COMPREHENSIVE PHASE
HANDOUTS
PROFESSIONAL ADJUSTMENT
Prepared By: Mr. Raymund Kernell B. Mañago, RN, UKRN, USRN
NOVEMBER 2024 Philippine Nurse Licensure Examination Review
INTRODUCTION - Suspension: Cannot practice temporarily (Max: 4
years)
Professional Nursing - Revocation: Cannot practice permanently (Unless
Requirements: approved by BON)
(1) Basic nursing education program
(2) Professional License in PH
Nursing Laws Board Rating
RA 9173 – Philippine Nursing Act of 2002 Gen. ave.: 75%; each subject: 60% 🡪 PASS
RA 7164 – Philippine Nursing Act of 1991 Gen. ave.: 75%; subject: less than 60% 🡪 Retake failed
subject (PASS if 75%)
Board of Nursing Renewal examination: Within 2 years
Members Gen. ave: less than 75% 🡪 FAIL
• Chairperson + 6 members
• Represents 3 areas of nursing: Oathtaking: Final requirement before obtaining license.
1) Nursing Education
2) Nursing Service Professional License/Certificate of Registration (COR)
3) Community Health Nursing - Legal document allowing person to offer skills.
- Forever [unless revoked]
Qualifications License reissuance
• Master’s in Nursing/ Allied Health/ Education - When cause of revocation is corrected.
• Chair: Master’s in Nursing
• 10 yrs Continuous Practice (last 5 yrs in PH) Professional Identification Card (PIC)
• Member of the Accredited Professional - Temporary
Organization (APO) - Renewal: q 3 years, 15 CPD units (5 CPD units per
• APO: Philippine Nurses Association year) - CPD Law (R.A. 10912)
(PNA)
• Good Moral Character Philippine Nurses Association (PNA)
• Not a faculty (conflict of interest) - Accredited professional organization (APO) of
registered nurses
Appointment - PNA Membership not required by law.
(1) Regular Appointment
- by the PH President through Power of Scope of Practice
Appointment - Nursing care (nursing process)
- when Congress is in session - Internal exam (without bleeding)
(2) Ad Interim Appointment - Establish linkage w/ community resources
- appointed in absence of regular incumbent - Health Education
- when Congress NOT in session - Supervise student nurses
(3) Doctrine of Hold-over - Training and research
- Holds office even beyond term until replaced * Episiorrhaphy (perineal suture): requires addtl training
Term Ethics vs Morality
Term: 3 years, Max: 2 terms (1st: appointment, 2nd: Ethics
reappointment) - Rules of conduct based on culture
- External – based on society
Powers and Duties Morality
1) Executive - Personal guide of right or wrong
- Conduct board exam - Internal - personal
- Administer oaths Ethics
- Issue license Code of Ethics for Nurses
-Annual Report • set of principles to guide nurses
• BON Board Resolution No. 220, series of 2004
2) Quasi-legislative • Primary responsibility: Preserve health at all cost.
- Write policies and guidelines Ethical Frameworks
• Deontological (Duty-based): right or wrong is based
3) Quasi-judicial on action, regardless of consequence
- Investigate cases • Teleological: right or wrong is based on
- Issue subpoena (called to hearing) consequence, regardless of action
• Subpoena DUCes tecum: Ethical Principles
DUCument • Most fundamental principle: Respect for people
• Subpoena TESTIFicandum: • Autonomy: voluntary decision
TESTIFy • Beneficence: do good (medications)
- Suspend or revoke license • Non-maleficence: do no harm (asepsis)
(not confiscated) (confiscated) • Justice: fairness, equal risks and benefits
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• Veracity: complete & true info - Abuse of public position
• Confidentiality: data not revealed - Insult to authority
- Anonymity: data not linked to person - Crime in times of calamity
• Paternalism: decision-making for others (in - Treachery
emergency) - Premeditation
• Fidelity: promise-keeping Misdemeanor
• Utilitarianism: greatest good for the greatest 1) Practicing without license
number of people - No license, using license of others
- Forged documents
Moral Principles - Revoked or suspended license
- Double-effect: Benefits > Risks - Appending “B.S.N./R.N.” to name
- Totality: Whole greater than Sum of Parts - Assists someone in illegal practice of nursing
Sacrifice a Part for the good of the Whole.
