Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing

Ethics of a Researcher
NURSING RESEARCH • S – Scientific Objective – conductive research for a good purpose or object for
your pt
• C – Cooperation and Consent. Do not conduct data/experiment w/o a consent
Nursing Research
(legally the patient owns the chart. However the hospital owns the chart)
• Kerlinger - the systematic, empirical, controlled and critical investigation of a
• I – Integrity – worked hard on the research
hypothetical proposition in relation to a natural phenomena/ problem
• E – Equitable – acknowledging works or contribution of others
• Conducted to affirm or deny a hypothesis
• N – Nobility – protect the rights of your subjects
Phenomenon. o Right not to be harmed
▪ (physical, mental, moral harm) usually done during experimental
• everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician)
research
▪ Physical Harm/ Negligence - undeliberate physical harm
Phenomenon + hypothesis = research problem
∟>(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)
• Omission – from the very start, you did not do something
Major Characteristics of a Good or Major Research about it.
• Systematic ▪ Moral Harm
o conduct research in a step by step process or procedure • Assault – mental fear/threat without physical harm
• Empirical • Battery – physically you harm the pt
o objective data should be observable/measurable or readily collected ▪ Restraint is never an independent nursing order
using your senses • physical restraint – eg. Jacket
• Controlled/ manipulated • chemical restraint – eg. use of psychotropic drug
o Methods/tool of controlling is research design ▪ Moral harm
• Critical investigation/fact finding investigation • Slander – oral defamation
o In order to answer the data is by using facts. • Libel – published or placed in the newspaper
o Looking for human beings who can give us facts o Right to self-determination
o Right to privacy
Purpose of Research in Nursing Profession [DEED] ▪ Anonymity – identity of subject may not be disclosed. Privacy of
• Descriptive the Informant (pt) eg. conduct a study on HIV pt. but the pt wants
o observe, describe and record his name to be written in the newspaper as Mr. X, Mr. Y or Mr. W
o gain richer familiarity regarding the phenomena ▪ Confidentiality – information acquired must be disclosed. Privacy
o 100% known to RN of the information eg. conduct a study on HIV pt. but the pt wants
• Exploratory the nurse should only know
o Explore to those areas that are unknown • T – Truthfulness – put only the data you have collected
o Observe more • I – Importance – importance to the nursing profession
o 50%-50% (50%known to nurses and 50% unknown to the nurses • F – Factual – facts or data
• Experimental • I – Ideal (follow the 11 steps of research)
o Active intervention, active manipulation • C – Courage
o Want to find out cause & effect
o Done something before observing results Steps in Nursing Research Process
• Developmental • Identification/formulation of research
o To improve the system of care for the your patient. o problem - anything that requires solution thru scientific investigation.
o Develop and improve existing system o Sources of problem :
Conducting research is for the benefit the pt or patient care/pt focus ▪ C – concepts (Ca, PTB, MI)
▪ L – literature, essays, books, journals
▪ I – Issues
Florence Nightingale
▪ E – experience
• Birthplace – Italy
▪ N – Nursing problems
• Training Ground – Germany ▪ T – theories
• Greatest Contribution – environmental Theory, training RNs in Crimean War
• School – Saint Thomas School of Nursing o Characteristics of a research problem

1 2

▪ G – general applicability and use 2. Purpose – objective using SMART (Systematic, Measurable, Attainable,
▪ Re – Researchable Realistic, Time Bounded)
▪ F – Feasible and measurable 3. Define Terms
▪ F – actors of a feasible research : a. Conceptual Definition – dictionary definition
• time, money, experience of the researcher, instruments, b. Operational Definition – defined in accordance on how the researcher
population used the word
▪ I – importance to nursing profession 4. Revision of Terms
▪ N – novelty/originality
• Plagiarism/illegal replication – unauthorized use of • Review of related literature
another’s literary work without any consent or permission o Purposes :
▪ S – significance to nursing ▪ to have an update regarding your topic
o 2 types of research according to use ▪ to have a basis of theoretical and conceptual framework
▪ basic/pure research o Main sources of literatures
• only the research benefits the research ▪ Conceptual
• It is only for your personal necessity • Formulated
• Answers your own question • Authors
▪ Applied research • Can be sold
• problem solving • Books – general use
• Solving the problems of the patient. ▪ Research
o Variable – subject to change • Researcher
▪ Kinds of variable • Research works only
• Independent variable • Future research purpose only
o use this to stimulate a target population • Formulation of conceptual and theoretical framework
• Dependent variable/Effectual variable o Thery – relationship between concepts
o results of the effects of the study o Conceptual framework
• Intervening Variable ▪ diagrammatic and structural presentation of the problem
o Comes between dependent and independent hypothesis
o Example: orghanism variable, internal factor, sex, o Paradigm
gender, color ▪ actual structural presentation of your conceptual framework
• Extraneous Variable • Formulating hypothesis
o External infuences that can be changed o 5 types of hypothesis
o Example: citizenship, educational status ▪ Null/statistical hypothesis
• Dichotomous Variable • shows no relationship or difference between an
o 2 choices/ 2 results independent variable and dependent variable.
o Example: Male/ Female • ID = DV
• Polychotomous Variable • Eg. “There is no difference regarding professional
o Multiple choices opportunities of Filipino Nurses working in the Philippines
o Example: Preferred foods – Chinese, Japanese, from those working in USA.”
American. . . . . ▪ Simple/Operational hypothesis/Alternative hypothesis
Examples • this shows relationship between a single independent
“A comparative Study in the Income of Filipino Nurses variable from single dependent variable.
Employed in P.G.H. and N.Y.G.H.” • Eg. “Filipinos Nurses working in USA has more
professional opportunities than those working in the
Independent variable : PGH and NYGH (place of work) Philippines.
Target population : Filipino nurses ▪ Complex hypothesis
Dependent variable : income • this shows a relationship between two or more
independent variable from two or more dependent
variable.
• Eg. “Filipino nurses who worked for 5yrs and passed the
Research: CGFNS, TORFL, TSE, NCLEX has greater opportunities in
1. Identify the Problem NY as compared to those in Manila
▪ Directional hypothesis

3 4
 • specifies the direction of the relationship between variables ▪ Descriptive
• Eg. “Filipino Nurses working in the USA has more • Observe, describe & record.
professional opportunities than those working in the Phils.” • Study of current events.
▪ Non-directional ▪ Prospective
• only predicts the relationship, but has no specific direction • Study of research about future
between variables. occurrence or future events.
• Eg. “There is a big difference between a Filipino Nurses ▪ Historical
working in USA than those working in the Phils.” • Past that is written, documented,
• Selecting research design published and recorded
o Systematic controlled plan for finding the answer to a problem • Primary Data
o Roadmap, blueprint of the study o Observe
o Should have a proper resign design o 1st hand information
o If improper research design, there will be improper collection of data o person himself
o Purpose : key or tool for proper collection of data • Secondary Data
o Types o 2nd Hand Information
▪ According to Application • About the past using records,
• Basic/ Pure journals, books.
o For personal knowledge, curiosity • Study of the dead people thru his
• Applied written materials, facts
o Based on problem solving approach o according to data
▪ According to Methods ▪ quantitative
• Experimental • data base on numerical
o performing active manipulation, observe and record interpretation, datas that are
the result. measurable, using your senses, data
o Types of Experimental Reseach that are observable.
▪ control ▪ qualitative
• divide grp into 2. • subjective data, feelings, perception,
• Group a – control/comparison grp – beliefs, culture, attitude
will use the same soap everyday o Survey Research Design
• Group b – experimental grp – those ▪ Group
who will use the sample soap • Small
▪ randomization • Face to face
• using sample by chance. • Large – not good result
• Choose randomly to avoid ▪ Methods
redundancy of result • Mailed survey
▪ Manipulation • Face to face
• Performing intervention • Telephone survey
▪ Validation o According to Time Orientation
• comparison of the effects ▪ Cross Sectional
▪ Quasi-experimental • Applicable to 2 or more identical
• false experiment. group
• No control sample. • Short term
• Non-experimental • For comparison
o No manipulation is done. Only observation, ▪ Longitudinal
describe and record down the result. • 1 group only
o Types of non-experimental research design • with initial and follow up survey
base on time element • long term study
▪ Retrospective (Ex Post Facto) • for developmental study
• Getting actual experience • Selecting your population and samples
• Studies a group of people after its o sample
occurrence, experience or facts. ▪ part of population, data is collected.
• Experience of people in the past

5 6

▪ The recipient of the experimental treatment in experimental design ▪ The data you get from your sample is not
or the individuals to be observed in a non-experimental design accurate.
o Types of sampling ▪ The sample has a problem
▪ Probability - equal presentation/ chances in the population. ▪ Solution : double blind research – they
• Simple random technique should not be conscious that they are being
o Used a single/identical group. studied
o Fish bowl technique o Halo effect
• Stratified random sampling ▪ The researcher has a problem.
o You will first going to create a sub population from ▪ He is manipulating the data collection.
the whole population before doing randomization. ▪ It is affected by special feelings/treatment
o One population, you divide it. between the researcher and the sample.
• Cluster random sampling • Analysis of Data
o You will first create a sub area in a population o part of research when the researcher is forming a body of knowledge out
before doing the randomization. In one population, of data collected for the purpose of affirming or denying your hypothesis
you make it smaller o Methods
• Systematic random sampling ▪ Nominal method
o choosing a sample every nth name in the • get data by means of categories.
population. • eg. male, female, income
o Multiple of 100 names ▪ Ordinal method – base on rank eg. mild, moderate, severe
o Sampling frame – list of names appearing as your ▪ Interval
population • base on the distance between 2 numerical values
▪ Non-probability sampling – you are not choosing by chance. • eg. BP – 150/100 – 120/80, wt, circumference, ht
• Accidental/ convenience sampling ▪ ratio – 3:10 children are malnourish
o Base on the accessibility/availability of your • Interpretation of Data
sample. o 2 Methods
o Kung sino pinakamalapit syo, yun ang kukunin mo. ▪ quantitative method – base on numerical or graphical standards
• Purposive/judgmental sampling ▪ qualitative method – use of narrative words
o base on the common knowledge or popular • Communicating your conclusion
knowledge. o Explaining the results of your work to the public
• Snow-ball sampling o Conclusion – final answer to your research
o get sampling base on last referral o Recommendation – suggestion to others
• Quota Sampling o Dissemination of Information
o Setting criteria and getting samples fitting the ▪ Methods :
criteria • thesis/book – written form
• Conducting pilot studies • symposia/symposium – oral presentation
• Collecting data • publish – a lot will be able to read your research
o types :
▪ questionnaires – use of pen and paper method
• dichotomous – divided into two. Eg. true or false. Yes or no
• rating scale – poor 1, good 2, better 3, best 4 LEADERSHIP
• multiple choice
▪ Interview – use of oral method of collection of data. Use of active
listening
Nursing Leadership
• Structured – with checklist, formal talk, list of question
• style or process whereby a person is called by a nurse leader were influence of
• Unstructured – informal talk, no pattern, anything goes
group of people called his followers for the purpose of attaining only one
▪ records – pre existing data
goal/objective.
▪ observation – use of ocular method using your senses
• participant observation Principle for Effective Leadership
• non-participant observation • Unity of Command – one group given by one leader
• Problems : • Unity of Direction – one group should always have one objective
o Hawthorne’s effects • Subordination of your personal to your general interest – patient first policy
o R – rescue your patient

7 8
 o A – alert the fire alarm o + power for the part of the leader
o C – confine the fire in one area o gives rewards, bonus, promotion, compensation
o E – extinguisher application • Coercive Power
o Esprit d’ corp/team spirit - Fault of one is the fault of all o – power on the part of the leader
• Respondeat Superior/Command responsibility o reprimand, suspend, terminate
o let the master or the superior answer for the negligence of his
subordinates in half of his patient who suffer from injury or death. ABC’s skills, qualities and abilities
o you can delegate responsibility but not the accountability • A – Authority
o basis of the leader to delegate tasks, responsibilities, jobs to be
Theories of Nursing Leadership performed by his subordinates
• Great-Man theory – born as a leader o 2 types of authority
• Trait theory – develop characteristics or born with the characteristics ▪ Centralized – top to bottom for proper management
o 3 traits of a leader ▪ Decentralized – Bottom, to manage directly
• P – personality (adaptability, independence, creative/assertive, • B – Behavioral
advocate) ability to adjust to the need of the pt o S – specialized body of knowledge and skills to do safe care
• I – intelligence (proper judgment, proper decision making, proper o P – patient centered
communication) o A – accountability – liable for the results of your actions
• A – ability – (influence others, respect others, participate and o C – confidentiality – nurse-patient relationship
cooperate) Proper way to influence is thru health teaching ▪ Exceptions to confidentiality of the contract :
• Charismatic theory – becomes a leader because of the charm • P – patient consent, if there is
• Situational theory/case to case basis • I – inform/report to healthcare team for purpose of
o a person can be a leader in one situation but only a follower in another precautionary measures
situation. (eg. becomes a leader in where he specializes) • C – Communicable disease
o RA 3573 Law on Notifiable Disease
Leadership styles o 24 – Polio/ Measle
• Authocratic/Authoritarian/dictatorial/”hard” leader o 1 Week – SAD/ HIV/Tetanus Neonaturom
o unilateral style of leadership. Only the leader here performs the decision • C – Crimes
making without getting the inputs from his members. o Child Abuse → 48 hours, Baranggay, NGO
o One sided style of leadership Behavior : • E – ethics
A – apathy – insensitive to others
B – Boisterous speech IV THERAPIST: Old→ RN, Training, 50 Insertion, ANSAP
C – consistency New→ RN, Training
D – Dominating
E – Exploitative behavior • C – Communication skill
F – ferocious behavior, to coerce or compel the group to follow him o transfer of information with understanding
o not a good style of leadership but only best style during emergency or o Communication barriers/communication backlog – eg. Dialect differences,
intensive crisis noise, deaf, high level of anxiety, hallucinating
• Permissive, ultra-liberal, laissez faire, free-rein • D – Decision making skills
o Loose style of nursing leadership. o Steps
o Giving excess freedom or liberality towards your subordinates if to lenient ▪ identify the problem
in your subordinates, there will be ↓ control and power = ↑ negligence ▪ identify person affected
• Democratic/participative ▪ gather options/alternative
o best style of leadership. Mutual style of nursing leadership • brainstorming
• delphitechnique – gathering solutions outside the group
5 Power of a Good Leader (eg. specialized nurse)
• Legitimate/ Formal/ exclusive Power ▪ choose and implement
o Exercise because you are appointed to a higher position ▪ Evaluation
• Expert Power • E – Ethics
o You acquire extra – ordinary skills, talent or ability o Principles
• Referent Power o Principle of Autonomy
o Charisma and charm ▪ independent judgment or decision making
• Reward Power

