LEGAL RESPONSIBILITES OF THE NURSE

DEFINITION OF TERMS:
Legal Rights a claim that can be enforced by
legal means against the persons or the
community whose duty is to respect it.
Accountability being answerable when
carrying out professional responsibilities
Liability being legally bound
Responsibility - an obligation to perform some
act for which one can be held responsible

PATIENTS RIGHTS
Nurses are the advocates of the patients. They
take appropriate steps to safeguard the
patients rights and privileges
Guidelines
1. Nurses shall respect the following rights
when rendering care:
a. cultural and religious beliefs
b. privacy, and
c. confidentiality of information
2. Nurses shall provide the patients all pertinent
information except those which may be
deemed harmful to their well-being.
3. They shall ensure that patients records are
available only to those who are professionally
and directly involved in their care except when
required by law.
4. When conflict arises regarding management
of patient care, the patients rights are upheld.

prognosis in terms that the patient or the

person in his behalf can understand.
3. to make decisions about the plan of care
prior to and during course of the treatment and
to refuse treatment and to be informed the
consequences of this action.
4. to have an advance directive concerning
treatment or designating a surrogate decisionmaker.
5. To every consideration of his privacy.
6. to expect all communication and records
pertaining his care should be treated
confidential.
7. To review the records pertaining to his care
and have them explained or interpreted as
needed.
8. to expect response to the request for
appropriate and medically indicated care and
services
9. to ask and be informed of the existence of
business relationship among hospital,
educational institutions, other health care
providers that may influence the patients
treatment and care.
10. to consent or refuse participation in
research studies or human experimentation.
11. to expect continuity of care and to be
informed of available and realistic care options
when hospital care is no longer appropriate.
12. to be informed of hospital policies and
practices that relate to patient care, treatment
and responsibilities

PATIENTS BILL OF RIGHTS

IMPLEMENTING MEDICAL ORDERS

1. to considerate and respectful care.

Republic Act 6675 states that only validly

registered medical, dental and veterinary
practitioners, whether in private

2. to obtain from his doctor complete current

info about his diagnosis, treatment and

institution/corporation or in the
government, are authorized to prescribe
drugs.
prescription made by unauthorized persons is
punishable under R.A. 2382 (Medical Act of
1959), R.A. 4419 (Dental Act), & R.A. 382
(Veterinary Act)
In accordance with R.A. 5921 (Pharmacy
Act), all prescriptions must contain the
following information:
a. name of the prescriber
b. office address
c. professional registration
number
d. professional tax receipt number
e. patients name, age and sex
f. date of prescription

is delayed, depending on the physicians

wishes.
b. The problem for which the medication no
longer exists.
c. The patient is suspected of having allergy
to the medication. Any suspected allergy
should be reported to the physician.
Refused Drug. The responsibilities of the
nurse to take during refusal to take
medication are the following:
a. Report promptly to the physician
b. Note properly in the patients chart
regarding the refusal.
*The nurse play an important role in
determining the reason for the refusal and
to clarify any misconceptions.

R.A. 6675 requires that drugs be written in their

generic names

Patients have the right to refuse therapy,

and the nurse should recognize and respect
that right.

RESPONSIBILITIES OF THE NURSE REGARDING

MEDICAL ORDER:

*BON 08

Carry out doctors order, provided that they

are written legal order of the physician and
bear the doctors signature
Help plan and implement patient care
Reports patients condition including results
of therapies to properly monitor and modify
the management of care.
Written orders must be clear, specific,
complete and legible in order to minimize
errors.
MANAGING THE OMITTED OR REFUSED
DRUG
Omitted Drugs. Drugs may be omitted
intentionally for the following reasons:
a. The patient is to have a diagnostic test
and is to fast prior to the test. Oral drugs
are usually omitted or their administration

INTRAVENOUS THERAPY AND LEGAL

IMPLICATIONS
Philippine Nursing Act 1991 Sec. 28 states
that in the administration of intravenous
injections, special training shall be required
according to protocol established.
Nurses should use the Intravenous Nursing
Standards of Practice developed by the
Association of Nursing Service
Administrations of the Philippines (ANSAP)
TELEPHONE ORDERS
Done only in extreme emergency cases and
when no other resident or intern is
available should a nurse receive telephone
orders.
Such order should be signed by the
physician on his/her next visit within 24
hours.

 The nurse should sign the name of physician

per her own and note the time the order
was received.

Question standing orders especially if the

nurse is inexperienced.
IMPLEMENTING DELEGATED AND
INDEPENDENT NURSING INTERVENTIONS

- a referral may be used within a particular

agency. Example: a hospital out-patient clinic
may refer a patient to the hospitals in-service
facilities.

Identify patients before initiating

interventions.
Protect patients from falls and preventable
injuries.
Documents all nursing assessments and
interventions accurately.
Ask for assistance and supervision in
situations for which you feel inadequately
prepared.
Delegate tasks to persons with the
knowledge and skill to carry them out.
Build and maintain good rapport with
patients

- most institutions have policies related to

referrals. Policies usually indicate who may
initiate a referral & how it is to be done.

DAMA (Discharged Against Medical Advised)

REFERRALS: the process of sending or guiding

someone to another source for assistance.
- a patient may be referred by a hospital to a
community-health nursing service for assistance
with home care.
- a school nurse may refer a student to a
hospital emergency room.

CARRYING OUT A PHYSICIANS ORDER

Only when the orders concerning treatment
and medications are in writing and bear the
MDs signature does the nurse have the
legal right to follow it.
It is expected that nurses know basic
information about procedures and
medications ordered by the physician
It is the responsibility of the nurse to clarify
ambiguous or seemingly erroneous orders
from the prescribing MD and/then to other
sources.
THE ORDERS THAT NURSES MUST QUESTION
TO PROTECT THEMSELVES LEGALLY
Question any order the patient questions.
Question any order if the patients
condition has changed.
Question and record verbal orders to avoid
miscommunications.

The right to refuse treatment includes the

right to leave the hospital against medical
advice.
Recognize a potential patient walk-out.
If the patient insist on leaving.
Follow the policy of the hospital regarding
DAMA
If the hospital doesnt have a policy about
DAMA:
1. Contact the patients SO and explain.
2. Explain the hospitals DAMA
procedure to the patient.
3. Give the client a DAMA form and ask
patient to sign.
4. Provide routine discharge care.
Dealing with an escape
Notify the nursing supervisor and security
immediately.
Notify patients family.

 Collect patients belongings and document

it.

CONSENT TO MEDICAL AND SURGICAL

PROCEDURES
Definition: free and rational act that
presupposes knowledge of the thing to
which consent is being given by a person
who is legally capable to give consent.
Only in case of emergency where the
consent requirement does not apply.
The physician should give as much
information about contemplated procedure
and the patient should receive enough
information to allow him to give an
informed consent for such procedure.
ESSENTIAL ELEMETS OF AN INFORMED
CONSENT
INFORMATION SHOULD INCLUDE: