Nursing Jurisprudence Essay Example

Nursing Jurisprudence Essay LEGAL ETHICAL issues in Nursing Nursing Etiquette concerned with moral principle governing the conduct of nurses towards patients, physicians, colleagues, the nursing profession and public Ethics part of philosophy that deals with systematic approaches to questions of morality a term for the study of how we make judgments regarding right and wrong a system of MORAL PRINCIPLES or moral standards governing conduct Moral human conduct in the application of ethics Concerned with JUDGMENT PRINCIPLES of right and wrong in relation to human actions and character Determinants of the Morality of Human Act †¢The OBJECT †¢The END †¢The CIRCUMSTANCES Ethical Principles Ethical Principles: INVIOLABILITY OF LIFE All human life, from the moment of conception and through all subsequent stages, is SACRED! No one can violate or destroy life! 8 ETHICAL DILEMMAS 1. 2. 3. 4. 5. 6. 7. 8. ARTIFICIAL INSEMINATION IN VITRO FERTILIZATION HUMAN CLONING CONTRACEPTION ABORTION EUTHANASIA PHYSICIA N ASSISTED SUICIDE HUMAN TRANSPLANTATION 9 Argument favoring Euthanasia: compassion for the patient and shortening the period of suffering of the patient Argument disapproving Euthanasia: it is intrinsically wrong since it rejects life. 10 STEWARDSHIP Man has DOMINION over God’s creation: himself (life and health), creatures and environment One should reasonably, responsibly and respectfully benefit from them for service NOT domination TOTALITY Parts are integral, destined to be part of and subordinate to a whole SOLIDARITY One to be with others; to have a unity of interest, responsibility or goal. Based on the common good, love of neighbor, preferential for the most proximate and most need SUBSIDIARITY Every creature should be entrusted with the functions he is capable of performing. It relates to human dignity and recognize persons as free and responsible agents able to care and make decisions for them AUTONOMY Self Governance/Self Rule Having the freedom to make choices 4 Basic Elements of Autonomy 1. Respect for Autonomous Person 2. Ability to determine personal goals 3. Capacity to decide 4. Has Freedom to Act CONFIDENTIALITY Requires non-disclosure of private or secret information Confidentiality of Information ? Privileged communication ? Based on trust Revealed when: a. We will write a custom essay sample on Nursing Jurisprudence specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nursing Jurisprudence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nursing Jurisprudence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The patient permits such revelation. b. Medico-legal cases/legal proceedings c. Communicable disease /public safety may be jeopardized. d. Continuity of care JUSTICE refers to the obligation to be fair to other people. Types: 1. distributive justice- fair distribution of responsibilities 2. criminal justice- penalty proportionate to crime 3. rectificatory justice- just compensation in civil law Distributive Justice To each equally. To each according to need. To each according to merit. To each according to person’s right. To each according to individual effort. To each as you would have done by. To each according to the greatest good to a greater number Double Effect Principle When an act has both good and bad effects, it is permissible if: 1) The direct freely chosen effect is morally good and the indirect foreseen but not desired may be harmful, 2) The action/object must not be evil, 3) The foreseen beneficial effect must be greater or equal to the foreseen evil effect 4) The beneficial effect must follow directly from the action or at least as immediate as the harmful effect BENEFICENCE- means to do good and not to do harm. NON- MALEFICENCE- one ought not to inflict evil or harm. 22 FIDELITY- refers to the obligation to be faithful to the agreements, commitments and responsibilities that one has made to oneself and others VERACITY- refers to telling the truth or not intentionally deceiving or misleading patients 23 RESPECT- treat all human beings as persons with rights SHARING AND ALLOCATION OF RESOURCESwho will receive particular scarce resources. 24 NURSING ETHICS ? All principles of right conduct in the practice of nursing ? Appraisal of rightness or wrongness of an act BIO–ETHICS Specific domain of ethics †¢ Systemic study of human behavior in the field of life science and health care in the light of moral values and principles Code of Nursing Ethics †¢ respect for human dignity †¢ safeguards the client’s right to privacy †¢ safeguard client and public †¢ assumes responsibility and accountability for own actions and judgments †¢ maintains competence in nur sing †¢ uses informed judgment, competence and qualifications in accepting responsibilities and delegating nursing activities †¢ Contributes to the development of the profession’s body of knowledge implement and improve standards of care †¢ establish and maintain conditions of employment conducive to high-quality nursing care †¢ protect the public from misinformation and misrepresentation and to maintain the integrity of nursing †¢ In collaboration with other allied health team members, meet the health care needs of the public Patient’s Bill of Rights The patient has the right to: 1) considerate and respectful care. 2) relevant, current, and understandable information concerning diagnosis, treatment, and prognosis. ) make decisions regarding his plan of care; in case of refusal, he is entitled to other appropriate care and service or to be transferred to another hospital. 4) Have advance directive (such as living will) concerning treatment or d esignating a surrogate decision maker. 5) Every consideration of his privacy such as in case discussion, consultation and treatment. 6) Confidentiality of communication and records 7) Review his records concerning his medical care and have these explained to him except when restricted by law. ) Expect that within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. 9) Be informed of business relationship among hospital, educational institution, health care providers that may influence the patients treatment and care. 10) Consent or decline to participate in experimental research affecting his care. 11) Reasonable continuity of care when appropriate and be informed of other care options when hospital care is no longer appropriate 12) Be informed of hospital policies and practices that relate to patient care. Nurse’s Bill of Rights Nurse’s have the right to: 1) Practice in a manner that fulfills their obligation to the society and to those who receive nursing care. 2) Practice in environments that allow them to act in accordance with professional standards and legally authorized scope of nursing. 