Nursing Exam Notes
Florence Nightingale
Modern Nursing Founder: Credited with laying the foundation for professional nursing.
Advocate for Sanitation: Improved hygiene and hospital conditions, drastically reducing mortality rates during the Crimean War.
Data-Driven: Used statistics and evidence to support healthcare reform.
Established Nursing Education: Founded the first secular nursing school (St. Thomas' Hospital, London), emphasizing formal training.
Raised Nursing's Status: Helped shift nursing from a domestic role to a respected, skilled profession.
The 1850s marks the start of nursing with Florence Nightingale.
First known epidemiologist and practicing nurse epidemiologist.
Established the first nursing philosophy based on health maintenance and restoration.
Advocated handwashing between patients.
Organized the first school of nursing in 1860.
Connected poor sanitation with cholera and dysentery.
Improved sanitation in battlefield hospitals.
Reduced mortality rate at the barracks hospital in Turkey from 42.7% to 2.2% in 6 months.
Her practices remain a basic part of nursing today.
The Development of a Profession
Specific characteristics of being a professional:
Having power.
Having a high level of education.
Demonstrates competence.
Participates in intellectual operations.
Provides services vital to human and social welfare, making the world a better place.
Has their own special body of knowledge on which they build their skills and services around.
High level of individual responsibility.
Has a relatively high degree of independence in practice.
Sees their job as their life's work.
Works under a professional organization that has a code of ethics.
Sources of Power
Legitimate power: Stems from an individual's structural role within an organization.
Reward power: Based on the ability to provide benefits or rewards to others.
Coercive power: The capacity to impose penalties or sanctions.
Expert power: Arises from possessing specialized knowledge or skills.
Information power: Involves having access to valuable data or insights.
Referent power: Derives from personal attributes that inspire admiration or respect, allowing one to influence others.
How Nurses Gain Power and Autonomy
Education: Higher levels of education increase knowledge, critical thinking, and credibility.
Professionalism: Adhering to ethical standards, maintaining competence, and being involved in professional organizations.
Collective Action: Unionizing and participating in professional associations to advocate for better conditions and policies.
Political Involvement: Influencing healthcare policy and legislation through voting, advocacy, and holding office.
Leadership Roles: Taking on roles in management, education, or advanced practice to shape practice and policy.
Evidence-Based Practice: Using research to guide care increases respect and professional authority.
Interdisciplinary Collaboration: Engaging equally with other healthcare professionals builds respect and influence.
Accountability and Professionalism
Accountability:
Being responsible and answerable for one's actions and decisions in nursing practice.
Accepting ownership of care provided and the outcomes that result.
Nurses must be accountable to patients, employers, the profession, and society.
Professionalism:
A commitment to carrying out professional responsibilities, adhering to ethical principles, and maintaining high standards of practice.
Includes behaviors such as competence, integrity, respect, lifelong learning, and advocacy.
A professional nurse demonstrates autonomy, accountability, and a strong identity within the healthcare team.
Advanced Practice Nurse (APRN) Roles
Expanded practice with more independence.
Types of APRNs:
CRNA: Certified Registered Nurse Anesthetist
CNM: Certified Nurse Midwife
NP: Nurse Practitioner
CNS: Clinical Nurse Specialist (works more in administration, education, and research; others focus more on direct patient care), having prescriptive authority in only a few states.
All CRNAs, CNMs, and NPs have some prescriptive authority in all states.
All programs are at the master's level or doctoral level, offering wide career options.
Goals and Benefits of Nursing Professional Organizations
Joining together in an organization expands impact.
A large membership allows the organization to speak with one voice with politicians, physicians groups, and the general public.
NLN (National League for Nursing):
First organization in the United States; accreditation via ACEN.
Purpose: To maintain and improve the standards for nursing education.
Membership: Open to individual nurses.
Primary membership is agency membership, usually through schools of nursing.
