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8/8/2019 23659437 Nursing Jurisprudence
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NURSINGNURSING
JURISPRUDENCEJURISPRUDENCE
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NURSING JURISPRUDENCENURSING JURISPRUDENCE
department of law whichdepartment of law whichcomprise all legal rules andcomprise all legal rules and
principles affecting the practiceprinciples affecting the practice
of nursing.of nursing.
NURSING LEGISLATIONNURSING LEGISLATION
the making of laws, or the bodythe making of laws, or the body
of laws already affecting theof laws already affecting the
practice of nursing.practice of nursing.
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LAWLAW
a rule of civil conducta rule of civil conduct
prescribed by the supremeprescribed by the supreme
power in a state commandingpower in a state commanding
what is right and prohibitingwhat is right and prohibitingwhat is wrong.what is wrong.
Sum total of rules andSum total of rules and
regulations by which society isregulations by which society isgovernedgoverned
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TYPES OF LAWTYPES OF LAW
PRIVATE OR CIVIL LAWPRIVATE OR CIVIL LAW
body of law that deals withbody of law that deals withrelationship among privaterelationship among private
individualsindividuals PUBLIC LAWPUBLIC LAW
body of law for the welfare of thebody of law for the welfare of thegeneral public; relationshipgeneral public; relationshipbetween individuals and thebetween individuals and thegovernment and governmentgovernment and governmentagenciesagencies
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LEGAL RIGHTLEGAL RIGHT
a claim which can be enforceda claim which can be enforced
by legal means against aby legal means against a
person whose duty is to respectperson whose duty is to respect
it.it.
COURTCOURT
An agency in the governmentAn agency in the governmentwherein the administration ofwherein the administration of
justice is delegated.justice is delegated.
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COURT MECHANISMCOURT MECHANISM
LAWSUITLAWSUIT-- proceeding in courtproceeding in court
for a purpose.for a purpose.
Purpose:Purpose:
EEnforce a rightnforce a right
RRedress a wrongedress a wrong
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QUESTIONQUESTION
If you think that a person has doneIf you think that a person has done
something seriously wrong to you, thesomething seriously wrong to you, the
correct action to do get redress for thecorrect action to do get redress for the
injury received is to:injury received is to:A. systematically plan on how to have aA. systematically plan on how to have a
vindication for the damage donevindication for the damage done
B. file a lawsuit against the person forB. file a lawsuit against the person for
damagedamage
C. hire someone to take revenge for youC. hire someone to take revenge for you
D. nothing, just forget about itD. nothing, just forget about it
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PARTIES TO A CASEPARTIES TO A CASE
Complainant VS Defendant:Complainant VS Defendant:
Civil caseCivil case
Plaintiff VS Accused: CriminalPlaintiff VS Accused: Criminalcasecase
WitnessWitness-- an individual held uponan individual held upon
to give necessary details eitherto give necessary details eitherfor the accused or against thefor the accused or against the
accusedaccused
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The person who institutes legalThe person who institutes legal
proceeding is called:proceeding is called:
A. PlaintiffA. Plaintiff
B. RespondentB. Respondent
C. DefendantC. DefendantD. AccusedD. Accused
QUESTIONQUESTION
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QUESTIONQUESTION
It is promulgated for theIt is promulgated for the
common good by one who hascommon good by one who has
legitimate authority:legitimate authority:
A. JurisprudenceA. Jurisprudence
B. DilemmaB. Dilemma
C. LawC. LawD. EthicsD. Ethics
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QUESTIONQUESTION
A hospital filed a case ofA hospital filed a case of
damages against a nurse fordamages against a nurse for
breach of contract. Who is thebreach of contract. Who is the
nurse in the case?nurse in the case?
A. complainantA. complainant
B. accusedB. accused
C. defendantC. defendant
D. plaintiffD. plaintiff
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STATUTE OF LIMITATIONSSTATUTE OF LIMITATIONS
Refers to the length of timeRefers to the length of time
following the event during whichfollowing the event during which
the plaintiff may file a suit.the plaintiff may file a suit.
Example:Example:
negligencenegligence-- filed within 2filed within 2--33
years from occurrence.years from occurrence.
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DUE PROCESSDUE PROCESS
A fair and orderly process which aimsA fair and orderly process which aimsto protect and enforce a personsto protect and enforce a persons
right.right.
FUNDAMENTAL REQUIREMENTSFUNDAMENTAL REQUIREMENTS
OF DUE PROCESS:OF DUE PROCESS:
1. Right to be informed1. Right to be informed
2. Right to remain silent2. Right to remain silent
3. Right to competent counsel3. Right to competent counsel4. No use of violence, threat, torture4. No use of violence, threat, torture
5. Right to know the witness face to5. Right to know the witness face to
faceface
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PHASES OF DUEPROCESSPHASES OF DUEPROCESS
PREPRE--TRIALTRIAL-- eliminate matterseliminate matters
not in dispute, agree on issuesnot in dispute, agree on issues
or settle procedural matters.or settle procedural matters.
TRIALTRIAL-- facts are presented andfacts are presented and
determined; law applied at thedetermined; law applied at theend.end.
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WRITTEN ORDERS OFWRITTEN ORDERS OF
COURTCOURT
WRITWRIT-- legal notes from courtlegal notes from court
SUBPOENASUBPOENA-- an order in courtan order in court
DucesDuces tecumtecum (papers)(papers) bringbring
documents, objects, materials, chartdocuments, objects, materials, chartto courtto court
AdAd testificandumtestificandum (person)(person) testify astestify as
witness at a specified time and placewitness at a specified time and place
SUMMONSUMMON-- a writ commanding ana writ commanding anauthorized person to notify a party toauthorized person to notify a party to
appear in court to answer a complaintappear in court to answer a complaint
made against him.made against him.
