III PROFESSIONAL & PERSONAL DEVELOPMENT

Legal Aspects of Nursing The Philippine Nursing Law Definition and Meaning of Law The word "law" may be defined as a rule of conduct pronounced by controlling authority, which may be enforced. There are three essential characteristics of every law. The first one is the authority or the right to declare the rule exists. The second is that such rule is pronounced or expressed and that its source can be identified. Lastly, a right to enforce the same must be provided.

Nursing Jurisprudence Department of law which comprises all legal rules and principles effecting the practice of nursing Includes the study and interpretation of rules and principles and their application in the regulation of the practice of nursing

Function of Law in Nursing Provides a framework for establishing what nursing actions in the care of patients are legal Delineates the nurse’s responsibilities from those of other professionals Helps to establish the boundaries of independent nursing actions Assists in maintaining a standard of nursing practice by making nurses accountable to the law

Brief History of the Philippine Nursing Law Actually, the first law that had to do with the practice of nursing was contained in Act No. 2493 in 1915, which regulated the practice of medicine. This act provided for the examination and registration of nurses in the Philippine Islands. During that time, the applicants need to be only twenty years old, of good physical health and good moral character. Graduates of intermediate courses of the public school could enter the school of nursing, which was then giving only two years, and a half of instruction. These graduates were called first class nurses. Those who desired to be second-class nurses filed an application with the district health officer in the district where they resided. In 1919 Act 2808 was passed- this is known as the First True Nursing Law. It created among others a board of examiners for nurses. However, it was in 1920 that the first board examination in the Philippines was given. On June 19. 1953, the Philippine Nursing Law or R.A. 877 was passed. This act regulated the practice of nursing in the Philippines.

One of the landmarks in the history of the nursing profession in the Philippines is the Presidential Proclamation of a Nurses' Week. Under Proclamation No. 539 dated October 17, 1958 the President of the Philippines designated the last week of October every year beginning in 1958 as Nurses' Week.

 Laws Governing The Practice of Nursing

1) REPUBLIC ACT NO. 9173 .An act providing for a more responsive nursing profession, repealing for the purpose republic act no. 7164, otherwise known as "the Philippine nursing act of 1991" and for other purposes.

2) REPUBLIC ACT NO. 7305 THE Magna Carta of public health workers3) PRESIDENTIAL DECREE NO. 603 December 10, 1974 The child and youth welfare

code4) PRESIDENTIAL DECREE NO. 1519, as amended revising the Philippine medical care

act of nineteen hundred and sixty nine5)  PRESIDENTIAL DECREE NO. 856 Code on sanitation6) REPUBLIC ACT NO. 4226 an act requiring the licensure of all hospitals in the

Philippines and authoring the bureau of medical services to serve as the licensing agency

7) REPUBLIC ACT NO. 6713 An act establishing a code of conduct and ethical standards for public officials and employees, to uphold the time-honored principle of public office being a public trust, granting incentives and rewards for exemplary

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service, enumerating prohibited acts and transactions and providing penalties for violations thereof and for other purposes

8) REPUBLIC ACT NO. 6716 An act providing for the construction of water wells, rainwater collectors, development of springs and rehabilitation of existing water wells in all barangays in the Philippines.

9) REPUBLIC ACT NO. 7610 an act providing for stronger deterrence and special protection against child abuse, exploitation and discrimination, and for other purposes.

10)REPUBLIC ACT NO. 7624 An act integrating drug prevention and control in the intermediate and secondary curricula as well as in the non-formal, informal and indigenous learning systems and for other purposes.

11)REPUBLIC ACT NO. 7659 an act to impose the death penalty on certain heinous crimes, amending for that purpose the revised penal laws, and for other purposes

12)REPUBLIC ACT NO. 3720 Food, Drug, and Cosmetic Act” An act to ensure the safety and purity of foods, drugs, and cosmetics being made available to the public by creating the food and drug administration which shall administer and enforce the laws pertaining thereto.

