I.

Carpers four patterns of knowing

A. Nursing science

- Empirical Nursing is the science of nursing. Based on the assumption that what is
known is accessible through the physical senses: seeing, touching, and hearing. It is
systematically organized into general laws and theories. One of the ways we employ
this knowledge is through the use of evidence-based practice (EBP). It is expressed
in practice as scientific competence grounded in scientific understanding. It also
involves conscious problem solving and logical reasoning.

B. Nursing ethics

- It is the component of moral knowledge in nursing. It is a guide and directs how

nurses conduct their practice. It requires experiential knowledge of social values and
ethical reasoning. Its focus is on the matters of obligation, what ought to be done
right, wrong, and responsibility. It also focuses on the Ethical codes of nursing,
guiding the development and refining of moral codes. Also, it includes confronting
and resolving conflicting values, norms, interests, or principles.

- The sources of Ethical knowing is the Nursing’s ethical codes and professional
standards. It also includes understanding different philosophical positions that cover
consequentialism, deontology, duty, and Social justice.

B. Nursing aesthetics

- Aesthetic knowing is the art of nursing. It is the nature of a clinical situation and
interpreting this information to respond with skilled action. It is expressed through
actions, bearing, conduct, attitudes, narrative, and interaction. It is knowing what to
do without conscious deliberation. It involves a deep appreciation of a situation's
meaning. Moves beyond the surface of a problem often shared without a conscious
exchange of words, transformative art/acts, brings together all the elements of a
nursing care situation to create a meaningful whole.

D. Personal knowledge

- Personal knowing is the acceptance of self that is grounded in self-knowledge,

reflection, and confidence. It is concerned with becoming self-aware that grows over
time through interactions with others. Used when nurses engage in the therapeutic use
of self in practice; scientific competence, moral/ethical practice, insight, and
experience of personal knowledge. It is the basis of the therapeutic use of self in the
nurse-patient relationship. And personal reflection and openness to experience.

I. Overview of the Professional Nursing Practice

1. Level of Proficiency according to Benner (Novice, Beginner, Competent, Proficient,
Expert)

- Stage 1 Novice: This would be a nursing student in his or her first year of clinical
education; behavior in the clinical setting is minimal and inflexible. Novices have a
minimal ability to predict what might happen in a particular patient situation.

- Stage 2 Advanced Beginner: Those are the new grads in their first jobs; nurses have
had more experiences that enable them to recognize recurrent, meaningful
components of a situation. They have the knowledge and the know-how but not
enough in-depth expertise. These nurses have 1-2 years of experience.

- Stage 3 Competent: These nurses lack proficient nurses' speed and flexibility, but
they have some mastery and can rely on advanced planning and organizational skills.
Competent nurses recognize the patterns and nature of clinical situations more
quickly and accurately than advanced beginners. These nurses have 2-3 years of
experience.

- Stage 4 Proficient: At this level, nurses can see situations as "wholes" rather than
parts. Proficient nurses learn from experience what events typically occur and can
modify plans in response to different events. These nurses have 3-5 years of
experience.

- Stage 5 Expert: Nurses who can recognize demands and resources in situations and
attain their goals. These nurses know what needs to be done. They no longer rely
solely on rules to guide their actions under certain conditions. They have an intuitive
grasp of the situation based on their in-depth knowledge and experience. Focus is on
the most relevant problems and not irrelevant ones. Analytical tools are used only
when they have no experience with an event or when events don't occur as expected.
These nurses have five or more experiences.

2. Roles and Responsibilities of a Professional nurse

- Caregiver/Care provider
The traditional and most essential role of a nurse. Functions as nurturer, comforter,
and provider. Consider as a mothering action of a nurse that provides direct care and
promotes the client's comfort. It shows concern for the client's welfare and acceptance
of the client as a person.

- Teacher
Provides information and helps the client to learn or acquire new knowledge and
technical skills. They encourage compliance with prescribed therapy. Promotes
healthy lifestyles and interprets data to the client.

