Evolution Act No.

2493 (1915) - regulating the practice of medicine in the Philippines during American time - sections 7 & 8 contain provisions related to nursing as an adjunct to medicine Act No. 2808 (1919) - first true Philippine nursing law - created the board of examiners for nurses (Board of Nursing). The 2 members are nurses. The chairperson is a physician. RA 877 (1953) Comprehensive Nursing Law of 1953 - BON was composed of 3 members & 1 chairperson; and 2 additional members with other powers and duties. RA 4704 (1966) - increased the composition of the BON into 5 - age limit of 65 years old RA 7164 (1991) - Philippine nursing act of 1991 -same composition for the BON but removed the age limit

y As members of the health team, nurses shall collaborate with other health care providers for the curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death

It shall be the duty of the nurse to PEPUT

y Provide nursing care Nursing care includes, but is not limited to, through the utilization of traditional and innovative approaches, therapeutic use of self, executing health care the nursing process. techniques and procedures, essential primary y Establish linkages with health care, comfort measures, health community resources and teachings, and administration of written prescriptions for treatment, therapies, oral, coordination with the topical and parenteral medications, internal health team examination during labor in the absence of y Provide health education antenatal bleeding and delivery. In case of suturing of perineal laceration, special to individuals, families training shall be provided according to and communities protocol established. y Undertake nursing and health human resource development training and research y Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision making skills of a registered nurse

RA 9173 The Philippine Nursing Act of 2002

~It is the law that governs the practice of the nursing profession in the Philippines. Principal authors: y Sen. Juan Flavier (Senate Bill No. 2293) y Cong. Carlos Padilla (House Bill No. 1084)

Goal: A more responsive nursing law and nursing profession to balance national health needs and global demands

Registration ~ The recording of names of persons who have qualified under the law to practice their respective professions License ~ A legal document given by the government that permits a person to offer to the public his or her skills and knowledge in a particular jurisdiction, where such practice would otherwise be unlawful without a license Modes of Registration REST: Reciprocity, Examination, and Special or Temporary Permit
S.S. Ocean y Registration by Reciprocity: SS ~A certificate of registration/professional license may be issued without examination to nurses registered under the laws of a foreign state or country provided:  Same requirements for registration or licensing of nurses as those prescribed under the RA 9173  Same privileges granted to registered nurses of the Philippines given in that country

Dates to remember: y October 08, 2002 Approval of the House of Senate (Senate Bill No. 2293) y October 15, 2002 Passed by Congress (House Bill No. 1084) the Bicameral Conference Committee consolidated the 2 bills y October 21, 2002 The consolidated version was signed into law by President Gloria Arroyo

Salient Points of the RA 9173

Scope of nursing practice: IIAA
y Initiate and perform nursing services to individuals, families and communities in any health care setting y Includes, but not limited to, nursing care throughout the lifespan (conception, labor, delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood, & old age) y As independent practitioners, nurses are primarily responsible for promotion of health & prevention of illness

 Requirements for applicants: BRRR BSN curriculum of applicant (copy), RN s in their country, Residents of the Philippine for 3 years, Reciprocal foreign law (copy)
y Practice through Special/Temporary Permit: MIX

 Medical missions for free  Internationally recognized experts or specialists (free or for a fee)  Xchange professors in schools/colleges of nursing
y Registration by Examination

~Suspension should not  Conviction by final judgment exceed four years  Offense against Nursing Law ~Revoked certificate of registration may be BRRR! Cold! and Code of Ethics  Wrong and unethical conduct issued after the maximum duration of 4 years upon  Practicing during suspension application and payment of appropriate fees,  Incompetence gross provided that the cause  Conduct unprofessional for revocation has been Reissuance of revoked certificates corrected or disappeared of registrations / replacement of lost certificates: ProCaRe  Proper application and payment  Cause of revocation has been corrected  Reasons of equity and justice, maximum of 4 years Requirements for nurses returning to practice: ROT  Retrain in a accredited institution  One month didactics (lecture)  Three months practicum The Board of Nursing ~ The government agency which regulates the practice of nursing in the Philippines ~ Composed of a Chairman & 6 members ~ Each one has a 3-year term, and can be reappointed once for another 3 years ~ If a BON member is unable to complete his/her term period, his/her replacement shall fill in and serve the unexpired portion of the term only.

