Chapter 4 Different Fields of Nursing o Hospital or Institutional nsg. o Public health or community health nsg.

o Private or special duty nsg. o Industrial or occupational nsg. o Nsg. Education o Military nsg. o School nsg. o Clinic nsg. o Independent nsg.practice Institutional Nursing - nsg. In hospitals and related health facilities such as extend care facilities, nsg.homes and neighborhood clinics comprises all of the basic components of comprehensive patient care and family health. - concept of the modern hospital as a community health center where in-patient and out-patient care are continuous describe the goal of medical care in most general hospital educational qualification for beginning practitioners is a Bachelor of Science Degree in Nsg. The nurse functions involve assessment of the patients needs for nsg. And planning for giving or providing the care indicated whether this personal care, rehabilitation measures or health instructions. Advantages of staff nsg.in Hospital 1. There is always a supervisor whom one can consult if problem exist 2. Nurses are updated with new trends in medicine and in the nsg. Care of patients 3. They undergo rotation to different units and have a chance to determine their special area of choice before they are assigned permanently in one area. 4. They have an 80 hour day and a 40 hour week duty which provide 2 days of rest. They have provisions for sick leaves, holidays, and vacations with pay according to personnel policies of the institution. 5. They have the chance to get promoted to higher positions if they are qualified 6. Salary increase are given periodically according to merit system thereby increasing their initiative and best effort. 7. They are considered an important member of the health team on providing care to the patients 8. More staff development programs are available in hospitals

Disadvantages of staff nsg. Hospitals 1. Great possibility of understaffing which may require nurses to put in overtime work and sacrifice some of their plans 2. Because of their bulk of work,some staff nurses do not find time to improve their skills through continuing education programs. 3. Administrative problems and overwork may tend to dissatisfy the staff nurse. SECTION 29 of RA 9173 Specifies that a person occupying supervisory or managerial position requiring knowledge of nsg.must: a. Be a RN in the Philippines b. Have at least 2yrs. Of experience in general nsg.serving administrative c. Possess a Bachelor of Science Degree in Nsg., with at least 9 units in mgt.and administration course at the graduate level d. Be a member of good standing of the accredited professional organization of nurses.

Occupying the position of chief nurse or director of nsg. Service shall : a. At least 5yrs. Of experience in a supervisory or managerial position in nsg., and b. A masters degree in nsg. General staff course Those occupying such positions before the effectively of this act shall be given a period of 5yrs. Within which to quality Memorandum circular No. 2000-05, series of 2000 of the PRC, board of nsg.mandates the implementation of this provision of the Philippine nsg. Act Resolution no. 14 series of 1999 In this country, a nsg. Specialty certification program has been adopted by the board of nsg.and created a nsg.certification council

SECTION 29 COMPREHENSIVE NSG.SPECIALTY PROGRAM -Within 90 days from the effectivity of this act, the board, in coordination with the accredited professional organization, recognized specialty

organizations and the DOH is hereby mandated to formulate and develop a comprehensive nsg.especialty program that would upgrade the level of skill and competence of specialty nurse clinicians in the country such as but not limited to the areas of critical care, oncology, renal and such other areas as may be determining by the board. SECCTION 23 FUNDING FOR THE COMPREHENSIVE NSG.SPECIALTY PROGRAM Benefits of certification 1. Nurses certified to be above minimum standards improve the quality of the patient care. 2. Certification measures expertise beyond that which is measured in basic licensure. 3. Certification ensures continued competence in changing world of health care. 4. Certification is a means of confronting the demands of healthcare. 5. It is a lifelong learning that advances nursing skill and knowledge to move the profession forward 6. It enhances the nurses self image and the publics view of profession. Public health community nursing a. PHN- refers to the practice of nsg.in the local, national and city health department which include health centers and public sectors. b. CHN- is broader as it encompasses nsg.practice in a variety of roles, which at times includes independent nsg.practice NURSES IN IN-SERVICE EDUCATION PROGRAMS Nurses in this field need experience in clinical nursing and research PRIVATE DUTY NSG. Are expected to be expert clinicians as well as expert generalist in nsg. PRIVATE DUTY PRACTITIONER Is a RN who undertakes to give comprehensive nsg.care to a client on a one-to-one ratio TWO CATEGORIES: 1. General private duty nurse -Has a capabilities for providing basic nsg.care to any type of patient. 2. Private duty nurse specialist