13)REPUBLIC ACT NO. 6425 the dangerous drugs act of 197214)REPUBLIC ACT NO. 6675 An act to promote, require and ensure the production of an

adequate supply, distribution, use and acceptance of drugs and medicines identified by their generic names.

15)Republic Act No. 7170 an act authorizing the legacy or donation of all or part of a human body after death for specified purposes.

16)REPUBLIC ACT NO. 7277 an act providing for the rehabilitation, self-development and self-reliance of disabled persons and their integration into the mainstream of society and for other purposes.

17)REPUBLIC ACT NO. 7392 an act revising republic act no. 2644, as amended, otherwise known as the Philippine midwifery act

18)Republic Act No. 7600 AN Act providing incentives to all government and private health institutions with rooming-in and breast-feeding practices and for other purposes

19)REPUBLIC ACT NO. 7719 An act promoting voluntary blood donation, providing for an adequate supply of safe blood regulating banks, and providing penalties for violation thereof

20)REPUBLIC ACT NO. 7875 NATIONAL HEALTH INSURANCE ACT OF 1995 an act instituting a national health insurance program for all Filipinos and establishing the Philippine health insurance corporation for the purpose

21)REPUBLIC ACT NO. 7877 an act declaring sexual harassment unlawful in the employment, education or training environment, and for other purposes.

22)Republic Act No. 7883 an act granting benefits and incentives to accredit barangay health workers and for other purposes

23)Republic Act No. 7885 Act to advance corneal transplantation in the Philippines, amending for the purpose republic act numbered seven thousand one hundred and seventy (R.A. no. 7170), otherwise known as the organ donation act of 1991

24)REPUBLIC ACT NO. 8172 an act promoting salt iodization nationwide and for related purposes.

25)REPUBLIC ACT NO. 8191 An act prescribing measures for the prevention and control of diabetes mellitus in the Philippines, providing for the creation of a national commission on diabetes, appropriating funds therefor and for other purposes.

26)Republic Act No. 8203 an act prohibiting drugs, providing penalties for violations and appropriating funds therefor

27)REPUBLIC ACT NO. 8344 An act penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency or serious cases, amending for the purpose Batas pambansa bilang 702, otherwise known as "an act prohibiting the demand of deposits or advance payments for the confinement or treatment of patients in hospitals and medical clinics in certain cases".

28)REPUBLIC ACT NO. 8423 An act creating the Philippine institute of traditional and alternative health care (pitahc) to accelerate the development of traditional and alternative health care in the Philippines, providing for a traditional and alternative health care development fund and for other purposes

29)  REPUBLIC ACT NO. 8503 An act providing for the promotion of health research and development, establishing for the purpose the national institutes of health (nih), defining its objectives, powers and functions, and for other purposes

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30) REPUBLIC ACT NO. 8504 An act promulgating policies and prescribing measures for the prevention and control of HIV/aids in the Philippines, instituting a nationwide aids/aids information and educational program, establishing a comprehensive aids/aids monitoring system, strengthening the Philippine national aids council, and for other purposes

31)REPUBLIC ACT NO. 8749 PHILIPPINE CLEAN AIR ACT OF 199932)REPUBLIC ACT NO. 8976 “THE PHILIPPINE FOOD FORTIFICATION ACT OF 2000”

An act establishing the Philippine food fortification program and for other purposes.33)REPUBLIC ACT NO. 8980 an act promulgating a comprehensive policy and a national

system for early childhood care and development (eccd), providing funds therefor and for other purposes.

34)REPUBLIC ACT NO. 8981 “THE PRC MODERNIZATION ACT OF 2000” An act modernizing the professional regulation commission, repealing for the purpose presidential decree numbered two hundred and twenty-three, entitled "creating the professional regulation commission and prescribing its powers and functions," and for other purposes.

35)REPUBLIC ACT NO. 9048 [March 22, 2001] An act authorizing the city or municipal civil registrar or the consul general to correct a clerical or typographical error in an entry and/or change of first name or nickname in the civil register without need of a judicial order, amending for this purpose articles 376 and 412 of the civil code of the Philippines

36)REPUBLIC ACT NO. 9165 An act instituting the comprehensive dangerous drugs act of 2002, repealing republic act no. 6425, otherwise known as the dangerous drugs act of 1972, as amended, providing funds therefore, and for other purposes.

