Legal Aspects of Gerontological Nursing

Legal Aspects of Gero Nursing

  • Laws Governing Practice

    • Many sources of laws

      • Both on the state and local level

      • Public and Private Laws

      • Scope and Standards of Gerontological Nursing

  • Legal Risks in Gero Nursing

    • Malpractice

    • Confidentiality

    • Patient Consent

    • Patient Competency

      • Guardianship (Conservatorship) vs. Power of Attorney

    • Staff Supervision

  • Risks in Gero Nursing

    • Medications

    • Restraints

      • Use alternatives whenever possible

      • Never use for convenience

    • Telephone Orders

      • In long-term care and home health frequently physician will not be onsite to give orders if you need orders by phone make sure you give all relevant information and then in addition to obtaining verbal order have physician fax orders as soon as possible

      • Read back & verified

      • Obtain physician’s signature in 24 hrs

    • Do Not Resuscitate Orders

      • Medical order, must be signed by physician

      • If able patient needs to consent, if unable then family member needs to

    • Advance Directives

      • Address an individual’s desires for terminal care, life-sustaining measures,
        and other issues pertinent to death and dying

        • Need to be developed while person is competent

          • Better to plan ahead instead of waiting till event occurs

      • Patient Self-Determination Act

      • Durable Power of Attorney

      • Living Will

    • Elder Abuse

      • Could be physical, emotional, sexual, exploitation, neglect, or
        abandonment

  • Legal Safeguards

    • Use common sense

    • Be familiar with the laws/rules/policies for the state you are working in and the agency/facility you are working for

    • Properly monitor any employees working under you

    • Refuse to work in circumstances that create a risk to the patient

Ethical Aspects of Gerontological Nursing

  • Ethical Standards

    • Beneficence- to do good for patients

    • Nonmaleficence- to protect harm from patients

    • Justice-to be fair

    • Fidelity and Veracity-to respect one’s words and be truthful

    • Autonomy-to respect patients’ freedoms, preferences, and rights

    • Confidentiality- to respect the privacy of patients

  • Ethical Dilemmas Facing Gero Nurses

    • Expanded Role of Nurses

    • Medical Technology

    • New Fiscal Constraints

    • Conflict of Interest

    • Great Numbers of Older Adults

    • Assisted Suicide

  • Making Ethical Decisions

    • Ethical dilemmas are complex, rarely has an “obviously right” answer

    • Know yoursel

    • Talk with patients to know their wishes/desires

      • Possibly include family members/SO who are involved w/ patient

    • Read relevant recent literature

    • Discuss situation with other members of health care team

    • Utilize ethics committee