NCM 219 FINALS

organized according to rules and principles. Nurses must

act ethically and morally when treating patients. Thus,
understanding rights and values and their possible

4J - FIRST SEMESTER
consequences on health care and society is crucial.

ETHICO-MORAL RESPONSIBILITY
TOPIC
TOPIC OUTLINE Every healthcare professional is expected to
I. Professional and Personal Development uphold the highest ethical standards. The term "ethics"
a. Ethico-Moral Responsibility is derived from the Greek word "ethos," which means
b. Code of Ethics for Filipino Nurses "character." Ethical principles, which are universal
c. Rights of Clients standards of conduct, provide a practical basis for
d. Ethical Decision Making/Ethical determining what kinds of behaviors, purposes, and
Framework for Decision-Making motivations are valued. Ethics are the moral rules that
II. Legal Responsibilities establish how a person or organization should act or
III. Unionization conduct itself. The focus is on appropriate and
IV. Legal Issues in Nursing Practice inappropriate behavior, as well as the process of
a. Informed Consent choosing actions and their consequences. Every
b. Breach of Contract individual has a unique set of personal values and
c. Negligence morals. Ethics within the healthcare industry is crucial
d. Professional Negligence because healthcare professionals must recognize ethical
e. Malpractice challenges and make wise choices based on their
f. Wills principles while abiding by the laws that control them.
g. Contracts
h. Testaments Basic Ethical Principles
V. Torts/Crimes related to Nursing Practice Fundamental ethical principles serve as the
basis for determining what is morally right and incorrect.
These principles guide moral behavior. Professional
PROFESSIONAL AND PERSONAL DEVELOPMENT codes of ethics are often based on these rules in law,
business, and medicine. Ethical decisions often require
INTRODUCTION weighing and applying these ideals in light of the
Nursing professionals represent the largest situation and its consequences.
segment of the healthcare industry today. Healthcare ● Autonomy (Self-Determination)
organizations recognize the importance of maintaining ○ The principle of autonomy refers to the
competent and confident nurses who are able to adapt freedom of an individual to determine
and meet the rising demands for safe and effective what can be done to his or her body. A
nursing care. Through continuing education and training, person makes autonomous decisions
Professional Development is the process of enhancing based on his or her own values,
practice. Personal development is a lifelong process of adequate and pertinent information, and
self-actualization that enables individuals to comprehend without any form of coercion.
their own, their employer's, and their profession's ● Beneficence
requirements and expectations. ○ The principle of beneficence demands
The term "ethico-moral responsibility" refers that good be done for the benefit of
to the obligations that individuals, groups, and societies others. For nurses, this means more
give one another and the rest of the world. It involves than rendering competent physical or
being righteously, justly, and compassionately toward technical care. It requires assisting
people and the environment.This responsibility goes patients to meet all their needs, whether
beyond following the law to include honesty, integrity, physical, social, or emotional.
empathy, and justice. Ethical and moral responsibility ● Nonmaleficence
includes personal, professional, and social behavior. ○ The moral duty to not cause harm or
Nursing promotes quality of life and develops injury to another person is referred to as
professional and personal skills. Nursing must be the nonmaleficence principle. Nurses
 honor the principle of nonmaleficence by B. Code of Ethics for Nurses
following standards of care and
implementing best practices. INTERNATIONAL COUNCIL OF NURSES (ICN) CODE
● Paternalism OF ETHICS FOR NURSES
○ Involves making decisions or taking
actions on behalf of others with the The Code of Ethics for Nurses consists of a
intention of promoting their best collection of moral guidelines and rules that oversee the
interests, oftentimes without their explicit professional behavior and responsibilities of nurses. It
consent, which raises ethical concerns forms the cornerstone of nursing practice and provides a
regarding autonomy and consent. structure for making ethical decisions. These principles
● Utility assist nurses in addressing complex ethical challenges
○ This principle reflects the utilitarian belief to ensure that their actions align with the most elevated
that what is best for the common good is ethical standards. The particulars of the Code of Ethics
more important than what is best for the for Nurses may be outlined by national nursing
individual. Utility justified paternalism as associations, regulatory bodies, or international entities
means of restricting individual freedom. like the International Council of Nurses (ICN).
● Justice (Treating People Fairly)
○ The principle of justice refers to the The International Council of Nurses (ICN)
obligation of nurses to treat all patients outlines four fundamental responsibilities of nurses, often
equally, fairly, and appropriately based summarized as the "Four Responsibilities of a Nurse."
on their needs and without bias. Justice These responsibilities encompass various aspects of
entails handling everyone fairly and nursing practice and are aimed at improving patient care
equally and providing individuals what and promoting overall well-being.
they deserve. Nurses implement the 1. To Promote Health: Nurses work to promote
principle of justice when they provide fair health and well-being by educating individuals
treatment to patients. and communities about healthy lifestyles,
● Veracity (Truth Telling) disease prevention, and health maintenance.
○ The significance of honesty and They engage in health promotion activities to
truthfulness in communication is help people achieve and maintain optimal health.
emphasized, as well as the obligation to 2. To Prevent Illness: Nurses play a key role in
provide accurate and complete preventing illness by identifying health risks,
information in order to maintain trust and providing immunizations, conducting health
transparency. screenings, and offering guidance on disease
● Fidelity (Keeping Promises) prevention strategies. They work to reduce the
○ This refers to being faithful or loyal to occurrence and spread of diseases.
others through keeping promises. The 3. To Restore Health: When individuals are ill or
nurse-patient relationship is built on injured, nurses are responsible for providing care
fidelity, which requires nurses to be and interventions to help them recover and
loyal, truthful, fair, and advocates for regain their health. This may involve
patients. administering treatments, medications, and
● Confidentiality (Respecting Privileged therapies, as well as offering emotional support.
Information) 4. To Alleviate Suffering: Nurses are tasked with
○ Confidentiality entails preventing the alleviating suffering and providing comfort to
disclosure of private information those in pain or distress. They address physical,
communicated between a patient and a emotional, and psychological suffering and aim
healthcare team. Once a patient reveals to enhance the overall quality of life for patients.
personal information to a nurse, the
nurse may only use that information with The ICN Code of Ethics for Nurses has four
the patient's permission. Nurses are principal elements that outline the standards of ethical
required to keep all patient information conduct. This serves as a framework for ethical nursing
confidential. practice. These principles guide nurses in their
decision-making and actions to ensure the highest remains person-centered and that such devices
standards of care. The four principal elements are: support and do not replace human relationships.

1. NURSES AND PEOPLE 2. NURSES AND PRACTICE

● 1.1 Nurses’ primary professional responsibility is ● 2.1 Nurses carry personal responsibility and
to people requiring nursing care whether accountability for nursing practice, and for
individuals, families, communities or populations maintaining competence by continual learning.
(hereinafter referred to as either ‘patients’ or They engage in continuous professional
‘people requiring care’). development and lifelong learning.
● 1.2 Nurses promote an environment in which the ● 2.2 Nurses maintain fitness to practice so as not
human rights, values, to compromise the ability to provide care.
● customs, religious and spiritual beliefs of the ● 2.3 Nurses practice within the limits of their
individual, family and community are respected individual competence and use judgment when
and promoted by everyone. accepting and delegating responsibility.
● 1.3 Nurses ensure that the individual receives ● 2.4 Nurses value their own dignity, well-being
accurate, sufficient and timely information in a and health. They know that positive practice
culturally appropriate manner on which to base environments, characterized by professional
consent for care and related treatment. recognition, education, support structures,
● 1.4 Nurses hold in confidence personal adequate resourcing, management practices
information and respect the privacy, and occupational health and safety, are pivotal to
confidentiality and interests of patients in the achieve them.
lawful collection, use, access, transmission, ● 2.5 Nurses, at all times maintain standards of
storage and disclosure of this information. personal conduct which reflect well on the
● 1.5 Nurses respect the privacy and profession and enhance its image and public
confidentiality of colleagues and people requiring confidence. In their professional role, nurses
care and uphold the integrity of the nursing recognise and maintain personal relationship
profession in person and in all media, including boundaries.
social media. ● 2.6 Nurses share their knowledge and provide
● 1.6 Nurses share with society the responsibility feedback, mentorship and guidance for the
for initiating and supporting action to meet the professional development of nursing students,
health and social needs of all people. novice nurses, other nurses and other health
● 1.7 Nurses advocate for equity and social justice care providers.
in resource allocation, access to health care and ● 2.7 Nurses foster and maintain a practice culture
other social and economic services. that promotes ethical behavior and open
● 1.8 Nurses demonstrate professional values dialogue.
such as respect, justice, responsiveness, ● 2.8 Nurses may conscientiously object to
compassion, empathy, trustworthiness and participating in a particular medical procedure or
integrity research study but must ensure that people
● 1.9 Nurses provide evidence-informed, receive care.
person-centered care, recognizing and using the ● 2.9 Nurses maintain a person’s right to give and
values and principles of primary health care and withdraw informed consent to access their
health promotion. genetic information, including activities linked to
● 1.10 Nurses encourage a culture of safe health genetic and genomic-based research. They
care and raise any concerns regarding the safety protect the use, privacy and confidentiality of
of people and health services. genetic information and human genome
● 1.11 Nurses support and protect the right to materials. They also foster equitable access to
self-determination of all patients and other health genomic technologies.
care professionals. ● 2.10 Nurses develop and sustain collaborative
● 1.12 Nurses ensure that use of technology and and respectful relationships with colleagues and
scientific advances are compatible with the other members of the health care team. They
safety, dignity and rights of people. In the case of recognise and respect their knowledge, skills
devices, such as robots, nurses ensure that care and perspectives.
● 2.11 Nurses take appropriate actions to and advocate for, policies and programmes that
safeguard individuals, families and communities address them.
when their health is endangered by a coworker, ● 4.6 Nurses collaborate and practice to preserve,
any other person, policy, practice or misuse of sustain and protect the natural environment and
technology. are aware of its consequences on health. They
● 2.12 Nurses are active participants in the advocate for initiatives that reduce
promotion of patient safety. They promote ethical environmentally harmful practices in order to
conduct when errors or near misses occur, promote health and well-being.
speak up when patient safety is threatened, and ● 4.7 Nurses collaborate with other health
work with others to reduce the potential of errors. professions and the public to uphold principles of
justice by promoting responsibility in human
3. NURSES AND THE PROFESSION rights, equity and fairness and by promoting the
● 3.1 Nurses assume the major role in determining public good and a healthy planet.
and implementing acceptable standards of
clinical nursing practice, management, research CODE OF ETHICS FOR FILIPINO NURSES
and education.
● 3.2 Nurses are active in developing a core of The Code of Ethics for Filipino Nurses serves as a
research-based, updated professional framework of principles and guidelines that define the
knowledge that supports evidence-informed ethical standards and obligations for nurses in the
practice. Philippines. It aims to direct nurses in delivering
● 3.3 Nurses are active in developing and high-quality and empathetic care while respecting the
sustaining a core of professional values. dignity, rights, and welfare of individuals and
● 3.4 Nurses, through their professional communities. This code typically covers topics like
organizations, participate in creating a positive advocating for patients, understanding diverse cultures,
practice environment that supports individual safeguarding patient information, and the significance of
practice and ensures safe quality care, and ongoing education to sustain nursing proficiency. It
maintains safe, equitable social and economic essentially provides a moral compass for nursing
working conditions for nurses. practice in the Philippines.
● 3.5 Nurses contribute to positive and ethical
organizational environments and challenge In 1984, the Board of Nursing integrated the Code of
unethical practices and settings. Ethics of the International Council of Nurses (ICN)
● 3.6 Nurses engage in the creation, dissemination with the addition of "promotion of spiritual environment"
and use of research. as the fifth-fold responsibility of nurses.
● 3.7 Nurses prepare for and respond to
emergencies, disasters, conflicts, epidemics and On July 14, 2004, a new Code of Ethics for Filipino
conditions of scarce resources. Nurses was officially adopted under Republic Act 9173
and was promulgated by the Board of Nursing.
4. NURSES AND GLOBAL HEALTH
● 4.1 Nurses value access to health care as a The Code of Ethics for Filipino Nurses consists of seven
human right, affirming the need for universal articles that embody ethical principles and guidelines for
health coverage. nurses in the Philippines. These principles serve as a
● 4.2 Nurses uphold the dignity, freedom and foundation for ethical nursing practice and conduct in the
worth of all human beings and oppose all forms country.
of exploitation, such as human trafficking and
Article I - Preamble
child labour.
● 4.3 Nurses lead or contribute to health policy
● This emphasizes that health is a fundamental
development.
right for everyone, and Filipino registered nurses
● 4.4 Nurses support and work towards the
have a significant responsibility to protect and
achievement of the United Nations Sustainable
promote health. This responsibility includes
Development Goals.
health promotion, illness prevention, relief from
● 4.5 Nurses recognise the significance of the
suffering, and restoring health. When recovery is
social determinants of health. They contribute to,
 not possible, they are obliged to provide
assistance for a peaceful death.
● To fulfill this role, registered nurses must acquire ● The registered nurse is in solidarity with other
a comprehensive understanding of various members of the healthcare team in working for
aspects of human well-being, including cultural, the patient’s best interest.
social, spiritual, physiological, psychological, and ● The registered nurse maintains collegial and
ecological factors related to illness. They are collaborative working relationships with
also encouraged to recognize the importance of colleagues and other health care providers.
cultural diversity and socio-economic status
when providing nursing care. Article V - Registered Nurses, Society, and
● Furthermore, this article underscores the Environment
importance of earning the respect and trust of
clients, colleagues, and co-workers while Ethical Principles
considering the ecological aspects of illness in
the nursing process.
● The preservation of life, respect for human
Article II - Registered Nurses and People rights, and promotion of a healthy environment
shall be a commitment of a registered nurse.
Ethical Principles ● The establishment of linkages with the public in
promoting local, rational, and international efforts
to meet health and social needs of the people as
● Values, customs, and spiritual beliefs held by a contributing member of society is a noble
individuals shall be respected. concern of a registered nurse
● Individual freedom to make rational and
unconstrained decisions shall be respected. Article VI - Registered Nurses and the Profession
● Personal information acquired in the process of
giving nursing care shall be held in strict Ethical Principles
confidence.

Article III - Registered Nurses and Practice ● This Code of Ethics for Nurses Shall take effect
after 15 days from its full and complete
Ethical Principles publication in the official Gazette or in any
newspaper of general circulation
● Maintenance of loyalty to the nursing profession
● Human life is inviolable. and preservation of its integrity are ideal.
● Quality and excellence in the care of the patients ● Compliance with the by-laws of the accredited
are the goals of nursing practice. professional organization (PNA), and other
● Accurate documentation of actions and professional organizations of which the
outcomes of delivered care is the hallmark of registered nurse is a member is a lofty duty.
nursing accountability. ● Commitment to continual learning and active
● Registered nurses are the advocates of the participation in the development of and growth of
patients; they shall take appropriate steps to the profession are commendable obligations.
safeguard their rights and privileges. ● Contribution to improvement of the
● Registered nurses are aware that their actions socio-economic conditions and general welfare
have professional, ethical, moral, and legal of nurses through appropriate legislation is a
dimensions. They strive to perform their work in practice and a visionary mission.
the best interest of all concerned.
Article VII - Administrative Penalties, Repealing
Article IV - Registered Nurses and Co-Workers Clause and Effectivity

Ethical Principles Section 17

 credentials, as well as any information about the
possibility of death or serious side effects, problems with
● The Certificate of Registration of Registered recovery, and what would happen in an emergency.
Nurse shall either be revoked or suspended for
violation of any provisions of this Code pursuant 3. Right to Privacy and Confidentiality
to Sec. 23 (f), Art. IV of R.A No. 9173 and Sec.
23 (f), Rule III of Board Res. No. 425, Series of The patient has the right to request that all
2003, the IRR treatment-related information, correspondence, and
documents be kept confidential. Any health care
Section 18 professional or practitioner involved in a patient's
treatment, as well as all those with valid access to the
patient's record, are not permitted to disclose any
● The Amended Code of Ethics promulgated information to a third party without the patient's consent.
pursuant to R.A. No. 877 and P.D. No. 223 is
accordingly repealed or superseded by the 4. Right to Information
herein Code.
During patient’s treatment and hospitalization, the
Section 19 patient's legal guardian has the right to be informed of
the results of the evaluation of the nature and extent of
the patient's disease, any other additional or further
● This Code of Ethics for Nurses Shall take effect contemplated medical treatment or surgical procedure or
after 15 days from its full and complete procedures, including any other additional medicines to
publication in the official Gazette or in any be administered and their generic counterpart, as well as
newspaper of general circulation. any potential complications, and any other pertinent
facts, statistics, or information.
RIGHTS OF CLIENTS
5. Right to Choose Health care Provider and Facility
The rights of clients, often referred to as patient rights,
are fundamental principles that ensure individuals The patient may consult a consulting specialist at his or
receiving healthcare services are treated with respect, her own expense and choice. If necessary, he also has
dignity, and fairness. These rights are designed to the right to seek a second and subsequent opinion from
empower patients and contribute to their well-being. another health care provider or practitioner. Except the
person is under the care of a service facility, when public
PATIENTS RIGHTS: health and safety require it, or if he waives this right in
1. Right to Appropriate Medical Care and Humane writing, the patient is free to choose both the health care
Treatment practitioner and the facility that will serve him