37)REPUBLIC ACT NO. 9241 an act amending republic act no. 7875, otherwise known as "an act instituting a national health insurance program for all Filipinos and establishing the Philippine health insurance corporation for the purpose"

38)REPUBLIC ACT NO. 9262 An act defining violence against women and their children, providing for protective measures for victims, prescribing penalties therefore, and for other purposes.

39)REPUBLIC ACT NO. 9288 an act promulgating a comprehensive policy and a national system for ensuring newborn screening

40)Act No. 2493 Regulations of the practice of Medicine which covers nursing practice41)RA 4704 Amendments to 877:BON from 3 to 5 Members; MA for deans; 18 as

minimum age requirement for licensure application42)RA 6136 Application and execution of legal orders in writing of physician re:

treatments and meds, IV injection by nurse under the direct supervision of the physician

43)RA 6511 Standardization of examination and registration fees, non-payment of fees for r consecutive years will mean suspension and removal from annual roster (PRC Resolution No. 217, S. 1992)

44)PD No. 223 Creation of the Professional Regulation Commission and its powers and responsibilities

45)RA 5101(1976) Practice of profession by a person who is permanent resident in Philippines for at least 3 years and reciprocity

46)LOI No. 1000 Compulsory membership to professional organization and priority in hiring of members

47)RA 1612 Privilege Tax payment before starting business or occupation, income tax payment on or before January 31

48)PD 69 Limits the number of children to 4 for exemptions49)RA 1080 Passing bar and board exams means civil service eligible50)Proclamation No. 539 Last week of October designated as Nurses’ Week 51)RA 3753/PD651 Civil Register Law, Birth Registration Law52)RA 2302 The Philippine Medical Act53)PD 541 Former Filipino Professionals are allowed to practice while in the Philippines54)RA 1082 (1954); RA 1891(1957) Creation of rural health units all over the Philippines55)RA 679: PD 148 Woman and Child Labor law56)RA 1054 Free emergency, medical and dental services for employees57)RA 4226 Hospital Licensure Act58)RA 5901 Maximum of 40 hours a week of work for nurses in agencies with 100 bed

capacity and/or in an area with 1M population

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59)PD 442 Labor Code of the Philippines…right to self-organization and collective bargaining

60)PD 603 Child and Youth Welfare Code61)ILO Convention No. 149 Improvement of work-life conditions of nursing personnel

through negotiations ratified by Proc. No. 185162)RA 6111 Philippine Medicare Act63)PD 1519 Medicare benefits of government employees 64)PD 1636 Compulsory membership of self-employed individuals to SSS65)RA 3573 Law on reporting communicable diseases to be monitored at least weekly66)RA 1136 Reorganization of the Division of Tuberculosis67)RA 4073 Liberalizing treatment of leprosy68)Executive Order No. 51 Milk Code69)Letter of Instruction 949 Primary Health Care70)Proclamation No. 6 Implementing UNICEF goal on child immunization71)PD 965 Couples to undergo family planning instruction before issuance of marriage

license72)PD 48 Limits paid maternity leave to 4 children73)LOI 47 Directing all health sciences and social work schools to incorporate family

planning in their curriculum74)PD 996 Compulsory basic immunization to infants and young children75)PD 825 Issuance of health certificate after venereal disease clearance to those

employed in the entertainment industry; examination for syphilis every six weeks/gonorrhea every two weeks

