Online Undergraduate Course

NURS 450 - RN to BSN Transition: Implications for Practice, Policy and the Profession

Module 6: Legal Considerations

Laws: Civil, Criminal, Administrative

Laws vary in types and in how each are enacted. Below are brief explanations of civil, criminal, and statutory laws that affect professional nursing practice. Examples of each type of law are provided. Two major types of categories of law have been created to deal with conduct that is considered unacceptable—criminal law and civil law. Nurses generally are more familiar with civil law and, in particular, the branch of civil law that deals with torts.

Civil law is the law governing the relations between private persons or organizations. Civil law regulates the conduct of private individuals, which then are enforced through the courts as damages or money compensation (Finkelman, 2019). Malpractice cases are a type of civil action or civil case, meaning the victim’s compensation is being fought for, often without regard for punishing the defendant. Medical malpractice cases aim to gain financial support for help with medical costs, lost income, pain, suffering, and disability. A patient suing a nurse because of an injury seeks compensation and this is an example of a civil case. This would be referred to as a tort. A tort is a civil wrong or injury committed by one person against another person or a property. The wrong results from a breach in one's legal duty regarding interpersonal relationships between private persons (Finkelman, 2019). That means a tort addresses the legal rights of patients and the responsibilities of the nurse in the nurse patient relationship. Some torts specific to nursing and nursing practice include things like negligence and violations relating to patient confidentiality.

Criminal law deals with crimes and their prosecution. These are crimes against the public or members of the public. Criminal cases are not brought by individuals or estates but by government prosecutors who work on behalf of the victims or the state. The goal in criminal cases is the punishment, including incarceration, of the defendants. Prosecutors must be able to prove that the defendant committed the crime in question beyond a reasonable doubt. Criminal law is the area of law concerned with allegations of illegal actions that were allegedly performed by the provider that must be proven beyond a reasonable doubt. A nurse practitioner who billed Medicare for  services not rendered or who submitted duplicate claims to Medicare could be charged with Medicare fraud by the federal government specifically Center for Medicare and Medicaid Services (CMS). This is an example of a criminal case.

Administrative law addresses rules or regulations made and enforced by governmental agencies. An example of an administrative law is the state Nurse Practice Act (NPA). The Board of Nursing is the administrative arm that enforces the states NPA that is the law for governing nursing practice in each state and is used for guidance to action. Registered nurses licensed in the state of Maryland are expected to know and practice under the NPA (https://mbon.maryland.gov/Pages/nurse-practice-act.aspx) Maryland laws and regulations can be found on the internet by searching for Annotated Code of Maryland (Health Occupations Article, Title 8. Nurses) and Code of Maryland Regulations (COMAR). The relevant regulations are found under COMAR Title 10, Subtitle 27.

Licensed nurses may have their RN license revoked if found to deviate from the NPA law. For example, the Virginia Board of Nursing, in December 2020, encumbered Nurse X’s license after finding the nurse had diverted narcotics. While on duty, Nurse X was found guilty of diverting narcotic medication from patients and self-injecting stolen narcotics for personal use. Nurse X was found unable to practice safely. Nurse X’s license was suspected for two years. During that time, Nurse X participated in the Health Practitioners Monitoring Program. Upon completion, Nurse X’s license was reinstated.

Note
: Diverting is stealing and this is a crime. Drug Diversion is a Federal Crime under the Controlled Substances Act. Diverting prescription medications is a federal crime under the Controlled Substances Act (CSA). The CSA applies to all healthcare providers, including (but not limited to) those that are registered with the DEA (U.S. Department of Justice, n.d.) (https://www.deadiversion.usdoj.gov/21cfr/21usc/)

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