Nursing Practice Leadership, Management and the Law Essay Assignment Papers: Essentials of Nursing Leadership & Management

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Nursing Practice Leadership, Management and the Law Essay Assignment Papers: Essentials of Nursing Leadership & Management

1.Discuss the differences between a leader and a manager.

2. Which is more important, working for an effective leader or an effective manager? Explain your answer.

3. Observe the nurse manager in a unit to which students have been assigned. What management style is displayed? How does the staff respond to this style

4. What qualities do you think are most important to be a good nurse manager?

1. Interview the nurse manager on your assignment unit. What interpersonal, decisional, and informational activities does he or she complete on a daily basis?

2. You are the nurse manager on your unit. One of the most experienced staffers has been out on sick leave, and another just had a baby. The rest of the staff are working very hard to pick up the slack to avoid using agency personnel. What tangible and intangible rewards might you use to thank the staff?

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PART 1: Begin by writing a 50-word description of the ideal nurse manger, someone you would like to work for. Describe a real-life nurse manager whom you have encountered in one of your clinical rotations. What qualities of this person meet your ideal? In what ways does this individual not meet your ideal? (Reminder: nobody is perfect.)

PART 2: Think about becoming an ideal manager yourself. What qualities of an ideal manager do you already possess? What qualities do you still need to develop? How will you accomplish this?

1. Find your own states requirements for informed consent. Do elective procedures and emergency situations use the same standard?

2. Obtain a copy of your states Nurse Practice Act. Does the act give adequate guidance for nurses to know if an action is within the scope of nursing practice?

1. Explain how the Nurse Practice Act in your state provides for consumer protection and for professional nursing progress.

2. What are your thoughts on multistate licensure? How does it strengthen and weaken professional nursing?

3. As a new nurse, how can you ensure confidentiality in clinical settings?

4. How can nurses safeguard the confidentiality of medical information when sending it by fax or e-mail?

5. Explain the role of the nurse in obtaining informed consent. Do you believe that this is within the scope of nursing practice? Explain your answer.

6. Should nurses carry malpractice insurance? Explain your answer.

7. Should all patients have advance directives? Explain your answer.

8. Should employers be permitted to require nurses to work overtime if there is a shortage of registered nursing staff on a unit? Support your answer with evidence from the literature

Nursing Practice Leadership, Management and the Law Essay Assignment Papers: Essentials of Nursing Leadership & Management

 

Manager

Manager

Management

Getting work done through others

Doing what is needed to assist employees to work well

 

Management Theories

Scientific Management

Efficiency-focused

Increasing productivity is the goal

Workflow and time to complete tasks is measured and evaluated.

Human Relations-Based Management Theory X

Work is something to be avoided.

People want to do as little work as possible.

Use: Control Supervision       Punishment

Human Relations-Based Management Theory Y

The work itself can be rewarding.

People really want to do their job well.

Support using

–Guidance

–Development

–Reward

Servant Leadership

People have value as people.

Commit to improving treatment at work.

Employee first

Qualities of an Effective Manager

Leadership

Clinical expertise

Business sense

Management

Decisional

Interpersonal

Informational

Behavior of an Effective Manager

Interpersonal

–Networking

–Conflict negotiation and resolution

–Employee development

–Coaching

–Rewards and punishments

Behavior of an Effective Manager (cont’d)

Decisional activities

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–Employee evaluation

–Resource allocation

–Hiring and firing

–Planning for the future

–Job analysis and design

Behavior of an Effective Manager (cont’d)

Informational activities

–Spokesperson

–Monitoring

–Reporting

Conclusion

Nursing management is a complex, responsible position.

Ineffective managers may harm

–Employees

–Clients

–Organizations

 

Nursing Practice and the Law

Nursing Practice and the Law pt 1

Nursing Practice and the Law pt 2

Objectives

Identify three major sources of law.

Explain the differences among various types of laws.

Differentiate between negligence and malpractice.

Explain the difference between an intentional tort and an unintentional tort.

Objectives (cont’d)

Explain how Standards of Care are used in determining negligence and malpractice.

Describe how nurse practice acts guide nursing practice.

