Table of Contents
Contributors xi
Foreword Penny Brooke xiii
Preface xvii
1 Law as a Partner in the Expansion of Advanced Practice Nursing Roles Diane Kjervik 1
Roles and Privileges 2
Standard of Care 2
Unintentional Acts (Negligence) 2
Intentional Acts 9
Expertise and Courtroom Testimony 10
Hospital and Prescriptive Privileges 11
Relationships Between APNs and Physicians 13
Antitrust 13
Noncompete Clauses 14
Insurance/Third-Party Payment 15
Supervision by Physicians 16
2 The Interface of Nursing Law and Ethics Diane Kjervik 25
Common Ethical Frameworks 26
Deontology 26
Consequentialism (Teleology) 27
Casuistry 27
Communitarianism 28
Ethic of Care 28
Virtue Ethics 28
Ethical Underpinnings of Legal Analysis 29
Promoting Patient Autonomy 30
APN Autonomy 31
Choice and Finance 32
Justice and Vulnerable Populations 33
Sources of Ethical Conflict 35
Access to Care 35
End of Life 35
Beginning of Life 36
Adolescents 36
Refusal of Treatment 37
Privacy and Confidentiality 38
Violence 38
Consequences of Ethical Conflict 39
APN Self-Reflections and Actions 39
3 Policy Changes Affecting Advanced Practice Diane Kjervik 47
Regulatory Models for Advanced Practice Registered Nurses 48
Whistleblowing 49
APN Compliance With State Law 51
Billing Issues 51
Retail Clinics 52
Evolving APN Practice and Educational Reform 54
Opportunities for Growth 55
4 Malpractice/Negligence Edith Ann Brous 59
Introduction 59
Background 60
Negligence and Malpractice 63
Elements of a Claim 65
Duty 65
Duty to Third Parties 69
Breach 72
Causation 73
Harm 83
Expert Testimony 85
Foreseeability 92
Causes of Action 93
Theories of Liability 95
Professional Liability Insurance 99
Types of Policies 99
Common Misconceptions 100
Collateral Impact 102
Reducing Exposure 103
Interpersonal Skills 103
Documentation 103
Insurance 104
5 Labor and Employment Issues Edith Ann Brous 109
Introduction 109
Employment Relationships 110
Employees 110
Employment-at-Will 111
Contractual Employment 111
Independent Contractors 111
Determination of Worker Classification 112
APNs' Rights as Employees 115
Department of Labor 115
APNs as "Supervisors" 128
Equal Employment Opportunity Commission 132
Title VII of the Civil Rights Act of 1964 132
Americans With Disabilities Act of 1990 133
Rehabilitation Act of 1973 134
Age Discrimination in Employment Act of 1967 135
Equal Pay Act of 1963 136
Civil Rights Act of 1991 139
APNs as Contractors 139
Contract Basics 140
Collaborative Practice Agreements and Nurse Practice Act Considerations 143
Terms 143
Negotiation Tips 144
6 Licensure and Regulation Edith Ann Brous 149
Introduction 149
Background 150
Board Structure 150
Board Authority 151
Board Function 152
Scope of Practice 154
Delegation 158
Licensure 161
Complaint Resolution 162
Professional Misconduct/Unprofessional Conduct 167
Appealing Board of Nursing Decisions 169
Legal Disability 173
Collateral Implications 174
7 Nursing and Law Pedagogy for Advanced Practice Nurses Diane Kjervik 179
Law and Nursing Theory 180
Teaching Strategies to Incorporate the Law into Advanced Practice Nursing Programs 183
Research Approaches for Understanding the Law and Advanced Practice Nursing Roles 185
8 International Law and Nurses Edith Ann Brous Gina Raineri Bernain 191
Introduction 191
Sources of Law 193
Civil Law 193
Common Law 194
Mixed Jurisdictions 194
International Issues 195
Recruitment 195
Danger 198
The Chilean Perspective 200
Solutions 202
Conclusion Diane Kjervik Edith Ann Brous 207
Future Roles and Opportunities for APNs 207
Potential Legal Challenges to APN Practice 208
Table of Cases 211
Index 215
