Are Your Nursing Assistants in the Know About Legal Issues?

Do your nursing assistants know that judges don't look kindly on anyone they feel may be taking advantage of a client? For example:

"Bob" has been "Mr. Howard's" home health aide for over a year. Bob tells Mr. Howard that he is having trouble paying his bills and he may have to look for a different job. To keep Bob from quitting, Mr. Howard gives him some money. When Mr. Howard's family members find out, they accuse Bob of stealing from Mr. Howard-and take him to court. Bob tries to defend himself by saying that the money was a gift. The judge does not agree...

"Sarah", a nursing assistant, has been charged with involuntary manslaughter in the death of a nursing home resident. The charges say that Sarah left "Mrs. Baxter", an elderly woman with Alzheimer's disease, alone in the bathtub for at least seven minutes. Unfortunately, Mrs. Baxter drowned.

By sharing the following information at your next CNA inservice meeting, you'll arm your aides with the knowledge they need to follow the laws pertaining to client care.

CNAs, Clients & the Law

Many different laws govern you as you go about your daily work. Think about it! There are laws relating to:

The type of training needed to become a certified nurse aide.
Who gets hired (or fired) at your workplace.
How many hours you can work at one time.
How many inservice hours you need for your job.
Which client care tasks you are allowed to do-and which must be done by a nurse.
Who can legally administer medications to clients.
The personal rights of each of your clients.

The law requires that all health care workers-like yourself-act in a professional manner. To accomplish this, you must:

Respect the rights of each client.
Behave in an ethical manner.
Perform your client care as assigned.
Follow the rules and regulations of your workplace.
Avoid doing anything beyond your level of training.

Remember...as health care workers, we often hold our clients' lives in our hands. Because of this, our work is monitored closely-by supervisors, administrators, surveyors, government agencies, family members and, sometimes, lawyers. Keep reading to learn more about some common legal issues facing health care workers today.

Legal Terms & What They Mean

Accountability. To be accountable means that you-and all other health care workers-are held legally responsible for your actions while you are at work. This includes what you do and what you don't do-but should have.

Assault. It is considered assault if someone threatens another person with physical harm. Whether the victim is actually harmed or is just threatened with harm-it's still assault.

Battery. To commit a battery means to touch another person in a harmful or offensive way.

False Imprisonment. Do you think false imprisonment means locking an innocent person in a jail cell? Well, there are other situations that are also considered false imprisonment. Both the threat of being physically restrained and actually being physically restrained are false imprisonment. So, for example, threatening to keep a patient in the hospital against his will is considered false imprisonment.

Foreseeability. Health care workers are expected to be able to foresee-or predict-the consequences of certain situations. For example, let's say that Mr. Jones tells you he wants to take a walk, but you notice the floor in the hallway has just been mopped. A lawyer would expect you to be able to foresee that Mr. Jones might fall if he walks on the wet floor.

Invasion of Privacy. There are several different ways a person's privacy can be invaded. For example, breaking confidentiality about a client is an invasion of privacy. So is undressing a client in front of others.

Liability. In legal terms, liability is the same as accountability. Health care workers are held liable for everything they do-or fail to do-while working with their clients.

Libel. To commit libel means to injure another person's reputation by writing something negative about that person. To be considered libel, the statement must be serious and it must be untrue.

Malpractice & Misconduct. Health care professionals, like doctors and nurses, can be charged with malpractice if their actions result in harm to their clients. In the same situation, nurse aides are charged with misconduct.

Negligence. All health care workers can be considered negligent if they fail to use reasonable care during their work with clients. (Care is considered reasonable if it's what the average health care worker would do in the same situation.)

Slander. To commit slander means to injure another person's reputation by saying something negative about that person. Just like libel, the statement must be serious and must be untrue.

Tips for Keeping Things Legal

Never document in a client's record that you didn't have time to do something or that your facility was short staffed. Saying "I was too busy" when asked why you didn't complete a task for a client is not considered a good excuse-even if your workplace was short staffed at the time.

Never "fill in the blanks" in a client's chart with false information-even if a supervisor or coworker tells you to do so.

Any time that you or a client is injured, complete an incident report according to your workplace policy. Remember that some states allow lawyers to read incident reports, so make sure your reports contain only the facts. And, keep the details of any incidents confidential!

Never abandon a client unless you fear for your own immediate safety. If you must leave your client, go to a safe place...and call your supervisor and/or 911 right away.

Be sure you know all the policies and procedures for your workplace-and that you follow them every day on the job. (In the case of a lawsuit, a lawyer will investigate carefully to see if you have followed workplace procedure.)

Linda H. Leekley BS, RN
President, In the Know, Inc.
knowingmore.com knowingmore.com
Do you struggle to provide your nursing assistants with high quality continuing education? With more than 120 inservice topics, In the Know has the solution to nearly any problem facing your nurse aides. (For a more comprehensive discussion of health care law, please check out our inservice "Legal Issues for Nursing Assistants".)
Using our inservices ensures that your CNAs will learn more-and achieve more. As a result, their client care will improve dramatically! And, we stand by the superior quality of our teaching materials with a 60-day money back guarantee. Please visit my website at knowingmore.com knowingmore.com to download a FREE Inservice Topic.