Legal Considerations

Question 1

Define fiduciary relationships*

Answer 1

The recipient of the care has to trust in the professional’s competency and integrity, because of the nature of the services provided

Question 2

What six things are regulatory bodies responsible for?*

Answer 2

1. Ensuring safe, competent, and ethical nursing care (through standards of practice)
2. Granting registration and licensing
3. Ensuring continuing competency
4. Investigating complaints against members conduct
5. Disciplining members when necessary
6. Approving nursing education programs

Question 3

What is a duty of care?*

Answer 3

The duty of care is owed to those who retain our services or are placed under our care

Expected to act in a competent manner to ensure care meets reasonable standards and expectations

Question 4

Define professional misconduct & provide examples*

Answer 4

Behaviour that fails to meet the ethical and legal rules and standards of the profession - doing what you are not supposed to be doing

Acts or omissions that breach or abuse the nurse-client relationship

Ex. Failure to uphold the code of ethics, abuse, misappropriating personal property/medications, abandoning a client, neglecting to provide care

Question 5

Define professional malpractice & provide examples*

Answer 5

Nursing acts that are performed in a sub-standard or careless manner that does not conform to the generally recognized practice standard - doing what you are supposed to be, but doing it badly

Does not necessarily involve misconduct

Ex. Doing or saying nothing when action is required, injuring a patient with equipment, improper administration of medication, inappropriate/inadequate documentation

Question 6

What is the difference between statute and case law?*

Answer 6

Statute law is created by elected legislative bodies and case law is built on the precedent of decisions set by other similar cases

Question 7

What is a tort?*

Answer 7

A civil wrong committed by one person against another causing injury or damage, either to person or property

Classified as intentional or unintentional

Question 8

Define assault*

Answer 8

Conduct that creates the apprehension or fear of imminent harmful or offensive contact

No actual contact is required to be charged with assault

Question 9

Define battery*

Answer 9

The intentional physical contact with a person, without that person’s consent

Can be harmful and bring about injury, or simply offensive to the patient’s personal dignity

Question 10

What are four intentional torts?*

Answer 10

Assault, battery, invasion of privacy, and false imprisonment

Question 11

When can medical treatment be administered without consent?*

Answer 11

Situations that are life-threatening and the patient is unconscious or mentally incompetent

Question 12

What three things are required for consent to be valid?*

Answer 12

1. Patient must have legal and mental capacity to consent
2. Consent must be voluntary without coercion
3. Consent must be informed (patient must understand all options, risks, and benefits)

Question 13

What three aspects need to be involved for a nurse to be liable for negligence?*

Answer 13

1. Duty of care owed to the patient/client
2. Breach of that duty of care by healthcare provider
3. Patient suffered damage as a direct result of the breach of the duty of care

Question 14

Define proximate cause*

Answer 14

Defendant is liable for any harm caused by their negligence

Damage must be something that could reasonably be foreseen as resulting from the negligent conduct

Question 15

Define contributory negligence*

Answer 15

Even if the plaintiff is partly to blame or partly at fault for the harm suffered, they can still receive damages for the remaining portion

Question 16

If a nursing student performs a nursing action, they will be held to the same standard of care as ___*

Answer 16

an RN

Question 17

Define gross negligence*

Answer 17

Conduct that drastically departs from the standard of a reasonably competent nurse

Question 18

Define criminal negligence*

Answer 18

Gross negligence that results in death or serious bodily harm - constitutes a criminal offence that may be punishable by law

Question 19

What is the employer’s responsibility in liability?*

Answer 19

Healthcare facilities, as employers, are vicariously liable for the negligent acts of their employees

Employers have a common law duty to take active steps to ensure that nurses falling short of a standard receive the appropriate improvement plan - the employer may be held liable otherwise

Question 20

What are five issues that may effect liability?*

Answer 20

1. Short staffing
2. Floating - nurses may feel pressure to practice outside their competence level
3. Physician’s orders
4. Dispensing advice over the phone
5. Contracts and employment agreements

Question 21

What are the four steps of risk management?*

Answer 21

1. Identify possible risks
2. Analyze risks
3. Act to reduce risks
4. Evaluate steps taken

Question 22

What is a nurse’s best defence to avoid legal issues?*

Answer 22

Documentation

Question 23

Define documentation*

Answer 23

Anything written or electronically generated that describes the status of a client or the care given to that client

Question 24

What are the six main tenets of documentation?*

Answer 24

1. Factual - avoids subjective information or opinion
2. Accurate - truthful, exact, concise, clear, correct spelling/grammar
3. Organized - follows a logical order/pattern
4. Timely - should occur asap after the treatment/incident/intervention, chronological
5. Complete - includes all appropriate and essential information, chart only your own actions/observations
6. Compliant with standards

Question 25

What are six high risk documentation errors?*

Answer 25

1. Falsifying records/documenting ahead of time
2. Failing to record client changes
3. Failing to document notification of primary provider
4. Incomplete documentation
5. Failing to follow policies
6. Documenting observations and/or the work of others

Question 26

Must act as any other “reasonable and prudent nurse” would in the same situation is an example of?*

Answer 26

Standard of care

Question 27

Are incident reports part of the patient’s health record?*

Answer 27

No, they are their own separate file and should not be documented in the health record