AACN (American Association of Colleges of Nursing):
Colleges of nursing work together.
ANA (American Nurses Association):
From the early 1900s, testing and certification; largest and oldest in the United States.
Purpose: Improvement of the standards of health and access to healthcare services for everyone; improvement and maintenance of high standards for nursing practice; promotion of the professional growth and development of all nurses, including economic issues, working conditions, and independence of practice.
Historical Perspectives: Positive Effects of WWII on Nursing
Increased Demand: The war created a huge demand for nurses, elevating the profession’s importance.
Federal Support: Government funding and programs supported nursing education and recruitment.
Expanded Roles: Nurses gained more responsibility and skills through military service.
Greater Respect: Public perception of nurses improved due to their critical role in wartime care.
Historical Perspectives: Negative Effects of WWII on Nursing
Shortages: The rapid expansion led to a shortage of trained nurses in civilian hospitals.
Training Issues: Some programs emphasized quantity over quality, producing inadequately trained nurses.
Gender Bias Reinforced: Nursing remained a female-dominated, subordinate profession, reinforcing traditional gender roles.
Purpose of the Bolton Act (1943)
Established the U.S. Cadet Nurse Corps to address the nursing shortage during WWII.
Provided federal funding for nursing education in exchange for service.
Allowed women to train as nurses without cost, boosting enrollment and professional development.
Significant Symbols in Nursing
The Lamp
Meaning: Symbol of enlightenment, knowledge, and compassion.
Significance: Associated with Florence Nightingale, who carried a lamp while tending to soldiers at night during the Crimean War.
Legacy: Represents the "light" nurses bring to patient care and is often featured in pinning ceremonies.
The Nursing Cap
Meaning: Symbol of service, dedication, and professionalism.
Significance: Originally used to keep nurses’ hair neat; later became a sign of nursing identity and school affiliation.
Legacy: Though no longer commonly worn, it remains a traditional emblem of the nursing profession.
The Nursing Pin
Meaning: Sign of academic achievement, commitment to nursing ethics, and school pride.
Significance: Each nursing school designs its own pin; graduates receive it during pinning ceremonies.
Legacy: Symbolizes a nurse’s readiness to serve and uphold the profession's values.
Theories and Models of Nursing: Grand Theorists
Roy: Allow the client to reach their highest level of function through adaptation. Health is defined as the location of the client along a continuum between perfect health and complete illness. Clients adapt to being sick/injured and still live their lives fully.
Orem: A client's responsibility to live fully within a particular physical, biological, and social environment and achieve the highest level of functioning. Health is a client's responsibility. Help client’s take care of themselves. Teach, support, care-based on clients needs. Healthy people carry out six activities:
Breathing air; ingesting water and food
Excreting waste
Participating in activity and resting
Being alone and participating in social interactions
Avoiding hazards to life and well- being
Being normal mentally under universal self-care
King: Help a client establish health care goals (typically small goals) and direct clients to meet those goals. Make sure the goal aligns with the patient's wants and needs.
Establish health care goals, direct clients to meet their goals
Client is an open system for energy and information
Personal, interpersonal, social systems
Nonsummativity: change in one part of an open system is felt in all other parts.
Johnson: This model integrates systems theory with behavioral health. It considers client behavior to be the key to preventing illness and to restoring health when illness occurs.
Human behavior is really a type of system in itself
Human behavior is influenced by input factors from the environment and has output that in turn affects the environment
Client: The person or client is viewed as a behavioral system that is an organized and integrated whole. The whole is greater than the sum of its parts because of the integration and functioning of its subsystems. The client as a behavioral system is composed of seven distinct behavior subsystems.
Neuman: Includes elements from stress theory with an overall holistic view on humanity and health care. Focuses on the individual and their environment.
Client: is viewed as an open system that interacts constantly with internal and external environments through the system's boundaries. Represented graphically as a series of concentric circles that surround the basic core of the individual.
