Basic Concepts of Nursing Procedures I Clement
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INTRODUCTION TO NURSING

INTRODUCTION TO NURSINGCHAPTER 1

 
NIGHTINGALE'S PLEDGE
I solemnly pledge myself before god and in the presence of this assembly, to conscientiously practice my profession.
I will respect all life, dignity, rights of man in the practice of my calling.
I will zealously seek, to nurse those who need care irrespective of nationality, race, creed, color, age, sex, politics or social status.
I will collaborate and coordinate, with health team, and devote myself, to the welfare, of my patients, my family and my country.
I will endeavor, to fulfill my rights and privileges, as a good citizen and take my share of responsibility, to promote health, to prevent illness, to restore health and to alleviate suffering.
I will constantly endeavor, to increase my knowledge, and skills, in nursing and to use them wisely.
I will be active, in assisting others, in safeguarding, and promoting the health and happiness of mankind.
 
LIBERAL MEANING OF THE WORD NURSE
N—Nobility, Knowledge
U—Usefulness, Understanding
R— Responsibility
S— Simplicity, Sympathy
E— Efficiency, Equanimity.
 
ESSENTIAL QUALITIES OF A NURSE
 
Devotion
The most important quality of any person who wishes to take up nursing as a profession and it should be treated with great care and consideration. Impassiveness is a quality much needed so that the nurse is calm and serene even under pressure of work and during emergency. Essential qualities of a nurse are described below:
 
Honesty
A nurse's reliability and integrity must never be questionable. Avoid exaggeration and confess mistakes frankly. So that they may be rectified immediately. Always think of the patients’ safety first rather than your possible punishment. Honesty is the most important quality on which others qualities depend.
 
Loyalty
This quality is practiced towards the school, fellow nurses, senior officers, patients-in fact, everybody and everything within the hospital. Hospital matters should not be discussed outside. The patients’ affairs should be treated with strict confidence. Disloyalty destroys the entire edifice of the hospital service and the profession itself. Loyalty builds a nursing service of the highest quality.
 
Discipline and Obedience
A nurse must understand the necessity of self-discipline, so that she trains herself to carry out vital orders immediately and accurately without question. At no time she should argue with the staff in authority. A calm, well poised nurse, who has her own emotions under control, inspires confidence and respect. A nurse should never refuse to carry out a legitimate order issued by a senior staff. if there is any point of argument it can be taken up later.
 
Courtesy
This is a simple form of consideration of others which is practiced towards patients and their relatives, senior officers and fellow nurses. It does not require any extra time and is much appreciated by all.
 
Dignity
To be dignified and to maintain a professional attitude towards each other and towards patients is essential. 2Peals of laughter, loud and immature conversation, anger and argumentation lower a nurse's dignity.
 
Personal Appearance
This is of major importance. A nurse, who appears healthy, neat, well groomed and meticulous about her personal hygiene, immediately creates a favorable impression on patients and colleagues alike. Jewellery excessive cosmetics, improper shoes, worn out, poorly fitting or soiled uniforms completely ruin the professional appearance.
 
Tact, Sympathy, Sense of Humor and Patience
These are all attributes which a nurse needs to develop, along with tolerance and breadth of outlook. All these help her enormously in dealing with her patients and her fellow nurses.
 
Optimistic Outlook
Without forcing cheerfulness, a nurse may still exude an aura of security and contentment by looking and acting as though she enjoys doing her work and by maintaining genuine interest in the patient and his welfare. A quick warm smile may be more therapeutic than a dose of medicine.
 
Observation and Adaptability
If these do not come naturally, a nurse may consciously develop these qualities. It is important to be observant of the small things which add to a patient's comfort or those things, which may indicate a change of condition. A sharp eye to see out-of-order or out-of-place equipment, lack of cleanliness in the ward, is the quality which makes a responsible nurse.
 
Gentleness and Quietness
Develop a gentleness of touch and quietness in handling the patient and equipment, with quick but smooth movements. These increase the patient's comfort and confidence.
 
Economy
This is the characteristic of an ideal nurse. Equipment and supplies, water and electricity which the nurse controls are valuable material. These must be preserved carefully as if they were personal property not only for the sake of the patients and the hospital, but also for our country.
 
Sense of Responsibility
The most difficult characteristics to acquire is a sense of responsibility. This is the quality, which produces reliable and efficient leaders. The nursing profession in India today is in great need of responsible leaders. But still more important are the thousands of nurses each of whom in her own place understand and shoulders her share of responsibility.
 
Adaptability
To adapt one to existing conditions and living with others counts for much in making of a good nurse.
 
DEFINITIONS OF NURSING
 
International Council of Nursing, 1973
Nursing is to assist the individual (sick or well) in the performance of those activities contributing to health, its recovery (or to a peaceful death) that he would perform unaided, if he had the necessary strength, will or the knowledge and to do this in such a way as to help him gain independence as rapidly as possible.
 
Florence Nightingale
Nursing is defined as the act of utilizing the environment of the patient to assist him in his recovery.
 
Canadian Nurses Association, 1987
Nursing practice as a dynamic, caring and helping relationship in which the nurse assists the client to achieve and obtain optimal health.
 
American Nurses Association
Nursing practice as direct goal oriented and adaptable to service the needs of the individual, the family and community during health and illness.
zoom view
Fig. 1.1: Diagrammatic representation of Henderson's definition of nursing
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BASIC NURSING PRINCIPLES
 
Safety
Safety is the protection to hazards to patients and members of the health team from the possible mechanical, chemical, thermal, bacteriological and psychological injuries.
 
Therapeutic Effectiveness
Therapeutic effectiveness is the result of the work, that is, whether the purpose of the procedure is fully achieved or out.
 
Comfort
Every nursing procedure is aimed for the comfort of the patient. It should give the satisfaction to the patient, relatives and nurse on completion of the work.
 
Use of Resources
The use of time energy and material should be economic. A procedure should not be cancelled due to the want of one or two items required, if they are not extremely essential. In such situations adjustment can be done by improving materials with the available resources.
 
Good Workmanship
Good workmanship is the skill in doing procedures. There is great difference, in doing things by a fresh hand and an experienced hand. Such skills or the art of doing procedure are developed only by doing the same repeatedly. Nursing is learning by doing and not merely by reading.
 
Individuality
The likes and dislikes are different persons. So when we are planning nursing care to a person, his needs are to be anticipated and problems are to be identified and feelings are to be considered.
 
NURSING SCIENCE
Science is a body of knowledge based on a large number of carefully collected facts, which have been arranged and classified in such a way as to establish certain laws and principles.
Nursing science is derived from scientific thinking about the discipline or field of nursing and the practice of the profession of nursing.
Nursing science is a basic to any professional discipline is the development of a body of knowledge that can be applied of its practice. Such knowledge is often expressed in terms of concepts and theories.
 
Steps of Scientific Method
 
Description
Clarifying ideas, phenomena, experiences or circumstances that are not well understood for example, describing what pain really means to patients. This clarification is accomplished by presenting new information.
 
Exploration
Exploring how ideas of interest are related. For example, what is the relationship between pain and patients physical and psychological conditions?
 
Explanation
Explaining often within the context of an existing theory, the ‘whys’ of events or occurrences. For example, why does pain occur more frequently and severely in persons whose physical and psychological resources are improvised or reduced.
 
Prediction and Control
Knowing and foretelling correctly what will happen and also how to make it happen on command and with some regularity. For example in what specific ways can the nurse control the severity of pain for patients?
 
NURSING AS A PROFESSION
Profession has been defined as that requires extensive education or a calling that requires special knowledge, skill and preparation. Profession is an occupation with moral principles that are devoted to the human and social welfare. Professional nursing is a service devoted to the promotion of human and social welfare.
Professionalizm refers to professional character, spirit or methods. It is a set of attributes, a way of life that implies responsibility and commitment. Professionalization is the process of becoming professional that is of acquiring characteristics considered to be professional.
Professional nurse is a health worker, a graduate from a recognized school who is identified by law as a registered nurse whether graduated from a baccalaureate in science (BSc) or a diploma program as give below:
 
Criteria of Profession
Specialized education is an important aspect of professional status. In modern times, the trend in education for the professions that shifted towards programs in colleges and universities.
 
Body of Knowledge
As a profession, nursing is establishing a well-defined body of knowledge and expertise. A number of nursing 4conceptual frameworks contribute to the knowledge base of nursing and give direction to nursing practice, education and ongoing research.
 
Service Orientation
Nursing as a tradition of service to others. This service, however, must be guided by certain rules, policies or codes of ethics. Today, nursing is also an important component of the healthcare delivery system.
 
Ongoing Research
Since the 1970s nursing research has focused on practice related issues. Increasing research in nursing is contributing to nursing practice. Nursing research as a dimension of the nurse's role directed to nursing education and practice.
 
Code of Ethics
Ethical code change as the needs and values of society change. Nursing has developed its own codes of ethics and in most instances has set up means to monitor the professional behaviors of its members.
 
Autonomy
A profession is autonomous, if it regulates itself and sets standards for its members. Providing autonomy is one of the purposes of a professional association. To be autonomous, a professional group must be granted legal authority to define the scope of its practice, describe its particular functions and roles and determine its goals and responsibilities in delivery of its services.
 
Characteristics of a Professional Nurse
  1. Good physical and mental health.
  2. Truthful and efficient in technical competence.
  3. Cleanliness, tidy, neat and well-groomed.
  4. Confidence in others and itself.
  5. Intelligence.
  6. Open minded, cooperative, responsible, able to develop good interpersonal relations.
  7. Leadership quality.
  8. Positive attitudes.
  9. Self-belief towards human care and cure.
  10. Convey cooperative attitudes towards co-worker.
  11. Responsible towards family and society.
 
Professional Equities
  1. Be gentle and polite in your talk.
  2. Greet your seniors, coworkers and patients.
  3. Keep dress neat and tidy.
  4. Help the seniors to carry a heavy load, if you find them on the way.
  5. Be punctual always.
  6. Keep eye contact and sit face-to-face when listening to some one.
  7. Knock the door and wait for the answer before you enter into other's room.
  8. Excuse yourself before you interfere with others engaged in talking or doing some work.
  9. Should not give and receive any gifts or present especially from the patients and their relatives.
 
ROLE AND FUNCTIONS OF A NURSE
Nurses assume a number of roles when they provide care to patients. Nurses often carry out these roles concurrently, not exclusively of one another. For example, the nurse may act as a counselor, while providing physical care and teaching aspects of the care.
 
Caregiver
The caregiver role traditionally included those activities that assist the patient physically and psychologically, while preserving the patient's dignity. Care giving encompasses the physical, psychological, developmental, cultural and spiritual levels.
 
Communicator
In the role of communicator, nurses identify patient's problems and then communicate these verbally or in writing to other members of the health team.
zoom view
Fig. 1.2: Role and functions of a nurse
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The nurse must be able to communicate clearly and accurately in order for a client's healthcare needs to be met.
 
Teacher
As a teacher, the nurse helps the client learn about their health and the health care procedures they need to perform to restore or maintain their health. The nurse assesses the client's learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies, and measures learning.
 
Client Advocate
A client advocate acts to protect the client. In this role the nurse may represent the client's needs and wishes to other health professionals, such as relaying the client's wishes for information to the physician.
 
Counselor
The nurse counsel's primarily healthy individual with normal adjustments difficulties and focuses on helping the person develop new attitudes, feelings and behaviors by encouraging the client to look at alternative behaviors, recognize the choices, and develop a sense of control.
 
Change Agent
The nurse acts as a change agent when assisting others that is clients, to make modifications in their own behavior, nurses also often act to make changes in a system, such as clinical care, if it is not helping a client return to health. Nurses are continually dealing with change in the health care system.
 
Leader
The leader role can be employed at different levels individual client, family, groups of clients, colleagues or the community.
 
Manager
The nurse manager also delegates nursing activities to ancillary workers and other nurses and supervises and evaluates their performance.
 
Case Manager
Nurse case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes. Each agency or unit specifies the role of the nurse case manager.
 
Research Consumer
Nurses often use research to improve client care. In a clinical area, nurses need to
  1. Have some awareness of the process and language of research.
  2. Be sensitive to issues related to protecting the rights of human subjects.
  3. Participate in the identification of significant researchable problems.
  4. Be a discriminating consumer of research findings.
 
Expanded Career Roles
Nurses are fulfilling expanded career roles, such as those of nurse practitioner (NP), clinical nurse specialist, nurse midwife, nurse educator, nurse researcher and nurse anesthetist.
 
PERSON-CENTERED NURSING CARE (NURSING PROCEDURES)
Procedure means a method of carrying out a treatment. Details of procedure differ in various hospitals, though underlying principles are same.
Nursing techniques is the skillful handling of patient with the least discomfort, the skillful handling of sterile apparatus without contamination and elimination of unnecessary movements so as to ensure the maximum speed with the highest efficiency.
Nurse is a primary member of the unit. She should have an interest to do work and should radiate joy, while doing it. She follows the systematic and orderly way of doing procedures; organizing correct equipments before procedure observe the patient condition and document the details promptly and properly.
 
Patient
Patient is considered as an individual holistic approach. While delivering the patient's care. Patient's physical, mental comfort should be considered. Adequate explanation, providing continuous observation is essential in quality nursing care.
 
Environment
The therapeutic environment should be pleasant to give care and to receive care. The environment should help the patient for faster recovery. The environment should be clean, neat, appropriate temperature, adequate light, well ventilated; noise and draughts should be avoided. The ward or room should be left in order after carrying out procedure.
 
Equipment
Adequate equipments are important for the effective patient care. All the equipments for a procedure should 6be clean and in good working condition. After use of all equipments, it should be washed, scrubbed, dried, boiled, aired, etc. All broken equipment should be reported and replacement obtained.
 
The Five Essential Steps in Every Procedure
Preliminary assessment of the patient and situation includes: Checks the doctor's order to note any specific instructions in doing the procedure; Assessing general condition of the patient, self-care ability, the mood of acceptance, hygienic status, position to be changed, need of the procedure and assistant.
Preparation and organization of articles: Organize the articles according to the order of use. The nurse must have a thorough knowledge about the details of the procedure. On the basis of judgment, a thoughtful nurse will collect and organize all the articles to meet the needs throughout the procedure and concentrate in the performance.
Performance of the procedure: The nurse obtains knowledge from the classrooms, books and demonstrations and by assisting senior nurses in the ward in the beginning. The sincere effort in the part of students and junior staff, in learning, observing and practicing, is the real method of developing knowledge and skill in doing procedures.
Aftercare of patients and articles: Make the patient comfortable, the effect of the treatment is observed and proper recording is made in the chart. All the articles are well cleaned and sterilized (if needed), replace it in the proper place and keep it ready for the next use.
5th essential steps in equipment: Monitoring for complications: fifth step of every essential procedure, nurse has to report and record at the earliest about the signs and symptoms of complications related to the procedure done, any abnormalities observed, condition of the patient, status of the vitals, call for additional help if the condition is unstable, inform to the physician, take measures to settle down the complications.
 
