or both, is provided.

1. Principal

2. Accomplice

3. Accessory

3 Degree of Participation

Principal

Degree of Participation

• Those who take a direct part in the execution of the act.

• Those who directly force or induce others to commit it.

• Those who cooperate in the commission of the offense by another act without which it would not have been accomplished.

Accomplice

Degree of Participation

• one who directly participates or cooperates, but such participation or cooperation is not vital nor invisible to consummating the criminal act. The crime is committed either before or simultaneous with the principal act.

Accessory

Degree of Participation

• Those who, having knowledge of the commission of the crime, and without having participated therein either as principals or accomplices, take part subsequent to its commission in any of the following manners:

  • By profiting themselves or assisting the offender to profit by the effects of the crime.

  • By concealing or destroying the body of the crime, or the effects or instruments thereof, in order to prevent its discovery.

  • By harboring, concealing, or assisting in the escape of the principal of the crime, provided the accessory acts with abuse of his public functions or whenever the author of the crime is guilty of treason, parricide, murder, or an attempt to take the life of the Chief Executive, or is known to be habitually guilty of some other crime.

1. Justifying Circumstances

2. Exempting Circumstances

3. Mitigating Circumstances

4. Aggravating Circumstances

5. Alternative Circumstances

5 Circumstances Affecting Criminal Liabilities

Justifying Circumstances

Circumstance Affecting Criminal Liabilities

• The act committed is completely in accordance with the law. Because the actor did the right thing under the circumstances, no crime is committed.

Exempting Circumstances

Circumstance Affecting Criminal Liabilities

• A crime was committed, but the person who did it lacks voluntariness, intelligence, or freedom of action. The law treats them with compassion rather than punishment.

Mitigating Circumstances

Circumstance Affecting Criminal Liabilities

• These do not clear a person of the crime, but they show a lesser degree of malicious intent or perversity, which reduces the penalty.

Aggravating Circumstances

Circumstance Affecting Criminal Liabilities

• Factors that show a greater perversity, cruelty, or malice on the part of the offender. These increase the penalty up to the maximum limit allowed by law.

Alternative Circumstances

Circumstance Affecting Criminal Liabilities

• These are unique conditions that change flavors depending on the specific facts of the case. They can be treated as either mitigating or aggravating.

Negligence (Negligentia)

failure to exercise appropriate and/or ethical care expected to be exercised in specified circumstances.

1. Duty

2. Breach of Duty

3. Resulting Injury, Harm, or Death

4. Causal Relation between breach of duty and resulting harm

To determine negligence, there must be the concurrence of four elements:

Delegation

• defined as the transfer of the nurse's responsibility for the performance of a task to another nursing staff member while retaining accountability for its outcome.

True

True or False: Responsibility can be delegated, but not accountability.

PTSDC

1. Right Person

2. Right Task

3. Right Supervision and Evaluation

4. Right Directions and Communication

5. Right Circumstances

5 Rights of Delegation

Respondeate Superior

• The institution is accountable under "____ ____" for problems arising from delegated tasks.

1. Teaching

2. Assessment

3. Planning

4. Evaluating

5. Decision-making

5 Tasks that cannot be delegated by the nurse to subordinate nursing personnel

1. Ambulating

2. Turning

3. Bathing

4. Intake and Output

5. Mouth Care

6. Toileting

7. Linen Changes

8. Feeding

9. Vital Signs (but not for unstable patients)

Tasks that can be delegated to a Nursing Assistant

1. Tasks for unstable patients

2. Medication administration

3. Invasive procedures (tube feeding, Foley catheterization, etc.)

Do Not Delegate

1. Intradisciplinary/Intraprofesional

2. Interdisciplinary/Interprofessional

3. Interdepartmental

4. Interagency

4 Types of Collaboration

Intradisciplinary/Intraprofessional

Type of Collaboration

• Coordination of patient care between members of the same discipline.

Interdisciplinary/Interprofessional

Type of Collaboration

• Coordination of patient care among members of various health care disciplines.

Interdepartmental

Type of Collaboration

• Coordination of patient care among various hospital departments within an institution.