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WARRANTWARRANT-- aa writing from awriting from acompetent authority in pursuance ofcompetent authority in pursuance of
law, directing the doing of an actlaw, directing the doing of an act
addressed to a person competent toaddressed to a person competent to
do itdo it
Warrant of arrestWarrant of arrest-- a court order toa court order toarrest or detain a personarrest or detain a person
Search warrantSearch warrant-- a court order toa court order tosearch for propertiessearch for properties
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QUESTIONQUESTION
A process whereby the BON onlyA process whereby the BON only
compel the personal attendance of acompel the personal attendance of a
witness to bring with him to the courtwitness to bring with him to the court
books, papers and the like tobooks, papers and the like toelucidate the matters in issue:elucidate the matters in issue:
A. WarrantA. Warrant
B. SubpoenaB. Subpoena
C. Subpoena duces tecumC. Subpoena duces tecum
D. SummonsD. Summons
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LAWS THAT PROMOTE THELAWS THAT PROMOTE THE
WELFARE AND WELLWELFARE AND WELL--BElNGBElNG
OF NURSESOF NURSES P.D. 442P.D. 442-- LaborLabor CodeCode
Defines among other things, hours ofDefines among other things, hours of
work, contract and nurse staffing inwork, contract and nurse staffing inindustrial clinicsindustrial clinics
P.D. 807P.D. 807-- Civil Service LawCivil Service Law
Provide for the recruitment andProvide for the recruitment and
selection of employees in governmentselection of employees in governmentservice; qualification standards;service; qualification standards;
personnel evaluation system; andpersonnel evaluation system; and
personnel disciplinepersonnel discipline
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R.A. 7305R.A. 7305-- Magna Carta for PublicMagna Carta for Public
Health WorkersHealth Workers
Has provisions on benefits, rights andHas provisions on benefits, rights and
responsibilities of public healthresponsibilities of public health
workersworkers
R.A. 8344 No Deposit PolicyR.A. 8344 No Deposit PolicyProhibits hospitals and clinics fromProhibits hospitals and clinics from
demanding advance payments/cashdemanding advance payments/cash
deposits before patients are admitteddeposits before patients are admitted
or treatedor treated
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LEGAL CONCEPTS ANDLEGAL CONCEPTS AND
ISSUES IN NURSINGISSUES IN NURSING
LIABILITY:LIABILITY: is an obligation or debtis an obligation or debt
that can be enforced by lawthat can be enforced by law
A person who is liable for malpracticeA person who is liable for malpractice
is usually required to pay foris usually required to pay fordamages.damages.
DAMAGES:DAMAGES: refer to compensation inrefer to compensation in
money recoverable for a loss ofmoney recoverable for a loss of
damagedamage
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PROFESSIONALPROFESSIONAL
NEGLIGENCENEGLIGENCE
NegligenceNegligence failure to dofailure to do
something which a reasonable &something which a reasonable &
prudent person should haveprudent person should have
done.done.
2 types:2 types:
1. Commission1. Commission wrong doingwrong doing
2. Omission2. Omission total neglect oftotal neglect of
carecare didnt do anythingdidnt do anything
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ELEMENTS OFELEMENTS OF
NEGLIGENCENEGLIGENCE
4DS4DS
DDuty for nurseuty for nurse
DDereliction (breach of duty)ereliction (breach of duty)
DDamages as resultamages as result
DDirect result (injury, harm orirect result (injury, harm or
death)death)
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OROR
AAn injury incurred within then injury incurred within the
BBreadth of duty of the nursereadth of duty of the nurse
wherewhereCCause of injury is the failure toause of injury is the failure to
perform theperform the
DDuty!uty!
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SPECIFIC EXAMPLESSPECIFIC EXAMPLES
Burns resulting from hot water bags, heatBurns resulting from hot water bags, heatlamps, vaporizers, sitz bathlamps, vaporizers, sitz bath
Objects left inside the patients body;Objects left inside the patients body;sponges suction tipssponges suction tips
Falls of the elderly, confused, unconscious,Falls of the elderly, confused, unconscious,sedated patientssedated patients
Falls of children whose bed rails were notFalls of children whose bed rails were notpulled up and lockedpulled up and locked
Mistaken identityMistaken identity-- drug given to the wrongdrug given to the wrong
patientpatient Wrong medicine, wrong concentration,Wrong medicine, wrong concentration,
wrong route, wrong dosewrong route, wrong dose
Defects in the equipmentDefects in the equipment
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QUESTIONQUESTION
Which of the following situations wouldWhich of the following situations wouldpossibly cause a nurse to be sued due topossibly cause a nurse to be sued due tonegligence?negligence?
A. Nurse gave a client wrong medication,A. Nurse gave a client wrong medication,and an hour later, client complained ofand an hour later, client complained ofdyspneadyspnea
B. While preparing a medication, the nurseB. While preparing a medication, the nursenotices that instead of 1 tablet, she put twonotices that instead of 1 tablet, she put twotablets into the clients medicine cuptablets into the clients medicine cup
C. As the nurse was about to administerC. As the nurse was about to administermedication, the client questioned why themedication, the client questioned why the
medication is still given when in fact themedication is still given when in fact thephysician discontinued it.physician discontinued it.
D. Nurse administered 2 tablets ofD. Nurse administered 2 tablets ofanalgesic instead of 1 tablet as prescribed.analgesic instead of 1 tablet as prescribed.Patient noticed the error and complained.Patient noticed the error and complained.
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QUESTIONQUESTION Wilfred, 30 years old male, was brought to theWilfred, 30 years old male, was brought to the
hospital due to injuries sustained from ahospital due to injuries sustained from a
vehicular accident. While being transported tovehicular accident. While being transported to
the Xthe X--ray department, the straps accidentallyray department, the straps accidentally
broke and the client fell to the floor hitting tobroke and the client fell to the floor hitting to
his head. In this situation, the nurse is:his head. In this situation, the nurse is:A. not responsible because of the doctrine ofA. not responsible because of the doctrine of
respondent superiorrespondent superior
B. free from any negligence that caused harmB. free from any negligence that caused harm
to pt.to pt.C. liable along with the employer for the use ofC. liable along with the employer for the use of
a defective equipment that harms the clienta defective equipment that harms the client
D. totally responsible for the negligenceD. totally responsible for the negligence
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QUESTIONQUESTION
Which of the following statements if made byWhich of the following statements if made by
the nurse, would you consider him/her as athe nurse, would you consider him/her as a
prudent nurse?prudent nurse?