76)BP 702 Unlawful to demand deposit in cases of serious conditions77)RA 807 Civil Service Law78)EO 180 Right of government employees to join unions79)PD 851 Requires employers to pay employees the 13th month pay80)RA 1981 GSIS Act81)RA 1161 SSS Act82)RA 7041 Publication of vacancies in government position83)RA 7160 The Local Government Code84)EO 503 Implementing rules and guidelines on the devolution of health services85)RA 8479 Clean Air Act86)PD 626 Employee Compensation and State Insurance Fund87)RA 6758 Salary Standardization Law88)RA 7432 Senior Citizens Act89)RA 6725 Law on women with respect to terms and conditions of employment90)EO 266 Institutionalization of continuing professional education of various boards

under the supervision of PRC (PRC Resolution No. 187, S. 1991, renewal of PRC license on birth date not later than the 20th of the next month

91)House Bill No. 4955 AN ACT PUNISHING THE MALPRACTICE OF ANY MEDICAL PRACTITIONER IN THE PHILIPPINES AND FOR OTHER PURPOSES

Legal Liabilities in Nursing As nurses begin their professional obligations, their legal responsibilities begin as well. Their license to practice attests that they are qualified under the law to practice their profession. The Philippine Nursing Act of 1992 is the best guide the nurse can utilize as it defines the scope of nursing practice. There are also standards of care that may be used as criteria in evaluating their work. The nurses are enjoined to be familiar with the Philippine Nursing Law, and the standards of nursing care, other laws which affect nursing practice and their code of ethics.

Responsibility and Accountability for the Practice of Professional Nursing When nurses undertake to practice their profession, they are held responsible and accountable for the quality- of performance of their duties. Nurses employed in an agency, institution, or hospitals are responsible directly to their immediate supervisors. Private duty nurses, being independent practitioners, are held to a standard of conduct that is expected of reasonably prudent nurses. The standard is clearly defined, legal expectation to which nurses are held accountable.

Professional Negligence

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The term negligence refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstances would or would not do, and acting or the non-acting is the proximate cause of injury to another person or his property.

The Doctrine of Res Ipsa Loquitur Three conditions are required to establish a defendant’s negligence without proving specific

conduct.1.        The injury was of such nature that it would not normally occur unless there was a

negligent act on the part of someone.2.        The injury was caused by an agency within control of the defendant,3.        That the plaintiff himself did not engage in any manner that would tend to bring about

the injury.

Malpractice Malpractice in the usual sense implies the idea of improper or unskillful care of a patient by a

nurse. It would also see that malpractice also denotes stepping beyond one's authority with serious consequences.

Doctrine of Force MajeureThe terms "force majeure" means an irresistible force, one that is unforeseen or inevitable.

Under the civil code of the Philippines, no person shall be responsible for those events which could not before seen, or which, though foreseen, were inevitable, except in cases expressly specified by law.

Doctrine of Respondent Superior The term means "let the master answer for the acts of the subordinate." Under this doctrine,

the liability is expanded to include the master as well as the employee and not a shift of liability from the subordinate to the master. Therefore, when a person through his negligence injures another, he remains fully responsible. This doctrine applies only to those actions performed by the employee within the scope of his employment

IncompetenceIncompetence is the lack of ability, legal qualifications or fitness to discharge the required

duty. Although a nurse is registered, if in the performance of her duty she manifests incompetency, this is a ground for revocation or suspension of her certificate of registration.

Liability of Nurses for the Work of Nursing Aides Nursing aides performs selected nursing activities under the direct supervision of nurses.

They are usually given on-the-job training by the Training Staff. Their responsibilities usually pertain to the routine care of chronically ill patients. They are therefore responsible for their own actions.

Liability for the Work of Nursing Students Under the Philippine Nursing Act of 2002 R.A. 9173 nursing students do not perform

professional nursing. They are to be supervised by their Clinical Instructors. In order that the errors committed by nursing students will be avoided/minimized the following measures should be taken:

Liability for the Work of Nursing Students • Nursing students should always be under the supervision of their Clinical Instructors.• They should be given assignments that are in level of their training, experience and

competency.• They should be advised to seek guidance specially if they are performing a procedure for

the first time.• They should be oriented to the policies of the nursing unit where they are assigned.• Their performance should be assessed frequently to determine their strengths and their

weaknesses.• Frequent conferences with the students will reveal their problems, which they may want

to bring to the attention of their instructors or vice-versa. Discussions of these problems will iron out doubts and possible solutions may be provided

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Legal Defense in Negligence The most common defense in a negligence action is when nurses know and attained that

standard of care in giving service and that they have documented the care they gave in a concise and accurate manner.

