SEMINAR

ON
VISIBILITY OF NURSES,
LEGAL CONSIDERATIONS,
ROLE OF REGULATORY BODIES

INDEX
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Content
VISIBILITY OF NURSES
INTRODUCTION
Definition
Strategies to improve the visibility of nursing
1) Collective bargaining
2) Computer technology
3) Elimination of external sexism
4) Development of internal media committee
5) External media committee
6) Education
7) Marketing
Nursing responsibilities for improving its own visibility
New forms of visibility of nursing
CONCLUSION
LEGAL CONSIDERATION
INTRODUCTION:
Concept of law
Meaning of law
Purpose of law
Terminologies
Types of law
Sources of law
Importance of law in nursing
Legal limits of nursing
Legal liability in nursing
Legal issues in nursing
Legal concepts and nursing practice:
Legal responsibilities of nurse

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Legal issues in specialty practice areas

Maternal and infant nursing
Pediatric nursing
Medical surgical nursing
Psychiatric nursing
Medico legal aspects of death
CONCLUSION
ROLE OF REGULATORY BODIES
INTRODUCTION
Definition of regulatory body
Role of regulatory bodies
Types of regulatory bodies
International level
International Council For Nurses
American Nursing Council
Canadian Nurses Association
National League For Nursing
Central level
Indian Nursing Council
Indian Nursing Council Act
Midwives And Auxiliary Nurses Midwives Association
Trained Nurses Association Of India
State level

Health Visitors League

Karnataka Nursing Council

Rajiv Gandhi University of Health Sciences

Kerala Nursing Council

CONCLUSION
BIBLIOGRAPHY

VISIBILITY OF NURSES

INTRODUCTION
Although nurses comprise the majority of health care professionals, they are
largely invisible. Their competence, skill, knowledge are as a word image that suggest only a
reflection, not reality. (Sullivan E J 2004). The public of nursing and nurses are typically
based on personal experienced with the nurses which can lead to narrow view of nurses are
often based on brief personal experience. This experience may not provide an accurate
picture of all that nurses can do provide in the healthcare delivery system. The truth is that
most often the nurse is invisible. When in the hospital, the patients interact with many staff
and there is little to distinguish from one another, so the patient may refer to most staff as
nurse.
This does not mean that people does not value nurses, they do. However many people do not
know about the education required to become nurse or about the variety of educational entry
points into the nursing that lead to RN qualification. Nurses need to present themselves as
profession through all with whom they come in contact.
Visibility of nurses
Meaning
A quality or fact of, degree of being visible.
Degree of exposure to public notice
Capacity of providing a clear un obstructed view.

Strategies to improve the visibility of nursing

1) Collective bargaining
Collective bargaining is the process by which unions participate in administrative
division involving the terms of employment and the price of labor. Labor union tries to
expand and strengthen the position of the nurse as a large, potentially strong and powerful
group of professional people. Nurses must continue to foster a positive powerful image and
continue to organize.
2) Computer technology
The visibility of nurses can be influenced by the increase in computer technology.
The development and implementation of computer technology enhances the management and
delivery of healthcare, and will continue to do so in the future. Documentation, care

planning, laboratory values, quality management and administrative records can be

computerized. Nurses save time by assessing a computerized system.to acquire the necessary
skill; nurses must become educated and proficient in computer technology.
3) Elimination of external sexism
Sexism continues to harm and disrupt the professional visibility of nursing.
Nursing is not limited to one gender; nursing is genderless and its potential is equally as
limitless. It is suggested that increasing the number of male nurse will make the profession a
different one. The nursing profession and practice will also take on an improved public
visibility of nurses by having more balance between men and women.
4) Development of internal media committee
Internal media, in the form of catalogs, brochures, newsletters, annual reports,
advertisements, films and educational materials are important to any health care institutions
relations but should be viewed as having equal importance to the image of nursing. It is
suggested that the health care facilities should have an internal media committee. Nurses
must become active in such committee and actively review all materials, paying special
attention to the effect these materials have on the visibility of nurse. Nurses must work with
the public relation committee to ensure that nursing is represented in a positive professional
manner to people.
5) External media committee
The mass media, print and broadcast are the most pervasive influences on public
attitudes and opinions in contemporary life. Numerous nurses and group of nurses suggest
that external nursing media committees be organization. These media watch groups must
take responsibility for monitoring the media for all references to nursing. The groups must
respond to the media for positive and negative referrals to nursing
6) Education
The visibility of nurses is changing due to the elevated efforts of our nursing
leader to attain the highest level of competency possible for our profession. The expectation
for nursing today call educated and motivated individual, so education strategies has become
one of the important strategies for improving visibility for nurses.
7) Marketing

As the nursing profession works to upgrade its visibility, marketing strategies are
important. It is crucial that nursing services, nursing programs and the nursing profession be
strategically marketed to a wide range of audience to promote nursing excellence and to
project an achievement oriented, professional visibility of nursing.
Nursing responsibilities for improving its own visibility
Recognize that an image problem does exist and that each nurse has a
responsibility to improve the professions visibility.
Strengthen involvement in professional organization, collectively, nursing is
extremely powerful.
Provide all nurses including staff nurses to become salaried staff members rather
than hourly wage earners.
Become politically active and politically knowledgeable, nurses should run for
office.
Document activities, it shifts the balance of power and allows nurses to state their
case on a rational basis.
Demand that nurse authors be considered for editing health columns.
Provide technical assistance to the media.
Improve the community image volunteer for community sponsored activities.
Revise and update nursing career literature, especially books in schools and public
libraries that introduce the profession to projective nurses.
Establish school of nursing as research and information centers for people
experiencing, critical health care issues e.g. AIDS, homelessness.
Be self-confident, self-confident behavior commends respect.
Share the positive aspects of the nursing profession with others.
Learn to describe nursing responsibilities in clear, non-technical terms.
Continue to develop alterative nursing education programs designed for adult
nurses needing to advance their education.
Increase visibility makes service that client and their families know that nursing
staff is responsible for 24hour care.
Visibility of nurse in cyberspace.

Healthcare professionals have been quick to ride the wave of the Internet revolution by
learning to use various kinds of internet tools that allow them to interact with each other,
unrestrained by national and geographical boundaries, time, and distance. They develop
collaborative research ideas and exchange information through the use of electronic mails,
subscribe to electronic newsgroups and participate in discussion lists.
New forms of visibility of nursing
Nursing work is made visible by its own definition, measurements and
enumeration; similarity, these are key elements in the governing process, as they allow for
evaluation, judgment and review. Initially, embryonic technologies produced nursing
knowledge by recording the type, number and outcomes of various patients (Winch
2001). These early conceptions of nursing work has been extended and refined through
medical record keeping, and the production of quantitative and qualitative nursing
research continuing until the present. The evaluation of nursing work through evidence
based reviews provides detailed information that may enable governments to target and
instruct nurses regarding their work.
CONCLUSION
In short, the major responsibility for improving the visibility of nurses lies in
the nursing profession itself. Black and Germaine Warner suggested a variety of things
nurses can do including recognizing that each nurse should work to improve nursings
image, participating in professional organization becoming politically active, writing for
local media, providing technical assistance to the media, taking advantage of public
speaking opportunities and sharing positive aspects of nursing with others.

