Lecture on Legal Consent, Responsibilities, and Risk Management in Nursing

Legal Consent for Medical Treatment

Nurse Responsibilities:

• Witness consent
• Advocate for patient
• Ensure informed consent
• Confirm patient competence (lucid, not under influence)

Resources:

• Calhospital.org for updated guidelines on:
  • Adult consent
  • Minor consent
  • Assault and abuse reporting

Consent for Adults:

• Adults (18+), parents, emancipated minors, guardians can consent
• Procedure performer explains risks/benefits/alternatives/consequences
• Consents needed for routine treatments, surgeries, research, etc.
• Official interpreters for deaf, illiterate, or foreign language speakers

Consent for Minors:

• Minors can consent for their own child, certain medical conditions (e.g., pregnancy, STI, substance abuse)
• Emancipated minors or married minors can consent for themselves
• Special cases for homeless or independent minors (15+ managing their own money)

Nursing Student Responsibilities

Legal Liabilities:

• Actions can cause harm, liable along with instructor, hospital, school
• Must act professionally in Concordia uniform
• Separate nursing student role from work role
  • Only perform tasks taught and checked off in school
  • Cannot perform work skills while in student role

Malpractice Insurance:

• Recommended to have personal malpractice insurance
• Hospital coverage may exist but personal insurance ensures individual protection

Assignment and Abandonment Issues

Assignments:

• Accepting responsibility for patient load is critical (e.g., refusing unsafe assignments)
• Abandonment occurs if you accept and then fail to care for assigned patients

Floating:

• Ensure qualifications match patient needs when floating to different units
• Request orientation to new units

Documentation

Importance:

• Medical record is key evidence in legal cases
• Accurate, factual documentation required
• Avoid pre-charting, adhere to approved abbreviations

Incident Reports:

• Separate from patient chart
• Alerts risk management without mentioning in patient chart to remain undiscoverable

Risk Management

Responsibilities:

• Notify risk management of potential lawsuits
• Conduct root cause analysis for errors

Impaired Practice:

• 10-20% of nurses may experience substance abuse
• Signs: overtime requests, narcotic errors, isolation, changes in grooming
• Board stance supports recovery efforts

Protecting Your License:

• Adhere to hospital policies
• Ensure proper delegation and supervision
• Clear and accurate documentation
• Report any issues, errors, or potential legal concerns to risk management

Miscellaneous Topics

Implications for Off-Duty Conduct:

• Off-duty actions (e.g., DUI) can impact nursing license due to unprofessional conduct

Case Study Review:

• Example of negligence with incorrect medication dosage administration
• Highlights importance of following protocol and questioning orders

Final Thoughts:

• Maintain professionalism
• Ensure patient care and safety
• Prepare for discussions in class with questions on these topics

These notes cover the key points discussed in the lecture, providing a thorough overview of legal responsibilities and ethical considerations for nursing professionals. Remember, documentation and patient advocacy are crucial elements in your role.