STANDARD COLLEGE OF NURSING

NURSING ETHICS
Course Code: GST 126

Placement: First Year (First Semester)

FOR
BASIC NURSING FIRST YEAR
2024

BY
WAZIRI, Alhaji Musa
August, 2024.
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 Unit I
Ethical Concept in Nursing
1. Value and value clarification
VALUE.
The regard that something is held to deserve; the importance, worth, or usefulness of
something.

CLARIFICATION
An explanation or more details that makes something clear or easier to understand: Some
further clarification of your position is needed.

Values Clarification is an approach that helps clients clarify their goals, priorities and values,
make decisions, and implement changes in their lives. It is not an approach to mental health
counseling by itself, but it can be integrated into many mental health counseling approaches.

2. Morality
Means principles concerning the distinction between right and wrong or good and bad
behaviour. Or the extent to which an action is right or wrong.
Morality is the belief that some behavior is right and acceptable and that other behavior is
wrong.
 Descriptive morality is relative to the culture and individual.
 Normative morality concerns objective questioning of right and wrong, rather than
subjective cultural standards.
What are the 2 features of morality?
Two aspects or aims of morality are distinguished:
a. The need to avoid trouble and ensure appropriate behavior, and
b. Forms of life which involve sharing, and hence require certain basic dispositions as well
as behavior patterns.

3. Ethics/Etiquettes in Nursing
Ethics
The field of ethics, or moral philosophy, investigates theories that can systematically describe
what makes acts right or wrong. Moral philosophy is usually divided into three categories:
i. Meta ethics,
ii. Applied ethics, and
iii. Normative ethics
 Meta ethics investigates where our moral values, language, and principles come
from and what they mean; it is concerned with “what is morality?” rather than
“what is moral?”
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 Applied ethics seeks to apply philosophical tools to examine specific controversial

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issues and provide practical solutions to moral problems.

  Normative ethics investigates the moral standards that regulate right and wrong
conduct. Theories within normative ethics include utilitarianism, consequentialism,
contractualism, virtue ethics, and more.

Value theory
Is concerned with theoretical questions about value and goodness of all varieties, questions
that often cross the boundaries between normative ethics and the meta ethical. It asks how and
why people value something, be it a person, idea, or object; thus both moral and natural goods
are equally relevant to value theory.

Nursing ethics and etiquette revolve around maintaining respect and dignity towards the
patient, attentive listening, maintaining personal boundaries, effective communication,
cooperation with colleagues, and adherence to health and safety guidelines.

Nursing ethics shares many principles with medical ethics, such as beneficence, non-
malfeasance and respect for autonomy. It can be distinguished by its emphasis on relationships,
human dignity and collaborative care.

The Four Main Nursing Ethics.

Nursing ethical principles can be broadly categorized into four major ethical nursing
principles:
 Autonomy: The right to self-determination.
 Beneficence: The promotion of good.
 Justice: Fairness or an equal distribution of benefits.
 Non malfeasance: The avoidance or minimization of harm.

There are four (4) Principles of Nursing Ethics and they are…
 Autonomy. Autonomy in nursing means that patients have the right to make their own
decisions based on their beliefs and values.
The philosophical underpinning for autonomy, as interpreted by philosophers Immanuel Kant
(1724–1804) and John Stuart Mill (1806–1873), and accepted as an ethical principle, is that all
persons have intrinsic and unconditional worth, and therefore, should have the power to make
rational decisions and moral choices, and each should be allowed to exercise his or her capacity
for self-determination. This ethical principle was affirmed in a court decision by Justice Cardozo
in 1914 with the epigrammatic dictum, “Every human being of adult years and sound mind has
a right to determine what shall be done with his own body
 Beneficence. Beneficence in nursing is not as intimidating as it sounds.
. The principle of beneficence is the obligation of physician to act for the benefit of the patient
and supports a number of moral rules to protect and defend the right of others, prevent harm,
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remove conditions that will cause harm, help persons with disabilities, and rescue persons in
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danger. It is worth emphasizing that, in distinction to non malfeasance, the language here is
 one of positive requirements. The principle calls for not just avoiding harm, but also to benefit
patients and to promote their welfare. While physicians' beneficence conforms to moral rules,
and is altruistic, it is also true that in many instances it can be considered a payback for the debt
to society for education (often subsidized by governments), ranks and privileges, and to the
patients themselves (learning and research).
 Justice.
Justice in nursing ethics implies that patients have a right to fair and impartial treatment. This
means no matter what a patient’s insurance status or financial resources may be, or what
gender identification, age or ethnicity they are, they have the right to fairness in nursing
decisions.
 Nonmaleficence.
Nonmaleficence is the obligation of a physician not to harm the patient. This simply stated
principle supports several moral rules − do not kill, do not cause pain or suffering, do not
incapacitate, do not cause offense, and do not deprive others of the goods of life.