a. Skill in handling, operating and monitoring other complicated devices b. Skill in interpreting data gathered from ECG,EEG laboratory diagnostic results and v/s. c. Skill in observing signs and symptoms and their favorable or untoward significance in the progress of patient care. d. Promptness and adeptness in instituting appropriate nsg.measures. QUALIFICATION OF PRIVATE PRACTITIONER 1. Be a RN in the Philippines 2. Have the following document for the current year: a. Professional task receipt b. PRC c. Residence certification 3. Have at least 2yrs.of beside nsg. Experience & professional nurses in a general hospital immediately prior to application 4. Be acceptable to the director of nsg. Service as suitable for orientation to do private duty nsg. 5. Be a full time private duty nurse 6. Preferably had undergone a critical care nsg.course and 7. Be a certified IV nurse therapist by the ANSAP. Policies and guidelines for nurses accompanying patients out of the country 1. Passport and other travel papers - all expenses for fees and processing of visa and travel papers are paid for by the patient or his representative. 2. The private duty nurse is required to: a. Leave with the private duty nurses association in the Philippines his address of destination and tentative duration of duty b. Report presence to the nearest nsg.organization in the area c. Report to the PNA his arrival in the country. OCCUPATIONAL HEALTH NURSING OR INDUSTRIAL NSG. Was once called industrial nsg. is the specialty practice that provides and delivers health care services to workers is autonomous and occupational health nurses make independent nsg.judgements in providing health services.

NURSING EDUCATION career opportunities in nsg.educ.are better today than before. There is a chronic teacher shortage in all nsg.educ.programs. QUALIFICATION OF THE FACULTY a. must be a RN in the Philippines b. must have at least 1yr.clinical practice in field of specialization c. must be a member of good standing in the accredited professional organization of nurses d. must be a holder of a masters degree in nsg.,education or other allied medical an health science conferred by a college or university duty recognized by the republic of the Philippines MILITARY NSG. The nurses corps Tandang Sora led the nsg.of the sick and wounded katipunan revolutionaries in 1890 Nurses and corps we know today dates back more precisely about three decades ago shortly before the outbreak of word war II Common wealth Act No.1 -commonly known as the national defense Act clearly provided for the establishment of medical service in the army of the Philippines September 5, 1938 -NDA was amended by common wealth act no.385 whereby the different corps of medical services were explicitly spelled out. Executive order No.2167 dated April 15 1940 -provided for the rules of the organization of the Phil. army nurse corps reserve intended to be mobilized in the event the Phil. would be involved in the impending war in the east C.A 385 -emphasize the female composition of the corps, the term nurse corps was changed to the female nurses corps, pursuant to common wealth Act No.569 dated June 7,1940 R.A 479 of June 10,1950 -amended R.A 203, and gave credit to the services of military nurses during the war -it also provide basis for determining the grade and rank, seniority,and retirement of NC officers

FUNCTIONS OF THE NURSE CORPS, AFP - Provides comprehensive and quality nsg.care to all military personnel, their dependents and authorized relatives 3 areas: 1. To meet the nsg.needs of todays patient in AFP medical facilities 2. To prepare each nurse corps officer for future assignments @ a higher level of responsibility in the different stations and general hospitals in times of peace an war 3. To teach and train enlisted personnel who perform nursing functions under supervision QUALIFICATION OF THE MILITARY NURSE Principles-the nurse consciously and scientifically intervenes in the health and illness environment for the purpose of ensuring that the soldier, his family and other significant groups will have adequate personal care,maintenance,safety and comfort Rationale -the military nurse works @different health settings with various levels of responsibilities. QUALIFICATIONS FOR CALL TO ACTIVE DUTY a. Must be commissioned b. Must have at least one year nursing experience in a reputable health agency c. Must have been cleared by appropriate security agency d. Must have passed the physical and mental examinations conducted by the appropriate authorities FLIGHT NURSING IN THE PHILIPPINES -Responsible for patients ,military or otherwise, who have been evacuated from battle areas to the nearest installation for treatment -also reduces medical personnel an supply requirements of military operations -is commissioned officer of the nurse corps in the active service -flight pay nurses has a 50% base pay SCHOOL HEALTH NURSING -often work alone, out of touch with other nurse -responsible for the schools activities in the areas of health service, health education and environmental health and safety -primary function: geared toward making the students and faculty understand those programs

which emphasizes health promotion, prevention of dse.and follow through of any finings that may indicate a need for medical care and treatment 3. CLINICAL NURSING -requires that a nurse possess general skills -teaching patients and their families has become an important functions -also known as a nurse specialist, nurse clinician or clinical specialist. INDEPENDENT NURSING PRACTICE -means a nurse is self employed and provides professional nsg. services to clients/patients and their families -are accountable for their decisions. CHAPTER 5 NURSING OPPURTUNITIES ABROAD New nurses are advised to serve the country first before planning to go abroad Reasons: 1. To acquire a better perspective of the actual health programs for the people in the country 2. To be able to participate in and contribute to the implementation of the national health programs for the people. 3. To develop skills not only in the care an preventive aspects of care but also in the art of good working relationship with the health team and the community 4. To gain more experience in a variety of situations an enable to be more mature in judgment, and finally 5. To acquire the satisfaction of having been able to serve our people first before serving others. IMMIGRANT - Person who migrate to other country U.S a nurse may enter the U.S as an immigrant under the 1965 amendment to the U.S immigration and nationality ACT Amendment establishes the following new preference for nationals of all countries outside the western hemisphere 1. First class- unmarried sons and daughters of U.S citizens 2. Second preference- spouse and

4.

