Professional Adjustment, Legal Management, Ethics & Research in Nursing Ethics of a Researcher

 S – Scientific Objective – conductive research for a good purpose or object for

NURSING RESEARCH your pt

Nursing Research  C – Cooperation and Consent. Do not conduct data/experiment w/o a consent
 Kerlinger - the systematic, empirical, controlled and critical investigation of a (legally the patient owns the chart. However the hospital owns the chart)
hypothetical proposition in relation to a natural phenomena/ problem  I – Integrity – worked hard on the research
 Conducted to affirm or deny a hypothesis  E – Equitable – acknowledging works or contribution of others
 N – Nobility – protect the rights of your subjects
Phenomenon. o Right not to be harmed
 everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician)  (physical, mental, moral harm) usually done during experimental
research
Phenomenon + hypothesis = research problem  Physical Harm/ Negligence - undeliberate physical harm
∟>(educated guess/scientific/ tentative answer)  Commission – done outside the standard practice of
Without hypothesis there is no research problem, only a problem nursing (eg. urinary catheter placed on the nose of the
pt)
Major Characteristics of a Good or Major Research  Omission – from the very start, you did not do
 Systematic something about it.
o conduct research in a step by step process or procedure  Moral Harm
 Empirical  Assault – mental fear/threat without physical harm
o objective data should be observable/measurable or readily collected using  Battery – physically you harm the pt
your senses  Restraint is never an independent nursing order
 Controlled/ manipulated  physical restraint – eg. Jacket
o Methods/tool of controlling is research design  chemical restraint – eg. use of psychotropic drug
 Critical investigation/fact finding investigation  Moral harm
o In order to answer the data is by using facts.  Slander – oral defamation
o Looking for human beings who can give us facts  Libel – published or placed in the newspaper
o Right to self-determination
Purpose of Research in Nursing Profession [DEED] o Right to privacy
 Descriptive  Anonymity – identity of subject may not be disclosed. Privacy of
o observe, describe and record the Informant (pt) eg. conduct a study on HIV pt. but the pt wants
o gain richer familiarity regarding the phenomena his name to be written in the newspaper as Mr. X, Mr. Y or Mr. W
o 100% known to RN  Confidentiality – information acquired must be disclosed.
 Exploratory Privacy of the information eg. conduct a study on HIV pt. but the
o Explore to those areas that are unknown pt wants the nurse should only know
o Observe more  T – Truthfulness – put only the data you have collected
o 50%-50% (50%known to nurses and 50% unknown to the nurses  I – Importance – importance to the nursing profession
 Experimental  F – Factual – facts or data
o Active intervention, active manipulation  I – Ideal (follow the 11 steps of research)
o Want to find out cause & effect  C – Courage
o Done something before observing results
 Developmental
o To improve the system of care for the your patient.
o Develop and improve existing system
Conducting research is for the benefit the pt or patient care/pt focus
Steps in Nursing Research Process o 2 choices/ 2 results
 Identification/formulation of research o Example: Male/ Female
o problem - anything that requires solution thru scientific investigation.  Polychotomous Variable
o Sources of problem : o Multiple choices
 C – concepts (Ca, PTB, MI) o Example: Preferred foods – Chinese,
 L – literature, essays, books, journals Japanese, American. . . . .
 I – Issues
 E – experience Examples
 N – Nursing problems “A comparative Study in the Income of Filipino Nurses
 T – theories Employed in P.G.H. and N.Y.G.H.”

o Characteristics of a research problem Independent variable : PGH and NYGH (place of work)
 G – general applicability and use Target population : Filipino nurses
 Re – Researchable Dependent variable : income
 F – Feasible and measurable
 F – actors of a feasible research :
 time, money, experience of the researcher, instruments, Research:
population 1. Identify the Problem
 I – importance to nursing profession 2. Purpose – objective using SMART (Systematic, Measurable, Attainable, Realistic,
 N – novelty/originality Time Bounded)
 Plagiarism/illegal replication – unauthorized use of 3. Define Terms
another’s literary work without any consent or a. Conceptual Definition – dictionary definition
permission b. Operational Definition – defined in accordance on how the researcher
 S – significance to nursing used the word
o 2 types of research according to use 4. Revision of Terms
 basic/pure research
 only the research benefits the research  Review of related literature
 It is only for your personal necessity o Purposes :
 Answers your own question  to have an update regarding your topic
 Applied research  to have a basis of theoretical and conceptual framework
 problem solving o Main sources of literatures
 Solving the problems of the patient.  Conceptual
o Variable – subject to change  Formulated
 Kinds of variable  Authors
 Independent variable  Can be sold
o use this to stimulate a target population  Books – general use
 Dependent variable/Effectual variable  Research
o results of the effects of the study  Researcher
 Intervening Variable  Research works only
o Comes between dependent and independent  Future research purpose only
o Example: orghanism variable, internal factor,  Formulation of conceptual and theoretical framework
sex, gender, color o Theory – relationship between concepts
 Extraneous Variable o Conceptual framework
o External infuences that can be changed  diagrammatic and structural presentation of the problem
o Example: citizenship, educational status hypothesis
 Dichotomous Variable
 o Paradigm  Applied
 actual structural presentation of your conceptual framework o Based on problem solving approach
 Formulating hypothesis  According to Methods
o 5 types of hypothesis  Experimental
 Null/statistical hypothesis o performing active manipulation, observe and
 shows no relationship or difference between an record the result.
