Nursing Practice And The Law: The Need For Effective Grooming By Barr. (Nurse) John Y. Shamata
Nursing Practice And The Law: The Need For
Effective Grooming
BEING A TEXT OF PAPER PRESENTATION AT INTRENATIONAL NURSES WEEK 2018 ORGANIZED BY NATIONAL ASSOCIATION OF
NIGERIAN NURSES AND MIDWIVES, HELD AT ABUJA, NIGERIA.
BY
Barr. (Nurse) John Y. Shamata (LLB, BL, RN, BNSC, MSC.) 08024102205 johnshamata@gmail.com
INTRODUCTION
}“People who regard themselves as highly efficacious, act, think, and feel differently from those who perceive themselves as inefficacious. They produce their own future, rather than simply foretell it”.
Albert Bandura
INTRODUCTION CON’T
}All over the world, Nurses fall within the structure of the general healthcare team where they are expected to safeguard and promote the interest of their patients while enhancing the reputation of their profession at the same time.
}Bailliere’s Nurses Dictionary (2002) defines Nursing as the profession of performing the functions of a Nurse.
}In essence, Nurses are not only qualified in the art and science of nursing, they must have met certain prescribed standards of education and clinical competence, making them to be rightly termed “Registered Nurses.”
INTRODUCTION CON’T
}No doubt a Nurse possesses specialized skill,
beyond that of the average lay person.
}that field, and lpossess the license to practice. }have been itrained and obtained certificates
}within the realm of registered Nurses, as they professionalism.
Why legal knowledge is important for nurses
}legislation, legal policies, and statutes relevant to
professional standards.
}The standard of practice of registered nurses must
analysis of the legislation that influences nursing. }nurses in interactions with patients, families off
practitioners.
}given increased responsibility, thereby increasing
}nursest are being delegated to lnon-professionals,
Common Essential Terms in Nursing Law
}Civil Law – Body of law dealing with private rights of
}Competent – Mentally and Emotionally able to
}substance whose possession and use are controlled }Plaintiff – the party that brings the charges against
}Defendanti – an individual or group being sued or }Damages– a sum of money paid in compensation
}Liability – an obligation to pay money to another }Litigation – a lawsuit, or legal disputation
Common terms Con’t }Malpractice – failure of professional duty or
}Negligence – failure to act with ithe prudence that a
}confidentiality; trust that information gained in the
}Tort – Violation of a civil law, a wrong against an
}Ethical Codesr- actions and beliefs approved of by }Ethical Principles – Rules of right and wrong from
}Laws – rules of conduct enforced by government
Common terms Con’t
} Nurse Practice Act – rules and regulations set by state boards
} Accountability – a willingness to answer for your actions and } Delegation – authorizing subordinates to make certain
} Standards of Care – Established by the nurse practice act that } Discrimination – unfair treatment of a person or group on the
} Consent – Permission Given by a patient
} Competent – One who is legally fit (mentally and emotionally) } DNR – do not resuscitate
} Patient Advocate – is a person who speaks for the patient in
effectively for themselves or when thei patient lacks the } Prudent – wise, careful, cautious
Common terms Con’t
} Assault – a threat or attempted physical attack by someone who
} Battery – an assault in which the assailant makes physical contact } Slander – words falsely spoken that damage the reputation of
} Libel – a tort consisting of false and malicious publication printed } Defamation – an abusive attack on a person’s character or good
} False Imprisonment -tunlawful restraint or restriction of a person’s } Incident Report – a record completed after an unusual occurrence
occurrence.
} Ethics – Ethical principles are rules of conduct that have been agreed
} Euthanasia – the act of killing someone painlessly (especially
} illegal, immoral, or illegitimaterpractices by an individual or an of
NURSING PRACTICE
}Registered nurses (RNs) utilize evidence-based nursing knowledge and professional nursing judgment to assess health needs, provide nursing care, educate clients and support individuals to manage their health holistically.
}They practice in collaboration with other healthcare professionals. They are accountable for their scope of practice including the supervision and delegation of nursing activities to the enrolled nurses.
}RNs may practice in a variety of clinical contexts depending on their education preparation and practice experience.