A. careful giving of medication in a centralA. careful giving of medication in a centrallineline
B. very cautiously asks supervision all theB. very cautiously asks supervision all the
timetime
C. follows the doctors order even when sheC. follows the doctors order even when she
thinks it is wrongthinks it is wrong
D. questions wrong order of the doctorD. questions wrong order of the doctor
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QUESTIONQUESTION
Which of the following actions by aWhich of the following actions by anurse would be considerednurse would be considerednegligence?negligence?
A. Playing cards with an 8 y/o boyA. Playing cards with an 8 y/o boywith diabeteswith diabetesB. Instructing a 6 y/o asthmatic toB. Instructing a 6 y/o asthmatic toblow on a pin wheelblow on a pin wheel
C. Massaging the abdomen of a 5C. Massaging the abdomen of a 5
y/o with Wilms tumory/o with Wilms tumorD. Obtaining a blood test on a 6 dayD. Obtaining a blood test on a 6 dayold infantold infant
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QUESTIONQUESTION
A nurse may be found negligent if:A nurse may be found negligent if:
1. a patient is injured1. a patient is injured
2. the nurse did not follow the2. the nurse did not follow the
standardstandard
3. failure to do the duty3. failure to do the duty
4. the injury incurred by the pt. is4. the injury incurred by the pt. is
foreseeableforeseeableA. 1,2,3A. 1,2,3 C. 1,2,4C. 1,2,4
B. All of the aboveB. All of the above D. 2,3,4D. 2,3,4
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QUESTIONQUESTION
Monica shared with the interviewerMonica shared with the interviewerher most recent experiences about aher most recent experiences about arestless pediatric patient whom sherestless pediatric patient whom sheputs up the side rails of the bed toputs up the side rails of the bed to
prevent accidental falls. Which of theprevent accidental falls. Which of thefollowing attributes is shown byfollowing attributes is shown byMonica?Monica?
A. ResourcefulnessA. Resourcefulness
B.P
rudenceB.P
rudenceC. HonestyC. Honesty
D. ReliabilityD. Reliability
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DOCTRINES OFDOCTRINES OF
NEGLIGENCENEGLIGENCE
1. RES IPSA LOQUITOR1. RES IPSA LOQUITOR
-- the things speak for itselfthe things speak for itself
-- the injury is enough proof ofthe injury is enough proof of
negligencenegligence2. RESPONDEAT SUPERIOR2. RESPONDEAT SUPERIOR
-- Let the master answer for the actsLet the master answer for the actsof the subordinateof the subordinate
-- The liability is expanded toThe liability is expanded toinclude the master as well as theinclude the master as well as theemployeeemployee
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3.3. FORCE MAJEUREFORCE MAJEURE
-- Irresistible force; unforeseen orIrresistible force; unforeseen orinevitable eventinevitable event
-- No person shall be responsible forNo person shall be responsible for
those events which cannot bethose events which cannot be
foreseenforeseen
Ex. Flood, fire, earthquakeEx. Flood, fire, earthquake
INCOMPETENCEINCOMPETENCE:: lack of ability,lack of ability,legal qualifications or fitness tolegal qualifications or fitness to
discharge the required dutydischarge the required duty
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QUESTIONQUESTION
One of the important conditionsOne of the important conditionsthat must be present in a negligentthat must be present in a negligentact to be considered as forceact to be considered as forcemajeure is:majeure is:
A.A. The nurse is unable to predict theThe nurse is unable to predict thepossible occurrence of the actionpossible occurrence of the actionhence, she cant prevent ithence, she cant prevent it
B.B. The injury is within the domain ofThe injury is within the domain ofnursing practicenursing practice
C.C. The patient did not voluntarilyThe patient did not voluntarilyparticipate in the actionparticipate in the action
D.D. The superior is also accountable forThe superior is also accountable forthe actionthe action
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QUESTIONQUESTION
When a staff nurse gives the wrongWhen a staff nurse gives the wrong
medication to her patient, the headmedication to her patient, the head
nurse and supervisor are alsonurse and supervisor are also
made responsible for the error.made responsible for the error.This is based on what doctrine?This is based on what doctrine?
A.A. Respondent superiorRespondent superior
B.B. Good Samaritan ActGood Samaritan Act
C.C. Res ipsa loquiturRes ipsa loquitur
D.D. Force majeureForce majeure
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QUESTIONQUESTION
When a nurse causes an injuryWhen a nurse causes an injuryto the patient and the injuryto the patient and the injurycaused becomes the proof ofcaused becomes the proof of
the negligent act, the presencethe negligent act, the presenceof the injury is said to exemplifyof the injury is said to exemplifythe principle of:the principle of:A. Force majeureA. Force majeure
B. Respondeat superiorB. Respondeat superiorC. Res ipsa loquiturC. Res ipsa loquitur
D. Holdover doctrineD. Holdover doctrine
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MALPRACTICEMALPRACTICE
Doing acts or conducts that are notDoing acts or conducts that are notauthorized or licensed or competentauthorized or licensed or competent
or skilled to perform, resulting toor skilled to perform, resulting to
injuries or noninjuries or non--injuriousinjurious
consequencesconsequences Stepping beyond ones authorityStepping beyond ones authority
Negligent act committed in theNegligent act committed in the
course of professional performancecourse of professional performance
RN exceeding the scope of nursingRN exceeding the scope of nursing
practice & does an MDs job.practice & does an MDs job.
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ELEMENTS OFELEMENTS OF
MALPRACTICEMALPRACTICE
DDuty of the nurseuty of the nurse
DDereliction or breach of dutyereliction or breach of duty
DDirect result (injury or harm)irect result (injury or harm)
DDamagesamages
EExceeds the limits of thexceeds the limits of the
standards of carestandards of care
FForeseability of harmoreseability of harm
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MEDICATIONS &MEDICATIONS &
PRESCRIPTIONSPRESCRIPTIONS
1. Only registered medical, dental and1. Only registered medical, dental andveterinary practitioners areveterinary practitioners areauthorized to prescribe drugs.authorized to prescribe drugs.