independent variable and dependent variable. o Types of Experimental Reseach
 ID = DV  control
 Eg. “There is no difference regarding professional  divide grp into 2.
opportunities of Filipino Nurses working in the  Group a –
Philippines from those working in USA.” control/comparison grp – will
 Simple/Operational hypothesis/Alternative hypothesis use the same soap everyday
 this shows relationship between a single independent  Group b – experimental grp
variable from single dependent variable. – those who will use the
 Eg. “Filipinos Nurses working in USA has more sample soap
professional opportunities than those working in the  randomization
Philippines.  using sample by chance.
 Complex hypothesis  Choose randomly to avoid
 this shows a relationship between two or more redundancy of result
independent variable from two or more dependent  Manipulation
variable.  Performing intervention
 Eg. “Filipino nurses who worked for 5yrs and passed  Validation
the CGFNS, TORFL, TSE, NCLEX has greater  comparison of the effects
opportunities in NY as compared to those in Manila  Quasi-experimental
 Directional hypothesis  false experiment.
 specifies the direction of the relationship between  No control sample.
variables  Non-experimental
 Eg. “Filipino Nurses working in the USA has more o No manipulation is done. Only observation,
professional opportunities than those working in the describe and record down the result.
Phils.” o Types of non-experimental research design
 Non-directional base on time element
 only predicts the relationship, but has no specific  Retrospective (Ex Post Facto)
direction between variables.  Getting actual experience
 Eg. “There is a big difference between a Filipino Nurses  Studies a group of people
working in USA than those working in the Phils.” after its occurrence,
 Selecting research design experience or facts.
o Systematic controlled plan for finding the answer to a problem  Experience of people in the
o Roadmap, blueprint of the study past
o Should have a proper resign design  Descriptive
o If improper research design, there will be improper collection of data  Observe, describe & record.
o Purpose : key or tool for proper collection of data  Study of current events.
o Types  Prospective
 According to Application  Study of research about
 Basic/ Pure future occurrence or future
o For personal knowledge, curiosity events.
  Historical  with initial and follow up
 Past that is written, survey
documented, published and  long term study
recorded  for developmental study
 Primary Data
o Observe  Selecting your population and samples
o 1st hand o sample
information  part of population, data is collected.
o person himself  The recipient of the experimental treatment in experimental
 Secondary Data design or the individuals to be observed in a non-experimental
o 2nd Hand design
Information o Types of sampling
 About the past using  Probability - equal presentation/ chances in the population.
records, journals, books.  Simple random technique
 Study of the dead people o Used a single/identical group.
thru his written materials, o Fish bowl technique
facts  Stratified random sampling
o according to data o You will first going to create a sub population
 quantitative from the whole population before doing
 data base on numerical randomization.
interpretation, datas that are o One population, you divide it.
measurable, using your  Cluster random sampling
senses, data that are o You will first create a sub area in a population
observable. before doing the randomization. In one
 qualitative population, you make it smaller
 subjective data, feelings,  Systematic random sampling
perception, beliefs, culture, o choosing a sample every nth name in the
attitude population.
o Survey Research Design o Multiple of 100 names
 Group o Sampling frame – list of names appearing as
 Small your population
 Face to face  Non-probability sampling – you are not choosing by chance.
 Large – not good result  Accidental/ convenience sampling
 Methods o Base on the accessibility/availability of your
 Mailed survey sample.