Every individual has the right to health and medical care 6. Right toSelf-Determination
that corresponds to his or her current condition of health,
without discrimination, and within the limits of the current Any person of legal age and sound mind may make a
health and medical care resources, personnel, and written advance directive authorizing physicians to
expertise. The patient has a right to health and medical administer end-of-life care when he or she is in the
care that is adequate as well as high quality. terminal phase of a terminal illness, provided the person
is.
2. Right to Informed Consent
7. Right to Religious Belief
The patient has the right to a complete, clear, and honest
The patient has the right to refuse medical treatment or
explanation of all proposed procedures, whether they are
procedures that are contrary to his religious beliefs.The
diagnostic, preventative, curative, rehabilitative, or
significance of these beliefs to the individual's identity
therapeutic, in a manner and language that the patient
and well-being should be recognized and respected by
can understand. The person who will be performing the
healthcare professionals.
procedure must give the patient his name and
 8. Right to Medical Records This encompasses a right to obtain clear and thorough
information regarding their healthcare, available
The patient has the right to receive a summary of his treatment alternatives, and prospective benefits as well
medical history and current condition. He has the right to as risks.Patients who are well-informed are able to make
inspect his medical records, excluding psychiatric notes decisions consistent with their values and preferences.
and incriminating information gained about third parties,
and to have the attending physician explain their D. ETHICAL DECISION MAKING / ETHICAL
contents. He may obtain a copy of the same record from FRAMEWORK FOR DECISION-MAKING
the health care facility at his expense and upon the
patient's discharge, regardless of whether he completed Ethical decision-making is a process of evaluating and
his financial obligation to the physician or institution in choosing among alternatives in a manner consistent with
concern. one's ethical principles and values. To make ethical
decisions effectively, individuals and organizations often
9. Right to Leave rely on ethical frameworks, which provide a structured
approach to analyze and address ethical dilemmas and
The patient has the right to leave the hospital or any distressing situations.
other health care facility regardless of their state of
health. No patient should be held against his or her will Making ethical decisions can be challenging for various
in a health care facility solely because of unpaid financial reasons. Some people struggle due to a lack of formal
obligations. However, he or she may only leave the education on problem-solving. Others may not possess
hospital if arrangements have been made to pay any the necessary thinking skills or risk-taking attitude
overdue bills: provided. required for complex ethical issues. Furthermore, some
nurses mistakenly judge the quality of decision-making
10. Right to Refuse in Participation in Medical solely based on the outcomes. However, it's important to
Research understand that while identifying good and bad
outcomes is important, it shouldn't be the only measure
Patients possess a right to receive information regarding of decision quality.
their involvement in medical research, including but not
limited human experimentation, from their healthcare Numerous variables influence outcomes, and some of
provider. This involvement can only occur with the these are beyond the control of the decision-maker.
patient's explicit written consent. However, it is important Even when choosing the most ethicakl course of action,
that an institutional review board or ethical review board it's crucial to evaluate the decision-making process. The
be established in adherence to the guidelines outlined in best decisions often result from structured
the Declaration of Helsinki for research that involves problem-solving, thorough data collection, and exploring
human experimentation multiple alternatives, even if the eventual outcomes turn
out to be unfavorable
11. Right to Correspondence and to Receive Visitors
EXAMPLE:
The patient has the right to communicate with family and
other people, as well as receive visitors, within the Consider the example of a healthcare administrator
reasonable boundaries established by the laws and tasked with making decisions about allocating limited
regulations of the health care institution. medical resources, such as ventilators, during a critical
shortage, as was the case during the COVID-19
12. Right to Express Grievances pandemic. Many variables influence the outcomes in
such a scenario, including the number of patients in
The patient has the right to express complaints and need, the availability of equipment, and the severity of
grievances about treatment without fear of discrimination patients' conditions.
and retaliation, as well as the right to be informed as to
how these complaints will be addressed. Even when the administrator aims to make the most
ethical decisions, some factors are beyond their control,
13. Right to be Informed of His Rights and such as the overall capacity of the is crucial to evaluate
Obligations as a Patient the decision-making process carefully.
The best decisions often result from a structured - Put your chosen solution into action.
problem-solving approach. The administrator may gather 7. Evaluate The Results:
data on the number of patients, their medical conditions, - Assess the outcomes of your
and the available resources. They might explore multiple implemented solution to see if the
alternatives, such as using triage protocols, transferring problem has been resolved effectively.
patients to other facilities, or seeking emergency
supplies. Despite their best efforts, the outcomes may 2. NURSING PROCESS
still be unfavorable due to the challenging circumstances
and resource limitations. Many nurses do not recognize the
problem-solving process as a decision-making tool. The
In this case, the administrator's ethical decision-making cyclic nature of this process allows for feedback at any
process involved careful consideration of the available stage, and it permits the cycle to repeat until enough
options and data, even though the ultimate outcomes information is gathered to make a decision. Importantly, it
might have been less than ideal due to factors beyond doesn't necessarily demand a clear problem
their control. The emphasis is on the thoroughness and identification at the outset, which can be beneficial when
ethical rigor of the decision-making process itself. a problem isn't well-defined or when new information
emerges during the process.
Hence, an ethical decision-making framework becomes
essential in these scenarios, as it streamlines the
process, ensuring that decisions are both systematic and
comprehensive in addressing all relevant factors. The
following are frameworks used by nurses:

1. TRADITIONAL PROBLEM SOLVING PROCESS

One of the most popular problem-solving models is the

traditional problem-solving process. Many people
incorporate some of these steps into their
decision-making, but they often fall short in two key
areas: they don't generate a sufficient number of
alternative solutions, and they neglect to thoroughly 1. Assessment:
evaluate the results. ○ Initial phase; the nurse collects and
analyzes information about the patient's
1. Identify The Problem:
condition.
- Recognize and define the issue that
○ It involves gathering data through
needs to be solved.
observation, interviews, and examination
2. Gather data analyze the causes and
to understand the patient's needs and
consequences of the problem:
problems.
- Collect information to understand why
2. Diagnosis:
the problem exists and what its potential
○ The nurse identifies the patient's health
effects are.
issues, often by using standardized
3. Explore Alternative Solutions:
nursing diagnoses or medical
- Generate various possible ways to
diagnoses.
address the problem.
○ It involves making a professional
4. Evaluate the alternatives:
judgment about the patient's actual or
- Assess the pros and cons of each
potential health problems.
solution to determine their feasibility and
3. Plan:
effectiveness.
○ Once the issues are identified, the nurse
5. Select The Appropriate Solution:
develops a plan of care.
- Choose the most suitable solution based
○ This plan outlines the goals,
on your evaluation.
interventions, and expected outcomes; a
6. Implement The Solution:
 roadmap for how to address the principles and serve as role models for others in the
patient's health problems. healthcare setting.
4. Implement:
○ The nurse carries out the planned A trend of ethical failures have become
interventions or treatments. commonplace in organizations and institutions
○ It involves providing the care outlined in
the care plan, which can include 1. Separate Legal and Ethical Issues
medications, procedures, patient ○ Legal controls are clearer and
education, and more. philosophically impartial; ethical controls
5. Evaluate: are much less clear and individualized.
○ After implementation, the nurse ○ Clear in terms of what is allowed or
assesses and evaluates the patient's prohibited by law, and they don't make
response to the care provided. exceptions based on individual
○ Determine whether the goals were met, circumstances or personal beliefs.
and if not, adjustments may be made to ○ Ethical decisions often involve
the plan to improve patient outcomes. considering factors like personal values,
cultural norms, and the specific context
3. THE MORAL MODEL of a situation.
2. Collaborate Through Ethics Committees
The MORAL model is a decision-making model ○ An individual's personal values and
developed by Crisham(1985) based on research on beliefs can sometimes limit their ability
nursing-specific moral issues involving client autonomy, to explore alternative solutions to ethical
quality of life, resource distribution, and professional dilemmas.
norms. Guiding through the process of analyzing and ○ Ethics committees promote collaborative
addressing ethical quandaries: ethical decision-making, and it's crucial
that they encompass representatives
● M: Massage the dilemma from all relevant stakeholders, including
○ Collect data by identifying those who patients when their concerns are part of
took part in interests and perspectives, the ethical issue at hand.
determining the dilemma, and describing 3. Use Institutional Review Boards
conflicts. Establish a goal. Appropriately
● O: Outline options ○ For managers, their primary
○ Generate several effective alternatives responsibility concerning IRBs is to
to reach the goal. ensure that their organization has
● R: Review criteria and resolve established an IRB, and that any
○ Review the issues and options, identify research conducted within their area of
moral criteria, and choose the best authority has received approval from this
decision based on the perspectives of all board.
people involved in the dilemma. 4. Foster an Ethical Work Environment
● A: Affirm position and act ○ One of the most impactful actions a
○ Implement action based on knowledge leader-manager can take to cultivate an
from the previous steps (M-O-R). ethical work environment is to serve as a
● L: Look back role model for ethical behavior.
○ Evaluate each step and the decision ○ Work collaboratively as a team with a
made. shared standard for ethical behavior.
This helps in fostering a positive ethical
E. ETHICAL LEADERSHIP IN NURSING climate within the workplace.

Ethical leadership in nursing is critical in F. PROFESSIONAL AUTONOMY

providing high-quality patient care and maintaining the
trust and integrity of the healthcare profession which Professional autonomy is the level of
involves nurse leaders to follow a set of core ethical independence and self-governance required for
professionals to make decisions and perform acts within different places, like the Constitution, laws passed by
their particular fields. lawmakers, government regulations, court decisions,
presidential orders, and official instructions. When a law
"Determining their own actions through is made, it's written down, and it's important because it
independent choice, including demonstration of tells us how we should behave, and there are
competence, within the full scope of nursing practice" is punishments if we break the rules.
what autonomy means for nurses. Making nurse leaders
and managers accountable for fostering and protecting A BRIEF HISTORY OF THE PHILIPPINE NURSING
both patient and professional autonomy among the staff. LAW

Autonomy in nursing gives nurses the power to The initial law related to nursing practice in the
make decisions about a patient's care without consulting Philippines was Act No. 2493 of 1915, which was
doctors. While nurses collaborate with doctors in more primarily concerned with regulating medicine but also
intensive situations, autonomy in nursing allows nurses included provisions for the examination and registration
to make quick judgments without having to wait for of nurses. At that time, applicants needed to be at least
another professional to approve or refuse a certain twenty years old, in good physical health, and of good
course of care. moral character. Graduates of intermediate public school
courses could attend a nursing school that provided two
This shows that nurses have more authority and and a half years of instruction, and they were referred to
respect for their medical knowledge, thus patients may as first-class nurses. Those aspiring to become
benefit from quicker decision-making processes, which second-class nurses had to apply to the district health
may result in reduced mortality rates and higher quality officer in their residence district. In 1919, Act 2808 was
of care. enacted, commonly referred to as the First True Nursing
Law, which established a board of examiners for nurses.
G. PERSONAL WORK ETHICS However, the first nursing board examination in the
Philippines wasn't held until 1920.
Personal work ethics, also known as individual
or professional ethics, are the moral guidelines and The Philippine Nursing Law, also known as
values that direct an individual's actions and choices in Republic Act 877, was passed by Congress on June 19,
their professional or work-related activities. 1953. It encompassed various provisions related to the
organization of the Board of Examiners for nurses,
Establishing the conduct of individuals within regulations concerning nursing schools and colleges,
their work environment and their interactions with examination processes, registration of nurses, and other
coworkers, clients, and partners through a set of aspects of nursing practice. Notably, R.A. 877
principles and convictions that define how one behaves emphasized the requirement for nurses to be registered
professionally and play a part in shaping their before they could legally practice nursing in the country.
professional standing and honesty within the field of
Nursing; adhering to fundamental ethical principles is a Republic Act 7164, introduced by Senator
means to enhance one's personal work ethics. Heherson Alvarez, codified and revised all the laws
regulating the practice of nursing in the Philippines. It
LEGAL RESPONSIBILITIES was known as the Philippine Nursing Act of 1991.
LAW
Republic Act 9173 - Change in the Philippine
A law is a set of rules that societies create to Nursing Act of 2002 from R.A. 7164, The Philippine
govern how people behave. It's made by people and is Nursing Act of 1998, taken from the Implementing Rules
meant to guide how we interact. Laws come from and Regulations of RA 9173.
authorities, are written down, and have consequences if
they're not followed. In our system, the government is INTRODUCTION TO NURSING LAW
the authority that makes and enforces laws. The ( RA no. 9173)
Constitution is like the fundamental rulebook for the
government, explaining how it works and who gets to do Every state has its own Nurse Practice and
what. Laws must be written down clearly so everyone Education Act, which protects the public by legally
knows what's expected. These rules can come from outlining the scope of nursing practice and regulating it
through licensing requirements. However, this act's Philippines who possess the qualifications prescribed in
specifics can vary from country to country. In the Section 4 of this Act.
Philippines, we have a law that enhances and
modernizes the nursing profession, known as the Section 4: Qualifications of the Chairperson and
Philippine Nursing Act of 2002. This act, approved by Members of the Board. — The Chairperson and
former President Gloria Macapagal Arroyo on October Members of the Board shall, at the time of their
21, 2002, aims to provide a more responsive and appointment, possess the following qualifications:
up-to-date framework for nursing practice in the country.
a) Be a natural born citizen and resident of the
Republic Act No. 9173 Philippines;
b) Be a member of good standing of the accredited
“AN ACT PROVIDING FOR A MORE RESPONSIVE professional organization of nurses;
NURSING PROFESSION, REPEALING FOR THE c) Be a registered nurse and holder of a master’s
PURPOSE REPUBLIC ACT NO 7164, OTHERWISE degree in nursing, education or other allied
KNOWN AS “THE PHILIPPINE NURSING ACT OF medical profession conferred by a college or
1991” AND FOR OTHER PURPOSES university duly recognized by the Government:
Provided, That the majority of the Members of
Provide protection and improvement of the the Board shall be holders of a master’s degree
nursing profession by implementing measures that would in nursing: Provided, further, That the
help the growth of nursing education, and nurses to have Chairperson shall be a holder of a master’s
better career options. degree in nursing;
d) Have at least ten (10) years of continuous
ARTICLE I - TITLE practice of the profession prior to appointment:
Provided, however, That the last five (5) years of
Section 1: Title – Act shall be known as the “Philippine which shall be in the Philippines; and
Nursing Act of 2002.” e) Not have been convicted of any offense
involving moral turpitude; Provided, That the
ARTICLE II membership to the Board shall represent the
three (3) areas of nursing, namely: nursing
Section 2: Declaration of Policy. — It is hereby
education, nursing service and community health
declared the policy of the State to assume responsibility
nursing.
for the protection and improvement of the nursing
profession by instituting measures that will result in Section 5: Requirements Upon Qualification as
relevant nursing education, humane working conditions, Member of the Board of Nursing. — Any person
better career prospects and a dignified existence for our appointed as Chairperson or Member of the Board shall
nurses. immediately resign from any teaching position in any
school, college, university or institution offering Bachelor
The State hereby guarantees the delivery of quality basic
of Science in Nursing and/or review program for the local
health services through an adequate nursing personnel
nursing board examinations or in any office or
system throughout the country.
employment in the government or any subdivision,
agency or instrumentality thereof, including
ARTICLE III
government-owned or controlled corporations or their
Section 3: Creation and Composition of the Board. — subsidiaries as well as those employed in the private
There shall be created a Professional Regulatory Board sector. He/she shall not have any pecuniary interest in or
of Nursing, hereinafter referred to as the Board, to be administrative supervision over any institution offering
composed of a Chairperson and six (6) members. They Bachelor of Science in Nursing including review classes.
shall be appointed by the President of the Republic of
Section 6: Term of Office. — The Chairperson and
the Philippines from among two (2) recommendees, per
Members of the Board shall hold office for a term of three
vacancy, of the Professional Regulation Commission,
(3) years and until their successors shall have been
hereinafter referred to as the Commission, chosen and
appointed and qualified: Provided, That the Chairperson
ranked from a list of three (3) nominees, per vacancy, of
the accredited professional organization of nurses in the
and Members of the Board may be reappointed for and those seeking permission to open nursing
another term. courses to ensure that standards of nursing
education are properly complied with and
Any vacancy in the Board occurring within the maintained at all times. The authority to open
term of a Member shall be filled for the unexpired portion and close colleges of nursing and/or nursing
of the term only. Each Member of the Board shall take education programs shall be vested on the
the proper oath of office prior to the performance of Commission on Higher Education upon the
his/her duties. written recommendation of the Board;
e) Conduct hearings and investigations to resolve
The incumbent Chairperson and Members of the complaints against nurse practitioners for
Board shall continue to serve for the remainder of their unethical and unprofessional conduct and
term under Republic Act No. 7164 until their violations of this Act, or its rules and regulations
replacements have been appointed by the President and and in connection therewith, issue subpoena ad
shall have been duly qualified. testificandum and subpoena duces tecum to
secure the appearance of respondents, and
Section 7: Compensation of Board Members. — The witnesses and the production of documents and
Chairperson and Members of the Board shall receive punish with contempt persons obstructing,
compensation and allowances comparable to the impeding and/or otherwise interfering with the
compensation and allowances received by the conduct of such proceedings, upon application
Chairperson and members of other professional with the court;
regulatory boards. f) Promulgate a Code of Ethics in coordination and
consultation with the accredited professional
Section 8: Administrative Supervision of the Board, organization of nurses within one (1) year from
Custodian of its Records, Secretariat and Support the effectivity of this Act;
Services. — The Board shall be under the g) Recognize nursing specialty organizations in
administrative supervision of the Commission. All coordination with the accredited professional
records of the Board, including applications for organization; and
examinations, administrative and other investigative h) Prescribe, adopt, issue and promulgate
cases conducted by the Board shall be under the guidelines, regulations, measures and decisions
custody of the Commission. The Commission shall as may be necessary for the improvement of the
designate the Secretary of the Board and shall provide nursing practice, advancement of the profession
the secretariat and other support services to implement and for the proper and full enforcement of this
the provisions of this Act. Act subject to the review and approval by the
Commission.
Section 9: Powers and Duties of the Board. — The
Board shall supervise and regulate the practice of the Section 10: Annual Report. — The Board shall at the
nursing profession and shall have the following powers, close of its calendar year submit an annual report to the
duties and functions: President of the Philippines through the Commission
giving a detailed account of its proceedings and the
a) Conduct the licensure examination for nurses;
accomplishments during the year and making
b) Issue, suspend or revoke certificates of
recommendations for the adoption of measures that will
registration for the practice of nursing;
upgrade and improve the conditions affecting the
c) Monitor and enforce quality standards of nursing
practice of the nursing profession.
practice in the Philippines and exercise the
powers necessary to ensure the maintenance of Section 11: Removal or Suspension of Board
efficient, ethical and technical, moral and Members. — The President may remove or suspend
professional standards in the practice of nursing any member of the Board after having been given the
taking into account the health needs of the opportunity to defend himself/herself in a proper
nation; administrative investigation, on the following grounds:
d) Ensure quality nursing education by examining
the prescribed facilities of universities or colleges (a) Continued neglect of duty or incompetence;
of nursing or departments of nursing education
 (b) Commission or toleration of irregularities in the the subject or subjects where he/she is rated below sixty
licensure examination; and percent (60%). In order to pass the succeeding
(c) Unprofessional, immoral or dishonorable examination, an examinee must obtain a rating of at
conduct. least seventy-five percent (75%) in the subject or
subjects repeated.
ARTICLE IV
EXAMINATION AND REGISTRATION Section 16. Oath. - All successful candidates in the
examination shall be required to take an oath of
Section 12. Licensure Examination. - All applicants for profession before the Board or any government official
license to practice nursing shall be required to pass a authorized to administer oaths prior to entering upon the
written examination, which shall be given by the Board in nursing practice.
such places and dates as may be designated by the
Commission: Provided, That it shall be in accordance Section 17. Issuance of Certificate of Registration/
with Republic Act No. 8981, otherwise known as the Professional License and Professional Identification
"PRC Modernization Act of 2000". Card. - A certificate of registration/ professional license
as a nurse shall be issued to an applicant who passes
Section 13. Qualifications for Admission to the the examination upon payment of the prescribed fees.
Licensure Examination. - In order to be admitted to the Every certificate of registration/ professional license shall
examination for nurses, an applicant must, at the time of show the full name of the registrant, the serial number,
filing his/her application, establish to the satisfaction of the signature of the Chairperson of the Commission and
the Board that: of the Members of the Board, and the official seal of the
Commission.
a) He/she is a citizen of the Philippines, or a citizen
or subject of a country, which permits Filipino A professional identification card, duly signed by
nurses to practice within its territorial limits on the Chairperson of the Commission, bearing the date of
the same basis as the subject or citizen of such registration, license number, and the date of issuance
country. Provided, That the requirements for the and expiration thereof shall likewise be issued to every
registration or licensing of nurses in said country registrant upon payment of the required fees.
are substantially the same as those prescribed in
this Act; Section 18. Fees for Examination and Registration. -
b) He/she is of good moral character; and Applicants for licensure and for registration shall pay the
c) He/she is a holder of a Bachelor's Degree in prescribed fees set by Commission.
Nursing from a college or university that
complies with the standards of nursing education Section 19. Automatic Registration of Nurses. - All
duly recognized by the proper government nurses whose names appear at the roster of nurses shall
agency. be automatically or ipso facto registered as nurses under
this Act upon its effectivity.
Section 14. Scope of Examination. - The scope of the
examination for the practice of nursing in the Philippines Section 20. Registration by Reciprocity. - A certificate
shall be determined by the Board. The Board shall take of registration/professional license may be issued
into consideration the objectives of the nursing without examination to nurses registered under the laws
curriculum, the broad areas of nursing, and other related of a foreign state or country: Provided, That the
disciplines and competencies in determining the subjects requirements for registration or licensing of nurses in
of examinations. said country are substantially the same as those
prescribed under this Act: Provided, further, That the
Section 15. Ratings. - In order to pass the examination, laws of such state or country grant the same privileges to
an examinee must obtain a general average of at least registered nurses of the Philippines on the same basis
seventy-five percent (75%) with a rating of not below as the subjects or citizens of such foreign state or
sixty percent (60%) in any subject. An examinee who country.
obtains an average rating of seventy-five percent (75%
or higher but gets a rating below sixty percent (60%) in Section 21. Practice Through Special/Temporary
any subject must take the examination again but only in Permit. - A special/temporary permit may be issued by
the Board to the following persons subject to the
approval of the Commission and upon payment of the f) For violation of this Act, the rules and
prescribed fees: regulations, Code of Ethics for nurses and
technical standards for nursing practice, policies
a) Licensed nurses from foreign countries/states of the Board and the Commission, or the
whose service are either for a fee or free if they conditions and limitations for the issuance of the
are internationally well-known specialists or temporarily/special permit; or
outstanding experts in any branch or specialty of g) For practicing his/her profession during his/her
nursing; suspension from such practice;
b) Licensed nurses from foreign countries/states on
medical mission whose services shall be free in Provided, however, That the suspension of the
a particular hospital, center or clinic; and certificate of registration / professional license shall
c) Licensed nurses from foreign countries/states be for a period not to exceed four (4) years.
employed by schools/colleges of nursing as
exchange professors in a branch or specialty of Section 24. Re-issuance of Revoked Certificates and
nursing; Replacement of Lost Certificates. - The Board may,
after the expiration of a maximum of four (4) years from
Provided, however, That the special / temporary the date of revocation of a certificate, for reasons of
permit shall be effective only for the duration of the equity and justice and when the cause for revocation has
project, medical mission, or employment contract. disappeared or has been cured and corrected, upon
proper application therefor and the payment of the
Section 22. Non-registration and Non-issuance of required fees, issue another copy of the certificate of
Certificates of Registration/Professional License or registration/professional license.
Special/Temporary Permit. - No person convicted by
final judgment of any criminal offense involving moral Article V - Nursing Education
turpitude or any person guilty of immoral or dishonorable
conduct or any person declared by the court to be of Section 25. Nursing Education Program. - The nursing
unsound mind shall be registered and be issued a education program shall provide sound general and
certificate of registration/professional license or a professional foundation for the practice of nursing.
special/temporary permit.
Section 26. Requirement for Inactive Nurses
The Board shall furnish the applicant a written Returning to Practice. - Nurses who have not actively
statement setting forth the reasons for its actions, which practiced the profession for five (5) consecutive years
shall be incorporated in the records of the Board. are required to undergo one (1) month of didactic
training and three (3) months of practicum. The Board
Section 23. Revocation and suspension of Certificate shall accredit hospitals to conduct the said training
of Registration/Professional License and program.
Cancellation of Special/Temporary Permit. - The
Board shall have the power to revoke or suspend the Section 27. Qualifications of the Faculty. - A member
certificate of registration/professional license or cancel of the faculty in a college of nursing teaching
the special/temporary permit of a nurse upon any of the professional courses must:
following grounds:
a) Be a registered nurse in the Philippines;
a) For any of the causes mentioned in the b) Have at least one (1) year of clinical practice in a
preceding section; field of specialization;
b) For unprofessional and unethical conduct; c) Be a member of good standing in the accredited
c) For gross incompetence or serious ignorance; professional organization of nurses; and
d) For malpractice or negligence in the practice of d) Be a holder of a master's degree in nursing,
nursing; education, or other allied medical and health
e) For the use of fraud, deceit, or false statements sciences conferred by a college or university
in obtaining a certificate of duly recognized by the Government of the
registration/professional license or a Republic of the Philippines
temporary/special permit;
In addition to the aforementioned qualifications, the dean Provided, That this section shall not apply to nursing
of a college must have a master's degree in nursing. students who perform nursing functions under the direct
He/she must have at least five (5) years of experience in supervision of a qualified faculty: Provided, further, That
nursing. in the practice of nursing in all settings, the nurse is
duty-bound to observe the Code of Ethics for nurses and
Article VI - Nursing Practice uphold the standards of safe nursing practice. The nurse
is required to maintain competence by continual learning
Section 28. Scope of Nursing. - A person shall be through continuing professional education to be provided
deemed to be practicing nursing within the meaning of by the accredited professional organization or any
this Act when he/she singly or in collaboration with recognized professional nursing organization: Provided,
another, initiates and performs nursing services to finally, that the program and activity for the continuing
individuals, families and communities in any health care professional education shall be submitted to and
setting. It includes, but not limited to, nursing care during approved by the Board.
conception, labor, delivery, infancy, childhood, toddler,
preschool, school age, adolescence, adulthood, and old Section 29. Qualification of Nursing Service
age. As independent practitioners, nurses are primarily Administrators. - A person occupying supervisory or
responsible for the promotion of health and prevention of managerial positions requiring knowledge of nursing
illness. A members of the health team, nurses shall must:
collaborate with other health care providers for the
curative, preventive, and rehabilitative aspects of care, a) Be a registered nurse in the Philippines;
restoration of health, alleviation of suffering, and when b) Have at least two (2) years experience in
recovery is not possible, towards a peaceful death. It general nursing service administration;
shall be the duty of the nurse to: c) Possess a degree of Bachelors of Science in
Nursing, with at least nine (9) units in
a) Provide nursing care through the utilization of management and administration courses at the
the nursing process. Nursing care includes, but graduate level; and
not limited to, traditional and innovative d) Be a member of good standing of the accredited
approaches, therapeutic use of self, executing professional organization of nurses;
health care techniques and procedures,
essential primary health care, comfort measures, Provided, that a person occupying the position of chief
health teachings, and administration of written nurse or director of nursing service shall, in addition to
prescription for treatment, therapies, oral topical the foregoing qualifications, possess:
and parenteral medications, internal examination
during labor in the absence of antenatal bleeding 1) At least five (5) years of experience in a
and delivery. In case of suturing of perineal supervisory or managerial position in nursing;
laceration, special training shall be provided and
according to protocol established; 2) A Master's degree major in nursing;
b) establish linkages with community resources and
coordination with the health team; Provided, further, that for primary hospitals, the
c) Provide health education to individuals, families maximum academic qualifications and experiences for a
and communities; chief nurse shall be as specified in subsections (a), (b),
d) Teach, guide and supervise students in nursing and (c) of this section: Provided, furthermore, that for
education programs including the administration chief nurses in the public health nursing shall be given
of nursing services in varied settings such as priority.
hospitals and clinics; undertake consultation
services; engage in such activities that require Provided, even further, That for chief nurses in military
the utilization of knowledge and decision-making hospitals, priority shall be given to those who have
skills of a registered nurse; and finished a master's degree in nursing and the completion
e) Undertake nursing and health human resource of the General Staff Course (GSC): Provided, finally,
development training and research, which shall That those occupying such positions before the
include, but not limited to, the development of effectivity of this Act shall be given a period of five (5)
advance nursing practice; years within which to qualify.
 Article VII - Health Human Resources Production, dependents, scholarship grants and other non-cash
Utilization and Development benefits.

