LEGAL ASPECT OF

NURSING
The aim of this unit is to introduce the Enrolled Nurse
(EN) to some legal and ethical concepts that are relevant
to the practice of nursing.

While the concepts of nursing ethics are generally

universal, the nurse needs to be aware that the law is
different between countries and can be different between
states and territories.

Where the nurse resides and practices determines the

legal knowledge required. Further reading on these
matters is necessary for safe and competent practice.

To this end, I can say categorically clear that nursing is a

highly responsible job.
As nurses, we work in situations that give us a privilege
in working with individuals, family and community
including care of their physical and emotional needs.

The laws define the boundaries of that privilege and

make clear what nurses’ rights and responsibilities are.

As long as we (nurses) keep this in mind and follow these

laws, then we would always be giving the clients we are
caring for the best care within our scope of practice.

In a democratic society the legal system provides a

framework inside which all sections of the community
interact.
It establishes the rights and privileges of the individual
and makes provision for enforcement of rights and
redress for wrongs suffered.

All citizens should be aware of their legally defined rights

and responsibilities, and should have an understanding of
the laws that govern their personal and professional lives.
Ignorance of a law is not accepted as an excuse for
violation of that law.

Nurses have legal responsibilities common to all

members of the community, and also the responsibilities
imposed by the nature of their work, which may be
defined as responsibilities in respect of:

 The provision of safe effective nursing care

 The health of the community
 The employing authority
 The nursing profession.

LEGAL ROLES OF THE NURSE/MIDWIFE AS A;

Provider of Service
Nurses and midwives, as service providers, have legal
responsibilities related to competence, safety, and
patient information.

They are legally bound to provide competent care, ensure

patient safety, and inform patients of alternative
treatment options.
Furthermore, their actions as employees must adhere to
their employment contracts, and as citizens, they must
uphold patient rights and follow ethical guidelines.

Midwives, in particular, are considered independent

medical professionals regulated by law, requiring
continuous learning and professional development.

Key Legal Responsibilities

Competent and Safe Care
Nurses and midwives are legally obligated to provide care
within their scope of practice and according to their
training, ensuring patient safety and well-being.

Informed Consent and Patient Rights

They must obtain informed consent from patients,
explaining treatment options and potential risks, and
protect patient autonomy and rights.

Confidentiality
Maintaining patient confidentiality is a crucial legal and
ethical responsibility.

Documentation
Accurate and complete documentation of patient care is
legally required.

Adherence to Employment Obligations

Nurses and midwives must fulfill their contractual
obligations with their employers.
Ethical Conduct
Upholding ethical principles, such as honesty, integrity,
and advocacy for patients, is essential.

Scope of Practice
Nurses and midwives are expected to practice within
their defined scope of practice, as outlined by
professional organizations and regulatory bodies.

Collaboration
Collaboration with other healthcare professionals,
particularly in emergency situations, may be required.

Specific Considerations for Midwives

Independent Practice
In some jurisdictions, midwives have the authority to
practice independently, making decisions about patient
care without direct supervision by a physician.

Autonomous Practice
Midwives are often considered primary care providers,
meaning they can be the initial point of contact for
patients in the healthcare system.

Regulation and Licensure

Midwifery practice is regulated by laws and regulations,
requiring professional training and certification.

Role in Childbirth
Midwives play a crucial role in providing care during
pregnancy, labor, and delivery, often with a focus on
natural childbirth and empowering women.

An Employer
As an employer, a nurse or midwife in Nigeria must
adhere to labor laws, including those regarding
employment contracts, wages, working conditions, and
employee rights.

They are also legally responsible for ensuring a safe and

healthy work environment for their employees and for
complying with the Nursing and Midwifery Council of
Nigeria's code of conduct.

Key Legal Responsibilities as an Employer

Employment Contracts
A contract is an agreement between parties that is legally
enforceable because of mutuality of agreement and
obligation.
A contract gives rise to rights and obligations that are
protected and enforced by the law.

A contract may be in writing or it may arise by

implication, such as the agreement that is reached
between a client and a health care agency to which they
are admitted.

While the client is not required to sign a document, they

will have entered into a contract as to the nature and
extent of their proposed treatment. Private clients enter
into a contract with their medical officer.