Medical Orders, Drugs and MedicationsRepublic Act 6675 states that only validly registered medical, dental and veterinary practitioners, whether in private institution/corporation or in the government, are authorized to prescribe drugs. Prescriptions made by unauthorized persons constitute illegal practice of medicine, dentistry or veterinary medicine and is punishable under R.A- 2832 or the Medical Act of 1959. R.A. 4419 or the Dental Act, and R.A- 382 or the Veterinary Act.

Intravenous Therapy and Legal Implications Nurses now participate in complex intravenous therapy procedures that were once performed

only by doctors. Because of this change, nurses must remember that their legal right to give intravenous injections is based on the Philippine Nursing Act of 1991 Section 28 which state that "in the administration of intravenous injections, special training shall be required according to protocol established."

Telephone OrdersThere are legal risks by telephone orders. These may be misunderstood or misinterpreted

by the receiving nurse. Sometimes too, messages from telephones may sound unclear or garbled because of some trouble in the telephone lines. Most importantly, the signature of the ordering physician is not present and this order may later be denied in case errors exist or court litigations arise.

Medical Records The value of medical records is both scientific and legal. As a record of illness and treatment,

it saves duplication in future cases and aids in prompt treatment. The record supplies rich material for medical and nursing research. It serves as a legal protection for the hospital, doctor and nurse by reflecting the disease or condition of the patient and his management. Nurses must remember the rule. "If it was not charted, it was not observed or done,"

Charting Done by Nursing Students When a nurse or a clinical instructor countersigns the charting of a nursing student, she

attests that she has personal knowledge of information and that such is accurate and authentic. Anyone who countersigns without verification commits herself to possible legal risk.

Medical Records in Legal Proceedings Medical records are usually used to give important evidence in legal proceedings such as

police investigations, determining cause of death, extent of injury incurred by the patient, etc. It is usually the medical records librarian, under a subpoena duces tecum who testifies that the patients' records are kept and protected from authorized handling and change. Only complete accurate records are accepted in court.

Legal Risks for Defective Equipment One important duty of the nurse is to make sure that the equipment used in procedures and

treatments are free from defects. While the nurse may or may not be responsible for inspecting the equipment for optimum functioning, she should see to it that these are regularly inspected, maintained and functioning properly- She should document the times She requested these to show that she was able to foresee the improper functioning of equipment which may cause possible injury to patients. This includes wheelchairs, stretchers, suction machines- anesthesia apparatus- x-ray tables, etc,

Intentional WrongsA nurse may be held liable for intentional wrongs. Intentional tortuous acts may arise in the

performance of her duties. A tort is a legal wrong committed against person or property independent of a contract, which renders the person who commits it liable for damages in a civil action. The person who has been wronged seeks compensation for the injury or wrong he has suffered from the wrong doer.

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Examples of torts are: 1. Assault and Battery 2. False Imprisonment or Illegal Detention 3. Invasion of Right to Privacy and Breach of Confidentiality 4. Defamation

CRIMES: MISDEMEANORS AND FELONIES Crime- Crime is defined as an act committed or omitted in violation of the law Criminal offenses are composed of two elements: a criminal act and an evil/criminal intent. In criminal action, the state seeks the punishment of the wrong doers

Conspiracy to commit a crime A conspiracy to commit a crime exists when two or more persons agree to commit a felony

and decide to do it. Persons who commit felonies are either principal, accomplice or accessory.

Criminal Actions Criminal actions deal with acts or offenses against public welfare. These vary from minor

offenses and misdemeanors to felonies. A misdemeanor is a general name for criminal offense, which does not in law amount to the grade of a felony. Punishment is usually a fine or imprisonment for a term of less than one year. A felony, is a public offense for the conviction of which a person is liable to be sentenced to death or to imprisonment in a penitentiary or prison. It is far more atrocious in nature than misdemeanor.