Section 30. Studies for Nursing Manpower Needs, The government and private hospitals are hereby
Production, Utilization and Development. - The mandated to maintain the standard nurse-patient ratio
Board, in coordination with the accredited professional set by the Department of Health.
organization and appropriate government or private
agencies shall initiate undertake and conduct studies on Article VIII - Penal and Miscellaneous Provisions
health human resources production, utilization and
development. Section 35. Prohibitions in the Practice of Nursing. -
A fine of not less than Fifty thousand pesos (P50,000.00)
Section 31. Comprehensive Nursing Specialty nor more than One hundred thousand pesos
Program. - Within ninety (90) days from the effectivity of (P100,000.00) or imprisonment of not less than one (1)
this Act, the Board in coordination with the accredited year nor more than six (6) years, or both, upon the
professional organization recognized specialty discretion of the court, shall be imposed upon:
organizations and the Department of Health is hereby
mandated to formulate and develop a comprehensive a) any person practicing nursing in the Philippines
nursing specialty program that would upgrade the level within the meaning of this Act:
of skill and competence of specialty nurse clinicians in i) without a certificate of
the country, such as but not limited to the areas of critical registration/professional license and
care, oncology, renal and such other areas as may be professional identification card or special
determined by the Board. temporary permit or without having been
declared exempt from examination in
Section 32. Salary. - In order to enhance the general accordance with the provision of this
welfare, commitment to service and professionalism of Act;
nurses the minimum base pay of nurses working in the ii) who uses as his/her own certificate of
public health institutions shall not be lower than salary registration/professional license and
grade 15 prescribes under Republic Act No. 6758, professional identification card or special
otherwise known as the "Compensation and temporary permit of another; or 3
Classification Act of 1989": Provided, That for nurses iii) who uses an invalid certificate of
working in local government units, adjustments to their registration/professional license, a
salaries shall be in accordance with Section 10 of the suspended or revoked certificate of
said law. registration/professional license, or an
expired or cancelled special/temporary
Section 33. Funding for the Comprehensive Nursing permits; or
Specialty Program. - The annual financial requirement iv) who gives any false evidence to the
needed to train at least ten percent (10%) of the nursing Board in order to obtain a certificate of
staff of the participating government hospital shall be registration/professional license, a
chargeable against the income of the Philippine Charity professional identification card or special
Sweepstakes Office and the Philippine Amusement and permit; or
Gaming Corporation, which shall equally share in the v) who falsely poses or advertises as a
costs and shall be released to the Department of Health registered and licensed nurse or uses
subject to accounting and auditing procedures: Provided, any other means that tend to convey the
That the department of Health shall set the criteria for impression that he/she is a registered
the availment of this program. and licensed nurse; or
vi) who appends B.S.N./R.N. (Bachelor of
Section 34. Incentives and Benefits. - The Board of Science in Nursing/Registered Nurse) or
Nursing, in coordination with the Department of Health any similar appendage to his/her name
and other concerned government agencies, association without having been coferred said
of hospitals and the accredited professional organization degree or registration; or
shall establish an incentive and benefit system in the vii) who, as a registered and licensed nurse,
form of free hospital care for nurses and their abets or assists the illegal practice of a
 person who is not lawfully qualified to 1991" is hereby repealed. All other laws, decrees,
practice nursing. orders, circulars, issuances, rules and regulations and
b) any person or the chief executive officer of a parts thereof which are inconsistent with this Act are
judicial entity who undertakes in-service hereby repealed, amended or modified accordingly.
educational programs or who conducts review
classes for both local and foreign examination Section 41. Effectivity. - This act shall take effect fifteen
without permit/clearance from the Board and the (15) days upon its publication in the Official Gazette or in
Commission; or any two (2) newspapers of general circulation in the
c) any person or employer of nurses who violate Philippines.
the minimum base pay of nurses and the
incentives and benefits that should be accorded UNIONIZATION
them as specified in Sections 32 and 34; or
d) any person or the chief executive officer of a Unionization refers to the organization of
juridical entity violating any provision of this Act workers into a group or a whole union. The organization
and its rules and regulations. of workers or ‘unionization’ is a result of workers aiming
to increase their power to get certain responses from the
Article Article IX - Final Provisions management.

Section 36. Enforcement of this Act. - It shall be the Labor relations pertain to the relationship or the
primary duty of the Commission and the Board to interaction between workers and the management.
effectively implement this Act. Any duly law enforcement ● Can be observed between a nurse and hospital
agencies and officers of national, provincial, city or administration
municipal governments shall, upon the call or request of
the Commission or the Board, render assistance in There can be many other reasons for unionization but
enforcing the provisions of this Act and to prosecute any these are the most common reasons:
persons violating the same. ● Poor working conditions and job inequities in
wages, promotions, and benefits
Section 37. Appropriations. - The Chairperson of the ● Poor quality of immediate supervision
Professional Regulation Commission shall immediately ● Arbitrary treatment from management
include in its program and issue such rules and ● Poor communications between employer and
regulations to implement the provisions of this Act, the employee
funding of which shall be included in the Annual General
Appropriations Act. Advantages of Unionization:
● High standard of living
Section 38. Rules and Regulations. - Within ninety (90) ● Secure justice in the workplace
days after the effectivity of this Act, the Board and the
Commission, in coordination with the accredited Disadvantages of Unionization:
professional organization, the Department of Health, the ● Labor unions cost money
Department of Budget and Management and other ● Cause adversarial relationships
concerned government agencies, shall formulate such ● Encourage dependence while discouraging work
rules and regulations necessary to carry out the
provisions of this Act. The implementing rules and LABOR LAWS
regulations shall be published in the Official Gazette or in
any newspaper of general circulation. The National Labor Relations Act or Wagner Act
was passed in 1935 to prevent employers from cutting
Section 39. Reparability Clause. - If any part of this Act the wages of employees. This act works in favor of the
is declared unconstitutional, the remaining parts not side of the employees but as a result, employers
affected thereby shall continue to be valid and become bankrupt since wages could not be reduced. To
operational. address this, the NLRA created the National Labor
Relations Board to investigate proceedings against
Section 40. Repealing Clause. - Republic Act No. employers who violate the law, especially employer
7164, otherwise known as the "Philippine Nursing Act of violations only.
 LABOR UNIONS
Amendments:
a. In 1947, the NLRA was amended due to bias by A labor union is organized by employees to
the Taft-Hartley Act or Labor Management bargain with employers and the management to meet
Relations Act wherein it placed restrictions on the employees’ interests in regards to their job–wages,
unions to maintain equality between employer working conditions, and more.
and employees, except for nonprofit health care
institutions. This amendment was set due to Unfair Labor Practices by Management
unions causing problems in public relations. The NLRA’s section 8(a) iterates prohibitions on
b. Further amendment was done in 1959 by the management as unfair labor practices:
Landrum-Griffin Act or Labor-Management 1. Domination
Reporting and Disclosure Act, which aims to - Management must not contribute any support or
defend against corrupt financial and election otherwise dominate and interfere in the
procedures done by some unions, hence the development of a labor organization.
Union Members’ Bill of Rights. 2. Discrimination
- Discrimination of any form towards employees
ADDITIONAL LABOR LAWS or discourage membership in a labor union is
a. The Equal Pay Act of 1963 states that men and not allowed.
women who perform equal work should receive 3. Refusal to bargain
equal pay. - The employer cannot refuse to bargain with
b. The Civil Rights Act of 1964 prevents employees.
discrimination and promotion of individuals 4. Restraining, coercing, or otherwise interfering with
based on race, religion, gender, and national employees exercising their right to unionization
origin.
c. The Age Discrimination in Employment Act Unfair Labor Practices by Unions
(ADEA) of 1967 encourages the employment of In 1947, the Labor Management Relations Act
older individuals based on experience and skills amended the NLRA to include restrictions specific for
rather than age; however, statistics show earlier labor organizations in section 8(b):
retirement began to trend, thus the Congress 1. Interference
decided to remove the protected age of 70 years - Labor organizations cannot interfere, restrain,
except in certain circumstances in 1987. nor coerce an employer in deciding their
d. The Rehabilitation Act of 1973 refers to the representative for bargaining.
recruitment of qualified handicapped people in 2. Discrimination
accordance with the Americans with Disabilities - Labor union members and employers cannot
Act (ADA) in 1990 in order to dispel discriminate against employees who are not
discrimination against individuals with members of the organization.
impairments. 3. Refusal to bargain
e. The Vietnam Veterans Act of 1973 pertains to - Similar to the unfair labor practices by
the privileges and employment rights of veterans management, a union representative cannot
who have returned from war. refuse to bargain.
f. In 1946, the American Nurses Association 4. Strikes and boycotts
(previously known as the Nurses’ Associated - Depending on the intentions, objectives, and the
Alumnae of the United States and Canada) methods used, strikes are discouraged and
started the Economic Security Program to aid illegal.
the state associations bargain collectively. ○ A primary boycott is a strike action by
g. The Family and Medical Leave Act (FMLA) of organization members against their
1993 was intended for pregnant employees and employer
maternity leave. The act requires eligible ○ A secondary boycott is an action
workers to be employed for at least 12 months directed to a customer
and completed 1,250 hours of service during the 5. Initiation fees
12 months preceding maternity leave. - Labor unions cannot charge their members any
excessive form of fees.
 6. Featherbedding medical treatment and can willingly and knowingly
- The union cannot cause an employer to pay for choose whether to proceed with it (Bulsoy, 2022).
services not rendered.
7. Recognition picketing Nurses play a critical role in obtaining and documenting
- Picketing is a form of protest where individuals informed consent, which empowers patients to make
publicize an issue to persuade management. informed decisions about their healthcare. It is an
○ Informational picketing is acceptable essential aspect of patient-centered care and respects
since this form of protest does not cause the patient's autonomy and right to self-determination.
any disruption Nurses must ensure that patients fully understand the
○ Recognition picketing involves an risks and benefits of treatments and procedures.
employer to recognize a labor union as (Prendin, 2021).
lawful without a petition.
The essential components for documenting an
COLLECTIVE BARGAINING informed consent discussion

Organization of workers or labor unions that 1. Explaining the procedure's nature

bargain for better working conditions or for the sake of 2. Outlining the associated risks and benefits
their interests is called collective bargaining. As nurse 3. Discussing reasonable alternatives
managers, they should be able to evaluate and improve 4. Detailing the risks and benefits of those
their management skills and motivational techniques alternatives
when working together as a team. 5. Assessing the patient's comprehension of these
points.
Nurse administrators must listen to staff’s
concerns, be aware about labor relations, and represent Exceptions to Informed Consent
their interests to top management. Collective bargaining
is a legal process to negotiate with an employer Several exceptions to the requirement for informed
regarding wages and concerns related to working consent include:
conditions through contracts. Contracts provide the
opportunity for nurses to input their interests pertaining 1. The patient is incapacitated
to policies, working conditions, shift rotations, non 2. Life-threatening emergencies with inadequate
nursing duties, and more. time to obtain consent
3. Voluntary waived consent.
A. INFORMED CONSENT
Children and Informed Consent
Informed consent refers to the ethical and legal
process through which nurses educate patients about Children, usually those under 17 years of age, are
the potential risks, benefits, and alternatives related to a unable to give informed consent. Instead, parents or
particular medical procedure, treatment, or intervention. legal guardians are responsible for granting permission
This process ensures that patients have a clear for medical treatments or interventions. This is referred
understanding of what they are consenting to and that to as "informed permission" rather than "informed
their consent is given voluntarily and based on complete consent." There is an exception for legally emancipated
information (Turrin, 2023). minors who can provide informed consent for
themselves. Emancipated minors can include those who
Informed consent is an ethical standard in medical are under 18 and married, serving in the military,
research and healthcare, involving a healthcare financially independent, or mothers. It is worth noting
provider's explanation of the potential risks and benefits that legislation concerning minors and informed consent
of a procedure to the patient before seeking their varies from one state to another, so it is crucial to be
approval. Beyond merely offering comprehensive aware of the specific state laws in this regard.
information about the treatment, it is essential to allow
the patient sufficient time to make a knowledgeable Example of Informed Consent real-life scenario
decision. The overarching goal is to guarantee that the
patient possesses a complete understanding of the Scenario: Elective Surgery Informed Consent
 ● A breach of contract may take place when a
Patient: Joseph party to a contract:
Procedure: Knee Arthroscopy for Meniscus Tear ○ Fails to perform their obligations under
Surgeon: Dr. Sarah the contract in whole or in part.
○ Behaves in a manner that shows an
Discussion intention not to perform their obligations.
Dr. Sarah discusses the knee arthroscopy ○ The contract becomes impossible to
procedure with Joseph, who has been experiencing perform as a result of the defaulting
persistent knee pain. Dr. Sarah explains the nature of the party’s own act.
surgery, its purpose, and the potential risks and benefits.
She also outlines alternative treatment options, such as Types of Breach of Contract
physical therapy. During the discussion, Dr. Sarah 1. Actual Breach
answers all of Joseph’s questions and addresses his ● Actual breach of contract occurs when one
concerns. party fails or refuses to perform his promise
under the contract.
Informed Consent ● Example: Nurse Belle has an employment
Dr. Sarah provides Joseph with an informed contract with a hospital that promises her a
consent form that outlines the procedure, associated yearly bonus of 50,000 after one year of
risks, and alternatives. Joseph reviews the form carefully, service. The hospital breaches the contract
asking for clarification on a few points. Once he is by not providing the bonus due to budget
satisfied and fully understands, he signs the form, constraints, causing financial loss to Nurse
indicating his voluntary consent. Jasmine. Legal remedies may be sought by
Nurse Jasmine for the breach.
Witnesses
Two nurses in the room, Nurse Anna and Nurse 2. Anticipatory Breach
Elsa, serve as witnesses. They observe Joseph signing ● It is also known as “renunciatory breach”
the informed consent form and sign as witnesses. ● This occurs when a party demonstrates his
intention to breach a contract.
Doctor's Confirmation ● Example: Nurse Anna agrees to care for
Dr. Sarah signs the form to confirm that she has Mrs. Cruz from Monday to Friday from 1st
provided all necessary information to Joseph and that he till 30th June. By the second week of June
has given informed and voluntary consent for the knee Nurse Anna starts to visit only once a week.
arthroscopy procedure.
C. NEGLIGENCE
This scenario represents the process of obtaining
informed consent in a real-life medical setting. It ensures Negligence is an umbrella term, and professional
that the patient has a clear understanding of the malpractice is a specific form of negligence (Brous,
procedure and the associated risks and benefits before 2021).
undergoing surgery.
Negligence is very similar to malpractice but is usually
B. BREACH OF CONTRACT differentiated by intent. Malpractice typically results from
a nurse intentionally deviating from established care
Breach of contract occurs when one or more parties to a standards or professional responsibilities. In contrast,
contract fail to meet up with obligations/ responsibilities. negligence often arises from inadvertent errors or lapses
that inadvertently harm the patient. For instance,
It also means a violation of contract through failure to mistakenly giving the wrong medication or failing to
perform contractual obligations whether partially, or document a patient's observations might be considered
wholly or as described in the contract (Muhammad, acts of negligence (UTA, 2020).
2020).
Negligence is a significant legal issue in nursing practice
Ways of Breaching a Contract and healthcare in general. Negligence in nursing refers
to a breach of the standard of care that results in harm to Medical malpractice is a significant legal issue in nursing
a patient. practice and the broader healthcare field. It occurs when
a healthcare provider, including nurses, deviates from
Four Elements of Negligence the standard of care, resulting in harm or injury to a
patient (ABPLA, 2022).
1. Duty: The nurse owed a duty of care to the
patient. Negligence is a broader concept that can apply to
2. Breach: The nurse breached the standard of various situations and is based on a general standard of
care. care. Malpractice, on the other hand, is a specific type of
3. Causation: The breach of care caused harm to negligence that is limited to healthcare and is associated
the patient. with the failure of healthcare professionals to meet the
4. Damages: The patient suffered actual damages accepted standards of care in their field.
or harm.