3) Work environment that supports and facilitates ethical practice 4) Freely and openly advocate for themselves and their patients without fear of retribution. 5. Fair compensation for their work consistent with their knowledge, experience, and professional responsibilities. 6. Work environment that is safe for themselves and their patients. 7. Negotiate conditions of employment, in all practice settings. LEGAL ASPECTS OF NURSING Nursing Jurisprudence the philosophy of law, or the science which treats the principles of positive law and legal relations Comprises all laws, rules, doctrines and principles, legal opinions and decisions of competent authority regarding governance and regulations of the practice of nursing. Functions of the Law in Nursing 1. Provides a framework for establishing what nursing actions in the care of patients are legal. . Delineates the nurse’s responsibilities from those of other health practitioners 3. Helps to establish the boundaries of independent nursing action 4. Assists in maintaining a standard of nursing practice by making nurses accountable under the law. Philippine Nursing Law Philippine Nursing Act of 2002 R. A. 9173 (October 21, 2002/ November 20, 2002) regulates Philippine nursing practice at present. The law p rovides about nursing registration, nursing examination, nursing education, nursing practice, and health human resource production, utilization and development. It is made up of 19 articles and 41 sections. Prohibitions in Practice of Nursing (Section 35) PENALTY: Fine: a. b. c. d. e. f. g. Php50,000- Php100,000 and/or Imprisonment 1- 6 years practice nursing without certificate or special permit use the certificate of others as his own use an invalid certificate give false evidence during registration falsely pose or advertise as a registered nurse illegally append BSN/RN to his/her name abet or assist the illegal practice of a person who is not lawfully qualified to practice nursing NEGLIGENCE Commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property Elements of Professional Negligence †¢ Duty †¢ Breach of duty †¢ Foreseeability †¢ Injury †¢ Direct relationship between failure to meet standard of care and injury can be proved Res Ipsa Loquitor â€Å"the thing speaks for itself† 3 conditions: 1. Accident which ordinarily doesn’t occur in the absence of someone’s negligence 2. Must be caused by an agency or within the exclusive control of the defendant 3. Must not have been due to voluntary action or contribution on the part of the plaintiff Specific Examples of Negligence †¢ Failure to report observations to attending physicians. †¢ Failure to exercise the degree of diligence which the circumstances of the particular case demands. †¢ Mistaken identity. †¢ Wrong medicine, wrong concentration, wrong route, wrong dose. Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients. †¢ Errors due to family assistance. †¢ Administration of medicine without a doctor’s prescription. Legal Defense in Negligence †¢ Provision of standard of care in giving service and that they have documented the care they given in a concise and accurate manner. †¢ Exercise sound judgment †¢ â⠂¬Å"assumption of risk† MALPRACTICE Stepping beyond one’s authority with serious consequences Reducing The Risk of Malpractice Litigation †¢ Maintain Good Communication Be courteous, show respect, and take time to listen – Do not belittle patients or make value judgment – Involve patients in decision making – Assess clients level of understanding – Explain so client understand – Clarify and verify Reducing The Risk of Malpractice Litigation †¢ Maintain Expertise in Practice – Keep up to date in both knowledge and skills – Do not attempt any task or give any meds that is unfamiliar – Practice within the professional scope of practice – Be familiar with standards of care – Be attentive of client’s changing status – Pay close attention to details – Document objectively, thoroughly and in a timely fashion Reducing The Risk of Malpractice Litigation †¢ Maintain autonomy and empowerment – Challenge questionable physician order – Seek attention for patient with changing needs – Challenge bureaucratic structures that threaten patient’s welfare – Avoid institutional settings that produce systematic threats to patient welfare Respondeat Superior †¢ Let the superior answer for the acts of the subordinate †¢ Master and servant are answerable; servant is responsible †¢ Actions performed by the employee within the scope of his employment. Force Majeure â€Å"irresistible/ superior force† †¢ Accident which human prudence can neither foresee or prevent †¢ â€Å"Act of God† Liability of Nurses †¢ Work of Nursing Aides †¢ Work of Nursing Students Delegation A process of transferring selected Nursing tasks to an individual who is competent. Any nursing intervention that requires independent special nursing knowl edge, skill or judgment CANNOT be delegated. Tasks that involve the assessment, planning and evaluation phases of the nursing process cannot be delegated. Delegation involves: †¢ Responsibility: an obligation to accomplish a task Accountability: acceptance of responsibility for the outcome of a duty †¢ Authority: right to act or empower Principles of delegation †¢ A nurse can only delegate those tasks for which that nurse is responsible, according to the specific states nurse practice act The delegator remains accountable for the task Along with responsibility for a task, the nurse who delegates must also transfer the authority necessary to complete the task The delegator knows well the task to be delegated Delegation is a contractual agreement that is entered into voluntarily †¢ †¢ †¢ Telephone Orders †¢ Only in an extreme emergency and when no other resident or intern is available. †¢ Nurse should read back the order to the physician. †¢ Signed by the physician within 24 hours. †¢ Nurse should sign the name of physician per her own and note the time the order was received. CONSENT CONSENT †¢ Free and rational act that presupposes knowledge of the thing to which consent is being given by a person who is legally capable to give consent. †¢ Authorization, by a patient or a person authorized by law to give the consent on the patient’s behalf. Informed Consent a) The diagnosis and explanation of the condition. b) A fair explanation of the procedures to be done and used and the consequences. c) A description of alternative treatments or procedures. d) A description of the benefits to be expected. e) Material rights if any. f) The prognosis. Things to Remember: †¢ Patient is the one who gives the consent. †¢ Person who is authorized to give the consent in behalf of the patient. †¢ Parents of minors. †¢ Minors are allowed if emancipated or married. †¢ Parents or legal guardians for mentally ill patients. Emergency situation entails implied consent. †¢ Patient has the right to refuse. MEDICAL RECORDS ? Legal protection for the hospital, doctor, and nurse ? â€Å"If it was not charted, it was not observed or done. † ? Nurses are expected to fully, accurately, legibly, and promptly document their observations. ? Subpoena duces tecum ? When a nurse or clinical instructor countersigns the chart ing of a nursing student, he/she attests that he/she has personal knowledge of information and that such is accurate and authentic. CRIME ?An act committed or omitted in violation of the law. Elements: a)Criminal act b)Evil/criminal intent TORTS ?A legal wrong, committed against a person or property. 