Online Companion: Fundamentals of Nursing Standards and Practice 2E

Chapter Summary

An increasingly important aspect of nursing involves the legal responsibilities of nursing practice. Chapter 23 provides an introduction to the different sources and types of law in the U.S. and Canada. The nurse's rights and requirements in contract law define the contractual relationship between the nurse and the client. Under civil law, the nurse incurs liability for failing to meet the legal expectations of care. Malpractice is behavior of a professional person that results in harm to another person. Informed consent is a legal concept that requires that the client understand the reason for a therapeutic intervention and agrees to the treatment by signing a consent form. There are special considerations about consent when the client is a minor. The use of chemical and physical restraint or seclusion can be done only with a physician's order. The nurse has a legal obligation to take action to protect a client's privacy and confidentiality. The concept of privacy includes the right to be left alone, give or refuse consent for treatment and control of how personal information is shared. A rapidly increasing problem that threatens privacy and confidentiality is access to electronic data. The use of cellular phones, fax data transfer, and computerized medical records may jeopardize privacy of information. The nurse is accountable for the welfare of the client and unprofessional conduct in any form that jeopardizes the client is prohibited. The improper use or diversion of controlled substances may lead to criminal action against the nurse under American and Canadian laws.

Maintaining client safety is a nursing responsibility in which there are four areas of legal risk: failure to monitor client status, medications errors, fall and use of restraints. The nurse must be aware of the rights nurses have when working conditions such as understaffing and reassignment threaten the safety and welfare of clients. Each state's nurse practice acts and the profession's standards of care form the legal framework for practice. There are several roles performed by nurses that relate to legal accountability: provider of care, expert witness, forensic specialist and reporting responsibilities in cases of abuse, rape and sexual assault. In Chapter 23, the authors offer a concise list of actions that can decrease the risk of liability in nursing situations.
The nurse is expected to comply with specific health care laws and regulations that govern abortions, the Americans with Disabilities Act, Good Samaritan Acts, the Occupational Health and Safety Act and the use of the National Practitioner Data Bank. Nurses encounter death on a regular basis in practice and have to be aware of the legal ramifications of such aspects as DNR orders, advance directives of the client, organ donation, care of the deceased and the use of autopsy.