Good Samaritan Laws
Fear of being sued has often prevented trained professionals from assisting during an emergency.
To encourage physicians and nurses to respond to emergencies, many states developed what are now known as the Good Samaritan laws. When administering emergency care, nurses and physicians are protected from civil liability by Good Samaritan laws as long as they behave in the same manner as an ordinary, reasonable, and prudent professional in the same or similar circumstances. In other words, when assisting during an emergency, nurses must still observe professional standards of care.
However, if a payment is received for the care given, the Good Samaritan laws do not hold.
ITQ
At what point do Good Samaritan laws cease to exist? hold even after payment for health care services have been made
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Good Samaritan laws cease to exist once payment has been received for the health care services. It does exist beyond this point.
Confidentiality
It is possible for nurses to be involved in lawsuits other than those involving negligence. For example, clients have the right to confidentiality, and it is the duty of the professional nurse to ensure this right.
Tip
Confidentiality a set of rules or a promise that limits access or places restrictions on certain types of information
This assures the client that information obtained by a nurse while providing care will not be communicated to anyone who does not have a need to know. This includes giving information by telephone to individuals claiming to be related to a client, giving information without a client’s signed release, or removing documents from a health-care provider with a client’s name or other information.
Slander and Libel
Slander and libel are categorized as quasi-intentional torts. Nurses rarely think of themselves as being guilty of slander or libel. The term slander refers to the spoken word, and libel refers to the written word. Making a false statement about a client’s condition that may result in an injury to that client is considered slander. Making a written false statement is libel.
For example, stating that a client who had blood drawn for drug testing has a substance abuse problem, when in fact the client does not carry that diagnosis, could be considered a slanderous statement.
Slander and libel also refer to statements made about co-workers or other individuals whom you may encounter in both your professional and educational life. Think before you speak and write.
Sometimes what may appear to be harmless to you, such as a complaint, may contain statements that damage another person’s credibility personally and professionally.
ITQ
What is Slander?
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Slander refers to spoken statements capable of causing harm to other’s professional capabilities. These are spoken words with the potential to destroy reputation.
False Imprisonment
False imprisonment is confining an individual against his or her will by either physical (restraining) or verbal (detaining) means. The following are examples:
■ Using restraints on individuals without the appropriate written consent
■ Restraining mentally handicapped individuals who do not represent a threat to themselves or others
■ Detaining unwilling clients in an institution when they desire to leave
■ Keeping persons who are medically cleared for discharge for an unreasonable amount of time
■ Removing the clothing of clients to prevent them from leaving the institution
■ Threatening clients with some form of physical, emotional, or legal action if they insist on leaving Sometimes clients are a danger to themselves and to others. Nurses need to decide on the appropriateness of restraints as a protective measure. Nurses should try to obtain the cooperation of the client before applying any type of restraints. The first step is to attempt to identify a reason for the risky behavior and resolve the problem. If this fails, document the need for restraints, consult with the physician, and carefully follow the institution’s policies and standards of practice. Failure to follow these guidelines may result in greater harm to the client and possibly a lawsuit for the staff.
To protect themselves against charges of negligence or false imprisonment in such cases, nurses should discuss safety needs with clients, their families, or other members of the health-care team. Careful assessment and documentation of client status are also imperative;
confusion, irritability, and anxiety often have metabolic causes that need correction, not restraint. There are statutes and case laws specific to the admission of clients to psychiatric institutions. Most states have guidelines for emergency involuntary hospitalization for a specific period. Involuntary admission is considered necessary when clients are a danger to themselves or others. Specific procedures must be followed. A determination by a judge or administrative agency or certification by a specified number of physicians that a person’s mental health justifies the person’s detention and treatment may be required. Once admitted, these clients may not be restrained unless the guidelines established by state law and the institution’s policies provide. Clients who voluntarily admit themselves to psychiatric institutions are also protected against false imprisonment. Nurses need to find out the policies of their state and employing institution.
ITQ
With respect to mentally handicapped individuals, what is the role of a nurse?
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A nurse does not reserve the right to restrain all classes of mentally handicapped individuals. Rather, mentally handicapped individuals should be observed to be capable of causing harm to themselves or to other individuals before any action is taken.
Assault and Battery
Assault is threatening to do harm. Battery is touching another person without his or her consent. The significance of an assault is in the threat:
“If you don’t stop pushing that call bell, I’ll give you this injection with the biggest needle I can find” is considered an assaultive statement.
Battery would occur if the injection were given when it was refused, even if medical personnel deemed it was for the “client’s good.”With few exceptions, clients have a right to refuse treatment. Holding down a violent client against his or her will and injecting a sedative is battery.
Most medical treatments, particularly surgery, would be battery if it were not for informed consent from the client.
Standards of Practice
Concern for the quality of care is a major part of nursing’s responsibility to the public. Therefore, the nursing profession is accountable to the consumer for the quality of its services. One of the defining characteristics of a profession is the ability to set its own standards.
Nursing standards were established as guidelines for the profession to ensure acceptable quality of care. Standards of practice are also used as criteria to determine whether appropriate care has been delivered. In practice, they represent the minimum acceptable level of care. Nurses are judged on generally accepted standards of practice for their level of education, experience, position, and specialty area. Standards take many forms. Some are written and appear as criteria of professional organizations, job descriptions, agency policies and procedures, and textbooks. Others, which may be intrinsic to the custom of practice, are not found in writing.
State boards of nursing and professional organizations vary by role and responsibility in relation to standards of development and implementation. Statutes, professional organizations, and health-care institutions establish standards of practice. The nurse practice acts of individual states define the boundaries of nursing practice within the state. In Canada, the provincial and territorial associations define practice. Institutions develop internal standards of practice. The standards are usually explained in a specific institutional policy (for example, guidelines for the appropriate administration of a specific chemotherapeutic agent), and the institution includes these standards in policy and procedure manuals. The guidelines are based on current literature and research. It is the nurse’s responsibility to meet the institution’s standards of practice. It is the institution’s responsibility to notify the health-care personnel of any changes and instruct the personnel about the changes. Institutions may accomplish this task through written memos or meetings and in-service education.
With the expansion of advanced nursing practice, it has become particularly important to clarify the legal distinction between nursing and medical practice. It is important to be aware of the boundaries between these professional domains because crossing them can result in legal consequences and disciplinary action. The nurse practice act and related
regulations developed by most state legislatures and state boards of nursing help to clarify nursing roles at the various levels of practice.
ITQ
What are the possible charges a nurse could face?
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A nurse can be charged to court for the following reasons. He/she could be charged for negligence, breech of confidence, slander, libel, assault, battery, and poor standard of practice.