LEGAL CONSIDERATION
INTRODUCTION:
Safe nursing practice includes an understanding of the legal boundaries within which
nurses must function. As with all aspects of nursing today an understanding of the
implications of the law supports critical thinking on the nurse` s part. Nurses must
understand the law to protect themselves from liability and to protect their clients` rights.
Nurses need not fear the law be rather should view the information that follows as the

foundation for understanding what is expected by our society from professional nursing care
providers.
CONCEPT OF LAW

MEANING OF LAW
Law is a rule or a body of rules of conduct inherent in human nature and essential to
or binding upon human society and to guide human functions.
Law is the body of principles recognized and applied by the state and the
administration of justice.

PURPOSE OF LAW
To define relationships among the members of a society and between individuals and
groups as they arise
To define which activities are permitted and which are not.
To allocate authority.
To dispose of troubled cases as they arise.
Functions of law in nursing

Terminologies related to law

Malpractice is defined as professional misconduct, unreasonable lack of skill or fidelity in
professional duties, evil practice, or illegal or immoral conduct.
Assault is any willful attempt or threat to harm another, coupled with the ability to actually
harm the other person.
Battery is any intentional touching of another` s body or anything the person is touching or
holding without consent.
Contract is a written or oral agreement between two people in which goods or services are
exchanged.
Tort is a civil wrong for which remedy is common law action for liquidated damages and
which is not exclusively the breach of contract or breach of trust or other merely equitable
obligation.

Negligence is the failure of an individual to do something that reasonably prudent person

would do or the commission of an act in particular circumstances in standard of care to
which a nurse is legally bound, would not do under similar circumstances.
Informed consent is a person` s agreement to allow something to happen (such as surgery)
based on a full disclosure of facts needed to make an intelligent decision (i.e., knowledge of
risks involved, benefits, alternatives, or consequences of refusal).
Crime is an offense against society that violates a law.
Felony is a crime of a serious nature that has a penalty of imprisonment for greater than 1
year or even death.
Misdemeanor is a less serious crime that has a penalty of a fine or imprisonment for less
than 1 year.
Fidelity refers to the agreement to keep promises.
TYPES OF LAW
Two types of laws are public law and civil law;
1) Public law
Public law governs the relationship between individual and the government and
governmental agencies.
2) Private law
Private law is the body of law deals with relationships among private individuals.
3) Contract law
Contract law involves the enforcement of agreements among private individuals
or the payment of compensation for failure to fulfill the agreements.
4) Tort law
Tort law defines and enforces duties and rights among private individuals that are
based on contractual agreements.

SOURCES OF LAW
I.

Constitutional law
Constitutional law deals with the relationship between the state and the

individual and the relationships between different branches of the state, such as executive,
the legislative and the judiciary.

II.

Administrative law
Administrative law refers to the body of law which regulates bureaucratic managerial

procedures and defines the powers of administrative agencies.

III.

Criminal law
Criminal law involves the state imposing sanctions for crimes committed by

individuals so that society can achieve justice and a peaceful social order.

IMPORTANCE OF LAW IN NURSING

It provides patients against deliberate and inadvertent injury by a nurse.
It protects the nurses against the suits if she renders right care.
It provides a framework for establishing which nursing actions in the care of clients
are legal.
It assists in maintaining a standard of nursing practice by making nurses accountable
under law.
It differentiates the nurses responsibilities from those of other health professional.
LEGAL LIMITS OF NURSING
Drug maintenance

Licensure

Standard of care

Student nurses

LEGAL LIMITS
Documentation

Standing orders
Correct identity

Informed consent

Licensure:
All registered nurses and licensed practical nurses are licensed by the board of nursing
of the state or province in which they practice. The requirements for licensure vary, but
requirements for education are in most licensing acts, and the nurse must pass an
examination. Licensure permits persons to offer special skills and knowledge to the public,

but it also provides legal guidelines for protection of the public. All states use the National
Council Licensure Examinations (NCLEX) for registered and licensed practical nurse
examinations.
A nurse`s license can be suspended or revoked by the board of nursing if conduct
violates provisions of the licensing statue. For example, nurses who perform illegal acts such
as selling or taking controlled substances jeopardize their license status. Before licenses are
revoked, nurses must be notified of the charges and permitted to attend a hearing to present
evidence on their own behalf. These hearings are not court proceedings but are usually
conducted by the state or provincial board of nursing. Some states are provinces provide for
judicial review of such cases if the nurse has exhausted all other forms of appeal.
Standards of Care:
One of the functions of law is to define the standards of care the nurse must provide.
All U.S. state legislatures and Canadian provincial parliaments have passed nursing practice
acts that define the scope of nursing practice.
Professional organizations are another source for defining the standards of care. The
American Nurses Association (ANA) and Canadian Nurses Association (CNA) have
developed standards for nursing practice, policy statements, and similar resolutions. These
standards are very general and include such recommendations as the obligation to provide
continuing education programs.
The written policies and procedures of the employing institution detail ways in which
the nurse is to perform duties. Such policies are usually quite specific and are set forth in
procedure manuals found in most nursing units. For example, a procedure and policy
outlining the steps that should be taken when changing a dressing or administering
medication gives specific information for nurses to perform these tasks. These policies
provide another definition of standards of care. Policies and procedures of institutions may
be more restrictive than nurse practice acts, but they can never request a nurse to act beyond
the standards of practice allowed by law.
Student Nurses:
If clients suffer harm as a direct result of nursing students` actions, the liability for the
incorrect action is generally shared by the student, instructor, and hospital or health care
facility. Student nurses should never be assigned to tasks for which they are unprepared and

should be carefully supervised by instructors as they learn new procedures. Although student
nurses are not considered employees of the hospital, the institution has a responsibility to
monitor the acts of nursing students.

Student nurses are expected to perform as a

professional nurse would; the law does not provide for a difference in quality of care
rendered to clients (Ulys, 1988).
Sometimes, student nurses are employed as nursing assistants or nurse` s aides when
they are not attending classes. If student nurses are so employed, they should not perform
tasks that do not appear in a job description for a nurse` s aide or assistant. For example,
even if a student has learned to administer intramuscular medications in class, this task may
not be performed by a nurse`s aide.
Standing orders
Nurses are requested to execute prescribed orders. In case of emergency or the doctor/
medical personnel is not available, each nursing service area should have standing
instructions or orders for the nurses to carry out.
Informed Consent
Informed consent is a person` s agreement to allow something to happen (such as
surgery) based on a full disclosure of facts needed to make an intelligent decision (i.e.,
knowledge of risks involved, benefits, alternatives, or consequences of refusal) (Black 1979).
The law has long recognized that individuals have the right to be free from bodily intrusion.
The doctrine of informed consent not only requires that a person be given all relevant
information required to reach a decision regarding treatment, but also that the person be
capable of understanding the relevant information and does, in fact, give consent. One who
performs a procedure on a client without informed consent may be found civilly liable for
committing battery.
A signed consent form is required for all routine treatment, hazardous procedures
such as surgery, some treatment programs such as chemotherapy, and research involving
clients (JCAHO, 1993). A client signs general consent forms when admitted to the hospital
or other health care facility. Separate special consent forms must be signed by the client or a
representative before specialized procedures are performed. The following factors must be
verified for consent to be valid (Fiesta, 1988; Prosser and Keeton, 1988):

