nine legal aspects

8/8/2019 Nine Legal Aspects

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LEGAL ASPECTS OF NURSING

Responsibility and Accountability

When nurses undertake to practice

their profession, they are held responsibleand accountable for the quality ofperformance of their duties.

Professional Negligence

Refers to the commission or omissionof an act, pursuant to a duty, that areasonably prudent person in the same or

similar circumstance would or would not

do, and acting or the non-acting of whichis the proximate cause of injury to anotherperson or his property.

Elements of negligence1. existence of a duty on the part of

the person charged to use due careunder circumstances.

2. failure to meet the standard ofcare.


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3. the foreseeability of harm resultingfrom failure to meet the standard

4. the fact that the breach of this

standard resulted in an injury tothe plaintiff.

Examples of Negligence1. Failure to report observations to

attending physicians.

2. Failure to exercise the degree ofdiligence, which the circumstancesof the particular case demands.

3. Mistaken identity4. Wrong medicine, wrong

concentration, wrong route, wrong

dose.5. Defects in the equipment such asstretchers and wheelchair that canlead to falls.

6. Administration of medicine withoutdoctors prescription.

Doctrine of Res Ipsa Loquitor The ThingSpeaks for Itself

Examples


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1. Wrong site injection leading tosciatic nerve paralysis

2. Burn area due to spilled hot water

bag or improvised hot water bag

Malpractice

Refers to improper or unskillful care ofa patient by a nurse.

Examples1. Insertion of urinary catheter

causing damage to urinary sphincter2. Failure to properly monitor patient,

resulting in aspiration pneumonia

and death3. Fall during transfer of patient

Doctrine of Force Majeure

Means an irresistible force, one that isunforeseen or inevitable.

Nurses who fail to render serviceduring floods, fire, earthquakes andaccidents are not held negligent.


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Doctrine of Respondeat Superior. Let theMaster answer for the acts of the

subordinate.

The liability is expanded to include thesuperior (doctors, hospitals, chief,head) as well as the nurse performingthe negligent act.

Examples1. The hospital will be held liable, if,

in an effort to cut down onexpenses decides to hire

underboard nurses or any non-

registered health care providers.2. The surgeon will be heldresponsible in a case wherevisceral pack or an instruments is leftin a patients abdomen.

Incompetence

It is the lack of ability, legalqualifications or fitness to discharge therequired duty.


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Liability of Nurses for the Work of NursingAides

Nurses should not delegate theirfunctions to nursing aides since thePhilippine Nursing Act specifies thescope of nursing practice of professionalnurses.

Liability for the Work of Nursing Students

Under the Philippine Nursing Act of2002 RA 9173, nursing students do

not perform professional nursing

duties.

They are to be supervised by theirclinical instructors, in order that theerrors committed by nursing students willbe avoided, the following measuresshould be taken:

1. Nursing students should always beunder the supervision of theirclinical instructors.


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2. They should be given assignmentsthat are at their level of training,experience, and competency.

3. They should be closely supervisedif they are performing proceduresfor the first time.

4. They should be oriented to thepolicies of the nursing unit.

5. Their performance should be

assessed frequently to determinetheir strengths and weaknesses.

6. Frequent conferences with thestudents will reveal their problemswhich they may want to bring to

the attention of their C.I. or vice

versa.

Intravenous Therapy and LegalImplications

Based on the Philippine Nursing Act of1991 Section 28 which states that inthe administration of intravenousinjections, special training shall berequired according to protocol

established.


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Therefore nurses have to undertake acertified training IV Therapy as

developed by ANSAP.Telephone Orders

Telephone orders should be done inemergency cases only.

The nurse should read back such orderto the physician to make certain the orderhas been correctly written.

Such order should be signed by the

physician on his next visit within 24hours.

The nurse should sign the name of thephysician per her own and note the timethe order was received.

Charting Done by Nursing Students

When a nurse or a clinical instructorcountersigns the charting of a nursing


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student he attests that he has personalknowledge of information and that such isaccurate and authentic.

Tort: A legal Wrong

1. Assault - is the imminent threatof harmful or offensive bodilycontact.

Battery - is an intentional,unconsented

touching of anotherperson.

A patient refuses an injectionand the nurse gives it anyway,the nurse can be charged for

battery.

A patient who gets injuredwhile being restrained maycause the nurse to be liable forassault and battery.

2. False Imprisonment or IllegalDetention - the unjustifiable


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Crimes, Misdemeanors, and Felonies

Crimes. It is an act committed oromitted in

violation of the law.

Felony. It is committed with deceitand fault. A

deceit exists when the actis

performed with deliberateintent and

there is fault when the

wrongful acts

result from imprudence, orlack ofskill or foresight.

Examples: rape, murder,drug-related

crimes, theft

Criminal negligence may beclassified into


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reckless imprudence and simpleimprudence.

Reckless imprudence occurswhen a person does an actor fails to do it voluntarily butwithout malice, from which materialdamage results immediately.

