Page 41 - Essentials of Nursing Leadership and Management, 5th Edition

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28 unit 1 | Professional Considerations CikguOnline
■ The consent is written. decisions about care reduce the likelihood of a law-
■ A minor’s parent or guardian usually gives suit. Tips to prevent legal problems are listed in
consent for treatment. Box 3-1.
All health-care personnel are accountable for
Ideally, a nurse should be present when the physi-
their own actions and adherence to the accepted
cian is explaining the treatment to the client.
standards of health care. Most negligence and mal-
Before obtaining the client’s signature, the nurse
practice cases arise from a violation of the accepted
asks the client to recall exactly what the physician
standards of practice and the policies of the
has told him or her about the treatment. If at any
employing institution. Common causes of negli-
point the nurse thinks that the client does not
gence are listed in Table 3-1. Expert witnesses
understand the treatment or the expected outcome,
are called to cite the accepted standards and assist
the nurse must notify the physician of this fact.
attorneys in formulating the legal strategies per-
To be able to give informed consent, the client
taining to those standards. For example, most med-
must be fully informed fully. Clients have the right
ication errors can be traced to a violation of the
to refuse treatment, and nurses must respect this
accepted standard of medication administration,
right. If a client refuses the recommended treat-
originally referred to as the Five Rights (Kozier
ment, a client must be informed of the possible
et al., 1995; Taylor, Lillis, & LeMone, 2008), which
consequences of this decision.
have been amended to Seven Rights (Balas, Scott,
Implied consent occurs when consent is
& Rogers, 2004):
assumed. This may be an issue in an emergency
when an individual is unable to give consent, as in 1. Right drug
the following scenario: 2. Right dose
3. Right route
An elderly woman is involved in a car accident on
4. Right time
a major highway.The paramedics called to the scene
5. Right client
find her unresponsive and in acute respiratory dis-
6. Right reason
tress; her vital signs are unstable. The paramedics
7. Right documentation
immediately intubate her and begin treating her
cardiac dysrhythmias. Because she is unconscious
Appropriate Documentation
and unable to give verbal consent, there is an
The adage “not documented, not done” holds true
implied consent for treatment.
in nursing. According to the law, if something has
not been documented, then the responsible party
Staying Out of Court
Prevention
Unfortunately, the public’s trust in the medical pro- box 3-1
fession has declined over recent years. Consumers Tips for Avoiding Legal Problems
are better informed and more assertive in their • Keep yourself informed regarding new research related
approach to health care. They demand good and to your area of practice.
responsible care. If clients and their families believe • Insist that the health-care institution keep personnel
that behaviors are uncaring or that attitudes are apprised of all changes in policies and procedures and
in the management of new technological equipment.
impersonal, they are more likely to sue for what
• Always follow the standards of care or practice for the
they view as errors in treatment. The same applies institution.
to nurses. If nurses demonstrate an interest in and • Delegate tasks and procedures only to appropriate
caring behaviors toward clients, a relationship personnel.
develops. Individuals do not sue those they view as • Identify clients at risk for problems, such as falls or the
development of decubiti.
“caring friends.” The potential to change the atti-
• Establish and maintain a safe environment.
tudes of health-care consumers is within the power • Document precisely and carefully.
of health-care personnel. Demonstrating care and • Write detailed incident reports, and file them with the
concern and making clients and families aware of appropriate personnel or department.
choices and methods can help decrease liability. • Recognize certain client behaviors that may indicate the
possibility of a lawsuit.
Nurses who involve clients and their families in