 Face to face o Kung sino pinakamalapit syo, yun ang kukunin
 Telephone survey mo.
o According to Time Orientation  Purposive/judgmental sampling
 Cross Sectional o base on the common knowledge or popular
 Applicable to 2 or more knowledge.
identical group  Snow-ball sampling
 Short term o get sampling base on last referral
 For comparison  Quota Sampling
 Longitudinal o Setting criteria and getting samples fitting the
 1 group only criteria
 Conducting pilot studies  Interpretation of Data
 Collecting data o 2 Methods
o types :  quantitative method – base on numerical or graphical
 questionnaires – use of pen and paper method standards
 dichotomous – divided into two. Eg. true orfalse. Yes or  qualitative method – use of narrative words
no  Communicating your conclusion
 rating scale – poor 1, good 2, better 3, best 4 o Explaining the results of your work to the public
 multiple choice o Conclusion – final answer to your research
 Interview – use of oral method of collection of data. Use of active o Recommendation – suggestion to others
listening o Dissemination of Information
 Structured – with checklist, formal talk, list of question  Methods :
 Unstructured – informal talk, no pattern, anything goes  thesis/book – written form
 records – pre existing data  symposia/symposium – oral presentation
 observation – use of ocular method using your senses  publish – a lot will be able to read your research
 participant observation
 non-participant observation
 Problems : LEADERSHIP
o Hawthorne’s effects Nursing Leadership
 The data you get from your sample is
 style or process whereby a person is called by a nurse leader were influence of
not accurate.
group of people called his followers for the purpose of attaining only one
 The sample has a problem
goal/objective.
 Solution : double blind research –
they should not be conscious that Principle for Effective Leadership
they are being studied
 Unity of Command – one group given by one leader
o Halo effect
 Unity of Direction – one group should always have one objective
 The researcher has a problem.
 He is manipulating the data  Subordination of your personal to your general interest – patient first policy
collection. o R – rescue your patient
 It is affected by special o A – alert the fire alarm
feelings/treatment between the o C – confine the fire in one area
researcher and the sample. o E – extinguisher application
o Esprit d’ corp/team spirit - Fault of one is the fault of all
 Analysis of Data
o part of research when the researcher is forming a body of knowledge out  Respondeat Superior/Command responsibility
of data collected for the purpose of affirming or denying your hypothesis o let the master or the superior answer for the negligence of his
o Methods subordinates in half of his patient who suffer from injury or death.
 Nominal method o you can delegate responsibility but not the accountability
 get data by means of categories.
Theories of Nursing Leadership
 eg. male, female, income
 Great-Man theory – born as a leader
 Ordinal method – base on rank eg. mild, moderate, severe
 Interval  Trait theory – develop characteristics or born with the characteristics
o 3 traits of a leader
 base on the distance between 2 numerical values
 P – personality (adaptability, independence, creative/assertive,
 eg. BP – 150/100 – 120/80, wt, circumference, ht
 ratio – 3:10 children are malnourish advocate) ability to adjust to the need of the pt
 I – intelligence (proper judgment, proper decision making,
proper communication)
  A – ability – (influence others, respect others, participate and  Centralized – top to bottom for proper management
cooperate) Proper way to influence is thru health teaching  Decentralized – Bottom, to manage directly
 Charismatic theory – becomes a leader because of the charm  B – Behavioral
 Situational theory/case to case basis o S – specialized body of knowledge and skills to do safe care
o a person can be a leader in one situation but only a follower in another o P – patient centered
situation. (eg. becomes a leader in where he specializes) o A – accountability – liable for the results of your actions
o C – confidentiality – nurse-patient relationship
Leadership styles  Exceptions to confidentiality of the contract :
 Authocratic/Authoritarian/dictatorial/”hard” leader  P – patient consent, if there is
o unilateral style of leadership. Only the leader here performs the decision  I – inform/report to healthcare team for purpose of
making without getting the inputs from his members. precautionary measures
o One sided style of leadership Behavior :  C – Communicable disease
A – apathy – insensitive to others o RA 3573 Law on Notifiable Disease
B – Boisterous speech o 24 – Polio/ Measle
C – consistency o 1 Week – SAD/ HIV/Tetanus Neonaturom
D – Dominating  C – Crimes
E – Exploitative behavior o Child Abuse  48 hours, Baranggay, NGO
F – ferocious behavior, to coerce or compel the group to follow him  E – ethics
o not a good style of leadership but only best style during emergency or
intensive crisis IV THERAPIST: Old RN, Training, 50 Insertion, ANSAP
 Permissive, ultra-liberal, laissez faire, free-rein New RN, Training
o Loose style of nursing leadership.
