NURSING JURISPRUDENCE

SEMI FINAL COVERAGE

LAWS GOVERNING THE PRACTICE OF NURSING

LAW ------‘the sum total of rules and regulations by which
society is governed.
= it is manmade and regulates social conduct in a formal and
binding way.
= It reflects society needs, attitudes and mores.
= a rule of conduct pronounced by controlling authority by
which may be enforced.
Three essential characteristics of law;
 The authority or the right to declare that the rule
exists.
 Such rule is pronounced or expressed and that its
source can be identified.
 A right to enforce the same and must be provided.
Government ----- is the controlling authority in our
system.
Constitution ---- if the fundamental law of the government.
It contains the principles on which the government is
founded., regulates the division of sovereign powers , directs
to what persons each of these powers is to be entrusted , and
specifies the manner by which these powers shall be
exercised.
= the first essential to a pronounced law that it must be
declared in writing.
 Principal sources of these pronouncements:
a. constitutions
b. statutes or legislation
c. regulations issued by the executive branch of the
government
d. case decisions or judicial opinions
e. presidential decrees
f. letters of instructions.

BRIEF HISTORY OF THE NURSING LAW

 The first law that had to do with the
practice in nursing is ACT NO. 2493 Of 1915.
 This act provided for the examination
and registration of nurses in the Philippine islands.
 In 1919, act 2808 --- was assed known
as the First true nursing law. It created a board of
examiners for nurses.
  1920 ---- first board examination in the
Philippines was given.
 RA 877, on June 19, 1953 ----provision
included in the organization of the Board of examiners
for nurse, provisions regarding nursing schools and
colleges, examination and registration of nurses.
 RA 7164 ----- the Philippine Nursing
Act of 1998
 RA 9173 ------ Philippine Nursing Act
of 2002

LEGAL ASPECTS OF THE NURSE

As nurses begin their professional obligations, their legal
responsibilities begin a s well. Their license to practice
attests that they are qualified under the law to practice their
profession.
 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 non-
acting of which is the proximate cause of injury to
another person or his property.
 If a person charged with negligence
shows that she meets or even surpasses this standard
then there is no negligence or carelessness. If the
 defendants actions fail to meet the standard, then there
has been negligence.
 Elements of professional negligence
a. existence of a duty on the part of the person charged to
use due care under circumstances.
b. failure to meet the standard of due care.
c. the foreseeability of harm resulting from failure to
meet the standard.
d. the fact that the breach of this standard resulted in an
injury to the plaintiff.
 Standard ------ is the desired and
achievable level of performance against which actual
practice is compared.
 Specific examples of Negligence:
1. Failure to report observations to attending
physicians. Ex. A nurse observed that the toes of a
patient with leg cast was cyanotic and cold to touch,
but she failed to report this to physician.

2. Failure to exercise the degree of diligence which

the circumstances of the particular case demands.
Ex. A community health nurse attended the delivery
of a patient who had no prenatal care. The baby was
born spontaneously but the placenta was not
expelled after 30 min. she advised that the patient be
brought to the hospital and left with no nurse with
 them along the way the patient died and the nurse
was found guilty of negligence
3. Mistaken identity ----- drugs could be given to
the wrong patient and latter the patient become
unconscious and could not respond to the nurse’s
verification of identity.
4.Wrong medicine, wrong concentration, wrong
route, wrong dose. There are many reported cases where
patients are inadvertently given the wrong medications or
wrong doses simply because the nurse did not take to check
the order.
5. Defects in the equipment such as stretchers and
wheelchairs may lead to falls thus injuring the patients.
6. Errors due to family assistance …. Suppose a nurse ask a
relative to apply ot water bag to the body of a chilling, child
and the latter suffered burns. The nurse would be held liable
for failure to test the temperature of the water and or for
failure to check whether the mother knew what was expected
of her during such assistance.
7. Administration of medicine without doctor’s prescription.
A case of negligence was filed against a puericulture center
nurse in 1979 for injecting Penstrep to a boy who has a
swollen foot. The nurse informed the parents that she was
not a doctor. Upon insistence of the parents to have their
child treated, she informed then the doctor usually give
Penstrep injections in such cases, she injected the medicine
without a doctors prescription. The boy died of
cardiorespiratory failure secondary to anaphylactic shock
due to the injection of the drug. The nurse found guilty as
charged.
Doctrine of RES IPSA LOQUITUR
Res ipsa loquitur ----- means “ the thing speaks for itself”
This means that the injury could not have happened if
someone was not negligent that no further proof is required.
Following are examples:
1. a patient came in walking to the out patient clinic for
injection. Upon administering the injection to his buttocks,
the patient experienced extreme pain. his leg felt weak and
he was subsequently paralyzed. His sciatic nerve was
injured.
2. he presence of sponges in the patient’s abdomen after an
operation.
3. fracture on a newly delivered baby born by breech
presentation.
Malpractice ------ it implies the idea of improper or
unskillful care of a patient by a nurse. It denotes stepping
beyond one’s authority with serious consequences.
Example:
---- is the giving of anesthesia by a nurse or prescribing
medicines.
Doctrine of FORCE MAJEURE
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 cannot be foreseen, or which, though foreseen are
inevitable except in cases expressly specified by law.
Example; floods, fire, earthquakes, and accidents fall under
this doctrine.
Habitual tardiness due to heavy traffic is not considered an
excuse for force majeure.
DOCTRINE OF RESPONDEAT SUPERIOR
= it 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 masters. Therefore when a
person through his negligence , injures another, he remains
fully lack responsible. This doctrine applies only to those
actions performed by the employee within the scope of his
employment.
1. the hospital will be held liable, if, an effort to cut down
on expenses it decides to hire underboard nurses or
midwives in place of professional nurses and these persons
prove to be incompetent.
2. the surgeon will be held responsible in case a laparotomy
pack is left in patient’s abdomen.
= private duty nurses however are considered as independent
contractors and they are liable for their own negligent
actions.
Incompetence ----- is lack of ability, or legal qualifications
and being unfit to discharge the required duty.
Although a nurse is registered, if in their performance of
their duty she manifest incompetency, there is a ground for
revocation or suspension of her certificate of registration.
Liability for the work of nursing students
= under the Philippine Nursing act of 2002 RA 9173, nursing
students do not perform professional nursing duties. They
are to be supervised by their Clinical instructors. In order
that the errors committed by nursing students will be
avoided/or minimized, the following measures should be
taken into;
a. nursing students should always be under the supervision
of Nurse
b. they should be given assignments that are at their level of
training, experience and competency.
c. they should be advised to seek guidance especially if they
are performing a procedure for the first time.
d. they should be oriented to the policies of the nursing unit
where they are assign.
e. their performance should be assessed frequently to
determine their strengths and weaknesses.
f. frequent conferences with the students will reveal their
problems which they may want to bring to the attention of
their instructors or vice versa. Discussion of these problems
will iron out doubts and possible solutions may be provided.
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 injection is based on the
Philippine Nursing act of 1991 section 28 which states that “
in the administration of intravenous injections, special
training shall be required according to protocol established”.
Consent to Medical and Surgical Procedures
Consent ------ is defined as a free rational act that
presupposes knowledge of the thing to which consent is
being given by a person who is legally capable to give
consent.
Consent ------ is an authorization by a patient or a person
authorized by law to give the consent on the patients behalf,
that changes touching.
Subpoena duces tecum ----- are patients records kept to give
important evidence in legal proceedings that are brought in
court.
Tort -----is a legal wrong committed against a person or
property independent of a contract which renders the person
who commits a liable for damages in a civil action.
a. Assault ----- is the imminent threat
of harmful or offensive bodily contact. It is unjustifiable
to touch another person, or to threaten to do so in such he
deposition it will be carried out.
b. battery ----- is an intentional, unconsented touching of
another person. It is therefore important that before a
patient can be touched, examined, treated or subjected to
medical/surgical procedures he must be given a consent to
this effect.
A patient who gets injured while being restrained may cause
the attendant or the nurse to be liable for assault and battery.