- Counselor
 Helps client to recognize and cope with stressful psychologic or social problems; to
develop and improve interpersonal relationships, and to promote personal growth.
Acts as an emotional, intellectual, and psychological support. It focuses on helping a
client develop new attitudes, feelings, and behaviors rather than promoting
intellectual growth.

- Change Agent
Initiate changes or assist clients in making modifications in themselves or the system
of care.

- Client Advocate
Involves concern for and actions on behalf of the client to bring about a change. They
also promote what is best for the client, ensuring that their needs are met and
protecting their rights. They explain in the client's language and support the client's
decisions.

- Manager
Makes decisions, coordinates activities of others, allocate resource and evaluate care
and personnel.

- Researcher
Participates in identifying significant researchable problems. Participates in scientific
investigation and must be a consumer of research findings. They must be aware of the
research process, the language of research, and sensitive to protecting human subjects'
rights.

Responsibilities of a nurse

- Provide high-quality patient care.

- Assist with the continuous development of staff.
- Identify hazards in the workplace and provide solutions.
- Treat emergency injuries.
- Develop programs to maintain health and safety.
- Identify work-related risks.
- Document all injuries and illnesses.

3. Scope of Nursing Practice Based on RA 9173

- Scope of Nursing. - A person shall be deemed to be practicing nursing within the

meaning of this Act when he or she singly or collaborates with another, initiates, and
performs nursing services to individuals, families, and communities in any healthcare
setting. It comprises, but is not limited to, nursing care during conception, labor,
delivery, infancy, childhood, toddler, preschool, school-age, adolescence, adulthood,
and old age. As autonomous practitioners, nurses are primarily responsible for the
promotion of health and prevention of illness. As members of the health team, nurses
shall collaborate with other healthcare providers for the curative, preventive, and
 rehabilitative aspects of care, restoration of health, alleviation of suffering, and
recovery is not possible, towards a peaceful death.

It shall be the duty of the nurse to:

(a) Provide nursing care through the utilization of the nursing process. Nursing care
includes, but not limited to, traditional and innovative approaches, the therapeutic use
of self, executing health care techniques and procedures, essential primary health
care, comfort measures, health teachings, and administration of written prescription
for treatment, therapies, oral, topical and parenteral medications, internal examination
during labor in the absence of antenatal bleeding and delivery. In the case of suturing
of perineal laceration, special training shall be provided according to the protocol
established;

(b) Establish linkages with community resources and coordination with the health
team;

(c) Provide health education to individuals, families, and communities;

(d) Teach, guide, and supervise students in nursing education programs, including the
administration of nursing services in varied settings such as hospitals and clinics;
undertake consultation services; engage in such activities that require the utilization
of knowledge and decision-making skills of a registered nurse; and

(e) Undertake nursing and health human resource development training and research,
which shall include, but not limited to, the development of advanced nursing practice;

Provided That this section shall not apply to nurse students who perform nursing
functions under the direct supervision of a qualified faculty: Provided, further, That in
the practice of nursing in all settings, the nurse is duty-bound to observe the Code of
Ethics for nurses and uphold the standards of safe nursing practice. The nurse must
maintain competence by continual learning through continuing professional education
to be provided by the accredited professional organization or any recognized
professional nursing organization: Provided, finally, that the program and activity for
the continuing professional education shall be submitted to and approved by the
Board.

4. Overview of the Code of Ethics for Nurses/Filipino Bill of Rights/Legal Aspects

- Overview of the Code of Ethics for Nurses

Code of Ethics for Nurses in the Philippines is a guide for carrying out nursing
responsibilities that would discuss difficult issues and decisions that a profession
might face. It gives specific instructions on what action would be considered ethical
or right in the given situation.
The Board of Nursing (BON) promogulated the Code of Ethics for Registered Nurses
in the Philippines and consulted with accredited professional organizations like the
Philippine Nurses Association. It also accords with the ideals of the Republic Act No.
9173 or the "Philippine Nursing Act of 2002." The Code of Ethics for Filipino Nurses
was made after a consultation on October 23, 2013, at Iloilo City after approval by
professional organizations that decided to adopt a new code of Ethics under the RA
9173.