o Giving excess freedom or liberality towards your subordinates if to lenient  C – Communication skill
in your subordinates, there will be ↓ control and power = ↑ negligence o transfer of information with understanding
 Democratic/participative o Communication barriers/communication backlog – eg. Dialect differences,
o best style of leadership. Mutual style of nursing leadership noise, deaf, high level of anxiety, hallucinating
 D – Decision making skills
5 Power of a Good Leader o Steps
 Legitimate/ Formal/ exclusive Power  identify the problem
o Exercise because you are appointed to a higher position  identify person affected
 Expert Power  gather options/alternative
o You acquire extra – ordinary skills, talent or ability  brainstorming
 Referent Power  delphitechnique – gathering solutions outside the group
o Charisma and charm (eg. specialized nurse)
 Reward Power  choose and implement
o + power for the part of the leader  Evaluation
o gives rewards, bonus, promotion, compensation  E – Ethics
 Coercive Power o Principles
o – power on the part of the leader o Principle of Autonomy
o reprimand, suspend, terminate  independent judgment or decision making
 in all situation the pt himself is the one who should decide for his
ABC’s skills, qualities and abilities own care
 A – Authority  Consent
o basis of the leader to delegate tasks, responsibilities, jobs to be  respect the decision of the pt
performed by his subordinates  explain the risk to the patient/SO
o 2 types of authority  waiver - a legal doc when the pt refuse for treatment.
 o Principle of Veracity
 telling the truth to the patient
 #1 the patient has the right to know from the PHYSICIAN (not
the nurse)
o Principle of Double Effects
 if the pt is made to choose between 2 equal danger and he only
needs to choose one, choose the one that will produce one good
effect and less evil effect.
o Principle of Beneficence
 doing good to the patient (eg. providing therapeutic
communication, providing privacy)
o Principle of Non-Maleficence
 do no harm
 3 types of Harm
 Physical – negligence by commission
 Mental – assault and battery
 Moral – slander and libel
o Principle of Justice
 Prioritize the needs of the patient.
 To be able to provide nursing care to the patient, provide the
nursing process.
 Nursing Process characteristics :
 A – acceptable universally
 B - based patients assessment needs
 C – client focused
 D – dynamics – base on the ever changing needs of the
pt
 E – equitable care
 F – familiarity/rapport to the patient
 G – goal directed towards solving the assess needs of
the patient (SMART)
o Principle of Respect/Inviolability of life
 Suicide and abortion is violation of this principle
 F – Face/solve Conflicts
o any clash of ideas resulting to crisis
o Methods of resolving conflict
 avoidance – by paying attention
 smoothing – appealing to ones conscience and kindness
 unilateral action – use of forced fear or threat
 negotiation – best method in resolving conflict. The head nurse
should offer negotiation between conflicting parties.
NURSING MANAGEMENT
NURSING MANAGEMENT
 choosing the right person and giving them the appropriate task for the purpose of
achieving their goal/objective in achieving total care
Frederick Taylor’s Scientific Management Theory
 Elements
o choosing the appropriate person (TAO)
o choosing the appropriate team
o choosing the appropriate training
o choosing the appropriate tools
Human Relations theory
 the be a good manager, there should be a good interpersonal relationship between
the leader and follower
Douglas Mc Gregor’s Motivational theory
 Theory X
o Negative workers
o negligence, inefficient, ineffective workers
 Theory Y
o Positive workers
o diligent, effective, efficient worker
 theory X should be given focus because they are prone to negligence and
malpractice.
Max Weber’s Bureaucratic/ authoritarian Theory
 whoever is on the top would perform the management function
 centralized
Elton Mayto’s Behavioral Theory
 overtime pay, rest day, day off
 provide physical needs of the workers
 Hawthorne’s Effect
o If workers knows they are observed they become more efficient
Henry Fayol’s Principle of Management
 Unity of Command – one leader, one command
 Unity of Direction – one group should always have one goal
 Remuneration of Personnel – patient first policy
 Esprit de corps – team spirit
 Command responsibility/Respondeat Superior – let the superior answer the
fault of his subordinates even harm or death
 Balance between centralization and decentralization
 Security tenure
  Delegation of responsibility  Capital
 Proper Compensation of workers  long term use equipment
o RA 7305 (Magna Carta Law) – salary grade 50 P13,000/month (MRI, CT Scan, hospital
o Overtime pay – additional of 25%/hr beds, hospital buildings)
o Night Differential – additional of 10%/hr  Organizing
o Legal holiday – x 2 o 4 stages
o Philhealth - Benefit of worker both related and non-related work  Organize your team RN Subordinates
(aesthetic, dental and cosmetics are not included)  Duties of the RN
o Maternity leave – 60days leave is NSD, 78days if CS only to first 4  Only assessment can perform the nurse
pregnancy only to legitimate spouse  Only the nurse can perform HT
o Paternity leave – 7day/1week leave  Only the nurse should explain the procedure to the
o Senior Citizen’s Act – 20% discount patient
 Preparation, administration, treatment of drugs to the
5 steps in Management Process patient
 Planning stage
 The nurse can only perform evaluation
o looking ahead of time.