The goal of these boundaries is to keep the basic coresystem stable by controlling system input and output.
Health: is the relatively stable internal functioning of the client, optimal when the client is maintained in a high state of wellness or stability. Health is a continuum that reflects the client’s internal stability when moving from wellness to illness and back.
Illness: Environmental factors, whether internal or external, are called stressors.
Environmental Stressors: Extrapersonal, interpersonal, intrapersonal
Types of Interventions: Primary, secondary, tertiary.
Difference Between Grand and Middle Range Theories
Grand Theories: Broad in scope, abstract not measurable
Middle Range Theories: More focused; less abstract; measurable; useful to guide research and practice.
Concrete concepts or propositions that lie between a minor working hypothesis found in everyday nursing research and a well-developed major nursing theory
More than 50 exist
Conceptually, between gran theories/models and practice theories/models
Practice theories or models: particular situations, rationale for interventions
Evidenced Based Practice
"The integration of the best current evidence with clinical expertise and patient/family preferences to deliver optimal health care."
Key Points from Catalano’s Definition:
Best Evidence: Comes from current, high-quality research and data.
Clinical Expertise: Involves the nurse’s own knowledge, skills, and experience.
Patient Preferences: Includes values, needs, and choices of the patient and their family.
Purpose of EBP in Nursing:
To improve patient outcomes.
To ensure safe, effective, and efficient care.
To bridge the gap between research and practice.
To promote lifelong learning and critical thinking in nurses.
EBP empowers nurses to make informed decisions and enhances the professionalism and credibility of nursing practice.
Why Theories and Models Are Important for the Profession of Nursing
Guide Practice:
Provide a framework for decision-making and help nurses understand what to do and why.
Promote Professionalism:
Establish nursing as a scientific and academic discipline, not just a task-oriented job.
Improve Patient Care:
Help identify effective interventions and predict patient outcomes.
Support Education and Research:
Offer a foundation for curriculum development and guide nursing research.
Clarify Roles and Relationships:
Define the nurse–patient relationship, roles, and scope of practice.
Encourage Critical Thinking:
Push nurses to think systematically and base actions on evidence, not routine.
The Process of Educating Nurses: BSN vs. Associates Degree vs. Nursing Diploma
Diploma: In hospital schools of nursing.
Three calendar years in length
Decreasing in number
No degree, diploma only
Associate Degree:
Earn AD-assoc degree, AS-associate of science, AAS- assoc of applied science degree
Nominally 2 years in length
Located in community colleges
Traditionally a technical orientation to bedside care
Baccalaureate Degree (BSN): Education for a profession
4 years in length
In universities and colleges
Stresses independence of practice; assessment skills; leadership and management abilities
Ladder programs- AD to BSN
Accelerated second degree programs (BSN or MSN for those with bachelors in a different field)
Highest NCLEX pass rates
More on BSN:
Are prepared in liberal education
Developed intellectual skills (critical thinking, writing, public speaking)
Have extensive management education
Learn teaching skills and principles
Use and conduct research
Use nursing theory and models
LVN, LPN Education and Credentialing
Hands-on and theory-based.
9 to 12 months in length.
Offered in hospitals, high schools, vocational/trade schools, community colleges.
Emphasis on skills, not theoretical knowledge.
Students learn how to do something, not why they are doing it.
Ladder program: LPN/LVN to AD to take RN license.
Master’s and Doctoral Level Education
Master’s Degree (MSN)
Must be an RN with a BSN to enter the program
Approximately 36 credits
Higher level, higher paying nursing roles; directors, managers, staff educators, academia
Doctoral Degree
Generalists’ degree at an advanced level
Often for EBP research
A variety of doctoral degrees, including PhD, EdD, and DNP, are possible.
Not many programs offer, only about 2% of nurses hold a doctoral degree.
Very high level nursing roles; Chief Nursing Officers, Directors, Chief researchers, Deans, ect.