1. The person giving consent must be mentally and physically competent and be legally
an adult.
2. The consent must be given voluntarily. No forceful measures may be used to obtain it.
3. The person giving consent must thoroughly understand the procedure, its risks and
benefits, as well as alternative procedures.
4. The person giving consent has a right to have all questions answered satisfactorily.
If a client is deaf, illiterate, or has some other impediment of communication (such as
speaking a foreign language), an interpreter should be available to explain the terms of
consent.
Correct identity
All babies born in the hospital are correctly labeled at birth and to ensure that at no
time they are placed in the wrong cot or handled to the wrong mothers. All people in the
hospital should wear identity card. Every patient before being given premedication for any
operation should be labeled in the manner approved by the hospital.
Documentation
Keeping accurate and comprehensive records are essential in any health care
facility. Records provide a legal and business document. Regardless of the format used to
record the data, it should be accurate, concise and up to date. Verbal orders if carried out,
then it should be documented or written as told over phone or verbal orders carried, etc. if
a proper documentation is done by for the activities done by the nurse, then she is safe in the
hands of law.
Drug maintenance
Checking the unlawful use of narcotic drugs is liable to drug dependence. These drugs
should be kept under lock and key.
LEGAL LIABILITY IN NURSING
When the nurse fail to meet the legal expectation of care, the client can initiate
action if harm or injury incurred by the client. These are mostly unintentional and intentional
tort.
1. Unintentional tort
These types of tort are accidents that cause injury to another person or property.
Negligence and Malpractice are the examples of unintentional tort.
Negligence

Negligence is conduct that falls below the standard of care. It is established by law
for the protection of others against unreasonable risk of harm, and it is characterized chiefly
by inadvertence, thoughtlessness, or inattention (Black 1979).
If nurses give care that does not meet appropriate standards, they may be held liable
for negligence. Negligence may involve carelessness, such as failing to check a client` s arm
band and then administering the wrong drug. Another example of negligence may be
administering a medication even when it has been documented that the client has an allergy
to that medication. However, carelessness is not always the cause. If nurses attempt a
procedure for which they have not been trained and does it carefully but still harm the client,
a claim of negligence could be made.
Nurses have been involved in several common negligent acts including the following.
Intravenous therapy errors resulting in infiltrations or phlebitis.
Burns to clients
Falls resulting in injury to clients.
Failure to use aseptic technique where required.
Errors in sponge, instrument, or needle counts in surgical cases.
Failure to give a report, or to give an incomplete report, to an oncoming shift.
Nurses are responsible for performing all procedures correctly and for exercising
professional judgment as they carry out the orders of physicians and duties not ordered but
for which they have authority: And nurse who does not meet accepted standards of care
while discharging duties or who performs duties carelessly runs a risk of being found
negligent.
Malpractice
Malpractice is one type of negligence. It is defined as professional misconduct, unreasonable
lack of skill or fidelity in professional duties, evil practice, or illegal or immoral conduct
(Black 1979). In a malpractice lawsuit against a nurse, the following criteria must be
established.
The nurse (defendant) owned a duty to the client (plaintiff).
The nurse did not carry out that duty.
The client was injured
The client` s injury was a result of the nurse` s failure to carry out his or her duty.

 These are the criteria for every type of tort, not only malpractice (Prosser and Keeton,
1988).
The best way for nurses to avoid being named in law suits is to follow standards of
care, give competent health care, document assessments, interventions and evaluations fully,
and develop empathetic rapport with the client. Poor client relations are leading causes of
lawsuits. A client who believes that the nurse performed duties correctly and was concerned
with his or her welfare is unlikely to initiate a lawsuit. In addition, careful, complete, and
objective documentation are keys to avoiding malpractice.
Assault is any willful attempt or threat to harm another, coupled with the ability to
actually harm the other person. The victim believes harm will come as a result of the threat
(Black 1979). Assault may be subtle; for example, a nurse might attempt to coerce a client
into taking a drug he or she does not wish to take. A more blatant example might involve a
nurse handing an uncooperative client in the emergency room. If the exasperated nurse yells.
If you don` t take off those filthy clothes, I` m going to rip them off you! and moves
toward the client, a claim of assault could be made.
2. Intentional tort
These types of torts are deliberate actions in which the intent is to cause injury to a
person or property these are more likely to be assessed against nurses and some intentional
torts fall under the criminal law, if there is gross violation of the standards of care. The
following are some of the intentional torts.
Battery
Battery is any intentional touching of another` s body or anything the person is touching
or holding without consent. Injury is not a requirement (Black 1979). There have been
instances of battery of confined clients by personnel in mental institutions (J. Health and
Hospital Law, 1989). In a less drastic case, if a nurse attaches fetal electrodes during labor
without the consent of the mother, a claim of battery could be made. The important issue is
the client` s informed consent, which will be addressed later in the chapter.
In some situations consent is implied (Prosser and Keeton, 1988). For example, if a
nurse says, I have your injection, Mr. Jones, and the client holds out his arm, he is giving
implied consent to the injection.

Whether the procedure that constitutes battery helps the client is unimportant. In a
classic case from 1905, Mohr V Williams, the client gave written consent for surgery on his
right ear. After the client was anesthetized, the physician discovered that the left ear was
more seriously affected, and he operated on the left ear. The client sued because surgery was
performed on the wrong ear.
Invasion of Privacy
Clients have claims for invasion of privacy when their private affairs, with which the
public has no concern, have been publicized (Prosser and Keeton, 1988). A client is entitled
to confidential health care. All aspects of care should be free from unwanted publicity or
exposure to public scrutiny (Calloway, 1986). An example of invasion of privacy occurs
when clients are unnecessarily exposed in the room or in the corridors.
Another form of invasion of privacy is the release of information to an unauthorized
person such as a member of the press or the client` s employer. Gossiping about a client` s
activities is another form of invasion of privacy and could lead to a charge of slander against
the nurse. Another example is a nurse ` s unwanted intrusion in private family matters. A
nurse has no right to intrude in matters not directly related to the client` s well-being. For
example, a nurse should respect a wish not to inform the client` s family of a terminal illness.
Defamation of Character
Defamation of character is the holding up of a person to ridicule, scorn, or contempt
within the community (Black 1979). There are two types of defamation: slander and libel
(Prosser and Keeton, 1988). For example, if a nurse tells a client that his physician is
incompetent; the nurse could be held liable for slander. If the nurse writes such a comment,
the charge would be libel. The important issues in a claim of defamation of character are
whether the information was shared with third persons (other than the client) and if harm has
been done to the reputation of the plaintiff (Prosser and Keeton, 1988).
LEGAL ISSUES IN NURSING
Legal issues in nursing practice reflect the changing trends in technology, medical
advancements and increased awareness among the patients.
Controlled substances
One of the legal issues that might arise for nurses involves the use of controlled
substances. The two acts that control the use of poison in medicine is: Misuse of drug act