Filipino Patient's Bill of Rights 

The Philippine Patient's Bill of Rights is declared by the state's policy to promote the
people's right to health and instill health consciousness among them. It also aims to
protect and enhance all people's rights to human dignity, thereby establishing the
Magna Carta of Patient's Rights and Obligations to ensure decent, humane, and
Quality Health Care for all patients and Health Care Providers.

A.) Right to good quality health care and humane treatment 

B.) Right to dignity
C.) Right to be informed of his rights and obligations as a patient 
D.) Right to choose his physician and health institution
E.) Right to informed consent
F.) Right to refuse diagnostic and medical treatment
G.) Right to refuse participation in medical research
H.) Right to religious belief and assistance
I.) Right to privacy and confidentiality
J.) Right to disclosure of, and access to, information
K.) Right to correspondence and to receive visitors
L.) Right to medical records
M.) Right to health education
N.) Right to leave against medical advise
O.) Right to express grievances.

Legal Aspects

Nursing Jurisprudence
Department of Law, which comprises all legal rules and principles affecting the
practice of nursing. It includes the study and interpretation of rules and principles and
their application in the nursing practice regulation.
 
Law in Nursing
 It provides a framework for establishing nursing legal actions. Aims the nurses to be
aware of the legal and ethical decisions and actions that they should be considered in
their duties to promote health, prevent illness, preserve human life, and respect
human rights. It pictures the nurse's responsibilities from those of other professionals.
It helps set the boundaries of independent nursing actions and helps maintain a
standard of nursing practice by making nurses accountable to the law.

5. Professional/Legal and Moral accountability/ responsibility

- When nurses begin to practice their profession, they are held responsible and
accountable for their duties, quality - of performance, and all the nursing care they
delivered. Their license to practice verify that they are qualified under the law to
practice their profession. The Philippine Nursing Act of 1991 is the best guide the
nurse can utilize to define the scope of nursing practice. Standards of care use as
criteria in evaluating their work. The nurses are advised to be familiar with the
Philippine Nursing Law, nursing care standards, and other laws that affect nursing
practice and their code of ethics.

Responsibility
It refers to the execution of duties associated with a nurse's particular role. That is, the
nurse is responsible for providing care within the established standards of the
profession. A responsible nurse demonstrates characteristics of reliability and
dependability.

Accountability
It refers to the nurse's capability to answer for one's actions. Most of the time, nurses
are accountable to themselves and their patients.

References:

Nursing’s fundamental patterns of knowing. Retrieved from: https://www.slideshare.net/Jijoall

saints/nursings-fundamental-patterns-of-knowing
Nursing Knowledge: The Ways of Knowing. Retrieved from:
https://www.excelsior.edu/article /nursing-the-ways-of-knowing/

From novice to expert. Retrieved from: https://nursing-theory.org/theories-and-models/from-

novice-to-expert.php

Republic Act No. 9173 Retrieved from: https://www.officialgazette.gov.ph/2002/10/21/republic-

act-no-9173/

Overview of the code of ethics for nurses. Retrieved from: https://studylib.net/doc/7012206/

overview-of-the-code-of-ethics-for-nurses

Legal aspects of nursing the Philippine nursing law. Retrieved from: https://studylib.net
/doc/7070653/legal-aspects-of-nursing-the-philippine-nursing-law

Martinez, J. (2017, August 31).Nursing Jurisprudence. Retrieved from: https://www.slideshare.

net/JofredMartinez/nursing-jurisprudence

LaSala, M. (2009, December 01). Moral Accountability and Integrity in Nursing Practice.
Retrieved from: https://www.nursing.theclinics.com/article/S0029-6465(09)00049-8/pdf#
:~:text=Nurses%20are%20morally%20accountable%20when,as%20''a%20moral%20concept.