1. Assault and Battery 2. False Imprisonment or Illegal Detention 3. Invasion of Right to Privacy and Breach of Confidentiality 4. Defamation Criminal Actions a. Misdemeanor †¢ †¢ General name for a criminal offense which does not amount to felony Punishment is usually a fine or imprisonment less than 1 year. b. Felony †¢ †¢ †¢ †¢ Public offense Liable to be sentenced to death or penitentiary imprisonment. Deceit (dolo) ? deliberate intent Fault (culpa)? rongful acts result from imprudence , negligence, or lack of skill or foresight Classes of Felonies Degree of the Acts of Execution Attempted †¦offender commences the commission of the act and does not perform all the acts or execution by reason of some cause or accident other than his own spontaneous desistance Frustrated Consummated †¦offender performs all †¦when all the elements acts or execution of felony necessary for its execution but never produce it and accomplishment are because of causes present independent of the will of the perpetrator Degree of Punishment Grave Less Grave Light capital punishment (death) or penalties which any of their periods are afflictive (imprisonment ranging from 6 yrs to 1 day to life improsnment or a fine not exceeding P6000. 00) †¦penalties which in †¦penalty of arresto their maximum period menor (imprisonment are correctional for 1 day to 30 days or a (imprisonment ranging fine not exceeding from 1 month and 1 day P200. 00 or both to 30 days or a fine not exceeding P6000. 00 but not less than P200. 00) CRIMINAL NEGLIGENCE a. Reckless Imprudence †¢ Person does an act or fails to do it voluntarily but without malice, f rom which material damage results immediately. Person did not use precaution and the damage was not immediate or the impending danger was not evident b. Simple Imprudence †¢ CRIMINAL INTENT †¢ State of mind of a person at the time the criminal act is committed †¢ Knowledge that the act was unlawful Requisites: †¢ There must be FREEDOM †¢ There must be INTELLIGENCE Requisites of Criminal Intent Freedom Intelligence Freedom is absent in the 1. An imbecile or insane (unless following circumstances: acting during lucid of 1. Under compulsion of an interval). irresistible force. 2. Under nine years old. 2. Under the impulse of 3. Over nine under fifteen uncontrollable fear or an equal (unless he had acted with or greater injury. discernment). Persons Criminally Liable Principals †¢Those who take direct part in the execution of the act (principal by direct participation) †¢Those who directly force or induce others to commit it (principal by inducement) †¢Those who cooperate in the commission of the offense by another act without which it would not have been accomplished (principal by cooperation) Accomplices †¢The person who have a common criminal purpose with the criminal. †¢Have the intention to help and knowledge about the crime. Accessories †¢Have the knowledge but did not participate in the act. a. By profiting themselves. b. By concealing or destroying body of the crime, or instrument thereof, in order to prevent its discovery. c. By harboring, concealing or assisting in escape of the principal. Circumstances Affecting Criminal Liability JUSTIFYING ? Does not commit crime in the eye of the law a. In defense of his person or rights b. In defense of the rights of his family c. In order to avoid an evil or injury d. In the fulfillment of a duty e. In obedience to an order by some superior for some lawful purposes EXEMPTING ? There is crime committed but there is no criminal on account of absence of freewill and voluntariness to act. a. An imbecile or insane (unless acted on lucid interval) b. Under 9 yrs c. Over 9 and under 15 (unless acted on discernment) d. While performing a lawful act with due care, cause an injury by mere accident without fault or intention of causing it e. Act under the compulsion of an irresistible force f. Acts under impulse of uncontrollable fear of an equal injury g. Who fails to perform an act required by law, when prevented by some lawful or insuperable cause. MITIGATING ? which lessen the penalty a. b. c. d. e. f. g. h. Under 18 or over 70 yrs old No intention to commit so grave There was sufficient provocation Acted on impulse so powerful to have produced obfuscation Voluntarily surrendered Deaf or dumb, blind or suffering from defect. Illness that diminish will power Immediate vindication of grave offense to the one committing the felony, his/her spouse, ascend ants, descendants, legitimate, natural or adopted brothers or sisters, or relative by affinity within the first degree Lack of education is not Mitigating in: 1. Rape 2. Forcible abduction 3. Arson 4. Treason 5. In crimes against chastity like seduction and acts of lasciviousness; and 6. Those acts committed in a merciless or heinous manner AGGRAVATING ? †¦which increases the penalty a. Public position b. In contempt of public authority c. Committed with insult or in disregard of the respect of the offended party on account of his/her rank, age, or sex or that it is committed in the dwelling of the offended party, if the latter has not given provocation d. With abuse or confidence or obvious ungratefulness e. in a place of worship f. Conflagration, shipwreck, earthquake, epidemic or other calamity or misfortune g. Price, reward, or promise h. Committed by means of fire, poison, explosion, i. With evident premeditation or after unlawful entry j. Craft, fraud, or disguise is employed k. Causing other wrongs not necessary for its commission ? ALTERNATIVE ? Those which must be taken into consideration as aggravating or mitigating according to the nature effects of the crime and other conditions attending its commission ? Alternative circumstance of relationship should be taken into consideration Points to Observe in Order to Avoid Criminal Liability a. Be very familiar with the nursing law. b. Beware