9 10

▪ in all situation the pt himself is the one who should decide for his
own care
▪ Consent
• respect the decision of the pt
• explain the risk to the patient/SO
• 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 NURSING MANAGEMENT
• D – dynamics – base on the ever changing needs of the pt
• E – equitable care
• F – familiarity/rapport to the patient NURSING MANAGEMENT
• G – goal directed towards solving the assess needs of the ▪ choosing the right person and giving them the appropriate task for the purpose of
patient (SMART) achieving their goal/objective in achieving total care
o Principle of Respect/Inviolability of life
▪ Suicide and abortion is violation of this principle Frederick Taylor’s Scientific Management Theory
• F – Face/solve Conflicts ▪ Elements
o any clash of ideas resulting to crisis o choosing the appropriate person (TAO)
o Methods of resolving conflict o choosing the appropriate team
▪ avoidance – by paying attention o choosing the appropriate training
▪ smoothing – appealing to ones conscience and kindness o choosing the appropriate tools
▪ unilateral action – use of forced fear or threat
▪ negotiation – best method in resolving conflict. The head nurse Human Relations theory
should offer negotiation between conflicting parties. ▪ 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

11 12
 o Positive workers ▪ Vision - statement of your future purpose of your future
o diligent, effective, efficient worker organization
▪ theory X should be given focus because they are prone to negligence and ▪ Philosophy – set of values and beliefs of your organization
malpractice. ▪ Goal – general statement of your purpose
▪ Objectives – more specific statement of your purpose
Max Weber’s Bureaucratic/ authoritarian Theory ▪ Policies – set of rules and regulations in your organization
▪ whoever is on the top would perform the management function ▪ Procedures
▪ centralized • Budgeting – proper allocation of your resources
o 3 types
Elton Mayto’s Behavioral Theory ▪ Personnel
▪ overtime pay, rest day, day off • Compensation for salaries of
▪ provide physical needs of the workers workers
▪ Hawthorne’s Effect ▪ Operational
o If workers knows they are observed they become more efficient • everyday use of equipment and
facilities (gloves, water, electricity)
Henry Fayol’s Principle of Management ▪ Capital
▪ Unity of Command – one leader, one command • long term use equipment (MRI, CT
▪ Unity of Direction – one group should always have one goal Scan, hospital beds, hospital
▪ Remuneration of Personnel – patient first policy buildings)
▪ Esprit de corps – team spirit ▪ Organizing
▪ Command responsibility/Respondeat Superior – let the superior answer the o 4 stages
fault of his subordinates even harm or death ▪ Organize your team RN Subordinates
▪ Balance between centralization and decentralization • Duties of the RN
▪ Security tenure • Only assessment can perform the nurse
▪ Delegation of responsibility • Only the nurse can perform HT
▪ Proper Compensation of workers
• Only the nurse should explain the procedure to the patient
o RA 7305 (Magna Carta Law) – salary grade 50 P13,000/month
• Preparation, administration, treatment of drugs to the
o Overtime pay – additional of 25%/hr
patient
o Night Differential – additional of 10%/hr
o Legal holiday – x 2 • The nurse can only perform evaluation
o Philhealth - Benefit of worker both related and non-related work • The nurse can only do judgment
(aesthetic, dental and cosmetics are not included) ▪ Delegate Task
o Maternity leave – 60days leave is NSD, 78days if CS only to first 4 • They can only delegate to subordinates the Routinary task
pregnancy only to legitimate spouse (standard, unchanging procedure) eg. monitoring of I&O,
o Paternity leave – 7day/1week leave bathing, ambulating, toileting, shampooing, transporting,
o Senior Citizen’s Act – 20% discount feeding, clothing, wiping
• Stable patient - predictable outcome (eg. postmortem care
5 steps in Management Process with direct supervision of the nurse only)
▪ Planning stage • Supervision – need guidance
o looking ahead of time. ▪ Staff Schedule/ Staffing
o Formulating future goals/objective • Schedules (How many hours)
o Types of plan o Traditional – 8hrs a day/40hrs/wk
▪ Standard/Operational Plan (NCP) o Ten hour shift/4 days a week
• plans for everyday or ordinary activities o Baylor plan – it consist of two shifting nurses
▪ Strategic/Contingency Plan ▪ traditional – mon-fri 8hrs
• plan used during sudden or acute crisis ▪ 2nd shift – 12hr shift during weekends
▪ Long-range/future Plan o Part-time work – fewer working hours per day and
• plans which you can’t evaluated immediately. may choose the day or work. Less than 8hrs job
• Usually last months or yrs. o On – call – during shortage of nurses/staff but
• Used for chronic pt which requires longer period of care. increase in the number of patients.
o Stages of Planning Process ▪ Methods of Nursing care Delivery
▪ Mission – present reason when established your organization • Different Methods
o Primary – 24hrs a day

