Module 6 Legal Dimensions in Nursing

Legal Dimensions of Nursing

Introduction

• Role of the nurse has expanded significantly.

• Legal accountability has evolved along with nursing roles.

• Nurses face increasing scrutiny in civil and criminal cases.

• Emphasizes the importance of practicing legally prudently rather than in fear of lawsuits.

Learning Objectives

• Understand professional and legal regulation of nursing.

• Identify grounds for license suspension or revocation.

• Differentiate between intentional and unintentional torts.

• Evaluate personal liability areas in nursing.

• Understand legal safeguards in nursing practice.

• Explain the purpose and importance of incident reports.

• Describe laws related to nursing practice.

Nursing Practice Hierarchy

• Federal Level: Medicare and Medicaid provisions affecting nursing services reimbursement.

• State Level: Regulations defining scope of practice for RNs, LVNs, and APRNs.

• BRN (Board of Registered Nursing): Guidelines on delegation, medication administration, licensing, and addressing unprofessional conduct.

• Institution Level: Policies and procedures governing nursing practice.

Crimes vs. Torts

• Crime: Violation punishable by the state.

• Tort: Civil wrong leading to legal action for damages.

  • Intentional torts: Grounds for prosecution.

  • Unintentional torts: Includes negligence.

• Serious criminal actions: drug trafficking, kidnapping, murder, fraud categorized as misdemeanors or felonies.

Intentional Torts

Types of Intentional Torts

• Assault: Threat to harm without consent.

• Battery: Actual harmful contact without consent.

Defamation of Character

• Slander: Spoken defamatory remarks.

• Libel: Written defamatory statements.

• Example: Nurses making false statements can be sued.

Invasion of Privacy

• Rights protected under the Fourth Amendment.

• Information is confidential—applies to all recorded, spoken, or written data.

  • Locations pose risks in hospitals regarding patient privacy.

  • Protected by the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA

• Violations lead to severe penalties:

  • $250,000 fine or up to 10 years in prison.

• Examples of invasions of privacy:

  • Unnecessary exposure of patients.

  • Discussing patient information in public settings.

  • Using tape recorders without consent.

Intentional Torts (Continued)

False Imprisonment

• Definition: Preventing movement without consent.

• Regulations on restraint use: Only reasonable use allowed, must not serve coercive, punitive, or convenient purposes.

Fraud

• Definition: Willful misrepresentation leading to harm.

• Examples include false claims about patient care outcomes or reporting erroneous assessment data.

Unintentional Torts

Negligence

• Definition: Failing to act as a reasonably prudent person under similar circumstances or performing unnecessary actions.

• Malpractice: Specifically in professional nursing contexts.

  • Common negligence issues: Failing to ensure safety, improper treatment, medication errors.

Issues Affecting Competent Practice

• Key factors include:

  • Nurse fatigue

  • Impairment in nursing.

Liability

• Four elements to prove malpractice/negligence:

  • Duty: Standard of care expected from nurses.

  • Breach of Duty: Failing to meet that standard.

  • Causation: Linking breach to injury (most challenging to prove).

  • Damages: Actual harm suffered by patient.

Example of Malpractice

• Scenario: Unattended patient, fall resulting in hip fracture and laceration.

  • Duty: Ensure patient safety, especially with confusion.

  • Breach of Duty: Leaving siderails down.

  • Causation: Direct link to the patient’s injuries.

  • Damages: Physical injuries sustained by the patient and related consequences.

Legal Safeguards for Nurses

• Essential practices include:

  • Maintaining competence in nursing skills and knowledge.

  • Upholding communication skills and legal practice boundaries.

  • Following institutional policies.

  • Acknowledging personal strengths/weaknesses.

  • Refusing unprepared responsibilities.

  • Documenting patient interactions accurately and thoughtfully based on standards.