1971 and Dangerous Drug Act 1965 and 1967. The misuse of drug act aims at checking the
unlawfully use of the drugs liable to produce dependence or cause harm if misused. A drug
affected by this act is referred to as controlled drugs. The common controlled drugs under the
dangerous drug act involves cocaine, heroin, methadone, morphine, opium, pethidine,
hallucinogens,etc.
Controlled substances should be kept securely locked, and only authorized personnel
should have access to them. Criminal penalties for misuse of controlled substances exist.
There have been cases in which physicians have illegally prescribed and dispensed controlled
substances, and if nurses employed by such physicians fail to report these activities, they
may be legally accountable for aiding and abetting the physicians.
Caring patient with AIDS
The care of AIDS and HIV+ patients has legal implications for nurses. Confidential
information must be protected of HIV + patients. An infected person cannot be discriminated
against based on contagiousness. The courts have upheld the employers right to fire a nurse
who referred to care for an AIDS patients.
Death and Dying
There are many issues regarding definition of death. The law identifies that death
occur when there is a greatly diminished brain function, despite function of other body organ.
Even though the client may be legally the brain death, the actual pronouncement of death is
usually the legal responsibility of the physician, nurses must be aware of legal definition of
death.
Autopsy and Organ donation
Legally competent persons are free to donate their bodies or organs for medical use.
Consent forms are available for the purpose. The nurse must be aware of the policies and
procedures of institutions and the laws in the state where they are asked to serve as a witness
for a person who wishes to give consent for a donation
Living Wills and Health care Surrogates
Living wills are documents instructing physician to hold or withdraw life sustaining
procedures whose death is imminent. Each state providing for providing living will need two
witness, either of whom can be a relative or doctor are needed when the client sign the
documents, medical special directives also must be legally prepared with the appropriate

witness of the clients signature. Client executes these documents to appoint someone to
make health care decisions if and when they are no longer able to make decision on their own
behalf.
E.g. In terminally ill state and persistently vegetative state. Nurse should be aware of
institutional policies with the patients self-determination act.
Patients property
Many of the unconscious patients admitted in emergency their belonging should be
listed, checked by two nurses and put in safe keeping. While a patient is in hospital, the nurse
has no right to go through his locker or personal property without his consent unless it is
suspected that the patient intent to injure him or others and has the means to do so. When the
patient has died in hospital, his possessions must be recorded in the property book, but
money and valuable should be listed and packed separately. Also write the color of
ornaments and also inform to administrative officers. Preoperatively and during delivery,
these things should be taken care of.
LEGAL CONCEPTS AND NURSING PRACTICE:
In addition to encountering legal problems in the care of clients, nurses may share
liability for errors made by physicians and other health care personnel or for inadequate care
provided by their employing institutions.
Physician Orders:
The physician is responsible for directing the medical treatment of a client. The nurse
is obligated to follow the physician` s order unless he or she believes the order is in error or
would be determined to clients. Therefore all orders must be assessed, and if one is
determined to be erroneous or harmful, further clarification from the physician is necessary
(Cushing, 1990; Cournoyer, 1989). If the physician confirms the order, but the nurse still
believes it is inappropriate, the supervising nurse is informed. A written memorandum to the
supervisor detailing the events in chronological order and the reasons for refusing to carry
out the order should protect the nurse from disciplinary action. The supervising nurse should
help resolve the questionable order. A nurse who carries out an inaccurate order may be
legally responsible for harm suffered by the client (Cushing, 1990).
The physician should write all orders, and the nurse should be sure they are transcribed
correctly. Verbal orders are not recommended because they leave possibilities for error. If a

verbal order is necessary as in an emergency, it should be written and signed by the physician
as soon as possible, usually within 24 hours (JCAHO, 1933).
A difficult area regarding physician orders involves an order of no code or do not
resuscitate (DNR) for a terminally ill client. In the past many physicians were reluctant to
write such an order because they feared legal repercussions for abandoning a client
(Younger, 1987). If a physician has documented in his progress notes that the client` s
condition is deteriorating and that the decision not to administer cardiopulmonary
resuscitation has been made, the physician us perfectly justified in writing a no code order.
Unless the physician decides that such a discussion would be detrimental to the client` s
condition, the order should be discussed with the client. In such cases, the physician should
also discuss the order with the family. A no code order should be written, not given verbally.
Physicians should regularly review DNR orders in case the client` s condition warrants a
change. The nurse should be familiar with the institution` s policies and procedures
concerning DNR orders. Physicians can list all specifics of DNR orders. For example, a
physician may order vasopressors and fluid management to maintain a client` s blood
pressure. But also state DNR in the presence of cardiac standstill, lethal dysrhythmias, or
respiratory arrest.

Short Staffing
During nursing shortages, the issue of inadequate staffing may arise (Horsley, 1981).
The JCAHO has established guidelines for institutions to determine the level of staff needed.
These are referred to as staffing rations. Legal problems may arise if there are not enough
nurses to provide competent care (Rosen, 1990). If assigned to care of more clients than is
reasonable, nurses should attempt to reject assignments by informing the nursing supervisor
that they are inappropriate. If nurses are required to accept the assignments, they should
make written protests to nursing administrators. Although these protests would not relieve
nurses of responsibility if clients suffered because of inattention, it would show that the nurse
was attempting to act in good faith. Nurses should not walk out when staffing is inadequate
because a charge of abandonment could be made.
Nurses are sometimes required to float from the area in which they normally
practice to other nursing units. In one case, a nurse in obstetrics was assigned to an

emergency room. A client entered the emergency room and complained of chest pain. He
was given a markedly increased dosage of lidocaine by the obstetrical nurse and died after
suffering cardiac arrest and subsequent irreversible brain damage. The nurse lost the
malpractice lawsuit brought against her (Goff, 1989).
Nurses who float should inform the supervisor of any lack of experience in caring for
the types of clients on the new nursing unit. They should also request and be given
orientation to the unit. Nurses floated to a unit are held to the same standards of care as
nurses who regularly work in that area (Murphy, 1988).
Incident:
An incident report is filed when something arises that could or did cause injury and
that was not consistent with good care. For example, if a nurse administers an incorrect dose
of medication, a client falls out of bed, or an intravenous solution infiltrates the skin causing
sloughing and scar formation, the nurse should complete an incident report (Orlikoff and
Vanagunas, 1988). Most institutions provide specific forms for this purpose. The nurse
objectively records the details of the incident, and the physician examines the client and
reports any untoward effects caused by the error (Figure 6-2). Subjective assumptions
should not be included on the incident report nor should statements assigning blame be
included.
Reporting Obligations:
Nurses are required to make a report in such situations as child abuse, rape, gunshot
wounds, attempted suicide, or certain communicable diseases to the appropriate authorities
(Kreitzer, 1981). The nurse may also be required to report unsafe or impaired professionals.
Because information that must be reported varies among states and provinces, the nurse
should become familiar with the appropriate statutes.
Good Samaritan Laws:
Good Samaritan Laws have been enacted in almost every state and province to
encourage health care professionals to assist in emergency situations. These laws limit
liability and offer legal immunity for people who help in an emergency, providing they give
the best possible care under the conditions (Northrop, 1990). If a nurse stops at the scene of
an automobile accident and gives appropriate emergency care such as using caution when
moving the injured person in case of a spinal injury or applying pressure to stop hemorrhage,

the nurse is acting within accepted standards, even though proper equipment was not
available.
Contracts:
A contract is a written or oral agreement between two people in which goods or
services are exchanged (Black, 1979). An oral contract is as legally binding as a written one,
but it may be more difficult to prove. A breach of contract occurs if either party fails to carry
out agreed obligations.
By accepting a job, a nurse enters into an agreement with an employer. The nurse will
perform professional duties competently, adhering to the policies and procedures of the
institution. In return the employer not only pays for services but also furnishes the facilities
and equipment in proper working order to enable the nurse to provide efficient and
competent care.
Nurses also enter into contractual agreements with clients (Cushing, 1988). Nurses
agree to give competent care, and clients agree to pay for the services. When clients sign
admission forms upon entering the hospital or agree to nursing care in any health care
agency; they initiated the contract. Private duty nurses have specific written contracts with
their clients. It is from such contracts that the duty to perform competently arises and the
failure to follow through leads to the concept of negligence.
LEGAL RESPONSIBILITIES OF NURSE
Responsibility of appointing and assigning
Nursing administrators are expected to be aware of legal restrictions affecting personnel
appointment and assignment. The nurse administrators have the responsibility for staffing
and supervising nursing units to ensure safe effective patient care.
Each nurse have the legal responsibility to make full disclosure of her or his background
knowledge and skills and notify the nurse manager who given an assignment for which he or
she is not qualified
Responsibility in quality control
The nursing administrator and the authority of the agency at all levels have the legal
obligation to ensure nursing care quality. A nurse managers legal responsibility for quality
control of nursing service imposes a duty to observe report and correct the incompetence of
any patient care provider.

 Responsibility for equipment

To protect patients and employees from injury a nurse manger must ensure that all patient
care equipment is fully functional and that the defective equipment is promptly repaired or
replaced. Nurses have the duty to refuse the equipment if it is faulty.
Responsibility for observation and reporting
Nursing personnel have more frequent and prolonged patient contact than other care giver.
Nurses are trained to detect significant symptoms and reactions. Nurses have a legal duty to
observe patients frequently and report findings. The nurse is expected to observe a patient
more closely when his or her condition implies increased health risk.
The nurse has a duty to record and report observations of a patient condition promptly,
so that the physician can base treatment, decisions on up to date information about the patient
health care needs.
Responsibility to protect public
The nurse has a legal duty to protect the public from injury by dangerous patients. Each nurse
manager or administrator should ensure that the agency in which she or he is employed has a
policy describing the procedure to be followed when a patient with violent tendencies or who
threatens violence to others is discharges or escapes from the health care agency.
Responsibility for record keeping and reporting
Nurses have legal; responsibility for accurately reporting and recording patients conditions,
treatment and responses to care. The medical record is a written or computerized account of a
patients illness and treatment that includes the information submitted by all members of
health care tea. The medical record is an information source document should be used to plan
care, evaluate care, allocate cost, educate personnel etc.
Responsibility for death and dying

Nurses must be aware of legal definition of death because they must document all events that
when the patient is in care. Sometimes there will be issues of euthanasia either active or
passive.
LEGAL ISSUES IN SPECIALTY PRACTICE AREAS
MATERNAL AND INFANT NURSING
Many legal issues are involved in the care of mother and her infant. Alike against a doctor
who is in charge of looking after mother and infant might be one of the following

 Failure to diagnose a high risk pregnancy

Delay in performing a cesarean section
Improper vaginal delivery or failure to perform a cesarean section
Improper use of forceps
Incidence surrounding inducting labor and use of Oxytocin
Delay in arriving at the hospital
Nonattendance at the delivery
The common causes for lawsuits against nurses will include the following
Problems of medication
Failure inadequate client monitoring
Failure to adequately assess the client
Failure to report changes in the patient
Abortions
Nursing care of newborn
PEDIATRIC NURSING
As in all areas of nursing practice, negligence involving pediatric clients is possible. Pediatric
nurses are responsible for preventing children, and their care, from accidently harming
themselves.
MEDICAL SURGICAL NURSING
As in the case of pediatric clients, disoriented adults may require some form of restraints.
Some common acts of negligence in medical surgical nursing are as follows
Overlooked sponges, instruments needles: in the operation theater it is a responsibility
of the nurse to count the sponges, instruments, needles before the closure of the
abdomen or any cavity.
Burns: the professional nurse is requires knowing the cause and effect of any heat
application so as to avoid burns. The nurse could be held liable if she/he neglects to
take proper safety measure prior to application of such measures.
Falls: the nurse could be held liable if a patient falls from the bed due to improper
securing of patient on examination table or improper application of restraint or
provision of a proper bed for an unconscious patient or a child.

 Injury due to the administration of wrong medicine, wrong dosage and wrong
concentration: administration of medicine without prescription by any concerned
authority, mixing up of poisonous and non-poisonous drug in cupboards, leading to
errors, and failing to identify right medication for right patient in right dosage, at right
time considered as negligent act can be liable to be used.
Loss or damage: the nurse is held liable if a patients property is lost when it has been
entrusted to her/ his care.
Assault and battery: failure to take the informed consent of the patient prior to any
procedure, treatment, investigation or operation the nurse is held liable.
Failure to report accidents: the nurse has a moral and legal responsibility to report to
the concerned authority any accidents, losses or unusual occurrences. Failure to do this
is an act of negligence.
Maintenance of records and reports: failure to maintain accurate record and reports or
removing a position of record may also make the nurse liable.
Nurses working in critical care units are also legally accountable for performing their duties.
Critical care nurses require additional training and ongoing intensive education to provide
them with information. The possible problem occurs in critical care nurses is associated with
the use of electronic monitoring device.
PSYCHIATRIC NURSING
The practice of psychiatric nursing is associated and influenced by the right of patients and
quality of care they are receiving.
In psychiatric setting the process of hospitalization can be traumatic or supportive for the
individual depending on the institution, attitude of the family and friends. At present three
types of admission are being used that is voluntary and involuntary
Informal admission
This type of admission to the psychiatric hospital occurs in the same way as a person is
admitted to a general medical hospital without formal or written application
Voluntary admission
Under this procedure any citizen of lawful age any apply in writing admission to a public or
private psychiatric hospital. This is preferred type of admission because it is similar to that of
any medical hospitalization. When admitted as voluntary the patient remains all civil rights

Involuntary admission
Involuntary commitments are continuously recognized by the court on the basis of two
theories; first under its police power the state has the authority to protect the community from
the dangerous acts of the mentally ill. Most laws justify commitments of the mentally ill on
these grounds
1. Dangerous to others
2. Dangerous to self
3. Need for treatment
State laws on commitment vary, but they attempt to protect the individual who is not
mentally ill from being detained in the psychiatric hospital against his will, for political,
economic family or other non-medical reason. Action is begun with sworn petition by a
relative, friend, public official, physician or any interested citizen stating the person is
mentally ill and as in need of treatment. Some states allow only specific individuals to file
such petition
The decision as to whether the patient requires hospitalization is then made. Precisely
who makes this decision determines the nature of the commitment.
Legal roles of nurses
Nurse as provider of services, if any malpractice claims are filed under the
law of negligent tort, and should prove the following
1, a legal duty of care existed.
2, the nurse performed the duty negligently.
3, damage was suffered by the plaintiff as a result.
4, the damage was substantial.
-provide standard nursing care.
-know the laws.
-keep record and reports.
-consult a lawyer if any question arises.
Nurse as an employee, accurate supervision and evaluation of her
responsibility.
Nurse as a citizen,

 Community health nursing. It is the combination of nursing practice and

public health practice. two legal aspects apply to most practice situation,
such as;
1, professional negligence or malpractice.
2, scope of practice
=examining the usual and customary practice of profession.
=taking into account how legislation defines the practice of profession
in a jurisdiction.
Medico legal aspects of death
Be with the patient during death.
Reassure the patient relatives.
Do not whisper in the patient and relatives presence.
Death declaration should be the responsibility of the doctor.
Proper recording of the death should be done in the hospital record.
Respect the body and conduct all the last offices of mummification of the body.
Body should be kept for observation for at least 3 hours to prevent misconception
in case of cadaver spasm.
Take signature of the party, before handing over the body in death register and case
paper.
In case of unknown patient; intimate nursing superintend and sent to mortuary with
proper labeling.
In the case of MLC intimate the police.

