PROFESSIONAL ADJUSTMENT INHOUSE  Quality Improvement

 Research
PROFESSIONAL ADJUSTMENT
 The growth of the individual & the development
of all his capacities physical, mental, CORE VALUES OF NURSING
emotional, social & spiritual.  Love of GOD
 Love of the PROFESSION- caring, integrity,
PROFESSION excellence
 The occupation of calling requiring advanced  Love of COUNTRY- nationalism
training and experience
MISSION OF THE NURSING
CRITERIA FOR A PROFESSION
 Service to human welfare
PROFESSION
 Specialized knowledge & skills  We, the Filipino nurses, responding to the
 Code of Ethics needs of society are engaged in providing
 Professional Association humane and globally competent nursing care
 Long Term Commitment
 Educated in Higher Education Institution COMMON AREAS OF NURSING
 Autonomy PRACTICE
 Acute Care
What is NURSING? Nursing is putting the patient  Extended Care Opportunities
in the best condition for nature to act upon him  Outpatient Nursing Opportunities
 Business Opportunities
ATTRIBUTES OF PROFESSIONAL
HOW TO GET A JOB:
NURSING?
 CONSCIENCE I. > choose jobs on the basis of
 COMPASSION C - ALLING
 COMMITMENT
 CONFIDENCE
H - APPINESS
 COMPETENCE O - BSTACLES
I - NTEREST
CORE COMPETENCY STANDARDS FOR C - HARACTER TRAITS
NURSING PRACTICE E - ARNING CAPACITY

 2005 Core Competency Standards For II. > Look inside YOU
Nursing Practice in the Philippines (BON III. > Don’t look for a JOB; start a CAREER
Res. #112 series of 2005) WHEN WRITING YOUR RESUME
 2012 National Nursing Care Competency R - eadability is important
Standards (BON Res. #34 series of 2012) E - xperience must be highlighted
S - ell your competencies
3 ROLES OF A NURSE U - se action words
 ROLE IN CLIENT CARE M - arket yourself
 LEADER / MANAGER E - ducation & Training counts
 RESEARCHER
HOW TO PASS AN INTERVIEW?
CORE COMPETENCIES I – MPACT
N – O NON SENSE
1. PATIENT CARE T – ALK
COMPETENCIES E – NERGY
 Safe Quality Nursing Care R – ELATIONSHIP
 Communication V – ISION
 Collaboration & Teamwork I – NTEGRITY
 Health Education E – NTREPRENEURSHIP
W - ISDOM
2. EMPOWERING
PASSING THE WRITTEN EXAMINATION
COMPETENCY/IES D – etermined to pass
 Legal Responsibilities
O – pen Mind
 Ethico-Moral Responsibility
N – ext Question
 Personal & Professional Development
T – IME CONSCIOUSNESS
3. ENABLING COMPETENCIES C – ONCENTRATION
 Record Management
R – ead Instruction
 Management of Resources & Environment
A – void Cheating
M – ake writing readable/ legible
4. ENHANCING COMPETENCIES
MAKE A GOOD SCORE REPEALING (*certain modifications) for the purpose RA
S – election
7164 aka Philippine Nursing Act of 1991
C – ompensation
O – ffer in writing
What is the title? Philippine Nursing Act of 2002
R – equirement When was the law approved? OCTOBER 21, 2002
E – xamination, Physical Examination
2 FOLD STATE POLICY
CONTRACTS A. State Responsibility- responsibility of
 A meeting of minds between 2 persons where government to protect & improve nursing
by one binds himself. profession
B. State Guarantee- commitment by government to
TYPES:
deliver quality health care services by providing
1. FORMAL – in writing as required by some adequate nursing personnel throughout the
special laws country.
2. INFORMAL – a result of oral decision
between parties DECLARATION POLICY
3. EXPRESSED – conditions & terms are given  It is hereby declared the policy of the state to
orally / in writing of the parties concerned assume responsibility for the protection &
4. IMPLIED – concluded a result of the parties improvement of the nursing profession by
instituting measures that will result in relevant
for which the law ascribes an objective
nursing education, humane working condition,
intention.
better career prospects & a dignified existence
5. VOID – inexistent from the beginning for our nurses.
6. ILLEGAL – prohibited by law
CREATION & COMPOSITION OF THE BOARD
Success is all in the MIND  CHAIRPERSON: 1
M – ental Ability  MEMBERS: 6
I – nsight & Initiative  Appointed by the PRESIDENT of the Republic of
N – urturing Attitude the Philippines
D – etermination  FROM: Two (2) recommendees for every vacancy
by the PRC
Resigning from JOB:  CHOSEN & RANKED FROM: Three (3) nominees
 Primary Reason: TO SEEK FOR BETTER from the APO for every vacancy.
POSITION
 Inability to adjust to work situation, marriage QUALIFICATIONS OF THE CHAIRPERSON & MEMBERS
and/or transfer of residence OF THE BOARD OF NURSING
 Be a natural born citizen & resident of the
LAWS – are those rules made by humans that regulate Philippines.
social conduct in a formally prescribed & legally  Be a member of good standing of the accredited
binding manner. professional organization of nurses
 Be a REGISTERED NURSE and a holder of
3 essential characteristics of LAW: a Master’s degree in nursing, education, or
 Authority / the right to declare that the rule other allied medical profession conferred by a
exists college/ university duly recognized by the
 Such rule is pronounced / expressed & that is Government provided that the Chairperson shall be
the source can be identified a holder of master’s degree in nursing.
 A right to enforce the same must be provided.  Have at least ten (10) years of continuous
practice of the profession prior to the appointment:
PRINCIPAL SOURCES OF LAW
Provided, however, that the last five (5) years of
 Constitutions which shall be in the Philippines;
 Statutes / Legislations (RA)  Not have been convicted of any offense involving
 Executive Order moral turpitude.
 Case decisions/ Judicial options  Provided, that the membership to the Board shall
 Presidential decrees represent three areas of Nursing, namely
 Letters of Instruction nursing education, nursing service and
community health nursing.
NURSE PRACTICE ACT
Law regulating the practice of nursing in a REQUIREMENTS UPON QUALIFICATION AS MEMBER OF
country/state. THE BOARD OF NURSING.

