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MY PRELIM NOTES FOR PROFESSIONA ADJUSTMENT o Preventive

PROFESSION o Rehabilitative aspects of care

 An occupation or calling requiring advance o Restoration of health


training
o Alleviation of suffering
 Experience in some specific or specialized
body of knowledge o Towards a peaceful death

 Provides service to society in that special  Provide nursing care through the utilization of the
field nursing process

 The term profession is honoric and should o Therapeutic use of self


be carried with pride and honor
o Executing health care techniques and
NURSING procedures

 An occupation requiring a unique body of o Essential primary health care


knowledge and skills and which serves
o Comfort measures
society

PROFESSIONAL NURSE o Health teachings

 Completed a basic nursing education o Administration of written prescription for


program treatment

o Therapies
 Licensed in his/her country or state to
practice professional nursing o Oral
NURSING PRACTICE o Topical
 Primary responsibility promotion of health and o Parenteral medications
prevention of illness
o Internal examination during labour in the
 Collaborate with other health care providers absence of antenatal bleeding and delivery
o Curative o Suturing of perineal laceration
 Establish linkages with community resources o Capacity and ability to work cooperatively
with others
 Coordination with the health team
o Skill in decision making
 Provide health education to individuals, families
and communities DEFINITION OF LICENSE

 Teach, guide and supervise students in nursing  A legal document given by the government that
education programs permits a person to offer to the public his or her
skills and knowledge in a particular jurisdiction
 The nurse is required to maintain competence by
continual learning through continuing professional CONTRACT
education
 Meeting of minds between two persons whereby
one binds himself, with respect to other, to give
something or to render some service
QUALIFICATIONS AND ABILITIES OF A
PROFESSIONAL NURSE  A promise or a set of promise which the law
recognizes as a duty and when that duty is not
 Professional Preparation
performed the law provides a remedy
o Have a license to practice NURSING ETHICS
o Bachelor of science degree in nursing
 Ethics came from the Greek word ETHOS moral
o Be physically and mentally fit duty

 Personal Qualities and Professional  Standard to examine and understand moral life
Proficiencies  Guides of human conduct provided by ethical
o Interest and willingness to work and learn systems

o Warm personality and concern for people  How people make judgement in regard to right or
wrong
o Resourcefulness and creativity, well
balanced emotional condition  Critical reflection about morality and rational
analysis about it
 JOHNSTON- examination of all ethical and bio-  Systematic study of human behaviour in the field
ethical issues from the prospective of nursing of life science and health care in the light of moral
theory and nursing ethics values and principles

 VERCOE- the fields of nursing ethics be focused on TELEOLOGICAL APPROACH


the needs and experiences of practicing nurses,
the exploration of its meaning and that of ethical  Greek word TELOS or goal or end
practice in terms of the perception of these nurses
 The right thing to do is the good thing to do

 Act utilitarianism- good resides in the promotion of


Morals happiness or the greatest net increase of pleasure
over pain
 Specific ways of behaviour or of accomplishing
ethical principles  If the act helps people, then it is a good act

 Greek work MORALIS  If the act hurts people then it is a bad act

 Social consensus about moral conduct for human


beings and society
FLETCHER’S GUIDELINES FOR MAKING ETHICAL
 Morality is what you believe is right and good DECISIONS

Health Care ethics 1. Consideration for people as human beings

 Division of ethics that relates to human health 2. Consideration of consequences

 Realm of human values, morals, customs, 3. Proportionate good to come from the choices
personal beliefs and faith 4. Propriety of actual needs over ideal or potential
Bioethics needs

 Specific domain of ethics that focuses on moral 5. A desire to enlarge choices and reduce chance
issues in the field of health care 6. A courageous acceptance of the consequence of
the decision
 Result of life and death dilemmas faced by health
care practitioners
DEONTOLOGICAL APPROACH OR DUTY ORIENTED  Duties of nonmaleficence- avoiding or preventing
THEORY injury to others