2. Prescription information (based on2. Prescription information (based on
R.A. 5921 of the Pharmacy Act)R.A. 5921 of the Pharmacy Act)-- allallprescriptions must contain theprescriptions must contain thefollowing information:following information: Name of MD, PTR, PRC#, location ofName of MD, PTR, PRC#, location of
clinic/ hospitalclinic/ hospital
Name of patient, age, sexName of patient, age, sex Information about drugInformation about drug frequencyfrequency
durationduration
Generic & brand name in prescriptionGeneric & brand name in prescription
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R.A. 6675R.A. 6675-- Generics Act of 1988Generics Act of 1988 All prescribed drug must be written in generic andAll prescribed drug must be written in generic and
brand names or generic name but never thebrand names or generic name but never thebrand name alonebrand name alone
Purpose: for the pt. to choose what brand theyPurpose: for the pt. to choose what brand theywantwant
3. Know rights in giving meds3. Know rights in giving meds
4. Proper identification of pts name4. Proper identification of pts name
5. In cases of doubts and errors in medication,5. In cases of doubts and errors in medication,refer to the physician.refer to the physician.
6. Special training is required before a nurse6. Special training is required before a nurse
can administer IV injection.can administer IV injection.BON Resolution No. 8 states that whoBON Resolution No. 8 states that whoadministers IV injection without training shalladministers IV injection without training shallbe held liable whether causing or not anbe held liable whether causing or not aninjury or death to the patient)injury or death to the patient)
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7. Verbal or telephone order7. Verbal or telephone order
General rule:General rule: as possible avoid T.O.as possible avoid T.O.
whatever is not written is not an orderwhatever is not written is not an orderException:Exception: During extreme emergency only!During extreme emergency only!
What to do?What to do?
1.1. Nurse should read back such order to theNurse should read back such order to thephysician to make certain the order hasphysician to make certain the order has
been correctly written.been correctly written.
2.2. Such order should be signed by theSuch order should be signed by the
physician within 24 hours.physician within 24 hours.3.3. The nurse should sign the physiciansThe nurse should sign the physicians
name per her own and note the time andname per her own and note the time and
order was received.order was received.
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QUESTIONQUESTION
A telephone order is given for a client inA telephone order is given for a client inyour ward. What is your most appropriateyour ward. What is your most appropriateaction?action?
A. Copy the order on to the chart and signA. Copy the order on to the chart and signthe physicians name as close to histhe physicians name as close to his
original signature as possibleoriginal signature as possibleB. Repeat the order back to the physician,B. Repeat the order back to the physician,copy onto the order sheet and indicate thatcopy onto the order sheet and indicate thatit is a telephone orderit is a telephone order
C. Write the order in the clients chart andC. Write the order in the clients chart andhave the head nurse cohave the head nurse co--sign itsign it
D. Tell the physician that you can not takeD. Tell the physician that you can not takethe order but you will call the nursethe order but you will call the nursesupervisorsupervisor
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QUESTIONQUESTION
In an extreme situation andIn an extreme situation andwhen no other resident or internwhen no other resident or internis available, should a nurseis available, should a nurse
receive telephone orders, thereceive telephone orders, theorder has to be correctly writtenorder has to be correctly writtenand signed by the physicianand signed by the physicianwithin:within:
A. 24 hours A. 24 hours C. 48 hoursC. 48 hours
B. 36 hoursB. 36 hours D. 12 hoursD. 12 hours
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INTENTIONAL WRONGSINTENTIONAL WRONGS
TORTS: A legal wrong,TORTS: A legal wrong,committed against a person orcommitted against a person orpropertyproperty
TYPES:TYPES:
1. Unintentional1. Unintentional-- do not requiredo not require
intent but do require the elementintent but do require the elementof harm.of harm.
Ex. Negligence and malpracticeEx. Negligence and malpractice
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2. Intentional2. Intentional-- the act was done onthe act was done onpurpose or with intent; nopurpose or with intent; no
harm, injury or damage isharm, injury or damage isneeded to be liable.needed to be liable.
A.A. ASSAULT AND BATTERYASSAULT AND BATTERY
ASSAULTASSAULT-- an attempt or threat toan attempt or threat totouch another persontouch another personunjustifiably; mental orunjustifiably; mental or
physical threatphysical threatEx.Ex.-- forcing a pt. to take hisforcing a pt. to take his
medication or treatmentmedication or treatment
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BATTERYBATTERY-- physical harm throughphysical harm throughwillful touching of person or clothingwillful touching of person or clothingwithout consent.without consent.
Ex.Ex. giving of injection without ptsgiving of injection without ptsconsentconsent
2.2. FALSE IMPRISONMENTFALSE IMPRISONMENT
-- Unjustifiable detention of a personUnjustifiable detention of a personwithout a legal warrantwithout a legal warrant
-- occurs when the person is notoccurs when the person is notallowed to leave a health care facilityallowed to leave a health care facilitywhen there is no legal justification towhen there is no legal justification todetain the client.detain the client.-- occurs when restraining devicesoccurs when restraining devicesare used without an appropriateare used without an appropriateclinical need.clinical need.
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3.3. INVASION OF PRIVACYINVASION OF PRIVACY
Right to privacy is the right to beRight to privacy is the right to be
left aloneleft alone
Right to be free from unwarrantedRight to be free from unwarranted
publicitypublicity
Exposure to public view
Exposure to public view
Divulge information from patientsDivulge information from patients
chart to improper sources orchart to improper sources or
unauthorized personunauthorized person
PRIVILEGEDPRIVILEGED COMMUNICATION:COMMUNICATION:Statements uttered in good faith; notStatements uttered in good faith; not
permitted to be divulged in court ofpermitted to be divulged in court of
justicejustice
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Exceptions:Exceptions: ConfidentialConfidentialinformation can be revealed!information can be revealed!