ELEMENTS OF NPA IMMEDIATELY RESIGN from:

 Definition of Professional Nursing  any teaching position in any school, college,
 Requirements for Licensure university/ institution offering Bachelor of Science
 Exemptions in Nursing and/or review program for the local
 Licensure Across Jurisdiction nursing board examinations or in
 Disciplinary  any office/ employment in the government or
 any subdivision, agency or instrumentality thereof,
RA 9173 – An act providing a more responsive including government-owned or controlled
nursing profession. corporations of their subsidiaries as well as
 those employed in the private sector
  He shall not have any pecuniary interest in or
administrative supervision over any institution
offering Bachelor of Science in Nursing including
review classes.
TERM OF OFFICE
 Shall hold office for a term of three (3) years
and until their successor have been appointed &
qualified.
 Maybe appointed for another term
 Any vacancy in the Board occurring within the term
of a member shall be filed for the unexpired
portion of the term only.
 Each Member of the Board shall take the proper
oath of office prior to the performance of his/her
duties.
COMPENSATION OF THE BOARD
 Shall receive compensation & allowances
comparable to the compensation & allowances
received by the Chairperson (SG 30) and
members (SG 28) of other professional regulatory
boards.
ADMINISTRATIVE SUPERVISION OF THE BOARD
 Custodian of its records- including applications
for examinations, administrative & other
investigative cases conducted by the Board
 Secretariat & support services
 The commission shall:
 designate the Secretary of the Board
 Provide Secretariat & other support
services to implement the provision of this
act.
POWERS & DUTIES OF THE BOARD
 Conduct licensure examination for nurses
 Issue, suspend & revoke certificates of registration
for the practice of nursing.
 Monitor & enforce quality standards of nursing
practice in the Philippines & exercise powers
necessary to ensure the maintenance of efficient,
ethical and technical, moral & professional
standard in the practice of nursing taking into
account the health needs of the nation.
 Conduct hearings & investigations to resolve
complaints against nurse practitioners for unethical
& unprofessional conduct & violations of this Act, or
its rules & regulations and in connection therewith,
issue subpoena ad testificadum and
subpoena duces tecum.
 Promulgate a Code of Ethics in coordination &
consultation with the accredited professional
organization within one (1) year from the
effectivity of this Act
 Recognize nursing specialty organizations in
coordination with the accredited professional
organization.
Who has the authority to OPEN & CLOSE colleges
and/or nursing education programs?
 shall be vested on the Commission on Higher
Education upon the written recommendation of the
Board
ANNUAL REPORT
 The Board shall at the close of its calendar year
submit an annual report to the President of the
Philippines through the Commission giving a
detailed account of its proceedings and
accomplishments during the years and making
recommendation for the adoption of measures
that will upgrade and improve the conditions
affecting the practice of nursing profession.
REMOVAL/ SUSPENSION OF BOARD MEMBERS:
 The President may remove/suspend any
member of the Board after having been given the
opportunity to defend himself/herself in a proper
administrative investigation.
GROUNDS FOR REMOVAL:
 Continued neglect of duty/ incompetence.
 Commission/ toleration of irregularities in the
licensure exam
 Unprofessional, immoral or dishonorable conduct.
LICENSURE EXAMINATION
 All applicants for license to practice nursing shall
be required to pass a written examination, which
shall be given by the Board of Nursing in such
places & dates as may be designated by the
Commission: Provided, that it shall be in
accordance with RA. 8981, (PRC
Modernization Act of 2000)
QUALIFICATIONS FOR ADMISSION TO THE LICENSURE
EXAMINATION
 He/She is a citizen of the Philippines, or a
citizen or subject of a country which permits
Filipino nurses to practice within its territorial
limits on the same basis as the subject or
citizen of such country.
Provided, that the requirements for
registration or licensing of nurses in said
country are substantially the same as
those prescribed in this Act.
 He / She is of good moral character
 He / She is a holder of Bachelor’s degree in
Nursing from a college/ university that complies
with the standards of Nursing Education duly
recognized by the proper government agency.
FEES FOR EXAMINATION & REGISTRATION:
 Applicants for licensure and for registration shall
pay the prescribed fees set by the Commission.
SCOPE OF EXAMINATION
 The scope of Examination for the practice of
Nursing in the Philippines shall be determined by
the Board
 The Board shall take into consideration the
objectives of the nursing curriculum, the broad
areas of nursing and other related disciplines &
competencies in determining the subjects of the
examinations.
RATINGS
 General Average: at least 75% with a rating of not
below 60% in any subject.
 Average rating of 75% or higher but gets a rating
below 60% in any subject must take the
examination again but only in the subject/
subjects where he/she is rated below 60%
 In order to pass the examination, an examinee
must obtain a rating of at least 75% in the
subject/subjects repeated.
OATH
 ALL successful candidates shall be required to
take an oath of profession before the Board or any
government official authorized to administer oaths
prior to entering upon the nursing practice.
ISSUANCE OF CERTIFICATES OF REGISTRATION/
PROFESSIONAL LICENSE & PROFESSIONAL
IDENTIFICATION CARD.
 A certificate of registration / professional license as
a nurse shall be issued to an applicant who passed
the examination upon payment of the prescribed
fees.
CERTIFICATE OF REGISTRATION/ PROFESSIONAL
LICENSE
Shall show the ff:
 Full name of the registrant
 Serial number
 Signature of the Chairperson of the Commission
and Members of the Board
 Official seal of the Commission
PROFESSIONAL IDENTIFICATION
CARD
 Duly signed by the Chairperson of the Commission
 Date of Registration
 License Number
 Date of Issuance
 Date of Expiration
AUTOMATIC REGISTRATION OF
NURSES
 All nurses whose names appear at the roster of
nurses shall be automatically or IPSO FACTO
registered as nurses under this Act upon its
effectivity.
REGISTRATION BY RECIPROCITY
A certificate of registration/ professional license
may be issued without examination to nurses