 The nurse can only do judgment
o Formulating future goals/objective
 Delegate Task
o Types of plan
 They can only delegate to subordinates the Routinary
 Standard/Operational Plan (NCP)
task (standard, unchanging procedure) eg. monitoring
 plans for everyday or ordinary activities
of I&O, bathing, ambulating, toileting, shampooing,
 Strategic/Contingency Plan
transporting, feeding, clothing, wiping
 plan used during sudden or acute crisis
 Stable patient - predictable outcome (eg. postmortem
 Long-range/future Plan
care with direct supervision of the nurse only)
 plans which you can’t evaluated immediately.
 Supervision – need guidance
 Usually last months or yrs.  Staff Schedule/ Staffing
 Used for chronic pt which requires longer period of  Schedules (How many hours)
care. o Traditional – 8hrs a day/40hrs/wk
o Stages of Planning Process o Ten hour shift/4 days a week
 Mission – present reason when established your organization o Baylor plan – it consist of two shifting nurses
 Vision - statement of your future purpose of your future
 traditional – mon-fri 8hrs
organization  2nd shift – 12hr shift during
 Philosophy – set of values and beliefs of your organization weekends
 Goal – general statement of your purpose o Part-time work – fewer working hours per day
 Objectives – more specific statement of your purpose
and may choose the day or work. Less than
 Policies – set of rules and regulations in your organization 8hrs job
 Procedures o On – call – during shortage of nurses/staff but
 Budgeting – proper allocation of your resources increase in the number of patients.
o 3 types  Methods of Nursing care Delivery
 Personnel  Different Methods
 Compensation for salaries of o Primary – 24hrs a day
workers  Primary nurse is the only nurse who
 Operational is responsible to make a care plan of
 everyday use of equipment the patient from the moment of
and facilities (gloves, water, admission till the moment of
electricity) discharge. (eg. private duty nurse or
special nurse)
 o Functional Method  Eg. lying – in due for C/S and was transferred to a
 DOH format/government hospitals hospital
 Assign nurse :  Evaluation/Controlling
 Duty/task o stage wherein you determine whether or not your plans for your patient is
 One nurse, one task met or achieved
 Highly recommended during o Methods of evaluating staff performance
a period of shortage of  Checklist
nurses and budget  it is being evaluated higher than you. (eg. nurse
 poorest method of delivery because manager/supervisor or head nurse)
communication is hindered  Nursing rounds
o Case Method/Case Nursing  it is being evaluated higher than you. (eg. Nurse
 provide total care within your shift. manager/supervisor or head nurse)
Used in ICU department  Psychiatric ward is not done by nursing rounds
 C – Case Method  Peer review
 T – total care to the patient  same rank or level is being evaluated you
 O – one is to one ratio  poor method
 Directing/Delegation stage  Performance appraisal
o a job or a task is done or performed by another perform for you  the patient evaluates you
o What you cannot delegate:  best method in evaluation
 you cannot delegate total control of the procedure
 you can’t delegate discipline of subordinates or staff members.
 Confidential task
PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE
 Technical task
 Medical task performing surgical procedure is done by the doc
Professional
not the nurse
 A calling in which its members profess to have acquired special values, knowledge,
 Coordination/Collaboration
training or by experience so that they may guide others in that special field.
o the nurse needs to collaborate to other members of the health care team.
o Multi-interdisciplinary approach – to be able to provide holistic approach
Nursing is a profession
to the patient.
o Types of Collaboration  Calling – service oriented
 Interpersonal/Intradepartmental  Others – patients
 One patient, one unit.
