Definition of Terms
Board of Registered Nursing
Each state has a Board of Registered Nursing organized within the executive branch of the state government. Primary Responsibilities of the BRN include the administration of the Nurse Practice Act as applied to registered nurses.
Authorization to Practice Nursing
To legally engage in the practice of nursing, an individual must hold on an active license issued by the state in which he or she intends to work.
Nurse Practice Act
A series of statutes enacted by each state legislature to regulate the practice of nursing in that state. Topics that are included are the following a. scope of nursing, education, licensure, grounds for disciplinary actions & related topics.
a. Provides legal authority for nursing practice including delegation of nursing tasks.
b. Many boards of nursing also provide decision and delegation checklist.
c. Set educational requirements for the nurse distinguishing Nursing Practice
from Medical Practice & defines the Scope of Nursing.
ANA (American Nurses Association) of 1980
Incorporates the following elements that demonstrate in a nurse:
a. Human dignity & uniqueness of individual regardless of health problems
& socio-economic status
b. Maintain patients right for privacy & confidentiality
c. Maintain competence through ongoing professional development & consultation.
Ethical Principles of Bio-ethics
A philosophical field that applies ethical reasoning process for achieving clear &
convincing reasons to issues & dilemmas ( conflicting between two obligations)
1. Autonomy: the right of the patient to make one’s own decision
- Example: Religious Practices & Cultural Beliefs (Blood Transfusion & Organ Donation)
2. Veracity: the intention to tell the truth
- Never give false reassurance to another person
3. Beneficence versus Non-malfeasance
a. Beneficence : duty to do good
b. Non-malfeasance: duty to avoid evil
4. Confidentiality: social contract in keeping one’s privacy
Standards of Care
Guidelines for determining whether nurses have performed duties in a appropriate manner & guidelines in which the nurse should practice
Patient’s Bill of Rights
Right for appropriate treatment that is most supportive & least restrictive
Right to individualized treatment plan, subject to review & treatment
Right to active participation in treatment with the risk and side effect of all medications and treatment
Right to give and withhold consent/contracts
Contracts & Consent: it is the meeting o the minds between two or more persons whereby one binds himself with respect to the other to give something or to render some service.
Pre-requisites of a Valid Consent and Contract (OPEN- V)
O- Opportunity to ask questions (possible consequences of the procedure)
P- Physically & Mentally Competent & Mature ( 18 years old & up )
E- Explained the Procedures & Treatment Specifically
N- Nothing should be misunderstood by the patient (the patient should not be
allowed to sign the informed consent if she / he is pre-medicated or under the influence of alcohol or drugs or mentally incapacitated
V-Voluntary Made (absence of force, fraud, deceit or duress ( force)
Exceptions to an Informed Consent (MEMO-S)
M –Married & Mature Minors
E- Emancipated minors (to release a child from the control of his parents)
Emergency Cases
M- Minors seeking birth control or pre-natal treatment
O- Over specific age (ex. 12 years old & above) may give consent for STD,
HIV testing, AIDS treatment, drugs & alcohol treatment WITHOUT
parents consent.
S- Sexually abused minors & adolescents
Right to refuse Treatment
1. Advance Directives: Legal, written or oral statements made by a
mentally competent person about treatment. In the event the person is unable to make these determinations, a surrogate decision-maker can do so, example: sudden serious illness.
Characteristics of Advance Directives
1. allows clients to participate in choosing health care providers
(Choosing his / her own nurses & doctors)
2. allows also in choosing the type of medical treatments the client
desires.
3. Allows clients to consent or refuse treatments
The Patient Determination Act of 1990 (PSDA)
- is a federal law that imposes on states and providers of health care certain requirements concerning Advanced Directives as well as client’s right under law to to make decisions concerning medical care.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1990
- Medical Screening of patients cannot be delayed until insurance coverage or the
ability to pay has been determined. This is to assure that the patients are not
denied care based on their ability to pay , patients must be medically screened &
stabilized before their ability to pay is determined. Failure of a Hospital to comply may result in denial of Medicare funding.
Example: All women patients having labor contractions must be medically screened & stabilized before transfer to another facility. Whether it is obvious that the patient is in labor or not, the patient must be medically screened & examined before the decision is made to transfer the patient to another facility.
The emergency department does not have the right to refuse treatment to a patient before medically screening the patient.
- It does not address payment for services as part of the admission procedure. It
only addresses medical screening & stabilization of patients before transport
or the determination of ability to pay for services rendered.
a. Living Will: legal document stating person does not wish to
have extra-ordinary life saving measures when not able to make decisions about his own care.
-applicable FOR LIFE SAVING TREATMENT ONLY.
Example: CPR, antibiotics & dialysis will be used or not
b. Durable Power of Attorney: legal document giving designated
person authority to make health care decisions on the
client’s behalf when the client is unable to do so.
Right to obtain Advocacy Assistance
Patient Advocate: is a person who pleads for a cause or who acts on
the client’s behalf. Example: nurse
Goal of Advocacy: help client gain greater self-determination &
Encourage freedom o choices, increase sensitivity
& responsiveness of the health care, social, politi-
cal systems to the needs of the client.
Example: advocates for HIV client rights for proper treatment & job
opportunities
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