registered under the laws of a foreign state or
country; Provided, that the requirements for
registration or licensing of nurses in said country
are substantially the same as those prescribed
under this Act.
Provided, further, that the laws of such state or
country grant the same privileges to registered
nurses of the Philippines on the same basis as the
subjects or citizens of such foreign state or country.
PRACTICE THROUGH TEMPORARY PERMIT
Licensed nurses from foreign countries/ states
whose services are either for a fee or free if they
are internationally well-known specialists or
outstanding experts in any branch or specialty of
nursing.
Licensed nurse from foreign countries/states on
medical mission whose services shall be free in a
particular hospital, center or clinic.
Licensed nurses from foreign countries/ states
employed by school/ colleges of nursing as
exchange professors in a branch or specialty of
nursing.
Provided, however, that the special/temporary
permit shall be effective only for the duration of the
project, medical mission or employment contract.
GROUNDS FOR NON-REGISTRATION & NON ISSUANCE
OF CERTIFICATES OF REGISTRATION/ PROFESSIONAL
LICENSE OF SPECIAL/ TEMPORARY PERMIT
 convicted by final judgment of any criminal offense
involving moral turpitude
 guilty of immoral or dishonorable conduct
 declared by the court to be of unsound mind.
GROUNDS FOR REVOCATION & SUSPENSION OF
CERTIFICATE OF REGISTRATION/ PROFESSIONAL
LICENSE & CANCELLATION OF SPECIAL/ TEMPORARY
PERMIT
 Any of the causes under no registration
 Unprofessional & unethical conduct
 Gross incompetence / serious ignorance
 Malpractice/ negligence in the practice of nursing
 Use of fraud, deceit, or false statements in
obtaining a certificate of registration/ professional
license or a temporary/ special permit.
 For practicing his/her profession during his/her
suspension from such practice
 Provided, however, that the suspension of the
certificate of registration/ professional license shall
be for a period not to exceed four (4) years.
 For violation of this Act, the rules & regulations,
Code of Ethics for nurses & technical standards for
nursing practice, policies of the Board and the
Commission, for the conditions and limitations for
the Issuance of the temporary/ special permit.
RE-ISSUANCE OF REVOKED
CERTIFICATED & REPLACEMENT OF
LOST CERTIFICATES.
 The Board may, after the expiration of a maximum
four (4) years from the date of revocation of a
certificate, for reasons of equity & justice and
when the cause for revocation has disappeared
or has been cured and corrected, upon
application thereof and the payment of the
required fees, issue another copy of the certificate
of registration/ professional license.
WHEN REGISTRATION CARDS/ ID’s ARE
LOST/ DAMAGED
 A new certificate of registration/ professional
license to replace the certificate that has been lost,
destroyed or mutilated may be issued subject to
the rules of the Board. (Affidavit of Loss or
Affidavit of Destruction)
REQUIREMENTS FOR INACTIVE NURSES
RETURNING TO PRACTICE
 Nurses who have not actively practiced the
profession for five (5) consecutive years are
required to undergo 1 month of didactic training
& 3 mos of practicum.
QUALIFICATIONS OF THE FACULTY
 RN in the Philippines
 At least 1 year of clinical practice in a field of
specialization
 Member of good standing in the APO
 Holder of Master’s degree in nursing, education or
other allied medical & health sciences conferred by
the college or recognized university.
QUALIFICATIONS OF THE DEAN
In addition to aforementioned qualifications;
Must have Master’s degree in nursing
At least 5 years’ experience in Nursing
QUALIFICATIONS OF NURSING SERVICE
ADMINISTRATORS
 RN in the Philippines
 At least 2 years’ experience in general nursing
service
 BSN degree & at least 9 units in management
and administration courses at the graduate level
 Member of good standing of APO.
QUALIFICATIONS OF CHIEF NURSE OR DIRECTOR OF
NURSING SERVICE
In addition to aforementioned qualifications:
 At least 5 years of experience in a supervisory
or managerial position in nursing
 Master’s degree in nursing
 General Staff Course for chief nurse in a military
hospital
 Those occupying such positions are given 5 years
to qualify.
DUTY OF THE NURSE:
 Provide nursing care through utilization of nursing
process
 Nursing care include but not limited to,
traditional and innovative approaches,
therapeutic use of self, executing health care
techniques & procedures, essential primary
health care, comfort measures, health
teachings & administration of written
presentation for treatment, therapies, oral,
topical and parenteral medications, internal
examination during labor in the absence of
antenatal bleeding and delivery.
 In case of SUTURING of PERINEAL
LACERATION, special training shall be
provided according to the protocol established.
 Establish linkages with community resources
and coordination with health team
 Provide health education
 Teach, guide and supervise students in nursing
education programs
 Undertake nursing & health human resource
development, training and research, which shall
include, but not limited to, the development of
advanced nursing practice.
COMPREHENSIVE NURSING SPECIALTY PROGRAM
The Board in coordination with the APO,
recognized nursing specialty organizations and
DOH- formulate or develop nursing specialty
programs upgrade level of skill and
competence of specialty nurse clinicians.
Beneficiaries are obliged to serve in any
Philippine hospital for a period of at least 2
years of continuous service.
THE 5 ESSENTIAL DRUGS UNDER THE MDRP
 Amlodipine for hypertension
 Atorvastatin for anti-cholesterol
 Azithromycin as antibiotic/ antibacterial
 Cytarabine & Doxorubicin and all its salt
form both for anti-neoplastics/ anti-cancer
LEGAL RESPONSIBILITIES OF THE NURSE
LAW- rules made by humans that regulate social conduct
in a formally prescribed & legally binding manner
DEFINITION OF TERMS
LEGAL RIGHTS- A claim that can be enforced by
legal means against the persons or the community whose
duty is to respect it.
HUMAN RIGHTS – Are items which are a
person’s due as a member of a society
ACCOUNTABILITY- being answerable when
carrying out professional responsibilities
LIABILITY- Being legally bound
RESPONSIBILITY- an obligation to perform some
act for which one can be held answerable.
PATIENT’s BILL OF RIGHTS
1. Right to Medical Care & Humane Treatment
2. Right to Informed Consent- right to clear
explanation, in lay man’s term all proposed procedures
including identity of the person who will perform such