of the laws affecting nursing practice. . At the start of employment, get a copy of your job description, the agency’s rules, regulations and policies. d. Upgrade your skills and competence. e. Accept only such responsibility that is within the scope of your employment and your job description. f. Do not delegate your responsibility to others. g. Determine whether your subordinates are competen t in the work you are assigning them. h. Develop good interpersonal relationships with your coworkers, whether they be your supervisors, peers or subordinates. i. Consult your superiors for problems that may be too big for you to handle. . Verify orders that are not clear to you or those that seem to be erroneous. k. The doctors should be informed about the patient’s condition. l. Keep in mind the value and necessity of keeping accurate and adequate records. m. Patients are entitled to an informed consent. Moral Turpitude An act of baseness, vileness or depravity in social or private duties which a man owes to hi fellow man or society in general, an act contrary to the accepted and customary rule of right and duty between men Murder ? Unlawful killing a human being WITH INTENT to kill. ? A very serious crime Ex. Criminal Abortion Euthanasia Homicide ? Killing of a human being WITHOUT CRIMAL INTENT by a person other than his father, mother or child or any of his ascendants or descendants, or his spouse Abortion ? Expulsion of the product of conceptus before the age of viability ? In the law, any person who, with the intention pr prematurely ending a pregnancy, willfully and unlawfully does any act to cause the same is guilty of procuring abortion ? Art. II Sec. 15 of Phil. Constitution protects the life of the unborn Infanticide ? Killing of a child less than three (3) days of age ? Mother who committed this crime shall be imprisoned for two (2) years, four (4) months and one (1) day to six (6) years Parricide ? Crime committed by one who kills his/her father, mother or child whether legitimate or illegitimate, or any of his ascedants or descedants or his spouse. ? Convicted with this crime, shall be imposed a penalty of life imprisonment (Reclusion Perpetua) to death Robbery ? Crime against a person or property ? The taking of personal property of another person from him or in his presence Common Legal Terms R. Ns should know Affidavit – is a written statement made under oath efore a notary public or other person duly authorized Civil Law – concerned with legal rights and duties of private persons Criminal Law – deals with conduct that is considered to be offensive to a society as a whole Day in Court – the right of a person to appear in court and be heard concerning his complaint/defense Defendant – the person being accused o f wrongdoing; therefore needs to defend himself Deposition – an oral interrogation answering all manner of questions relating to the transaction at issue, given under oath and taken in writing before a judicial officer or attorney Nursing Jurisprudence Essay Example Nursing Jurisprudence Essay LEGAL ETHICAL issues in Nursing Nursing Etiquette concerned with moral principle governing the conduct of nurses towards patients, physicians, colleagues, the nursing profession and public Ethics part of philosophy that deals with systematic approaches to questions of morality a term for the study of how we make judgments regarding right and wrong a system of MORAL PRINCIPLES or moral standards governing conduct Moral human conduct in the application of ethics Concerned with JUDGMENT PRINCIPLES of right and wrong in relation to human actions and character Determinants of the Morality of Human Act †¢The OBJECT †¢The END †¢The CIRCUMSTANCES Ethical Principles Ethical Principles: INVIOLABILITY OF LIFE All human life, from the moment of conception and through all subsequent stages, is SACRED! No one can violate or destroy life! 8 ETHICAL DILEMMAS 1. 2. 3. 4. 5. 6. 7. 8. ARTIFICIAL INSEMINATION IN VITRO FERTILIZATION HUMAN CLONING CONTRACEPTION ABORTION EUTHANASIA PHYSICIA N ASSISTED SUICIDE HUMAN TRANSPLANTATION 9 Argument favoring Euthanasia: compassion for the patient and shortening the period of suffering of the patient Argument disapproving Euthanasia: it is intrinsically wrong since it rejects life. 10 STEWARDSHIP Man has DOMINION over God’s creation: himself (life and health), creatures and environment One should reasonably, responsibly and respectfully benefit from them for service NOT domination TOTALITY Parts are integral, destined to be part of and subordinate to a whole SOLIDARITY One to be with others; to have a unity of interest, responsibility or goal. Based on the common good, love of neighbor, preferential for the most proximate and most need SUBSIDIARITY Every creature should be entrusted with the functions he is capable of performing. It relates to human dignity and recognize persons as free and responsible agents able to care and make decisions for them AUTONOMY Self Governance/Self Rule Having the freedom to make choices 4 Basic Elements of Autonomy 1. Respect for Autonomous Person 2. Ability to determine personal goals 3. Capacity to decide 4. Has Freedom to Act CONFIDENTIALITY Requires non-disclosure of private or secret information Confidentiality of Information ? Privileged communication ? Based on trust Revealed when: a. We will write a custom essay sample on Nursing Jurisprudence specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nursing Jurisprudence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nursing Jurisprudence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The patient permits such revelation. b. Medico-legal cases/legal proceedings c. Communicable disease /public safety may be jeopardized. d. Continuity of care JUSTICE refers to the obligation to be fair to other people. Types: 1. distributive justice- fair distribution of responsibilities 2. criminal justice- penalty proportionate to crime 3. rectificatory justice- just compensation in civil law Distributive Justice To each equally. To each according to need. To each according to merit. To each according to person’s right. To each according to individual effort. To each as you would have done by. To each according to the greatest good to a greater number Double Effect Principle When an act has both good and bad effects, it is permissible if: 1) The direct freely chosen effect is morally good and the indirect foreseen but not desired may be harmful, 2) The action/object must not be evil, 3) The foreseen beneficial effect must be greater or equal to the foreseen evil effect 4) The beneficial effect must follow directly from the action or at least as immediate as the harmful effect BENEFICENCE- means to do good and not to do harm. NON- MALEFICENCE- one ought not to inflict evil or harm. 22 FIDELITY- refers to the obligation to be faithful to the agreements, commitments and responsibilities that one has made to oneself and others VERACITY- refers to telling the truth or not intentionally deceiving or misleading patients 23 RESPECT- treat all human beings as persons with rights SHARING AND ALLOCATION OF RESOURCESwho will receive particular scarce resources. 