Felonies are committed with deceit and, fault. A deceit exists when the act is performed with deliberate intent and there is fault when the wrongful acts result from imprudence, negligence, or lack or skill or foresight.

Criminal negligence may be classified into reckless imprudence and simple imprudence. Criminal intent is the state of mind a person has at the time the criminal act is committed, that

is, knowing an act is not lawful and decided to do it anyway. To be criminal, an act must be defined as a crime. Deliberate intent includes two other elements without which there can be no crime. These are freedom and intelligence. However, when a person, accused of the crime offers evidence showing insanity, necessity, compulsion, accident, or infancy the court wilt decide if he did not commit a criminal offense and will declare the person not guilty.

Felonies are classified according to the degree of the acts of execution, which would produce the felony, into consummated, frustrated, and attempted felonies.

Felonies are also classified according to the degree of punishment attached to the felony into grave, less grave, and light felonies.

Circumstance Affecting Criminal Liability Justifying Circumstances Exempting CircumstanceMitigating Circumstances Aggravating Circumstances Alternative Circumstances

Moral TurpitudeThis is an act of baseness, vileness or depravity in social or private duties. Crimes involving moral turpitude are acts, which are bad in themselves such as rape, robbery and murder,

Murder is the unlawful killing of a human being with intent to kill. It is very serious crime. Nurses should keep in mind that death resulting from a criminal abortion is murder. Euthanasia is also considered murder

Homicide is the killing of a human being by another, it may be committed without criminal intent, committed by any person who kills another, other than his father, mother, or child or any of his ascendants or descendants- or his spouse, without any

Abortion The term abortion means the expulsion of die product of conception before the age of viability. In law, any person who, with the intentions of prematurely ending a pregnancy, willfully and unlawfully does any act to cause the same is guilty or

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of the circumstances attendant the crime of murder enumerated above being present.

procuring abortion.

Parricide is a crime committed by one who kills his father, mother or child whether legitimate or illegitimate, or any of his ascendants or descendants or his spouse. A person who is convicted of this crime shall be imposed a penalty from life imprisonment (reclusion perpetual) to death.

Robbery is a crime against a person or property. The taking of personal property to another person from him or in his presence constitutes robbery. An example would be when a nurse takes the patient’s cash or jewelry while the latter was sleeping.

Simulation of birth is a crime committed by one who enters in a birth certificate a birth that did not occur. It is a crime against the civil status of a person. Substitution of one child for another or concealing or abandoning any legitimate child with intent to cause such child to lose its civil status shall be punishable like simulation of birth, by prison mayor and a fine not exceeding one thousand pesos.

Legal Safeguards a. Written Consent

Consent to Medical and Surgical Procedures. The consent signed by the patient or his authorized representative/legal guardian on

admission is for the initial diagnosis and treatment. Subsequent treatments/operations require individual, informed consent.

Nature of Consent Consent is an authorization, by a patient or a person authorized by law to give the consent on

the patient's behalf that changes a touching from non-consensual to consensual.Proof of Consent A written consent should be signed to show that the procedure was the one consented to and

that the person understood the nature of the procedure, the risks involved and the possible consequences. A signed special consent is necessary before any medical or surgical treatment is done such as x-rays, special laboratory tests, blood confusions, operations, cobalt therapy, or chemotherapy and the like.

Who Must Consent Ordinarily, the patient is the one who gives the consent in his own behalf. However, if he is

incompetent (such as in the case of minors or the mentally ill) or physically unable and is not an emergency case, consent must be taken from another who is authorized to give this in his behalf.

Consent of Minors Parents, or someone standing in their behalf, give the consent to medical or surgical

treatment of a minor. Parental consent is not needed however, if the minor is married or otherwise emancipated.

Consent of Mentally ill A mentally incompetent person cannot legally consent to medical or surgical treatment. The

consent must be taken from the parents or legal guardian.