Eight (8) Ethics of Nursing

The 8 obtained values in this literature review and their definitional traits are presented
subsequently.

1. Human dignity. Dignity is a complex concept. In academic and legal contexts, it is

typically used in the couplet “human dignity” to denote a kind of basic worth or
status that purportedly belongs to all persons equally, and which grounds
fundamental moral or political duties or rights.
2. Social justice. is the view that everyone deserves equal economic, political and
social rights and opportunities.
3. Altruism. disinterested ( having or feeling no interest in something;
uninterested) and selfless concern for the well-being of others.
4. Autonomy in decision making.
5. Precision and accuracy in caring. In public health the terms accuracy, precision,
validity and reliability mean the following: Accuracy: The degree to which a
measurement
6. Responsibility. the state or fact of having a duty to deal with something or of
having control over someone or the state or fact of being accountable or to
blame for something.
7. Human relationship. the social and interpersonal relations between human
beings and you know Human relations involve mainly communication, self-
awareness, acceptance, motivation, trust, disclosure, and conflict management.
8. Individual and professional competency. It refers to knowledge based on
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personal abilities to achieve, develop and maintain experience, skills, and

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understanding using academic, practical, and interpersonal skills.

 Code of Ethics
Key Takeaways. A code of ethics sets out an organization's ethical guidelines and best practices
to follow for honesty, integrity, and professionalism.
What are the 5 codes of Professional ethics?
It is divided into three sections, and is underpinned by the five fundamental principles of ethics
1. Integrity,
2. Objectivity,
3. Professional Competence and due care,
4. Confidentiality, and
5. Professional behavior.

What are the 4 standards of ethical practice?

All members of Health Professionals have some responsibility to comply and uphold to and
they are:,
a. Competence,
b. Confidentiality,
c. Integrity, and
d. Credibility.
Failure to comply may result in disciplinary action. Maintain an appropriate level of professional
leadership and expertise by enhancing knowledge and skills.

Qualities of a good nurse

1 – Caring and compassion
Many people assume that nurses enter the field because compassion is one of their leading
qualities — but this nursing characteristic isn’t necessarily a given. Many who choose nursing
prioritize the job security of nursing or see it as a career starting point while failing to consider
whether they have the compassion needed to become a good nurse.
But as a nursing quality, compassion makes all the difference to patients. Nurses who show
they truly care about their patients — and how well they perform their jobs — have a greater
likelihood of advancing, making compassion a key indicator for nurse success.

2 – Excellent communication skills

Strong communication skills are an important nurse characteristic. Good nurses rely on the
ability to effectively communicate with other nurses, physicians, and clinicians in other units
and with patients and their families.
Without the ability to interpret and accurately convey critical information, medical errors are
more likely to occur, patients may feel neglected or misinformed, and an entire unit could feel
the impact. By prioritizing great communication skills, nurses provide safer care, which in turn
benefits their patients, their units, and the entire hospital or health system — not to mention
their own long-term
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 3 – Empathy
With nurses caring for perhaps thousands of patients during their careers, it can be all too easy
to become desensitized or forget what it was like to be a nonclinical person. A good nurse is
one who shows empathy for every patient, making a true effort to put themselves in their
patients’ shoes.
By practicing empathy, nurses are more likely to treat their patients as individuals, focusing on a
person-centered care approach rather than strictly following routines and guidelines. When
patients are fortunate enough to encounter this characteristic in a good nurse, it makes for a
far better care experience and healing journey.

4 – Organization and attention to detail

Nurses are undoubtedly under immense pressure as they balance following orders from
physicians with using their own knowledge, skills, and critical judgement to provide the highest
quality patient care. Add to this caring for multiple patients simultaneously, and the possibility
of making an error can seem almost inevitable.
A good nurse knows the stakes are high and that unlike most other industries, they’re
responsible for peoples’ well-being and — more importantly — their lives. Being organized,
accurate, and attentive to details are nursing traits that determine how successful they’ll be in
their role.

5 – Problem-solving skills
While clinical training occurs throughout a nurse’s education, on-the-job training is the most
effective way to develop a nurse’s problem-solving skills. Years of experience help hone this
skill, but good nurses work to improve their problem-solving skills.
Problem-solving skills are essential to nursing, as nurses generally have the most one-on-one
time with patients and are often responsible for making decisions about issues that arise with
their care. Even seemingly small decisions can proactively improve outcomes — or conversely,
cause major adverse impacts if incorrectly made.

6 – Stamina and endurance

The physical demand on nurses is perhaps one of the most underestimated aspects of their
role. In one shift, a nurse lifts an average of 1.8 tons (roughly the weight of a hippo) by lifting
and adjusting patients. Additionally, studies have found that nurses walk an average of four to
five miles per shift.
In an average 12-hour shift, nurses exercise a unique balance of physical and emotional stamina
that few other occupations encounter. This extremely important quality impacts nurses, their
coworkers, and of course, patients. Having sufficient stamina and staying power are important
qualities of a great nurse.

7 – Sense of humor and resilience

To derive satisfaction from such a mentally and physically exhausting role, nurses who can find
time for a laugh are typically more successful. Because nurses encounter varying degrees of
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high-stress situations, taking the opportunity to enjoy the downtime and incorporate a
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 lighthearted attitude can provide a sense of stress relief and ensure their well-being over the
long term.
Having a good sense of humor also helps spread positivity to other nurses, patients, and their
families. A good sense of humor is not only a characteristic of a nurse leader but reminds
patients and their families that nurses are people too and ultimately increases their trust and
openness to sharing feedback and concerns.

8 – Commitment to patient advocacy

The concept of advocacy is a core tenet of health care, from the Hippocratic oath to nearly
every hospital’s mission statement in one phrasing or another — keep patients safe and deliver
the highest quality of care. In other words, be an advocate for patients, with special attention
to their overall safety.
As one of the leading qualities of a nurse, patient advocacy is a mindset that a good nurse must
practice every day with every patient, throughout every stage of the care continuum. Many
patients enter a hospital or healthcare setting feeling disoriented, confused, and unable to
advocate for their own safety. A nurse who empowers patients through education and
engagement will help them get the best care.

9 – Willingness to learn and grow

With constant technological improvements and breakthroughs in science, the healthcare
industry and its workers must successfully adapt. Nurses’ willingness to develop themselves —
and put their new knowledge into practice — is one of the leading traits of a good nurse.
Improvements in educational approaches such as interprofessional training and personalized
learning can help foster successful learning environments, but a good nurse must possess
flexibility and a willingness to learn for them to be truly beneficial. This important skill applies
to nurses of all ages, throughout every stage of their career — from recent graduates to the
highly experienced.

10 – Strong critical thinking

While having the willingness to learn is an important skill, putting that knowledge into
successful practice requires the ability to think critically — especially in high-stress situations. A
nurse with high-functioning critical thinking has one of the most important characteristics of a
professional nurse.
After years of education and training, the ability to apply clinical guidelines and best practices
on the floor depends on a nurse’s capacity for critical thinking, which is quickly noticed by
leadership, other nurses, and ultimately, patients. While this skill can improve over time, it may
come more readily to some nurses than others.

11 – Good time management

Balancing multiple patients, stressful care settings, and competing priorities is no small feat
during a 12-hour shift. Having effective time management is a key personality trait for nursing,
as is being able to concentrate on the most critical issues first — and not necessarily the most
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demanding patient or family.

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 Setting time aside for self-care is also a crucial component of time management. Neglecting to
take a quick break or regroup during an especially intense shift won’t benefit anyone involved
in the care process.

12 – Integrity and leadership

While most nurses approach their careers with patient care in mind, some will eventually
transition into leadership roles. Unfortunately, it’s all too common for a promotion to happen
without adequate training, development opportunities, or sufficient mentoring and support to
achieve the level of professionalism and ethics that good leadership requires.
The ability to lead is a quality that continues to become more valuable in nursing and is not
limited to individuals who are in leadership roles. Exercising leadership skills in any role or level
shows that a nurse can serve as a model of integrity and effectiveness for others. Being a
mentor in any capacity helps others become better nurses and benefits both the organization
and the nursing profession itself.