5. 6. 7.

unmarried sons/daughters of alien lawfully admitted for permanent residence Third preference- members of the profession of persons of exceptional ability in the sciences or arts Fourth preference- married sons/daughters of U.S citizens Fifth preference brothers/sisters of U.S citizens Sixth preference- skilled or unskilled workers in short supply Seventh preference- refugees

SECTION 212 (a)(14) OF THE ACT a. 3RD preference immigrants- qualified immigrants who are members of the professionals. b. 6th preference- qualified immigrants who are capable of performing special skilled or unskilled labor. c. Non preference immigrants- other qualified immigrants strictly in chronological order in which they qualify d. Special immigrants- who were born on any independent foreign country in the western hemisphere CANADA -all nurses who wish to work in Canada must first meet all the requirements of the Canadian Immigration Authorities -the form prescribed and issued by the Department of Manpower and Immigration of Canada AUSTRALIA -information regarding this matter may be attained from the Australian Embassy in Manila -attached to the application form are documents that have to be completed a. 6 passport photographs b. Birth certificate c. Civil status for persons age sixteen and above,thsese may be obtained from the parish church,civil registrar, or by statutory declaration d. Copies of reference from previous employers

e. Copies of certificates an transcripts of duties from highschool, or if a college graduate, from the college. -if one has completed other courses of studies ,such as trade training, copies of certificates an transcripts of studies of the course should be procured. UNITED KINGDOM -they only have to submit the necessary documents for evaluation so that they may be granted a license to practice there. -if the nurse is outside the UK he must pay through a bankers raft drawn in pounds sterling. further information may be sought from the UK central council for nsg. midwifery and health visiting @ 23 Portland place London W1B1P2

(permanent) occupational preference visa 3. Most American states require that a nurse who been educated outside the U.S RN licensing examination called the NCLEX-RN 4. An applicant who passes the CGFNS qualifying exam portion of the certification program can be reasonably assure of success in the NCLEX-RN.this is because the CGFNS qualifying exam is modeled after the NCLEX-RN TWO PART CGFNS CERTIFICATION PROGRAM 1. The CGFNS credentials review, establishes that an applicant, according to his education is first level, general nurses as defined historically by the international council of nurses. 2. An applicant who passes the CGFNS credentials reviews moves to the second part of the certification program, the CGFNS qualifying exam -this is a one day test of nursing knowledge and proficiency in the English language, both spoken and written CGFNS TELLS THE RESULT -eight to ten weeks after the applicants has taken the CGFNS qualifying exam,CGFNS will send a letter telling him whether he passed or failed the nursing portion and/or the English portion of the exam WHAT HAPPENS WHEN AN APPLICANT PASSES? -will receive their CGFNS certificates -CGFNS will send such a letter @ the applicants request. This is called verification of certificate status -CGFNS does not reissue or make duplicate certificates -if the certificate is lost, CGFNS will supply an official letter stating the date of certification. called missing certificate

SHORT TERM EMPLOYMENT -nurses who wish to work on a temporary service,non-immigrant status usually apply to agencies abroad who may nee their services through local travel agencies. -the department of labor and employment now arranges for nurses to go to countries which may need their services -applicants are required to submit documents to attest to their qualifications such as school records, nsg.diplomas, record of clinical experience, result of board examination in the different subjects, certificate of registration, certificate of employment and passport-size photographs Requirements to pass examination for nurses wishing to migrate or word in the U.S: 1. To get a non immigrant (temporary) occupational preference visa (H1-A) from the U.S immigration and naturalization service, an applicant must have a CGFNS certificate or hold a full and unrestricted license to practice as a RN in the state where he plans to work, and have an offer of employment from a health care organization in the U.S 2. An applicant who wants to live in the U.S may plan to apply for an immigrant

WHAT HAPPENS IF APPLICANT DOES NOT PASS?