Simple imprudence occurswhen the person or nurse didnot use precaution and thedamage was not immediate or

impending danger was not evident or

manifested.

Criminal intent is the state of mindof a

person at the time the criminal actis

committed, that is he knows thatan act is not lawful and stilldecided to do it anyway.

Misdemeanor. Is a general name forcriminal


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offense which does not in law amountto

felony. Punishment is usually fine or

imprisonment of less than one year.

Conspiracy to commit a crime: Whentwo or more persons agree to commita felony and decide to do it. Personswho commit felonies are either

principals, accomplices or accessories.

Principals - are those who take adirect part in

the execution of the act.

Accomplices - are those persons whocooperate inthe execution of the offense

Accessories - are those who, havingknowledge

of the commission ofthe crime,

take part or assistingthe crime


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by concealing thecrime.

Classes of Felonies1. According to the degree of the acts ofexecution

1.1consummated, when the elements(time, place, how) of felony arewell-planned prior to its

execution.1.2 frustrated, when the elements are

present however its executionfailed.

1.3attempted, when the offender

commences the act but does not

perform all the acts whichshall produce the felony by reasonof some cause or accident.

2. According to the degree of punishment2.1grave felonies, are those to which

the law attaches the capitalpunishment (death,

imprisonment from 6 years and 1 day,fine of not exceeding 6,000

pesos).


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2.2 less grave felonies, are those towhich

the law punishes with correctional

imprisonment from 1 day to 6years and, fine of not exceeding6,000 pesos but not less than 200pesos.

2.3 light felonies, are punishable onlywhen they have been

consummated.

Circumstances affecting criminalliability.

1. Justifying Circumstances.

1.1 when one acts in defense of

his life or rights.

2. Exempting Circumstances.2.1 insane person2.2 person under 15 years old2.3 any person who acts under

irresistible force, anduncontrollable fear


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3. Mitigating Circumstances (asituation which lessens theoffense)

3.1no intention3.2the offender is under 18 or over

70years old

3.3presence of provocation orthreat

3.4the offender is suffering fromsevere illness

4. Aggravating Circumstances (asituation / act making the crime

worse)

4.1 taking advantage of his publicposition4.2 when the crime is committed

with insult to publicauthorities

4.3 the crime is committed in aplace of worship

4.4 when the crime is committedduring misfortune andcalamities


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4.5 premeditated crime or after anunlawful entry

4.6 fraud or disguise

5. Alternative Circumstances, arethose which must be taken intoconsideration as

aggravating or mitigating accordingto the offenders relation to

complainant, degree of instructionand education.

Lack of education is not mitigatingin: rape, abduction, arson,

treason, seduction, acts of

lasciviousness (lying on top of thecomplainant, embracingand kissing her, mashing herbreasts, inserting his hand

inside her panty and touching hersexual organ) and heinouscrimes.

Moral TurpitudeIt is the gross disregarding of moral

standards expected of a human being


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while doing some activity or crime.Example: raping a person in front ofher parents or husband.

Murder. Unlawful killing of a person.

Examples:* Death resulting from

abortion

* Euthanasia

Abortion. Expulsion of the fetusbefore the age

of viability.

Infanticide. Killing of a child lessthan 3 daysold.

Parricide. Killing ones father, motheror child whetherlegitimate or illegitimate or any

of his descendants.

Robbery. Taking of the property fromanother person.


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Points to Observe in Order to AvoidCriminal Liability

1. Be familiar with the Philippine NursingLaw.2. At the start of employment, get a copyof your job description, agency rules,regulations and policies.3. Upgrade your skills and competence.

4. Accept only such responsibility that iswithin the scope of your employment andyour job description.5. Do not delegate your responsibility toothers.

6. Determine whether your subordinates

are competent in the work you areassigning them.7. Consult for problems.8. Verify orders that are not clear.9. Keep the value and necessity ofkeeping accurate and adequaterecords.10.Patients are entitled to an informedconsent.

Sources of Law


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Law- ordinance of reason promulgated forthe common good by one whohas legitimate authority. It

consists of enforced rules underwhich a society is governed.

Types of Law1. Public Law - a bill or jointresolution (other than for

amendments to the Constitution)passed by both Houses of Congress

and approved by the President.

Branches1.1Felonies

1.2Misdemeanor

2. Private/Civil Law - a body of lawsregulating relations betweenindividuals or between individualsand corporations concerning

property rights, personal dignity

and freedom, and personal injury.

3. Contract Law - that branch of jurisprudence that studies the


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rights and obligations of partiesentering into contracts.

4. Tort - court cases that seekcompensation for damages..

Criminal LawInvolves the state imposing

sanctions for crimes

committed by individuals so thatsociety can achieve justice and a

peaceable social order.

Administrative LawRefers to the body of law which

regulates bureaucratic managerialprocedures and defines thepowers of administrative

agencies.

Characteristics of a Law1. Authority or the right to declare

that the rule exists.2. The rule is pronounced or

expressed and that its source canbe identified.
http://en.wikipedia.org/wiki/Social_orderhttp://en.wikipedia.org/wiki/Social_order


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3. A right to enforce the same mustbe provided.

The Controlling Authority of a Law:The

Government

Pronouncement of the Law: Must bedeclared in writing

Good Samaritan LawA rule that exempts from liability a

person (such as an off-dutyphysician/nurse) who voluntarily

renders aid to another in imminent

danger but negligently causes injurywhile rendering theaid.

This rule is to protect those who cometo the aid of others for no other reasonthan kindness.

Nurse-Attorney Relationship

Licensure (discussed in RA 9173)


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Laws, Resolutions, Proclamations andExecutive

Orders Affecting the Practice ofNursing in the Philippines

RA 877 An act regulating the practiceof nursing profession in thePhilippines

RA 4704 June 18, 1966An act amending certain

sections of RA 877 also known asthe Philippine Nursing Law.

RA 6136 August 31, 1970An act amending subparagraphseven of RA 877 (application andexecution of legal orders).

RA 7164 Philippine Nursing Act of 1991

RA 6511 An act amending RA 465 whichstandardized the examination andregistration fees chargedby the various Board of Examiners.


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PRC Memorandum No. 90 11. DatedAugust 20, 1990, provided the new

rates for examination and registration.

LOI No. 1000 March 20, 1980 Pres.Ferdinand Marcos

required that members ofaccredited professional

organizations shall be givenpriority in the hiring of employees in

the government service andin the engagementof professional services.

RA 1612 Privilege Tax Law ProfessionalTaxPayment

RA 7392 June 18, 1960Amended RA 2644 known as

Midwifery Law

RA 2382 The Philippine Medical Act


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RA 5181 This act prescribes permanentresidence and reciprocity asqualifications for any

examination or registration for thepractice of any profession in thePhilippines

RA 6425 Dangerous Drug Act

RA 3573 in 1929 declared that allcommunicable diseases shallbe reported to the nearest

health station and that any personmay be inoculated, administered

or injected with prophylactic

preparations.

RA 1082 Approved on June 1954 andamended by RA 1891 on June 22,1957 provides for the

creation of RHUs.

RA 1891 an act amending someprovisions in RA 1082


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PD791 the revised Population Act.

PD 166 amending PD 791 which

strengthens family planningprograms through participation of

private organizations and individuals inthe formulation andimplementation of the

program planning policies.

General Order No. 18 enjoins allcitizens of the Philippines topromote the concept of family

welfare, responsible parenthood and

family planning.

LOI No. 47 directs all schools ofmedicine, nursing, midwiferyand allied medical professions

and social work to prepare, plan andimplement the

integration of familyplanning in their curricula.

Dept of Labor Order No. 7 requires allindustrial establishments to


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provide familyplanning services.

PD 48 limits paid maternity leaveprivileges to four children.

PD 69 limits the number of children tofour for tax exemption purposes.

PD 965 requires that couples intendingto get married must firstundergo a family planning andresponsible parenthood instruction prior

to the issuance of a marriage

license.

RA 1054 requires the owner, lessee oroperator of any company andestablishment to furnish freeemergency, medical and dental

attendance to his workers.

RA 4226 Hospital Licensure Act

PD 442 Labor Code of the Philippines


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PD 603 Child and Youth Welfare Code

PD 651 decrees the registration of birth

of a child within 30 days with theCivil Registrar

ILO Convention149 provides for theimprovement of lifeand work conditions of nursing

personnel.

PD 1519 gives Medicare benefits to allgovernment employeesregardless of status of

appointment.

PD 1636 requires compulsorymembership in the GSIS orSSS Retirement Plan

PD 626 Employee Compensation andState

Insurance Fund

RA 6675 Generic Act of 1988


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RA 6758 standardizes the salaries ofgovernment employees whichinclude the nursing

personnel

RA 7160 The Local Government Code

RA 7305 The Magna Carta for HealthWorkers

RA 7600 Rooming-in and BreastfeedingAct

RA 7432 Senior Citizens Act

PD 223 creating the ProfessionalRegulation Commission(Board of Nursing) and

prescribing its powers and functions.

PD 541 allows former Filipinoprofessionals to practicetheir respective profession in the

Philippines. Balikbayans may practicetheir profession during the periodof their stay in the country.


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PronouncementsNurses Week - Last week of

October

National CancerConsciousnessWeek - Second week

of January

InternationalWomens Day - March 8

World Health Day - April 7

Earth Day - April 2

National HealthWorkers Day - May 7

World Red CrossDay - May 8

International NursesDay - May 12


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World Diabetes Day - June 27

World AIDS Day - December 1

World BreastfeedingDay - August 1

International DayFor Drug Abuse

and Child Trafficking - January 2

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