Examples of Negligence Four Elements of Medical Malpractice

Negligence can take many forms in nursing,
including medication errors, failure to monitor a 1. Duty: The nurse owed a duty of care to the
patient's condition, not properly documenting patient.
care, not following physician orders, or 2. Breach: The nurse breached the standard of
inadequate patient assessment. care, which means they failed to provide care at
an acceptable level.
Note: 3. Causation: The breach of care caused the
● To reduce the risk of negligence, nurses patient harm or injury.
must follow best practices, maintain 4. Damages: The patient suffered actual damages
accurate documentation, communicate as a result of the breach.
effectively with patients and other
healthcare professionals, and adhere to Example of Malpractice in real-life scenario
established protocols and standards of
care. Scenario: Medication Error Leading to Harm

D. PROFESSIONAL NEGLIGENCE Patient: Myrna, a 60-year-old woman with a

history of hypertension
Professional negligence, often referred to as Healthcare Provider: Nurse Elsa, who works in a
"malpractice" in the context of healthcare, is a failure of a hospital's medical-surgical unit
licensed professional to meet the standard of care
expected in their field, resulting in harm or injury to a Details:
client, patient (Aggarwal, 2017). ● Myrna is admitted to the hospital for
chest pain and high blood pressure.
In healthcare, professional negligence is commonly ● Nurse Elsa is responsible for
known as medical malpractice. It may involve actions like administering medications, including
surgical errors, misdiagnoses, medication mistakes, or antihypertensive drugs.
improper patient care. ● Nurse Elsa mistakenly administers the
wrong antihypertensive medication due
Example of Professional Negligence to a labeling error in the medication
chart.
Medical Malpractice: A surgeon leaves a surgical ● Myrna experiences a severe drop in
instrument inside a patient during an operation, blood pressure, leading to dizziness and
causing complications and requiring additional loss of consciousness.
surgery. ● Myrna is quickly stabilized, but she
suffers from anxiety and emotional
E. MALPRACTICE distress due to the incident.
 Medical Malpractice Claim: Medical Care Preferences:
● Duty: Nurse Elsa had a duty to 1. Life-Preserving Care:
administer the correct medication as per ● I wish to receive life-preserving
Myrna's medical chart. care in the following situations:
● Breach: Administering the wrong ○ If I have a treatable
medication represents a breach of the illness or injury and the
standard of care. prognosis for recovery
● Causation: Myrna's severe drop in blood is good.
pressure and distress resulted from the
medication error. ● I wish to decline life-preserving
● Damages: Myrna’s incurred physical care in the following situations:
harm, emotional distress, and a longer ○ If I have an irreversible
hospital stay as a result of the error. and terminal condition
with no hope for
In this scenario, the medication error by Nurse meaningful recovery.
Elsa constitutes medical malpractice. The 2. Location of Care:
breach of the standard of care led to harm and ● I prefer to receive medical care:
injury to the patient, making it a valid basis for a ○ At home.
medical malpractice claim ○ In a hospice facility.
○ In a nursing home with
F. WILLS a strong focus on
palliative care.
A living will, often referred to as an advance directive, is 3. Nutrition Provision:
a legally binding document that outlines an individual's ● I would like nutrition and
preferences regarding the medical treatments they wish hydration to be administered:
to receive or avoid if they become unable to express ○ Intravenously if
their wishes (Howard, 2021). necessary.
○ Orally if I can swallow
In the case of an unconscious person who suffers from a safely.
terminal illness or a life-threatening injury, doctors and ○ I do not wish to receive
hospitals consult the living will to determine whether or artificial nutrition or
not the patient wants life-sustaining treatment, such as hydration if there is no
assisted breathing or tube feeding. In the absence of a reasonable expectation
living will, decisions about medical care become the of my recovery.
responsibility of the spouse, family members, or other 4. Pain Management
third parties. These individuals may be unaware of the ● I want pain management that
patient’s desires, or they may not wish to follow the focuses on maintaining comfort,
patient’s unwritten, verbal directives. even if it may shorten my life,
when I am suffering from severe
It is best to understand that it will not serve as a last will pain that cannot be relieved.
and testament, whereby property and personal effects ● If pain management is unlikely
are allocated to others upon death. A living will stipulates to provide relief, I do not want to
the type and levels of medical care one receives if extend my life through
incapacitated and for how long. aggressive treatment.
5. Decision-Makers:
Example of living will in real-life scenario ● In the event I cannot
communicate my wishes, I
Patient Information: designate my spouse, Jane, as
Name: Joseph my healthcare proxy. If Jane is
Date of Birth: January 15, 1960 unavailable or unable to serve, I
Date: November 15, 2023 designate my daughter, Karen,
 as the alternative healthcare ● If two people want to change some aspects of a
proxy. written contract, the change must be written into
6. Witnesses: the contract.
● [Witness 1 Name]: [Witness 1
Signature] H. TESTAMENTS
● [Witness 2 Name]: [Witness 2
Signature] In healthcare, the term testaments is often used to refer
to a patient's written statement of their medical treatment
G. CONTRACTS preferences, often in the form of an advance directive or
living will. These documents are not the same as a last
Contracts in healthcare are legal agreements that define will and testament used in estate planning but serve a
the rights, responsibilities, and expectations of the crucial purpose in healthcare decision-making (Howard,
parties involved. They play a fundamental role in the 2021).
healthcare industry, governing various relationships and
transactions (Muhammad, 2020). These healthcare testaments are essential tools for
individuals to convey their preferences for medical care
It is a mutual arrangement between a patient and a and treatment when they cannot express them directly.
nurse concerning their expectations of each other during They provide legal guidance for healthcare providers and
a hospital stay. family members to make informed decisions in
accordance with the patient's wishes.
A contract is the basis of the relationship between a
nurse and an employer. For example, a contact exists Example of Testaments
between a nurse and a hospital/ healthcare setting.
Patient Armelita has created a testament,
Types of contracts in healthcare specifying her healthcare preferences in case
1. Verbal Contract she becomes unable to make decisions. In it,
● Verbal contract is a contract in which the she clearly states that she does not wish to
terms are agreed by spoken receive life-sustaining treatments, such as
communication. mechanical ventilation or cardiopulmonary
● A verbal contract has no legal document resuscitation (CPR), in the event of a terminal
binding it however has been discussed and illness.
agreed upon by the parties involved.
● An oral contract is equally binding as a Torts/Crimes related to Nursing Practice
written contract.
● However it is difficult to prove an oral ● Torts law refers to the area of civil law that deals
contract in a court of law. with legal issues related to personal injuries,
2. Written Contract harm, or wrongful conduct. It is defined as a civil
● This is an agreement made on a printed wrong for which remedy may be obtained.
document that has been signed by parties ● A tort can be any of the following:
to a contract. ○ The denial of a person's legal right
● Written Contracts provide more certainty for ○ The failure to comply with a public duty
parties than verbal contracts. ○ The failure to perform a private duty that
● Written contracts help prevent results in harm to another
misunderstandings by stating clear terms of ● Types of Torts:
the agreement. ○ Unintentional Tort
● An example of a written in nursing is a ○ Intentional Tort
contract between a nurse and a client ○ Quasi-intentional Tort
before care is commenced.
1. UNINTENTIONAL TORT
Changing/ Amending a Contract
● A written contract cannot be changed legally by An unintentional tort, also known as a "negligence tort,"
an oral agreement. is a type of civil wrong that occurs when someone
causes harm to another person or their property due to A violation of a person's reputation, personal privacy, or
their failure to exercise reasonable care. freedom from malicious or unfounded legal prosecution

Unintentional torts are not based on intentional harm or ● Have characteristics of both intentional and
malice but rather on a lack of diligence and prudence. unintentional torts
Unintentional torts can cover a wide range of situations, ● Principles of law for intentional torts apply
and they often lead to compensation or damages being ● Often deal with communication issues.
awarded to the injured party.
A quasi-intentional tort is a category of tort law that falls
Examples: between intentional and negligent torts. These torts
● Malpractice and Negligence involve actions where the wrongdoer did not act with full
● Medical errors intent to cause harm but displayed a level of intent
● Delay in patient care greater than simple negligence.
● Failure to follow physician's orders
● Incorrectly performing a procedure Examples:
● Documentation Error
● Failure to get informed consent ● Defamation of character: the sharing of
information that unintentionally harms a person's
2. INTENTIONAL TORT reputation
1. Slander: oral defamation of character
An intentional tort is a category of tort law that involves that is intentional and malicious
cases where an individual or entity deliberately engages 2. Libel: written defamation of character
in actions that cause harm or injury to another person or that is intentional and malicious.
their property. It revolve around the concept that the ● Fraud: Fraud is a crime or offence of deliberately
harm was inflicted on purpose. deceiving another in order to damage another -
to obtain property or services.
In such cases, the victim may file a civil lawsuit to seek
compensation for the harm or injuries they have suffered Example:. Trying to obtain a higher position by
due to the intentional actions of the wrongdoer. ○ giving incorrect information to the prospective
employer.
Examples:
● Assault: saying or doing something that will ● Invasion of privacy: violation of a person's right
make a person genuinely fear that he or she will to keep information about self, family, and
be touched without consent (threat) property from public scrutiny
● Battery: unconsented touching of a person, or ○ Not an absolute right-can and may be
anything he or she is wearing or holding, or required by law to be breached in certain
anything that is attached to him or her, without situations such as child, spousal or elder
the person's permission; does not have to cause abuse; gunshot wounds; knife wounds;
injury rape; communicable diseases,
● False imprisonment: making a person stay in a suspected crimes.
place against his or her wishes; can be verbal, ● Breach of confidentiality: revealing information
physical, or chemical. obtained from privileged communication
● Intentional infliction of emotional distress: the ○ Privileged communication: a special type
use of extreme or outrageous conduct that of privacy that exists in certain
causes severe emotional distress in the patient professional relationships where its
or family. violation would destroy trust and
● Conversion of property: interference by the confidence in the professional.
nurse with the right to possession of the patient's ■ Physician-patient
property by either intermeddling or destroying ■ Lawyer-client
the property ■ Priest-penitent

3. QUASI-INTENTIONAL TORT
 ● Legal liability - occurs if a person is found guilty ● Equipment manufacturers manuals, for example,
of any tort; generally results in the payment of cardiac monitoring equipment manuals
damages. ● Written policies and procedures ot a facility, such
○ Compensatory damages: the actual as Foley catheter insertion procedures
costs incurred because of the negligent ● Nurse, practitioner, or other health care
act. professional expert testimony
○ Punitive damages: money awarded ● Professional health care accreditation agency
beyond the compensatory damages to criteria, for example, JC (Joint Commission)
"punish" the violator and send a criteria
message that this behavior is ● Medication books and so on.
unacceptable; tend to much greater
amounts of money. PRIVILEGED COMMUNICATION
○ Types of Liability:
■ Personal liability: each is a legal concept that protects certain confidential
professional is responsible for information shared between a healthcare provider
his or her own actions. (including nurses) and a patient. It is intended to
■ Supervisor liability: supervisors encourage open and honest communication between
are responsible for the actions patients and healthcare
of those working under their
direction This information can not be told to anyone else without
■ Employer liability: employers the written consent of the patient.
can be held responsible for
actions committed by The types of information considered privileged, such as
employees patient medical history, conversations between
healthcare providers and patients, and information
NURSES AND EVIDENCE related to a patient's mental health. Emphasize the
sensitivity of this information and the legal obligation to
This is accomplished by reviewing the employing protect it.
institution's policies and Procedures and other evidence,
including the state's Nurse Practice Act and hearing Discuss situations where privileged communication may
testimony from nurses who are accepted as expert not apply, such as when there is a clear threat to the
witnesses to the standard of nursing practice in the patient or others. Explain that there are limitations to this
community. The nurse would present evidence that the protection, and healthcare providers need to balance
institution's policies and procedures were followed and confidentiality with ethical and legal responsibilities.
that the care rendered adhered to accepted nursing
standards. NURSES AS WITNESS

To present the nurse's case, the nurse's attorney would Nurses can be called in as witnesses in various legal
also use expert witnesses to document that the care situations, such as medical malpractice cases,
given fulfilled the duty owed, was the kind that would be investigations, or court trials. Highlighting the importance
given by a reasonable nurse in such a circumstance, and of their testimony in establishing facts and ensuring
that it was not the cause of the plaintiff's harm. justice.

Selected sources of Evidence regarding the standard of The specific duties and responsibilities of nurses when
care acting as witnesses is to as providing accurate and
● Nursing and medical textbooks, articles, and honest testimony, maintaining patient confidentiality, and
research complying with legal processes
● State professional practice acts, such as Nurse
Practice Act, Physician Practice Act Nurses should take steps to prepare for testifying in
● Standards of professional association, for court or other legal proceedings, including reviewing
example, American Nurses' Association patient records, understanding the case, and seeking
Standards legal counsel if necessary.
 INCIDENT REPORT ● Policies & procedures
● Administrative records
Incident reports are records of unusual or unexpected
incidents that occur in the client's treatment Because How do nurses document?
attorneys use incident reports to defend the course ● Electronically
health agency against lawsuits brought by clients the ● Paper/pen
reports are considered confidential communications and ● Dictation/transcription
cannot be subpoenaed by clients or used as evidence in ● Some combination of above
their lawsuits.
Why do nurses document?
However, incident reports that are inadvertently ● Provides an account of the care delivered
disclosed are no longer considered confidential and can ● Promotes continuity of care
be subpoenaed in court. Thus a copy of an incident ● Reduces redundancy in care delivered.
report should not be left in the chart. In addition no entry ● Supports charges/billing
should be made in the patient's record about the ● May be your best defense -or your worst enemy
existence of an incident report. The chart should, in the event of legal action.
however, provide enough information about the incident
or occurrence that appropriate treatment can be given. Why do patients sue?
● To obtain compensation for perceived
Information included on Incident are the following: harm/injury
● To obtain information
● Identify the client by name, initials, and hospital ● To retaliate, vent anger or frustration
or identification number ● To "prevent this from happening to anyone else"
● Date, time, and place of the incident ● (Family) To advocate on behalf of injured or
● Description of the facts of the incident (no deceased relative
conclusions or blame)
● Incorporation of the client's account of the What kinds of documentation may be reviewed?
incident in quotes ● Patient's medical record
● identification of all witnesses ● "Off the record" documentation
● Identification of any equipment by number and ● Policies and procedures
any medication by name and dosage ● Personnel and administrative records
● Photographs
DOCUMENTATION
● Other
It encompasses the accurate and comprehensive
● Realities of documentation
recording of patient information, care, and interactions,
○ "If it wasn't charted, it wasn't done."
which has far-reaching legal implications. Proper
○ "The palest ink is better than the best memory".
documentation is essential for maintaining transparency,
○ Considered by some authors to be the 6th right of
ensuring patient safety, and protecting nurses in case of
medication administration.
legal disputes. It also serves as a means of
communication among healthcare professionals, assists
● Barriers to timely and complete documentation
in complying with legal and regulatory requirements, and
○ "not enough time"
plays a vital role in the continuity of patient care.
○ *keep getting interrupted or distracted"
Inadequate or inaccurate documentation can lead to ○ "hard to keep all the patients straight"
legal issues, including malpractice claims, making it ○ "not humanly possible to chart the way we were taught
imperative for nurses to be well-versed in the legal in nursing school"
aspects of documentation in healthcare settings.
● Accurate documentation is dependent upon:
What do nurses document? ○ A thorough physical assessment
● Patient information ○ Use of standardized measures (e.g. pain scale)
● Nursing care delivered ○ Promptly recording findings
● Outcomes of care ○ and interventions
 5. Defects in the equipment such as stretchers and
WHAT IS PROFESSIONAL NEGLIGENCE? wheelchairs may lead to falls thus injuring
patients.
There is professional negligence, which incorporates the 6. Errors due to family assistance.
doctrine of res ipsa loquitur. Professional negligence 7. Administration of medicine without a doctor's
refers to an act or omission of an act that would not have prescription.
caused injury to another person or their property. It
involves the existence of a duty to use due care, failure A. RES IPSA LOQUITUR
to meet this standard, the foreseeability of harm, and the
breach of this standard resulting in injury. The doctrine of Res Ipsa Loquitur means "the thing
speaks for itself". It defines an injury that could not have
On another note, there are four elements of professional happened if someone was not negligent, so no further
negligence. The following are: proof is required.
1. Existence of duty on the art of the person
charged to use due care under circumstance Below are the three conditions that are required to
2. failure to meet the standard of due care establish a defendant's negligence without proving
3. foreseeability of harm resulting from failure to specific conduct:
meet the standard, and 1. That the injury was such nature that it would not
4. the fact that the breach of this standard resulted normally occur unless there was a negligent act
in an injury to the plaintiff. on the part of someone;
2. that the injury was cause by an agency within
Non-compliance to the aforementioned standards control of the defendant;
constitutes negligence. The Article 19 of the Civil Code 3. that the plaintiff himself did not engage in any
states that one shall act with justice, give every man his manner that would tend to ring about the injury.
due, observe honesty and good faith. In addition, Article
20 states that those who, in the performance of their Above mentioned can conclude that the defendant is
obligations through negligence cause any injury to negligent, especially when substantiated by the plaintiff
another are liable for damages. Liability for negligence that each of the factors exists in a given situation. No
shall be imposed upon those nurses who have had failed further proof is required
to reasonably behave, prudent nurse would in a
particular circumstance. An example for this are the following;
1. A patient came in walking to the out-patient clinic
There are common acts of negligence such as burns for injection. Upon administering the injection to
from hot water bags, heat lamps, vaporizers, sit bath; his buttocks, the patient experienced extreme
objects. left inside the patient's body such as sponges, pain. His leg felt weak and he was subsequently
suction tips, loose dentures. lodge in the patient's paralyzed. His sciatic nerve was injured.
trachea; falls of the elderly, confused, unconscious, 2. The presence of sponges in the patient's
sedated patients, or those who are not fully recovered abdomen after an operation.
from the anesthesia; falls of the children whose side rails 3. Fracture on a newly-delivered baby born by
of beds were not pulled up and locked; and failure to breech presentation.
observe and take appropriate action as needed. Incident
report clarify cause and preventive actions, and are used WHAT IS MALPRACTICE?
for medico-legal purposes.
Malpractice is a term used for the act of negligence or
The specific examples are as follows; carelessness by professional personnel. It implies the
1. Failure to report observations to attending idea of improper or unskillful care for patients by a nurse.
physicians It also denotes stepping on one's authority with serious
2. Failure to exercise the degree of diligence which consequences. The law has developed a standard of
the circumstance of the particular case demands care for a prudent nurse to do or not do under similar
3. Mistaken identity. circumstances to determine what is careless and what is
4. Wrong medicine, wrong concentration, wrong not. According to Lesnik (1962), the term malpractice
route, wrong dose. shall only be utilized when a negligent act has been
committed in the course of professional performance.
Malpractice has encompassed two different doctrines. PERSONAL AND PROFESSIONAL
These doctrines are force majeure and respondeat RESPONSIBILITIES
superior. Wherein the two doctrines speak for a nurse Definition of Terms:
who is accountable for a negligent act, whether under a ● Responsibility
natural catastrophe or when there are other people ○ is a duty that an individual must perform
involved. to ensure there is accountability and
transparency in various activities.
A. FORCE MAJEURE ● Professional Decorum
○ It is an unwritten code of conduct
The first doctrine that lies under malpractice is force regarding the interactions among the
majeure, which refers to an inevitable or irresistible force members in a healthcare setting.
that was unforeseen. Except in cases where it was ○ Professional decorum or professional
expressed specifically by the law, no person shall be etiquette is about presenting oneself
responsible for those events that cannot be foreseen or with polish and professionalism that
may be seen but are inevitable, as stated under the Civil demonstrates one can be trusted and
Code of the Philippines. taken seriously.
○ It means being comfortable around
Natural catastrophes such as floods, fire, earthquakes, people and making them feel
and accidents fall under this doctrine, and the nurses comfortable around you while working
who failed to perform duty under these circumstances hand in hand in meeting both the patient
are not held negligent. Contrarily, those who have and nurse’s expected goals.
practiced habitual tardiness shall not be excused as ● Professional Nurse
force majeure. ○ A nurse must have a high standard of
professional ethics, behavior, and work
B. RESPONDENT SUPERIOR activities while performing one’s
profession.
Subsequent to the Force Majeure that falls under
○ Generally, the professional nurse is
malpractice, there is Respondeat Superior, which means
required to put the interest of the client
"let the master answer for the acts of the subordinate".
ahead of his/her own.
Under this doctrine, a liability extends to the masters as
○ Appropriate treatment of relationships
well as the employees, not the other way around. Thus,
with colleagues. Consideration should
it explains that a person is held accountable for his own
be shown to elderly, junior, or
actions when he has been injured through his
inexperienced colleagues, as well as
negligence.
those with special needs. An example
must be set to perpetuate the attitude of
This is applicable when actions rendered by the
one’s business without doing it harm. A
employee fall within the scope of his employment.
professional who is an expert is also a
Such circumstances are as follows: master in a specific field.
● Student nurse
1. The hospital will be held liable, if, in an effort to cut ○ A person who is in training to become a
down on expenses it decides to hire underboard nurses professional nurse at a nursing school or
or midwives in place of professional nurses, and these hospital. A student nurse is trained by
persons proves to be incompetent. professional nurses.