-those who fail either the nsg.or English portion of the CGFNS qualifying exam will not receive a CGFNS certificate -to retake the CGFNS qualifying exam,one need not send all documents again. CONSIDER DECISION TO RE-APPLY -An applicant must consider the experience of others CURRENT CGFNS FEES -fees are to be paid in full U.S dollars, either through international money order,cash or credit card -if there are changes, the applicant must notify in writing the CGFNS -application forms may be obtained from: 1. Philippine American Educational Foundation 2. Philippine Nurses Association 3. Chapters of the PNA outside the metro manila area. CHAPTER 6 GUIDELINES IN CHOOSING A FIELD OF NURSING -first consideration that nurses must make self evaluation QUALIFICATION -you will be required to have a Bachelors Degree in nsg. YEARS AND EXPERIENCE AND TRAINING, AGE AND PHYSICAL CONDITION -consider your age and physical condition administrative positions will require nurses who are mature in judgment and decision making and who possess the educational qualification require by the Philippine nsg.law EMOTIONAL STABILITY AND GOALS IN LIFE FACTORS IN SELECTING A FIELD OF NURSING 1. kind of work to be performed 2. availability of the work 3. hours of work 4. qualification 5. opportunities for advancement 6. method of entering 7. earning 8. fringe benefits 9. other benefits

USEFUL POINTERS IN MAKING A LETTER OF APPLICATION -enables the prospective employer to form an opinion about the burse -observe the following when writing a letter of application: 1.use clean,white unlined paper 2. use ink or ballpen in writing 3.use proper salutation 4. observe proper margin an paragraphing 5.write in a courteous manner 6.enclose return postage -a letter of application usually contains the following facts: 1. source of purpose 2.qualification 3.referance 4. a request for a personal interview PERSONAL INTERVIEW -is face to face conference between two people -the employee: gives him a chance to assess the applicants personality, alertness in answering questions,poise,command of the spoken language and the like. The following pointers will be help in preparing for an interview: 1. make an appointment either by email or telephone- the nsg. Office personnel division schedules time to conduct interview. 2. be at the place at the appointed time-it is necessary therefore that you start early from your place so that you are at the agency 10-15mins.before the time so you can relax and appear unhurried 3. know something about the institution where you will apply so that you can answer questions intelligently- be prepared to answer questions that are likely to be asked 4. be at your best- be presentable 5. knock first before you enter- be courteous enough 6. bring credentials such as registration card, residence certificate, tax account number and the like- be prepared 7. ask questions about the job- it may help in deciding if you like the position

8. thank the interviewer for giving you some of his/her time- if there are another applicants to be interviewed, do not delay the interview unnecessarily 9. give yourself to think about the position- you should have equal right to choose the place of work and the people whom you can best work with 10. if the prospective employer does not answer, you may write a follow-up letter stating your interest in the positionRETAINING A POSITION -while there is no sure-fire formula for success the following are suggested: 1.have adequate knowledge and preparation for the job. 2. have a well developed personality 3.develop good interpersonal relationship with your co-workers 4.develop proficiency in communication, both in oral and in written forms 5.be able to adjust to working conditions and to life patterns characteristic of particular occupations and communities 6.keep abreast with advances in medicine,nursing,and related sciences b reading professional literature and attending activities of professional organization CAUSES OF FAILURE 1.incompetence or lack of the required ability and knowledge for the particular job. 2.poor interpersonal relationship, lack of cooperation with co-workers, dishonestly, boastfulness, and inability to get along with people 3. personality defects such as imprudence in choosing friends, sarcasm, lack of tact,eny 4. inadequate knowledge in social conduct, too little time for relaxation and recreation 5. indifference to need professional growth, always finding reason for not attending professional meetings. HOW TO TURN FAILURE INTO SUCCESS - nurses who accepts their limitations know their weakness - there are more average nurse than the geniuses - those who are very bright in the classroom may not always be successful in the field of nsg.while

those who are willing to turn their weakness into assets may be more successful nurses should fit into and adjust to the position being competent for the job, taking it with pride and doing ones best at all times

RESIGNING FROM A JOB - reasons why nurses resign from their job: to seek better position inability to adjust to the work situation, marriage, children, and/or transfer of family to other place WRITE A LETTER OF RESIGNATION OBSERVE THE FOLLOWING POINTS: 1.give the date of resignation- usually effective on the 15th or the end of the month, for easy computation of salaries, accrued leaves, etc. 2.state the reason for resigning- it is important to be courteous because the letter is usually on file an is usually referred to when the need arises 3. express gratitude for kindness an consideration given during the period of employment- express regret of leaving regardless of the reason 4.attatch clearance for money, work, and property responsibilities never walk off from a position DISMISSAL FROM A POSITION - reason may include negligence,incompetence,malpractice, unprofessional behavior, or breach contract