NEGLIGENCE

Refers to the commission or omission of an act, pursuant to a duty, that a reasonably person in
the same or similar circumstance would or would not do, and acting or the non-acting of which is
the proximate cause of injury to another person or his property. When this occurs person or
persons might look for legal aid from someone similar to these MRH Solicitors.
Elements of Professional Negligence
Existence of a duty on the part of the person charged to use due care under circumstances
Failure to meet the standard of due care can result in neglicence, if you suspect negligence
within a care environment it is important that it is reported so those affected can get the
assistance required.
The foreseeability of harm resulting from failure to meet standard
The fact that the breach of this standard resulted in an injury to the plaintiff.
Specific Examples of Negligence
1.Failure to report observations to attending physicians.
2.Failure to exercise the degree of diligence which the circumstances of the particular case
demands.
3.Mistaken identity.
4.Wrong medicine, wrong concentration, wrong route, and wrong dose.
5.Defects in equipments that may result in injuring the patients.
6.Errors due to family assistance.
7.Administration of medicine without a doctor prescription.
The Doctrine of Res Ipsa Loquitor
“The thing speaks for itself.”
It means that the nature of the wrongful act or injury is suggestive of negligence
Three conditions are required to establish a defendant’s negligence without proving specific
conduct.
1.That the injury was of such nature that it would not normally occur unless there was a
negligent act on the part of someone.
2.That the injury was caused by an agency within the control of the defendant
3.That the plaintiff himself did not engage in any manner that would tend to bring about the
injury.
Malpractice
“you do things beyond your scope of practice”
Also denotes stepping beyond one’s authority with serious consequences.
Doctrine of Force Majeure
It means an irresistible force, one that is unforeseen or inevitable.
“you cannot stop it from happening”
circumstances such as floods, fire, earthquakes and accidents fall under this doctrine.
Doctrine of Respondeat Superior
“let the master answer for the acts of the subordinate”
the liability is expanded to include the master as well as the employee and not a shift of
liability from the subordinate to the master
this doctrine applies only to those actions performed by the employee within the scope of his
employment.
Incompetence
Is the lack of ability, legal qualifications or fitness to discharge the required duty.
Although a nurse is registered, if in the performance of her duty she manifests incompetency,
there is ground for revocation or suspension of her certificates of registration.
Liability of Nurses for the Work of Nursing Aides
Nursing aides perform selected nursing activities under the direct supervision of nurses.
Nurses should not delegate their functions to nursing aides since the Philippine Nursing Act
specifies the scope of nursing practice of professional nurses.
If a nurse delegates, he is responsible.
Liability for the Work of Nursing Students
Under the Philippine Nursing Act of 2002, nursing students do not perform professional
nursing duties.
They are to be supervised by their Clinical Instructors.
Assumption of Risk
A nurse cannot bring suit against the patient if she gets hurt or contacts the disease since upon
accepting the case, the nurse agreed to assume the risk of harm or infection.
Consent
Is defined as a “free and rational act that presupposes knowledge of the thing which consent is
being given by a person who is legally capable to give consent.”
It is the NURSE who actually secures the consent of the patient upon admission.
1. Informed Consent
“it is established principle of law that every human being of adult years and sound mind has the
right to determine what shall be done with his on body”
Essential elements of Informed Consent
Diagnosis and explanation of the condition
A fair explanation of the procedures to be done and used and the consequences
A description of alternative treatment or procedures
A description of benefits to be expected
Material rights if any
The prognosis, if the recommended care, procedure, is refused.
2. Proof of Consent
A written consent should be signed to show that the procedure is the one consented to and that
the person understands the nature of procedure
A signed special consent is necessary before any medical or surgical treatment is done such as X-
rays etc.
3. Who Must Consent
Normally the patient himself is the one who gives the consent,
If he is incompetent (minors or mentally ill) or physically unable, consent must be taken from
another who is authorized to give it in his behalf.
4. Consent of Minors
Parents, or someone standing in their behalf
If emancipated minor consent is signed by them.
5. Consent of Mentally Ill
They cannot legally give consent. Parents or guardians.
6. Emergency Situation
When an emergency situation exists, no consent is necessary because inaction at such time may
cause greater injury.
7. Refusal to Consent
Patients other than those who are incompetent to give consent can refuse consent.
Medical Records
As a record of illness and treatment, it saves duplication in future cases and aids in prompt
treatment
It serves as a legal protection for the hospital, doctor, and nurse by reflecting the disease or
condition of patient and its management.
“If it was not charted, it was not observed or done.”
Nurses have the responsibility of keeping the patient’s right to confidentiality.
Permission has to be taken from the Medical Records Division of the Hospital.
Intentional Wrongs
nurse may be held liable for intentional wrongs.
Torts
,Is a legal wrong, committed against a person or property, independent of a contract which
renders the person who commits it liable for damages in a civil action.
,The person who has been wronged seeks compensation for injury or wrong he has suffered.
Examples of Torts are:
1. Assault and Battery
Assault is the imminent threat of harmful or offensive bodily contact; “banta”.
Battery is an intentional, unconsented.
touching of another person.
2.False Imprisonment or Illegal Detention
Unjustifiable detention of a person without legal warrant within the boundaries fixed by the
defendant by an act or violation of duty intended to result in such confinement.
3.Invasion of Right to Privacy and Breach of Confidentiality.
The right to privacy is the right to be left alone, the right to be free from unwarranted publicity
and exposure to public view.
4.Defamation
Character assassination, be in written or spoken.
Slander is oral defamation of a person by speaking unprivileged or false words by which his
reputation is damaged.
Libel is defamation by written words, cartoons or such representations that cause a person to
be avoided, ridiculed or held in contempt or tend to injure him in his work
If refuses to sign, this should be noted in his chart.
8. Consent for Sterilization
Is the termination of the ability to produce offspring.
The husband and wife must consent to the procedure if the operation is primarily to accomplish
sterilization.
If it’s medically necessary or an incidental result, the patient alone is sufficient.
Community Health Nursing
1.Which is the primary goal of community health nursing?
A. To support and supplement the efforts of the medical profession in the
promotion of health and prevention of illness
B. To enhance the capacity of individuals, families and communities to cope with
their health needs
C. To increase the productivity of the people by providing them with services that
will increase their level of health
D. To contribute to national development through promotion of family welfare,
focusing particularly on mothers and children.