13 – Experience
It’s important to note that as veteran nurses leave the healthcare field and begin retirement,
they’re taking with them years of experience and knowledge that cannot be quickly replaced.
As nursing leaders work to bring in new nurses, available candidates are predominantly new
graduate nurses — a stark contrast to their predecessors in terms of experience and the many
patient care skills and knowledge that can only come with time and practice.
By engaging with new nurses to instill an expectation of continuous learning — while creating a
positive environment for them to learn from experienced nurses without fear of judgment —
nursing leaders can set new nurses up for success, benefiting their careers, the organization,
and most importantly — their patients.
14 – Cultural sensitivity and awareness
With today’s diverse patient populations, every nurse needs to understand the importance of
being culturally inclusive of others. Communication, customs, and expectations for medical
treatment may vary depending on patients’ cultural backgrounds. A good nurse takes these
factors into consideration when treating patients to better understand their needs and provide
culturally sensitive care..

Other sought-after personality traits of a nurse include:

 Being even-tempered, hardworking, and flexible
 Displaying a sense of humor
 Practicing self-care
 Demonstrating leadership skills

Work attitude
Work attitudes are the feelings we have toward different aspects of the work environment. Job
satisfaction and organizational commitment are two key attitudes that are the most relevant to
important outcomes.
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 Various Examples of Job Attitude
 Job Satisfaction.
 Work Engagement.
 Organizational Commitment.
 Job Involvement.
What is Job Attitude in the context of Business Studies?
a. Job Attitude is an employee's ability to perform their assigned tasks without any
errors. It is purely performance-based and doesn't involve any cognitive or affective
components
b. Job Attitude is defined as an employee's set of evaluations about their job, focusing
on their work environment, colleagues, supervisors, and job satisfaction. It
encapsulates both cognitive and affective components and influences the
performance and satisfaction levels in a workspace.
c. Job Attitude refers only to the physical aspects of a job like the workspace location
and availability of resources. It doesn't include emotional or cognitive evaluations.
d. Job Attitude concerns only the employee's relationship with the supervisor. It
doesn't impact the overall productivity or satisfaction levels in a workspace.

Ethical dilemma and model of resolving ethical dilemma.

An ethical dilemma is a type of ethical issue that arises when the available choices and
obligations in a specific situation do not allow for an ethical outcome. In such instances, a
choice or an action is required and all of the available alternatives violate an explicit ethical
principle or guideline. This should not be confused with ignorance of what is ethical or with the
discomfort that often comes from having to make difficult ethical decisions. It also bears
mentioning that ethical dilemmas are essentially unavoidable when working with others that
maintain different moral foundations or ethical obligations, or when serving in multiple roles
with diverse obligations.

Ethical dilemmas commonly occur along one of the following themes:

(1) Truth v. Loyalty: Choosing between maintaining personal integrity or keeping fidelity
pledged to others (e.g., friends, family members, co-workers, employers, and organizations).
(2) Individual v. Group: Choosing between the interests of an individual, or a few, and those of
a larger community.
(3) Immediate v. Future: Choosing between present benefits and those that that are long-
term.
(4) Justice v. Compassion: Choosing between fair and dispassionate application of
consequences and the individual need or warrant for charity.

Resolving ethical dilemmas

Consider this three-step process for solving an ethical dilemma:
(1) Analyze the consequences;
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(2) Analyze the actions;

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(3) Make a decision.

 Unit II
Regulation of Nursing
The Nursing Profession is Regulated by Nursing and Midwifery Council of Nigeria
Nursing and Midwifery Council of Nigeria Act.
The Nursing and Midwifery Council of Nigeria (abbr. NMCN), is the sole governing body that
regulates all cadres of nurses and midwives in Nigeria. It was established by government decree
in 1979, and re-established as a Parastatal by the government of Nigeria by Act Cap. No 143
Laws of the Federation of Nigeria, 2004.

The Structure of Nursing and Midwifery Council of Nigeria.

The Council is structured around four themes – prioritized people, practice effectively, preserve
safety and promote professionalism and trust, headed by a Secretary General/Registrar and is
assisted by other professionals and non-professional staff. They are responsible to a Board
headed by a Chairman with 19 members drawn from various aspects of Nursing from
institutions and zones in the country. Appointed by the Federal Government, on the
recommendations of the Federal Ministry of Health. The Council has four major departments,
namely,
1. Education Inspectorate,
2. Planning,
3. Research and Statistics,
4. Human Resources /Finance & Accounts.

With the Vision;

To be the foremost regulatory Council with the best Nursing and Midwifery Professionals in the
world.

The role of the Nursing and Midwifery Council.

