Page 37 - Essentials of Nursing Leadership and Management, 5th Edition

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24 unit 1 | Professional Considerations CikguOnline
element of intent is missing. Quasi-intentional torts Marcos, a second-level student, was unable to find his
usually involve problems in communication that instructor, so he decided to administer digoxin to his
result in damage to a person’s reputation, violation of client without supervision. The dose was 0.125 mg.
personal privacy, or infringement of an individual’s The unit dose came as digoxin 0.5 mg/mL. Marcos
civil rights. These include defamation of character, administered the entire amount without checking
invasion of privacy, and breach of confidentiality the digoxin dose or the client’s blood and potassium
(Aiken, 2004, p. 139). levels. The client became toxic, developed a dys-
rhythmia, and was transferred to the intensive care
Negligence unit. The family sued the hospital and the nursing
Negligence is the unintentional tort of acting or school for malpractice. The nursing instructor was
failing to act as an ordinary, reasonable, prudent also sued under the principle of respondeat superior,
person,resulting in harm to the person to whom the even though specific instructions to the contrary had
duty of care is owed (Black, 2004). The legal ele- been given to the students.
ments of negligence consist of duty, breach of duty,
causation, and harm or injury (Cushing, 1999). All Other Laws Relevant
four elements must be present in the determination. to Nursing Practice
For example, if a nurse administers the wrong med-
ication to a client, but the client is not injured, then
Good Samaritan Laws
the element of harm has not been met. However, if
Fear of being sued has often prevented trained
a nurse administers appropriate pain medication but
professionals from assisting during an emergency.
fails to put up the side rails, and the client falls and
To encourage physicians and nurses to respond to
breaks a hip, all four elements have been satisfied.
emergencies, many states developed what are now
The duty of care is the standard of care. The law
known as the Good Samaritan laws. When admin-
defines standard of care as that which a reasonable,
istering emergency care, nurses and physicians are
prudent practitioner with similar education and
protected from civil liability by Good Samaritan
experience would do or not do in similar circum-
laws as long as they behave in the same manner as
stances (Prosser & Keeton, 1984).
an ordinary, reasonable, and prudent professional in
Malpractice the same or similar circumstances (Prosser &
Keeton, 1984). In other words, when assisting dur-
Malpractice is the term used for professional negli-
ing an emergency, nurses must still observe profes-
gence. When fulfillment of duties requires special-
sional standards of care. However, if a payment is
ized education, the term malpractice is used. In
received for the care given, the Good Samaritan
most malpractice suits, the facilities employing the
laws do not hold.
nurses who cared for a client are named as defen-
dants in the suit. Vicarious liability is the legal
Confidentiality
principle cited in these cases. Respondeat superior,
It is possible for nurses to be involved in lawsuits
the borrowed servant doctrine, and the captain of
other than those involving negligence. For exam-
the ship doctrine fall under vicarious liability.
ple, clients have the right to confidentiality, and it
An important principle in understanding negli-
is the duty of the professional nurse to ensure this
gence is respondeat superior (“let the master
right. This assures the client that information
answer”) (Aiken, 2004, p. 279).This doctrine holds
obtained by a nurse while providing care will not be
employers liable for any negligence by their
communicated to anyone who does not have a need
employees when the employees were acting within
to know. This includes giving information by tele-
the realm of employment and when the alleged
phone to individuals claiming to be related to a
negligent acts happened during employment
client, giving information without a client’s signed
(Aiken, 2004).
release, or removing documents from a health-care
Consider the following scenario:
provider with a client’s name or other information.
A nursing instructor on a clinical unit in a busy The Health Insurance Portability and
metropolitan hospital instructed his students not to Accountability Act (HIPAA) of 1996 was passed
administer any medications unless he was present. as an effort to preserve confidentiality and protect