CONCLUSION
The nurse in the modern era has multifunction in their work setting. In spite of
having in the job description, these job activities are not explicitly defined. There is job
ambiguity , so in that situation they need to know about the law and legal issues that can have
positive impact on them in day to day functioning and on their clients who are the recipient
of their care nursing practice is governed by many legal concepts. It is important to know the
basics of legal concepts, because nurse is accountable for their professional judgments and
actions.

ROLE OF REGULATORY BODIES

INTRODUCTION
Each state has regulatory bodies, which provide a vital role to ensure the public
right to quality health care service; and to support and assist professional members. All
nurses are required to be licensed to practice with their designated provincial nursing
regulatory body. Legal responsibility in nursing practice is becoming of greater importance
as each year passes. In order to provide safe and competent nursing care an understanding of
legal boundaries is very essential. It is important to know the law in one state and the
authorities enforcing these laws.
DEFINITION OF REGULATORY BODY
Regulatory body is an external organization that has been empowered by legislation
to supervise and control the educational process and outputs.
ROLE OF REGULATORY BODIES
To ensure the publics right to quality health care service.
To support and assist professional members.
Establish and enforce standards of nursing practice.
To provide public authority, credibility, protection and support to nurses.
To maintain and update knowledge, skill and attitude of professionals.
To promote regulation of profession of nursing.
To develop code of ethics, professional conduct and job classification measures.
To define scope and standards of education, training and practice.
TYPES OF REGULATORY BODIES
International level
International Council for Nurses
American Nurses Association
Canadian Nurses Association
National League for Nursing
Central level

 Indian Nursing Council

Midwives and Auxiliary Nurses Midwives Association
Student Nurses Association
State level
Trained Nurses Association of India
Health Visitors League
Karnataka Nursing Council
Rajiv Gandhi University of Health Sciences
Karnataka State Diploma In Nursing Examination Board
Kerala Nursing Council

INTERNATIONAL COUNCIL FOR NURSES

It was formed in 1899 by Mrs.Bedford Fenwick. It is a federation of Non
Political and self Governing National Nurses Association. Its an international association
for all nurses in the world. The headquarters are in Geneva, Switzerland.
The five core values of ICN are
Visionary
Leadership
Inclusiveness
Flexibility
Partnership
Purposes

To provide a means through which the National Associations can share their interests
in the promotion of health and care of the sick.
Great emphasis has been on non-discrimination.

Objectives
Promote the development of strong national nurses associations.
Assist national nurses association to improve the standards of nursing and the
competence of nurses.
Assist national nurses associations to improve the status of nurses within their
countries.
Serve as the authoritative voice for nurses and nursing internationally.

Activities
Makes policy statements on health and social issues.
Offers a great variety of seminars
Maintaining and improving the status of Nursing around the world
Membership
All nurses can become members of the ICN but not as individuals. The individual
nurse becomes a member if his/her national nurses association is a member of ICN. Nurses in
India become members of ICN when they become members of the TNAI.
Publications
The ICN publishes the International Nursing Review on a quarterly basis. The Newsletter,
which is published ten times a year, gives new of the ICN and the National member
Associations.
Role of International Council of Nurses
ICN is the global voice of Nursing. Among its many activities and accomplishments
are the publication of the code for Nurses, the world wide accepted definition of a
Nurse and the Nurses Dilemma, a book of Ethics
It also makes policy statements on health and social issues and offers a great variety of
seminar and the statements aimed at maintaining and improving the status of the Nurse
and the standard of Nursing around the world.
The Guidelines for National Nurses Associations in the Indian Nursing year book,
1988 89 is one example of how the council works to improve Nursing education and
practice. ICN (Council of National) Representation which is made up of the ICN
Honorary officers and President, of the National member Association Council meets at
least every other year and once every face year at the time of ICN congress underwork
at the headquarters is carried on by a staff or clerical and expert nursing advisor
personnel
Benefit
Among benefits to the graduate Nurse are attendances of international congresses
(or) conferences. The ICN exchange of privilege programme, professional advice
(or) assistance through ICN Headquarters and use of the ICN information Centre.
Nurses may receive publications about development in Nursing and Nursing
education around the world
This helps the Nurse become aware of being professionally related to international
organizations such as the united Nations and World Health Organization.

ICNs role in regulation

1) Convening regular international meetings of National Nurses Association leaders,
government Chief Nurses, and national nursing regulatory authorities to address key
issues in regulation.
2) Monitoring and analysing nursing regulation and regulatory forces and trends
worldwide.
3) Providing regular opportunities for interaction among individuals, groups and
organisations who have an interest in or are responsible for regulating nursing. (e.g.
conferences, network and web based activities)
4) Providing national nurses associations and others with the tools(e.g. information,
guidelines, international standards, competencies and frameworks) to enable them to
remain up-to-date on regulatory matters
5) Providing nursing and other key stakeholders with advice and consultation to
undertake reforms and to respond to changes having an impact on professional
regulation.
6) Liaising with international institutions addressing issues of regulation.
7) Influencing/negotiating regulatory reform in the best interest of the public and the
profession.
8) Establishing accreditation, certification and endorsement services in selected areas.
9) Collaborating with other groups and interested parties on regulatory activities and
issues of common interest.
10)
Setting directions for the on-going development of nursing regulation
worldwide.
11)
Promoting data collection in order to provide an evidence base for regulatory
policies and practices.
AMERICAN NURSES ASSOCIATION
The ANA is the professional organization for registered nurses in the United States to
advance and protect the profession of nursing the purpose of ANA are;
To work for the improvement of health standards and the availability of health care
services for all people.
To foster high standards of nursing and to stimulate and promote the professional
development of nurses and advances their economic and general welfare.
Aims
Provide certification for individual registered nurse
Supplies data for research analysis.
Provide public policy analysis and political education and maintains government
relations and political action activities.
Implements an economic and general welfare program.

 Publishes a variety of publications including the American Nurses

Holds conferences and a biennial convention.
They are responsible for creating code of ethics for nurses.
ANA standards of clinical nursing practice
Assessment
Outcome identification
Planning
Implementation
Evaluation
ANA standards of professional performance
Quality of care
Performance appraisal
Education
Collegiality
Ethics
Collaboration
Research
Resources
Purposes
To work for the improvement of health standards
To foster high standards for nursing
To stimulate and promote the professional development of nurses.
Functions
Standards of nursing practice
Education and nursing practice
Code of ethics
Credentialing
Legislation
Health policy
Evaluation
Research economic and general welfare
Professional leadership
Professional development of nurses
Affirmative action
Collective bargaining
Communicating with the members
Consumer advocacy
Representation of the profession