WILL
= Is a legal declaration of a person’s intentions upon death
= it is an act whereby a person is permitted with the
formalities prescribe by law, to control to a certain degree
the deposition of his estate, to take effect after his death.
Decedent ----- is a person whose property is transmitted
through succession whether or not he left a will.
Testator ---- a person who left a will.
Testatrix ---- a person making a will is a woman.
Heir ----- is a person called to succession either by the
provision of a will or by operation of a law.
Testate ---- a person who dies leaving a will.
 Intestate ---- one who dies without a will.
Probate ----- validation of a will in court.
Administrator ---- one who administers the provision of the
will.
Holographic will ---- a will which is written, dated and
signed by the testator.
Nuncupative will ---- is an oral will or nuncupation…
LEGAL PROCEDURE AND TRIAL
= In trial , the judicial procedure I to ascertain facts by
hearing evidence, determine which facts are relevant, apply
the appropriate principle of law and pass judgment.
Procedures in the lawsuit’
 Commencement
 Pleading
 Pretrial
 Trial’
 Execution
A. commencement of the action
= the first step in the trial process is to determine what kind
of legal action to take. If the action relates to negligence, the
correct action would be negligence, and if it relates to
contract, the proper action would be for breach of contract.
The court which ahs the jurisdiction over the case and the
geographic area must determine the venue where the case
will be presented.
B. Statutes of limitation
= complaint must be made within a specific time or the right
to complain may be lost forever. There is a time limit in
filing cases because witness become less reliable after
passage of time.
= claims for negligence or malpractice vary from two to
three years. In criminal cases, statutes of limitation vary
from 2 to 6 years except in cases where murder is committed
in which there is no time limit.
C. Commencement of Legal proceedings:
= the primary function of the court is to determine a
controversy between two disputants ,technically called the
LITIGANTS.
Complainant or plaintiff ---- the accuser
Respondent or defendant ---- the accused.
The preliminary process will be taken care of by the attorney
or counselor, who files 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.
d. Pleadings:
= each party presents a statement of facts or pleading to the
court. First pleading is generally known as a Complaint or
petition. In less serious crimes known as Misdemeanor,
these pleadings are called complaints while in crimes of
more serious nature known as felonies, the pleadings are
called Indictments.
After the complaint is filed, the defendant must make some
reply within a specific time. He must be aware of his
fundamental right due to process of law.
e. Pre-trial Procedures:
= This is an informal discussion between the judge and
attorney to eliminate matters not in dispute, agree on issues
and settle personal matters relating to the trial. Cases are
often settled at this point.
f. 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.
Subpoena ------ court summon served directing a witness to
appear and give testimony on the date and time ordered.
Perjury ---- false swearing under oath.
Privilege against self incrimination -------The witness
should neither hesin fine or imprisonment.tate to say she
does not know, nor answer any question that might
incriminate her.
Appeals
= an appellate court reviews the case, and when the case is
decided by it, the final judgment results and the 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 judgement. Failure to obey will
be regarded as Contempt of court and will result in fine or
imprisonment. If the judgement is for payment of money, the
plaintiff may cause the sheriff to sell so much of to pay the
the defendants property as is necessary to pay the costs.