Is to advise the Minister for Health on matters relating to the training and practice of nursing
and midwifery; monitor and inspect training institutions and health facilities in collaboration
with the Health Facilities Regulatory Agency; and. perform any other functions that are ancillary
to the object of the Council.

FUNCTION
The primary objectives of the Nursing and Midwifery Council of Nigeria are to ensure high
quality of Nursing and Midwifery education in Nigeria, maintain high standard of professional
nursing and midwifery practice and enforce discipline within the profession.
Broadly, the Council’s functions are related to those of designing, implementing and evaluating
various nursing and midwifery educational programmes, of indexing, examination, registration,
certification, licensure of professional nurses and midwives and monitoring standards of
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nursing and midwifery practice in the Country.

Specifically, the Council’s functions are as follows:
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1. Index all categories of nursing and midwifery students on commencement of their training.
 2. Develop and review periodically, the different curricula utilized for the education of all
categories of Nurses and Midwives.
3. Co-operate with recognized bodies interested in conducting new schemes for Basic and Post
Basic Education of Nurses and Midwives such as: National Universities Commission, World
Health Organization, etc.
4. Accredit all training institutions and clinical practice areas utilized for the education of all
categories of Nurses and Midwives in Nigeria.
5. Conduct Professional Examinations for all categories of Nurses and Midwives in Nigeria.
6. Establish and maintain Registers of all persons qualified to practice the discipline of Nursing and
Midwifery in Nigeria.
7. Conduct Registration interviews for Nurses and Midwives trained outside Nigeria who are
seeking to practice in Nigeria.
8. Issue and update Professional Practicing Licenses every three years to all cadres of qualified
Nurses and Midwives.
9. Issue Professional Certificates to all cadres of Nurses and Midwives at the end of their training.
10. Revoke and/or Restore Professional Certificates as applicable.
11. Determine and maintain standards of knowledge and competencies in Nursing and Midwifery
Education and Practice in Nigeria.
12. Organize and Conduct Mandatory Continuing Professional and Educational Development
Programmes for all cadres of Nurses and Midwives.
13. Conduct and Promote Research in relevant areas of Nursing and Midwifery.
14. Maintain discipline within the Nursing and Midwifery profession in Nigeria through the Nurses
and Midwives Tribunal.
15. Prosecute illegal Training Institutions.
16. Regulate and control the practice of Nursing and Midwifery in all its ramifications.

Rights and responsibilities of a nurse

Nurses provide mental and physical health care and wellness services while maintaining respect
for human dignity and delivering equitable, patient-centered care regardless of race, origin, or
background.
Some Important Responsibilities of Nurses
1. Safe patient handling
2. Medication Administration
3. Recording medical information
4. Changing bandages and wound dressings
5. Patient education
6. Collaborate with other health care providers
7. Nurses Bill of Rights
8. Operate medical equipment
9. Be treated with dignity and respect
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10. Checking medical protocols

11. Interpreting care plans
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12. Patient assessment

 13. Provide basic bedside care
14. Serve as a patient advocate
15. The right to confidentiality

Human rights and Patient's bill of rights

As a patient, he has the right to:

1. Receive complete and current information concerning your diagnosis, treatment, and
prognosis in terms you can be reasonably expected to understand
2. Request a second opinion from another physician.
3. Participate actively in determining a course of treatment for yourself.
4. Determine the course of medical treatment for yourself and, if you are a pregnant
woman, for your fetus. It is the policy of this hospital that your doctor must consider
your health and the health of your fetus in assessing the range of medically reasonable
treatment options. Our physicians are committed to providing you with information to
help you evaluate the risks and benefits of both to you and your fetus of any
recommended treatment or course of care.
5. Receive information that you need to give informed consent for any proposed
procedure or treatment including information related to the risks, benefits and
alternatives to the proposed procedure or treatment in light of your condition and
current medical knowledge.
6. Refuse treatment and be told what effect this may have on your health, and to be
informed of the other potential consequences of refusal.
7. Receive considerate and respectful care in a clean and safe environment.
8. Refuse to take part in research.
9. Know by name the physicians, nurses, and other staff members responsible for your
care.
10. Have privacy while in the hospital and confidentiality of all information and records
regarding your care.
11. Have language-interpreter services arranged by the hospital.
12. Examine and receive an explanation of your bill.
13. Limit those persons who visit you.
14. Receive equal treatment at all times and under all circumstances, regardless of race,
color, religion, national origin, sex, age, marital status, personal appearance, sexual
orientation, veteran status, family responsibilities, disability, infectious disease,
matriculation, political affiliation, source of income or place of residence or business. For
more information regarding the hospital's policy on discrimination, please refer to the
nondiscrimination policy.
15. Be advised should the hospital propose to initiate court proceedings pertinent to your
course of treatment.
16. Designate an individual to represent you in making decisions regarding your treatment
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and health care. Please ask your nurse for a copy of our brochure, Making Your Medical
Choice Known, and our advanced directive form.
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 Your Responsibilities
Also individuals, has the responsibilities to adhere to the rules and regulations pertaining to
patient conduct are necessary to ensure that all patients are treated fairly and feel secure while
in the hospital. Your cooperation in these responsibilities will help us provide quality care and
services. Good communication promotes good care. Talk to our staff and ask questions.
1. Please cooperate with your caregivers and follow the plan of care upon which you, your
physician, and your health care team have agreed
2. We ask that you respect the privacy and rights of others by cooperating in our non-
smoking policy and regulations regarding noise and the number of visitors you receive.
The hospital maintains a case manager to answer questions about patients' rights, provide
information and referrals, solve problems, investigate complaints and act as your advocate. To
reach the patient representative.