Emergency Situation When an emergency exists, no consent is necessary because inaction at such time may

cause greater injury. A mother who is on the advanced stage of labor or a patient who goes to the emergency room gives an implied consent to an immediate treatment or attendance.

Refusal to Consent A patient who is mentally and legally competent (sane mind and of legal age) has the right to

refuse to permit touching of his body or to submit to a medical or surgical procedure.

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Examples are those patients who, because of their religious beliefs, may refuse blood transfusion.

Consent for Sterilization Sterilization is the termination of the ability to produce offspring’s. The husband and the wife

must consent to the procedure if the operation is primarily to accomplish sterilization. When the sterilization is medically necessary, the sterilization is an incidental result such as in cases of abruption placenta, ectopic pregnancies or ruptured uterus, the patient's consent alone is sufficient.

b. Incident Reports The primary purpose of an incident report is to document and prevent possible consequent

injuries. Classifying an event, as an incident does not imply that someone made a mistake, it only means that something unusual happened.

c. Contracts

 A contract is a meeting of minds between two persons whereby one binds himself, with respect to the other, to give something or to render some service.

 A contract is a promise or a set of promises for which the law recognizes as a duty and when

that duty is not performed, the law provides a remedy.

Kinds of Contracts

1. Formal contract.

2. Informal contract

3. Express 4. Implied

contract 5. Void contract 6. Illegal contract

Requisites of a Contract1. To have a contract, two or more persons must participate.2. The parties involved must be consent to the contract,3. The object, which is the subject matter of the contract, must be specified. 4. The cause of obligation is established. - The time, price and subject

matter are expressed. 5. Contracting parties must have the legal capacity to enter into a contract.

Legal excuse or defenses in refusing, neglecting or failure to perform a contract. 1. Discovery of material misrepresentation made and relied upon.2. Where performance would be illegal.3. Where performance is made impossible by reason of illness.4. Where performance is made impossible by death of patient or nurse.5. Where performance is made for other reasons.6. Where contract is insufficient,

Advantages of Written Contracts Many nurses fear written contracts. The following are the advantages of written contracts

over oral ones.1. It is certain. It avoids the uncertainty of human memory,2. It can specify a definite time within which it is binding so as to protect both sides against

sudden changes without notice. It also fixes a time limit after which conditions are no longer binding but may be opened for re-discussion.

3.  It sets a standard and relieves individual professional persons from haggling over compensation.

4. It is more likely to be open and well known so that the use of written contracts tend to establish minimum standards for professional practitioners and to protect them against discrimination in compensation.

5. It is definite and can be definite on many details, which might otherwise stimulate favoritism or caprice even among professional people, such as hours of work, vacation allowances, holiday privileges, health and insurance provisions.

6. It can provide a definite procedure in case of complaints about substandard work so that the employer has a clear course and the professional nurse has protection against arbitrary action.

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7. It creates at least a minimum of certainty and security for the professional employee so that he is free to concentrate in his work without concern for the details, which the written contracts has settled.

d. Nurses and Wills A will is a legal declaration of a person's intentions upon death. It is called a testamentary

document because it takes effect after the death of is maker. It is an act whereby a person is permitted with the formalities prescribed by law, to control to a certain degree the deposition of his estate, to take effect after his death."

Testamentary Capacity and Intent Essentials of will to meet legal requirements:1. The testator must have the expressed intention of making will. He must be of right age- A

person under 18 years of age cannot make a will. He is required to be of sound mind and to have thinking ability clear at the time of its execution. He must be free from undue influence.

2. The testator should name the person who will be charged with carrying out the provisions of the will.

3. Properties must be disposed in accordance with legal requirements.4. The will must be signed by the testator attested and signed at least three witnesses in his

presence and of one another. It must be in a language or dialect known to the testators.5. Every will must be acknowledged before a notary public by the testator and witnesses.6. Witnesses to the wills should be of sound mind, 18 years of age or more, not blind, or deaf

or not off dumb and able to read and write.7. A married woman may make a will without the consent of her husband and without the

authority of the court. She may dispose by will all of her separate property 'as well as her share of the conjugal partnership or absolute community property.

