Professional Documents
Culture Documents
Submitted by:
KEISHA FERREZE ANN A. QUIŇONES
RLP-BSN4
Submitted to:
JANET B. LIM
Subject Professor
LEGAL ASPECTS OF NURSING
According to the American Nurses Association (ANA), “the Standards of
Professional Nursing Practice are authoritative statements of the duties that all registered
nurses, regardless of role, population or specialty are expected to perform competently”.
The ANA further states that the standards can change as the dynamics of professional
nursing evolve and that specific clinical circumstances or conditions might affect the
application of the standards at any given time.
The legal aspects of nursing have an impact on the manner in which care is
delivered to patients by nurses. Legal concerns shape the environment in which nursing
is practiced and determine how documents are kept or shared. Ultimately, nurses and the
nursing care they provide are judged based on a legal definition for the standard of care
for nurses. Written “standards of care” and “guidelines” are available as resources for
determining how nursing care is to be delivered and the quality of care. However, the
legal definition of the standard of care for nurses is not a “guideline” or a “policy” set by
any one individual or institution. Rather, it is the embodiment of collective knowledge for
what is required of the average nurse and sets the minimum criteria for proficiency.
Nursing Malpractice
In 1975, nurses were finally identified as professionals worthy of the protection of
the law afforded to other medical professionals, when statutory protection was afforded
to nurses who might be sued on the basis of nursing practice. Since July 9, 1975, a
negligence claim against a nurse has been characterized as malpractice. This meant that
nurses were identified as providing specialized care and treatment based upon the
principles of nursing. A nurse's knowledge and the delivery of nursing care were no longer
compared to the standard of an ordinary man or woman.
In the past, physicians or other health care professionals could offer their opinions
on the standard of care for nurses. No longer can physicians testify about the standard of
care for nurses. Only a nurse is considered to have the special body of knowledge,
education/training, and experience to provide testimony regarding what the average
nurse would do, under the same or similar circumstances, for a patient presenting in the
same or similar manner.
Nursing Malpractice
Malpractice is negligence, misconduct, or breach of duty by a professional that
results in injury/damage to a patient. Common malpractice claims arise against nurses
when nurses fail to:
Assess and monitor.
Follow standards of care.
Use equipment in a responsible manner.
Communicate.
Document.
Act as a patient advocate and follow the chain of command.
Elements of Malpractice
To prove malpractice, all 4 of the following elements must be proven by the plaintiff:
the nurse had a duty to the patient, the nurse breached the duty, a patient injury occurred,
and there was a causal relationship between the breach of duty and the patient injury.
Therefore, in determining if malpractice has occurred, these 4 elements must be carefully
considered. First, did the nurse have a duty to the patient? This means that the nurse was
actively engaged in providing nursing care to the patient. Second, was there a breach of
that duty? In other words, did the nurse commit an act or omission in the act of taking
care of the patient and did that act or omission result in harm to the patient?
The third element is “proximate cause.” The question here is whether the action or
omission caused any harm to the patient. If the action did not result in harm or injury,
there was no malpractice. Finally, the fourth element is damage. What harm occurred as
a result of the action of omission during the delivery of nursing care? A nurse might have
a duty to a patient and commit an action or omission during the course of nursing care,
and it might not constitute malpractice if the action or omission did not result in harm to
the patient.
Minimizing the Risk of Malpractice
Nurses should be cognizant of legal risks in providing care. The following actions
can help minimize a nurse's risk of being sued for malpractice:
Know and follow your state's nurse practice act and your facility's policies and
procedures.
Stay up to date in your field of practice.
Assess your patients in accordance with policy and their physicians' orders and,
more frequently, if indicated by your nursing judgment.
Promptly report abnormal assessments, including laboratory data, and document
what was reported and any follow-up.
Follow up on assessments or care delegated to others.
Communicate openly and factually with patients and their families and other health
care providers.
Document all nursing care factually and thoroughly and ensure that the
documentation reflects the nursing process; never chart ahead of time.
Promptly report and file appropriate incident reports for deviations in care.
During that time, the applicants need to be only twenty years old, of good physical
health and good moral character. Graduates of intermediate courses of the public school
could enter the school of nursing, which was then giving only two years, and a half of
instruction. These graduates were called first class nurses. Those who desired to be
second-class nurses filed an application with the district health officer in the district where
they resided.
In 1919 Act 2808 was passed- this is known as the First True Nursing Law. It
created among others a board of examiners for nurses. However, it was in 1920 that the
first board examination in the Philippines was given.
On June 19, 1953, the Philippine Nursing Law or R.A. 877 was passed. This act
regulated the practice of nursing in the Philippines. One of the landmarks in the history of
the nursing profession in the Philippines is the Presidential Proclamation of a Nurses'
Week.
Under Proclamation No. 539 dated October 17, 1958 the President of the
Philippines designated the last week of October every year beginning in 1958 as Nurses'
Week.
On June 18, 1966, Republic Act 4704 amended certain portions of R.A. 877. The
following were included among the salient changes:
a. The scope of nursing practice was broadened to circumscribe the whole
management of the care of patients and the acts constituting professional practice
of nursing were spelled out to include such services as reporting, recording and
evaluation of a patient’s case, execution of nursing procedures and techniques,
direction and education to secure physical and mental care and the application
and execution of physician’s orders concerning treatment and medication.
b. The minimum age required of applicants for admission to the nurse’s examination
was lowered from 21 to 18 years of age, but no candidate who passed the
examination was permitted to practice the profession until he or she reached the
age of 21.
Republic Act 7164, introduced by Senator Heherson Alvarez, codified and revised
all the laws regulating the practice of nursing in the Philippines. It was known as the
Philippine Nursing Act of 1991.
In October 21, 2002, Republic Act No. 9173 otherwise known as “The Philippine
Nursing Act of 2002” replaced R.A. 7164.
There are laws governing the practice of Nursing, one of which is House Bill No.
4955, AN ACT PUNISHING THE MALPRACTICE OF ANY MEDICAL PRACTITIONER
IN THE PHILIPPINES AND FOR OTHER PURPOSES