The Evolution of Licensure, Certification, and Nursing Organizations: The Relevance of Nurse Practice Acts
Nurse practice acts are state acts of legislation to regulate the practice of nurses to…
Protect the public
Define the scope of practice- for each individual role, do not venture outside of the scope of practice
Make nurses accountable- legally held for their actions
Create state boards on nursing- NCLEX
In the late 1800’s and early 1900’s there was little or no regulations, hospitals were the main source of primary care
Florence Nightingale created the first registry
The first North American attempt at credentialing came in 1896 with the forerunner of the ANA.
What is the APRN’s Role in Healthcare?
The APRN created LACE
LACE: Licensure, Accreditation, Certification, and Education.
Developed by the APRN consensus Work Group and the national Council of State Board of Nursing (NCSBN) APRN Advisory Committee in 2008
This Addresses:
Lack of common definitions regarding APRN practice
Ever-increasing number of specializations
Inconsistency in credentials and scope of practice
Wide variations in education for APRNs
The Meaning and Purpose of Licensure and Certification
Licensure:
Definition: A legal credential granted by a state board of nursing that allows a person to practice nursing legally.
Purpose: To protect the public by ensuring that nurses meet minimum standards of competency and safety.
Mandatory: You must be licensed to practice as an RN or LPN.
Examples: NCLEX-RN (for registered nurses), NCLEX-PN (for practical nurses).
Certification:
Definition: A voluntary, professional credential that recognizes expertise and advanced knowledge in a specialty area of nursing.
Purpose: To demonstrate higher-level competence and specialization beyond basic licensure.
Not Required to Practice: But it enhances professional credibility, job opportunities, and often pay.
Examples: Certification in critical care (CCRN), pediatrics (CPN), or nurse practitioner specialties (FNP-BC).
In Short (Catalano):
Licensure = Legal permission to practice.
Certification = Recognition of advanced competence
Ethics in Nursing: Describe Ethical Dilemmas
Ethics: Involves a system for making decisions about help and harm to others.
Nurses make ethical decisions on a regular basis, but it is often not covered in the nursing curriculum.
According to Joseph T. Catalano in Nursing Now!, ethical dilemmas in nursing are situations where:
"Two or more ethical principles are in conflict, and no clear right or wrong answer exists."
Conflict of Values:
Occur when moral principles (like autonomy, beneficence, nonmaleficence, or justice) clash.
Example: A patient refuses life-saving treatment (autonomy) vs. the nurse's desire to preserve life (beneficence).
No Clear Solution:
Involve complex decisions where each option may have both positive and negative consequences.
Require Critical Thinking:
Nurses must weigh ethical principles, patient rights, professional guidelines, and often legal factors.
Common in Practice:
Arise in end-of-life care, informed consent, resource allocation, confidentiality, and cultural issues.
Support Needed:
Nurses should use ethics committees, colleagues, and professional codes (like the ANA Code of Ethics) to guide decisions.
Catalano emphasizes that dealing with ethical dilemmas is a core part of professional nursing, requiring moral courage, communication, and ethical reasoning.
Define: Morals, Values, Ethics, and Laws
Morals: The fundamental standards of right and wrong that an individual learns and internalizes, usually as a child.
Customs, traditions
May be based on religious beliefs
Killing an animal for sport, eating an animal for dinner, animal activists
What people think of as right and wrong, what society sees as right and wrong
Morals have the ability to change over time
Values: Personal beliefs or ideals that guide behavior and decisions.
Values influence how nurses prioritize care, respect patients, and make moral choices.
Compassion, honesty, respect for human dignity.
Ethics: A system of moral principles that govern conduct; determines right from wrong in professional practice.
Ethics guide how nurses handle complex situations, protect patient rights, and uphold professional integrity.
Often derived from professional codes (like the ANA Code of Ethics).
Laws: Rules established by governments to maintain order and protect society.
Laws set minimum standards of practice, define scope of practice, and hold nurses legally accountable.