CANADIAN NURSES ASSOCIATION

It is the national nursing association of Canada. The Canadian Nurses Association has
developed national standards and a code of ethics and it offers support to all professional
associations. Though this foundation research grants, fellowships and scholarships and
offered to Canadian Nurses.
The nursing profession in Canada is regulated in the public interest meaning that a
person is not allowed to work in a nursing job or even use the little nurse unless he/she is
registered with a provincial regulatory authority.
Goals
CNA advances the discipline of nursing in the interest of the public.
CNA advocates public policy that incorporates the principles of primary health care
CNA advances the regulation of Registered Nurses in the interest of the public.
CNA works in collaboration with nurses, other health-care providers to achieve and
sustain quality practice.
CNA advances international health policy and development in Canada and abroad to
support global health and equity.
CNAs Mission
CNA is the national professional voice of Registered Nurses, supporting them in their
practice and advocating for healthy public policy.
CNAs Vision
Registered nurses: leaders and partners working to advance health for all.
Roles
Concerned with quality and quantity of nurses available
Standards of preparation and performance of professional nurse.
Social and economic welfare of nurse
Advancement of knowledge, techniques of competence
Functions
Regulating nursing education standards for nursing programs.
Setting criteria for admission to the professional
Setting standards for practice
Acting on complaints from the public
Disciplining members who fail to meet the necessary standards of life practice.
Providing support for nursing practice to registered members.
NATIONAL LEAGUE FOR NURSING
The mission of the national league for nursing is to advance the promotion of health
and the provision of quality health care within a changing health care environment by

promoting and monitoring effective nursing education and practice through collaborative
efforts of nursing leaders, representatives of relevant agencies, and the general public.
Functions
Strengthen nursings role in the promotion of quality health care that is both accessible
and affordable.
Promote quality in nursing practice.
Assure quality in nursing education.
Enhance the consumer involvement in attaining the goals of the organization.
Develop creative and collaborative approaches to the resolution of health care
problems.
Restructure the organization to provide flexibility for fixture growth and development.
Ensure the financial solvency of the organization.
The NLN is recognized in the United States as the national accrediting body for all
basic nursing education, programs, as well as for masters degree nursing programs.
Provide peers-review accreditation programs for home health agencies and community
nursing service.
Provide consultation services, continuing education, programs, analysis of statistical
data related to nursing education and a variety of information package to affect recruitment
image and legislative affairs.
INDIAN NURSING COUNCIL
The Indian Nursing Council is an autonomous body under the Government of India,
Ministry of Health and Family Welfare. Indian Nursing Council Act, 1947 enacted by, giving
statutory powers to maintain uniform standards and regulation of nursing education all
over the Country.
Purpose:
Providing uniform standards in Nursing education and reciprocity in Nursing
Registration throughout the country.
To prescribe and specify minimum requirement for qualifying for a particular course
in nursing.
Advisory role in the state nursing council.
To collaborate with state nursing councils, schools and colleges of nursing and
examination board.
Responsibilities
1. Prescribes curricula for nursing education in all the states.
2. Refuses or Recognises Programmes of Nursing Education according to standards required.

3. Support high standards in Nursing.

4. Providing registration for foreign nurses.
5. Maintenance of the Indian Nurses Register. This register contains the names of all nurses,
midwives, auxiliary nurse midwives who are enrolled on all state registers.
Aims and Objectives of Indian Nursing Council:
Nursing.

training of various Nursing

programmes.

Bachelors Degree / P.G. Diploma / Diploma /Certificate Courses in the field of Nursing.
reciprocal basis.

rsonnel.
of Nurses and the Nursing profession. This includes the issue of discipline, the promotion of
health and health care, proposing and commenting on planned legislation, as well as
proactively advising, alerting and offering comment to the Govt. on matters affecting
the Nursing profession. Indian Nursing Council prime responsibility is to set the norms and
standards for education, training, research and practice with in the ambit of the relevant
legislative framework. In this regard, the following issues are considered critical.
-going review of curriculum in response to national priorities.
-going review of the education system with a focus on community based education
Integrated education with a focus on problem - based learning to promote critical thinking.

-going review of the performance of work of nursing professionals with in the ambit
of the service delivery principles.

INDIAN NURSING COUNCIL ACT

The Indian Nursing Council, which was authorized by the Indian Nursing Council Act
of 1947, was established In 1949 for the purpose providing uniform standards in nursing
education and reciprocity in nursing registration throughout the country.
The only national legislation directly related to nursing practice, also provides a basis
from which rules for nursing practice can be developed. Among other responsibilities, this
Act gives authority to the Indian Nursing Council for prescribing curricula for nursing
education and recognizing qualifications of institutions with teaching programmes for
nursing. This means that the INC has authority to control nursing education and what
the nurse is prepared to do. It is important because legal responsibility does finally depend
upon what you should be able to do and how you should do it as well as what you are not
prepared to do. The INC uses this authority in nursing education but it delegates authority for
control of nursing practice to the State Nurses Registration Councils.
Indian nursing council
President - Shri. T.Dileep Kumar
Vice president Dr.Asha Sharma
Secretary Dr.Sandhya Guptha
Asst.Secretary-Mrs. K.S. Bharathi

MIDWIVES AND AUXILIARY NURSES MIDWIVES ASSOCIATION

Objectives
To Uphold in Every Way the dignity and honour of midwives and auxiliary nurses
To promote Espirit de corps among all health visitors
To enable members to take counsel together on matters affecting profession
To raise the standard of education and practice of health visitor.

Role of state government

The state government controls nursing practice through the state Nurses
Registration Acts. The state Nurses Registration Councils have authority to prescribe
rules of conduct, to take disciplinary action and to maintain registers of nurses. Except
for the uniform standards given by the INC, the state nurse practice act is the important
law affecting one nursing practice act that protects the public by broadly defining the
legal scope of nursing practice.

Functions:
1) It registers Nurse / Midwives
2) It serves as legal protections to the nurse
3) It protect the public from incompetent nursing practice or poor nursing care
4) It accredits and inspects schools of nursing and college of nursing
5) It prescribes the rules of conduct, table disciplinary action
6) It takes united efforts to elevate the standards of nursing
7) It works for the welfare of the members
Unethical practices commonly prohibited by state
The dishonest use of certificate
Procuring registration by false means
Falsification of the register
Representation of registration by an unrecognized person
Representation of a registrant as a medical practitioner
Many states prohibit an unregistered person from holding a nursing position in an
institution wholly or partially supported by government funds. Some states prohibit
practice of any unregistered nurse.
A fine is the usual penalty imposed for disobeying the laws stated above
although imprisonment is also possible. In actual practice, the state Council often
delegates responsibility for the supervision of nurses to local authorities such as the
District Civil Surgeon or a board appointed for this purpose.
The Trained Nurses Association of India bases its standards for conduct of
professional nurses upon the International Code for Nurses.
TRAINED NURSES ASSOCIATION OF INDIA
TNAI means Trained Nurses Association of India, is a national professional
association of nurses. The level of organization moves to the district, state and national
levels. Members of TNAI are usually most active on the level of the local unit.
Activities and conference however are planned regularly by the state branches and
provide opportunities for valuable professional participation and development of the
individual member.
Objectives

 Upholding the dignity and honour of the nursing profession.

