Nursing Jurisprudence Questions and Answers with Verified Solutions

Nursing Jurisprudence Questions and Answers with Verified Solutions Nursing jurisprudence ✔✔application of the principles of law as they relate to the practice of nursing, to the obligations of nurses to their patient ...

Nursing Jurisprudence Questions and Answers with Verified Solutions Nursing jurisprudence ✔✔application of the principles of law as they relate to the practice of nursing, to the obligations of nurses to their patients and to the relations of nurses with each other and with other health care professionals` NPA ✔✔. peer review . Nurse licensure compact . defines its responsibility for regulating nursing education, licensure, and practice What is the primary responsibilities of the Texas Board of Nursing? ✔✔. Protecting the interest of the public BON ✔✔. Represent people of Texas . Can not lobby the lefislature . Does not regulate practice settings Professional Associations ✔✔. Represent their members . Do lobby the legislature . Efforts to improve work conditions and benefits for nurses BON services ✔✔. Licensing . Enforcement Services . Audit of CE . Information Services Not BON services ✔✔. Job Referral services . Legal Referral . salary Question . Co worker disputes . Employment issues Temporary permit ✔✔. GN permit expires in 75 days . When pass or fail NCLEX Renew ONLIne ✔✔60 days prior to expiration BON will send postacard Continuing Education ✔✔. Must complete 20 hours in 2 years . First time renewal exempt . CE hours must be in area of practice . Keep records for 4 years Ethical Conduct ✔✔. Honesty . Accountability . Trustworthiness . Reliability . Integrity Peer Review ✔✔. employer must establish a peer review committee if they regularly employ, hire or contracts more than 10 nurses. The employer must establish policies and procedures governing the peer review committee process . committee will evaluate nursing services, qualifications of a nurse and the quality of care provided by a nurse and the merits of a complaint. . committee will determine whether the incident needs to be reported to the BON . Incident based (whistle blower) . Safe harbor Standards that apply to RN ✔✔. Make nursing diagnosis . Develop nursing care plan . Evaluate pt resonse to nursing care . Perform comprehensive assessment . Delegate tasks to unlicensed personnel . Practice independently within the NPA and Board rules . Education to care for all patients Standards that apply to LVN ✔✔. Participate in pllaning of nursing care . Assist in evaluating pt response to tx . Complete focused nursing assessment . Implement appropriate aspects of nursing care . Practice must be supervised . Educated to care for patients with stable and predictable conditions Step 1 ✔✔. Is the activity consistent w/ the NPA and Board rules? if no stop, if yes continue to next step Step 2 ✔✔. Is the activity appropriately authorised? . Is there a valid order, if necessary? . Does a current policy exist regarding the procedure? . Clarify any questionable orders? If no, stop. if yes, go to next step Step 3 ✔✔. Is it supported by nursing research? . Has a national nursing organization issued a position statement supporting engaging in this practices? Step 4 ✔✔. Do you possess the required knowledge and competency to carry out the act? Step 5 ✔✔. Would a reasonable and prudent nurse perform this activity in this setting? Step 6 ✔✔. Are you prepared to accept the consequences of your actions? 5 Rights of Delegation ✔✔. Right task . Right Circumstances . Right Person . Right Directions/Communication . Right supervision/evaluation Prohibited tasks to delegate ✔✔. Nursing assessments . Plan of Care . Professional Judgment and Intervention . Responsibility for Initial teaching . Medication Administration, including IV fluids - Prohibited in acute care settings - May be delegated in independent living situations Minor Incidents ✔✔. Conduct that does not indicate the nurse's continuing to practice professional nursing poses a risk of harm to the client or other person Exclusion to MI rule ✔✔. A nurse involved in a minor incident need not be reported to teh board unless the conduct indicates the nurse: . creates a significant risk of physical, emotional or financial harm to the client . Lacks a conscientious apporach or accountability . Lacks knowledge and competency and can not be easily remediated . Pattern of multiple minor incidents - five minor incidents w/n a 12 month period-reported to peer review Never a minor incident ✔✔. error that contributed to a patient's death or serious harm . criminal conduct . serious violation of unprofessional conduct . a practice related violation involving impairment or suspected impairment by reason of chemical dependency Which nurse must be reported to the BON? ✔✔. a nurse who misses a 0900 stool softener and is suspected of chemical abuse Safe Harbor ✔✔. Allows a nurse to accept an assignment