PPt. consent, if there ist. consent, if there is
IInform HCT for precautionarynform HCT for precautionary
measuresmeasuresCCrimes, child abuse, BWSrimes, child abuse, BWS
CCommunicable diseaseommunicable disease-- R.A.R.A.3573 (Law on Notifiable3573 (Law on NotifiableDiseases)Diseases)
EEthicsthics
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4.4. DEFAMATIONDEFAMATION
Character assassinationCharacter assassination There must be a third person whoThere must be a third person who
hears or read the comment before ithears or read the comment before it
can be considered defamationcan be considered defamation
TYPES:TYPES:
SlanderSlander--oral defamationoral defamation
LibelLibel--written wordswritten words
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QUESTIONQUESTION
The nurse writes the followingThe nurse writes the followingnote in the clients chart, thenote in the clients chart, thephysician is incompetentphysician is incompetent
because he ordered the wrongbecause he ordered the wrongdrug dosage. This statementdrug dosage. This statementmay lead to a charge of:may lead to a charge of:
A. AssaultA. Assault
B. SlanderB. Slander
C. LibelC. Libel
D. Invasion of privacyD. Invasion of privacy
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QUESTIONQUESTION
Doing a nursing procedureDoing a nursing procedure
without the patients informedwithout the patients informed
consent may bring the healthconsent may bring the health
professional to the court of lawprofessional to the court of law
for what violation?for what violation?
A. TortA. Tort C. NegligenceC. Negligence
B. AssaultB. Assault D. BatteryD. Battery
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QUESTIONQUESTION
Two janitors are having a heatedTwo janitors are having a heatedargument as to who shall disposeargument as to who shall disposethe waste of a patient with typhoidthe waste of a patient with typhoidfever. The first one called the otherfever. The first one called the otherlazybone and pain in the necklazybone and pain in the neckwithin the hearing of the rest of thewithin the hearing of the rest of thenurses. The case is:nurses. The case is:
A. LibelA. Libel
B. SlanderB. Slander
C. Invasion of privacyC. Invasion of privacy
D. NegligenceD. Negligence
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QUESTIONQUESTION
Allowing a person who is in noAllowing a person who is in noway involved in the care of theway involved in the care of thepatient to read the patientspatient to read the patients
chart constitutes which of thechart constitutes which of thefollowing violations:following violations:
A. Invasion of pts privacyA. Invasion of pts privacy
B. Breach of trustB. Breach of trustC. MalpracticeC. Malpractice
D. Violation of pts dignityD. Violation of pts dignity
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QUESTIONQUESTION
Which of the following personsWhich of the following persons
cannot have the access to thecannot have the access to the
patient record?patient record?
A. physical therapistA. physical therapist
B. lawyer of the familyB. lawyer of the family
C. the patientC. the patient
D. speech therapistD. speech therapist
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QUESTIONQUESTION
It is unethical to tell ones friendsIt is unethical to tell ones friends
and family members data aboutand family members data about
the patient because doing so isthe patient because doing so is
a violation of patients rights to:a violation of patients rights to:
A.A. Informed consentInformed consent
B.B. ConfidentialityConfidentiality
C. Least restrictive environmentC. Least restrictive environment
D. Civil libertyD. Civil liberty
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QUESTIONQUESTION
Should the accusation be writtenShould the accusation be written
in the newsletter of the hospital,in the newsletter of the hospital,
such liability is a/an:such liability is a/an:
A. AssaultA. Assault
B. LibelB. Libel
C. SlanderC. Slander
D. BatteryD. Battery
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QUESTIONQUESTION
Confidentiality of patients identityConfidentiality of patients identity
and condition is one of the nursingand condition is one of the nursing
responsibilities in the hospital.responsibilities in the hospital.
Which of the following reasons canWhich of the following reasons caninformation be given without patientinformation be given without patient
consent EXCEPT:consent EXCEPT:
A.A. Patient is charged with a crimePatient is charged with a crime
B.B. Patient has a TBPatient has a TB
C.C. Patient is a victim of child abusePatient is a victim of child abuse
D.D. Patient with cancerPatient with cancer
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RESTRAINTSRESTRAINTS
Restraints are protective devicesRestraints are protective devicesused to limit the physical activity of aused to limit the physical activity of aclient or to immobilize a client or anclient or to immobilize a client or anextremity.extremity.
TYPES:TYPES: Physical restraints: restrict clientsPhysical restraints: restrict clients
movement through the application ofmovement through the application ofa devicea device
e.g. restraint jacket, straps,e.g. restraint jacket, straps, Chemical restraints: MedicationsChemical restraints: Medications
given to inhibit a specific behavior orgiven to inhibit a specific behavior ormovement.movement.
e.g. sedation, psychotrophic druge.g. sedation, psychotrophic drug
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RESTRAINTS SHOULD NOTRESTRAINTS SHOULD NOT
BE USED PRN!!!BE USED PRN!!!
RR--equires physicians order; consentequires physicians order; consent
EE--mergency, get MDs order ASAPmergency, get MDs order ASAP
SS--hortest duration, least restrictive typehortest duration, least restrictive type
TT--o protect pt. and otherso protect pt. and others
RR--enew order every 24 hoursenew order every 24 hours
AA--ssess every 15 to 30 minutes andssess every 15 to 30 minutes anddocumentdocument
II--ndividualized supervisionndividualized supervision
NN--ever used as a punishmentever used as a punishment
TT--otal documentationotal documentation
SS--eclusion as last stepeclusion as last step
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ALTERNATIVES TOALTERNATIVES TO
RESTRAINTSRESTRAINTS
Before restraints offer explanations, askBefore restraints offer explanations, asksomeone to stay with the client, use clocks,someone to stay with the client, use clocks,calendars, TV & radio (to decreasecalendars, TV & radio (to decreasedisorientation) or any relaxationdisorientation) or any relaxation
techniques.techniques. Use LESS restrictive methods first.Use LESS restrictive methods first.
RESTRAINTS should always be the last.RESTRAINTS should always be the last.
Assign confuse and disoriented clients toAssign confuse and disoriented clients torooms near the nurserooms near the nurses station.s station.
Maintain toileting routines & instituteMaintain toileting routines & instituteexercise and ambulation schedules as theexercise and ambulation schedules as theclient condition allows.client condition allows.
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QUESTIONQUESTION
The nurse noticed that restrainingThe nurse noticed that restrainingpatients is a common practice. Which ofpatients is a common practice. Which ofthe following should she remember?the following should she remember?