 Basic rightness or wrongness of an act depends VIRTUE ETHICS APPROACH


on the intrinsic nature rather than upon the
situation or its consequences  ARETIC, Greek word ARETE, heart of the person
performing the act
 Greek word DEON meaning DUTY
 Traits and virtues of a good person, courage,
 Immanuel Kant- rational human being with temperance, wisdom, and justice
freedom and social worth
DIVINE COMMAND ETHICS
 A person is morally good and admirable if his
 Supreme or divine that sets down rules to provide
actions are done from a sense of duty and reason
guidance to moral decisions
W.D ROSS- PRIMA FACIE DUTIES- WHAT ONE
UNIVERSAL PRINCIPLES OF BIOMEDICAL ETHICS
SHOULD DO WHEN OTHER RELEVANT FACTORS IN
A SITUATION ARE NOT CONSIDERED  To determine right or wrong in regard to value
issues
 Duties of fidelity- telling the truth, keeping
promises  Autonomy-
 Duties of reparation- righting the wrong we have o Greek word AUTOS meaning self and nomos
done to others meaning governance
 Duties of gratitude- recognizing the service others o Self determination
have done for us
o Freedom to choose and implement one’s
 Duties of justice- preventing distribution of decision
pleasure or happiness that is not in keeping with
the merit of people involved o Informed consent

 Duties of beneficence-helping to better the o Allowing the patient to refuse treatment if


condition of other beings he decides so

 Duties of self improvement- bearing ourselves


with respect to virtue or intelligence
o The person making the decision must be o Reasonable continuity of care when
deemed competent, intellectual capacity, appropriate and be informed of other care
legal age options

 Veracity o Be informed of hospital polices and


practices
o Health care providers are bound to tell the
truth  NONMALEFICENCE-

 Beneficence o To do no harm

o Promotes the doing acts of kindness and o Not assisting in or performing abortion
mercy that directly benefit the patient
o Not to assist people to commit suicide
 PATIENT’s BILL OF RIGHTS
o Be involved in mercy killing
o Considerate and respectful care
 JUSTICE
o Relevant, current and understandable
o The right to demand to be treated justly,
information
fairly and equally
o Make decisions regarding his care plan
 NURSES’ BILL OF RIGHTS
o Have advance directive (living will)
o Registered nurses promote and restore
o Every consideration of his privacy health

o Confidentiality of communications and o Prevent illness


records
o Protect the people entrusted to their care
o Review his records concerning his medical
o Alleviate suffering
care

o Be informed of business relationship among o Provide services that maintain respect for
the hospital educational institution human dignity

o Consent or decline to participate  LVING WILLS OR ADVANCE DIRECTIVE


experimental research affecting his care
o Accept or refuse any treatment, service or  The whole is greater than any of its
procedure used to diagnose or treat physical parts
or mental condition
o Epikia
o Decision to provide or withhold life-
sustaining measures  Exception to the general rule

o This living will is signed by the patient o One who acts through an agent is
himself responsible
o Witnessed by two other persons who is not
designated as the person’s health care  Ex. Nurse recommends patient to
representative another clinic for abortion but does
not want to perform
o Directive has force of law
o No one is obliged to betray
 MORAL PRINCIPLES himself/herself

o The golden rule  No one can force any person to


answer a question if such will
 Do unto others what you would like
incriminate him/her
others do unto you
o The end does not justify the means
o The two fold effect
 Giving sleeping tablets to someone
 May have bad and good effect who has chronic illness
 Must be morally good o Defects of nature may be corrected
 Good effect must be willed and the  Corrected by plastic surgery
bad effect merely allowed
o If one is willing to cooperate in the act,
 Good effect must not come from an no injustice is done to him/her
evil action
 With patient’s consent
 Good effect must be greater than the
bad effect o A little more or less does not change
the substance of an act
o The Principle of Totality
 Stealing o Perform their responsibilities with the
highest sense of integrity
o The greatest good for the greatest
number • Professional Competence

