NURSING JURISPRUDENCE

Dept of law composed of all legal rules and regulations affecting nursing practice
JURIS law; JURISPRUDENCE the study, understanding, and interpretation of law

LAW
Sum total of rules and regulations by which society is governed
Rule of human conduct pronounced by controlling authority and may be enforced
Government controlling authority in our system
Constitution law of the land or government

PROUNOUNCEMENT OF THE LAW
Must be declared in writing to enforce control
Sources of Pronouncements
o Constitutions
o Statutes / Legislations
o LOI order by the Pres. as a guide to his previous order or decree
o PD order by the PRES who exercised legislative powers
o Case Decisions / Judicial Orders
o Executive Branch

TYPES OF LAW
Public Law - between individuals and the government
o Criminal law
Private Law or Civil Law - among private individuals
o Contract Law, Tort Law

PARTIES TO CASES
Criminal Case Plaintiff vs Accused
Civil Case Complainant vs Defendant

LEGAL TERMS THAT NURSES SHOULD NOW
AFFIDAVIT voluntary sworn statement
o voluntary written statement that a person swears to be TRUE before
authorized to administer an oath

DEFENDANT
o accused person in criminal case and should defend themselves
DUE PROCESS
o fair and orderly process which aims to protect a persons rights
o judgment is given only after a FAIR trial
FALSE TESTIMONY/STATEMENT
o punishable both criminal and civil law
HEARSAY EVIDENCE
o rumours, not admissible in evidence
INQUEST
o legal inquiry of the cause or manner of death
PERJURY
o wilful telling of a lie or giving false statements under oath
PLAINTIFF
o complainant; person who files lawsuit and seeking for perceived wrong doing
PRIMA FACIE EVIDENCE
o true, valid; legally sufficient to establish a fact
STATUTE OF LIMITATIONS
o length of time allowed for filing lawsuit, usually from the time the person
discovered the wrong (ex. negligence- filed within 2-3 years from occurrence)
SUBPOENA
o court order requiring a person to appear in court to testify as witness
SUBPOENA DUCES TECUM
o requires a witness to come to court and bring required papers or documents in
his possession
SUMMONS
o a writ commanding an authorized person to notify a party to appear in court to
answer a complaint against them
TRIAL
o Judicial process that involves presentation of facts, at the end in which the law
is applied
WARRANT
o presented by an arresting officer
WITNESS
o person who is called to give testimony in the court of law
RESPONSIBILITY AND ACCOUNTABILITY FOR THE PRACTICE OF PROFESSIONAL NURSING
Nurses are liable on their actions or duties

PROFESSIONAL NEGLIGENCE
Commission or omission of an act, pursuant to a duty, that a reasonable prudent
nurse in the same or similar situation would or would not do.
3 ELEMENTS
o duty on part of the nurse
o failure to do said duty or failure to meet the standards of due care
o injury, harm, death most important negligence
COMMON ACTS
o Burns resulting from hot water bags, heat lamps, vaporizers, sitz bath
o Objects left inside patients body; sponges suction tips, loose dentures lodged
in the patients trachea
o Falls of the elderly; confused, unconscious, sedated patients
o Falls of children whose bed rails were not pulled up and locked
o Failure to observe and take appropriate action
o Failure to report observations to attending Physician
o Administration of medicine without doctors prescription
o Mistaken Identity drug given to wrong patient
o Wrong medicine, wrong concentration, wrong route, wrong dose
o Errors due to family assistance
o Defects in equipment - stretchers and wheelchairs that may lead to falls
LEGAL DEFENSE OF NURSES IN NEGLIGENCE
o Standard of care was attained and able to document accurately

THE DOCTRINE OF RES IPSA LOQUITUR
The thing speaks for itself---Injury would not normally occur unless someone is
negligent and that no proof is required.
o Injury was caused by an agency within control of the defendant
o Plaintiff himself did not engage in any manner that would tend to bring injury
Examples
o nurse injected the sciatic nerve of patient and became paralyzed
o sponges inside the abdomen of client was left after operation
o fracture of newborn baby delivered via breech presentation
MALPRACTICE
Improper or unskilful care of patient by a nurse
Negligence or Carelessness of Professional Personnel
Stepping beyond ones authority
LESNIK- negligent act committed in the course of professional performance
Nurse is allowed to perform episiorrhapy with proper training but not episiotomy
Nurse is allowed to perform IE but with 2 conditions
o fetal aberration or abnormal delivery
o prior to complete delivery
Ex: nurse prescribes medications and gives anesthesia

DOCTRINE OF FORCE MAJEURE
Irresistible force; unforeseen or inevitable; fortuitous event ; acts of God
No person shall be responsible for non-performance of what was expected of him
Calamities, floods, fire, earthquakes

DOCTRINE OF RESPONDEAT SUPERIOR
Let the master answer for the acts of the subordinate
Employer is responsible for the act of his employees
Liability is expanded to include the superior as well as the employee
Ex. hiring under board nurses or midwives in place of RNs and RMs

INCOMPETENCE
lack of legal qualifications or skill to perform
There is ground of revocation or suspension of COR

LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES
Perform under direct supervision of RNs, but responsible for their own actions.
Responsibility: routine care of chronologically ill patients
If RNs delegated their own functions to them and they committed a mistake, the
RN is held responsible.