A. Restraints are necessary so that theA. Restraints are necessary so that the
nurse could do more work for patientsnurse could do more work for patientsB. Use of restraints is an effectiveB. Use of restraints is an effectiveinterventionintervention
C. Restraints require a physiciansC. Restraints require a physiciansorderorder
D. Refusal to be restrained is a groundD. Refusal to be restrained is a groundfor terminating the nursefor terminating the nurse--patientpatientrelationshiprelationship
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CRIMES & OTHER ACTSCRIMES & OTHER ACTS
CRIME: An act committed or omittedCRIME: An act committed or omitted
in violation of the lawin violation of the law
Two elements:Two elements:
Criminal actCriminal act
Evil/criminal intentEvil/criminal intent
Criminal ActionsCriminal Actions
Acts or offenses against public welfareActs or offenses against public welfare
MisdemeanorMisdemeanor-- offenses or acts lessoffenses or acts less
than a felonythan a felony
FelonyFelony-- a public offense committed witha public offense committed with
deceit and faultdeceit and fault
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Criminal negligenceCriminal negligence
Reckless imprudenceReckless imprudence-- person does an actperson does an act
from which damage results immediatelyfrom which damage results immediately Simple imprudenceSimple imprudence-- did not usedid not use
precaution and the damage was notprecaution and the damage was not
immediateimmediate
CLASSIFICATIONCLASSIFICATION
1. Manner of commission:1. Manner of commission:
Deceit (Deceit (dolodolo) with criminal intent) with criminal intent
Fault (culpa) without; negligenceFault (culpa) without; negligence
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2. Stages ofExecution2. Stages ofExecution
1. Consummated1. Consummated all elementsall elementsexecuted, withexecuted, with
successful resultsuccessful result
2. Frustrated2. Frustrated all elementsall elements
executed but noexecuted but no
successful resultsuccessful result
3. Attempted3. Attempted not all elementsnot all elements
executed, noexecuted, no
successful resultsuccessful result
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3. Degree of penalty and fine3. Degree of penalty and fine
gravegrave CapitalCapitalpunishment orpunishment or
>>6yrs & 1 day6yrs & 1 day
above P6kabove P6k
LessLess
gravegrave
1 month and 11 month and 1
day to 6 yearsday to 6 years
not > P 6 Knot > P 6 K
but notbut not
P 200P 200
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4. Degree of participation4. Degree of participation
PRINCIPALPRINCIPAL
Primary authorPrimary author
a. By direct participationa. By direct participation-- doer ofdoer of
the actthe act
b. By inducementb. By inducement--directly force ordirectly force or
induce othersinduce others
c. By cooperationc. By cooperation-- indispensableindispensable
ACCOMPLICEACCOMPLICE
A person whoA person who
cooperatescooperates
cooperates before the factcooperates before the fact--
absent at the time crime isabsent at the time crime is
committed.committed.
ACCESSORYACCESSORY cooperates after the factcooperates after the fact
PProfitsrofits
CConceals/ destroys evidenceonceals/ destroys evidence
AAssists in the escape of thessists in the escape of the
principalprincipal
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QUESTIONQUESTION
A crime can be committed with theA crime can be committed with the
element of culpa if:element of culpa if:
A. the person committed the crimeA. the person committed the crime
because of ignorance of the lawbecause of ignorance of the lawB. the person knows the action is aB. the person knows the action is a
crime and he chooses to do itcrime and he chooses to do it
C. the person committed the crimeC. the person committed the crime
because he lacked the competencybecause he lacked the competency
to act correctlyto act correctly
D. all of theseD. all of these
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QUESTIONQUESTION
The nurse out of pity unhookedThe nurse out of pity unhooked
the patient from a respirator.the patient from a respirator.
The patient died after 15The patient died after 15
minutes. This type of felony is:minutes. This type of felony is:
A. ConsummatedA. Consummated
B. FrustratedB. Frustrated
C. AttemptedC. Attempted
D. MurderD. Murder
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QUESTIONQUESTION
If the penalty is death, what is theIf the penalty is death, what is the
degree of the felony?degree of the felony?
A. graveA. grave
B. less graveB. less grave
C. light felonyC. light felony
D. none of the aboveD. none of the above
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SITUATIONSITUATION
Danaya is twoDanaya is two--months pregnant. Hermonths pregnant. Herparents do not know this. Sheparents do not know this. Sheinformed her friend Alena about theinformed her friend Alena about theproblem. Alena then referred Danayaproblem. Alena then referred Danaya
to Pirena, an abortionist. Danayato Pirena, an abortionist. Danayahad an abortion.had an abortion.
If those involved will be chargeIf those involved will be chargelegally, who is considered thelegally, who is considered theprincipal?principal?
A. PirenaA. Pirena C. AlenaC. AlenaB. DayanaB. Dayana D. None of themD. None of them
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If during the investigation, the piecesIf during the investigation, the piecesof evidence were not found becauseof evidence were not found becauseGurna, the maid ofPirena burned it.Gurna, the maid ofPirena burned it.Gurna is considered as:Gurna is considered as:
A. AccompliceA. Accomplice
B. AccessoryB. Accessory
C. PrincipalC. Principal
D. CoD. Co--principalprincipal
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QUESTIONQUESTION
A nurse is liable as anA nurse is liable as an
accomplice in an abortion if she;accomplice in an abortion if she;
A. Assist in the escape of theA. Assist in the escape of the
offenderoffenderB. Refers the pregnant mother toB. Refers the pregnant mother to
the abortionistthe abortionist
C. Conceals the evidence of theC. Conceals the evidence of the
crimecrime
D. None of theseD. None of these
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QUESTIONQUESTION
A person uses the license ofA person uses the license of
another person to practiceanother person to practice
nursing is liable for what?nursing is liable for what?