Professionalism; National and International (NANNM)

Professionalism in nursing means providing top-quality care to patients, while also upholding
the values of accountability, respect, and integrity.
Nursing and Midwifery Council (NMC) stands with professionalism as;
You uphold the reputation of your profession at all times. You should display a personal
commitment to the standards of practice and behaviour set out in the Code. You should be a
model of integrity and leadership for others to aspire to.

Association of Nurses
National Association of Nigeria Nurses and Midwives (NANNM)
Professional bodies that formed the NANNM
1. The Professional Association of Trained Nurses of Nigeria,
2. The Professional Association of Midwives of Nigeria,
3. The Professional Association of Public Health Nurses,
4. The Professional Association of Psychiatric Nurses
5. The Professional Association of Industrial Nurses.

The difference between NMCN and NANNM

The NMCN safeguards quality by setting and enforcing standards for education and practice.
The NANNM, on the other hand, champions the rights, well-being, and professional
development of nurses and midwives. Together, they ensure a strong foundation for the
nursing and midwifery workforce.
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 Unit III
The Legal Aspect of Nursing.

Legal roles of the Nurse as Legislated in Nigeria

 As Provider of Service.
Nurses are trained to detect and report significant symptoms and reactions.
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.
 Assessment and Monitoring: Nurses must continuously assess and monitor
patients' health conditions.
 Documentation: Accurate and thorough documentation of patient care is crucial.
 Communication: Effective communication is essential in nursing.

As Employer
Nurses are a mandated reporter, which means all Nurses have a legal
responsibility to report any suspected abuse or neglect of vulnerable individuals.
Nurses must be vigilant and learn to recognize signs of abuse or neglect in
children, the elderly, or other vulnerable populations.

As Private citizen
Nurses are responsible for being aware of public and private laws that affect
client care, as well as legal actions that can result when these laws are broken.
Laws are generally classified as public or private law.

Nursing Legislation in Nigeria.

The current legislation governing nursing in Nigeria is the NMCN Act of 1979.
This Act outlines the functions, powers, and composition of the NMCN. It also
provides for the registration and licensing of nurses and midwives. The Act
mandates the council to monitor and enforce standards of nursing education.

Nursing Practice Act

It was established by government decree in 1979, and re-established as a
Parastatal by the government of Nigeria by Act Cap. No 143 Laws of the
Federation of Nigeria, 2004. The Council maintains standards of practice, and
enforces discipline within the Nigerian nursing profession.

Decree No. 89 of 1979 and amended decree No. 54 of 1988, No. 18

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of 1989.
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 The Nursing and Midwifery Council of Nigeria (N&MCN) (Established by Decree
No 89 of 1979) is the regulatory Body of the Nursing Profession in Nigeria. It is
concerned with Nursing Education, Registration and Practice.

The renewal of license by the Council is supported and enforced by

section 5 of the Amended Decree 54 of 1988 which categorically stipulates that
“No Nurse shall be allowed to practice or continue to practice in any year except
such a Nurse has paid Licensing fees as prescribed by the Council”.