and provide the best care they are capable of w/o fear of licensure action if they make a practice error . Does not protect the nurse from civil action . Before refusing an assignment, must recognize that the patient comes first . Must be invoked BEFORE engaging in the activity . Must notify supervisor in writing . Supervisor may not refuse to accept . May use Quick Request Form to make initial written request . Comprehensive Written Request must be completed before leaving the work setting Safe harbor refusal of assignment ✔✔. may refuse an assignment if he/she lacks the basic knowledge and ability that would be necessary to render care . assignment would constitute unprofessional behavior such as fraud, theft, patient abuse or falsification Quick Request Form ✔✔. Nurse/s name and signature . Date and time of the request . Location of where the assignment is to be completed . The name of the person making the assignment . Abrief explanation of why safe harbor is being requested Safe Harbor Chain after Nurse Completion ✔✔1. Nurse supervisor or administrator who made the assignment or gave the directive in question 2. nurse administrator 3. peer review committee 4. the physician who reviews the medical reasonableness of any physician's order 5. nurse administrator who reviews the peer review findings or acts in response to them 6. nurse who initiated the request Mandatory Overtime ✔✔. Permits nurses to refuse to work overtime . Defined as a requirement to work days or hours that are in addition to the hours or days scheduled regardless of the length of a scheduled shift or the number of scheduled shifts each week . Time immediately before or after shift is NOT included . Pre scheduled and compensated on cal time is NOT included Mandatory overtime NOT prohibited when... ✔✔. An ongoing procedure requires a nurse's presence . During a disaster . In certain emergencies Who do you take your concerts to regarding mandatory overtime? ✔✔. Unit Manager . Staffing Committee . DSHS Patient Abandonment ✔✔. NPA/BON rules do not define abandonment . If nurse violates duty to patient - licensure issue . If nurse leaves employment - not a licensure issue (employment issue) . DON does not define when nurse's duty to patient begins Not Abandonment- BON ✔✔. Resignation w/o notice- assuming the nurse's work shift has been completed . Refusal to wrk additional shifts, either doubles or extra shifts on days off What is considered patient abandonment? ✔✔. ICU nurse who has left the building in the middle of a shift to smoke What to do if question the safety of an assignment? ✔✔. First: be clear about what it is that you are being asked to do and what about the request makes you uncomfortable - a patient condition/problem you are unfamiliar with? - the number of patients regardless of acuity? - An unfamiliar setting/unt? - the lack of support staff? - Geographic distance b/w patients? - Something else? . Next: consider what about the assignment could be changed to make you feel comfortable accepting it - A resource person was available for questions or assistance? - Several of your patients will be discharged during the shift? - An additional CAN will be assigned to work with you? . Then: state your concern to the person making the assignment; identify what about the assignment concerns you and what ideas you have to modify the assignment . Listen to the response: did he/she understand your concern? Was he/she able to offer any ideas you had to modify the assignments to make the assignment feasible? Disciplinary Action ✔✔. Chemical dependency . Alcohol dependency . mental illness . Even prescription durgs can impair fitness to practice . Fatigue and sickness Red Flags ✔✔. Lack of energy . Frequent absences . Spike in patients' need for pain medication . Lateness to work . Red eyes . No or unusual documentation . Frequently stands behind other nurses signing out medication Unprofessional Conduct ✔✔. drug diversion . unsafe practice . failure to repay student loans . dismissal from peer assistance program . drug related actions . criminal conduct types of remediation if board finds nurse to be at fault ✔✔. Remedial education . Supervision - work under direct or indirect supervision of another nurse . Work environment - work in stable environment; eg not home health . losing license is not common Home state license ✔✔. nurse must be licensed in state in which he/she permanently resides Party State ✔✔. other states belonging to the compact Nurse Licensure Compact ✔✔. Can hold home state license in only one state . if move from one party state to another rule 220.2 permits nurse to practice on former home state license for 30 days while waiting for new license . if move to a non party state- license converts to a single state license . Violations in practice occurring in a remote state will be reported to home state nursing board . Home state will investigate and take disciplinary action