Ethical and Legal Issues in Nursing

[vadee]

Just some stuff to refresh your memory on the ethical and legal issues in nursing. you may add on to this.

When to contact the Nursing Supervisor (NS)

1. A nurse questions an order but the Physician can not be located, the nurse should then CONTACT the NURSING SUPERVISOR. Under no circumstances should the nurse carry out the order without clarification.
   
2. Under the Nurse Practice Acts, impaired nurses on the job should be reported to the Nursing Supervisor. The NS will then report it to the Board of Nursing or Police as required. Security should only be called if a disturbance occur.
   
3. Nurses can not be a witness to a living will/advance directives (Patient Self-Determination Act). Ask the NS to seek assistance for the client (usually a clinical social worker).
   
4. Report all sexual harassments to NS immediately.

Examples of legal torts:

1. Invasion of Privacy example: a nursing student observing a procedure without the client's consent or taking photos of the client.
   
2. False imprisonment example is telling the client that he/she may not leave the hospital or the use of restraints.
   
3. Battery example: performing procedure without consent such as resuscitation.
   
4. Do not resuscitate (DNR) should be reviewed every 3 days for hosptialized clients and every 60 days for residential clients.
   
5. when the word threatens is in the question= it's assault
   
6. Defamation (Slander): something untrue was said to ruin the reputation of a person.
   
7. Defamation (Libel): something untrue was written to ruin the reputation of a person.

INFORMED CONSENT:

1. IN ONLY TWO INSTANCES where the INFORMED CONSENT is not needed: emergency (where the client's life is endanger) and when the client waives the right to give informed consent.
   
2. A client under medications that affects their cognition, should not be asked to sign a consent. Legally the client must be emotionally and mentally competent to sign consent.
   
3. a nurse can witness the client signing the informed consent.
   
4. Mentally or Emotionally INcompetent Clients: declared imcompetent, unconcious, under the influence of alcohol/drugs, chronic dementia or other mental deficiency

REPORTING

1. The nurse must report situations of child/elderly abuse, gunshot wounds, suicides, and infectious diseases to the proper personnel.

OTHERS

1. Jehovah's Witness: may accept an organ transplant but the organ must be cleansed with a nonblood solution.
   
2. When giving medication to the client, think of the 5 rights C.T.D.M.R. right Client, right Time, right Dosage, right Medication, right Route (i think of the mneumonic as Connecticut (CT) Dept of Mental Retardation (DMR)....formally known..now it is CT Dept of Social Services (DSS))

[iamchange]

what if a patient does not want the nurse to touch her and wants to remove all the IV contraptions all by herself?

what if she is about to run outside the hospital and is at risk of being hit by a car?

what can we do to avoid injury to the patient at the same time not charged of battery?

[caliotter3]

Ethics/legal questions can be approached with the thought in mind, "what would a prudent nurse do in this situation?" If you do your job, the patient will not be injured, nor will you be charged with battery, in most situations. Security can be called for assistance for a patient running out of the hospital before they can get hurt. The first situation probably calls for an AMA form to be signed and preparation for discharge; to be discussed with the physician. NCLEX questions would be more likely to be about more common scenarios than described here and the last comment was too broad and open ended for an NCLEX question.