2. The surgeon will be held responsible in a case of PERSONAL RESPONSIBILITIES

laparotomy pack is left in the patient's abdomen.
A nurse's personal obligations cover several areas and
Afar from this. nurses. like private duty nurses, are go beyond what is often expected of someone in their
responsible for their own negligent actions as they are line of work. They carry the responsibility of providing
considered independent contractors. medical treatment of the highest quality, fostering
wholesome interactions with patients and coworkers,
and supporting disease prevention initiatives. These
roles demand strict adherence to professional standards, nursing profession and ensuring safe, quality nursing
requiring nurses to work within established regulations care. Lifelong learning and self-reflection are
and expectations. professional responsibilities for nurses (AACN, 2021).
Every nurse should make an effort to balance their
Nurses play three key roles in ensuring the health and personal and professional lives. Additionally, nurses
safety of patients and their families. Firstly, they are should encourage one another to balance their personal
entrusted with the responsibility of managing diseases and professional lives. A solid foundation for proving
and health conditions that significantly impact people's nursing's important contribution to patient outcomes as
lives. Through professional interventions, they deliver well as to the institutions that offer and support
precise nursing diagnoses, administer suitable high-quality patient care is provided by effective
medications, and offer health teachings to patients. documentation (Murray, 2021).
Negligence or lack of dedication in this role can pose
severe risks to patients' lives. Competent nurses must Additionally, nurses share a collective professional
possess the necessary qualifications to safeguard responsibility to mentor new members in the clinical field.
patients' welfare and maintain the delivery of top-quality The mentor bears the responsibility of not only fostering
healthcare services. professional growth through educating them about
professionalism, but also creating avenues for the
Secondly, nurses are not content merely witnessing a protégé's active involvement. Professionalism, in this
surge in patients seeking medical treatment. They context, includes personal and professional
proactively engage in public education initiatives, accountability, ethical conduct, career planning,
emphasizing methods and the significance of evidence-based clinical and management practices, and
maintaining good health. Nurses are duty-bound to advocacy for nursing practice. Nurses must uphold the
enlighten the public about adopting healthy practices that same obligations to themselves as they do to others,
enhance overall well-being. This educational outreach safeguarding their integrity and safety, ensuring ongoing
includes diverse topics such as food safety, first aid, competence, and pursuing continuous personal and
disease prevention, and early symptom detection. professional development. This integrated approach
Nurses assume the vital responsibility of raising reflects the holistic nature of nursing responsibilities.
awareness about disease management, disseminating
knowledge to the public, and thereby contributing to the To make sure that the nurses accept their professional
creation of a healthier society. obligation as stated in the Code of Ethics for Nurses and
to preserve professional competence, nurse managers
Lastly, nursing responsibilities extend far beyond must routinely review and update their documentation of
classrooms and family settings. Nurses are mandated to the nursing staff's competence. Using the nursing
deliver care to patients dealing with terminal illnesses in Competency Scale created and developed by Meretoja
the comfort of their homes. Conducting home visits and et al. (2004), nurse managers could assess the level of
regular checkups to monitor patients' progress nursing competence of the nursing staff. The following
constitutes a fundamental aspect of their duties. seven roles and functions were used to group the 73
Additionally, nurses conduct periodic follow-ups to competencies: (1) assisting role, (2) teaching-coaching
ensure patients adhere to prescribed medications and role, (3) diagnostic functions, (4) controlling situations,
dietary guidelines. This meticulous monitoring enables (5) therapeutic treatments, (6) assuring quality, and (7)
nurses to assess patients' progress, identify potential job role. The scale's categories were developed from the
vulnerabilities in their recovery process, and promptly Novice to Expert competency framework by Benner.
intervene to support their swift recuperation (Grace &
Uveges, 2023). According to the American Nursing Association (ANA),
the RN after our name implies a commitment to the
PROFESSIONAL RESPONSIBILITIES legal, ethical, and moral responsibilities that define your
professional roles. These responsibilities are based on
It is the professional responsibility of nurses to document the ANA’s Nursing Scope and Standards of Professional
patient outcomes, actual care given, and care planning. Practice, the ANA’s Nursing Code of Ethics, and the
Nurses document all patient interactions, including ANA’s Nursing Social Policy Statement.
assessments, interventions, evaluations, and treatment
outcomes. Continued competence is critical to the ● You are the fulcrum of patient care.
 ● You are the safety net for your patient. of care, and practicing honesty and integrity. As nurses,
● You are your patient’s advocate. caring for our patients is our ultimate purpose and goal.
In caring for our patients, communication is a very
Remember that nurses have a legal obligation to clarify important tool. Make sure to relay information and health
the physician’s orders and to conduct proper teachings to patients using terms that they will easily
documentation. grasp and understand. Being their advocate is essential
in ensuring that the treatment we can provide to them is
off high quality and beneficial to their recovery. As
nurses, we should also remember to not take presents in
exchange for special treatment. Furthermore, we should
always treat patients and coworkers with respect, and
honesty. In working with other healthcare workers,
collaboration and integrity is important in order to give
the best care that we can offer as part of the healthcare
team and to uphold the highest standards of behavior
both in personal and professional life. We must never be
NURSING RESPONSIBILITIES
late in our responsibilities and we should also admit and
● Must be able to articulate why you are recognize our weaknesses in order to seek for
performing a particular nursing action or assistance to our fellow healthcare providers. We should
procedure. also respect the dignity of patients by observing their
● Must understand the scientific rationale of your privacy especially in dealing with their data.
interventions.
ROLES AND RESPONSIBILITIES OF BEGINNING
● Must be able to define the goals of your
NURSE PRACTITIONER
interventions and the outcomes for your patient
● Know your patient’s health history—not only the
Dr. Patricia Benner proposed the idea that skilled nurses
medical and surgical but the psychosocial as
acquire knowledge and expertise in patient care over
well.
time by building on a strong educational foundation and
● Reassess your patient. How often? Every 15
a wide range of experiences. She suggested that
minutes, 30 minutes, hourly, every 4 hours, and
knowledge and abilities (or "knowing how") can be
so forth.
acquired without ever studying the theory (or "knowing
● Evaluate your patient and the effectiveness of
that"). She goes on to say that the growth of knowledge
your interventions: Were your goals reached?
in practical fields such as medicine and nursing are
made up of the characterization and comprehension of
PROFESSIONAL DECORUM
the "know how" of clinical experience, as well as the
As student nurses, we are expected to follow a set of extension of practical knowledge (know how) through
etiquette or decorum. We have to introduce ourselves to research.
the patient and to their significant others, we have to be
5 levels of nursing experience
polite, enthusiastic, eager to help and have a positive
● Beginner with no experience (novice)
attitude. We also have to dress properly for class and
○ Taught general rules to help perform
clinical and act accordingly in alignment with the hospital
tasks.
protocol. Nursing students should also show respect and
○ Recognized as being task oriented and
courtesy towards their clinical instructors, the hospital
focused.
staff, and each other at all times. Professional decorum
○ Rules are: context-free, independent of
may lessen the dangers of workplace conflict that might
specific cases, and applied universally.
arise from prejudices or personal differences by
○ Rule-governed behavior is limited and
encouraging dialogue and compassion.
inflexible.
As nurses, our professional decorum includes care as ○ E.g. Tell me what I need to do and I’ll do
our number one priority, treating everyone equally, it.
respecting the dignity of our patients, collaborating with ● Advanced beginner
other members of the health team, giving high standards
 ○ Demonstrates acceptable independent ● Prescribing suitable pharmaceutical and
performance non-pharmacological therapy options
○ Has gained prior experience in actual ● carries out measures to assist the patient in
situations to recognize recurring regaining or maintaining physiologic steadiness,
meaningful components such as handling the first assisting responsibility,
○ Principles, based on experiences, begin but not exclusively.
to be formulated to guide actions ● Assisting to provide surgical treatment in line
● Competent with institution, state, and federal regulations.
○ Typically a nurse with 2-3 years of ● Monitors the effectiveness of interventions.
experience on the job in the same area ● Helps patients move within and between
or in similar day-to-day situations healthcare facilities, such as when being
○ More aware of long-term goals admitted, transferred, or discharged.
○ Gains perspective from planning own ● Makes necessary referrals in cooperation with
actions based on conscious, abstract, members of interdisciplinary teams.
and analytical thinking and helps to ● Provide educational resources to assist staff,
achieve greater efficiency and patients, and families in making decisions.
organization ● Prescribing Medications.
● Proficient
○ Perceives and understands situations as Although all nurse practitioners have certain
a whole rather than as series of tasks similar roles and obligations, they often differ by
○ More holistic understanding improved specialty. Primary care, pediatrics, geriatrics,
decision making cancer, and mental treatment are among the
○ Learns from experiences what to expect specialties.
in certain situations and how to modify
plans NURSE PRACTITIONER SPECIALTIES
● Expert
○ No longer relies on principles, rules, or ● Family Nurse Practitioners (FNPs)
guidelines to connect situations and ○ are NPs who specialize in providing
determine actions family-centered care and may treat
○ Much more background of experience patients of all ages, from newborns to
○ Has intuitive grasp of clinical situations the elderly.
○ Performance is now fluid flexible and ● Pediatric Nurse Practitioners (PNPs)
highly proficient ○ are NPs who focus on dealing with
children and are knowledgeable about
The role of a licensed nurse practitioner who is in charge developmental difficulties
of managing health issues and coordingating medical ● Psychiatric Mental Health Nurse Practitioner
care for perioperative patients in accordance with laws (PMHNP)
and regulations and nursing standards of care ○ Are NPs that specialize in working with
(assessment of patient’s health status, diagnosis, patients who have been diagnosed with
creation of care and treatment plan, implementation of arange of mental health problems.
plan, and patient status evaluation) in cooperation with ● Women’s Health Nursing Practitioners (WHNP)
other members of the health team, preoperative planning ○ Are NPs who focus on treating women,
and postoperative clinical management are carried out. including services like wellness checks,
breast cancer screenings, gynecological
Nursing Responsibilities: care, pregnancy, delivery, and post-natal
● Performs age-appropriate history-taking and care.
physical examinations on perioperative ● Adult Gerontology Nurse Practitioners (AGNPs)
● patients who are critically unwell, acutely ill, and ○ are NPs often do not handle children
complexly ill. and concentrate on working with
● Orders and interprets diagnostic and therapeutic patients ranging in age from adolescents
tests considering the demands of each patient's to the elderly.
particular age.
 CAREER DEVELOPMENT it? What kinds of skills are needed? Is it
CAREER PLANNING hazardous?
2. Availability of the work.
Career planning is an ongoing process that involves a - Will you choose a field of nursing that is
crowded? Or where there is a shortage
personal and professional self-assessment. Process
of workers?
involves setting goals, searching for a job, preparing a 3. Hours of work.
cover letter and resume, and participating in an - How many hours a day or week do you
interview, including followup. It includes evaluating one's go on duty? Is your work rotated on
strengths and weaknesses, setting goals, examining shifts? Will you be paid for extra hours of
career opportunities, preparing for potential duty you will perform?
opportunities, and using appropriate developmental 4. Qualifications.
- What are the requirements in terms of
activities.
educational qualifications? Experience?
Training?
JOB SEARCH / JOB LEADS 5. Opportunities for advancement.
Guidelines In Choosing A Field of Nursing - What chances do you have in being
promoted after several years of
The first consideration that nurses must make is employment? Will they allow you to go
self-evaluation. They need to consider their capacities, to school if you so desire? Are you
interests, qualifications and goals. If necessary, they can allowed to attend professional
meetings/seminars on official time?
ask the guidance of more experienced persons such as
6. Method of Entering.
advisers, clinical instructors, or their parents. - Do you need an examination to enter?
Do you need someone to recommend
These are the factors to consider when making a you?
self-evaluation: 7. Earning.
- How much is the initial salary? The
1. Qualifications maximum salary? Is the salary paid
● What is your educational qualification? weekly or every fifteen days? Is
● Does it fit the job you are applying for? additional pay given for overtime work?
2. Years of Experience and Training 8. Fringe benefits.
● What are your experiences and training? - How many days of vacation and sick
● Are these relevant to the position you leaves are given? Maternity leaves?
are applying for? Education leaves?
3. Age and Physical Condition. 9. Other benefits.
● Consider age and physical condition. - Are insurances, medicare, retirement
4. Positions in public health may require extensive benefits provided for? Can nurses
evaluation. participate in discussion of conditions of
● How much physical energy is required of work?
the job?
● Can you work long hours without getting Planning and Implementing a Job Search
tired easily?
5. Emotional Stability and Goals in Life 1. Networking through family, friends, and
● How is your emotional self? acquaintances.
● Can you be calm even under stress? 2. Look at positions advertised in the newspaper,
● Do you get along well with people? bulletin board, or online job listings.
● Will you rather be alone or in a crowd? 3. Attending a job fair.
● What is your primary aim in nursing: 4. Make an appointment with the nurse recruiter to
earn money or have the satisfaction of learn about the mission and services of the
helping people? organization.

Factors in Selecting a Field of Nursing Since individual nurses are free to choose the field of
nursing they wish to enter, it is important that they
1. Kind of work to be performed choose wisely and well. It is therefore imperative that
- Are you prepared for the job? Can you they make a self-analysis and that of the work they want
work under stress? Do you get along to enter into to see that these are matched. Money or
well with people? Are you interested in salary is not the only important factor. Most important will
be the ability to give one’s best, enjoy the work, and get
along well with patients and members of the health team. 3. Reference. At least three names of persons who
The relationship that nurses have with their co-workers have given consent to the use of their names
and their attitudes towards their work will determine to a may be used as references.
great extent their success or failure in their work. They
a. These persons must know the applicant
must choose the agency where they will be able to
develop their fullest as professional nurses. well enough in order to serve as good
reference background. Among the
DEVELOPING A RESUME / PROFESSIONAL preferred references are former
PORTFOLIO principals or deans, leading persons in
the community, a parish priest or a
The cover letter and resume are a form of marketing minister of one's church, a professional
strategy. You are marketing and advertising yourself to a nurse or one's former instructor.
potential employer. 4. A request for a personal interview, if time and
distance permits, is usually indicated in the last
APPLICATION LETTER
paragraph.
A letter of application enables the employer to judge the
Example:
applicant's scholarship ability. Employers take interest in
a well-written letter of application and usually arrange for
an interview when they see one.

Useful Pointers in Making a Letter of Application

1. Use clean, white, unlined paper. If working in an

agency, do not use the agency's stationery with
letterhead.
2. Use ink or ball pen in writing. May want to type
te letter if preferred.
3. Use proper salutation. Preferably know the name
of the person to whom the letter is to be
addressed.
4. Observe proper margin and paragraphing. Use
good English and correct spelling.
5. Write in a courteous manner. Ask permission
before using a person's name as reference. After
permission has been granted, write a letter of
thanks especially if the desired position was
obtained.
6. Enclose return postage so that the person to
whom the letter is addressed will be encouraged
to reply and will not have to spend for postage in
doing so.

