Professional Legal Issues
Legal controls on the practice of nursing are to protect the public. Law provides a framework for
• identifying what nursing actions are legal,
• differentiating the nurses’ responsibilities from those of other health care professionals,
• establishing the boundaries of independent nursing actions, and
• assisting in maintenance of a standard of nursing practice.
Nurse Practice Act
• This is a set of laws defining the scope of nursing practice.
• Each state has its own Nurse Practice Act usually administered by the State Board of Nursing.
• Most Nurse Practice Acts address performing services for compensation, specialized knowledge bases, use of the nursing process, and components of nursing practice.
Licensure
• License is a legal credential conferred by a state granting permission to an individual to practice a given profession.
• It is commonly required for professions requiring direct contact with clients.
• Licensure requires that a level of competency be demonstrated by the individual seeking a license; for an RN license this is done by passing the NCLEX-RN.
• Mandatory licensure for registered nursing is the standard in the United States—one must have a valid nursing license to work in any state, territory, or province.
• RN Nurse Licensure Compact (NLC) is a mutual recognition licensure model which allows a nurse to be licensed in his or her state of residence but to practice physically or electronically in other ccompact states. Practice in compact states is subject to each state’s practice law and regulation.
• Each state or jurisdiction establishes its own licensing laws, which usually require graduation from an approved nursing educational program, passing score on the NCLEX-RN, a good moral character, good physical and mental health, and disclosure of criminal convictions.
Standards of Care
• Standards of care are authoritative statements that define an acceptable level of patient care (professional practice).
• These are used to evaluate the quality of care provided by the nurse and, therefore, become legal guidelines for nursing practice.
• American Nurses Association (ANA) has developed general standards and guidelines for more than 20 specialty nursing practice areas.
• State Nurse Practice Acts describe standards of practice that apply to a nurse in the particular state.
• Individual health care agencies may have developed standards of care for selected patient problems, e.g., critical pathways, clinical pathways.
Malpractice
• Malpractice is the term used when a nurse while performing her/his responsibilities commits an act of negligence resulting in harm to the patient.
• Harm must be based on the failure to act in a prudent professional manner and within professional standards.
• Nurse must have had a professional duty toward the person receiving the care for malpractice to have occurred.
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