Nursing Jurisprudence Texas exam with complete solutions.

Jurisprudence The science or philosophy of law Sources of Law - Constitutional Law Federal State - Statutory Law Federal State - Common Law - Administrative Law Criminal Law Federal or state government is attempting to deprive an individual of life or liberty for something the law considers an offense against society in general. Civil Law Seeks to resolve disputes between private parties, which often results in the payment of money. Different Burden of Proof Beyond a reasonable doubt A preponderance of the evidence Tort Law A civil wrong that causes someone else to suffer loss or harm resulting in legal liability for the person who commits the tortious act. Types of Torts - Negligence - Intentional Torts Assault Battery False Imprisonment - Quasi-Intentional Torts Defamaiton Libel Slander Malpractice Negligence committed by a person in his or her professional capacity is malpractice. Also known as professional negligence. Medical and nursing malpractice occur when a doctor or nurse fails to do that which a reasonable, prudent doctor or nurse would do under the same or similar circumstances, or does that which a reasonable or prudent doctor or nurse would not do under the same or similar circumstances. Elements of a Nursing Malpractice Lawsuit Duty - the existence of a duty, owed by the nurse to a patient, to conform to a recognized standard of care Breach - a failure to conform to the required standard of care Harm - an actual injury Cause - there must be proof that the injury was caused by the nurse's act or omission Intentional Tort: Assault Intentionally placing another in apprehension or fear that they will suffer harmful or offensive contact. Intentional Tort: Battery Intentional contact that is harmful or offensive, or creating the apprehension that such contact is imminent. Intentional Tort: False Imprisonment Willful detention without consent and without authority of law. Quasi-Intentional Tort: Defamation A communication that tends to hold the plaintiff up to hatred, contempt or ridicule, or to cause him to be shunned or avoided. Tarnishing the reputation of someone. Quasi-Intentional Tort: Defamation Types Types: Libel - printed or broadcast Slander - spoken Nurse Practice Act The practice of nursing is a right granted by a state to protect those who need nursing care. The guidelines of the NPA and its rules provide safe parameters within which to work, as well as protect patients from unprofessional and unsafe nursing practice. The act is a dynamic document that evolves and is updated or amended as changes in scope of practice occur. All states and territories have enacted a NPA Generally, NPAs include: Authority, power and composition of a board of nursing Education program standards Standards and scope of nursing practice Types of titles and licenses Requirements for licensure Grounds for disciplinary action, other violations and possible remedies Rules & Regulations The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore, each NPA establishes a board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the law more specific. Rules and regulations must be consistent with the NPA and cannot go beyond it. These rules and regulations undergo a process of public review before enactment. Once enacted, rules and regulations have the full force and effect of law. IT IS A NURSE'S RESPONSIBILITY TO KNOW NPA/RULES AND REGULATIONS As a nurse in Texas, you have a responsibility to know and follow the Nursing Practice Act and all applicable BON Rules and Regulations relating to your nursing practice. All current BON Rules and Regulations and the Nursing Practice Act can be downloaded from the BON's web site at Standards of Nursing Practice Standards Applicable to All Nurses. All vocational nurses, registered nurses and registered nurses with advanced practice authorization shall: (A) Know and conform to the Texas Nursing Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules or regulations affecting the nurse's current area of nursing practice. The standards of practice establish a minimum acceptable level of nursing practice in any setting for each level of nursing licensure or advanced practice authorization. Failure to meet these standards may result in action against the nurse's license even if no actual patient injury resulted. Laws & Regulations Regarding Nursing - Texas Nurse Practice Act (NPA) - Texas Board of Nursing (BON) Rules & Regulations - BON Position Statements Don't have the force of law, but the Board strongly encourages nurses to choose those position statements applicable to their practice setting and incorporate them into their daily practice to assure patient safety The Texas Board of Nursing (BON) Established by passage of the NPA BON empowered by NPA with the responsibility and legal authority for ensuring competent practitioners of nursing. Grants authority to the BON to make the rules and regulations to carry out the act. The Board: protects the public from unsafe nursing practice, provides approval for more than 200 nursing education programs, issues licenses to more than 27,000 nurses per year by examination to new graduates and by endorsement to licensees from other states seeking a Texas license, as well as providing nursing practice and education guidance to more than 350,000 currently licensed nurses practicing in the State of Texas. BON Responsibilities & Services Licensing qualified practitioners Enforcement - investigating violations of the NPA and initiating appropriate legal action when necessary Establishing minimum standards for educational programs in nursing BON Mission Statement To protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely. BON Mission Fulfilled Through The regulation of the practice of nursing, and The approval of nursing education programs. Licensure Required A person may not practice or offer to practice professional nursing or vocational nursing in this state unless the person is licensed [NPA § 301.251] This section of the NPA establishes the NPA as a practice control act for RNs and LVNs Use of Titles Must hold a license to use the title: Registered Nurse or RN Professional Nurse Licensed Vocational Nurse or LVN Any designation that implies that the person is a licensed registered or vocational nurse Clearly Legible Insignia When interacting with the public in a nursing role, RNs and LVNs must wear an insignia identifying them as RNs or LVNs [NPA § 301.351] APRNs