24 NURSING ETHICS ? All principles of right conduct in the practice of nursing ? Appraisal of rightness or wrongness of an act BIO–ETHICS Specific domain of ethics †¢ Systemic study of human behavior in the field of life science and health care in the light of moral values and principles Code of Nursing Ethics †¢ respect for human dignity †¢ safeguards the client’s right to privacy †¢ safeguard client and public †¢ assumes responsibility and accountability for own actions and judgments †¢ maintains competence in nur sing †¢ uses informed judgment, competence and qualifications in accepting responsibilities and delegating nursing activities †¢ Contributes to the development of the profession’s body of knowledge implement and improve standards of care †¢ establish and maintain conditions of employment conducive to high-quality nursing care †¢ protect the public from misinformation and misrepresentation and to maintain the integrity of nursing †¢ In collaboration with other allied health team members, meet the health care needs of the public Patient’s Bill of Rights The patient has the right to: 1) considerate and respectful care. 2) relevant, current, and understandable information concerning diagnosis, treatment, and prognosis. ) make decisions regarding his plan of care; in case of refusal, he is entitled to other appropriate care and service or to be transferred to another hospital. 4) Have advance directive (such as living will) concerning treatment or d esignating a surrogate decision maker. 5) Every consideration of his privacy such as in case discussion, consultation and treatment. 6) Confidentiality of communication and records 7) Review his records concerning his medical care and have these explained to him except when restricted by law. ) Expect that within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. 9) Be informed of business relationship among hospital, educational institution, health care providers that may influence the patients treatment and care. 10) Consent or decline to participate in experimental research affecting his care. 11) Reasonable continuity of care when appropriate and be informed of other care options when hospital care is no longer appropriate 12) Be informed of hospital policies and practices that relate to patient care. Nurse’s Bill of Rights Nurse’s have the right to: 1) Practice in a manner that fulfills their obligation to the society and to those who receive nursing care. 2) Practice in environments that allow them to act in accordance with professional standards and legally authorized scope of nursing. 3) Work environment that supports and facilitates ethical practice 4) Freely and openly advocate for themselves and their patients without fear of retribution. 5. Fair compensation for their work consistent with their knowledge, experience, and professional responsibilities. 6. Work environment that is safe for themselves and their patients. 7. Negotiate conditions of employment, in all practice settings. LEGAL ASPECTS OF NURSING Nursing Jurisprudence the philosophy of law, or the science which treats the principles of positive law and legal relations Comprises all laws, rules, doctrines and principles, legal opinions and decisions of competent authority regarding governance and regulations of the practice of nursing. Functions of the Law in Nursing 1. Provides a framework for establishing what nursing actions in the care of patients are legal. . Delineates the nurse’s responsibilities from those of other health practitioners 3. Helps to establish the boundaries of independent nursing action 4. Assists in maintaining a standard of nursing practice by making nurses accountable under the law. Philippine Nursing Law Philippine Nursing Act of 2002 R. A. 9173 (October 21, 2002/ November 20, 2002) regulates Philippine nursing practice at present. The law p rovides about nursing registration, nursing examination, nursing education, nursing practice, and health human resource production, utilization and development. It is made up of 19 articles and 41 sections. Prohibitions in Practice of Nursing (Section 35) PENALTY: Fine: a. b. c. d. e. f. g. Php50,000- Php100,000 and/or Imprisonment 1- 6 years practice nursing without certificate or special permit use the certificate of others as his own use an invalid certificate give false evidence during registration falsely pose or advertise as a registered nurse illegally append BSN/RN to his/her name abet or assist the illegal practice of a person who is not lawfully qualified to practice nursing NEGLIGENCE Commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property Elements of Professional Negligence †¢ Duty †¢ Breach of duty †¢ Foreseeability †¢ Injury †¢ Direct relationship between failure to meet standard of care and injury can be proved Res Ipsa Loquitor â€Å"the thing speaks for itself† 3 conditions: 1. Accident which ordinarily doesn’t occur in the absence of someone’s negligence 2. Must be caused by an agency or within the exclusive control of the defendant 3. Must not have been due to voluntary action or contribution on the part of the plaintiff Specific Examples of Negligence †¢ Failure to report observations to attending physicians. †¢ Failure to exercise the degree of diligence which the circumstances of the particular case demands. †¢ Mistaken identity. †¢ Wrong medicine, wrong concentration, wrong route, wrong dose. Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients. †¢ Errors due to family assistance. †¢ Administration of medicine without a doctor’s prescription. Legal Defense in Negligence †¢ Provision of standard of care in giving service and that they have documented the care they given in a concise and accurate manner. †¢ Exercise sound judgment †¢ â⠂¬Å"assumption of risk† MALPRACTICE Stepping beyond one’s authority with serious consequences Reducing The Risk of Malpractice Litigation †¢ Maintain Good Communication Be courteous, show respect, and take time to listen – Do not belittle patients or make value judgment – Involve patients in decision making – Assess clients level of understanding – Explain so client understand – Clarify and verify Reducing The Risk of Malpractice Litigation †¢ Maintain Expertise in Practice – Keep up to date in both knowledge and skills – Do not attempt any task or give any meds that is unfamiliar – Practice within the professional scope of practice – Be familiar with standards of care – Be attentive of client’s changing status – Pay close attention to details – Document objectively, thoroughly and in a timely fashion Reducing The Risk of Malpractice Litigation †¢ Maintain autonomy and empowerment – Challenge questionable physician order – Seek attention for patient with changing needs – Challenge bureaucratic structures that threaten patient’s welfare – Avoid institutional settings that produce systematic threats to patient welfare Respondeat Superior †¢ Let the superior answer for the acts of the subordinate †¢ Master and servant are answerable; servant is responsible †¢ Actions performed by the employee within the scope of his employment. Force Majeure â€Å"irresistible/ superior force† †¢ Accident which human prudence can neither foresee or prevent †¢ â€Å"Act of God† Liability of Nurses †¢ Work of Nursing Aides †¢ Work of Nursing Students Delegation A process of transferring selected Nursing tasks to an individual who is competent. Any nursing intervention that requires independent special nursing knowl edge, skill or judgment CANNOT be delegated. Tasks that involve the assessment, planning and evaluation phases of the nursing process cannot be delegated. Delegation involves: †¢ Responsibility: an obligation to accomplish a task Accountability: acceptance of responsibility for the outcome of a duty †¢ Authority: right to act or empower Principles of delegation †¢ A nurse can only delegate those tasks for which that nurse is responsible, according to the specific states nurse practice act The delegator remains accountable for the task Along with responsibility for a task, the nurse who delegates must also transfer the authority necessary to complete the task The delegator knows well the task to be delegated Delegation is a contractual agreement that is entered into voluntarily †¢ †¢ †¢ Telephone Orders †¢ Only in an extreme emergency and when no other resident or intern is available. †¢ Nurse should read back the order to the physician. †¢ Signed by the physician within 24 hours. †¢ Nurse should sign the name of physician per her own and note the time the order was received. CONSENT CONSENT †¢ Free and rational act that presupposes knowledge of the thing to which consent is being given by a person who is legally capable to give consent. †¢ Authorization, by a patient or a person authorized by law to give the consent on the patient’s behalf. Informed Consent a) The diagnosis and explanation of the condition. b) A fair explanation of the procedures to be done and used and the consequences. c) A description of alternative treatments or procedures. d) A description of the benefits to be expected. e) Material rights if any. f) The prognosis. Things to Remember: †¢ Patient is the one who gives the consent. †¢ Person who is authorized to give the consent in behalf of the patient. †¢ Parents of minors. †¢ Minors are allowed if emancipated or married. †¢ Parents or legal guardians for mentally ill patients. Emergency situation entails implied consent. †¢ Patient has the right to refuse. MEDICAL RECORDS ? Legal protection for the hospital, doctor, and nurse ? â€Å"If it was not charted, it was not observed or done. † ? Nurses are expected to fully, accurately, legibly, and promptly document their observations. ? Subpoena duces tecum ? When a nurse or clinical instructor countersigns the chart ing of a nursing student, he/she attests that he/she has personal knowledge of information and that such is accurate and authentic. CRIME ?An act committed or omitted in violation of the law. Elements: a)Criminal act b)Evil/criminal intent TORTS ?A legal wrong, committed against a person or property. 1. Assault and Battery 2. False Imprisonment or Illegal Detention 3. Invasion of Right to Privacy and Breach of Confidentiality 4. Defamation Criminal Actions a. Misdemeanor †¢ †¢ General name for a criminal offense which does not amount to felony Punishment is usually a fine or imprisonment less than 1 year. b. Felony †¢ †¢ †¢ †¢ Public offense Liable to be sentenced to death or penitentiary imprisonment. Deceit (dolo) ? deliberate intent Fault (culpa)? rongful acts result from imprudence , negligence, or lack of skill or foresight Classes of Felonies Degree of the Acts of Execution Attempted †¦offender commences the commission of the act and does not perform all the acts or execution by reason of some cause or accident other than his own spontaneous desistance Frustrated Consummated †¦offender performs all †¦when all the elements acts or execution of felony necessary for its execution but never produce it and accomplishment are because of causes present independent of the will of the perpetrator Degree of Punishment Grave Less Grave Light capital punishment (death) or penalties which any of their periods are afflictive (imprisonment ranging from 6 yrs to 1 day to life improsnment or a fine not exceeding P6000. 00) †¦penalties which in †¦penalty of arresto their maximum period menor (imprisonment are correctional for 1 day to 30 days or a (imprisonment ranging fine not exceeding from 1 month and 1 day P200. 00 or both to 30 days or a fine not exceeding P6000. 00 but not less than P200. 00) CRIMINAL NEGLIGENCE a. Reckless Imprudence †¢ Person does an act or fails to do it voluntarily but without malice, f rom which material damage results immediately. Person did not use precaution and the damage was not immediate or the impending danger was not evident b. Simple Imprudence †¢ CRIMINAL INTENT †¢ State of mind of a person at the time the criminal act is committed †¢ Knowledge that the act was unlawful Requisites: †¢ There must be FREEDOM †¢ There must be INTELLIGENCE Requisites of Criminal Intent Freedom Intelligence Freedom is absent in the 1. An imbecile or insane (unless following circumstances: acting during lucid of 1. Under compulsion of an interval). irresistible force. 