Interagency

Type of Collaboration

• Coordination of patient care among various health institutions.

Triaging

process of sorting patients into groups based on their need for or likely benefit from immediate medical treatment

1. Emergent

2. Urgent

3. Non-Urgent

3 Triage Categories

Emergent

Triage Category

• shall be seen immediately and not exceed 15 minutes. These include cases that need immediate resuscitation that, if not immediately attended to, will result in death and permanent disability.

Urgent

Triage Category

• shall be seen in 30–60 minutes

Non-Urgent

Triage Category

• shall be seen within 2–4 hours

1. Red (Immediate)

2. Yellow (Observation)

3. Green (Wait)

4. White (Dismiss)

5. Black (Expectant)

5 Color-Coding Scheme in Mass Casualty Situations

Red (Immediate)

Color-Coding Scheme in Mass Casualty Situations

• Used to label those who cannot survive without immediate treatment but who have the chance of survival.

• Examples:

  • Massive hemorrhage

  • Tension pneumothorax

  • Cardiac tamponade

Yellow (Observation)

Color-Coding Scheme in Mass Casualty Situations

• For those who require observation and possible later re-triage.

• Their condition is stable for the moment and they are not in immediate danger of death.

• Examples:

  • Pulmonary contusion

  • Minor amputations

  • Wounds

Green (Wait)

Color-Coding Scheme in Mass Casualty Situations

• Reserved for walking wounded patients who need medical care at some point after more critical injuries have been treated.

• Examples:

  • Minor lacerations

  • Abrasions

  • Sprain

White (Dismiss)

Color-Coding Scheme in Mass Casualty Situations

• Given to those with minor injuries for whom a doctor's care is not required.

Black (Expectant)

Color-Coding Scheme in Mass Casualty Situations

• Assigned to those whose injuries are so extensive that they will not survive even with available care.

1. Narrative Charting (Traditional)

2. Problem-Oriented Medical Record (POMR) / SOAPIE(R) Format

3. Focus Charting: Involves the Data, Action, Response (DAR) category.

4. Electronic Medical Records (EMR)

4 Methods of Documentation in Nursing

1. Kardex

2. Flow Sheets

3. Nurse's Progress Notes

4. Discharge Summary

4 Other Forms of Documentation

Noted :))

Note the following:

Nurse's Responsibilities on Charting

• Nurses should maintain a systematic manner in keeping records. Legible handwriting is observed, avoiding any alterations and unnecessary erasures. Keeping each entry concise and clear is a must.

• Whenever an order, handwritten or automated, is done, it is the nurse’s responsibility to ensure that the order is complete and appropriate and that orders are carried out promptly.

• Nurses are responsible for receiving and processing physician provider orders. Some of the specific aspects of this responsibility include the nurse’s review of an order for completeness, numerically correct interpretation, questioning orders that are incomplete, illegible, and/or not clear.

• Telephone orders and other verbal orders are strongly discouraged. They can lead to serious errors, which increases the risk of a provider to get an order. The nurse must fully document the order and the circumstances that necessitated the telephone order. The nurse will then read the order back to the ordering physician to confirm its correctness. Some facilities also require two nurses to hear and confirm the order.

Noted :))

Note the Following:

Incidents, Irregular Occurrences, and Variances

Purpose

• To give the institution and the health care team data about the incident and the opportunity to address the issue and minimize risks.

  • Example: The development of a pressure ulcer secondary to falls, immobility, and poor nutritional status.

Information That Is Typically Reported in Incident / Accident Reports Includes:

1. The date, time, and place of the incident or accident.

2. Clear, concise, and objective data about the occurrence and any surrounding factors (e.g., slippery floor) that may have led to the incident or accident.

3. The name of the person or persons who were affected by the incident or accident.

4. The names of any witnesses.

5. Any injuries that were sustained as a result of the incident or accident.

6. All care and treatments that were provided to the person who was adversely affected by the incident or accident.

7. The names of people, such as the client’s doctor, who were contacted and notified about the incident or accident.