A Letter of Application Usually Contains The

Following Facts:
The cover letter that accompanies the résumé
1. Source and purpose. The first paragraph usually
should be addressed to the right person, usually the
contains the source of information concerning chief nurse, nursing director, or assistant director for
the vacancy and the nurse's intent to apply to nursing depending on the position title which varies from
the position. These two points may be one institution to another (e.g. government hospitals,
interchanged. private hospitals, etc.).
2. Qualifications. The second and third paragraphs
must contain the applicant's qualifications, the RESUME
school or college from where he/she graduated, The résumé also is an important screening tool
used by employers for selection of applicants. Often
and the year of graduation.
résumés are attached to the application but serve a
a. Experience and training along the field somewhat different purpose. It illustrates your
applied for may also be included. employment history and is good for those with little or no
gaps in work history in the same. When preparing a
résume, assessing one's own values, skills, and interests
is an essential part of the process. Résumés should
concentrate on what applicants like to do and what they
do well.

Basic Components of a Resume:

1. Name
2. Address
3. Phone number (landline or cell phone)
4. Education, experience
5. Continuing education
6. Honors/awards (if any)
7. Professional affiliation

The résumé should be checked for typographical errors

or misspelled words. All information should also be
accurate.

Guidelines for Resume Preparation:

1. The résumé should be typed in a format that is
easy to read.
2. The résumé should maximize strong points and
minimize weaknesses.
3. The style should reflect good grammar, correct
punctuation, proper sentence structure, and
simple, direct language.
4. The content of the résumé should consist of
educational history; work experi-ence; personal
characteristics; membership in professional
organizations; community involvement; awards,
honors and publications; professional objectives;
health status; and license information.
PREPARING FOR AN INTERVIEW
Example: Personal Interview
● An interview is a face-to-face conference
between two people about something. An
interview between an applicant and a
prospective employer gives both a chance to
assess each other. For the employer, it gives
him/her a chance to assess the applicant's
personality, alertness in answering questions,
poise, command of the spoken language, and
the like. For the applicant, it gives him/her a
background of the institution, its potential as a
working place, its philosophy and objectives, the
working conditions, among others.
● An applicant sells himself/herself in an interview.
He/She wants to convince the prospective
employer that he/she is the best applicant for the
job. It is best to prepare to make a good first
impression.

Pointers:
1. Make an appointment either by mail or
telephone. The Nursing Office or Personnel
Division schedules time to conduct interviews. It
is seldom that on-the-spot interviews are given.
2. Be at the place at the appointed time. It is
necessary therefore that you start early from
 your place so that you are at the agency ten to
fifteen minutes before the time so you can relax If a new graduate has no experience, look for a
and appear unhurried. Do not come during hospital that accepts volunteers or internships for a fee.
breaks or mealtime. If you get delayed, Some specialty hospitals like the Philippine Heart
apologize and state your reason. Do not insist on Center, the Lung Center of the Philippines, and the
being interviewed as the person who will National Kidney and Transplant institute offer training for
interview you may have another business to a fee. Specialty training increases the chances of being
attend to. Request for another schedule if he/she accepted when applying for a position.
is indisposed and be sure to be on time if he/she
gives you another chance. RESIGNING FROM A NURSING POSITION
3. Know something about the institution where you
will apply so that you can answer questions ● There are many reasons why nurses resign from
intelligently. If possible, know the name of the their jobs. Primarily, the reason is to seek better
person who will interview you, so you can use it. positions whether in the Philippines or abroad.
Be prepared to answer questions that are likely Other reasons may be inability to adjust to the
to be asked. work situation, marriage, children and/or transfer
4. Be at your best. If you are a female, be neat, of family to other places.
have a simple hairdo and moderate make-up, ● It is suggested that nurses keep their positions
and wear a conservative dress reaching below for at least two years it the position is acceptable
the knee. If you are a male, be likewise to them. The first year is usually spent in
impeccably groomed. Cover any tattoo. Do not adjusting to the position, the second in helping
wear rings on facial piercings. Be sure your them find the field of nursing specialty of their
clothes are spotlessly clean, especially at the choice. They should not change positions, as
collar line. Have a decent haircut and be much as possible, more often than once within a
well-shaved. If you have a tendency to perspire year of service.
profusely, use an antiperspirant to prevent or ● If nurses feel that they are not suited to the
minimize underarm sweat on your clothing. position, and feel that the advantages of leaving
5. Be courteous and at ease. Knock before you far outweigh the reasons for staying it may be
enter. Greet the person who lets you in and the wise to make a change. It is, however, advised
person who will interview you with courtesy and that they think over the whole situation. Seek
a firm handshake. Establish eye contact. Let assistance in making decisions. If possible,
your personality shine by speaking confidently involve the family especially if it will, in a way,
and demonstrating enthusiasm and affect them.
professionalism. Sit properly and make sure you ● If offered a better position, talk it over with the
have turned off your cell phone. Finally, do not employer. It is best to observe "an open-door
chew gum. policy." Leave a friendly feeling towards
6. Bring credentials such as your registration card, superiors and co-workers. A reference from
residence certificate, tax account number, and them may be netted later or one may decide to
the like. If possible, bring small photographs (1 x return to the institution or agency. Goodwill is an
1) to enclose in a personal data form. Bring a asset that can be banked on.
fountain pen or ballpen for filling out forms. Do ● Use prudence in accepting another position. Be
not borrow from the prospective employer. sure it has more to offer in terms of salary,
7. Ask questions about the job. It may help in opportunity for promotion, advancement or
deciding if you like the position. professional growth, and better chances of
8. Thank the interviewer for giving you some of his adjusting to the new position than the present
or her time. If there are other applicants to be one.
interviewed, do not delay the interview ● A self-analysis may be necessary including the
unnecessarily. reason for transferring. Improvements may have
9. Give yourself time to think about the position. to be made so that unpleasant traits may not be
Notify the prospective employer if you have carried on to the new position.
changed your mind or have transferred to ● Give advance notice. A month is usually enough
another address. As a prospective employee you for those holding staff nurse positions. For those
have an equal right to choose the place of work in teaching or administrative positions, six
and the people whom you can best work with. months is recommended. Give the employer
10. If the prospective employer does not answer, enough time to get a reliever.
you may write a follow-up letter stating your ● Leave with a clean record. Clearance includes
interest in the position. It is possible that they non-liability from responsibilities. Do not leave in
may not have an immediate vacancy but your the midst of activities in the agency. Leave in the
letter will show that you are interested and they most gracious professional manner.
may give you first preference should one occur.
 Nursing provides a diverse range of job
Write a letter of resignation. Observe the following prospects, from entry-level practitioner to doctoral-level
points: researcher. Nurses are hands-on health workers that
1. Give the date of resignation. It is good practice
provide targeted, highly customized care. They are also
to complete the month from the date the notice
of resignation is filed. The date is usually in high demand, with the employment of registered
effective on the 15th or at the end of the month, nurses expected to expand. Before going abroad, newly
for easy computation of salaries, accrued leaves, licensed nurses are recommended to serve their country
etc. first. The reasons for this are for them (1) to acquire a
2. State the reason for resigning. Although you may better perspective of the actual health status of the
have had an unhappy employment experience, it people in the country, (2) to be able to participate in and
is important to be courteous because the letter is
contribute to the implementation of the national health
usually on file and is usually referred to when the
need arises. (An example of a resignation letter programs for the people, (3) to develop skills not only in
will follow) the cure and preventive aspects of care but also in the
3. Express gratitude for kindness and consideration art of good working relationships with the health team
given during the period of employment. Express and the community, (4) to gain more experience in a
regret for leaving regardless of the reasons. variety of situations and enable them to be more mature
4. Attach clearance for money, work, and property in judgment, and finally, (5) to acquire the satisfaction of
responsibilities. Never walk off from a position.
having been able to serve our people first before serving
This will make one liable for breach of contract
or abandonment of duty. This is sometimes others.
referred to as "French Leave" or AWOL
(absence without official leave). There are also a variety of reasons why new
graduate nurses want to go abroad and work there.
EMERGING OPPORTUNITIES FOR NURSES AND Some take it as an opportunity to see other places,
FIELDS OF SPECIALIZATION others like to gain more experience, while the majority
INTRODUCTION prefer to go for financial reasons. This is because there
are not enough positions for nurses to accommodate the
Nursing provides nearly limitless opportunity for thousands who graduate yearly.
learning and progress. This is due to a changing
healthcare industry that is developing as a result of rising The nurse who wants to go to abroad falls into
demand for medical services from all sectors, notably immigrants.
from an aging population. As medicine and medical
services advance, there is a greater demand for highly United States. Under the 1965 Amendment to
trained nurses who are able to deliver specialized the US Immigration and Nationality Act, a nurse may
nursing abilities in a variety of clinical and service enter the United States as an immigrant.
settings. A shortage of primary care physicians places
further strain on the nursing profession to fill up the gap. The new law requires a determination and
For these two reasons, registered nurse progression certification made by the U.S. Secretary of Labor
through higher education is not only possible, but may pursuant to Section 212 (a) (14) of the Act, as a
be necessary for the continued operation of our condition precedent to the admission of immigrants in
healthcare system. the following categories:

This development into a range of community a) Third-preference immigrants - described as

health services offers roles that allow nurses to "qualified immigrants who are members of the
specialize in new areas. Nursing advancement professions, or who, because of their exceptional
opportunities span from patient care to administration ability in the sciences or in the arts, will
and education. There are numerous categories of substantially benefit prospectively the national
nursing fields in general that new nurses must fill in on economy, cultural interest, or welfare of the
which positions they wish to play in the future. But the United States;"
initial preparation for this kind of practice should have b) Sixth-preference immigrants - described as
been incorporated first in nursing programs before "qualified immigrants who are capable of
nurses can assume this role effectively. performing specified skilled or unskilled labor,
not of a temporary or seasonal nature for which
 a shortage of employable and willing persons Australia. Information regarding this matter may be
exist in the United States;" attained from the Australian Embassy in Manila.
c) Nonpreference immigrants - described as Attached to the application form are documents that
"other qualified immigrants strictly in have to be completed. These documents include:
chronological order in which they qualify;"
d) Special immigrants - described as "immigrants a. Six (6) passport photographs;
who were born in any independent foreign b. Birth certificate;
country in the Western Hemisphere or in the c. Civil status for persons aged sixteen and above.
Canal Zone and the spouses and children of any These may be obtained from the parish church,
such immigrants if accompanying or following to civil registrar, or by statutory declaration;
join them. d. Copies of reference from previous employers;
and
Requirements to pass examination: e. Copies of certificates and transcripts of studies
● Non-immigrant (temporary) occupational from high school; or if a college graduate, from
preference Visa from US Immigration and the college.
Naturalization services (NIS).
○ CGFNS certification United Kingdom. Nurses who wish to work here
○ Full unrestricted license don’t need to take any licensure examination unlike
● Applicants who wants to live in US United States. All you need to do is to complete the
○ Labor certificate from Department of necessary data needed.
Labor
○ CGFNS certificate The following are to be submitted with the forms
● Nurse, who has been educated outside the US given out by the United Kingdom Central Council for
○ Hold CGFNS certificate before taking Nursing, Midwifery and Health Visiting:
NCLEX-RN
a. Form RR/OR/9/OS2 to be sent to a Senior Nurse
Canada. Nurses who want to go to Canada with whom the nurse has worked for at least 12
should get a planned job from any agency in the nation months. In exceptional circumstances only,
because there is no lack of nurses there. Any alien where no Senior Nurse is available, this
applying for admission to Canada is advised to go to the reference can be completed by a Medical
Canadian Embassy in Makati for assistance and must Officer;
meet the requirements needed. b. Form RR/OR/9/OS1 to be sent to the nurse's
present professional employer or the Senior
Requirements for Registration of Graduates of Other Nurse who most recently employed her/him in
Countries: professional nursing practice for at least three
● Provinces of Newfoundland, Prince Edward months; and
Island, New Brunswick, Nova Scotia, Alberta, c. Form RR/OR/5/V which should be sent to the
Quebec, and in the Northwest Territories Registration Authority where the nurse is
○ Must hold a provincial license currently registered. That authority may require a
○ Registered as members of the fee for the service requested. The applicant's
respective provincial associations of name and registration number should be
nurses inserted in the spaces provided so the nurse
○ Proficiency in English or French or, both may be identified.
is required d. Transcript of training form completed by the
● Provincial legislation and legislation in the training institution from which the nurse gained
Northwest territories the qualifications he/she wishes
○ Registration is undertaken by the e. birth certificate;
nurses’ association f. statutory change or any name change (e.g.,
○ Proficiency in English or French or, both marriage certificate), if the name in which the
is required applicant wishes to be registered is different
from that on his/her certificate(s);
 g. registration certificate (s) issued by the passed or not. Necessary information are
registration authority of the country or state in included in the letter to take the next step
which training area was completed and in which towards acceptance.
the nurse was first licensed, together with a WHAT HAPPENS WHEN AN APPLICANT PASSES?
current certificate, if he/she is now registered in ● Receive CGFNS certificate
another country or state; and ● Verification of the status as a certificate holder
h. copies of the documents listed above certified as called “Verification of Certificate Status”
true copies of the original by a WHAT HAPPENS WHEN AN APPLICANT FAILED?
i. lawyer/commissioner for oath/notary public or ● Send all documents needed again.
similarly authorized official. If the documents are ● If the applicant passes the English portion, but
not in the English language, certified translations fails the Nursing portion, he/she must re-take
must also be submitted. both the Nursing and English portions.
● If the applicant passes the Nursing portion, but
If in doubt about the acceptability of present fails the English portion, he/she must re-take the
qualification, inquire from the Council before submitting English portion and pass it, within two years of
application and the fee. As of March 2002, the fee is the date he/she passed the Nursing portion.
£117.00 or 8,084php. Further information may be sought ● If the applicant does not pass the English portion
from the United Kingdom Central Council or Nursing, within two years of passing the Nursing portion,
Midwifery and Health Visiting at 23 Portland Place he/she must retake and pass both the Nursing
London W1B1P2. and English portions in order to receive a
Certificate.
SHORT TERM EMPLOYMENT ● If the applicant fails both portions, he/she must
retake both portions to earn a Certificate.
Nurses who wish to work on a temporary
service, not immigrant status usually apply to agencies IN THE PHILIPPINES:
abroad who may need their services through local travel Testing centers:
agencies. Department of labor arranges the employment ● Manila
based on a country-to-country agreement. ● Cebu City
● Cagayan de Oro City
United States –
● pass the CGFNS (Commission on graduates of CURRENT CGFNS FEES:
Foreign Nursing Schools) examination is Fees are to be paid in full US dollars, either
required. through International money order, cash, or credit card.
● State board examination within 6 months of their
arrival
● Germany, Vienna, Saudi Arabia, other Middle
East countries –
● Board examination are NOT required

TWO-PART CGFNS CERTIFICATION PROGRAM

CGFNS Credentials Review

● an applicant, according to his/her education and
registration, is a first- level, general nurse as
Application Forms may be obtained from:
defined historically by the International Council
1. Philippine American Educational Foundation
of Nurses
1148 Roxas Blvd., Manila
2. Philippine Nurses Association
●If passed, move to the next part – CGFNS
1663 FT. Benitez Street Malate, Manila
Qualifying exam for proficiency in English
3. Chapters of the PNA outside the Metro Manila
language both written and spoken.
area
CGFNS RESULTS
● About 8-10 weeks after the exam, letter will be
DIFFERENT FIELDS OF NURSING IN GENERAL
sent directly to the applicant stating if he/she
 1. Hospital or Institutional Nursing ● Hospitals are in far-flung areas, no continuing
education programs are provided; bulk of work
2. Public Health Nursing or Community Health ● Administrative problems
Nursing
3. Private Duty or Special Duty Nursing PUBLIC HEALTH NURSING / COMMUNITY HEALTH
4. Industrial Or Occupational Health Nursing NURSING
5. Nursing Education According to Public Health Nursing Practice in the
6. Military Nursing Philippines (2006),
7. School Nursing ● Public Health Nursing refers to the practice of
8. ClinicNursing nursing in the local, national and city health
9. IndependentNursingPractice departments which include health centers and
public schools. It is community health nursing
HOSPITAL OR INSTITUTIONAL NURSING practice in the public sector.
● Community health nursing is broader as it
The educational qualification for beginning practitioners encompasses nursing practice in a variety of
is a Bachelor of Science degree in Nursing. The nurse roles, which at times include independent
cares for the patient in the hospital or in the out-patient nursing practice.
department and plans for the nursing care needs of the
patient about to be discharged. The nurse performs In the nursing curriculum and in the licensure
nursing measures that will meet the patient's physical, examination for nurses, the term used is community
emotional, social and spiritual health needs while in the health nursing. It includes parish nursing, community
institution and helps him and his family plan for his mental health nursing, and school nursing. The National
further healthcare needs when he returns home. The Health Program of the Philippines gives as much
nurse's functions involve assessment of the patient's emphasis on the promotion of health and prevention of
needs for nursing and planning for giving or providing the diseases rather than care of the sick.
care indicated whether this be personal care,
rehabilitation measures or health instructions. Advantages of Community Health Nursing:
● Focus is on family and community health rather
Advantages of Staff Nursing in the Hospital: than an individual basis
● There’s always a supervisor whom one can ● Gives better perspective of the health conditions
consult of the community and health programs
● Updated with new trends in medicine and conceived and implemented by the government
nursing care of patients ● It maximizes efforts to improvise where there are
● Undergoes rotation to different units before no sufficient facilities, supplies, and equipment.
assigning to their special area ● Enables to utilize various community resources
● 8-10 hrs duty and 40-hour week duty; providing and maximize coordination with other members
2 days of rest away from duty. of the health team.
● Focus of care is more on educational and
They have provisions for sick leaves, holidays, and preventive aspects.
vacations with pay according to personnel policies of the ● Individuals, families and communities are
institution. motivated to assume responsibility for their own
● Have the chance to get promoted to higher healthcare.
positions Disadvantages of Community Health Nursing:
● Salary increases ● Case found is limited
● Considered an important member of healthcare ● More hazards than hospital
team ● No fixed hours of work
● More staff development programs are available ● Some say CHN is not exciting skills
in hospitals ● Facilities are limited so that the practice are also
limited
Disadvantages of Staff Nursing in the Hospital: ● Not immediately aware of changes or trends in
● Overtime work and sacrifice of own plans. the field of medicine or nursing o Not a place for
introverts
 ● No immediate supervisor to consult in case of ● To study human nature, to know close range
emergency interesting people of different nationalities,
cultures, religion, and status
Nurses in this field need: ● Chance to travel and see the world
● 2 years of experience in basic nursing practice ● Ability to own time, adjust work, and private life
● Understanding of skills in teaching, supervision, satisfactory, and direct off-duty time into
and consultation enjoyable leisure
● Ability to plan and implement programs ● Challenge of giving his/her best in providing care
● Understanding of the broad problems and and satisfaction of seeing its results
desirable practices in patient-care planning.

PRIVATE DUTY NURSING Disadvantages of Private Duty Practice:

● Patient will totally dependent on them
Private practice nurses are expected to be expert ● Not enough nurses for evening, night shifts, for
clinicians as well as nursing generalists. They use the holiday, weekends, and vacation period
title Private Duty Nurse, Private Nurse Practitioner, ● Minimizes opportunity for developing good
Special Duty Nurse or Private Duty Nurse Specialist. It relationships with other hospital personnel.
must be able to give comprehensive nursing care to the ● Very little or no participation in professional
patient on a one-to-one ratio, and independent activities
contractor. ● No retirement, insurance, and medicare benefits
unless the private it provide it with themselves
2 Categories:
1. General Private Duty Nurse. – Provides basic OCCUPATIONAL HEALTH NURSING OR INDUSTRIAL
nursing care to any type of patient NURSING
2. Private Duty Nurse Specialist. – demonstrates
skills in interpreting data gathered from ECG, Was once called “industrial nursing”.
EEG, laboratory diagnostic results and vital Occupational health nursing is a specialty of nursing that
signs, observes signs and symptoms, provides and delivers healthcare to workers. The
promptness and adeptness in instituting practice promotes, protects, and supervises workers'
appropriate nursing measures. The private duty health within the context of a safe and healthy work
nurse is expected to follow the hospital's norms environment. Occupational health nursing is
and regulations on nursing processes, the usage self-contained, and occupational health nurses make
and procurement of equipment and supplies, the independent nursing decisions when providing health
medication system, charting, diets, precaution care. Because occupational health nurses sometimes
tactics, and so on. As with other areas of work alone and must provide rapid care to patients with
nursing, he or she is expected to follow the code significant injuries, they must be fully aware about their
of ethics and practice. legal responsibilities. Furthermore, industrial nurses
must be familiar with corporate policies regarding
4 General Guidelines: employees, insurance benefits, sick leave, pay rates,
1. He/She is directly under the supervision of the health programs, medical issues, and records. Because
nursing service in the hospital, or of the Head industrial nurses may only have part-time or on-call
Nurse in the unit. Must report comprehensively medical supervision, they may find themselves as
verbal and written. custodians of employees' health records, workers'
2. Responsible for nursing care of the patient counselors and advisers, interpreters of business
3. Give complete nursing care before going-off duty policies, health and safety teachers, and first aiders to
4. Regular monthly audit shall be given to the the injured. Often, the industrial nurse works only during
Director of Nursing Service who day hours. They are off duty on weekends most of the
referred her/him for employment time.