13 14

▪ Primary nurse is the only nurse who is o Methods of evaluating staff performance
responsible to make a care plan of the ▪ Checklist
patient from the moment of admission till the • it is being evaluated higher than you. (eg. nurse
moment of discharge. (eg. private duty manager/supervisor or head nurse)
nurse or special nurse) ▪ Nursing rounds
o Functional Method • it is being evaluated higher than you. (eg. Nurse
▪ DOH format/government hospitals manager/supervisor or head nurse)
▪ Assign nurse : • Psychiatric ward is not done by nursing rounds
• Duty/task ▪ Peer review
• One nurse, one task • same rank or level is being evaluated you
• Highly recommended during a • poor method
period of shortage of nurses and ▪ Performance appraisal
budget • the patient evaluates you
▪ poorest method of delivery because • best method in evaluation
communication is hindered
o Case Method/Case Nursing
▪ provide total care within your shift. Used in
ICU department
▪ C – Case Method
▪ T – total care to the patient
▪ O – one is to one ratio
PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE
▪ Directing/Delegation stage
o a job or a task is done or performed by another perform for you
o What you cannot delegate: Professional
▪ A calling in which its members profess to have acquired special values,
▪ you cannot delegate total control of the procedure
▪ you can’t delegate discipline of subordinates or staff members. knowledge, training or by experience so that they may guide others in that
special field.
▪ Confidential task
▪ Technical task
▪ Medical task performing surgical procedure is done by the doc not Nursing is a profession
the nurse • Calling – service oriented
▪ Coordination/Collaboration • Others – patients
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 Characteristics by profession
to the patient. • A – accountability/liability for the result
o Types of Collaboration • C – caring profession  Central Focus
▪ Interpersonal/Intradepartmental • C – competent
• One patient, one unit. • E – ethics
• Collaboration between one nurse to another healthcare • S – service oriented
team in one unit/department • S – specialized scientific body of knowledge and skills
• Eg. MI patient - nurse, dietary, specialized in cardio
▪ Interdepartmental PROFESSIONAL DUTIES OF A NURSE UNDER RA 9173
• 4 units in one hospital.
• Coordination of the patients care between 2-more All are independent nursing actions
units/departments but still under one same hospital or • Promotive, preventive, curative and rehab care in all health care service
institution • health education
• Eg. patient due for appendectomy is transferred to the OR • utilizes nursing process
▪ Inter Agency/Institutional • link of patients in different health care services
• Coordination of patient’s care between 2 or more • collaboration of patient’s care for continuity of patient care
hospitals/health care institution for the benefit of the patient • train nursing students
• Eg. lying – in due for C/S and was transferred to a hospital • supervision of subordinates
▪ Evaluation/Controlling • accurate recording and reporting
o stage wherein you determine whether or not your plans for your patient is • execution of valid doctor’s order (the only one that is dependent nursing action)
met or achieved