}have iusedi to lorganize their activity traditionally and
prevalent in most health in-situations in Nigeria and }This method of care does not individualize care and
individual patients andrit. lacks continuity and }This has a negativei impact onrbest practices,
}The need for nurses to adopt other care approaches
care rendered can be of quality.
}The situation is worsened with acute staff shortage
} Prof A.O. Ojo lin his inaugural i lecture at Igbinedion University, } These according to him include the fact that the educational
utilization of the most current concepts in nursing such as advanced nursing practice and reflective practice etc. which
globally.
} education thereby limiting their opportunities for progress r. } In addition, governments’ cost saving practice for minimum
endangers the health of the citizens as standards and quality } All these factors are negatively impacting on the quality of
envisioning of nursing education and practice is the panacea.
Core nursing competences
}The Core Competencies are organized into 4 domains.
}Each domain has associated competency standards, with each standard representing a major function/functional area to be performed by a RN.
}Competence Domain 1: Professional, Legal and Ethical Nursing Practice
}Competence Domain 2: Management of Care
}Competence Domain 3: Leadership and Nursing Management
}Competence Domain 4: Professional Development
REGULATION OF NURSING PRACTICE
}In Nigeria, the Nursing and Midwifery (Registration etc.) Act of Cap, N143 Laws of the Federation of Nigeria 2004 provides that the Nursing and Midwifery Council of Nigeria is the only legal, administrative and statutory body charged with the responsibility to regulate the standards of Nursing and Midwifery practice and code of conduct in the country.
}This statute which relates to the ethical Nurse and patient relationship is mostly universal in nature.
The Council has the following general duties
}Determining what standards of knowledge and skill are to be attained by persons seeking to become members of the profession.
}Securing in accordance with the provisions of this Act the establishment and maintenance of a register of persons entitled to practice the profession
}Regulating and controlling the practice of the profession in all its ramifications
}Maintaining, in accordance with this Act, of discipline within the profession and
}Performing the other functions conferred upon the Council by this Act.
SOME UNETHICAL BEHAVIORS IN NURSING PRACTICE
}Some unethical behaviors constituting misconduct, for which Nurses and Midwives can be removed or suspended from the professional register, are listed as follows:
}1. A Nurse should take instructions from a doctor and act strictly on the instructions given.
}(BARNETT v CHELSEA AND KESSINGTON HOSPITAL MANAGEMENT COMMITTEE) (1969) 1 QB 428).
}2. A Nurse should not divulge or disclose personal information she receives from the patient to a third party, or else that will be infringing on his right of privacy
}3. A patient should understand what he is getting into. It is therefore wrong for a Nurse to harbor the erroneous impression that patients cannot understand medical information.
}4. It is an unethical for a Nurse to label and stigmatize a patient with the disease or ailment affecting him
}Challenges such as shortage of Nurses, upgraded facilities in the hospital, are no
}For iexample, the Somali Medical Association says “If anyone has saved a life, it would be as
mankind” (Al-Mai’dah 5:32).
}6. In the course of her duty, professional
hostile or impolite to patients in order to
}concerns and must realize that each patient is
patients’ choice must be respected
}for vaccinatingI anf11-year-oldJ plaintiff against
plaintiff’s parents had given a verbal consent to basis, even though the plaintiff informed the
vaccinated.
}The Court held that the record of the plaintiff’s
made in error.
}8. A Nurse should not embark on a sexual relationship with a patient, especially if he is vulnerable.
}For example, an adult Psychiatric Nurse in the United Kingdom who married her patient, was found guilty of misconduct, but because she had an unblemished nursing career, she was given a caution.
}9. Even though it is allowed that a Nurse can consider the views, culture and beliefs while providing care, a Nurse should as a duty place medical ethics over her personal faith or ethics. All manner of prejudices are unprofessional
}11. A Nurse should generally be aware of the definition of standard of care, what constitutes negligence; professional malpractice and misconduct; patient’s constitutional rights and autonomy; care in emergencies and breach of professional standards,
}12. Nurses on duty who have been found to be drinking alcohol or who steal drugs intended for patients or who sell items to patients or who are indecently dressed are all engaging in acts constituting misconduct.