Advantages of Private Duty Practice: NURSING EDUCATION

Qualifications:
 (a) be a registered nurse in the Philippines; have the professional, personal and other qualifications
(b) have at least one (1) year of clinical practice in a commensurate with job responsibilities.
field of specialization;
(c) be a member of good standing in the accredited Criterion I - Qualifications for Commission in the Reserve
professional organization of nurses; and Force Nurse Corps?
(d) be a holder of a master's degree in nursing,
education, or another allied medical and health a. have a Bachelor of Science degree in Nursing
sciences conferred by, college or university duly from a duly recognized university/college;
recognized by the Government of the Republic b. be licensed to practice nursing,
of the Philippines. c. be a natural-born Filipino citizen;
d. single
The career ladder in nursing education starts with a e. be mentally and physically fit for military service
Clinical Instructor's position up to that of a Dean of a and cleared by appropriate security agencies;
College of Nursing. Generally, salaries of those in the f. have a pleasing personality and a good moral
field of nursing education are higher than those working character;
in the hospitals. These vary according to the teachers' g. & be skillful in
experience, their fields of specialization and the ○ applying the nursing process in meeting
educational attainments. Nursing education is an health/nursing needs of
interesting, important, and challenging field and the individuals/families/groups/
opportunities for well-prepared nursing educators are communities,
numerous. ○ communicating and relating with others,
and
MILITARY NURSING ○ making sound/rational judgment in a
given situation;
When the famed Tandang Sora led the nursing of the h. be interested and willing to work in both peaceful
sick and wounded Katipunan revolutionaries in 1890, and wartime conditions;
military nursing in the Philippines may be said to have i. not be more than thirty two (32) years of age at
begun. On September 5, 1938, the National Defense Act the time of commission; and
was amended by Commonwealth Act. No. 385 whereby j. satisfy the following height requirements -
the different corps of the medical services were explicitly ○ minimum of sixty two (62) inches for
spelled out, with the Nurse Corps being one of them. males, and a
This is the date celebrated by the Nurse Corps as its ○ minimum of sixty (60) inches for
foundation day. Brig. Gen. Elvegia R. Mendoza was the females.
first military nurse to hold the rank of being a Chief nurse
as Technical Staff of General Headquarters. Qualifications for Commission in the Regular Force,
Nurse Corps?
Functions:
a. successfully pass the rigid screening and battery
● To meet the nursing needs of today's patients in test for the purpose;
AFP medical facilities; b. satisfy the height requirements of
● To prepare each Nurse Corps Officer (regular ○ minimum of 64 inches for males, and a
and reserve) for future assignments at a higher ○ minimum of 62 inches for females; and
level of responsibility in the different stations and ○ not be more than 26 years of age at the
general hospitals in times of peace and war; and time of regular commission.
● To teach and train enlisted personnel who
perform nursing functions under supervision. Qualifications for Call to Active Duty (CAD)
Special emphasis is on enlisted members who
function in settings where there are no nurses. a. must be commissioned;
b. must have at least one year nursing experience
The military nurse works at different health settings with in a reputable health agency;
various levels of responsibilities. As such, he/she must c. must have been cleared by appropriate security
agency; and
 d. must have passed the physical and mental 8. Opportunity to attend gala, social functions and
examinations conducted by the appropriate parade.
authorities.
9. Opportunity to travel abroad
Qualifications for General Duty Nurse
FLIGHT NURSING
a. would have the rank of Second Lieutenant;
b. must have adequate knowledge of general Flight nursing, also known as aero-space nursing, is a
nursing theory and practice, including basic subset of nursing that is exclusive to the military and the
knowledge about biological, social, and medical Air Force. A flight nurse is in charge of patients, military
sciences and their application; or civilian, who have been evacuated from conflict zones
c. must have knowledge of new developments in to the nearest medical facility for treatment. On such
the nursing field; and missions, the flight nurse is the most important member
d. must demonstrate ability to perform of the aeromedical team. More often than not, medical
comprehensive nursing care. missions are performed without a flight surgeon. When
such situations arise, the flight nurse assumes full
Privileges and Benefits of a Military Nurse responsibility for the care of the patients.

1. High salary rate and allowances according to rank: SCHOOL HEALTH NURSING
a. as Second Lieutenant, they will initially
receive the same base pay as officers of School health nursing is very different from hospital
equivalent rank, incentive pay, nursing. School health nurses must like children a lot.
subsistence allowance, quarters They often work alone, out of touch with other nurses,
allowance, clothing allowance, and the hospital and all professional supports they have
others when applicable; known. They are responsible for the school's activities in
b. flight pay for flight nurses which is 50% the areas of health service, health education, and
of base pay; environmental health and safety.
c. hazard pay (radiation hazard pay) which
is 20% of base pay; Some responsibilities of the school nurse are:
d. cold weather clothing allowance for
those assigned in cold regions like PMA 1. organizing and implementing the school health
in Baguio, or areas abroad; and program;
e. overseas pay when detailed to foreign 2. coordinating school health programs;
countries on schooling, or on missions. 3. undertaking functions directly related to pupil's
health;
2. Glamour and prestige of the uniform, rank and 4. evaluating school health programs; and
position. 5. carrying out functions related to the health of
school personnel.
3. All junior officers and enlisted personnel will salute
and accord them due military courtesy. Advantages of School Health Nursing: o

4. Hospitalization and free medical benefits for parents, ● It gives an opportunity to watch children advance
dependents, authorized relatives with specialists' care. from grade to grade in school health.
● Hours as usual, no shift duty.
5. Military schooling and basic training at the Armed
Forces Disadvantages

6. Medical Service School at the V. Luna Medical Center ● Many school nurses do not update themselves
(VLMC). on the current issues in nursing making them
unaware of changes in the nursing practice.
7. Opportunity to meet people who hold key positions in ● should accept the educational functions of the
the AFP and in the government. school and be committed to the promotion of
health through education.
 CLINICAL NURSING advocacy" has been accepted by the nursing profession
to describe an ideal of practice, its meaning, range, and
Clinic nursing requires that a nurse possess general significance have not yet been fully explored.
skills. Nurses in this field must have excellent teaching Furthermore, inadequately defined concepts may result
and communication skills, exhibit organizational and in practice issues that could eventually affect patient
leadership ability, possess good assessment skills, and care. Thus, the term "advocacy" as used in nursing is
have good insight in order to anticipate and interpret the reviewed, and since the phrase has also been found in
needs of their patients. the literature of other disciplines like law or medicine, it
has been useful to compare the various viewpoints.
ADVANCED PRACTICE NURSING Accordingly, it was found that the acts made to advocate
for a specific patient or group of patients inevitably have
The phrase "advanced practice nurse" refers to nurses an impact more than just the person for whose benefit
who have specific education and experience beyond the the efforts are taken. This is due to the fact that nursing's
basic nursing curriculum. This advanced practice goal of promoting "health" encompasses both individuals
necessitates the information and supervised skills and society as a whole
earned via graduate nursing studies (either a master's or
doctoral degree). This field encompasses the role of the This professional advocacy upholds a commitment
clinical nurse specialist. These nurses do a variety of specifically:
tasks, including direct patient care, research, education,
consultation, and management. 1. Promote clinical perspective in organizational
decisions
INDEPENDENT NURSING PRACTICE 2. Involve nurses and other staff in decisions that affect
their practice
The nurse is self-employed and provides professional 3. Represent the perspective of patients and families
nursing services to clients/ patients and their families. 4. Advocate for optimal health care in the community
While some independent nursing practitioners set up 5. Ensure that patient care is the core of the
their clinics near a hospital, most of them are organization's work
community-based. Independent nurse practitioners are
held responsible for their actions. Whether their position IMPORTANCE OF PROFESSIONAL ADVOCACY:
is independent or collaborative, it is predicated on the
idea that each health care field provides a unique set of Advocacy is part of a nurse's commitment to the
skills and knowledge. standards of the nursing practice. It is important because
it may reduce the chances of errors and harm to
SYNTHESIS patients. It can also foster a deeper insight into the
complications and hazards that patients may experience
Nurses promote health, prevent disease, and assist in the healthcare system, and it prepares nurses to use
patients with illness management. They have a distinct their expertise and skills to increase the likelihood of
scope of practice and can practice independently, but successful outcomes. In addition, nurses working as
they also collaborate with all members of the health care advocates can ease a patient's stress and discomfort to
team to provide the care that each patient requires as an help them focus on their health and well-being.
individual. Nurses are advocates for their patients and
their families. They create and manage nursing care ROLES AND DUTIES:
plans, as well as educate patients and their families
about proper care. The foundation of an advocate's functions and
responsibilities is patient education. Roles and duties
A. PROFESSIONAL ADVOACY could include:

The concept of "professional advocacy" is understood as ● Assessing patient care needs during hospitalization
actions stemming from professional role objectives. And and discharge
compared to "advocacy" or "patient rights advocacy," it ● Reaching out to community resources as needed
better describes the scope of nursing responsibilities.
This term was coined due to advocacy being a slippery
concept for nursing. Although the concept of "patient
● Speaking up while serving on committees or councils ● Recognise and reward employee
to solve problems an ensure patients receive the best contribution/performance.
care possible ● Regularly assess employee satisfaction and act on
● Participating in the local and national discussion outcomes.
regarding the future of healthcare
● Advocating for treatments/procedures/tests that are 2. Management Practices
appropriate for patient care/diagnoses ● Commit to equal opportunity and fair treatment.
● Reviewing patient care concerns or grievances ● Offer decent and flexible benefit packages.
● Providing education on insurance benefits ● Involve employees in planning and decision making
● Educating patients on current standards of practice in affecting their
healthcare ● practice, work environment and patient care.
● Demonstrating compassion and empathy with patients ● Encourage open communication, collegiality, teamwork
and families with regards to their healthcare wishes and supportive
● Educating patients on necessary healthcare decisions ● relationships.
without bias or coercion. ● Foster a culture of mutual trust, fairness and respect.
● Adopt policies and procedures that positively
B. POSITIVE PRACTICE ENVIRONMENT encourage the reporting of
● professional misconduct or violation of
Positive practice environments (PPE) are settings where laws/regulations.
excellence and decent work are encouraged. It works ● Provide clear and comprehensive job
particularly hard to promote great patient care; protect descriptions/specifications.
the staff's health, safety, and personal well-being; and ● Demonstrate effective management and leadership
enhance both individual and organizational motivation, practices.
productivity, and performance. The American Nurses
Association (2016) describes it as a setting that is safe, 3. Support Structures
empowering, and satisfying. Meanwhile, the World ● Foster strong employment relationships between and
Health Organization defines it as a setting that optimally among employer/employee/co-workers/patient.
promotes the "physical, mental, and social well-being" of ● Provide access to adequate equipment, supplies and
the nurses. In addition, it has the potential to boost the support staff.
health sector as a whole, and attract and keep ● Engage employees in continuous assessment and
employees (WHPA, 2021). As a result, it is advised that improvement of work
health professionals, managers, governments, policy ● design and work organization.
and decision-makers, and community leaders stand up ● Promote healthy work-life balance through policies and
and support positive practice environments. programmes that
● support fair and manageable workloads and job
CHARACTERISTICS OF POSITIVE PROTECTING demands/stress, and
ENVIRONMENT ● flexible work arrangements.
● Offer employment security
The following key characteristics below present quality
workplaces for health care professionals. It is intended to 4. Education
be used as a reference tool to evaluate the standard of ● Support opportunities for professional training,
their practice environment, identify any problems, and development and career advancement.
create plans to solve any priority gaps. Each of these ● Offer thorough orientation programmes for new hires.
traits entails a set of obligations and rights for the ● Foster effective supervisory, mentoring and peer
relevant parties. coaching programmes.

1. Professional Recognition 5. Occupational Health and Safety

● Recognise the full range of competencies provided by ● Adhere to safe staffing levels.
health care professionals and provide the autonomy for ● Adopt occupational health, safety and wellness
these competencies to be fully utilized. policies and programme that address workplace
● Promote professional autonomy and control over hazards, discrimination, physical and psychological
practice and pace of work. violence and issues pertaining to personal security.
 Because nurses cannot accommodate all of the patients
in clinical rounds due to the high nurse-to-patient ratio,
nurses may receive poor treatment from their patients
while providing care. This can lead to low patient
satisfaction and negative feedback, which can affect the
7 ISSUES IN NURSING PRACTICE institution due to unsustainable nursing care
WORK ENVIRONMENT
STAY ON THE JOB
A nurse's ideal work environment should include
assisting all patients as equally as possible and meeting Since the prevalence of physiological-related injuries is
the patient's needs. A healthy work environment higher, and psychological harm such as bullying,
supports excellent nursing care and gives satisfaction to emotional abuse, and disrespectful treatment are
nurses that they are valued and their work is meaningful. common in healthcare settings, the nurse's workplace
An inadequate work environment, on the other hand, can should be free of any physical and psychological harm.
cause problems for nurses and will result in poor patient Also, hazards from chemicals, sharp injuries, exposure
and handling and potential for risk of harm can be result to infectious diseases because nurses are constantly in
in a not conducive work environment which can lead to direct contact with sick people, and violence that could
nurses that they would not continue to work due to the jeopardize nurses' safety and affect their ability to
unsafe environment that could compromise the patient provide proper nursing care to patients.
care.
QUALITY IMPROVEMENT
OVERWORKED AND UNDERPAID
Some healthcare institutions are unable to meet the
Despite nurses being overworked, such as long shifts needs of their patients due to a lack of manpower
that extend beyond the required shift because of too capable of providing proper nursing care, as well as a
much procedure that needs to be done and pending of lack of necessary equipment and supplies. This will
medical orders that needs to be carried out immediately result in poor staff communication, medical errors, and
and insufficient nurse-to-patient ratios, nurses are often improper implementation of evidence-based practice, all
underpaid compared to the level of responsibility and of which will result in poor patient outcomes and overall
expertise due to financial compensation cannot reflect quality of care
the value of the work that they do.
TRENDS IN NURSING PRACTICE
NURSE BURNOUT MIGRATION

As nurses experience and encounter burnout as a Nurses tend to migrate from another country due to the
common problem, it remains an issue due to long hours high demand for nurses in another country, and they
of demanding shifts, a lack of rest, and increased want to grab the benefit of opportunities abroad in order
workloads and fatigue that may have an adverse effect to live a better life. Long working hours, a lack of
on nurses. resulting in work-to-family conflict, unrealistic resources needed to implement nursing treatment,
patient expectations, lowering of performance and any political instability, a lack of benefits, a lack of safety for
mishaps such as medical errors during duty, causing you nurses, and mistreatment of nurses in their respective
physically and emotionally exhausted. countries are all reasons why nurses migrate. The
advantages of migrating include improving the financial
INADEQUATE STAFFING situation of the nurse who works abroad for his or her
family, aiding the recipient country in filling a nursing
When hospitals and other healthcare facilities do not
shortage, and improving the work environment. On the
have enough nurses for a shift, this results in insufficient
other hand, the challenges for nurses who migrate to
staffing, which can lead to serious problems in nurses'
another country include a language barrier, a shortage of
work environments. With fewer staff nurses on duty,
nurses in their mother country, and a long distance from
each nurse's workload will increase, resulting in the
their loved ones.
resignation of other nurses.

PATIENT EXPERIENCE
 AGING POPULATION ● to another city within the same country to seek
medical treatment.
Because of the growing population, this may contribute
to nursing practice issues. Some countries, particularly Evidence–based practice
those in the first world, are gradually losing capacity in
their workplaces due to a population that is aging, It is defined as an integration of research and clinical
resulting in their retirements that will cause staff expertise in health-care decisions that promotes patients'
shortage. Their health status, ability to perform complex values and patients' circumstances so as to avoid any
tasks, and health conditions that could jeopardize their misapplication of quality care as it would include a
health all contribute to this factor. This may increase variety of nursing research sources that are reliable
demand in certain countries to hire nurses from other enough to use as a reference. Nurses should use
countries to compensate for their declining workforce evidence-based clinical decision making because it is
due to a population that is aging. critical for implementing patient safety and quality care
by individualizing nursing care needs based on patients'
Complementary Therapy specific treatment references from nursing research and
patients' references. To integrate evidence into practice,
Also known as complementary medicine or alternative clinical questions should be identified using the PICOT
therapy. A treatment plan that utilizes alternative (Population/Patient Problem, Intervention, Comparison,
therapies instead of conventional medicine. Outcome, Time) framework.
Complementary medicine is becoming popular because
it allows some healthcare professionals to function PROFESSIONAL NURSING ASSOCIATIONS
independently and play a more active role in their
patients' treatment and recovery and also some The evolution of the nursing profession is
therapies are included in some of the interventions that reflected in the history of professional nursing
will be implemented to the patients. It also makes them associations. Midway through the 19th century, Florence
feel better by inducing relaxation and lowering stress. Nightingale initiated her pioneering work. In 1860, her
However, there is inadequate medical evidence to contributions to nursing care during the Crimean War
support the claim that complementary therapies are safe and the establishment of the Nightingale Training School
and reliable; they can still be dangerous and harmful if for Nurses in London marked a turning point. Here,
performed by an untrained healthcare professional formalized nursing education commenced, elevating the
standing of nurses within the healthcare system. The
Medical Tourism founding of the American Nurses Association (ANA) in
1896 marked a turning point in the history of nursing
Also known as medical travel or health tourism. It is a of organizations in the United States. The ANA has
treatment in which they travel abroad to seek medical consistently worked to improve patient care, uphold
care for a variety of reasons such as organ transplant, nursing standards, and promote the professional
chemotherapy, cosmetic surgeries, and fertility development of nurses. The American Nurses
treatments, which may reduce the cost of a specific Association (ANA) has collaborated with international
medical treatment or procedure, certain equipment that nursing organizations to define global nursing standards.
is not available in their country of residence that requires
complex care, and recommendations from their The twentieth century marked a turning point for
physician. nursing associations. During World Wars I and II, nurses
played crucial roles on the front lines. These wartime
Types of medical tourism experiences contributed to the professionalization of
nursing. The momentum gained during the wars resulted
● Outbound - a type of medical tourism in which in the formation of many more nursing associations in
patients leave their home country to seek the postwar era, each focusing on the specific
medical treatment in another country. requirements of various nursing specialties, such as
● Inbound - a type of medical tourism in which nurse anesthetists and nurse practitioners. The
patients from another country travel to a International Council of Nurses (ICN) was founded in
recipient nation to receive medical treatment. 1899 as an organization dedicated to uniting nurses
● Domestic - a type of medical tourism in which worldwide and promoting the nursing profession on a
patients travel
global scale. The ICN has consistently addressed global including hospitals, clinics, schools,
issues including nursing standards, education, and home care.
nurses' rights. c. Association
- An association is a group of people
Professional nursing associations remain central intentionally organized to accomplish an
to the patient-centered approach in an environment overall, common goal or set of goals.
where healthcare is constantly evolving. These d. Professional Nursing Association
organizations, which are composed of devoted nurses, - A professional nursing association is an
have played a pivotal role in the healthcare industry for organized group of nurses and
decades. In addition to hospital corridors and clinic sometimes other healthcare
rooms, their influence permeates legislative chambers professionals who come together to
and educational institutions. Associations of professional advance the nursing profession. These
nurses are the backbone of a profession characterized associations often work on issues
by unwavering dedication, compassion, and dedication related to nursing practice, education,
to the highest standards of patient care. As nurses from and policy, while also providing support,
across the globe unite under the banners of these resources, and networking opportunities
associations, they stress the importance of collaboration, for their members.
education, advocacy, and unity in the pursuit of e. Local Specialty Organization
excellence. - A local specialty organization is a group
or society typically focused on a specific
Nursing associations continue to address area or aspect of a profession or field. In
contemporary healthcare issues as the 21st century the context of nursing, a local specialty
progresses. These include healthcare access, the organization might be a group of nurses
incorporation of technology into nursing practice, patient in a particular geographic area who
safety, and the elimination of disparities in healthcare. In share a common interest or
addition, they have demonstrated extraordinary specialization, such as pediatric nursing
resilience during times of crisis, such as the COVID-19 or critical care nursing. These
pandemic, by providing guidance, resources, and organizations often provide a platform
unwavering support to frontline nurses. for members to collaborate and enhance
their expertise in their specific field of
DEFINITION OF TERMS interest.