Qualifications: BCG  BSN graduate  Citizen of the Philippines, or a citizen or subject of a country which permits Filipino nurses to practice on the same basis as the citizen of such country (reciprocity)  Good moral character Board Rating Prescribed by Law  General average of at least 75%  No subject with a rating below 60%  Should an applicant obtain an average of 75% or higher but gets a rating below 60% in any subject, he/she has to retake the exam but only on the subject/s which is rated below 60%. To pass, he/she has to get at least 75% in the subject/s repeated Grounds for Non-Issuance of License/Non-Registration: C3  Conviction by final judgment of any crime involving moral turpitude  Conduct, immoral and dishonorable  Court declared him/her as having unsound mind

Current composition of the BON (until mid-2011): Chairperson: Hon. Carmencita Abaquin Members: Hon. Perla Po, Hon. Betty Meritt, Hon.Marco Antonio Sto. Tomas, Hon. Leonila Faire, Hon. Yolanda Arugay, and Hon. Members of the BON may be appointed by: Amelia Rosales 1. Regular appointment. The Philippine Nurses Association certifies for the Appointment to the Board of Nursing from the three (3) nominees per vacancy and the Board shall endorse two (2) nominees per vacancy to the President 2. Ad interim Appointment A board member is appointed in the meantime to fill in a vacancy or perform the duties of an office during the absence of the regular incumbent. There is no definite term of appointment
y Qualifications: RN MAMA

Grounds for Suspension/Revocation of Registration: MUD COW PIC

 Registered nurse  Natural born Filipino citizen and resident of the Philippines  Master s degree in nursing, education and related fields (Chairperson and majority of members should be masters in nursing)  At least 10 years of practice of the nursing profession; the last 5 years should be in the Philippines  Moral turpitude crimes- not convicted of any  Accredited professional organization member picture a cow stuck in the mud  Malpractice or negligence  Unsound mind  Deceit, fraud, or false statements in obtaining certificate of registration Hold-over doctrine simply requires those who have been appointed to continue serving or holding their position even if their terms has already lapsed, until such time that their replacement shall be appointed. Jus Sanguines Doctrine nationality is determined by parental descent Jus Soli Doctrine nationality is determined by place of birth Natural-born citizen citizens of the Philippines by birth who need not perform any act of acquire or perfect his/her citizenship Citizen - A person owing loyalty to and entitled by birth or naturalization to the protection of a state or nation Moral Turpitude -acts contrary to justice, honesty, modesty, or good morals

y Powers and Functions of the Board

Regulatory Function: CRIME  Conduct nurses licensure exam  Recognize nursing specialty  organizations in coordination  with the accredited professional organization (APO)  Issue, suspend or revoke certificates of registration in the practice of nursing  Monitor and enforce quality standards of nursing practice  Ensure quality nursing education Quasi-Judicial Function: CPP (Mnemonics includes Quasi-Legislative)  Conduct hearings and investigations to resolve complaints against nurse practitioners: with powers to issue subpoena and cite contempt Quasi-Legislative Function:  Promulgate a Code of Ethics in coordination and consultation with the APO  Prescribe, adopt, issue and promulgate guidelines, regulations and decisions for the improvement of the nursing practice, advancement of the profession and enforcement of Nursing Act subject to review and approval of the PRC
y Removal and Suspension of Board Members: ICU  Incompetence  Commission/toleration of irregularities in the NLE, continued neglect of duty  Unprofessional, immoral, dishonorable conduct

2. Specialty Certification Board in Each of the Four Major Nursing Specialties CM3 Nursing Specialty Certification Program aims to train at least y Community Health 10% of all public nurses per y Medical - Surgical year and its funding shall come y Maternal and Child Health from the Philippine Charity y Mental Health and Psychiatric Sweepstakes Office (PCSO) Certification shall be given in three (3) levels  Level I - Nurse Clinician I  Level II -Nurse Clinician II  Level III - Clinical Nurse Specialist (fields: critical care, oncology , renal and other areas as may be determined by the board) Qualifications for Certain Fields of Nursing Nursing Service Administrators (Hospital /Institutional Nursing): NARA y Nine units in management and administration graduate level y At least 2 years of experience in general nursing administration y Registered nurse in Philippines, BSN graduate y Accredited professional organization member in good standing Those occupying the position of chief nurse or director of nursing service: FM  Five years of experience in a supervisory or managerial position in nursing  Master's degree in Nursing Clinical Instructor (Nursing Education) y Master's degree in nursing, education, or other allied medical & health sciences y At least 1 year of clinical practice in the field of specialization y Registered nurse in the Philippines y APO member in good standing

Nursing Specialty Certification Program Certification ~Mechanism that is used to validate achievement of a level of clinical specialty or functional expertise and competence that goes beyond the level of basic licensure. By passing specifically prepared written examinations, nurses are able to qualify for certification in most nursing practice areas. Legal Basis - R. A. 7164 - Philippine Nursing Act of 1991, Board of Nursing Resolution No. 14, S. 1999; R. A. 9173 Sec. 32 1. Creation of a Nursing Specialty Certification Council (NSSC) to oversee the administration of the program by the Specialty Certification Board
y NSSC shall be composed of 5 officers  Chairman - member of BON  Vice-Chair, Secretary, Treasurer - appointed by the Chairman of the PRC from the recommendees of the BON  Business manager - consumer representative

Those occupying the position of dean of the college of nursing  Five years of experience in nursing education  Master's degree in Nursing Fields of Nursing/Areas of Specialization: In CAMP PINIS
y Independent Nursing Practice ~Means that the nurse is self-employed and provides professional nursing services to patients & their families e.g.EntrepreNurse

y Clinic Nursing ~ Nurses work with a doctor and serves as the receptionist, data gatherer and organizer. Scheduling of appointments and organizing the patient s files are the major activities in this field. Simple procedures such as immunizations or suturing of wounds are assisted by clinic nurses. y Advanced Practice Nursing ~Synonymous with specialization; an umbrella term for nurses who have specialized education & experience beyond the basic nursing program e.g. clinical nurse specialists. y Military Nursing ~ Nurses here are specially trained for medical services during war or peace. They are responsible on the health of both civilians (mostly in delivering services as part of community relations) and military men as well as people considered as enemies. This kind of field demands endurance of the rapid activity and action on the unpredictable field of work. y Private Duty or Special Duty Nursing ~Nurse renders comprehensive nursing care to any type of patient on a one-to-one ratio. A private duty nurse is an independent contractor. y Public Health or Community Health Nursing ~ Nurses are exposed to the community set-up wherein their clients are individuals, families or groups. Emphasis is on promotion of health and prevention of diseases. y Institutional or Hospital Nursing ~ Nurses work with a health team and the setting is most likely hospitals, hospices, clinics and nursing homes. y Nursing Education ~ Nurses here are also teachers and molders of the future of nursing. They equip young minds in order to be competent nurses later on. y Industrial or Occupational Health Nursing ~Specialty practice that provides and delivers health care services to workers. The focus is on promotion, protection, and supervision of workers' health within the context of a safe and healthy work environment. y School Nursing ~ Nurses are responsible primarily in the welfare of students as well as the faculty. They responsible in health care activities by the school in the areas of health service, health education and environmental health and safety.