2. Under nine years old. 2. Under the impulse of 3. Over nine under fifteen uncontrollable fear or an equal (unless he had acted with or greater injury. discernment). Persons Criminally Liable Principals †¢Those who take direct part in the execution of the act (principal by direct participation) †¢Those who directly force or induce others to commit it (principal by inducement) †¢Those who cooperate in the commission of the offense by another act without which it would not have been accomplished (principal by cooperation) Accomplices †¢The person who have a common criminal purpose with the criminal. †¢Have the intention to help and knowledge about the crime. Accessories †¢Have the knowledge but did not participate in the act. a. By profiting themselves. b. By concealing or destroying body of the crime, or instrument thereof, in order to prevent its discovery. c. By harboring, concealing or assisting in escape of the principal. Circumstances Affecting Criminal Liability JUSTIFYING ? Does not commit crime in the eye of the law a. In defense of his person or rights b. In defense of the rights of his family c. In order to avoid an evil or injury d. In the fulfillment of a duty e. In obedience to an order by some superior for some lawful purposes EXEMPTING ? There is crime committed but there is no criminal on account of absence of freewill and voluntariness to act. a. An imbecile or insane (unless acted on lucid interval) b. Under 9 yrs c. Over 9 and under 15 (unless acted on discernment) d. While performing a lawful act with due care, cause an injury by mere accident without fault or intention of causing it e. Act under the compulsion of an irresistible force f. Acts under impulse of uncontrollable fear of an equal injury g. Who fails to perform an act required by law, when prevented by some lawful or insuperable cause. MITIGATING ? which lessen the penalty a. b. c. d. e. f. g. h. Under 18 or over 70 yrs old No intention to commit so grave There was sufficient provocation Acted on impulse so powerful to have produced obfuscation Voluntarily surrendered Deaf or dumb, blind or suffering from defect. Illness that diminish will power Immediate vindication of grave offense to the one committing the felony, his/her spouse, ascend ants, descendants, legitimate, natural or adopted brothers or sisters, or relative by affinity within the first degree Lack of education is not Mitigating in: 1. Rape 2. Forcible abduction 3. Arson 4. Treason 5. In crimes against chastity like seduction and acts of lasciviousness; and 6. Those acts committed in a merciless or heinous manner AGGRAVATING ? †¦which increases the penalty a. Public position b. In contempt of public authority c. Committed with insult or in disregard of the respect of the offended party on account of his/her rank, age, or sex or that it is committed in the dwelling of the offended party, if the latter has not given provocation d. With abuse or confidence or obvious ungratefulness e. in a place of worship f. Conflagration, shipwreck, earthquake, epidemic or other calamity or misfortune g. Price, reward, or promise h. Committed by means of fire, poison, explosion, i. With evident premeditation or after unlawful entry j. Craft, fraud, or disguise is employed k. Causing other wrongs not necessary for its commission ? ALTERNATIVE ? Those which must be taken into consideration as aggravating or mitigating according to the nature effects of the crime and other conditions attending its commission ? Alternative circumstance of relationship should be taken into consideration Points to Observe in Order to Avoid Criminal Liability a. Be very familiar with the nursing law. b. Beware of the laws affecting nursing practice. . At the start of employment, get a copy of your job description, the agency’s rules, regulations and policies. d. Upgrade your skills and competence. e. Accept only such responsibility that is within the scope of your employment and your job description. f. Do not delegate your responsibility to others. g. Determine whether your subordinates are competen t in the work you are assigning them. h. Develop good interpersonal relationships with your coworkers, whether they be your supervisors, peers or subordinates. i. Consult your superiors for problems that may be too big for you to handle. . Verify orders that are not clear to you or those that seem to be erroneous. k. The doctors should be informed about the patient’s condition. l. Keep in mind the value and necessity of keeping accurate and adequate records. m. Patients are entitled to an informed consent. Moral Turpitude An act of baseness, vileness or depravity in social or private duties which a man owes to hi fellow man or society in general, an act contrary to the accepted and customary rule of right and duty between men Murder ? Unlawful killing a human being WITH INTENT to kill. ? A very serious crime Ex. Criminal Abortion Euthanasia Homicide ? Killing of a human being WITHOUT CRIMAL INTENT by a person other than his father, mother or child or any of his ascendants or descendants, or his spouse Abortion ? Expulsion of the product of conceptus before the age of viability ? In the law, any person who, with the intention pr prematurely ending a pregnancy, willfully and unlawfully does any act to cause the same is guilty of procuring abortion ? Art. II Sec. 15 of Phil. Constitution protects the life of the unborn Infanticide ? Killing of a child less than three (3) days of age ? Mother who committed this crime shall be imprisoned for two (2) years, four (4) months and one (1) day to six (6) years Parricide ? Crime committed by one who kills his/her father, mother or child whether legitimate or illegitimate, or any of his ascedants or descedants or his spouse. ? Convicted with this crime, shall be imposed a penalty of life imprisonment (Reclusion Perpetua) to death Robbery ? Crime against a person or property ? The taking of personal property of another person from him or in his presence Common Legal Terms R. Ns should know Affidavit – is a written statement made under oath efore a notary public or other person duly authorized Civil Law – concerned with legal rights and duties of private persons Criminal Law – deals with conduct that is considered to be offensive to a society as a whole Day in Court – the right of a person to appear in court and be heard concerning his complaint/defense Defendant – the person being accused o f wrongdoing; therefore needs to defend himself Deposition – an oral interrogation answering all manner of questions relating to the transaction at issue, given under oath and taken in writing before a judicial officer or attorney

The History of the ACT Test