procedure, the risks and benefits involved in the procedure.
3. Right to Privacy- the right to be left alone when this
will not prejudice the provision of necessary medical care.
4. Right to Information- right to clear, complete and
accurate evaluation of the nature and extent of his disease,
the contemplated medical treatment and surgical
procedure.
5. Right to Privileged Communication- to expect all
communication and records pertaining his care should be
treated confidential.
6. Right to Choose Physician to serve him - except
when he is confined in a charity ward, when he has entered
into contract with a health maintenance organization or any
health insurance org. which stipulates that his doctor should
be affiliated with them.
7. Right to Self Determination- the right to refuse
treatment or diagnostic procedures.
8. Right to Religious Belief
9. Right to Medical Records- a summary of his
medical history and condition to be accomplished by his
attending physician
10. Right to Leave- to leave the hospital regardless of
his physical condition.
11. Right to Refuse Participation in Medical
Research
12. Right to Correspondence and Receive
Visitors
13. Right to Express Grievances about the care &
services received
14. Right to be Informed of his Rights and
Obligations as a patient
15. Right to choose his own physician.
NURSE’S BILL OF RIGHTS (ANA Board of
Directors, JUNE 26, 2001)
Nurses have the right:
1. To practice in a manner that fulfills their obligations to
society.
2. To practice in environments that allow them to act in
accordance with professional standards and legally
authorized scope of practice.
3. To a work environment that supports and facilitates
ethical practice in accordance with the Code of Ethics for
Nurses.
4. To freely and openly advocate for themselves and their
patients without fear of retribution.
5. To a fair compensation for their work, consistent with
their knowledge, experience and professional
responsibilities.
6. To a work environment that is safe for themselves and
their patients.
7. To negotiate the conditions for their employment, either
as individuals or collectively, in all practice settings.
Additional Right from the Nurse’s Lounge Website
(Nursing Power Website – Accessed 1/31/05)
8. Not to be abused in any form by physicians, pharmacists,
administrators or nursing directors.
9. Not to be exploited and abused by being floated to areas
of practice they are not familiar with.
10. To refuse any assignment that they feel is unsafe.
IMPLEMENTING MEDICAL ORDERS
OR REFERRALS
RA 6675 - Only valid registered medical, dental and
veterinary practitioners are authorized to prescribed drugs.
 prescribed drugs be written for their GENERIC
NAMES.
RA 2832 & RA 4419 – Prescriptions made by
unauthorized persons constitute illegal practice of medicine,
dentistry and veterinary medicine.
CARRYING OUT PHYSICIAN’S ORDER
 ONLY when the orders concerning treatment and
medications are IN WRITING and bear the MD’s
SIGNATURE does the nurse have the legal right to
follow it.
 It is expected that nurses know the basic
information about procedures and medications
ordered by the physician.
 It is the responsibility of the nurse to clarify
ambiguous or seemingly erroneous orders from
the prescribing MD and/then to other sources.
THE ORDERS THAT NURSES MUST
QUESTION TO PROTECT THEMSELVES
LEGALLY:
 Question any order the patient questions
 Question any order if the patient’s condition has
changed.
 Question and record verbal orders to avoid
miscommunications
 Question standing orders especially if the nurse is
inexperienced.
IMPLEMENTING DELEGATED & death of senior citizens.
INDEPENDENT NURSING INTERVENTIONS
 Function within the scope of your education, job
description and area nurse practice act.
 Follow the procedure and policies of the employing
institution
 Observe and monitor the patient accurately
 Communicate and record significant changed in
the patient’s condition to the physician.
 Check any orders that a patient questions.
 Identify patients before initiating interventions
 Protect patients from falls and preventable injuries
 Document all nursing assessments and
interventions accurately
 Ask for assistance and supervision in situations for
which you feel inadequately prepared.
 Delegate tasks to persons with the knowledge and
skill to carry them out.
 Build and maintain good rapport with patients.
DAMA (Discharge Against Medical Advice)
 The right to refuse treatment includes the right to
leave the hospital against medical advice.
 Recognize a potential patient walk-out
If the patient insist on leaving…
 Follow the policy of the hospital regarding DAMA
 If the hospital doesn’t have a policy about DAMA:
1. Contact the patient’s SO and explain
2. Explain the hospital’s DAMA procedure to the
patient
3. Give the client a DAMA form and ask the
patient to sign
4. Provide routine discharge care.
Dealing w/ an ESCAPEE / ABSCONDEE
 Notify the nursing supervisor and security
immediately
 Notify patient’s family
 Collect patient’s belongings and document it.
INFORMATION should include:
 Description of the treatment procedure
 Name and qualification of the person who will
perform the procedure.
 Benefits and risks involved
 Alternative treatment or procedure
 Possible effects of not having the treatment or
procedure.
SENIOR CITIZENS ACT
RA 7432
 Senior Citizens Act, gives honor and justice to the
elderly, giving them 20% discount in all public
establishments such as restaurants, pharmacists,
public utility vehicles and hospitals.
RA 9257
 Expanded Senior Citizens Act of 2003
amending RA 7432
PRIVILEGES FOR THE SENIOR CITIZENS
 20% discount for all establishments relative to
the utilization of services in hotels or similar lodging
establishments, restaurants and recreation
centers, purchase of medicines in all establishment
for the exclusive use or enjoyment of senior
citizens including funeral and burial services for the
 EXCEPTION from payment of income taxes
 FREE medical and dental services, diagnostic
and laboratory fees in government facilities; 20%
discount in private facilities.
 20% discount in fare for domestic air and sea
travel, public railways, skyways and bus fares.
 Provision for express lanes for senior citizens
RA 9994
 Amended RA 7432 exemption from paying
the Value Added Tax for goods and services
produced by a senior citizen.
LEGAL LIABILITIES IN NURSING PRACTICE
The Judicial Process  Employee or contractor for service
 Citizen
 functions to settle disputes peacefully and in
accordance with the law
AREAS OF POTENTIAL LIABILITY IN
STEPS IN THE JUDICIAL PROCESS NURSING