NURSE AS A MEMBER OF THE HEALTH CARE TEAM
The health team in a health care system may be as simple as consisting only of three members, the doctor, the nurse and the patient or it may be a large team consisting of members of many other specialized fields of care like physical therapists and the occupational therapists, the dieticians and people who look into the spiritual and social needs of the patient.
Each member of the team possesses unique knowledge and skill which, he/she contributes to the total health care system. There are also many areas of shared knowledge and skill, e.g. communication skills, anatomy, physiology, psychology and sociology. The essence of the team concept is that all members work cooperatively for individual family or a community towards their common goal of attaining the highest level of health possible.
 
ETHICAL ISSUES IN NURSING
Ethics are the rules or principles that govern right contact. Ethics are designed to protect the rights of human being. Ethics are characteristics of a healthy profession.
The code of ethics will state what kind of conduct is expected from the members of a profession, what are the responsibilities of its members towards those whom they serve, their coworker, the profession and the society as a whole.
 
Nursing Ethics
The nursing ethics provide professional standards for nursing activities, which protect the nurse and the patient.
In 1973, the International Council for Nurses (ICN) adopted code of ethics.
The fundamental responsibility of the nurse is four fold. They are:
  • To promote health
  • To prevent illness
  • To restore health
  • To alleviate suffering.
The need for nursing is universal. Inherent in nursing is respect for life dignity and rights of men. It unrestricted by considerations of nationality, race, creed, color, age, sex, politics or social status.
Nurses render health services to the individual, the family and the community and coordinate their services with those of related groups.
 
Code of Ethics
 
Nurses and People
The nurse's primary responsibility is to those people who require nursing care. The nurse holds in confidence personal informations and use judgment in sharing this information.
 
Nurses and Practice
The nurse maintains the highest standards of nursing care possible within the reality of a specific situation. The nurse when acting in a professional capacity should at all times maintain standards of personal conduct, which credit upon the profession.7
 
Nurses and Society
The nurse shares with other citizens the responsibility for initiating and supporting action to meet the health and social needs of the public.
 
Nurses and Coworker
The nurse maintains a co-operative relationship with coworkers in nursing and other fields. The nurse takes appropriate action to safeguard the individual when his care is endangered by a co-worker or any other person.
 
Nurses and the Profession
The nurse acting through the professional organization participates in establishing and maintaining equitable social and economic working conditions in nursing.
 
Ethical Principles
Ethical principles actually control professionalism nursing practice much more than to ethical theories. Principles encompass basic promises from which rules are developed. Principles are the moral norms for nursing, as a profession, both demands and strives to implement to every day clinical practice. Ethical principle that the nurse should consider when making decisions are as follows:
  • Respect for persons
  • Respect for autonomy
  • Respect for freedom
  • Respect for beneficence (doing good)
  • Respect for non-maleficence (avoiding harm to others)
  • Respect for veracity (truth telling)
  • Respect for justice (fair and equal treatment)
  • Respect for rights
  • Respect for fidelity (fulfilling promises)
  • Confidentiality (protecting privileged information).
 
Ethical Dilemmas
A dilemma is defined as situations requiring a choice between two equally desirable or undesirable alternatives. In ethical dilemma, each alternative course of action can be justified by two ways in which a person views the course of action based on his or her value system. Issues in healthcare delivery practices present different alternatives based on whether the issue or course of action is viewed by the patient, the healthcare agency, the legal system or the nurse. Increasingly, staff nurses and nurse managers face difficult decisions caused by tensions between technological capabilities, budgetary structures, and quality of life concerns. Nurses in all clinical and functional specialties face the following ethical dilemmas:
  1. Need to ration patient care to conserve scarce resources.
  2. Need to make treatment and care decisions for terminally ill patients.
  3. Need to obtain patients informed consent for care and treatment orders and measures such as:
    • Do not resuscitate order
    • Withholding/withdrawing nutrition and fluids
    • Starting/discontinuing life support system.
  4. Response to patient request for assisted suicide.
  5. Need to balance the patients need for confidentiality and privacy against society's needs for protection from unreasonable risk.
  6. Need to protect autonomy rights of children and incompetent adults concerning consent for research participation.
  7. Need to protect justice rights of patients who participate in random trials of experimental treatment.
Usually the dilemma occurs when opposing views are seen for the solution of an issue and a decision must be made. There is no set of procedures or easy answers for how an ethical dilemma should be resolved. Ethical decision making is needed in all steps of the nursing process and all phases of the nursing management process. Ethical reasoning is similar to the nursing process in that it requires critical thinking skills. A nurse can best resolve ethical dilemma, by systematically considering all options for solving the dilemma. A ethical dilemma occurs as a result of conflict between moral principles that support different courses of action.
 