}In Columbia, a Nurse who danced just for few minutes to pop music and filmed herself while in the middle of an operation, was sanctioned after she posted the video online.
THE SIGNIFICANCE OF EFFECTIVE GROOMING
}nurses to possess i increasing knowledge, clinical
autonomy in clinical judgment.
}society’s orientation tto health and self-care are
grow.
}This development is good for the profession as
because betterreducational preparation will lead
Effective Grooming Con’t
}panacea that will guarantee sustainable future
}There are two dimensions to effective
}1. Academic preparedness (competence) }2. Evidence based clinical competence }These dimensions are the sole responsibility
the legal framework regulating the practice of
ACADEMIC PREPAREDNESS (COMPETENCE)
}Nursing education in Nigeria continues to struggle with its content-overload curricula that attempts simultaneously to “prepare” nurses to practice in a biomedical orientated disease care system and to educate nurses to be responsible health care professionals committed to the social changes necessary for health promotion and disease prevention
}Within this setting it is pertinent to ask some
}provide nursing students sufficient learning
}What are the future health needs of this nation? }How can these nurses be best prepared?
}Howtcan schools be changed to educate these }innovationf in nursing education tof create and }All levels of nursing education, under-graduate
traditions and design evidence-based curricula collaborative, and integrate current technology.
EVIDENCE BASED CLINICAL EXPERIENCE
}What ist evidence-based practice (EBP), and why is this }EBP is an approach to healthcare clinical decision-
designed research studies with a clinician’s expertise
}clinical intelligence: clinical data from the electronic translated into information and then into knowledge,
}EBP improves practice, improves patient outcomes, }Patient safety can be improved whenrhealthcare
How can a healthcare institution integrate EBP?
}The first step is to change its collective mindset
}satisfied with doing things lthe way they’ve always
}The institution must invest in technology and healthcare professionals can easily access
}Evidence-based information must include
clinical decision lsupport tools to assist healthcare
}The second step is to recognize the barriers to implementing evidence within a healthcare institution.
}These barriers need to be addressed before an evidence-based culture can be successfully implemented. Implementing EBP isn’t as easy as one might expect.
}Historically, the major barriers to EBP have been clinicians’ lack of EBP knowledge and skills, a perception that EBP is time consuming, the belief that EBP is burdensome and organizational cultures that don’t support an EBP environment.
} The third step in implementingrEBP within a healthcare system } Without mentors, an organization will have a very difficult time
} experts in clinical practice as well as EBP and analytical e
} principles of EBP and to function as coaches on quality
} The next step in implementing EBP is education.
} The entire staff, from the bedside to the boardroom, needs to
adopt onesof the many methodologies related to EBP, which all } 1. Develop the clinical question. (EBP Question)
} 2. Generate or search for the best evidence. (Literature)
} 3. Appraise or synthesize the evidence. (Filter the Literature) } 4. Implement the evidence.
} 5. Evaluate the outcomes.
LEADERSHIP IN NURSING }accomplish goals by inspiring confidence andl support
communicating that vision to others to realize, the status quo, taking risks, and facilitating change (Valiga
}industry. They coordinate patient care, they manage }skills forreffective grooming and to efficiently manage
members.
}carrier and so should be well aware of lthese concepts
CONCLUSION/RECOMMENDATION
} For the profession of nursing to take its leadership
countries like Nigeria, there is need tfor psychological t
} of the health care provider team. This i is needed to address
the clinical practice settings.
} initiate change on multiple levels, including policy ando
promotioni of nursing initiatives in improving health care } environment for life-longi learning, sharingcbest practices
understanding of the law governing the practice of nursing
} African College of Nursing (WACN) conference in Abuja, made, many of which are still relevant if we are to achieve
} University degreerto achieve their dreamswithin 2 years of experience, similar to what is being done in advance
} disciplines to take up nursing, and revising curriculum to } There is need to establish Advanced Nurse Practitioner
} In view of the prevailing University degree nursing program
programs in all the Universities to allow room for self-exit } All post basic specialty programs should be up-graded to
THANK YOU