Nurse Practice Acts, HIPAA, informed consent laws.
In Short:
Morals= What you do
Values= What you believe
Ethics= What you should do
Laws= What you must do
Define Ethical Principles
Fidelity: An obligation to be faithful to commitments made to oneself and to others.
Professional faithfulness or loyalty to agreements and responsibilities accepted as a part of the practice of the profession.
Consider your values and morals, find a workplace that fits them.
Beneficence: A primary goal of healthcare. Doing good for clients under your care (based off of patients values and morals, not your own; educate them, help them get better). Take into account beliefs, feelings, and wishes (“tell me what that looks like”)
Autonomy: Respect patient self-determination. Patients have the right to accept/ reject recommendations for medical care if they have appropriate decision-making capacity.
Beneficence: Doing what is best for the patient. Definition of “what is best” may derive from the physicians judgment or the patient’s wishes (autonomy).
Non-Maleficence: Primum non nocere- “First, do not harm.” Physicians are fallible, we are equally capable of harming as we are helping our patients.
Justice: Fair allocation of resources. Patients in similar situations should have access to the same care.
Veracity: Truthfulness; as a nurse, you are required to tell your patients the truth. You should not deceive or mislead; rather, you should have a principle of truthfulness.
Purpose of Ethics Committee
Ethics committees are not about right or wrong; it's about gathering information and making informed decisions.
Established by more and more facilities to help employees with ethical dilemmas.
Usually involve a variety of members (nurse, doctor, administrator, and so on).
Steps in Ethical Dilemma Decision Making
Identify the Problem
Clearly define the ethical issue or conflict.
Determine which ethical principles are in conflict (e.g., autonomy vs. beneficence).
Gather Relevant Information
Collect facts, medical data, legal aspects, and the patient’s values and preferences.
Involve interdisciplinary team members if needed.
Examine Your Own Values
Reflect on your personal values and biases that might influence the decision.
Consider Ethical Principles and Theories
Apply core principles (e.g., autonomy, justice, nonmaleficence, beneficence).
Consider relevant ethical theories (e.g., deontology, utilitarianism).
Explore Options and Consequences
List possible courses of action and evaluate the ethical and practical consequences of each.
Make a Decision
Choose the best course of action that aligns with ethical principles, patient rights, and professional responsibilities.
Act on the Decision
Implement the decision clearly and compassionately.
Evaluate the Outcome
Assess the results of the decision.
Reflect on what was learned and how it may guide future practice.
Bioethical Issues and Nursing Response
According to Joseph T. Catalano in Nursing Now!, bioethical issues are sensitive, complex, and often controversial because they involve matters of life, death, human rights, and moral decision-making in healthcare.
Sensitive Nature of Bioethical Issues (Catalano):
Highly Emotional and Personal: Topics like abortion, euthanasia, genetic testing, organ donation, and end-of-life decisions touch deeply held personal, cultural, and religious beliefs.
No Clear Right or Wrong: Bioethical issues often involve conflicting ethical principles, such as autonomy vs. beneficence, or individual rights vs. societal good.
Rapid Advances in Technology: New medical technologies (e.g., cloning, stem cell research, life support) outpace ethical guidelines, creating uncertainty.
Legal and Social Implications: Decisions often involve legal concerns and may impact families, institutions, and society at large.
Nurse’s Response to Bioethical Issues (Catalano):
Advocate for Patients:
Nurses support patients' rights to informed decision-making and help them navigate difficult choices.
Practice Ethical Reasoning:
Nurses must apply ethical principles and professional codes of ethics when confronted with dilemmas.
Maintain Nonjudgmental Attitudes:
Respond to sensitive issues with respect, compassion, and cultural sensitivity, even when personal beliefs differ.
Collaborate with the Healthcare Team:
Work with ethics committees, physicians, and families to reach ethically sound decisions.
Stay Informed and Educated:
Keep up with current bioethical debates, laws, and professional standards to respond appropriately.