 Have more good effects for more o Knowledge, technical skills, attitudes and
people than a smaller group experience

o No one is held to the impossible • Solidarity and teamwork

 Do not promise impossible things o Maintain and support one professional


organization
o The morality of cooperation
• Social and Civic Responsibility
 Formal cooperation is an evil act and
never allowed o Shall always carry out their professional
duties with due consideration of the broader
o Principle relating to the origin and
interest of the public
destruction of life
• Global Competitiveness
 Thou shall not kill
o Shall remain open to challenges of a more
GOOD SAMARITAN LAW
dynamic and interconnected world
• A nurse who renders first aid or treatment at the
• Equality of All professions
scene of an emergency and who does so within
the standard of care, acting in good faith, is o Shall treat their colleagues with respect and
relieved of the consequences strive to be fair in their dealings with one
another
CODE OF GOOD GOVERNANCE
AMENDED CODE OF ETHICS FOR NURSES
• Service to others
• Section 3 Republic Act No. 877 known as the
o Commitment to a life of sacrifice and
Philippine Nursing Law and Section 6 of P.D No.
genuine selflessness in carrying out their
223 the amended Code of Ethics of Nurses
professional duties
• Article I
• Integrity and Objectivity
o Preamble- health is a fundamental right of • Article VI
every individual
o Maintenance of loyalty to the nursing
• Article II profession and preservation of its integrity
are ideal
o Values, customs and spiritual beliefs held by
individual shall be represented • Article VII

o Consider the individuality and totality of o The certification of registration of the


patients when they administer care registered nurse shall either be revoked or
suspended for violation of any provisions of
• Article III
this code.
o Human life is inviolable DEFINITION AND MEANING OF LAW
o Quality and excellence in the care of • The sum total of rules and regulations by which
patients are the goals of the nursing society is governed
practice
• Man mad regulates social conduct in a formal and
o Accurate documentation of actions and
binding way
outcomes of delivered care is the hallmark
of nursing accountability • Rule of conduct pronounced by controlling
authority and which may be enforced
• Article IV
o Authority or right to declare that the rule
o The registered nurse is in solidarity with
exists
other members of the healthcare team in
working for the patient’s best interest o Rule is pronounced or expressed

• Article V o Source can be defined

o Preservation of life, respect for human rights o A right to enforce the same must be
and promotion of healthy environment provided

o Promotion in local, national, and • Controlling authority in our system is the


international efforts to meet health and government
social needs of the people
• Fundaments law of the government is the • Article 19 of the civil code
constitution
o One shall act with justice, give every man
• Principal sources of pronouncements his due, observe honest and good faith

o Constitution • Article 20

o Statutes or legislations o Those who in the performance of their


obligations through negligence causes any
o Executive branch
injury to another, are liable for damages
o Case decision/judicial opinions
• Common acts of negligence
o Presidential decrees
o Burns resulting from hot water bags, heat
o Letters of instructions lamps, vaporizers, sitz bath

RESONSIBILITY AND ACCOUNTABILITY FOR THE o Objects left inside the patient’s body;
PRACTICE OF PROFESSIONAL NURSING sponges suction tips, loose dentures lodged
in the patient’s trachea
• Professional Negligence
o Falls of the elderly; confused, unconscious,
o Commission or omission of an act, pursuant sedated patients
to a duty
o Falls of children whose bed rails were not
 Existence of a duty on the part of the pulled up and locked
person charged to use due care under
circumstances o Failure to observe and take appropriate
action
 Failure to meet the standard of due
care o Failure to report observations to attending
physicians
 The foresee ability of harm resulting
from failure to meet the standard o Failure to exercise the degree of diligence
which the circumstances of the particular
 The fact that the breach of this case demands
standard resulted in an injury to the
plaintiff
o Mistaken identity- drug given to the wrong • Irresistible force; unforeseen or inevitable
patient
• No person shall be responsible for those events
o Wrong medicine, wrong concentration, which cannot be foreseen
wrong route, wrong dose
• Floods fire, earthquakes
o Defects in the equipment
DOCTRINE OF RESPONDEAT SUPERIOR
o Errors due to family assistance
• Let the master answer for the acts of the
o Administration of medicine without a subordinate
doctors prescritption
• The liability is expanded to include the master as
THE DOCTRINE OF RES IPSA LOQUITUR well as the employee
• Injury was of such nature that it would not INCOMPETENCE
normally occur unless there was negligent act
• Lack of ability, legal qualifications or fitness to
• Injury was caused by an agency within control of discharge the required duty
the defendant
CONSENT TO MEDICAL AND SURGICAL PROCEDURES
• Plaintiff himself did not engage in any manner
that would tend to bring about the injury • Consent