TELEPHONE ORDERS BY PHYSICIANS
Should accepted by Nurse only in EXTREME EMERGENCY
What the nurse should do:
o Read back the order to ensure that order has been correctly received
o Write doctors name and ones name and signature
o Note the time
o Make sure Physician signs the order within 24hrs

CONSENT TO MEDICAL AND SURGICAL PROCEDURES
CONSENT
Nature of Consent: authorization by the patient or a person authorized by the law to
give consent on the patients behalf

INFORMED CONSENT
Written consent should be signed by the patient understanding of procedure
Protects the client, nurse, physician, and the hospital
Essential elements
o Diagnosis and explanation of the condition
o Explanation of procedures
o Consequences and Benefits
o Alternative treatments or procedures
o Prognosis, recommended care, and consequences if refused

WHO MUST CONSENT
patient must voluntarily consent on his own behalf
if incompetent or physically unable, and is not in emergency case, consent is taken
from another authorized persons (ex. significant others)

CONSENT OF MINORS
parents or someone standing in their behalf gives the consent
parental consent not needed if patient is married or emancipated

CONSENT OF MENTALLY ILL
cannot legally consent & must be taken from parents or legal guardian

CONSENT DURING EMERGENCY SITUATIONS
no consent is necessary b/c inaction at that time may cause greater injury

REFUSAL TO CONSENT
patient who is mentally and legally competent has the right to refuse no matter
how necessary nor how imminent danger to his life or health

CONSENT FOR STERILIZATION
sterilization is the termination of the ability to produce offspring
husband and wife must consent
If emergency cases, such as ectopic pregnancy and abruption placenta, consent
from patient is sufficient.

NURSES RESPONSIBILITY IN WITNESSING THE GIVING OF INFORMED CONSENT
witnessing the exchange between client and physician
witnessing client affix signature
establishing that client really understood

MEDICAL RECORDS
Primary: means of COMMUNICATION among health care practitioners
evidence in legal suits but not admissible evidence against patient
If information is not charted, it was not done or observed

INCIDENT REPORT
Administrative report that is required of nurses if there are violations of standards
and policies whether or not injury occurs
through this, hospital admin can monitor quality patient care and institute measures
to prevent similar incidents in the future

CONTRACT - Agreement between 2 persons in which one binds oneself to render
professional services for which proper compensation is provided.
Formal Contract - done in writing by law (marriage contract, work contract, deed
of sale)
Informed Contract
o oral or spoken discussion between parties
Express Contract
o conditions and terms are given orally or written at the time contract is
made
DOCTRINE OF FACIO UT DES: I DO THAT YOU MAY GIVE
o Private duty nurse is asked to go on a special duty by a Physician and
patient doesnt object to the service, nurse will be paid under this doctrine.
Implied Contract
o performance of actions which constitute an intention to enter into a
contract
Void or Inexistent Contract
o inexistent from the start
Illegal Contract
o prohibited by law

INTENTIONAL WRONGS
TORTS A legal wrong, committed against a person or persons property
ASSAULT
o attempt or threat to touch another person unjustifiably

BATTERY
o actual carrying out of the threatened physical contact
o intentional touching of a person (including his clothes or something person is
carrying) without consent that may or may not cause harm

FALSE IMPRISONMENT OF ILLEGAL DETENTION
o Illegal confinement of an individual
o Unlawful limitation of freedom or mobility

INVASION OF RIGHT TO PRIVACY and BREACH OF CONFIDENTIALITY
o Right to be left alone, free from unwarranted publicity and right to live ones
life
o Nurses are liable if they divulge any information from patients chart to
unauthorized person


DEFAMATION
o Character assassination
o Person discusses another person that can damage reputation
o Slander- oral defamation by speaking false words
o Libel- written word (print, pictures, cartoons)
o There must be a third person who hears or read the comment before it can
be considered defamation

CRIMES, MISDEMEANORS, AND FELONIES
CRIME
An act committed or omitted in violation of the public (criminal) law and punishable
by a fine and or imprisonment

CONSPIRACY TO COMMIT A CRIME - Two or more persons agree to commit a felony
PRINCIPAL
o who take direct plan/part in the execution of the crime (doer of the act)
o who directly force or induce or pay a person to commit the crime
o who cooperates in the offense, by an act without which the crime would
have not been accomplished

ACCOMPLICES - accessory before the fact
o cooperate in the execution of the offense
o absent when the crime is committed

ACCESSORIES accessory after the fact
o Profited from the crime
o Concealed or Destroyed evidence of crime (disposing the body)
o Assisted or supported the escape of principal







CRIMINAL ACTIONS offenses against public welfare
FELONY
o public offense liable to be sentenced to death or be imprisoned
o committed with deceit (dolo) and fault (culpa)

