student nurse clinical practice, many nurses work with student nurses:
student nurses do NOT...
they practice under an...
students are...
instructors and RN can be...
Student nurses do NOT practice on your license
They practice under an EXEMPTION in the NURSE PRACTICE ACT that allows non-nurses to practice nursing in certain situations
Students are liable for their own actions
Instructors and RN can be held liable unde
As a student nurse:
you must perform as a.....you are held to...
you must be directly...
You must perform as a professional nurse. You are held to the same standards of safe and competent care as the registered nurse.
You must be directly supervised during skilled procedures - giving meds., setting up meds., doing dressing changes and other i
what are the State and Federal Statutory Law affecting nursing? (9)
1. Delegation
2. Good Samaritan Law
3. Confidentiality and Privacy Law
4. Informed Consent - doctor gives the patient the information
5. Advance Directives/Self Determination
6. Physical Restraint
7. Physician's orders
8. Patient dumping
9. Do Not Resusci
Nursing practice and unlicensed assistive personnel (UAP):
Skyrocketing health care costs have forced hospitals to use more unlicensed assistive personnel to help with patient care. Unfortunately, educational requirements and on-the-job responsibilities f
not clearly understand what UAPs under their supervision may or may not legally do.
Nurses are responsible for the education, training, and supervision of UAPs who participate in direct patient care.
limit their liability by encouraging their supervisors
The nurse who establishes a solid working relationship with his/her UAPs, and who communicates openly and clearly with them, is...
is less likely to get into potentially litigious situations.
what is the Good Samaritan Act designed to do?
health care provider...
- Designed to protect health care workers
- Health care provider can't be sued if care is given in accordance within established guidelines and scope of practice
What is confidentiality? what laws protect the patient?
- It is the duty of health care providers to protect the secrecy of a patient's information no matter how it is obtained
- State and Federal laws protect patients with legal remedies if their privacy is breached
What is HIPAA? What does it do?
Health Care information is protected by this statute
Health Insurance Portability and Accountability Act, a US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, h
what is informed consent? what are some exceptions?
Law that requires that patients receive adequate information concerning the proposed treatment, the material risks and benefits of the proposed treatment, the risks of doing nothing, and the right to accept or refuse.
Exceptions:
Emergency situations (imp
what allows health care providers to preform a procedure on a patient? the person performing the procedure has...
Voluntary permission by a client for a health care provider to carry out a procedure on the client
has the responsibility to obtain the informed consent
Often, the physician gives the nurse the consent form and says "Get the client to sign this," informed consent can be given only...
who should provide most of the informed consent?
can be given only after the client receives sufficient information of the procedure, risks involved, outcome hoped for and consequences of not having treatment.
The physician should provide most of this information.
when providing informed consent, what can the nurse do?
nurse can reinforce the physician teaching, but should not be the only source of information for the informed consent.
what are the acts that protect patient self-determination?
patient self determination act
advance directives: directive to physicians, medical power of attorney, living wills
What is the Patient Self-Determination Act?
encourage people to discuss and document their wishes concerning the type of treatment and care they want so it will ease the burden on their families and providers when it comes time to make a decision.
two types of advanced directives?
Advanced directives states...
medical durable power of attorney (health care proxy...
Advanced Directives States what health care a client will accept or refuse when client is no longer competent to make such decisions.
Medical Durable Power of Attorney (Health care proxy):
Designates another person to make health care decisions for a pers
the nurse's role in Advance Directives:
must know...
not all...
discrimination must...
must know the laws of the state pertaining to advance directives and client's rights must know the policies and procedures of the institution.
Not all clients can make decisions to formulate advance directives
Discrimination must be prevented against clie
when is a physical restraint applied to patients?
patient is...
restraint is...
regular...
who orders it?
how long does it last?
how does it vary in different in different facilities?
- Patient is a threat to self or others
- Restraint is the least intrusive to control the patient
- Regular reassessment according to policy
- Physician order
- Restraint is discontinued as soon as possible
- Many facilities have a no restraint policy
delegation factors:
a nurse may only...
RNs may not...
delegate tasks appropriate for the skill and education level of the individual who is receiving the assignment (the delegatee)
RNs may NOT delegate the nursing process, client education, or tasks that require nursing judgment to PNs or to APs
what is Emergency Medical Treatment and Active Labor Act?
also called the "patient dumping" act, requires all hospitals (public and private) to provide appropriate medial screening within the capacity of the hospital. If an emergency condition exists, the hospital can not discharge or transfer the patient until
Although DNR orders may be included in an advance directive...
DNR/DNI orders are legally separate from advance directives.
For the nurse to be legally protected...
what must the nurse be familiar with? when might a nurse face a legal dilemma?
there must be a WRITTEN physician's order for a "no code" or DNR in the client's chart
The nurse must be familiar her his/her particular hospital's policy concerning DNR orders.
Nurses may face legal dilemmas when dealing with confusing or conflicting DNR
what can happen during DNR/DNI if there is a lack of proper documentation?
Lack of proper documentation in the medical records indicating how the DNR decision was reached can be an important and crucial issue if a medical malpractice case is involved and it is disputed whether or not the client or family actually gave consent fo
when is patient is DNR/DNI, it is important to the nurses to not...
how must DNR/DNI be respected?
not stigmatize patients who have DNR orders. (eg the practice of placing "dots" over the patient's bed or on the wristband to identify a DNR patient)
It would be extremely unprofessional to give "less than the best" care because "the client is going to di