Transcript for:
Nursing Legalities: Torts and Mandatory Reporting

Hi. I'm Meris and today we're going to be talking about unintentional torts, intentional torts, and mandatory reporting for nurses. I'm going to be following along with our Fundamentals of Nursing flashcards. These are available on our website, LevelUpRN.com, so if you are following along with me at home, these are going to be cards 9, 10 and 11. Remember we do have some cool chicken hints coming up, so these are fun ways of remembering things. I always want you to tell me in the comments if you have a better way to remember it. And the most important information, we always call out by making it bold and red, or putting it with a key point icon. So be on the lookout for those symbols inside these cards. So let's get started. So first up, on card 9 we are talking about intentional torts. Now an intentional tort is a willful act that violates a patient's rights. So willful and intentional being the key words. It was something that was done with intent. So there's a couple of different kinds, and these get pretty tricky for nursing students sometimes. So let's kind of lay it out in a way that we can understand. So first is assault. And assault is not what you think it is based on popular culture and TV. Assault is a threat, a threat made against a patient that makes them fearful. So for instance if you don't stop acting up, I'm going to tie you down, right? That is a threat. If we say to a patient that I'm going to hit you or something like that, again, that is assault because it is a threat. Now battery, on the other hand, is actually the touching of a patient without consent that causes harm. So this is if for instance I then did something to a patient such as administer a medication, if I gave them a shot that they refused and they were capable of refusing, that would be battery. So that is a very important distinction. Assault is the threat. Battery is actually carrying it out and harming the patient, putting your hands on them. So we have our cool chicken hint right here is A before B, right? It's just alphabetical. Assault before battery meaning that you make the threat before you actually carry it out. So if you have a better way to remember, please tell me below, but if you like that one, go ahead and like this video for us so that we know. Okay, next up is false imprisonment. Now this one is really important when it comes to restraints and patients leaving against medical advice. So false imprisonment is keeping somebody somewhere against their will, when they should otherwise be free to go. So for instance, if we have a patient that we put in seclusion, and we didn't have an order for it, then that would be false imprisonment. If a patient is trying to leave against medical advice and I physically block the door, that's false imprisonment and that is an intentional tort. Very important. Defamation of character is another one that you might not think of as being a tort but it actually is. So this is making derogatory remarks that harm somebody's reputation or character within a community or just has the potential to do that. There's two kinds. There is slander and there is libel. Both of them are defamation of character, but they're slightly different. Slander is any defamation of character that is spoken, so if I gossiped and I knew something was untrue and I said to another nurse, "Did you hear so-and-so?" that's slander. Now, if I made a Facebook post about it, or if I hung up signs in the hospital saying something that was not true that was going to harm a patient or a staff member's reputation, that is libel—L-I-B-E-L, libel—because it was written. So another cool chicken here, slander is spoken, but libel is written, like a book in the library. So I hope that one is helpful to you in keeping those two straight. So unintentional torts are up next on card number 10. As the name may suggest, these are unintended acts that may cause a patient harm. So I didn't mean to do it, but it still caused harm. You'll hear two of these come up time and time again. One is negligence, and the other being malpractice. Now negligence is where there was a failure to provide care that a reasonably prudent person would have, meaning someone of sound mind and good reasoning capabilities would have done something. That's negligence. Malpractice though is negligence by a professional

• for instance a registered nurse. That would be negligence - where you had a duty to act, for instance, and then you failed to act in the correct capacity. You did not meet the standard of care. So for instance, if I didn't check a medication before administering it, if I didn't verify that what the label says is what I'm supposed to be giving, that's malpractice, and that is something that is very important that we understand so that we can try to do our best to avoid those acts. Again, they are unintentional, but we can find ways to work safer and keep our patients safer. Up next we're talking about abandonment, and abandonment is what it sounds like. This is going to be desertion of a patient by anyone who has taken responsibility for their care. So for instance if I am the nurse on duty for a patient and I just decide I'm going home, and I don't care over to anybody else, that's abandonment. So certainly things happen, right? There could be emergency situations I need to handle, but I would need to transfer care to somebody of lateral licensing, somebody who is a registered nurse as well, who can then assume care for that patient. Okay, last, on card 11 we are talking about mandatory reporting. And as nurses we are mandatory reporters, meaning that by law, we are required to report any suspicion of abuse for a child, a vulnerable adult, or an elder. So this does not mean that I have to have proof, that I have concrete evidence. I don't have to have that. As a mandated reporter, all I need is the suspicion of neglect or abuse, and I need to report that. It's not my job to prove it. What do I need to do though? I need to document anything that leads me to suspect this. If I see incompatibilities in the stories, if I see suspicious injuries or various injuries in stages of healing that are not consistent with what the story is, that's a big red flag. I need to document that. The other thing is that priority nursing action and you can see bold in red right here, because it's very important. The priority nursing action is to protect your patient from harm. So for instance, if the person who I believe could be abusing this patient is in this room, they may be putting my patient at risk for further harm, so I may need to ask them to leave, or separate them or get security involved, those sorts of things. That is always my first priority, is keeping my patient safe. Okay, now what else can I do? Well, I need to interview the suspected abuser and the patient separately, so this way if it's a parent and a child, right, I can ask the child about, so how did you break your arm? And then I ask the parent, so how did your son break his arm? And then I can compare notes, right? I can document the inconsistencies or the consistencies in the stories. The other thing is, for instance if we have a patient who's experiencing intimate partner violence or something like that, I may not be able to help them out of that situation. They may not want to leave at this time, but what we can do is develop a safety plan. Maybe we talk about what to do, where to go, what kind of "go bag" they could pack to have at the ready, and that would be very helpful for them. Lastly, I do want provide information to any vulnerable adult about safe houses or shelters that they can find refuge in and they can be safe in. This is incredibly important for keeping our patients safe. They need to know what to do the next time this happens or when they're ready to leave. Okay, so that's it for intentional torts, unintentional torts, and mandatory reporting. I hope that review was helpful. If it was, please go ahead and like the video. Be sure to leave me a comment below if you thought that was especially helpful, or like I said, if you have a better Cool Chicken hint, I want to hear it. So thank you so much for watching this with us. Next video is going to be covering the thing you guys just love to hate, which is theoretical foundations such as Kohlberg, Maslow, Erikson and Piaget. So definitely check that out if you need a refresher on those concepts. Be sure to subscribe to the channel so that you can be kept up-to-date with all of our new content. Thanks so much for watching, and happy studying!