A. negligenceA. negligence
B. malpracticeB. malpractice
C. misdemeanorC. misdemeanor
D. invasion of privacyD. invasion of privacy
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QUESTIONQUESTION
The receptionist of a clinic wasThe receptionist of a clinic wasasked by police if a certain doctorasked by police if a certain doctorcharged with murder was hiding incharged with murder was hiding inthe premises of the clinic. She liedthe premises of the clinic. She lied
about it but unfortunately the doctorabout it but unfortunately the doctorwas discovered inside the clinic.was discovered inside the clinic.She could be charged with:She could be charged with:
A.A. PrincipalPrincipal
B.B. AccessoryAccessory
C.C. AccompliceAccomplice
D.D. AssistantAssistant
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JUSTIFYINGJUSTIFYING SELFSELF--DEFENSEDEFENSE
Unlawful aggressionUnlawful aggression
Reasonable necessityReasonable necessity
Lack of sufficient provocationLack of sufficient provocation Fulfillment of DutyFulfillment of Duty
Obedience to an order fromObedience to an order fromsuperiorsuperior
Order must be lawfulOrder must be lawful Superior acting within theSuperior acting within the
scope of practicescope of practice
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EXEMPTINGEXEMPTINGIInsane/imbecilensane/imbecile
PPerformance of a lawful act causeserformance of a lawful act causesinjury by mere accidentinjury by mere accident
UUnder 9 y/onder 9 y/oUUnder compulsion of uncontrollablender compulsion of uncontrollable
forceforce
UUnder impulse of uncontrollablender impulse of uncontrollablefearfear
FFailure to perform an act requiredailure to perform an act requiredby law when prevented by someby law when prevented by somelawful causelawful cause
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MITIGATINGMITIGATINGUUnder18y/o or over 70 y/onder18y/o or over 70 y/oNNo intention to commit so grave ao intention to commit so grave a
wrongwrong
SSufficient provocation/threatufficient provocation/threat
preceding the actpreceding the act
IImmediate vindication of a gravemmediate vindication of a grave
offenseoffense
VVoluntary surrenderoluntary surrenderDDeaf & dumb/ with physical defecteaf & dumb/ with physical defect
SSuffer from such illness thatuffer from such illness that
diminishes willpowerdiminishes willpower
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AGGRAVATINGAGGRAVATINGTTreachery/taking advantage ofreachery/taking advantage of
superior strength or positionsuperior strength or position
PPrice, reward, promiserice, reward, promise
UUse of fire, poison, explosionse of fire, poison, explosion
CCalamitiesalamities
CCraft, fraud or disguise employedraft, fraud or disguise employed
EEvident Premeditationvident Premeditation
CCrueltyruelty
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ALTERNATIVEALTERNATIVE
May increase/ decreaseMay increase/ decrease
criminal liability depending oncriminal liability depending on
the nature and effects of thethe nature and effects of the
crimecrime
RRelationshipelationship
IIntoxicationntoxication
DDegree of instruction/egree of instruction/educationeducation
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DRILLSDRILLS
1. Under compulsion of1. Under compulsion of
uncontrollable forceuncontrollable force
2. There is sufficient2. There is sufficient
provocationprovocation
3. Act is committed with abuse3. Act is committed with abuse
of confidenceof confidence
4. Fulfillment of a duty4. Fulfillment of a duty
5. Offender is over 70 years old5. Offender is over 70 years old
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6. Voluntary surrender6. Voluntary surrender
7. Disguise in being employed7. Disguise in being employed
8. Defense of a stranger8. Defense of a stranger9. Acts under the impulse of an9. Acts under the impulse of an
uncontrollable fearuncontrollable fear
10. Offender is insane10. Offender is insane
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QUESTIONQUESTION
Premeditating to commit a crimePremeditating to commit a crime
is considered as:is considered as:
A. justifyingA. justifying
B. mitigatingB. mitigating
C. aggravatingC. aggravating
D. exemptingD. e
xempting
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QUESTIONQUESTION
All of the following areAll of the following are
exempting circumstancesexempting circumstances
except:except:
A. ImbecileA. Imbecile
B. 8 year oldB. 8 year old
C. performance of a lawful actC. performance of a lawful act
D. offender is deaf and dumbD. offender is deaf and dumb
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QUESTIONQUESTION
When a politician takes advantageWhen a politician takes advantage
of his power in the performance ofof his power in the performance of
unlawful actions, this is consideredunlawful actions, this is considered
as:as:A. justifying circumstanceA. justifying circumstance
B. exempting circumstanceB. exempting circumstance
C. mitigating circumstanceC. mitigating circumstance
D. aggravating circumstanceD. aggravating circumstance
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QUESTIONQUESTION
When the defendant killsWhen the defendant kills
someone accidentally:someone accidentally:
A. justifyingA. justifying
B. exemptingB. exempting
C. aggravatingC. aggravating
D. mitigatingD. mitigating
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CRIMESCRIMES
CONCERNINGCONCERNING
THE NURSETHE NURSE
MORAL TURPITUDEMORAL TURPITUDE
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MORAL TURPITUDEMORAL TURPITUDE Are acts contrary to the acceptedAre acts contrary to the accepted
and customary rule of rightand customary rule of right
1. Rape:1. Rape:
a.) Ordinary rapea.) Ordinary rape forcible penetration offorcible penetration of
sex organ to a sex organsex organ to a sex organb.) Sexual assaultb.) Sexual assault anything forciblyanything forciblyinserted to any orifice.inserted to any orifice.
InterventionIntervention
SSafety (emotional and physical)afety (emotional and physical)RReport the incidenceeport the incidence
RReferral (if the father is the rapist, refer toeferral (if the father is the rapist, refer toDSWD)DSWD)
ANTIANTI RAPE LAWRAPE LAW (RA 8353)(RA 8353)
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ANTIANTI-- RAPE LAWRAPE LAW (RA 8353)(RA 8353)
R.A. 7877 Anti-sexual Harassment Act
1. Any person who exercises authority
2. Asking sexual favors in exchange of
another favor
2 MURDER2 MURDER-- killing of another with intentkilling of another with intent
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2.MURDER2.MURDER killing of another with intentkilling of another with intent
3. HOMICIDE3. HOMICIDE-- unintentional killing of anotherunintentional killing of anotherpersonperson
4. PARRICIDE4. PARRICIDE
Killing of a person to whom you have aKilling of a person to whom you have arelationshiprelationship
1. father1. father2. mother2. mother
3. brothers/sisters3. brothers/sisters
4. ascendants4. ascendants
5. descendants5. descendants
6. spouse6. spouse
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5. ABORTION5. ABORTION-- termination of producttermination of product
of conception before the age ofof conception before the age of
viability.viability.
6. INFANTICIDE6. INFANTICIDE
-- the killing of an infant less thanthe killing of an infant less than
three days or 72 hours.three days or 72 hours.