a. Profession Why should you join and learn more about these
- A profession is a type of occupation or nursing organizations?
vocation that typically involves
specialized training, education, and a. Staying Informed
expertise in a specific field. It often has a - Nursing organizations play a crucial role
formal code of ethics, standards of in keeping members updated on the
practice, and a commitment to serving latest news, research findings, and
the public good. Professions are changes in the field. This helps nurses
characterized by a high level of skill, remain current with best practices and
knowledge, and responsibility. emerging trends, which is vital in the
b. Nursing rapidly evolving healthcare environment.
- Nursing is a healthcare profession b. Continuing Education
focused on the care and support of - These organizations often provide
individuals, families, and communities to access to continuing education
promote, maintain, or restore health and opportunities. This can include
well-being. Nurses provide various workshops, webinars, and courses.
healthcare services, including patient Many offer these resources at reduced
assessment, treatment, and education, rates for members, which is beneficial
and they work in a variety of settings, for nurses looking to expand their
knowledge and skills.
c. Networking a. International level
- Nursing organizations facilitate - At the international level, nursing
networking through various channels. organizations collaborate on a global
Members can connect with peers scale to address common challenges,
through online forums, local meetings, set global standards, promote best
and networking events. The annual practices, and advocate for the nursing
conventions organized by these profession's interests at an international
associations offer a platform for level.
in-person networking, which can lead to - Ex. International Council of Nurses (ICN)
career advancement opportunities, b. National Level
collaborations, and mentorship. - At the national level, nursing
d. Career Assistance organizations focus on issues and
- Nursing organizations typically have matters specific to a particular country.
career centers that offer valuable - Ex. American Nurses Association (ANA)
resources for job seekers. This includes c. Regional/Local Level
job postings, guidance on the job search - The regional level involves organizations
process, information about typical that operate within a specific geographic
salaries, and insights into employee region or territory, such as a state or
benefits within the profession. Such province.
resources are particularly useful for
nurses at all career stages. LIST OF ACCREDITED PROFESSIONAL NURSING
e. Discounts and Resources ASSOCIATIONS
- Membership often comes with practical
benefits, such as discounted or free a. International Council of Nurses (ICN) (1899)
access to newsletters and certification - International Council of Nurses (ICN) is
review materials. Additionally, some a global federation of national nursing
nursing organizations offer associations that aims to advance
member-exclusive discounts on various nursing, promote health, and improve
products and resources, including healthcare outcomes worldwide.
insurance and financial services, which - The ICN was founded by Ethel Gordon
can result in cost savings for members. Fenwick and Hélène de Sailly.
f. Certification - Founded in 1899 as the "International
- Many specialty nursing organizations Council of Nurses and Red Cross
provide certification programs in their Societies" and was the first international
respective areas. Earning these organization for healthcare
certifications can enhance a nurse's professionals.
credentials and open up new career - Renamed as the “International Council
opportunities in specialized fields. of Nurses” (ICN) in 1909. Headquarters
g. Self-Care in Geneva, Switzerland
- Participating in professional organization - The council is a federation of more than
events and interacting with peers can be 120 national nurses’ associations such
a crucial aspect of a nurse's self-care as the ANA and CNA.
routine. It offers emotional support, - 5 Core Values
reduces burnout, and helps prevent 1. Visionary Leadership
compassion fatigue. Connecting with 2. Inclusiveness
like-minded professionals who 3. Partnership
understand the challenges of the job can 4. Innovativeness
provide a sense of community and 5. Transparency
well-being. b. American Nurses Association (1896)
- The American Nurses Association (ANA)
3 LEVELS OF NURSING ORGANIZATION is a professional organization that
represents registered nurses in the
 United States, advocating for their released the first standard curriculum for
interests and the advancement of the school of nursing in 1917.
nursing profession.
- Considered to be one of the most - Offer continuing education programs
prominent and influential nursing and testing services, such as licensure
professional organizations in the entire examination (NCLEX-RN), achievement
world. tests, and pre admission testing.
- - The early organization was founded by
Isabel Hampton Robb and Mary d. Sigma Theta Tau
Adelaide Nutting, prominent nursing
figures of their time. - STT has become the national honor
- - Founded in 1896 as the Nurses society of nursing and recognizes the
Associated Alumnae of the United value of scholarship and excellence in
States and Canada, later becoming the nursing practice, technology, and
American Nurses Association in 1911. research, striving to improve nursing
- ANA is headquartered in Silver Spring, care and health worldwide.
Maryland.
- Programs involved in this organization
ii. Journal: The American Nurse include mentoring programs in
leadership, encouraging members to
iii. Newspaper: American Nurse Today become involved in chapter, regional,
and international efforts of study, task
- Has three subsidiary forces, and work.
organization
- Established in 1922 by six students
1. AmericanAcademyofnursing named Ethel Palmer Clarke, Edith
Moore Copeland, Elizabeth McWilliams
2. AmericanNursesFoundation Miller, Elizabeth Russell Belford, Mary
Tolle Wright, Marie Tolle Wright and
3. Marie Hippensteel Lingeman from
AmericanNursesCredentialingC Indiana University Training School for
enter Nurses.

c. National League for Nursing (1893) e. Philippine Nursing Association

- The National League for Nursing (NLN) - The Philippine Nursing Association
is a professional organization in the (PNA) is a professional organization in
United States dedicated to advancing the Philippines that represents Filipino
excellence and innovation in nursing registered nurses, advocates for their
education to prepare the nursing welfare, and promotes the advancement
workforce and is open to all people of the nursing profession.
interested in nursing including nurses,
non-nurses and agencies. - It was established on September 2,
1922 by Anastacia Giron-Tupas
- Founded in 1893 by Isabel Hampton
Robb and Mary Adelaide Nutting as the - Formerly known as Filipino Nurses
American Society of Superintendent of Association (FNA), not until
Training Schools for Nurses and was the
first organization for nursing in the US. 1966, it was renamed as the Philippine
Nurses Association (PNA)
- In 1912, it was renamed the National
League for Nursing Education and - PNA is headquartered in Quezon City,
Philippines.
E. List of Local Specialty Organization in the - Headquarters: DOH Compound,
Philippines Manila

a. d.
PhilippineSocietyofEmergencyCareN Operating-RoomNursesofthePhilippines(ORN
urses(PSECN) AP)

- dedicated to promoting excellence in - dedicated to the practice of nursing in

emergency care nursing. Its goal is likely operating rooms. Its goal is likely to
to advance the knowledge and skills of provide a platform for operating room
nurses in the field of emergency care, nurses to share knowledge, develop
improve patient outcomes, and enhance their skills, and promote the highest
the quality of emergency nursing care in standards of patient care in surgical
the Philippines. settings.
- President: ROSARIO G. DUMANGON,
- President: VIRGINIA C. DUCUSIN, RN RN, MAN
- Headquarters: Eisenhower St. Green
- Headquarters: Nursing Service Office hills San Juan Metro Manila
Philippine General Hospital, Manila
e. Occupational Health Nurses Association of
b. the Philippines (OHNAP)
PhilippineOncologyNursesAssociatio
n(PONA) - A non-stock, non-profit professional
organization of nurses working in the
- focuses on oncology nursing, which is industrial, agricultural, commercial,
the specialized care of patients with educational, service (hotel & restaurant),
cancer. Its goal is to provide support and government and non-government
resources for nurses working in institutions.
oncology, promote research and - serves nurses working in various
education in the field, and ultimately industries and institutions. Its goal is to
improve the care and well-being of promote occupational health and safety,
cancer patients. protect the well-being of workers, and
ensure compliance with occupational
- President: JOSHUA JAIME P. NAIRO, health regulations.
RN, MAN, CLDP - President: MERCEDES CASTILLO, RN,
MPA
- Headquarters: Nursing Service Office - Headquarters: 98 Gil Puyat Avenue,
Philippine General Hospital, Manila Makati City

c. f. Military Nurses Association of the

PhilippineInfectionControlNursesAss Philippines (MNAP)
ociation(PHICNA)
- A duly-recognized specialty organization
- focused on promoting infection control of the Philippines Nurses association
practices and standards within (PNA) that is also recognized by the
healthcare settings. Its goal is to Philippine Society of Geriatric Medicine
enhance the knowledge and skills of (PSGM).
nurses in preventing and managing - serves as an academic and professional
infections, ultimately improving patient advocate for military nursing. Its
safety. objectives are centered on supporting
the unique needs of military healthcare
- President: MA. LAARNI D.
providers, conducting research in
CANCERAN, RN
 military medicine, and enhancing the ■ Traumatic brain injury
academic discourse surrounding the
healthcare of military personnel. ■ Birth injury
- President: COL VICTORIA L VIDAL
(RET) ■ Failure to thrive
- Headquarters: MNAP building, Quezon
City ■ Congenital disease

g. ■ Rare disease
GerontologyNursesAssociationofthePhilippin
es(GNAP) c.
YoungNursesAssociationofthePhilippines(YN
- A duly recognized specialty organization AP)
of the Philippine Nurses Association
(PNA) that specializes in gerontological ● is a recently established professional
nursing. Its core mission is the group for young Filipino nurses that they
advancement of geriatric nursing themselves developed.
knowledge and practice through ● composed of dynamic, active and
academic research, education, and the dedicated youthful nurses who desire a
dissemination of evidence-based care proactive change in their nursing
protocols that promote the well-being of professional growth.
aging populations. ● The Vision of YNAP is to be a leading
- President: ELIGIO S. RAZALAN, RN, professional nursing organization in the
PhD Philippines, dedicated to advancing the
- Headquarters: Malate, Manila career and professional development of
young Filipino nurses globally. Their
F. List of Local Specialty Organizations in Davao Mission involves enhancing the
competencies of newly-registered and
a. practicing nurses to make them globally
GenuineCarePrivatePracticingNursesAssocia competitive, assisting young nurses in
tionINC. finding ethical and decent employment,
showcasing their talents and skills,
● A private practicing nurses association improving healthcare services provided
● Has a slogan " WE ARE COMPETENT, by young Filipino nurses, and exploring
ARE YOU?" collaboration with other nursing
● According to their website, this organizations locally and internationally.
association cares for patients like ● YNAP believes in the core concepts to
LEAD:
family. The nurses provide care at its best. As
this organization is equipped with knowledge, ○ Leadership
skills and a good attitude.
○ Excellence
b. Davao PrivateDutyNursesAssociationInc
○ Advocacy
● A skilled nurse, with long term
comprehensive nursing care in a ○ Dedication
patient's home
● Who needs a private duty nurse? RELEVANT RESOLUTIONS AFFECTING NURSING
PRACTICE
○ Patients with:
Nursing leadership management involves guiding health
■ ALS care teams in setting and attaining their goals intended
for patient care and safety. Nurse leaders are the one
responsible for overseeing, promoting and assessing the programs and services effectively to specific client
efficiency in health care settings. They lead and groups in the community settings
collaborate with other healthcare teams to ensure
effective patient outcome and patient care. Responsibility 4: Manages a community/village based
health facility /component of a health program or a
nursing service.
Relevant resolutions impacting nursing care discusses a
wide range of issues which include Nurse to patient Responsibility 5: Demonstrates ability to lead and
ratios, guidelines in their scope of practice which include supervise nursing support staff.
the roles and responsibilities of nurses to deliver patient
care and maintain patient safety. It also includes the
CPD or Continuing professional development which is Responsibility 6: Utilizes appropriate mechanisms for
mandates nurses to receive ongoing education and networking, linkage building and referrals.
training to keep the nurses up to date with the latest
trends and latest practices. c. Beginning Nurse's Role In Research

2012 NATIONAL NURSING CORE COMPETENCY Responsibility 1: Engages in nursing or health related
STANDARDS (2012 NCCS) research with or under the Supervision of an
experienced researcher.
a. Beginning Nurse’s Role on Client Care
Responsibility 2: Evaluates research study/report
Responsibility 1: Practices in accordance with legal utilizing guidelines in the conduct of a written research
principles and the code of ethics in making personal and critique.
professional
Judgment. Responsibility 3: Applies the research process in
Responsibility 2: Utilizes the nursing process in the improving client care in partnership with a quality
interdisciplinary improvement /quality ass
care of clients that empowers the clients and promotes
safe quality care. LEGAL BASIS FOR THE 2012 NATIONAL NURSING
CORE COMPETENCY STANDARDS (2012 NNCCS)
Responsibility 3: Maintains complete and up to date
recording and reporting system. Article III, section 9 (c) of Republic Act No. 9173 or
the Philippine Nursing Act of 2002
Responsibility 4: Establishes collaborative relationships
with colleagues and other members of the team to a. states that the Professional Regulatory Board of
enhance nursing Nursing is empowered to “monitor and enforce
quality standards of nursing practice in the
and other health care services. Philippines and exercise the powers necessary
Responsibility 5: Promotes professional and personal to ensure the maintenance of efficient, ethical
growth and and technical, moral and professional standards
in the practice of nursing taking into account the
development. health needs of the nation.” It is, therefore,
incumbent upon the Board of nursing to take the
b. Beginning Nurse’s Role On Management And lead in the improvement and effective
Leadership implementation of the core competency
standards of nursing practice in the Philippines
Responsibility 1: Demonstrates management and to ensure safe and quality nursing care, and
leadership skills to provide safe and quality care. maintain integrity of the nursing profession.

Responsibility 2: Demonstrates accountability for safe B. Continuing professional development

nursing practice. Responsibility 3: Demonstrates
management and leadership skills to deliver health Continuing Professional Development, refers to the
ongoing process of learning, acquiring new skills, and
enhancing existing ones to keep up with the To attain personal excellence, they identified seven
fast-evolving landscape of healthcare. CPD builds on the self-mastery skills that should be learned and developed
rigorous education and training nurses undergo before . Taking this as a premise for all CPD programs, the
they become professionals, ensuring that they remain service providers should be guided by the tenet " do
knowledgeable and competent in delivering safe and more, MENTORING rather than lecturing , COACHING
effective care. rather than telling."

Given the complex purpose of CPD for nurses, it The framework takes into consideration the National
encompasses a range of learning activities and covers a Nursing Career Progression Program (PRBON
variety of topics. As such, the Philippine Board of (Professional Regulatory Board of Nursing ) Resolution
Nursing has mandated that nurses must earn a minimum No. 22, series 2009) for the continuing growth and
of 15 credit units every three years in order to renew development of the nurse practitioners. Thus, through
their licenses. This means that nurses must earn at least the CPD programs, a level 6 nurse generalist can be
five units every year. classified later on, upon credentialing by the PRBON into
Level 7 or Level 8 professional in any of the three tracks
The Importance of CPD for Nurses in the Philippines of 10. 1. Advanced Nursing Practice; 2. Nursing
Education; or 3. Leadership and Governance.
Continuing professional development is not just another
requirement for renewing a PRC license. It has
numerous benefits for nurses, the healthcare industry,
and society. Expanding Skills and Knowledge, Growing
as a Professional, Advancing Your Career, Ensuring
Regulatory Compliance, Improving Quality of Patient
Care, Building Confidence and Reputation and last but
not the least Achieving Job Satisfaction

Framework of CPD

A graduate of the Bachelor of Science in Nursing (BS)

Program, after passing the Nurse Licensure Examination
(NLE), is classified as a Level 6 professional (Philippines
Qualifications Framework).
NATIONAL NURSING CAREER PROGRESSION
Learning is a continuous process. It is life-long. In PLAN
consonance with the Philippine Qualifications
Framework (PQF) and the ASEAN Qualifications ● Outlines the professional development path for
Reference Framework (AQR), the Continuing nurses.
Professional Development Council (CDC) of the ● Begins with obtaining a nursing degree, followed
Professional Regulatory Board of Nursing (PRBON) by licensure as a Registered Nurse (RN) and
developed a framework to guide service providers in start in clinical roles to gain experience and
crafting their programs for their stakeholders. expertise
● Advancement opportunities include
The Continuing Professional Development (CPD) specialization in areas like pediatrics, critical
programs can be provided through either a combination care, or advanced practice roles.
of formal and/or informal education and self-directed
learning, and through professional work experiences. The National nursing career progression plan aligned
with the Philippine qualifications framework uses Patricia
The CPD programs will utilize the Whole-brain Learning Benner’s Model of Career Path development and the
System model. This model was developed by Dr. Dreyfus Model of Progressive skills acquisition.
Eduardo Morato, Jr. in 2012. Dr. Morato believes that a
person must lap the full faculties of the brain, the heart, The NNCPP uses the Philippine Qualifications
and the spirit to be the best he or she can ever be." framework to assess the competency levels of the nurse
starting from Beginning nurse, advance beginner, RECONFIGURED DREYFUS MODEL AND
competent, proficient and expert. PHILIPPINE QUALIFICATIONS FRAMEWORK

INITIAL PREPARATION IN DREYFUS MODEL AND

PHILIPPINES QUALIFICATIONS FRAMEWORK
 SUMMARY

The 2012 National Nursing Core Competency Standards

(2012 NNCCS) provide a comprehensive framework for
the roles and responsibilities of beginning nurses in the
Philippines wherein it includes standards on client care,
management, leadership, and research. Rooted in
Republic Act No. 9173, or the Philippine Nursing Act of
2002, the legal basis includes empowering the
Professional Regulatory Board of Nursing to monitor and
enforce quality standards in nursing practice which
ensures safe and high-quality care.

Continuing Professional Development (CPD) ensures

regulatory compliance, improves the quality of patient
care, builds confidence and reputation, and ultimately
leads to job satisfaction. The Whole-brain Learning
System model guides the development of CPD programs
using the framework of the National Nursing Career
Progression Plan.

The framework of CPD in the Philippines aligns with the

Philippine Qualifications Framework and the ASEAN
Qualifications Reference Framework, allowing:

● Combination of formal and informal education

● Self-directed learning
● Professional work experiences

In essence, the 2012 NNCCS and the CPD framework

ensure that nurses in the Philippines are well-prepared
to provide safe, high-quality care, continue their
professional development, and contribute to the growth
and advancement of the nursing profession. These
standards are instrumental in maintaining the excellence
of nursing practice and ultimately benefiting the
healthcare system and society as a whole.