Ethical Decision Making
Nurse's decisions are increasingly constrained by ethical issues. Ethical decision making involves reflection on the following:
  • Who should make the choice?
  • Possible options or courses of action
  • Available options
  • Consequences, both good and bad, of all possible options
  • Rules, obligations and values that should direct choices
  • Desired outcomes.
 
Ethical Decision Making Model
When making decisions, nurses need to combine all of these elements using an orderly, systematic, and objective method. There are various models for ethical decision making. Perhaps the easiest ethical decision making model to remember and to implement in practice is the ‘moral model’ developed by Thirona and Halloraw as follows:
M—Massage the dilemma: Identify and define the issues in the dilemma. Consider the opinions of all major players in the dilemma as well as their value system. 8This includes patient's family members, nurses, doctors, priest and any other interdisciplinary healthcare team member.
O—Outline the options: Examine all options including those less realistic and conflicting; this stage is designed only for considering options and not for making final decision.
R—Resolve the dilemma: Review the issues and options, applying the basic principles of ethics to each option. Decide the best option based upon the views of all those concerned in the dilemma.
A—Act by applying chosen action: This step is usually the most difficult as it requires actual implementation. While the previous steps had only allowed for dialogue or discussion.
L—Look back and evaluate: The entire process including the implementation No process is complete without a through evaluation. Ensure that those involved are able to follow through on the final option. If not, a second decision may be required and process must start again at the initial step.
Another exchange of traditional model as follows:
  1. Identify the problem.
  2. Gather data to analyze the causes and consequence of the problem.
  3. Explore the optional solutions to the problem.
  4. Evaluate the optional solution.
  5. Select the appropriate solution from all the options.
  6. Implement the selected solution.
  7. Evaluate the result.
 
Statements of Ethical Responsibility
  1. Caring demands the provision of helping services that are appropriate to the needs of the client and significant others.
  2. Caring recognizes the client's membership in a family and community and provides for the participation of significant others in his or her care.
  3. Caring acknowledges the reality of death in the life of every person and demands that appropriate support the provided for the dying person and family to enable that to prepare for and to cope with death when it is inevitable.
  4. Caring acknowledges that the human person has the capacity to fact up to health needs and problems in his or her own unique way and directs nursing action in a manner that will assist the client to develop, maintain or gain personal autonomy, self-respect and self-determination.
  5. Caring, as a response to a health need, requires the consent and the participation of the person who is experiencing the need.
  6. Caring dictates that the client and significant others have the knowledge and information adequate for free and informed decisions concerning care requirements, alternative and preferences.
  7. Caring demands that the needs of the client supersede those of the nurse.
  8. Caring acknowledges the vulnerability of a client in certain situations and dictates restraint in actions, which might compromise the client's rights and privileges.
  9. Caring involving a relationship which is, in itself, therapeutic, demands mutual respect and trust.
  10. Caring acknowledges that information obtained in the course of the nursing relationship is privileged and that is requires the full protection of confidentiality unless such information provides evidence of serious impending harm to the client or to a third party or is legally required by the courts.
  11. Caring requires that the nurse represents the needs of the client and that the nurse takes appropriate measures when fulfillment of these needs is jeopardized by the actions of other persons.
  12. Caring acknowledges the dignity of all persons in the practice of educational setting.
  13. Caring acknowledges, respects and draws upon the competencies of others.
  14. Caring establishes the conditions for the harmonization of efforts of different helping professionals in providing required services to clients.
  15. Caring seeks to establish and maintain a climate of respect for the honest dialogue needed for effective collaboration.
  16. Caring establishes the legitimacy of respectful challenge and or confrontation when the service required by the client is compromised by incompetency, incapacity or negligence or when the competencies of the nurses are not acknowledged or appropriately utilized.
  17. Caring demands the provision of working conditions which enable nurses to carry out their legitimate and responsibilities.
  18. Caring demands resourcefulness and restraint- accountability for the use of time, resources, equipment and funds and requires accountability to appropriate individuals and/or bodies.
  19. Caring requires that the nurse should bring to the work situation in education, practice, administration 9or research, the knowledge, effective and technical skills required that competency in these areas should be maintained and updated.
  20. Caring commands fidelity oneself and guards the right and privilege of the nurse to act in keeping with an informed moral conscience.
 