Characteristics by profession
 Collaboration between one nurse to another healthcare
 A – accountability/liability for the result
team in one unit/department
 C – caring profession  Central Focus
 Eg. MI patient - nurse, dietary, specialized in cardio
 Interdepartmental  C – competent
 4 units in one hospital.  E – ethics
 Coordination of the patients care between 2-more  S – service oriented
units/departments but still under one same hospital or  S – specialized scientific body of knowledge and skills
institution
 Eg. patient due for appendectomy is transferred to the PROFESSIONAL DUTIES OF A NURSE UNDER RA 9173
OR All are independent nursing actions
 Inter Agency/Institutional  Promotive, preventive, curative and rehab care in all health care service
 Coordination of patient’s care between 2 or more  health education
hospitals/health care institution for the benefit of the  utilizes nursing process
patient  link of patients in different health care services
  collaboration of patient’s care for continuity of patient care  Involves proper sanitation of an institution that engage in food
 train nursing students and water supply. Inside the institution. (eg. canteen, mineral
 supervision of subordinates water store, public market, Sex shop : ADONIS, PEGASUS,
 accurate recording and reporting CHICOS) not applicable to private sex practitioners.
 execution of valid doctor’s order (the only one that is dependent nursing action)  Prevention of Disease
 Perennial Suturing after training o PD 996 (EPI law)
 Perform IE if antenatal bleeding is absent and before full delivery  Compulsory Immunization of children below 9 y/o
 Psychological and social adjustments because you will be taking care of
A doctor’s order is valid when giving medication is when it is put into writing and signed by numerous clients
the physician. Whatever is not put into writing is considered not ordered by the physician. o RA 7160 (local government code)
 decentralization or devolution of care. The DOH together with
Good Samaritan Act DILG and local government units (brgy, provincial) together with
 During emergency, national calamity, national epidemic there is no doctor around community participation they made a local health board which is
the life or the patient is in possible danger, then you can give drugs alone provided the MAYOR.
you know the drugs for the patient.  Purpose of local health board : it makes quality health care
available, accessible and proximal for all
RA 8344 – No deposit policy during emergency cases only  Participation is maintained with all members of the community, health care
team and family
Areas of Nursing Practice
1. Institutional Nursing 3. Occupation Health Nursing
 Hospital Based Venue  industrial or company health nurse
 D – Duties are routinary and supervised  Duties :
 A – Acquired different learning and technical skills o Curative/rehabilitative
 C- Coordination with HCT  C – care for sick/injured laborers
 S – Specialized areas  R – Referral
o Nurse Generalist – community nurse  V – Visit and ff. ups (home visits)
o Nurse specialist – staff nurse o Promotive/Preventive
 N – nutritional
2. Public Health Nursing  S – safety and sanitation
 Once a Public nurse in the community, you are focus on the preventive and  C – Counseling
promotive of health because this is the mandate of Primary Health Care Law.
 1st PHC 4. Clinical Instructor
o Date : 1978 o Qualifications :
o Place : Alma Ata  A – accredited nursing Org
o Country : Russia  M – MAN in nursing or other health courses
o Local version of F. Marcos after 1yr of Alma Ata  O – One yr clinical experience
o Conference: Letter of Instruction 949 that mandates that all public workers  R – R.N.
to have a duty of promotive and preventive care for the patient.
 Promotion of Public Health PHILIPPINE NURSES ASSOCIATION
o PD 8976 – Micronutrient Supplement Act o When was PNA founded : Oct. 22, 1922 (10-22- 22)
o Who is the founder PNA : Anastacia G. Guiron Tupas
 Vit. A, iron supplements, iodine
o Purposes :
o PD 825 (Environmental sanitation law of the Phils.)
 P – professional well-being
 It is cleanliness of the environment. Outside the institution (eg.
 U - unity
proper disposal of excreta, proper drainage system)
 P – promotes reciprocity even outside the Phils.
o PD 856 (sanitation code of the Phils.)
 A – advancement of the knowledge and skills of the nurse
  E – ethics promulgation  Intestate Succession – without last will and testament
 2 types of Last Will and Testament
Proclamation Order 539 o Property
 Declared by Pres. Garcia law declaring the last week Oct as the official nurses  Notarial/ Ordinary Will
week.  Check LOC
 Check proper location of the signature – end part of all
School of Nursing in the Philippines the pages at the side
 UPCN – 1st  Nurses can be a witness
 Schools originated in the Phil.  Holographic Will
o Iloilo Mission hospital  During emergency cases
o PGH  No witness involved call a persdon who knows and
o St. Luke’s familiar with the handwritten of the testator
o Mary Johnston Hospital  Entire last will and testament is hand written dated and
o St. Paul Hospital signed by the testator
o San Juan de Dios o Life Body
 Advance Directives
Contracts and Consents  Respectful death
 Direction/ instruction of the patient in advance
Characteristics of a Valid Consent
 DNR, donate organ, cremation
 V – voluntariness
 O – Opportunities to ask question be explained to pt Medications and prescription
 T – treatment explained to the patient  only registered medical, dental and veterinary practitioners are authorized to
 U – understood by pt prescribe drugs
 M – matured both physically and mentally  3 information
o name of the AMD, address of his clinic/hosp and PTRC license #
Criteria of a good consent : o name of the pt, age, sex
 18 y/o – above o drug name, frequency, duration of the drug
 Mentally capacitated (absence of insanity and imbecility)  RA 6675 Generic Act
 If below 18 y/o and mentally incapacitated a proxy consent : in chronological order o all prescribe drug must be written in generic and brand name or generic
o Parents name but never the brand name alone)
o Guardian o Purpose : for the pt to choose what brand name they want
o physician (if parents and guardian are dead)  Remember the 10 R’s of medication
 Guardian Ad Litem – social worker or Surgeon  Right patient name by checking the pt wrist tag
 Verbal or telephone – only done during emergency
Nurses and Illegal Detention  doubts or error – in case there is doubt in medication, refer to the physician
 it happens if someone will limit the freedom of the patient to move or travel from  IV drugs – in proper training
one place to another.