2. Qualifications of the Chairperson and Members of the BON y RA 7164: 6 qualifications y RA 9173: 5 qualifications removed the provision from RA 7164 prohibiting the appointment to the BON of holders of green card (US permanent residence status) and the like. 3. New Provisions y Rules on licensure exam with the exclusion of a requirement of the refresher course. In R.A. 7164, if the exam was taken for 3 times without passing, a refresher course is required. While in R.A. 9173, the taker could have the exam countless times without a refresher course. y Addition of a section: Requirements for nurses who have not actively practiced for 5 consecutive years 1 month didactic program and 3 months practicum in any hospital accredited to conduct continuing education units y Provision of time frame within which a nurse with a revoked Certificate of Regulation (COR) may seek reissuance of another Certificate of Regulation/ID card not exceeding 4 years. y Revision on the qualifications of the faculty and dean of the College of Nursing. y Simplification but comprehensiveness in the scope of nursing practice. y Refocusing on continuing professional education with trainings and seminar. y Enrichment on the qualifications of nursing service administrators by giving priority to those with Master s degree in Nursing and general staff course. In R.A. 7164, A Master of Arts in Nursing Major in Nursing Service Administration and 9 units of Management courses is required. y Supplementing the article on Health Human Resources, Product Utilization and Development. With sections on salary (sets salary grade 15, as described in RA 6758, as the minimum base pay for all public health nurses; PNA calculates salary grade 15 at around P24,000 today), comprehensive nursing specialty program, funding on incentives and benefits y Increase of the minimum and maximum fine for those in violation of any of the provision of this act Fine for violations of RA 9173 have been raised to not less than P50,000 pesos to not more than P100,000. In RA 7164 it used to be not less that P10,000 to not more than P50,000. y An article on final provisions covering the mechanism on the enforcement of this act. y Applicants to nursing schools are no longer required to be on the top 40% of his/her high school graduating class y Minimum age of 18 years old qualify in applying for the NLE has been removed. y BSN graduates from state colleges and universities are no longer required to render 1 year of nursing service in the Philippines after issuance of license y IV Therapy training is no longer a requirement of the nursing law but only that of the ANSAP (Association of Nursing Service Administrators of the Philippines). Latest BON guidelines indicate that it should already be incorporated in the BSN curriculum.

Penalties for violations of RA 9173: FIB y Fine (not less than P50,000 and not more than P100,000) y Imprisonment (not less than 1 year and not more than 6 yrs) y Both, depending on the court RA 9173 repealed and superceded RA 7164 (Philippine Nursing Act of 1991) as the special law governing the nursing profession RA 9173 and RA 7164: What has changed? 1. Creation and composition of the BON y RA 7164: 5 Members, 1 Chairperson. The Chairperson and members of the BON are appointed by the President from a list of 12, nominated by the PNA & duly certified by the PRC. y RA 9173: 6 Members, 1 Chairperson. (1) The PNA recommends 3 nominees per vacancy. (2) The PRC will recommend 2. (3) The President appoints 1. To illustrate, if there are 2 vacancies, there will be 6 nominees from the PNA, 4 recommendees by the PRC, and 2 appointees by the President.

The End-all, Be-all Reference Guide to Other Related Laws

REPUBLIC ACT an act passed by the Congress of the Philippines in a Republican form of government.
y Republic Act 349 Use of human organs for surgical, medical and scientific purposes. y Republic Act 546 The BON was transferred under the authority of the President y Replublic Act 649 Government Nurse Salary Act y Republic Act 997 Abolished the Division of Nursing and established the 3 main divisions of nursing service, education, communication, and community health. y Republic Act 1054 Requires the owner, lessee or operator of any commercial, industrial or agricultural establishment to furnish free emergency, medical and dental assistance to his employees and laborers. y Republic Act 1080 Civil Service Eligibility (NLE passers are automatically civil service eligible) y Republic Act 1082 Rural Health Unit Act y Republic Act 1136 Act recognizing the Division of Tuberculosis in the DOH y Republic Act 1612 Privilege Tax/Professional tax/omnibus tax should be paid January 31 of each year y Republic Act 1891 Act strengthening Health and Dental services in the rural areas y Republic Act 2382 Philippine Medical Act which regulates the practice of medicine in the Philippines Nurses may perform acts of physicians in case of national emergencies and if the DOH secretary gives a permit y Republic Act 2644 Philippine Midwifery Act y Republic Act 3573 Reporting of Communicable Diseases Report within 24 hours: Polio, Measles Report within 1 week: Neonatal teatanus, HIV/AIDS, severe acute diarrhea y Republic Act 4073 Domicillary (home) treatment of Leprosy y Republic Act 4226 Hospital Licensure Act y Republic Act 5181 Reciprocity law y Republic Act 5821 The Pharmacy Act y Republic Act 5901 40 hours work for hospital workers y Republic Act 6111 Medicare Act y Republic Act 6365 Established a National Policy on Population and created the Commission on population y Republic Act 6425 Dangerous Drug Act of 1992 y Republic Act 6511 Act to standardize the examination and registration fees charged by the National Boards y Republic Act 6675 Generics Act of 1988 y Republic Act 6713 Code of Conduct and Ethical Standards for Public Officials and Employees (reference for BON Res. 220) y Republic Act 6725 Act strengthening the prohibition on discrimination against women with respect to terms and condition of employment y Republic Act 6727 Wage Rationalization Act y Republic Act 6758 Standardized the salaries y Republic Act 6809 Majority age is 18 years old y Republic Act 7164 Philippine Nursing Act of 1991 y Republic Act 7170 Law that governs organ donation y Republic Act 7277 Magna Carta of Disabled Persons y Republic Act 7305 The Magna Carta of Public Health Workers

y Republic Act 7392 Philippine Midwifery Act of 1992 Nurses may take midwifery exam without a midwifery degree y Republic Act 7432 Senior Citizen Act (20% discount) y Republic Act 7600 Rooming In and Breastfeeding Act of 1992 Breastfeeding: Early (first 30 mins) Exclusive (first 6 months) Extended (up to years and beyond) Republic Act 7610 Special protection of children against abuse, exploitation and discrimination act y Republic Act 7624 Drug Education Law y Republic Act 7658 An act prohibiting the employment of children below 15 years of age y Republic Act 7719 National Blood Services Act of 1994 Requirements: Weight 45 kg for 250 cc blood 50 kg for 450 cc blood Age 18-65 (16-17 yrs old need parental consent) BP 90/60 - 160/100 mmHg Hgb 12.5 g/dL General good health y Republic Act 7875 National Health Insurance Act of 1995 y Republic Act 7877 Anti-sexual harassment Act of 1995 y Republic Act 7883 Barangay Health workers Benefits and Incentives Act of 1992 y Republic Act 8042 Migrant Workers and Overseas Filipino Act of 1995 y Republic Act 8172 Asin Law y Republic Act 8187 Paternity Leave Act of 1995 y Republic Act 8203 Special Law on Counterfeit Drugs y Republic Act 8282 Social Security Law of 1997 (amended RA 1161) y Republic Act 8291 Government Service Insurance System Act of 1997 (amended PD 1146) y Republic Act 8344 Hospital Doctors to treat emergency cases referred for treatment y Republic Act 8423 Philippine Institute of Traditional and Alternative Medicine y Republic Act 8504 AIDS Prevention and Control Act of 1998 y Republic Act 8749 The Philippine Clean Air Act of 1999 y Republic Act 8981 PRC Modernization Act of 2000 y Republic Act 9165 Comprehensive Dangerous Drugs Act 2002 y Republic Act 9173 Philippine Nursing Act of 2002 y Republic Act 9226 Hospital Licensure Act y Republic Act 9288 Newborn Screening Act Time: 24 hours to 2 weeks after birth (ideal 48-72 hours) Heel prick, then blood is dried for 4 hours Transport within 24 hours to newborn screening facility Results are released in 7 days (within 24 hours if positive) Diseases: congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketunuria, G6PD deficiency y Republic Act 9439 Anti-Hospital Detention Act Hospitals may not hold patients for inability to pay. Patients need only to sign a promissory note. y Republic Act 9442 20% discount for persons with disabilities y Republic Act 9502 Cheaper Medicines Law (includes a provision that medical professionals should prescribe using the generic names only) y Republic Act 10028 Expanded Breastfeeding Promotion Act 2010 requires lactation stations and lactations breaks in workplaces

