Law & Disorder:
Nursing Unit
Nursing Unit
A nurse threatens to insert a Foley catheter into a patient who refuses.
“What is assault?”
Rationale: Assault occurs when a person is threatened with unwanted touching or harm.
Posting a patient selfie from clinicals online without permission is probably one giant violation of this federal law.
“What is HIPAA?”
Rationale: HIPAA protects patient privacy and confidential health information.
This legal process requires that patients understand risks, benefits, and alternatives before treatment.
“What is informed consent?”
Rationale: Patients must receive adequate information before agreeing to procedures.
Finish this sentence, “If it wasn’t charted…”
“What is ‘it wasn’t done’?”
Rationale: Documentation is essential legal evidence of patient care.
This ethical principle means “do no harm.”
“What is nonmaleficence?”
Rationale: Nonmaleficence requires avoiding unnecessary harm.
Suspected abuse of this population must always be reported.
“What are children?”
Rationale: Healthcare workers are mandatory reporters for suspected child abuse.
This tort occurs when a nurse actually performs unwanted physical contact on a patient.
“What is battery?”
Rationale: Battery involves intentional physical contact without consent.
Discussing patient information in the hospital elevator is an example of this type of disclosure.
“What is a breach of confidentiality?”
Rationale: Patient information should only be shared privately with authorized individuals.
This person is primarily responsible for obtaining informed consent for surgery.
“Who is the provider performing the procedure?”
Rationale: The provider explains the procedure and obtains informed consent.
Charting “patient is lazy and dramatic” violates this documentation principle.
“What is objective charting?”
Rationale: Documentation should contain factual, objective observations.
This ethical principle involves telling the truth to patients.
“What is veracity?”
Rationale: Veracity promotes honesty in patient communication.
Bruises in multiple healing stages on an older adult may require this action.
“What is mandatory reporting of elder abuse?”
Rationale: Nurses must report suspected abuse or neglect of vulnerable adults.
Keeping a competent patient in bed with restraints and refusing to let them leave may result in this tort.
“What is false imprisonment?”
Rationale: False imprisonment occurs when a person is unlawfully confined or restrained.
This principle means nurses should only access patient records if involved in the patient’s care.
“What is the need-to-know principle?”
Rationale: Healthcare workers should only access information necessary for care responsibilities.
The nurse’s role during informed consent usually includes witnessing this.
“What is the patient’s signature?”
Rationale: Nurses commonly witness signatures and verify voluntary consent.
This type of chart entry is used to document information after the actual time of occurrence.
“What is a late entry?”
Rationale: Late entries should be clearly labeled with current date and time.
Treating all patients fairly regardless of background reflects this ethical principle.
“What is justice?”
Rationale: Justice requires fairness and equality in care.
This should include only factual observations when filing an abuse report.
“What is documentation?”
Rationale: Objective, accurate documentation is legally important.
A nurse tells coworkers that a patient has a sexually transmitted infection when it is untrue. This tort may apply.
“What is defamation?”
Rationale: Defamation involves damaging someone’s reputation through false statements.
A student nurse takes a picture of a cool wound for Snapchat. The instructor’s blood pressure immediately rises because of this likely violation.
“What is a HIPAA violation?”
Rationale: Photographing patients or identifying information without authorization violates privacy protections.
A patient signs consent while heavily sedated after receiving IV pain medication. The consent may not be valid because the patient lacked this.
“What is competence or decision-making capacity?”
Rationale: Patients must be mentally capable of understanding and voluntarily consenting.
Using correction fluid on a paper chart can create this legal concern.
“What is alteration of the medical record?”
Rationale: Tampering with records may appear deceptive or fraudulent.
A nurse keeps promises and follows through with patient care responsibilities. This demonstrates this principle.
“What is fidelity?”
Rationale: Fidelity involves faithfulness, loyalty, and keeping commitments.
A nurse reports suspected abuse in good faith. These laws generally protect the nurse from retaliation.
“What are mandatory reporting protections?”
Rationale: Good-faith reporting is legally protected in many jurisdictions.
This occurs when a nurse fails to follow the standard of care and the patient is harmed.
“What is malpractice?”
Rationale: Malpractice is professional negligence that causes patient injury.
This federal department enforces HIPAA privacy protections.
“What is the U.S. Department of Health and Human Services (HHS)?”
Rationale: HHS oversees HIPAA enforcement and privacy compliance.
A competent adult refuses life-saving surgery. The nurse must respect this ethical principle.
“What is autonomy?”
Rationale: Competent adults have the right to make healthcare decisions, including refusal.
A nurse realizes 2 hours after administering a high-alert medication that the dose was incorrectly documented in the MAR. The nurse immediately corrects the entry by erasing the original dose and writing the correct one without indicating any change. What legal/documentation issue is present?
“What is improper alteration of a medical record (falsification of documentation)?”
Rationale: Medical records must never be altered in a way that obscures the original entry. Erasing or deleting documentation without indicating a correction violates legal documentation standards and can be interpreted as falsification or tampering. Proper correction requires a late entry or electronic amendment that preserves the original record with a clear, dated, and signed correction.
An RN notices that a licensed practical nurse (LPN) has been independently completing initial patient assessments and writing nursing care plans in the EHR without RN review. The RN signs off on the notes later to “help the team move faster,” even though they did not verify the findings. What legal and professional issue is most concerning in this situation?
“What is improper delegation and failure to uphold RN accountability for assessment and nursing care planning?”
Rationale: Initial patient assessments and nursing care plans are core RN responsibilities and cannot be delegated to an LPN. Even if an LPN documents findings, the RN remains legally accountable for validating assessments and ensuring accuracy of the plan of care. By signing off without verifying the information, the RN is falsifying documentation and violating professional standards of practice, delegation rules, and potentially the state Nurse Practice Act. This behavior compromises patient safety, undermines the integrity of the care plan, and exposes the RN to disciplinary action, malpractice liability, and possible license sanctions.
Failure to report suspected abuse could place a nurse at risk for these consequences.
“What are legal and disciplinary actions?”
Rationale: Failure to report may violate law and professional standards.