 HIV Patient – should be kept in one room Documentation, recording and charting
o Felacio – oral sex – most fastest mode of transfer  Patient Chart – absolutely legal
o Cannalingus – tongue on clitoris  Purpose of a patient Chart
o Analingus – tongue on anus – least mode of transfer o Communication and conitinuity of care
o Assurance of quality of care
Last Will and Testament o Research
 Act whereby a person is permitted by the law to have control in the manner of o Legal document
disposing/ giving his estate but will take effect at the time of his death o Statistics of disease
 Testate Succession – son or daughter will inherit the last will of the parents
  Subpoena – order coming from the court  the offended performs everything to consummate the crime but it
o Subpoena Duces Tecum – any documents, objects, papers, materials did not happen
o Subpoena Ad Testificandum – person who will testify (witness) o attempted
 Do’s in Charting  crime has not happened (overt acts – acts merely showing the
o F – full, factual and objectively accurate intention to commit the crime)
o L – legible  degree of participation
o I – immediate o principal
o P – Personal  degree of participation is very important/indispensable because
 Adendum – late entry/late documentation he is the primary author of the crime.. If no principle, there is no
 Don’ts in charting crime.
o L – language, jargons or words which are unacceptable o accomplice
o I – improper corrections  participation is merely dispensable.
o S – Spaces and skips  Usually performs before (eg. referral by the nurse of a abortionist
o Abbreviation to a pregnant women) or during the crime eg. OB nurse is to
perform abortion. The nurse is look out for police. The nurse is
the accomplice.
LEGAL DOCTRINES IN NURSING o accessory
 usually performs after the crime (eg. stole a nebulizer in the
Professional Negligence hospital. Sold the nebulizer to an asthmatic pt) This is an
Negligence accessory because he benefited from the crime
 failure to do something which are reasonable and prudent nurse should have done
something under a particular situation. (eg. failure to raise side rales when the pt is RA 7877 – Anti sexual harassment law
unconscious)  committed by any person who exercises authority. (eg. teacher to student, head
 3 elements of negligence nurse to staff nurse).
o duty on part of the nurse  That person who is in authority is asking for a sexual favor in an exchange of
o failure to do said duty another favor.
o injury, harm, death – most important negligence
Types of Rape
Malpractice  Ordinary rape
 injury, harm or death is not important in malpractice o a forcible penetration of an organ for copulation to another organ for
 The nurse is allowed to perform episiorrhapy copulation. (eg. women are only the victim)
 with proper training but not episiotomy  sexual assault
 The nurse is allowed to perform IE but with 2 conditions : o anything that is forcible inserted to a body orifice with sexual malice.
o fetal aberration/ abnormal delivery o Also form of rape (eg. hand or an object is being inserted in the anal.
o prior to complete delivery Committed in both female or male)
o Intervention :
Crimes affecting nurses  S – safety (emotional or physical safety)
 Types of crime :  R – report (↓ 18 – report to brgy.)
 Manner of Commission  R – referral (if father is the rapist, refer to DSWD)
o DOLO – crimes committed with deceit. Crime with real criminal intention
o CULPA – crimes committed under negligence. Crimes that are intentional Abortion
 stages of execution  is the expulsion or termination of a product of conception before the stage of
o consummated viability. (3-6month/12-24weeks)
 when the crime intended is totally committed or perfected Infanticide
o frustrated  kill the person in less than 3days or 72hrs of life.