PRESIDENTIAL DECREE An order of the president by virtue of possessing the powers of law-making and execution. Such was the case during the Martial Law period (1972-1986).
y Presidential Decree 46 An act making it punishable for any public official or employee, whether of the national or local government, to receive directly or indirectly any gifts or valuable things y Presidential Decree 48 Limits benefits of paid maternity leave privileges to four children y Presidential Decree 69 Limits the number of children to four (4) for tax exemption purposes y Presidential Decree 79 Population Commission y Presidential Decree 147 Declares April and May as National Immunization Months y Presidential Decree 148 Woman and Child Labor Law Employable age is 16 years old y Presidential Decree 166 Strengthened Family Planning program by promoting participation of private sector in the formulation and implementation of program planning policies. y Presidential Decree 169 Requiring Attending Physician and/or persons treating injuries resulting from any form of violence. y Presidential Decree 223 Professional Regulation Commission y Presidential Decree 442 Labor Code regulates employees unionization and collective bargaining rights. Provision for a 10% night differential pay for hospital workers. y Presidential Decree 491 Nutrition Program y Presidential Decree 539 Declaring last week of October every as Nurse s Week. October 17, 1958 y Presidential Decree 541 Allowing balikbayan Filipino professionals to practice their respective professions in the Philippines so they can provide the latent and expertise urgently needed by the homeland y Presidential Decree 568 Role of Public Health midwives has been expanded after the implementation of the Restructed Health Care Delivery System (RHCDS) y Presidential Decree 603 Child and Youth Welfare Act / Provision on Child Adoption y Presidential Decree 626 Employee Compensation and State Insurance Fund. Provide benefits to person covered by SSS and GSIS for immediate injury, illness and disability. y Presidential Decree 651 All births and deaths must be registered 30 days after delivery. y Presidential Decree 791 Empowered nurses, midwives, and other health professionals to promote acceptable methods of contraception (mostly artificial) y Presidential Decree 825 Providing penalty for improper disposal garbage and other forms of uncleanliness ~(garbage is collected from 8 2 5) th y Presidential Decree 851 13 Month pay y Presidential Decree 856 Code of Sanitation y Presidential Decree 965 Requiring applicants for Marriage License to receive instruction on family planning and responsible parenthood. y Presidential Decree 996 Provides for compulsory basic immunization for children and infants below 8 years of age. y Presidential Decree 1359 A law allowing applicants for Philippine citizenship to take Board Examination pending their naturalization. y Presidential Decree 1519 Gives medicare benefits to all government employees regardless of status of appointment. y Presidential Decree 1636 requires compulsory membership in the SSS and self-employed

PROCLAMATION an official declaration by the Chief Executive / Office of the President of the Philippines on certain programs / projects / situations y Proclamation No.6 UN s goal of Universal Child Immunization; involved NGO s in the immunization program y Proclamation No. 118 Professional regulation Week is June 16 to 22 y Proclamation No. 499 National AIDS Awareness Day y Proclamation No. 539 Nurse s Week every third week of October y Proclamation No. 1275 Declaring the third week of October every year as Midwifery Week LETTER OF INSTRUCTION An order issued by the President or department secretary to concerned public officials/government bodies which serve as a guide to his/her previous decree or order.
y LOI 47 Directs all school of medicine, nursing, midwifery and allied medical professions and social work to prepare, plan and implement integration of family planning in their curriculum y LOI 949 legal basis for Primary Health Care (10-19-79) y LOI 1000 Government agencies should be given preference to members of the accredited professional organization when hiring

EXECUTIVE ORDER an order issued by the executive branch of the government in order to implement a constructional mandate or a statutory provision.
y Executive Order 51 The Milk Code, banning of ads of milk formulas for less than 2 year olds. y Executive Order 174 National Drug Policy on Availability, Affordability, Safe, Effective and Good Quality drugs to all y Executive Order 180 Government Workers Collective Bargaining Rights Guidelines on the right to Organize of government employee. y Executive Order 203 List of regular holidays and special holidays y Executive Order 209 The Family Code (amended by RA 6809) y Executive Order 226 Command responsibility y Executive Order 503 Provides for the rules and regulations implementing the transfer of personnel, assets, liabilities and records of national agencies whose functions are to be devoted to the local government units. y Executive Order 857 Compulsory Dollar Remittance Law

OTHERS: y Act 1931- establishment of nursing schools under the Bureau of Education in 1909 y Act 1975 authority over nursing schools transferred from Bureau of Education to Bureau of Health y Administrative Order 114 Revised/updated the roles and functions of the Municipal Health Officers, Public Health Nurses and Rural Midwives y Administrative Order 2009-0025 - New Emergency Newborn Care Protocol y BON Resolution 220 Code of Ethics for Nurses (drafted by the PNA, based on RA 6713) y ILO Convention 149 Provides the improvement of life and work conditions of nursing personnel. y PRC Resolution 2004-179 reimplementing continuing professional education (60 units per 3 years, 1 hour=1 unit)