Explain the purpose of licensure.

Explain the difference between internal standards and external standards.

Objectives (cont’d)

Discuss Advance Directives and how they pertain to patients’ rights.

Discuss the legal implications of the Health Insurance Portability and Accountability Act (HIPAA).

Meaning of Law

Law refers to any system of regulations that govern the conduct of individuals within a community and/or society in response to the need for regularity, consistency, and justice.

Law is the rules that prescribe and control social conduct in a formal and legally binding manner.

Types of Laws

Statutory law

Common law

Administrative law

Statutory Law

Created by various legislative bodies

Nursing Practice Leadership, Management and the Law Essay Assignment Papers: Essentials of Nursing Leadership & Management

–Congress

–State legislatures

Examples of federal statutes

–Patient Self-Determination Act of 1990

–The Americans with Disabilities Act

Statutory Law (cont’d)

Examples of state statutes

–Nurse Practice Acts

–Good Samaritan Law

Common Law

Comes from the traditional unwritten law of England.

Based on custom and usage.

Develops within the court system as judicial decisions are made.

One decision creates the precedence for another.

Administrative Law

Procedures created by administrative agencies

–City councils

–County boards

–State government

Established through the authority given to government agencies by a legislative body

–Boards of Nursing

–

Sources of Law

The Constitution

Foundation of American law

The Bill of Rights

Limits the power of the government and protects citizens’ freedoms

Constitutional law evolves as issues emerge.

Statutes

Localities, state legislatures, and the U.S. Congress create statutes.

Ordinances

–Local statutes

–Example: noise ordinance

Nurses can influence the development of statutory laws.

Administrative Law

Created by administrative agencies that develop specific rules and regulations that direct the implementation of statutory law.

Rules must be consistent with statutory laws.

Specific statutory laws give state Boards of Nursing the authority to issue and revoke licenses.

Agencies

Department of Health and Human Services

Department of Labor

Department of Education

Types of Laws

Criminal Law

Felony

Misdemeanor

Juvenile

Civil Law

Tort

Quasi-intentional tort

Negligence

Malpractice

Other Laws Relevant to Nursing Practice

Good Samaritan Laws

Created to encourage physicians and nurses to respond to emergencies

Protects licensed health-care providers from civil liability as long as they “behave in the same manner as an ordinary, reasonable, and prudent professional in the same or similar circumstances.”

Confidentiality

Patients have the right to confidentiality.

Information should only be shared with others who have a “need to know.”

Need permission to share information

HIPAA

Social Networking

Use of technology has caused an increase in violations of confidentiality.

Breach of confidentiality without intent

Need to be aware of institutional policies on social networking

–Immediate termination

–Cancellation of contracts/affiliation agreements with outside agencies

Slander and Libel

Quasi-intentional torts

Slander
refers to the spoken word.

Libel
refers to the written word.

Can refer to patients, coworkers, or other individuals

False Imprisonment

Confining an individual against his or her will

–Restraining

–Detaining

Removing a patient’s clothes

Keeping a patient who has been medically discharged for an unreasonable amount of time

Assault and Battery

Assault
is the threat to do harm.

Battery
is touching without consent.

The significance of an assault is embedded in the threat.

Often, the terms are used together.

Informed consent

Standards of Practice

Purpose

Guidelines to ensure quality of care

Criteria to determine if quality care has been delivered

May be specialty directed

–AACN standards of care

–AWHONN standards of care

Internal Standards

Developed within institutions

Usually explained within specific policies

Included in Policy and Procedure Manuals

Based on current literature and research

Nursing responsibility to meet the institution’s standards

Use of Standards in Nursing Negligence and Malpractice

One of the elements used to determine liability

Use of professional standards

Institutional policy

Standards of the Specialty organization if warranted

Expert opinions

Patient’s Bill of Rights

Created by the American Hospital Association in 1973 and amended in 1992

In 2003, replaced by the Patient Care Partnership

The patient rights were derived from the ethical principle of autonomy.

Informed Consent

Informed consent is a legal document in all 50 states.

Requires physicians to divulge the benefits, risks and alternatives to treatment, nontreatment, and/or procedures.