MALPRACTICE o Free and rational act that presupposes


knowledge of teh thing to which consent is
• The idea of improper or unskilful care of a patient being given by a person who is legally
by a nurse capable to give consent

• Stepping beyond one’s authority with serious o Signed by the patient or authorized
consequences representative/legal guardian

• Carelessness of professional personnel o An authorization by a patient or a person


authorized by law to give the consent on the
• LESNIK- negligent act committed in the course of patient’s behalf
professional performance

DOCTRINE OF FORCE MAJEURE


o Nurse secures the consent of the patient • False Imprisonment of Illegal Detention
upon admission
o Unjustifiable detention of a person without a
• Informed Consent legal warrant within boundaries

o Established principle law that every human • Invasion of Right to Privacy and breach of
being of adult years and sound mind has the confidentiality
right to determine what shall be done with
his own body o Right to privacy is the right to be left alone

o May choose whether to be treated or not o Right to be free from unwarranted publicity

• Proof of Consent o Exposure to public view

o A written consent should be signed to show o Divulge information from patient’s chart to
that the procedure is the one consented to improper sources or unauthorized person
and that the person understands the nature • Defamation
of the procedure
o Character assassination
TORTS
o Slander-oral defamation
• A legal wrong, committed against a person or
property o Libel-written words

• Assault and Battery o There must be a third person who hears or


read the comment before it can be
o Imminent threat of harmful or offensive
considered defamation
bodily contact

o Unjustifiable to tough another person or to


threaten to do so CRIMES, MISDEMEANORS, AND FELONIES

• Battery

o An intentional, unconsented touching of CRIME


another person
• An act committed or omitted in violation of • Criminal Intent
the law
o States of mind of a person at the time
• Two elements the criminal act is committed that
he/she knows that an act is not lawful
o Criminal act and still decide to do it anyway
o Evil/criminal intent

• Conspiracy to commit a crime WILLS

o Two or more persons agree to commit • A legal declaration of a person’s intentions upon
a felony death

 Principals- who take a direct • Testamentary document takes effect after the
plan/part death of its maker

 Accomplices- cooperate in the • Decedent- person whose property is transmitted


execution through the succession whether or not he left a
will
 Accessories- having knowledge
of the commission of the crime • If he left a will he is called a testator
• Criminal Actions • Woman is testatrix
o Acts or offenses against public welfare • Heir- called to succession either by the provision
of a will or by operation of law
• Criminal negligence

o Reckless imprudence- person does an • A person who dies leaving a will is said t have died
testate
act or fails to do it voluntarily but
without malice • One who dies without will is said to have died
o Simple imprudence- did not use intestate
precaution and the damage was not • Validation of the will in a court is known as
immediate or the impending danger probate
was not evident or manifest
• A will which is written, dated and signed by the
testator is called holographic will

• An oral will is called nuncupative will or


nuncupation- made during the person’s last
illness, that it be done in the place in which he
died, one or more witnesses to the will

• Testator must have the expressed intention of


making a will

• Must be right of age

• Under 18 cannot make a will

• Required to have sound mind

• Think clearly ability at the time of its execution

NURSES OBLIGATIONS IN THE EXECUTION OF A WILL

• The nurse should note the soundness of the


patient’s mind

• There was freedom from fraud or undue influence

• Make a notation on the patient’s chart of the


apparent mental and physical condition of the
patient at the time of making the will