The History of the ACT Test SAT / ACT Prep Online Guides and Tips How did the ACT get started? And how did it become the test it is today? Read on to learn more about ACT history, its successes and failures, and how things might change for it in the future. Early Days In 1959, an education professor at the University of Iowa named Everett Franklin Lindquist developed the ACT as a competitor for the SAT, which had been around for about 20 years as a mainstream college admissions test. The ACT originally stood for American College Test and wasbased off of the Iowa Tests of Educational Development.The goal for the ACT as an alternative to the SAT was that it wouldn’t just test cognitive reasoning; it would test information actually learned in school.It was the first standardized test to include a science section.It was also more focused on identifying strengths and weaknesses to guide student placement rather than determining cognitive reasoning strength across the board like the SAT. The first ACT was administered to 75,460 students in 1959.The original sections were English, Mathematics, Social Studies, and Natural Sciences, with 45 minutes for each section and scores on a scale of 0-36.It gained popularity as a college admissions exam in the central and midwestern US where the SAT had not yet established its dominion.In fact, part of the purpose of the ACT was to provide other colleges and public universities with an admissions exam to use since the SAT was only used by selective institutions in the northeast. By 1972, the number of students taking the ACT had grown to over a million! Changes In 1989, the â€Å"enhanced ACT† was released, bringing us nearly up to speed with the current version of the test that we all know and love. The Natural Sciencesection was replaced with Science Reasoning.This was a move towards de-emphasizing specific scientific knowledge and insteadjust testing core analytical and problem-solving skills. Social Studieswas also replaced with Reading.This was when the Reading section really moved closer to the SAT.The Social Studies section had tested specific information about US History, whereas the new Reading section was only supposed to test pure reading ability and comprehension. There were also some changes to the Math and English sections. In math, trigonometry and pre-algebra were added as topics. In english, the test began to focus less on grammar and more on writing skills like coherent organization of thoughts. Scores from the old test to the new test were not directly comparable. On the new test, average composite scores rose two points, and the range of scores became 1-36 rather than 0-36. After this big change, some minor changes continued to be implemented. In 1996, the ACT redefined its name so the letters no longer stood for anything, and in2005, the ACT added an optional Writing section (a 30 minute essay) so that it could more directly compete with the essay requirement on the SAT. Starting in 2015, the format of the essay was changed slightly. Students are now given 40 minutes to write, and the Writing section is scored out of 36 rather than out of 12. Prompts deal with how students interpret big changes that are going on in the world, opening up the essay to a broader focus than previous prompts that focused on issues specifically related to high school. The ACT has now surpassed the SAT as the most popular college admissions test. Successes and Failures of the ACT The ACT today has many of the same problems as the SAT in terms of the achievement gap between minority/low-income students and white/high-income students.The percent difference between black and white students meeting the ACT’s benchmarks for college readiness across subjects ranges from 35-42%. According to the chart below, the percentage of African American students passing 3 or more ACT benchmarks lingers around 10%, whereas for white students it’s about 50% and for Asian students it’s almost 60%. The ACT, just like the SAT, has had little success in terms of leveling the playing field between races and income levels and creating an objective test. The ACT does seem to have recognized that this battle needs to be fought at a lower level in education.Many students who do poorly on the test are victims of years of subpar learning experiences.ACT Aspire is a system created by the ACT to track students from a young age based on Common Core standards to make sure they are reaching appropriate goals.So far, however, it has not had a very broad reach. The ACT overall does have much more straightforwardness and consistency in its testing model than the SAT, which makes it a better option for many students.Some people might argue that it’s a fairer test, and it's definitely less tricky in a lot of ways. However,it still hasn’t overcome the achievement gap.The ACT may be less entrenched in notions of elitism than the SAT, but it still contributes to the same problematic systems. ACT, Inc.: Non-Profit? It’s tempting to think of the ACT as a lovable underdog that overcame all odds to beat the snobby SAT in the college admissions test market. However,ACT, Inc. has almost as many issues with its supposed non-profit status as the College Board. In 2009, the CEO of ACT, Inc. was compensated over a million dollars.Just like the College Board, ACT, Inc. pays its executives at levels that are much higher than the average for most nonprofits.ACT, Inc. also sells test prep materials for its exams to increase revenue.The goal of the ACT is the same as that of the College Board: get as many people to buy into their tests and programs as possible. The ACT has surpassed the SAT as the most prevalent admissions test, so it has been pretty successful with this goal.Still, it may have to play catch up again after the SAT revamps its test model in 2016.The new SAT is going to be more similar to the ACT (less confusing question phrasing, trigonometry in the math section) so it should be interesting to see which one ends up dominating the market. Overview The ACT was created in 1959 as competition for the SAT.It was supposed to be an achievement test that dealt with content learned in school rather than just cognitive reasoning skills.However, it moved closer to the SAT as time went on, especially when the Science and Reading sections were created in 1989. The ACT has similar problems to the SAT in terms of the achievement gap and its questionable non-profit status.Even though it is often thought of as a fairer and less confusing alternative to the SAT, it’s really a pretty similar test at this point. It’s possible that the release of the new SAT and increased pressure from colleges for a more reliable performance assessment will catalyze changes to the ACT.Hopefully we're getting closer to creating assessments that are both fair to students and reliable as higher education standards. What's Next? Wondering whether you should take the ACT over the SAT? Check out these comparison charts to see the differences between them. If you want to try your hand at an ACT practice test, here's a link to some free full tests! You should also take a look at this list of test dates for the upcoming school year so you can start thinking about when to register for the ACT. Want to improve your ACT score by 4+ points? Download our free guide to the top 5 strategies you need in your prep to improve your ACT score dramatically.