Support Emotional Needs:
Provide emotional support to patients and families facing morally distressing decisions.
Advance Directives
Advance directives are legal documents that allow individuals to state their healthcare preferences in advance, in case they become unable to communicate or make decisions in the future.
Types of Advance Directives:
Living Will:
States a person's wishes regarding life-sustaining treatment (e.g., mechanical ventilation, CPR) if they are terminally ill or incapacitated.
Durable Power of Attorney for Healthcare (Health Care Proxy):
Appoints someone to make medical decisions on the patient’s behalf if they become unable to do so.
Significance of Advance Directives (Catalano):
Promote Autonomy:
Ensure that patients' wishes are respected even when they cannot voice them.
Prevent Ethical Dilemmas:
Provide clear guidance to families and healthcare teams, helping avoid conflict during crisis situations.
Reduce Emotional Burden:
Help families and nurses feel more confident in decision-making, reducing moral distress.
Legal Protection:
Offer legal documentation that protects the patient’s rights and guides clinicians.
Nurse’s Role in Advance Directives (Catalano):
Educate Patients and Families:
Inform them about their rights and options regarding advance directives.
Advocate for Patient Wishes:
Ensure the patient's directives are followed and respected in the plan of care.
Assess for Documentation:
Ask whether advance directives are in place and ensure they are on file in the medical record.
Support Ethical Practice:
Help the team navigate end-of-life care decisions using the patient's stated preferences.
Remain Nonjudgmental:
Respect all choices, even if they differ from the nurse’s personal beliefs.
Healthcare Proxies
A healthcare proxy is a type of advance directive that legally designates another person (a proxy or agent) to make healthcare decisions on a patient’s behalf if the patient becomes unable to do so.
Key Features of a Health Care Proxy:
Legal Authority: The proxy has the authority to make medical decisions, including those about treatments, surgeries, or life support, based on the patient’s wishes and best interests.
Activates Only When Necessary: It only becomes active when the patient is deemed incapable of making decisions (e.g., due to unconsciousness, cognitive decline).
Chosen by the Patient: The patient selects someone they trust, such as a family member or close friend, to speak for them.
Significance of a Health Care Proxy (Catalano):
Preserves Patient Autonomy: Ensures that the patient's values and choices are upheld when they can't speak for themselves.
Prevents Conflicts: Helps avoid family disagreements or uncertainty during medical crises.
Supports Ethical Decision-Making: Offers a clear ethical and legal framework for end-of-life and complex care decisions.
Complements a Living Will: While a living will outlines specific treatments, a proxy makes real-time decisions that a living will may not cover.
Nurse’s Role in Health Care Proxies (Catalano):
Educate Patients:
Inform patients about the importance of appointing a proxy and help facilitate the process.
Assess and Document:
Ensure that proxy information is on record and accessible in the patient’s medical chart.
Advocate for Patient’s Wishes:
Work with the healthcare proxy to ensure the patient's stated preferences are honored.
Support Ethical Practice:
Help guide care decisions that are aligned with both the patient's and the proxy's understanding.
Nursing Law and Liability: Legal Documents
Advance Directive: Includes living wills, health care proxies/POA and can include DNR orders and organ donation.
Living Will: Written documents that direct treatment per patient wishes, used in the event that something should happen to someone
Health Care Proxy/ POA for Healthcare:
Legal document that designates a person to make healthcare choices if something were to happen to you, a POA is not specified for healthcare.
DNR: Do not resuscitate, requires a physician's order.
Informed Consent
Agreement to allow something to happen once you have full disclosure/ info of
treatment proposed
risks
benefits
consequences of refusal
alternative treatments
Informed consent should be acquired by the person doing the procedure, nurses may have to witness the signature when signing documents for informed consent.
MD is required to provide education/information
Nurse may witness the signature- voluntary
A signed form is required for all routine treatment, hazardous procedures, research, and some treatments. Patient or legally designated person may sign the form.