2.CHN is a community-based practice. Which best explains this statement?

A. The service is provided in the natural environment of people.
B. The nurse has to conduct community diagnosis to determine nursing needs and
problems.
C. The services are based on the available resources within the community.
D. Priority setting is based on the magnitude of the health problems identified.

3.Population-focused nursing practice requires which of the following processes?

A. Community organizing
B. Nursing process
C. Community diagnosis
D. Epidemiologic process
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of
employees, what other factor must be considered in determining the
occupational health privileges to which the workers will be entitled?
A. Type of occupation: agricultural, commercial, industrial
B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees

5.A business firm must employ an occupational health nurse when it has at least
how many employees?
A. 21
B. 101
C. 201
D. 301

6. When the occupational health nurse employs ergonomic principles, she is

performing which of her roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environmental manager

7. A garment factory does not have an occupational nurse. Who shall provide the
occupational health needs of the factory workers?
A. Occupational health nurse at the Provincial Health Office
B. Physician employed by the factory
C. Public health nurse of the RHU of their municipality
D. Rural sanitary inspector of the RHU of their municipality

8.“Public health services are given free of charge.” Is this statement true or false?
A. The statement is true; it is the responsibility of government to provide basic
services.
B. The statement is false; people pay indirectly for public health services.
C. The statement may be true or false, depending on the specific service required.
D. The statement may be true or false, depending on policies of the government
concerned.

9. According to C.E. Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights of health and longevity
B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts

10. We say that a Filipino has attained longevity when he is able to reach the
average lifespan of Filipinos. What other statistic may be used to determine
attainment of longevity?
A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate
CHN Answer Key
1. Answer: B.
To enhance the capacity of individuals, families and communities to cope
with their health needs To contribute to national development through
promotion of family welfare, focusing particularly on mothers and children.
2. Answer: A.
The service is provided in the natural environment of people. Community-
based practice means providing care to people in their own natural
environments: the home, school and workplace, for example.
3. Answer: C.
Community diagnosis Population-focused nursing care means providing
care based on the greater need of the majority of the population. The
greater need is identified through community diagnosis.
4. Answer B
Location of the workplace in relation to health facilities Based on R.A. 1054,
an occupational nurse must be employed when there are 30 to 100
employees and the workplace is more than 1 km. away from the nearest
health center.
5. Answer: B
Again, this is based on R.A. 1054.
6. Answer D
Environmental manager Ergonomics is improving efficiency of workers by
improving the worker’s environment through appropriately designed
furniture, for example.
7. Answer C
Public health nurse of the RHU of their municipality. This question is based
on R.A.1054.
8. Answer: B.
The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are pre-paid
services, though taxation, for example.
9. Answer: A.
 For people to attain their birthrights of health and longevity According to
Winslow, all public health efforts are for people to realize their birthrights
of health and longevity.
10. Answer C
Swaroop's index is the percentage of the deaths aged 50 years or older.

Comprehensive Quiz

1. A client has just returned to the medical-surgical unit following a segmental

lung resection. After assessing the client, the first nursing action would be to
A) administer pain medication
B) suction excessive tracheobronchial secretions
C) assist client to turn, deep breathe and cough
D) monitor oxygen saturation

2. The nurse is performing physical assessments on adolescents. What finding

would the nurse anticipate concerning female growth spurts? *
A) They occur about 2 years earlier than for males.
B) They begin about the same time for males.
C) They begin just prior to the onset of puberty.
D) They are characterized by an increase in height of 4 inches each year.
Comprehensive Quiz Answer Key
1. Answer B
Suctioning the copious tracheobronchial secretions present in post-thoracic
surgery clients maintains an open airway which is always the priority
nursing intervention.
2. Answer C
A) They occur about 2 years earlier than for males.
3. Feedback
4. Normally, females in their teenage years experience a growth spurt about 2
years earlier than their male peers.
5.
6.