15 16
 • Perennial Suturing after training • decentralization or devolution of care. The DOH together with
• Perform IE if antenatal bleeding is absent and before full delivery DILG and local government units (brgy, provincial) together with
community participation they made a local health board which is
A doctor’s order is valid when giving medication is when it is put into writing and signed the MAYOR.
by the physician. Whatever is not put into writing is considered not ordered by the • Purpose of local health board : it makes quality health care
physician. available, accessible and proximal for all
• Participation is maintained with all members of the community, health care
Good Samaritan Act team and family
• During emergency, national calamity, national epidemic there is no doctor around
the life or the patient is in possible danger, then you can give drugs alone 3. Occupation Health Nursing
provided you know the drugs for the patient. • industrial or company health nurse
• Duties :
RA 8344 – No deposit policy during emergency cases only o Curative/rehabilitative
▪ C – care for sick/injured laborers
Areas of Nursing Practice ▪ R – Referral
1. Institutional Nursing ▪ V – Visit and ff. ups (home visits)
• Hospital Based Venue o Promotive/Preventive
• D – Duties are routinary and supervised ▪ N – nutritional
• A – Acquired different learning and technical skills ▪ S – safety and sanitation
• C- Coordination with HCT ▪ C – Counseling
• S – Specialized areas
o Nurse Generalist – community nurse 4. Clinical Instructor
o Nurse specialist – staff nurse o Qualifications :
▪ A – accredited nursing Org
2. Public Health Nursing ▪ M – MAN in nursing or other health courses
• Once a Public nurse in the community, you are focus on the preventive and ▪ O – One yr clinical experience
promotive of health because this is the mandate of Primary Health Care Law. ▪ R – R.N.
• 1st PHC
o Date : 1978 PHILIPPINE NURSES ASSOCIATION
o Place : Alma Ata o When was PNA founded : Oct. 22, 1922 (10-22- 22)
o Country : Russia o Who is the founder PNA : Anastacia G. Guiron Tupas
o Local version of F. Marcos after 1yr of Alma Ata o Purposes :
o Conference: Letter of Instruction 949 that mandates that all public ▪ P – professional well-being
workers to have a duty of promotive and preventive care for the patient. ▪ U - unity
• Promotion of Public Health ▪ P – promotes reciprocity even outside the Phils.
o PD 8976 – Micronutrient Supplement Act ▪ A – advancement of the knowledge and skills of the nurse
• Vit. A, iron supplements, iodine ▪ E – ethics promulgation
o PD 825 (Environmental sanitation law of the Phils.)
Proclamation Order 539
• It is cleanliness of the environment. Outside the institution (eg.
proper disposal of excreta, proper drainage system) • Declared by Pres. Garcia law declaring the last week Oct as the official nurses
o PD 856 (sanitation code of the Phils.) week.
• Involves proper sanitation of an institution that engage in food and
School of Nursing in the Philippines
water supply. Inside the institution. (eg. canteen, mineral water
store, public market, Sex shop : ADONIS, PEGASUS, CHICOS) • UPCN – 1st
not applicable to private sex practitioners. • Schools originated in the Phil.
• Prevention of Disease o Iloilo Mission hospital
o PD 996 (EPI law) o PGH
o St. Luke’s
• Compulsory Immunization of children below 9 y/o
o Mary Johnston Hospital
• Psychological and social adjustments because you will be taking care of
o St. Paul Hospital
numerous clients
o San Juan de Dios
o RA 7160 (local government code)
Contracts and Consents