Employers must enter into employment contracts that

clearly outline the terms and conditions of employment,
including wages, hours, duties, and benefits, according to
the Nigerian Labour Act.

Wages and Salaries

Employers must adhere to the minimum wage laws and
pay employees their wages and salaries in a timely
manner, as per the Nigerian Labour Act.

Working Conditions
Employers must ensure that the workplace is safe and
healthy, providing adequate facilities, equipment, and
resources for employees to perform their duties,
according to Nigerian Labour Act.

Employee Rights
Employers must respect the rights of their employees,
including the right to organize, join unions, and bargain
collectively.

Non-Discrimination
Employers must not discriminate against employees on
the basis of race, religion, gender, age, or other protected
characteristics.

Code of Conduct
Employers must ensure that their employees adhere to
the Nursing and Midwifery Council of Nigeria's code of
conduct and that all members of the public are treated
fairly without prejudice.

Duty of Care
Employers must ensure that their employees provide safe
and competent care to patients, and are responsible for
the actions of their employees within the scope of their
employment, according to the Nursing and Midwifery
Council of Nigeria's code of conduct.

Confidentiality
Employers must protect the confidentiality of patient
information, as well as other confidential business
information, according to the Nursing and Midwifery
Council of Nigeria's code of conduct.

Supervision and Management

Employers must ensure that nurses and midwives are
adequately supervised and managed, and that they have
the resources and support they need to perform their
duties effectively, according to the Nursing and Midwifery
Council of Nigeria's code of conduct.

Vicarious Liability
Employers may be held vicariously liable for the
negligence or misconduct of their employees if it occurs
within the scope of their employment, according to the
Nursing and Midwifery Council of Nigeria's code of
conduct.

As a private citizen
As a private citizen, a nurse or midwife in Nigeria, like any
other citizen, is bound by the same laws and legal
obligations that apply to all individuals.
These include laws related to criminal conduct, contracts,
property, and family matters. However, their professional
status and training also bring specific legal
considerations, particularly regarding confidentiality and
patient rights.

Specific Legal Roles and Obligations

Provider of Service
Nurses and midwives, as providers of care, have a legal
duty to provide competent and safe care to the
patients. This includes: Informing patients of alternatives
and ensuring they have adequate access to necessary
care.

Employee/Contractor
If employed, they must fulfill the terms of their
employment contract and adhere to workplace
regulations.

Private Citizen
They (nurses) have the same rights and responsibilities
as other citizens, including the right to vote, freedom of
speech, and the obligation to obey the law.
They are also expected to protect patient rights and
uphold ethical standards within their profession.

Confidentiality
Nurses and midwives are legally bound to maintain the
confidentiality of patient information. This means they
cannot disclose patient details to unauthorized individuals
without the patient's consent.

Duty of Care
They have a legal duty to act with reasonable care and
skill in their practice, ensuring that they provide
appropriate and safe care to their patients.

Legal Responsibilities in Specific Scenarios

Emergency Situations
In emergencies, midwives, if a doctor is unavailable, are
legally obligated to stay with the patient and provide the
best care they can until the emergency is over, as long as
they have taken reasonable steps to summon medical
assistance.

Scope of Practice
Registered nurses and midwives in Nigeria are entitled to
carry out nursing or midwifery care as defined in their
training curriculum, with the understanding that they can
access prompt assistance from experienced medical
practitioners for emergencies.

Patient Rights
Nurses and midwives must uphold patients' rights to
care, adequate working conditions, compensation, and
respect.

Legal Considerations
Professional Ethics
Professional ethics may sometimes conflict with legal
requirements, but the law is generally superior, according
to a study published by NOUN.

Litigation
Nurses and midwives must understand the legal and
ethical implications of their actions to protect themselves
from potential legal actions or disciplinary measures.

Registration
Nurses and midwives in Nigeria must be registered with
the Nursing and Midwifery Council of Nigeria (NMCN) to
practice legally, according to the NMCN's order.

Nursing ethics and jurisprudence

Ethics of nursing and law are necessary in nursing
because nursing is concerned with providing services that
impact on human life and health etc.