7 ROBBERY7 ROBBERY
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8. THEFT8. THEFT-- --anyone who gets theanyone who gets thepersonal property of another withoutpersonal property of another without
the latters permission.the latters permission.
7. ROBBERY7. ROBBERY
-- Anyone whoAnyone who
gets thegets thepersonalpersonal
property ofproperty of
another with theanother with the
use ofuse offorce,violence orforce,violence or
intimidation.intimidation.
9 SIMULATION OF BIRTH9 SIMULATION OF BIRTH
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9. SIMULATION OF BIRTH9. SIMULATION OF BIRTH
1.P
retend that a woman gave birth1.P
retend that a woman gave birth2. Substitution or exchanging of babies2. Substitution or exchanging of babies
in the nurseryin the nursery
3. Intentionally putting wrong3. Intentionally putting wrong
information in the birth registrationinformation in the birth registrationformform
P.D. 651P.D. 651 Birth Registration ActBirth Registration Act -- requiresrequiresany person (RN,OB, midwife) who shallany person (RN,OB, midwife) who shallassist in giving birth to report within 30 daysassist in giving birth to report within 30 dayswithout penalty any live birth at Local Civilwithout penalty any live birth at Local CivilRegistrars Office.Registrars Office.
10 DISPENSING OF10 DISPENSING OF PROHIBITEDPROHIBITED
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10. DISPENSING OF10. DISPENSING OF PROHIBITEDPROHIBITED
DRUGSDRUGS
R.A. 6425 (1965)R.A. 6425 (1965) Dangerous Drugs ActDangerous Drugs ActA. ProhibitedA. Prohibited chemicals or substances thatchemicals or substances that
are totally and absolutely cant beare totally and absolutely cant be
consumed by human being.consumed by human being.
Ex. Shabu, cocaine, cannabisEx. Shabu, cocaine, cannabis
B. RegulatedB. Regulated can use this drugcan use this drug -- withwith
appropriate prescriptionappropriate prescription -- MD withMD with
appropriated licenseappropriated licenseEx.Ex.-- Valium, dormicumValium, dormicum
PENALTY FOR VIOLATINGPENALTY FOR VIOLATING
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For licensed health care providersFor licensed health care providers
FFinesines
IImprisonmentmprisonment
AutomaticAutomatic revocation of licenserevocation of license
PENALTY FOR VIOLATINGPENALTY FOR VIOLATING
THE ACTTHE ACT
GUIDELINES TO PREVENTGUIDELINES TO PREVENT
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GUIDELINES TO PREVENTGUIDELINES TO PREVENT
CRIMINAL LIABILITY:CRIMINAL LIABILITY:
1. Be very familiar with the Philippine1. Be very familiar with the Philippine
Nursing lawNursing law
2. Be familiar with the laws affecting2. Be familiar with the laws affecting
nursing practicenursing practice3. Know agency rules, regulations,3. Know agency rules, regulations,
policiespolicies
4. Upgrade skills and competence4. Upgrade skills and competence
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5. Develop good IPR with co5. Develop good IPR with co--workersworkers
6. Consult superior as needed6. Consult superior as needed
7. Verify vague/ erroneous orders7. Verify vague/ erroneous orders
8. Always keep doctor updated8. Always keep doctor updatedregarding patientregarding patient
9. Ensure accurate recording and9. Ensure accurate recording andreportingreporting
10. Get informed consent10. Get informed consent11. Do not delegate responsibilities to11. Do not delegate responsibilities to
othersothers
TIPS FOR AVOIDING LEGALTIPS FOR AVOIDING LEGAL
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TIPS FOR AVOIDING LEGALTIPS FOR AVOIDING LEGAL
PITFALLS:PITFALLS:
1. Patient Falls1. Patient Falls
do properdo proper
assessmentassessment
appropriateappropriateassistanceassistance
use protectiveuse protective
measuresmeasures
document alldocument all
nursingnursing
interventionsinterventions
2. Medication errors2. Medication errors
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2. Medication errors2. Medication errors observe the rights of drug administrationobserve the rights of drug administration
Check drs orderCheck drs order
Understand the medication you will administerUnderstand the medication you will administer Consult drug handbook/ pharmacyConsult drug handbook/ pharmacy
Not exempt from liability for following wrong drsNot exempt from liability for following wrong drs
orderorder
3. Equipment injuries3. Equipment injuries refuse to use a device you do not know how torefuse to use a device you do not know how to
operateoperate
report adverse events to superiorsreport adverse events to superiors
monitor patient regularlymonitor patient regularly
bring questionable orders to the attentionbring questionable orders to the attention
of the doctor or superiorof the doctor or superior
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DRILLSDRILLS
1. A student nurse is overheard1. A student nurse is overheard
talking in the cafeteria about atalking in the cafeteria about a
client and his suicidalclient and his suicidal
tendencies.tendencies.
2. A nurse asks a client why he2. A nurse asks a client why he
chose Dr. Smith for herchose Dr. Smith for her
physician when this doctor isphysician when this doctor isalways rude to the staff.always rude to the staff.
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3. A client is told he must pay the3. A client is told he must pay theremainder of his medical billremainder of his medical billbefore he can leave the facility.before he can leave the facility.
4. A nurse told the client that she4. A nurse told the client that shewill inject her with sedatives if hewill inject her with sedatives if hedoes not cooperate.does not cooperate.
5. A nurse forcibly opened the5. A nurse forcibly opened themouth of a pedia patient andmouth of a pedia patient andgave his medication.gave his medication.
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6. A nurse takes the wallet of the6. A nurse takes the wallet of the
patient while the latter ispatient while the latter is
sleeping.sleeping.
7. A nurse takes the wallet of the7. A nurse takes the wallet of the
patient with the use of violencepatient with the use of violence
and intimidation.and intimidation.
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8. A nurse gives a potent injection8. A nurse gives a potent injection
of morphine to a patient causingof morphine to a patient causing
his death.his death.
9. A nurse poisons his client to9. A nurse poisons his client to
end his life.end his life.
10. A patient died because of10. A patient died because of
wrong medication given.wrong medication given.
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SEESEEYOUYOU
ALLALL
AGAINAGAINTOMORROWTOMORROW