TYPES OF FELONIES
o CONSUMMATED
all elements of the crime are executed and is successful
o FRUSTATED
all elements present and executed, but unsuccessful
o ATTEMPTED
has attempt to start the offense but it was thwarted
Not all elements executed, unsuccessful result.
MANSLAUGHTER
o second degree of murder (accidental administration of overdose narcotics)

MISDEMEANOR
o offense less than felony and punishable by fine or short-term jail sentence
o ex. nurse who slaps the patients face

CRIMINAL NEGLIGENCE
RECKLESS IMPRUDENCE
o person does an act or fails to do it involuntarily without malice, from which
damage results immediately
SIMPLE IMPRUDENCE
o person did not use precaution and the damage was not immediate or the
impending danger was not evident or manifest

CRIMINAL INTENT
State of mind of a person at during criminal act is committed that he/she knows
that act is not lawful and still decide to do it anyway




CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY - JEMAA
JUSTIFYING CIRCUMSTANCES
o Self Defense
o Fulfilment of Duty
o Obedience to an order from superior

EXEMPTING CIRCUMSTANCES
o Insane or Imbecile
o Performance of lawful act causes injury by mere accident
o Under 9yo
o Under uncontrollable force
o Under uncontrollable fear

MITIGATING CIRCUMSTANCES
o Under 18 or over 70 y/o
o Voluntary surrender
o Dead and dumb / physical defect
o Suffer from illness

AGGRAVATING CIRCUMSTANCES
o Treachery/taking advantage of superior strength or position
o Price, reward, promise
o Use of fire, poison, explosion
o Calamities
o Craft, fraud or disguise employed
o Cruelty

ALTERNATIVE CIRCUMSTANCES
o Aggravating or Mitigating
o May increase/ decrease liability depending on nature and effects of the crime
Relationship, Intoxication, Degree of instruction/ education of offender




LACK OF EDUCATION IS NOT MITIGATING IN:
o RAPE
o FORCIBLE ADBUCTION
o ARSON
o TREASON
o SEDUCTION AND ACTS OF LASCIVIOUSNESS

CRIMINAL LIABILITIES OF NURSES
MORAL TURPTITUDE
o anything done in contrary to justice, honesty, or modesty
MURDER
o unlawful killing of human being; intent to kill
HOMICIDE
o killed a person to whom you have no relationship
ABORTION
INFANTICIDE
o killing of child <3 days or 72 hours
o imprisonment: 2 yrs, 4 mos, and 1 day to 6 yrs
PARRICIDE
o victim or offender is the father, mother, brothers, sisters, ascendants,
descendants, or spouse.
SIMULATION OF BIRTH
o pretend that a woman gave birth
o substitution or exchanging of babies in the nursery
o intentionally putting wrong information in birth registration form
o PD 651 register birth within 30 days in the civil registrar
ROBBERY
o crime against a person or property in the presence of victim
THEFT
o anyone who gets the personal property of another w/o permission

WILLS
Legal declaration of a persons intentions upon death
Testamentary document takes effect after the death of its maker

DECEDENT
person whose property is transmitted thru succession whether or not he left a will
TESTATOR - decedent who left a will
TESTATRIX if person making a will is a woman
TESTATE - person who dies leaving a will
INTESTATE - dies without will
PROBATE - validation of the will in a court
HEIR - person called to succession

KINDS OF WILL
HOLOGRAPHIC WILL
o written, dated and signed in the handwriting of the testator
Nuncupative/ Nuncipation
o Oral will made during persons last illness, that it be done in the place in
which he dies, that he is asked one or more witnesses to the will, that the
will be put on writing within a given number of days

TESTATOR QUALIFICATIONS
Those not prohibited by law
18 yr old and above
Sound mind
Think clearly ability at the time of its execution

WITNESSES
Sound mind
18 and above
not blind / deaf / dumb
able to read and write

NURSES OBLIGATIONS IN THE EXECUTION OF A WILL
Note soundness of patients mind
Make sure there is freedom from fraud and undue influence
Make sure patient is 18yo and above
Testator should name the person who will carry out the provisions of the will
Will must be signed by testator and attested and signed by at least 3 witnesses in his
presence
Will must be acknowledged before a notary public by testator and witness
Married woman can make a will w/o consent of husband

ADVANCE DIRECTIVE
Document prepared by competent individual to establish the desired health care for
the future OR give someone else the right to make health care decisions if he or she
becomes incompetent.

TYPES OF ADVANCE DIRECTIVE
LIVING WILL OR INSTRUCTIVE DIRECTIVE
o Specifies the treatments that a client wants or does not want, if he or she
becomes unable to make decisions for himself or herself.

HEALTH PROXY OR DURABLE POWER OF ATTORNEY
o Clients appoint a particular person or surrogate to make medical decisions for
himself or herself.

GIFTS MORTIS CAUSA
Disposing of gifts by a person in anticipation of death/ belief in approaching death.
Limitations:
o limited to personal properties
o acceptance by the recipient
o gifts are revocable and subject to the claims of creditors without proof of
intent of defrauding them