17 18

• only registered medical, dental and veterinary practitioners are authorized to

Characteristics of a Valid Consent prescribe drugs
• V – voluntariness • 3 information
• O – Opportunities to ask question be explained to pt o name of the AMD, address of his clinic/hosp and PTRC license #
• T – treatment explained to the patient o name of the pt, age, sex
• U – understood by pt o drug name, frequency, duration of the drug
• M – matured both physically and mentally • RA 6675 Generic Act
o all prescribe drug must be written in generic and brand name or generic
Criteria of a good consent : name but never the brand name alone)
• 18 y/o – above o Purpose : for the pt to choose what brand name they want
• Mentally capacitated (absence of insanity and imbecility) • Remember the 10 R’s of medication
• If below 18 y/o and mentally incapacitated a proxy consent : in chronological • Right patient name by checking the pt wrist tag
order • Verbal or telephone – only done during emergency
o Parents • doubts or error – in case there is doubt in medication, refer to the physician
o Guardian • IV drugs – in proper training
o physician (if parents and guardian are dead)
• Guardian Ad Litem – social worker or Surgeon Documentation, recording and charting
• Patient Chart – absolutely legal
Nurses and Illegal Detention • Purpose of a patient Chart
• it happens if someone will limit the freedom of the patient to move or travel from o Communication and conitinuity of care
one place to another. o Assurance of quality of care
• HIV Patient – should be kept in one room o Research
o Felacio – oral sex – most fastest mode of transfer o Legal document
o Cannalingus – tongue on clitoris o Statistics of disease
o Analingus – tongue on anus – least mode of transfer • Subpoena – order coming from the court
o Subpoena Duces Tecum – any documents, objects, papers, materials
Last Will and Testament o Subpoena Ad Testificandum – person who will testify (witness)
• Act whereby a person is permitted by the law to have control in the manner of • Do’s in Charting
disposing/ giving his estate but will take effect at the time of his death o F – full, factual and objectively accurate
• Testate Succession – son or daughter will inherit the last will of the parents o L – legible
• Intestate Succession – without last will and testament o I – immediate
• 2 types of Last Will and Testament o P – Personal
o Property • Adendum – late entry/late documentation
▪ Notarial/ Ordinary Will • Don’ts in charting
• Check LOC o L – language, jargons or words which are unacceptable
• Check proper location of the signature – end part of all the o I – improper corrections
pages at the side o S – Spaces and skips
• Nurses can be a witness o Abbreviation
▪ Holographic Will
• During emergency cases LEGAL DOCTRINES IN NURSING
• No witness involved call a persdon who knows and familiar
with the handwritten of the testator Professional Negligence
• Entire last will and testament is hand written dated and Negligence
signed by the testator • failure to do something which are reasonable and prudent nurse should have
o Life Body done something under a particular situation. (eg. failure to raise side rales when
▪ Advance Directives the pt is unconscious)
• Respectful death • 3 elements of negligence
• Direction/ instruction of the patient in advance o duty on part of the nurse
o failure to do said duty
• DNR, donate organ, cremation
o injury, harm, death – most important negligence
Medications and prescription
Malpractice

19 20
 • injury, harm or death is not important in malpractice ▪ R – report (↓ 18 – report to brgy.)
• The nurse is allowed to perform episiorrhapy ▪ R – referral (if father is the rapist, refer to DSWD)
• with proper training but not episiotomy
• The nurse is allowed to perform IE but with 2 conditions : Abortion
o fetal aberration/ abnormal delivery • is the expulsion or termination of a product of conception before the stage of
o prior to complete delivery viability. (3-6month/12-24weeks)
Infanticide
Crimes affecting nurses • kill the person in less than 3days or 72hrs of life.
• Types of crime :
• Manner of Commission Parricide
o DOLO – crimes committed with deceit. Crime with real criminal intention • killing another person to whom you have a relationship (mother, father, husband)
o CULPA – crimes committed under negligence. Crimes that are intentional Homicide
• stages of execution • unintentionally killing another person without any relationship (eg. negligence in
o consummated giving meds)
▪ when the crime intended is totally committed or perfected Murder
o frustrated • intentionally killing another person without any relationship
▪ the offended performs everything to consummate the crime but it Simulation of birth
did not happen • committed by any person who shall substitute one child to another child or alter
o attempted his identities for the purpose of losing his civil status. (eg. the midwife failed to
▪ crime has not happened (overt acts – acts merely showing the report the birth of the baby, giving wrong information of the gender of the baby)
intention to commit the crime) PD 651 (Birth registration act)
• degree of participation • law any person who assist in giving birth to report within 30 days to the Local
o principal Civil Registration Office
▪ degree of participation is very important/indispensable because he
is the primary author of the crime.. If no principle, there is no Law Affecting Nurses
crime. • Act 2808 (yr. 1919) – first true nursing law
o accomplice o It removed from the doctor the control of nurses with 3 man team (1
▪ participation is merely dispensable. chairman and 2 members all nurses)
▪ Usually performs before (eg. referral by the nurse of a abortionist • 1920 – 1st official board exam
to a pregnant women) or during the crime eg. OB nurse is to • 1st nursing school (6months)
perform abortion. The nurse is look out for police. The nurse is o Iloilo Mission Hospital (1906)
the accomplice. o PGH School of Nursing (1907)
o accessory o St. Luke’s school of nursing (1907)
▪ usually performs after the crime (eg. stole a nebulizer in the o Mary Johnson’s school of Nursing (1907)
hospital. Sold the nebulizer to an asthmatic pt) This is an o St. Paul Iloilo 1907)
accessory because he benefited from the crime o San Juan de Dios (1907)
• 1st college of nursing (4years) – UP
RA 7877 – Anti sexual harassment law • RA 7164 (1991)
• committed by any person who exercises authority. (eg. teacher to student, head • RA 9173 (Oct 21, 2002)
nurse to staff nurse). o Board of Nursing
• That person who is in authority is asking for a sexual favor in an exchange of ▪ Old
another favor. o M – MAN
o A – Accredited Nursing Org (PNA)
Types of Rape o F – five MAN team (1 chairman, 4 members)
• Ordinary rape o S – 65 y/o – 1 year interim period
o a forcible penetration of an organ for copulation to another organ for o N – Not convicted of any crime
copulation. (eg. women are only the victim) o P – Pecuniary interest (Absence)
• sexual assault o T – 10 years nursing practice
o anything that is forcible inserted to a body orifice with sexual malice. o C- Citizen of R.P.
o Also form of rape (eg. hand or an object is being inserted in the anal. ▪ New
Committed in both female or male) o M – MAN
o Intervention : o A – Accredited Nursing Org (PNA)
▪ S – safety (emotional or physical safety)