Parricide o P – Pecuniary interest (Absence)
 killing another person to whom you have a relationship (mother, father, husband) o T – 10 years nursing practice but 5 yrs must be in the
Homicide Phils.
 unintentionally killing another person without any relationship (eg. negligence in o C- Citizen & resident of R.P.
giving meds)  Who formulates the question of the Board Exam? – Board of
Murder Nursing
 intentionally killing another person without any relationship  In having a license it is a Privilege not a Right
Simulation of birth  Board of Nursing issues the license
 committed by any person who shall substitute one child to another child or alter his  PRC issues the certificate of registration
identities for the purpose of losing his civil status. (eg. the midwife failed to report  CHED are the ones who has the power to open and close a
the birth of the baby, giving wrong information of the gender of the baby) nursing school
PD 651 (Birth registration act)  BON just inspects 5 consecutive years of below 80% passing
 law any person who assist in giving birth to report within 30 days to the Local Civil rate, the school will be closed
Registration Office  Powers and Functions of BON
o L – Licensure exam
Law Affecting Nurses o I – Issue COR
 Act 2808 (yr. 1919) – first true nursing law o M – Monitor standards of nursing practice
o It removed from the doctor the control of nurses with 3 man team (1 o E – Education
chairman and 2 members all nurses) o C – Code of ethics
 1920 – 1st official board exam o H – Hear and decides cases of negligence and
malpractice
 1st nursing school (6months)
o A – Accredits different organizations
o Iloilo Mission Hospital (1906)
o G – Guides Nursing Practice in the phils
o PGH School of Nursing (1907)
o Dean
o St. Luke’s school of nursing (1907)
 R.N., MAN
o Mary Johnson’s school of Nursing (1907)
 5 years nursing experience
o St. Paul Iloilo 1907)
o Clinical Instructor
o San Juan de Dios (1907)
 A – allied in nursing or any allied health courses
 1st college of nursing (4years) – UP
 M – member of PNA
 RA 7164 (1991)
 O – 1 yr experience
 RA 9173 (Oct 21, 2002)  R – R.N.
o Board of Nursing o Nursing Administrator
 Old Supervisor/Manager H Community Military Hosp
o M – MAN
o A – Accredited Nursing Org (PNA)
 B – BSN RN
o F – five MAN team (1 chairman, 4 members)
o S – 65 y/o – 1 year interim period  A – Accredited Org
o N – Not convicted of any crime  N – 9 units
o P – Pecuniary interest (Absence)  T – 2 yrs
o T – 10 years nursing practice
o C- Citizen of R.P. Chief/Director
 New RN + MAN + Add only MAN +
o M – MAN 5 yrs supervisor master’s in GSC
o A – Accredited Nursing Org (PNA) experience PHN or (Gen.
o S – 7 MAN team (1 chairman, 6members) (N.B. if primary CHN Staffing
o I – immediately resigned upon appt. hosp) Course)
o N – Not convicted of any crime
  What are the grounds for nurse not to be registered?
o Examinees o D – Dishonorable conduct
 CGM (Good Moral Character) o U – Unsound mind
 Proofs of Valid Holder of Filipino Citizenship o M – moral turpitude
 Proofs of valid holder of a BSN Degree only from schools whose o I – Indecent immortal conduct
curriculum is approved by the CHED
 3 docs sub to PRC
 RLE certificate
 TOR with Scanned picture
 List of cases
 Examination fee is P900
 Last day Is :

Other related laws

 PD 223 – PRC Act
 RA 1080 – Civil Service exam Cum Laude, Board passer – eligible in taking CSE
 RA 6425 – Dangerous drugs Act
o punishable with 2 chemical substances
 Prohibited drugs
 chemical substance totally, abosultely can’t be
consumed by human being (eg. Shabu, Mariana,
Cocaine, Opium)
 Regulated drugs
 you can use this drug provided the pt has the
prescription and the AMD has appropriate license
coming from the BFAD or Dangerous Drugs
 RA 7600 – Baby Friendly Hospital.
o Early bonding for mother is Early Rooming in and early baby breast
technique for early bonding Early bonding for father is thru cuddling
 E.O. 51 – Milk Code (Breast Milk)
o Avoid manufactured or formula milk
 How to be an R.N. under 9173
o Have all qualifications
o take the exam
o acquire the required ratings
o In order to pass the examination, an examinee must obtain a general
average of at least 75 % with a rating of not below sixty percent (60%) in
any subject
o An examinee who obtains an average rating of 75% or higher but gets a
rating below 60% in any subject must take the examination again but only
in the subject or subjects where he/she us treated below 60 % (60%). In
order to pass the succeeding examination, an examinee must obtain a
rating of at least 75% in the subject or subjects repeated.”
 RA 8981 –Modernization Act.
 For every 5,000, results will be released after 5days