Common Offences
The most common charges brought against nurses Includes:.
a. Substance abuse,
b. Incompetence, and
c. Negligence.
A nurse can be charged with incompetence if something was done that
could or did harm a patient, such as a Medication error. Discrimination,
Defamation, and libel are not common charges against nurses.

Implications In Nursing
Legal issues related to nursing are jurisprudence, ethical implications, and
negative charges that can occur from inadequate nursing practices. If a nurse
neglects to fulfill their duty or tries to act outside of their scope of practice, they
can be charged with incompetence, negligence, or malpractice.

Tort
A tort is an act or omission that gives rise to injury or harm to another and
amounts to a civil wrong for which courts impose liability.
But in general, know that a “tort” is a fancy way of saying
“malpractice.” Medical torts are triggered when a healthcare professional or
organization causes patient injury. The aggrieved party files a suit and asks for
compensation due to the damage.

Negligence
Negligence is the failure to behave with the level of care that a reasonable
person would have exercised under the same circumstances. Either a person's
actions or omissions of actions can be found negligent.
Negligence is a failure to exercise appropriate care expected to be exercised in
similar circumstances. Within the scope of tort law, negligence pertains to harm
caused by the violation of a duty of care through a negligent act.
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 Malpractice
Malpractice: Negligence, Misconduct, lack of ordinary skill, or a breach of duty in
the performance of a professional service (as in medicine) resulting in injury or
loss
In the law of torts, malpractice, also known as professional negligence, is an
"instance of negligence or incompetence on the part of a professional

Assault and battery

In the terminology of law, an assault is the act of causing physical harm or
unwanted physical contact to another person, or, in some legal definitions, the
threat or attempt to do so. It is both a crime and a tort and, therefore, may
result in criminal prosecution, civil liability, or both.
Assault refers to the wrong act of causing someone to reasonably fear
imminent harm. This means that the fear must be something a reasonable
person would foresee as threatening to them. While Battery refers to the actual
wrong act of physically harming someone.

Example of a battery
Essentially, it's any unwanted or unwelcome contact from another person. This
can include pushing, shoving, spitting, hugging, touching, or even kissing. Even
the act of creating a threatening environment can count as battery, depending
on the jurisdiction.

False Imprisonment
False imprisonment or unlawful imprisonment occurs when a person
intentionally restricts another person's movement within any area without legal
authority, justification, or the restrained person's permission. Actual physical
restraint is not necessary for false imprisonment to occur.

Invasion of Privacy
What is considered an invasion of privacy?
Someone intruded into your private affairs, isolation, or solitude without your
consent or approval; and. A reasonable person would think the intrusion is
objectionable.

Patient privacy encompasses a number of aspects.

 Including personal space (physical privacy).
 Personal data (informational privacy),
 Personal choices including cultural and religious affiliations
(decisional privacy). and
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 Personal relationships with family members and other intimates

(associational privacy).
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 Examples of invasions of privacy regarding medical information may include:
 Sharing the results of a test in front of family members or other patients
without your permission.
 Taking pictures of an undressed patient under anesthesia.

Vicarious Liability
Vicarious liability is when a supervisory party is liable for the negligent
actions of a third party for which they are responsible. Employers have a strong
chance of avoiding vicarious liability by proactively exercising reasonable care to
prevent employees' negligent behavior.

Direct liability holds the person who committed the wrongful act liable for his or
her conduct. In contrast, vicarious liability holds a principal, who did not
personally engage in any wrongful conduct, liable for the actions of another who
engaged in the wrongful conduct.

For Example.
An employer can be held vicariously liable for the negligence of its employees.
This means that if an employee is negligent and causes injury to someone, the
employer can be held responsible. Another example is when an employee
commits a crime.

Infringement of patient's right

Patient have the right to:-
Be treated with respect, regardless of gender, race, religion, ethnicity, disability,
economic circumstances or allegations of crimes.. Relevant information in a
language and manner the patient understands.

Section 20 of the National health Act 2014.

1. Health care provider, health worker or health establishment shall not refuse a person
emergency medical treatment for any reason.
2. A person who contravenes this section commits an offence and is liable on conviction to a
fine of N100, 000.00 or to imprisonment for a period not exceeding six months or to both.

Patient Rights That are Most Often Violated.

The most common examples of patient rights violations go against the Professional Ethics of
Regulations for Patients’ Rights in Skilled Nursing Facilities. Here are some examples:

 Understaffing (considered a primary cause of patient rights violations).