Promoting a sense of espirit de corps among all nurses.
Enabling members to take counsel together on matters relating to the profession
Aims
The aims of TNAI are as follows: Upgrading development and standardization of nursing education
Improvement of living and working conditions for nurses in India
Registration for qualified nurses and reciprocity of registration within different states
in India.
Activities
Setting up of basic nursing curricula.
Development of higher education courses
Formation of nursing institutions
Help eliminate discrimination against male nurses
Monthly publication The Nursing Journal of India
Publication of nursing year book
Benefits
Gives the nurse a feeling of belonging and security
Information of the current events
Provides opportunities to publish articles
Railway concessions
Functions:
Up grading development and standardization of nursing education
Improvement of living and working condition for nurses in India
Registration for qualified nurses
It has promoted the development of courses in higher education for nurses
It gives scholarships for nurses who wish to go on for advanced study

 Helped to organize the state nurse and midwives Registration Council

Helps to develop leadership ability
Helps to share and solve professional problems
Helped to remove discrimination against male nurses
Helped to improve economic conditions for nurses
The official organ of TNAI is the Nursing journal of India which is published monthly
Trained nurses association of India
President: Sr. (Prof.) Gilbert
1st Vice President: Dr. (Mrs.) Bimla Kapoor
2nd Vice President: Mrs. Gracy Mathai
3rd Vice President: Dr. (Mrs.) S. Sasankan,.
Hony. Treasurer: Miss Surekha Sama.
Secretary-General: Mrs. Sheila Seda.
Deputy Secretary-General: Mrs. Nanthini Subbiah,
Assistant Secretary-General: Mrs. Sujatha Atri
HEALTH VISITORS LEAGUE
Health visitors league is an associate organization of TNAI
Objectives
To Uphold In Every Way the dignity and honour of health visitors
To promote espirit de corps among all health visitors
To enable members to take counsel together on matters affecting profession
To raise the standard of education and practice of health visitor.
STUDENT NURSES ASSOCIATION
The SNA was founded in 1929 with 1 unit in Madras. Its an organization of students
in the field of nursing in the country. Among its purposes is the improvement of nursing
education to improve health care, aid in the development of the nursing student, and
encourage optimal achievement in the professional role of the nurse. It publishes a

journal, Imprint, five times a year, participates in legislative activities at all levels, and gives
scholarships, awards, and career workshops.
Objectives
To help students to uphold the dignity and ideals of the profession for which they are
qualifying
To promote a cooperative spirit among students
To furnish nurses in training with advices in their courses of study leading up to
professional qualification.
Activities
SNA exhibition
Fund raising
Special prizes
Annual meets for the students
KARNATAKA NURSING COUNCIL
The Karnataka State Nursing Council was constituted in the year 1971 under the
authority of Karnataka Nurses, Midwives & Health Visitors Act of 1961.
The First council was nominated by Government with different members representing
various constituencies under section 3 of the Act, all together consisting of 22 members. The
Council is an Autonomous Statutory Registration body for qualified Nurses, Midwives,
ANMs and Health Visitors. Its function include besides others:1. Regulation of training programme of the diploma, Graduate and Post Graduate Courses.
2. Supervision of the practice of the profession by its Member.
3. Granting recognition to the training institutions and periodical Inspection there on, as the
Council is governing authority of physical and clinical facilities in almost all the nursing
courses conducted in the institution.
4. Proscribing syllabus and curriculum for various nursing courses and conducting qualifying
examination there for.
5. Registration and granting certificate to qualified persons to practice their profession and to
watch and take action against practice of profession by quacks and check mal-practice as
well and to take action.
The Council is as per the Act headed by President and Vice-President of the Council
and both are duly elected by the members of the council under section 5 of the Act.

The Council meets under the Chairmanship of and takes decision on the matters covered by
its statutory functions as enumerated above. The expenditure of the Council will be met with
the fees charged for Registration and Renewal.
Karnataka nursing council
President - Dr. A. R. Aruna
Vice president Dr. Smt G. Kasthuri
Registrar -Sri. H.L. Ramamurthy
Nurse registrar - Sri B.N. Muninarayanappa
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
Rajiv Gandhi University of Health Sciences, centered in Bangalore, India, is a
unitary university set up in 1996 by the government of Karnataka, India, for the regulation
and promotion of higher education in health sciences throughout the state of Karnataka. The
establishment of the university was directed by the Rajiv Gandhi University of Health
Sciences Act of 1994.
About 276 colleges throughout the state, affiliated with different universities, that
conducted courses on Medicine, Dentistry, Physiotherapy, Pharmacy and Nursing were
placed under the Rajiv Gandhi University in order to establish uniform standards in
academics and administration. The institution is named after former Prime Minister of
India Rajiv Gandhi. Originally it was centered in Mysore, but in 1998 the Karnataka State
Legislature directed that it be moved to Bangalore.
Functions
To verify the eligibility requirements of the students before each examination.
To arrange to conduct examination and issue Degree and post graduate Certificates to
successful Candidates.
To maintain and enhance the educational standards of college of Nursing by arranging
continuing education programs / workshops / exhibitions.
To prepare the Calendar of Events at the beginning of each academic year.
To decide the disciplinary action against students / concerned staff in case of
Malpractice in Examinations.
To nominate members for the panel of examiners for BSC AND MSC Nursing
examinations.
To appoint the examiners before annual and supplementary examination.

 To appoint an auditor to audit the board accounts. To Co-ordinate and bring a uniform
standard of Nursing Education in Karnataka, in accordance with the requirements of
the Indian Nursing Council and Karnataka Nursing Council.
Governing bodies
Chancellor: H.E.Sri Hans Raj Bhardwaj
Pro-Chancellor: Sri. S.A. Ramadas
Vice-Chancellor: Dr.S.Ramananda Shetty
Registrar: Dr.D.Prem Kumar
KERALA NURSING COUNCIL
The Kerala Nursing Council And Midwives Council was established in 1953 under
the provisions of nurses and midwives act and works as an autonomous body under the
government of Kerala, Department of Health and Family Welfare. It is a regulatory body for
nurses and education in nursing in Kerala and it is monitored by Indian Nursing Council.
Function
To establish and maintain a uniform standard of nursing education for Nurses,
Auxiliary Nurses Midwives and Health Visitors by doing periodic inspection of the
institution.
To give registration to Nurses and Midwives who had undergone their training from
recognized institutions
To conduct undergraduate courses and to issue diploma and registration certificate
To conduct examinations for GNM, ANM, Post Basic Diploma Courses and Health
Supervision courses.
Power to withdrawn the recognition of qualification in case the institution fails to
maintain its standards
Organization
Registrar

Deputy registrar

Office staff
Committees

Education committee: deals with matters related to conduct of examination, policy matters
concerning the nursing education.
Scrutiny committee: scrutinizes the inspection report of colleges and schools of nursing and
give report to council.
Board of examiners
Board of examiners consists of president and board members: deals with matters
related to examination and publication of results.
Kerala University Of Health Science
Kerala University of Health Sciences, centered in Trissur by 2010for the regulation and
promotion of higher education in health sciences throughout the state of Kerala
CONCLUSION
The provincial regulatory bodies have responsibility for monitoring and approving nursing
education. All nursing education programs must prove that their nursing curriculum.
Prepares graduates to practice professionally and meet the required standards and
competencies. The government sets out the legislation for the protection of the public it is
the nurses themselves who carry out this legislation under the specific mandate and structure
required by the law.
BIBLIOGRAPHY
Book references
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7) Taylor Carol (2008), Text Book of Fundamentals of Nursing / The Art and
Science of Nursing Care, Vol. 1, Sixth edition, Lippin Cott Williams and Wilkins
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Journals
Regulatory Model on Transitioning Nurses From Education to practice, Nancy
Spector, Sulling Li, Joans Health Care Law, ethics and Regulation / volume 9 No.1
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