The Nurse's Obligations in the Execution of a Will The nurse, therefore, should note the soundness of the patient’s mind (he understands the

act of making a will) and that there was freedom from fraud or undue influence (he was not induced to make someone the beneficiary of the will) and that the patients is above 18 years of age She should note that the will is signed by the testator, that the witnesses shall all be present at the same time and should sign the will in the presence of the testator.

Gifts Another way of disposing property is not only through a will but also by gifts.  Four legal requirements for a gift are:1. The gift must consist of personal property,2. There must be an intention to make the gifts,3. An indication of transfer of control over such property, and4. There must be acceptance by the recipient.

Gifts made by a person because of anticipation of death or belief in approaching death is called gifts causa mortis or donation causa mortis. These are revocable and subject to the claims of the donor’s creditors without proof of intent to defraud them. Such gifts are same as in the execution of will that the person is of sound mind, if of age, and is not under undue influence. The nurse should make notes on the patient's chart the patient's condition and reactions for the record.

5. Legal Procedures and Trial In trial, the judicial procedure is to ascertain facts by hearing evidence, determine which facts

are relevant, apply the appropriate principle of law and pass judgment. These procedures in a lawsuit can be divided into commencement, pleading, pretrial, trial and execution.

Commencement of the Action The first step in the trial process is to determine what kind of legal actions is to be

determined. If the action relates to negligence that correct action would be in negligence

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and if it relates to contract, the proper action would be for breach of contract. The court that has Jurisdiction of the case and the geographic area where one of the parties resides or where the action causing the complaint occurred determine the venue where the case will be presented.

Statutes of Limitation Complainant must be made within a specific time or the right to complain may be lost forever.

There should be a time limit in filing cases because witnesses become less reliable after passage of time, it is more difficult to procure records that may be important, death may intervene and prevent the presence of essential persons, parties may wait indeterminably until an unfair advantage accrues by reason of death of an important witness or the destruction of documents. Claims for negligence or malpractice vary from two (2) to three (3) years. In criminal cases, statutes of limitation varies from two (2) to six (6) years excepts in cases where murder is committed in which there is no time limit,

Commencement of Legal Proceedings The primary function of the court is to determine a controversy between two (2) disputants,

technically called litigants: The accuser is also known as the complainant or a plaintiff, whereas, the accused is known as the respondent or defendant. The preliminary items will be taken cared of the attorney or counselors, who file an order with the court clerk to issue a writ of summons to the sheriff to inform the defendants that they must appear before the court on a particular date. The complaint is filed and served. The defendant's attorney will now study the case and prepare a strategy and defense.

Pleading Each party presents a statement of facts or pleading to the court-First pleading is generally

known as a "complaint" or "petition". Fundamental Requirements of Due Process There are fundamental requirements to due process as per Article III Bill of Rights of the New

Constitution

Pre-Trial ProceduresThis is an informal discussion which the judge and attorney eliminate matters not in dispute,

agree on issues and settle procedural matters relating to the trial. It often happens that cases are settled at this point.

Trial At the trial, facts of the case are determined, the principles of law relating to those facts are

applied and a conclusion as to liability is reached. The judge determines the facts and applies the law.

Witness The necessity of testimony by any person in a legal proceeding is determined by the

attorneys for the parties. Thus, a subpoena or a court summons is served directing a witness to appear and give testimony on the date and time ordered. A subpoena duces tecum is served to a witness requiring him to bring records, papers and the like which may be in his profession and which may help clarify the matter in issue.

 Appeals An appellate court reviews the case and when the case is decided by it, the final Judgment

results and matter is ended.

Execution of Judgment Generally lawsuits against hospitals or physicians and nurses involve recovery of money

damages. The defendant is compelled to execute the judgment. Failure to obey will be regarded as

contempt of court and will result in fine or imprisonment. If the judgment is for payment of money, the plaintiff may cause the sheriff to sell the defendant's properly as is necessary to pay the costs.

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