21 22

o S – 7 MAN team (1 chairman, 6members) ▪ Proofs of valid holder of a BSN Degree only from schools whose
o I – immediately resigned upon appt. curriculum is approved by the CHED
o N – Not convicted of any crime ▪ 3 docs sub to PRC
o P – Pecuniary interest (Absence) ▪ RLE certificate
o T – 10 years nursing practice but 5 yrs must be in the ▪ TOR with Scanned picture
Phils. ▪ List of cases
o C- Citizen & resident of R.P. ▪ Examination fee is P900
▪ Who formulates the question of the Board Exam? – Board of ▪ Last day Is :
Nursing
▪ In having a license it is a Privilege not a Right Other related laws
▪ Board of Nursing issues the license • PD 223 – PRC Act
▪ PRC issues the certificate of registration • RA 1080 – Civil Service exam Cum Laude, Board passer – eligible in taking CSE
▪ CHED are the ones who has the power to open and close a • RA 6425 – Dangerous drugs Act
nursing school o punishable with 2 chemical substances
▪ BON just inspects 5 consecutive years of below 80% passing rate, ▪ Prohibited drugs
the school will be closed • chemical substance totally, abosultely can’t be consumed
▪ Powers and Functions of BON by human being (eg. Shabu, Mariana, Cocaine, Opium)
o L – Licensure exam ▪ Regulated drugs
o I – Issue COR • you can use this drug provided the pt has the prescription
o M – Monitor standards of nursing practice and the AMD has appropriate license coming from the
o E – Education BFAD or Dangerous Drugs
o C – Code of ethics • RA 7600 – Baby Friendly Hospital.
o H – Hear and decides cases of negligence and malpractice o Early bonding for mother is Early Rooming in and early baby breast
o A – Accredits different organizations technique for early bonding Early bonding for father is thru cuddling
o G – Guides Nursing Practice in the phils • E.O. 51 – Milk Code (Breast Milk)
o Dean o Avoid manufactured or formula milk
▪ R.N., MAN
• How to be an R.N. under 9173
▪ 5 years nursing experience
o Have all qualifications
o Clinical Instructor
o take the exam
▪ A – allied in nursing or any allied health courses
o acquire the required ratings
▪ M – member of PNA
o In order to pass the examination, an examinee must obtain a general
▪ O – 1 yr experience
average of at least 75 % with a rating of not below sixty percent (60%) in
▪ R – R.N.
any subject
o Nursing Administrator
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
Supervisor/Manager H Community Military Hosp only in the subject or subjects where he/she us treated below 60 %
(60%). In order to pass the succeeding examination, an examinee must
• B – BSN RN obtain a rating of at least 75% in the subject or subjects repeated.”
• A – Accredited Org • RA 8981 –Modernization Act.
• N – 9 units
• T – 2 yrs
• For every 5,000, results will be released after 5days
Chief/Director • PRC rating NAME
RN + MAN + Add only MAN + • Text to 263 (smart) 233 (globe)
5 yrs supervisor master’s in GSC
experience PHN or (Gen. • What are the grounds for nurse not to be registered?
(N.B. if primary CHN Staffing o D – Dishonorable conduct
hosp) Course) o U – Unsound mind
o M – moral turpitude
o I – Indecent immortal conduct
o Examinees
▪ CGM (Good Moral Character)
▪ Proofs of Valid Holder of Filipino Citizenship

23 24