HESI Exit (RN)

Constitutional law provides the foundation for individual rights including privacy, due process, and equal protection. These principles underpin patient rights in healthcare settings.

Statutory law includes nurse practice acts enacted by state legislatures that define nursing scope of practice, licensure requirements, and grounds for disciplinary action. Each state's board of nursing enforces its nurse practice act.

Regulatory law consists of rules and regulations developed by state boards of nursing to implement nurse practice acts. These regulations provide specific guidance on practice standards.

Common law develops through court decisions and precedent. Malpractice case law establishes standards for negligence and professional liability.

Negligence is the failure to exercise the degree of care that a reasonably prudent person would exercise under similar circumstances. Nursing malpractice is professional negligence by a nurse.

Duty is established when a nurse-patient relationship exists. Once a nurse accepts responsibility for a patient, a legal duty to provide competent care is established.

Breach occurs when the nurse fails to meet the applicable standard of care. Standards are established by nurse practice acts, institutional policies, professional organizations, and expert testimony.

Causation requires demonstrating that the breach directly caused the patient's injury. The injury must be a foreseeable consequence of the nurse's action or inaction.

Damages are the actual harm suffered by the patient, including physical injury, pain and suffering, economic losses, and wrongful death.

Documentation creates a permanent legal record of care provided. If it was not documented, legally it was not done.

Document objectively using specific, measurable terms. Record what was observed, not interpretations or conclusions.

Document in a timely manner, as close to the event as possible. Late entries should be clearly identified as such.

Document patient responses to interventions, changes in condition, and communications with providers.

Informed consent is the patient's voluntary agreement to treatment based on understanding of the proposed intervention, risks, benefits, alternatives, and consequences of refusal.

Elements of valid informed consent include competence (patient has decision-making capacity), disclosure (adequate information provided), comprehension (patient understands information), voluntariness (decision made without coercion), and consent (patient agrees to treatment).

The physician or provider performing the procedure is responsible for obtaining informed consent. Nurses witness signatures, verify patient understanding, and notify providers if patients express concerns or confusion.

Patients have the right to participate in care decisions, refuse treatment, access their medical records, privacy and confidentiality, be informed of their condition, and be treated with dignity and respect.

HIPAA (Health Insurance Portability and Accountability Act) protects patient health information. Nurses must access only information necessary for patient care and maintain confidentiality in all communications.

Advance directives allow patients to specify preferences for future healthcare decisions. Living wills specify treatment preferences. Durable power of attorney for healthcare designates a decision-maker.

Autonomy respects the patient's right to self-determination and independent decision-making. Nurses support autonomy by providing information and respecting patient choices.

Beneficence is the duty to do good and act in the patient's best interest. Nurses advocate for interventions that benefit patients.

Justice requires fair and equitable distribution of resources and treatment. Nurses advocate for equal access to care regardless of patient characteristics.

Veracity is the duty to tell the truth. Nurses provide honest information to patients and families.

Fidelity is faithfulness to commitments and obligations. Nurses keep promises and fulfill professional responsibilities.

Nurses are mandated reporters for suspected abuse or neglect of children, elderly, and dependent adults. Reports should be made to appropriate authorities based on state requirements.

Communicable diseases must be reported to public health authorities. Specific diseases and reporting requirements vary by jurisdiction.

Impaired practice by colleagues must be reported to protect patient safety. Most states have peer assistance programs for nurses with substance use disorders.