(1) Plaintiff files a complaint 1. CRIME – An act committed in violation of public law
and punishable by a fine and/or imprisonment.
(2) An answer will be made by the defendant

(3) DISCOVERY Classification

A. FELONY- crime of a serious nature
(4) TRIAL punishable by a term in prison
B. MISDEMEANOR – An offense of a less
(5) DECISION/ VERDICT serious nature and is punishable by a fine or
short-term jail sentence.
CONCEPT OF A REASONABLY PRUDENT
MAN 2. TORT
 When a person engages in an activity, he/she  a civil wrong committed against a person or a
has a legal duty to act as an ordinary prudent person’s property
reasonable person would act.  Usually litigated in court by civil action between
individuals and is based on fault.
STANDARD OF REASONABLENESS
 Doctrine of “Res Ipsa Loquitor” Classification
 Doctrine of “Respondeat Superior” A. INTENTIONAL
 Doctrine of “Force Majeure”
B. UNINTENTIONAL
DOCTRINE OF “RES IPSA LOQUITOR”:
 “the thing speaks for itself” INTENTIONAL
 The thing causing the accident lies within the A. FRAUD – false representation of some fact
exclusive control of the defendant. with the intention that it will be acted upon by
another person.
CONDITIONS: B. INVASION OF PRIVACY – A direct
1. The accident won’t happen in the absence of
wrong of personal nature through revealing
someones negligence
information that will affect the person’s standing in
2. The accident was caused by an instrumentality or
the community or group where he belongs.
agency within exclusive control of the defendant.
- The patient has the right to be left alone.
3. There is no voluntary action or contribution on the
part of the plaintiff. C. DEFAMATION – Communication that is
false, or made with a careless disregard for the
DOCTRINE OF “RESPONDEAT SUPERIOR”: truth, and results in injury to reputation of a person.
 “let the superior or principal answer” C.1 LIBEL – defamation by means of
 In doing the acts out of which the accident arose,
PRINTING, WRITING / PICTURES
the servant was representing the master at the
time. C.2 SLANDER – defamation by means of
SPOKEN WORDS, stating unprivileged (not legally
Test of liability under the doctrine of “Respondeat protected) or false words by which someone’s
Superior”: reputation is damaged.
The power of control – if the master cannot D. ASSAULT – An attempt to THREAT to touch
command the alleged servant, then the acts of the another person unjustifiably.
latter are not his, and he is not responsible for
them. E. BATTERY – WILLFUL TOUCHING of a
person that may or may not cause harm.
If the principal cannot control and direct the
alleged agent, then he is not his agent. F. FALSE IMPRISONMENT –
The rule is when the general employer assigns UNLAWFUL RESTRAINT / DETENTION of
another person against his/ her will.
his servants to duty for another and surrenders
to the other, direction and control is hence shifted
UNINTENTIONAL
to that person.
(E.g. hospital direction and control of the surgeon A. NEGLIGENCE – doing of that thing which a
in the OR) reasonably prudent person would not have done, or the
failure to do a thing that a reasonably prudent person would
DOCTRINE OF “FORCE MAJEURE”: have done in like or similar circumstances.
 Due to “an irresistible or superior force”  indicates deficiency of perception and lack of
 No person will be held liable for events which could foresight.
not be foreseen, or which though foreseen, were
inevitable. B. IMPRUDENCE – a deficiency of action involving
a lack of skill
LEGAL ROLES of NURSES
 Provider of service SPECIFIC EXAMPLES OF NEGLIGENCE:
  Failure to report observations to attending CONSPIRACY TO COMMIT CRIME
physician
 Failure to exercise the degree of diligence
which the circumstances of the particular case
PRINCIPAL
demands.  DIRECT PART IN THE
Those who take
 Mistaken identity EXECUTION of the act
 Errors in medication  who directly force or induce others to commit it.
 Defects in equipment  who cooperate in the commission of the crime by
 Errors due to family assistance another act without which it would not have been
 Administration of medicine without a doctor’s accomplished.
prescription