Allows individuals to be involved in choices about their health care.

Informed Consent (cont’d)

Permits health-care providers to “touch.”

Physicians are responsible for “obtaining” the informed consent.

Nurses are involved in the process when

–Witnessing a signature

–Clarifying questions

If a nurse assesses that a patient lacks a full understanding of the risks/benefits, the nurse should notify the physician.

Criteria for Informed Consent

A mentally competent adult as voluntarily given the consent.

The client understands exactly what he or she is consenting to.

The consent includes the risks involved in the procedure, alternative treatments, and risk of refusal.

The consent is written.

Implied Consent

Occurs when consent is assumed

Emergency situations

Child is involved and the health-care institution is unable to reach parents and/or legal guardians

Staying Out of Court

Prevention

Practice caring behaviors.

Demonstrate an interest in patients and their families.

Assist patients and families in making choices by providing information.

Maintain accountability.

Adhere to Standards of Practice.

Documentation

Needs to be legally credible

Avoid charting by exception.

Clear, concise, and accurate

Only sign off on medications once administered.

Document assessments after completion.

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Keys to Credible Documentation

Contemporaneous

Accurate

Truthful

Appropriate

Common Actions Leading to Malpractice Suits

Failure to assess properly

Failure to report changes in a patient’s condition to the appropriate personnel

Failure to document in a patient’s record

Altering or falsifying a patient’s record

Failure to obtain an informed consent

Failure to report a coworker’s negligence or poor practice

Violation of internal or external standards of practice

What to Do if Named in a Suit

Contact the legal department of your institution.

Answer the complaint.

Obtain legal guidance/representation.

Only sign documents after review by legal counsel or malpractice insurance company.

Maintain a file of all information connected to the case.

BE HONEST.

Professional Liability Insurance

Nurses need to consider obtaining insurance.

Policies protect nurses against personal financial loss.

If a nurse is found guilty of malpractice the employing agency has the right to sue the nurse to reclaim damages.

End-of-Life Decisions and the Law

Do Not Resuscitate Orders (DNRs)

Advance Directives

Patient Self-Determination Act

Living Will

Health-Care Surrogate

Patient Self-Determination Act

Allows individuals to make decisions regarding treatment in advance of a time when they may be unable to make these decisions.

Federal law directs that health-care institutions that receive federal funding inform patients of their right to create advance directives.

Provisions of the Act

Provide information to every patient.

Document.

–All patients must be asked if they have a Living Will.

–Ask about a health-care surrogate (Durable Power of Attorney).

–Must be placed in the patient’s record.

Educate.

Be respectful of patients’ rights.

Have cultural humility.

Nursing Implications

The Patient Self-Determination Act does not specify who should discuss treatment decisions or advance directives with patients.

Nurses are patient advocates.

Nurses need to have knowledge about documents pertaining to the Act.

Review institutional policies.

Issues Affecting Practice

Legal implications of mandatory overtime

–Affects patient safety

–Position statements from nursing organizations

–Nurse Practice Acts

Licensure

–Qualifications

–Endorsement

–Multistate

Disciplinary action

NCLEX-RN

Preparation

–Review courses

–NCSBN online NCLEX-RN study program

Test plan

–Test plan blueprint changed in April 2013

–Changes in the blueprint are based on findings from practice.

–Level of difficulty increased

Alternative question formats

Preparing for NCLEX-RN

Be positive.

Use relaxation techniques.

Advance planning.

–Pack an “NCLEX bag.”

–Perform a “dry run” at the same time you would leave to get to the test site to familiarize yourself  with the area, parking, etc.

–Call the Center and see if you may bring water or snacks.

Eat well and get a good night’s sleep the night before the test.

On the Day of the Test

Eat before you leave.

Leave early and give yourself sufficient time to arrive at your destination.

Bring a jacket or sweater.

Conclusion

Nurses need to understand the legal issues regarding practice.

It is important to know and understand the Nurse Practice Acts in your state.

Patients expect nurses to provide safe, competent, and quality care.

Nursing Practice Leadership, Management and the Law Essay Assignment Papers: Essentials of Nursing Leadership & Management

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