What is Libel, Fraud, Slander, Malpractice:
Libel and Slander are both forms of defamation.
Libel: Involved written statements
Slander: Spoken
Malpractice: a type of negligence, something was supposed to be done and it was not. For it to be considered malpractice you must find issue with one of the following:
The nurse had a duty to the patient
The nurse did not carry out the duty
The patient was harmed/injured
The nurses failure to perform duty caused the injur
Good Samaritan Law
If you stop to help someone and identify yourself and follow within your scope of practice, you will be covered by the good samaritan law.
You are not required to reply to someone who is in need.
Limit liability and offer legal immunity if a nurse helps at the scene of an accident.
If you begin to provide care, you cannot leave until you transfer care to another healthcare provider; if not you may be liable for abandonment
If you perform outside the scope of practice you can be liable
Risk Management
Incident Report: Complete, but not a part of a medical record. Dont document that you completed the form
Get your own malpractice insurance
Assess the patient
Tell those who needs to know
Do paperwork last
Do not chart that you fill out the incident report
Complete Documentation: Do not leave EMR (electronic medical record) blank, Keep it current throughout the day.
Protocols: Stop and check, especially before surgeries or procedures
Steps of A Malpractice Lawsuit
Malpractice: A type of negligence. Must find issue with one of the following:
The nurse had a duty to the patient (ex. Give meds at 8am)
The nurse did not carry out the duty (ex. Forgot to give the meds)
The patient was harmed/injured (ex. Patient got sick because they didn't get their meds)
The nurses' failure to perform duty caused the injury (ex. Have to be able to prove this to prove malpractice)
Possible Defenses to a Malpractice Suit
Contributory negligence: client contributed to own injuries
Comparative negligence: the award is based on the percentage of fault by both parties
Assumption of risk: if injury is listed as a possible risk on the informed consent, healthcare provider not liable
Good Samaritan act: Protects healthcare providers in emergency situations
Unavoidable act: accidents happen without any contributing causes
Defense of the fact: even if action was in violation of the standard of care the action itself did not directly cause the injury
Facing A Lawsuit
Rapidly proliferated since the 1990s
Statute of limitation 1 to 6 years, usually 2
Legal complaint filed, then answer filed, due process begins
Discover: uncover all information relevant to the lawsuit, deposition- taking testimony under oath, trial- often years after the complaint is filed. The jury is selected. Both parties present their case, the judge or jury decides.
Monetary awards are ordered if the decision favors the plaintiff.
Preventing Lawsuits
Effective communication protects nurses
SBAR from the nuclear navy allows nurses to make recommendations up the chain of command
Situation (what is the situation, Who am i? Why am I calling? Patient update)
Background (explains what the issue is)
Assessment (what are the specifics of the issue? what do you see that raises concern?)
Recommendation (what can I do to act on this, bring up your ideas, give the provider your opinions to see what they think?)
Medical records are important proof (document everything)
Client rapport (connect with patients)
Keep skills up to date (keep everything current)
Keep clients informed (explain what you are doing so they are well aware of what is going on in their body)
Torts
Intentional torts, quasi-intentional torts Unintentional Torts:
Negligence
Nonfeasance
Malpractice
Intentional Torts:
Assault and battery
False imprisonment
Abandonment
Quasi- Intentional Torts:
Defamation
Invasion of privacy
Confidentiality
Distinguish Between Statutory Law and Common Law
Statutory Law: laws written and enacted by the U.S. congress are federal statutes. State drafted laws are state statutes.
Individual cities/municipalities draft laws called ordinances, codes and regulations.
Laws governing nursing are mostly state statutory laws by licensure in the responsibility of individual states.
Common Law: Evolves from previous legal cases that set a precedent.
Laws created through the accumulated decisions of judges through the years.
The common laws involving negligence or malpractice are the laws most frequently encountered by nurses.