Professional Liability Insurance for Nurses

							Legal and professional issues.
Learning Outcomes

 The attendees will be able to describe a number of
  legal and professional areas for consideration when
  employed as a practice nurse.

 The attendees will be able to describe how to
  access the Competency Standards for Nurses
  working in General Practice.
    Legal and professional issues: Considerations

   Licensure
   Scopes of practice
   Supervision of the Enrolled Nurse ( Div. 2)
   Competency standards
   Codes of Ethics
   Codes of Professional Conduct
   Other relevant legislation
Scope of Nursing Practice
 The scope of nursing and midwifery practice
  is that which nurses and midwives are
  educated, competent and authorised to
  perform. The actual scope of an individual
  nurse’s or midwife’s practice is influenced
  by:
  – The context in which they practice the client’s
    health needs;
  – The level of competence, education and
    qualifications of the individual nurse or midwife;
    and
  – The service provider’s policies
Competency Standards for nurses in General
Practice
 Nurses use competency standards as their
  professional framework against which to measure
  performance and prepare a professional
  development plan so that competence is maintained
  and enhanced.

 Nurse regulatory authorities in each state and
  territory use competency standards to determine
  the eligibility of people applying for a licence to
  practice as a nurse and to assess nurses required to
  demonstrate continuing competence.
Competency Standards for nurses in General
Practice
REGISTERED NURSE ( Div.1):
 ANMC national competency standards for the registered nurse;
 Competency standards for the registered nurse in general
  practice;
 Competency standards for the advanced registered nurse;
 Competency standards for the nurse practitioner.

ENROLLED NURSE (Div. 2):
 ANMC national competency standards for the enrolled nurse;
 Competency standards for the enrolled nurse in general
  practice;
 Competency standards for the advanced enrolled nurse.
www.anf.org.au/nurses_gp
What is a Professional Portfolio?

 A professional portfolio is a comprehensive record
  of your professional roles.
 It is updated on an annual basis at the minimum.
 A professional portfolio is a confidential document
  although you can use copies of some of the
  information when applying for a new position or a
  pay increase, applying to undertake some further
  education, or when audited by the nurse regulatory
  authority for the purposes of continuing
  competence.
Code of Ethics for Nurses in Australia

 Identify the fundamental moral commitments of the
  profession;
 Provide nurses with a basis for professional and self
  reflection on ethical conduct;
 Act as a guide to ethical practice; and
 Indicate to the community the moral values which
  nurses can be expected to hold.
Code of Professional Conduct for Nurses in
Australia

 The nursing profession expects that nurses will
  conduct themselves personally and professionally in
  a way that will maintain public trust and confidence
  in the profession.

 Nurses have a responsibility to the individual,
  society and to the profession to provide safe and
  competent nursing care which is responsive to
  individual group and community needs, and the
  profession.
Code of Professional Conduct for Nurses in
Australia

 Set of expected national standards of conduct for
  the nursing profession;
 Identifies the minimum requirements for conduct in
  the profession;
 Informs the community of the standards for
  professional conduct of nurses in Australia; and
 Provides consumer, regulatory, employing and
  professional bodies with a basis for decisions
  regarding standards of professional conduct.
 Code of Professional Conduct for Nurses in
 Australia
STATEMENT 1
     A nurse must practise in a safe and competent manner.

STATEMENT 2
     A nurse must practice in accordance with the agreed standards
     of the profession.

STATEMENT 3
     A nurse must not bring discredit upon the reputation of the
     nursing profession.
 Code of Professional Conduct for Nurses in
 Australia
STATEMENT 4
     A nurse must practise in accordance with laws relevant to the
     nurse’s area of practice.

STATEMENT 5
     A nurse must respect the dignity, culture, values and beliefs of
     an individual and any significant other person.

STATEMENT 6
     A nurse must support the health, well being and informed
     decision-making of an individual.
 Code of Professional Conduct for Nurses in
 Australia
STATEMENT 7
     A nurse must promote and preserve the trust that is inherent
       in the privileged relationship between a nurse and an
       individual and respect both the person and property of that
       individual.

STATEMENT 8
     A nurse must treat personal information obtained in a
     professional capacity as confidential.

STATEMENT 9
     A nurse must refrain from engaging in exploitation,
     misinformation or misrepresentation in regard to health care
     products and nursing services.
Insurance for Nurses in General Practice

   Vicarious liability
   Professional indemnity
   Workers’ compensation
   Legal fees
   Income protection
   Accident or injury
Ongoing licensure requires that you:

 practice within your scope
 practice competently
 practice in accordance with your code of ethics
 practice in accordance with your code of
  professional conduct
 practice within a legislative framework.
The Nurse as an employee

 Employers are legally responsible for an employee’s
  negligence, based on the principle of vicarious
  liability. Under this principle, an employer is legally
  liable for the negligent acts and omissions of its
  employees where those acts and omissions arise
  from or occur in the scope and course of the
  employment relationship.

 It is important to understand that the principle of
  vicarious liability does not absolve the nurse
  working in general practice from responsibility or
  remove their legal exposure.
The Nurse as an employee
 On rare occasions the employer may seek to recover
  costs from a nurse employee or join them in legal
  action in relation to a medical negligence claim, or
  very rarely, the patient and the patient’s lawyers
  may decide to sue the nurse alone, or may sue the
  nurse as well as the employer.

 The nurse working in general practice may also face
  exposure additional and unrelated to the
  prosecution of a claim for compensation. For
  example, they may face disciplinary proceedings or
  may have their management investigated by the
  coroner.
The Nurse as an independent contractor
 The principle of vicarious liability does not apply in
  this instance. If the nurse is an independent
  contractor from a Nursing Agency, Division of
  General Practice or similar and is not an employee
  of a general practice, liability for any negligent act
  by a nurse lies with that nurse. A nurse who is an
  independent contractor should therefore obtain
  his/her own professional indemnity cover and the
  practice who has engaged the nurse should ensure
  that the nurse has this cover.
Practice considerations
 If a patient is harmed, or is allegedly harmed, as a
  result of the negligent acts or omissions of a nurse
  working in general practice, the general
  practitioners legal responsibility in part depends on
  whether the practice nurse is:
   – An employee of the practice; or
   – An independent contractor.

 The distinction between these two, while often
  clear, can sometimes be quite difficult to make.