LEGAL ISSUES IN NURSING
The law constitutes body of principles recognized or enforced by public and regular tribunals have the administration of justice.
The law is the body of principles recognized and applied by the state and the administrations of justice.
Law is that portion of the established thought and habit, which has gained district and formal recognition and the shape of uniform rules backed by the authority and power of the government.
 
Types of Laws
 
Civil Law
Civil law includes rules and regulations that specify the required course of action to be followed by an individual in business and social relationships with others. It is concerned with relationships among people and the protection of a person's rights.
 
Criminal Law
Criminal law defines offences that affect public welfare and security and impose penalties. It includes rules forbidding conduct that is injurious to public order and specifying punishments to be administered to individual who exhibits injurious conduct.
 
Common Legal Issues
  1. Wrong medications, wrong dosage, wrong route of administration and wrong concentration.
  2. Mistaken identity—prepare the wrong patient for an operation, to exchange babies in the labor room, to exchange dead bodies in the mortuary.
  3. Failure to communicate.
  4. Maintenance of record.
  5. Giving explanation and getting the concerned.
  6. Bums and false.
  7. Counting sponges and instruments during surgery.
  8. Loss or damage to patient's property and fame.
  9. Euthanasia or mercy killing—taking positive step to kill a person in order to end his suffering is a murder.
 
Law and Nurse
 
Responsibility of Appointing and Assigning
The nurse administrators have responsibility for staffing and supervising nursing units to ensure safe, effective patient care. Therefore, they have the authority to temporarily reassign a nursing employee to compensate for emergency staff shortages.
 
Responsibility of Quality Control
A nurse manager's legal responsibility for quality control of nursing service imposes a duty to observe report and correct the incompetence of any patient care provider.
 
Responsibility for Equipment
To protect the patients and employees from injury, a nurse manager must ensure that all patient care equipments are fully functional and that defective equipment is promptly repaired or replaced.
 
Responsibility for Observation and Reporting
Consequently nurses have a legal duty to observe patients frequently and report findings that have diagnostic or treatment value for the patient's physician and other members of the patient's treatment team.
 
Responsibility to Protect Public
The nurse has a legal duty to protect the public from injury by dangerous patients. The manager must ensure that nursing personnel follow the procedures to alert community members to the presence of a potentially dangerous patient in their midst.
 
Responsibility for Record Keeping and Reporting
Nurses have legal responsibility for accurately reporting and recording patient's conditions, treatments and response to care. The medical record is an information source document that should be used to plan care, evaluate care, allocate costs, educate personnel, research care measure and substantiate legal claim.
 
Responsibility for Death and Dying
Nurses must be aware of legal definition of death because they must document all the events that happens, when the patient is in their care.