LEGAL DEFENSE IN NEGLIGENCE

ACCOMPLICE
 those who, not being the principals
 Know the standards of care
 Comply with the established set of the standards of COOPERATE IN THE EXECUTION OF
care THE CRIME by previous or simultaneous
 Document actions taken as well as the outcome of act.
such interventions accurately and completely.
ACCESSORY
C. MALPRACTICE – Any professional  HAVING THE KNOWLEDGE
those who,
misconduct, or any unreasonable lack of skill or fidelity in
the performance of professional or fiduciary duties.
of the commission of the crime , either as
principals or accomplices take part subsequent to
 It means objectionable practice, or a practice
its commission by:
contrary to established rules
profiting themselves or assisting the offender
 Loosely refers to the negligence of a member of
to profit from the effects of the crime.
any professional group.
Concealing or destroying the body of the
crime, or the effects or instruments thereof in
POTENTIAL MALPRACTICE SITUATIONS IN order to prevent its discovery or
NURSING harboring, concealing or assisting in the
 Medication errors escape of the principal of the crime, provided
 Sponges or other small things left inside a the accessories act with abuse of their public
patient during surgery functions or are known to be habitually guilty
 Burning a patient of some other crimes.
 Falls
 Mistaken identity CLASSES OF FELONIES
 Failure to observe and take appropriate action.  Based on the degree of the acts of execution
 Consummated
ELEMENTS OF MALPRACTICE  Frustrated
 Attempted
1. DUTY OWED THE PATIENT
A. Nature of the duty  Based on the degree of punishment
 Existence of duty + standard of care that  Grave
represent minimum requirement for an  Less Grave
acceptable practice.  Light
B. Breach of the duty DEGREE OF EXECUTION
 After establishing standard of care, show that
defendant fall below the standard of care.  CONSUMMATED – All the elements
necessary for its execution and accomplishment
2. FORESEEABILITY are present
 Certain events may reasonably be expected to  FRUSTRATED – When the offender
cause specific results. performs all the acts or execution of the felony but
which do not produce it by reasons independent of
3. CAUSATION the will of the perpetrator.
 The nurse’s action or lack of action directly cause  ATTEMPTED – when the offender
specific results. commences the commission of the felony by overt
acts, and does not perform all the acts or execution
4. INJURY by reason of some cause or accident other than his
 The resultant harm must be physical, not merely spontaneous desistance.
psychological or transient.
DEGREE OF PUNISHMENT
5. DAMAGES
 The plaintiff must show financial harm before the
court will allow a finding of liability against the
 GRAVE FELONIES – those with
CAPITAL PUNISHMENT (death) or penalties
defendant nurse or hospital.
which in any of their periods are afflictive
(imprisonment) ranging from 6 years and 1 day to
2 ELEMENTS OF CRIMINAL OFFENSE
LIFE IMPRISONMENT or a fine not exceeding
 CRIMINAL ACT
₱6000.00
 EVIL / CRIMINAL INTENT
 LESS GRAVE FELONIES – those with
PENALTIES WHICH ARE CORRECTIONAL
 (ranging from 1 month and 1 day to 6 years) or a
fine not exceeding ₱6,000.00 but not less than
₱200.00
 LIGHT FELONIES- those with the
penalty of ARRESTO MENOR (imprisonment for 1
day to 30 days) or a fine not exceeding ₱200.00
CIRCUMSTANCES AFFECTING CRIMINAL
LIABILITY
 Justifying Circumstances
 Exempting Circumstances
 Mitigating Circumstances
 Aggravating Circumstances
 Alternative Circumstances
JUSTIFYING CIRCUMSTANCES
 Those circumstances which make the act of a
person to be LEGAL & NOT CRIMINAL, so he is
deemed not to have violated the law and is free
from both criminal and civil liability.
1. SELF DEFENSE
 unlawful aggression on the part of the
offender
 Reasonable necessity for the means
employed by the person to defend himself.
 Lack of sufficient provocation
2. In DEFENSE of FAMILY MEMBERS/
RELATIVES
3. In DEFENSE of STRANGERS / rights of
strangers
4. AVOIDANCE OF GREATER EVIL /
INJURY – evil exist, injury feared is greater or
no other practical or less harmful way to
prevent it.
5. ACTS IN FULFILLMENT OF DUTY /
LAWFUL EXERCISE OF RIGHT OR
OFFICE
6. OBEDIENCE TO A LAWFUL ORDER
EXEMPTING CIRCUMSTANCES
 IMBECILITY/ INSANITY
 Being 9 years of age or less of age
 Over 9 years and under 15 years, unless has not
acted with discernment
 Performing a lawful act with due care but caused
an injury by mere accident.
 Under the compulsion of irresistible force
 Under an impulse of an uncontrollable fear of an
equal or greater than injury
 Failed to perform an act required by law, when
prevented by some lawful cause.
MITIGATING CIRCUMSTANCES
 Incomplete Justifying or Exempting
Circumstances
 No intention to commit so grave a wrong as the
one committed
 Being UNDER 18 years old or over 70 years old
 With sufficient provocation or threat on the part of
the offender.
 Immediate vindication of a grave offense
 Acts upon impulse so powerful as naturally to have
produced passion or obfuscation.
 Voluntary surrender or confession of guilt
 With physical defect, deaf or dumb, blind which
restricts his means of action, defense or
communication with his fellow beings
 Illness of the offender that diminishes the exercise
of his will power.
 Similar and analogous
circumstances – as impulse of jealousy,
extreme poverty and necessity
AGGRAVATING CIRCUMSTANCES
 Taking advantage of public position
 Contempt of or insult to public authorities
 Committed with disregard of Rank, Age or Sex
 Committed in the dwelling of the offended party
 Committed with abuse of confidence
 Obvious ungratefulness
 Palace of the Chief Executive of the country
 In the presence of the Chief Executive
 Committed in the place of worship
 Committed on the occasion of calamity or
misfortune
 Committed in consideration of a price, reward,
promise or fortune.
 Committed by means of inundation, fire, poison,
explosions, intentional damage etc.
 Committed with evident premeditation or after an
unlawful entry
 When craft, fraud, or disguise is employed
 Where public authorities are engaged in the
discharge of their duties
 Wrong done in the commission of the crime is
deliberately augmented by doing other wrongs not
necessary for its commission.
 Night time or during period of darkness
 In an uninhabited place
 By a band or cuadricilla or a group of more
than 3 armed men.
 With the aid of armed men
 RECIDIVISM – when one who at the time
of his trial for 1 crime shall have been previously
convicted of another crime by final judgment.
 HABITUALITY – have been previously
punished with an equal or greater penalty or with a
lighter penalty
 Utilization of the offender’s superior strength
 When means to weaken defense are employed
 TREACHERY
 Add Ignominy to the natural effects of the felony
(make the effects more humiliating/ shameful)
 Breaking a wall, roof, floor, door or window as a
means
 With the aid of minors or by means of motor
vehicles, airships or other similar means.
 Cruelty
ALTERNATIVE CIRCUMSTANCES
 Those which must be taken into consideration as
aggravating or mitigating according to nature &
effects of crime and other conditions attending to
its commission.
 Relationships, intoxication, degree of instruction
and education of offender.
PENALTIES
 Is the suffering being inflicted by the state for
the commission of the crime.
THEORIES JUSTIFYING PENALTY
 1. PREVENTION – penalty prevents the  Abandonment of Persons in Danger
 Abandonment of One’s Victim
danger to society that may arise from crimes
 Threats
2. SELF – DEFENSE – penalty is a  Grave Coercion
measure of self-defense intended to protect
society from the threat and wrong inflicted by
the criminal.
Crimes Against Property
 Robbery
3. REFORMATION – penalty is intended  Theft
to correct and reform the offender  Swindling / Estafa
4. EXEMPLARITY – The criminal is  Destructive Arson
penalized as an example to deter others from  Malicious Mischief
committing crimes.
5. JUSTICE – penalty is imposed as an act of Crimes Against Chastity
retributive justice / vindication of right and  Adultery – committed by a married woman
moral law violated by the criminal. who has sexual intercourse with a man not her
husband
CAUSES OF TOTAL EXTINCTION OF CRIMINAL  Concubinage – Cohabits with woman not
LIABILITY his wife in any other place
 Death of the Convict  Acts of Lasciviousness
 Seduction
 Service of the Sentence  Abduction
 AMNESTY – general pardon of a class of
persons who are guilty of high political crimes. Crimes Against Honor
 ABSOLUTE PARDON – an act of grace  LIBEL – written public / malicious act to
which exempts the convict from the punishment of discredit or dishonor a person
his crime without any condition
 SLANDER – oral defamation
 PRESCRIPTION OF THE CRIME
– forfeiture or loss of the right of the state to  SLANDER BY DEED – one who
prosecute the offender after the lapse of a certain performs an act to dishonor or discredit someone
time.
 PRESCRIPTION OF THE PROFESSIONAL LIABILITY
PENALTY – the forfeiture or loss of the right INSURANCE
of the State to execute the FINAL SENTENCE  Defrays legal fees, settlement made out of
after the lapse of a certain time court
 MARRIAGE OF THE OFFENDED  Covers all costs incurred by the nurse up to the
face value of the policy.
WOMAN OR THE MARRIAGE
OF THE OFFENDER – in good faith, GOOD SAMARITAN LAW
with the offended woman after the commission of  Designed to protect health care providers’
the crime of Rape, Acts of Lasciviousness, assistance at the scene of the emergency
Seduction or Abduction. against claims of malpractice.
 Unless it can be shown that there was a gross
SOME CRIMES OR FELONIES departure from the normal standard of care of
willful wrongdoing.
Crimes against Persons
 Parricide – killing of a person’s father, mother THINGS TO REMEMBER IN BEING A
or child.
GOOD SAMARITAN
 Murder – An unlawful killing by a person of
 Make a decision quickly as to whether or not you
another committed due to the ff circumstances:
will stay & help. Remember there is no common
treachery, reward, promise, inundation, fire,
law/duty to stop and render aid.
poison etc.
 Ask the injured person for permission to help. Don’t
 Homicide – unlawful killing by a person of force your services.
another without the presence of the  Care for the injured party where you can do safely.
circumstances qualifying it as murder Move the injured party ONLY if you must do so
 Giving assistance to suicide without causing further harm and as needed to
 Infanticide – killing of a child less than 3 prevent further harm.
days of age  Apply rules of first aid; assess for and prevent
 Abortion bleeding; assess for the need to initiate CPR, cover
 Dispensing of Abortifacients patient with blanket.
 Mutilation  Continuously assess & reassess the person for
 Physical Injuries additional injuries and communicate findings to
 Rape patients/ relatives.
 Have someone call or go for additional help while
you stay with the injured party
Crimes Against Personal Liberty  Stay with the person until equally or more qualified
 KIDNAPPING – when you deprive help arrives
somebody of his liberty  Give as complete a description as possible of the
care you have rendered to the police and
 emergency medical personnel so that continuity of
care exists.
 Do not accept any compensation
 Should you choose not to stop and render aid; stop
at the nearest phone & report the incident to proper
authorities.