 Failure to provide quality care and proper nursing services.
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 Failure to adequately educate patients and help them make informed decisions about their
treatment plans.
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 Failure to protect a patient against abuse from healthcare providers or other patients.
  Disrespecting patients and refusing to treat them with dignity (this snowballs into abysmal
services, like neglecting to change dirty beddings, clean a patient’s room, administer medication
on time, or give the elderly or bedridden patients a bath or change of clothes).
 Mistreating a patient because of their ethnicity, gender identity, country of origin, etc.
 Disregarding a patient’s requests and claiming that they are making hysterical demands.
 Administering unnecessary psychotropic medications like antidepressants, antipsychotics, and
stimulants without medical supervision or the patient’s or family’s express consent.

Criminal offences
Negligent nursing errors can result in criminal charges for assault, neglect, or negligent
homicide. In some jurisdictions, negligent homicide is known as involuntary manslaughter.
These crimes are usually lower level felonies or higher level misdemeanors, depending on the
jurisdiction.
Common criminal offences includes
Malpractice
Fraud
Invasion of privacy
Assault
Defamation
Drug-related
Rape
Battery
Nursing malpractice
Patient confidentiality

Manslaughter
The crime of killing a human being without malice aforethought, or in circumstances
not amounting to murder.

Some involuntary manslaughter examples are as follows:

 Texting while driving, resulting in the death of a pedestrian.
 Giving drugs or alcohol to a teenager who overdoses and dies.
 Punching someone, who then dies of a facial or head injury due to the severity of the blow.

Infanticide
Infanticide is the intentional killing of infants or offspring. Infanticide was a widespread practice
throughout human history that was mainly used to dispose of unwanted children, its main
purpose being the prevention of resources being spent on weak or disabled offspring.
The crime of killing a child within a year of its birth (in some legal jurisdictions, specifically by
the mother).
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"Cases of infanticide often involve extreme emotional disturbance"

The practice in some societies of killing unwanted children soon after birth.
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"Female infanticide was practiced to reduce the population in times of famine"

 Latent errors and active failures
Active failures are those errors which traditionally have been described as human error - driver
error and pilot error being typical examples. Latent Failures - these are decisions and actions
that dormant in an organization for some time until revealed by active failures.
Latent errors (or latent conditions) refer to less apparent failures of organization or design
that contributed to the occurrence of errors or allowed them to cause harm to patients.

Latent errors are the ones inherent in the system (system design, administrative
decisions, quality of equipment and supplies, etc.). Active error is the actual event that results
in harm/causes catastrophe. (Faulty ventilator is a latent error.

Legal Safeguards in Nursing practice

This legal protection means that as long as nurses carry out their nursing practices in
accordance with service standards, professional standards, standard operating procedures and
applicable laws and regulations, then they may not be arbitrarily arrested or imprisoned by law
enforcement or required to compensate for any loss of damages.

Record keeping
Commonly Record-keeping. The act or practice of recording important information for future
reference : The act of keeping records.

Good record keeping can be your proof that you have made considered decisions and taken
appropriate actions. Records become your protection if you are questioned or challenged.
Without them, you are at risk. Good record keeping can not only protect you but can support
your organization in legal or other challenges.

Incident Report.
An incident report is a formal written document that serves as a reference when an unexpected
event or accident occurs. This event could result in injury, damage to property, or work
interruptions.
In a health care facility, such as a hospital, nursing home, or assisted living, an incident report or
accident report is a form that is filled out in order to record details of an unusual event that
occurs at the facility, such as an injury to a patient.

Provision of competent care.

They must practice autonomously and be responsible and accountable for safe, compassionate,
person-centered, evidence-based nursing that respects and maintains dignity and human rights.
They must show professionalism and integrity and work within recognized professional, ethical
and legal frameworks.
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 Good Samaritan Act.
What is the purpose of the Good Samaritan acts?
The Good Samaritan Law offers legal protection to individuals who render aid to any injured
person. The goal of Good Samaritan Laws is to encourage citizens to help one another without
fear of a lawsuit providing reasonable care.

Professional Liability.
Professional liability insurance covers claims arising from errors, mistakes, or negligence in the
delivery of professional services. For example, if a consultant provides advice those results in
financial loss for a client, the consultant may be held liable for the resulting damages.

Indemnity Insurance
Indemnity is a comprehensive form of insurance compensation for damages or loss. In a legal
sense, it may also refer to an exemption from liability for damages. The insurer promises to
make the insured party whole again for any covered loss in exchange for premiums the
policyholder pays.
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