practicing in an advance practice role must identify themselves with their APRN title BON Rule 217.10(b) requires the nurse's first or last name and licensure level Although the board does not require the inclusion of any other designations, with the exception of the specific authorization of advanced practice nurses, the insignia may not contain information other than: (A) the registered nurse or licensed vocational nurse designation; (B) the nurse's name, certifications, academic degrees, or practice position; (C) the name of the employing facility or agency, or other employer; or (D) a picture of the nurse. No More Paper Licenses The BON discontinued issuing wallet-sized paper licenses for nurses renewing their licenses beginning September 1, 2008 Paper license certificates are issued for: Graduate nurses who pass the NCLEX® exam and obtain their initial license in Texas; Nurses who hold licenses in other states and are obtaining a Texas license for the first time; and Nurses who receive full licensure as APRNs Licensure Verification Employers may verify the licensure status of all nurses seeking employment online or by phone. Renewal of Licensure 60 days prior to license expiration, the BON will mail a postcard reminder to renew online. This is one of the reasons it is important to keep your contact information up to date! Continuing Competency (TAC Chapter 216) Purpose: to ensure nurses stay abreast of current industry practices, enhance their professional competence, learn about new technology and treatment regimens, and update their clinical skills. [TAC § 216.2] All nurses are required to demonstrate continuing competency for renewal of licensure. Methods: Complete 20 hours of continuing education, or Attain, maintain, or renew an approved national nursing certification in the area of practice Nursing Jurisprudence & Ethics - 2 hours [Rule 216.3 (g)] Older Adult or Geriatric Care - 2 hours [Rule 216.3 (h)] Nurse Licensure Compact The Nurse Licensure Compact (NLC) allows RNs and LVNs to have one multistate license, with the ability to practice in both their home state and other NLC states. The APRN Compact allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states. Agreement among states to mutually recognize each others' licenses Texas among first to adopt Premise: current licensure requirements essentially the same from state to state Does not interfere with each state defining scope of practice Only defines requirements to hold license Nurse Licensure Compact - Definitions Party states - states who have adopted the compact Home state license - where you permanently reside Remote state - where you practice using multistate privilege (must be a party state) Nurse Licensure Compact - Requirements Maintain home state license Adhere to state practice laws of state in which patient is located at the time care is provided Use multistate privilege only in party states Hold home state license in only one party state at a time. Practice in a Non-Party State To practice in a state that is not part of the Compact, the nurse must obtain license from the non-party state May concurrently hold a home state license and a license to practice in a non-party state If you live in a non-party state, you must obtain a non-resident Texas license in order to practice in Texas Ethical Conduct Year after year, Nursing is recognized as one of the most trusted professions. It is important to maintain that trust, so we can practice efficiently. ...what is good and bad and with moral duty and obligation... Good Professional Character Integrated pattern of personal, academic and occupational behaviors which, in the judgment of the Board, indicates that an individual is able to consistently conform his or her conduct to the requirements of the Nursing Practice Act, the Board's rules and regulations, and generally accepted standards of nursing practice including, but not limited to, behaviors indicating honesty, accountability, trustworthiness, reliability, and integrity [TAC § 213.27(a)]. Factors Indicating Good Professional Character Distinguish right from wrong; Think and act rationally; Keep promises and honor obligations; Accountable for own behavior; Able to practice nursing in an autonomous role with patients/clients, their families, significant others, and members of the public who are or who may become physically, emotionally, or financially vulnerable; Recognize and honor the interpersonal boundaries appropriate to any therapeutic relationship or health care setting; and Promptly and fully self-disclose facts, circumstances, events, errors, and omissions when such disclosure could enhance the health status of patients/clients or the public or could protect patients/clients or the public from unnecessary risk of harm [ Rule 213.27(b)(2)(A-G)]. Any conviction for a felony or for a misdemeanor involving moral turpitude or order of probation with or without an adjudication of guilt for an offense that would be a felony or misdemeanor involving moral turpitude if guilt were adjudicated [Rule 213.27 (b)(3)]. Any revocation, suspension, or denial of, or any other adverse action relating to, the person's license or privilege to practice nursing in another jurisdiction [Rule 213.27 (b)(4)]. Criminal Behavior Disclosure Requirement for criminal history for applicants for a license [NPA § 301.2511]. Requirement for criminal history for renewal of license [NPA § 301.3011]. Disclose: Convictions Deferred adjudications Probated sentences Domestic offenses Professional Boundaries The appropriate limits which should be established by the nurse in the nurse/client relationship due to the nurse's power and the patient's vulnerability. Refers to the provision of nursing services within the limits of the nurse/client relationship which promote the client's dignity, independence and best interests and refrain from inappropriate involvement in the client's personal relationships and/or the obtainment of the nurse's personal gain at the client's expense. A zone of patient-centered care is in the center of the professional behavior continuum. This is where the patient interactions should occur for effectiveness and patient safety. Over-involvement with a patient is on the right side of the continuum; this includes boundary crossings, boundary violations and professional sexual misconduct. Under-involvement lies on the left side; this includes distancing, disinterest and neglect, and can be detrimental to the patient and the nurse.