SOME QUESTIONS

1. As a registered nurse, which of the following

can be performed within the meaning of the
Nursing Act of 2002?
1. Internal examination during labor &
delivery in the absence of antenatal
bleeding
2. Suturing of perineal lacerations
 3. Nursing care of pregnant mothers during not produce it by reason of causes
labor and delivery independent of the will of the perpetrator
4. Administration of medications and c. The offender commences the
therapies including IV commission of a felony and does not
a) 1,2,3 perform all the acts of execution which
b) 1,3,4 should produce the felony
c) 2,3,4 d. None of the above

2. Petra choose nursing as her life-long career. Situation: Vivian is 2 months pregnant. Her
It is necessary that she must understand this friend Donna referred her to Sandra, an
profession as to guide her practically as a abortionist. Vivian without the consent of Carlo
nurse. Which among the following phrases best had an abortion.
describes what professional nursing is all
about? 8. If those involved be charged legally, who is
a. A nurse has always experienced proper considered as the principal of the crime?
community health training a. Vivian
b. Has independence towards proactive of b. Sandra
her nursing profession c. Donna
c. Always observe ethical and professional
practice. 9. Who is charged as an accomplice?
d. Provide diligent care for all regardless of a. Donna
their financial status b. Sandra
c. Vivian
3. To avoid legal embarrassment, the nurse
should do the following? 10. A nurse becomes liable as an accomplice in
a. He must have basic knowledge an abortion if she:
regarding the new Philippine Nursing a. performs the act
Law b. refers the pregnant mother to abortionist
b. He is aware of the laws affecting nursing c. conceals the evidence of the crime
c. Upgrade one’s skills and competence as
a nurse 11. If during the investigation, the pieces of
d. All of the above evidence were not found because Carling, the
maid of Juaning burned it. Carling is
4. Carmelita is a nurse who just passed the considered as:
local licensure examination for nurses. She a. Accomplice
knows that professional practice of nursing b. Accessory
involves all the following except: c. Principal
a. Administration of intravenous injection d. Co-principal
after completion of training
b. Motivation of individuals, families and 12. An agreement between 2 or more persons to
communities do or not to do a particular thing is known as:
c. Undertaking consultation services a. agreement
d. Participation in teaching, guidance and b. contract
supervision of students. c. subpoena

5. When the law attaches the capital 13. A contract is:

punishment, the felony is considered:
a. grave
b. less grave
c. light felony
6. Which of the ff is a grave felony?
a. Guilty of committing euthanasia
b. Untidy appearance while on duty
c. Reporting a wrongdoing of a colleague
a. A bond gathered by a nurse from the
patient
b. A document that permits 2 person to
offer the same services
c. A written agreement between the nurse
and the patient
d. An agreement which creates an
obligation

7. Felony is considered consummated when: 14. When a patient enters a doctor’s clinic for
a. All the elements necessary for its treatment, this is an example of:
execution are present a. formal contract
b. The offender performs all the acts of b. implied contract
execution which would produce felony c. single contract
as a consequence but nevertheless do
15. Which of the following statement is false b. 1,3,4
about an implied contract? c. 1,2,3,4
a. Its an agreement is assumed
b. Its agreement is inferred from the acts of 21. The following are possible penalty of the act
the parties except:
c. It must still have consent by the parties a. revocation of license
d. It is a formal contract b. life imprisonment
c. monetary penalty
16. A verbal agreement where one undertake to
render service to another in which either party 22. The professional license that has been
agrees to give for a fee or remuneration is revoked means:
enforceable: a. suspension to practice nursing
a. Formal written contract b. removal of license number
b. Contract that is null and void c. cancellation of the license
c. Form of an informal contract
d. Form of an implied contract 23. A nurse who executes a doctors order
which to her honest belief or judgment may
Situation: Nurse Robert is the scrub nurse in endanger the life of the patient can be accused
the surgical team which performed exploratory of:
laparotomy. Dr. Leonard was the surgeon, a. Malpractice
Nurse Cha was the circulating nurse and Dr. b. Accessory
Siony was the anesthesiologist. After the c. Criminal Negligence
operation, the patient complained of severe
abdominal pain while in the recovery room. X- 24. Negligence means failure to:
ray showed a mosquito forceps left in the a. Observe the behavior of an
patient’s abdomen. unscrupulous person
b. Behave properly as a professional nurse
17. The nurses are considered guilty based on c. Carry out one’s duties and function
the doctrine of: d. Do what is supposed to do.
a. Res ipsa Loquitor
b. Respondeat superior 25. The essential element to determine parricide
c. Force Majeure is:
a. Presence of the body of the crime
18. The doctrine of Respondeat superior b. Kind of weapon used
applies: c. Part of victim’s body at which the
a. where the injury occurs while the servant weapon is aimed
is not within the legitimate scope of his d. The relationship of the offender with the
authority victim
b. When the injury occurred in the course
of his employment 26. Infanticide is the unlawful killing of an
c. When the injury occurred outside the infant under:
commerce of man. a. Three days old
d. When the instrumentality was within the b. Three months old
full control of the servant c. Under 3 lbs baby weight
d. Three years old
19. The test for liability under the doctrine of
Respondeat superior is the: 27. Any person who kills his father is guilty of:
a. Power of master servant a. Parricide
b. Inquire itself b. Murder
c. Extent of damage caused c. Infanticide
d. Circumstances surrounding the act d. Abortion

20. The nurses were guilty of professional 28. Circumstances or actions which are said to
negligence, which of the following are the be in accordance with law is said to be:
elements of the act? a. Justifying
1. Existence of a duty on the part of the b. Exempting
person charged c. Mitigating
2. Failure to meet standards of care d. Aggravating
3. Foreseeability of harm resulting from
failure to meet standards 29. All of the following are exempting
4. The power to control over the circumstance except:
circumstances a. Imbecile
a. 1,2,4 b. 8 years old
 c. performance of a lawful act
d. offender is deaf and dumb

30. When a politician takes advantage of his

power in the performance of lawful actions this
is considered as:
a. Justifying Circumstances
b. Exempting circumstances
c. Mitigating circumstances
d. Aggravating circumstances

31. Each professional nurse must be legally

accountable in all his action which involves
proper monitoring and recording. The legal
implication of this is due to:
a. That regardless of the nurse re-recorded
his observation or not, he shall still be
accountable and liable
b. If the nurse did not document anything,
he shall be liable
c. If it was not written although it was
performed, it is considered as not having
been done at all.
d. Because a chart needs to be completed
by handwritten words

32. Which of the following principles apply to

the action of the nurse to refrain from
discussing the condition of the patient with
those who are not involved in his care?
a. Beneficence
b. Non-maleficence
c. Autonomy