- Solidarity: Unity of Healthcare team 2) Conducting nursing review classes (local/foreign)
- Stewardship: You are the steward of your own body without BON permit
- Epikia: Exception to the rule (e.g.: restraints, 3) Violates minimum base pay of nurses (Salary grade 15)
evidence needed in court)
Penalties:
Legal Issues/Jurisprudence Fine: P50,000 – P100,000
Civil vs Criminal vs Administrative Cases AND/OR
• Civil: monetary damages Imprisonment: 1-6 years
• Criminal: imprisonment and/or monetary damages
• Administrative: suspension, revocation of license Felony
- Homicide: killing of a person, with intent to kill,
Parties:
• Plaintiff: injured without aggravating circumstances
- Murder: killing of a person, with intent to kill, with
• Defendant: accused
aggravating circumstances
CIVIL CASES
- Aggravating circumstances
- Evident Premeditation
Torts
- Determined to commit
- Legal (civil) wrong
crime
- Two types:
- Clung to determination
- Unintentional
- Time to reflect upon
- Intentional
consequences of act
Unintentional Torts
- Treachery
• Negligence vs Malpractice
- No opportunity to defend
• Negligence: “hindi ginawa ang dapat;
(John Wick 3, homicide
ginawa ang hindi dapat”
only)
• Malpractice: Professional negligence
- Deliberate execution
• Elements (4)
- Cruelty
• Duty
- Additional suffering
• Breach of duty
- Scoffing/Outraging at
• Causation
corpse: “Paglibak sa
• Injury
bangkay”
Intentional Torts
- Prize or reward
• Assault vs Battery
- Killed someone with
• Assault: threat
promise of getting reward
• Battery: physical injury, touching without
- Fire, explosion, poison
consent
- Parricide
• False imprisonment
- Killing relatives by direct line
• Unauthorized restraint of movement
- Father
• Invasion of privacy
- Mother
• Intrusion to personal life
- Child
• Defamation (paninirang-puri/ damage to reputation)
- Spouse
• Libel: written, larger group (general public)
- Legitimate grandparent/grandchild
• Slander: spoken, smaller group
- NOT included: Siblings (Not direct line)
Reqt: 3rd party (reputation is harmed)
- Side note: Legitimacy
CRIMES/ CRIMINAL CASES
- Legitimate: after marriage,
Misdemeanor vs Felony
adoption
• Misdemeanor: lesser crime
- Illegitimate: not married/out of
• Felony: serious crime wedlock
- Legitimated: parents married after
Circumstances in Crimes being born
- Justifying: No civil and criminal liability - Infanticide
- Defense of self or another person - Killing of a child < 3 days old
- Fulfillment of duty - Abortion
- Exempting: No criminal liability - Intentional killing of a fetus in utero
- Insane/Imbecile Stages of Execution
- Under 9 y/o - Attempted – not all elements for execution are
- Under 15 y/o (w/o discernment) present, failed
- d/t Irresistible force/ Force majeure - Consummated – all elements for execution are
- Mitigating: Reducing liability present, succeeded
- Voluntary surrender - Frustrated – all elements for execution are present,
- Provoked but failed
- <18, >70 y/o Conspiracy in Crimes
- Physical defect - Principal
- Aggravating: Increasing liability - By Direct participation
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- Actually executed the act • ✔ Witnesses: ensure
- By Inducement validity of signature
- Commanded, threatened, promised • Patient – spouse – child – parent – sibling – next
a reward of kin
- mastermind, nag-utos 3 exceptions (CANNOT consent)
- Indispensable cooperation 1) Minors: parent’s consent
- “Hindi mangyayari kung wala siya.” 2) Unconscious/Injured (Emergency): implied consent
- Eg. 3) Mentally ill: patient can consent in lucid intervals (periods
- Avoiding security features of mental competence)
- Combination number in
bank vault 3) Medical Records
- Provided weapons/tools • Who owns?
- Accomplice • Record: Hospital (Pt can access
- cooperated in execution of offense through a process)
- Kahit wala siya, magagawa pa rin ang crime • Information: Patient
- Acts not as fatal as principal’s
- Eg. 4) Advance Directives
- Words of encouragement • Health care decisions made in advance in case of
- Physical acts to victim incapacity in the future.
- Giving ADDITIONAL weapons • Living Will: patient decides
- Accessory • Durable Power of Attorney:
- Participated AFTER the crime • Patient appoints person to decide
- Profiting themselves • Aka Health care proxy
- Concealing evidence
- Assist in escape of PRINCIPAL
Liability
• Respondeat superior
• Master responsible for acts of servants
• Employer SHARES liability with employee
• Res ipsa loquitur: “The thing speaks for itself.”
• Obvious accident=Negligence
• Force majeure: acts of nature, uncontrollable forces
• No liability, also called “vis major”
DOCUMENTATION
- Hallmark of Nursing Accountability
- Why? If it is not written, it didn’t happen.
Privileged communication
- Exchange of privileged information between two
parties
- Private and protected
- Right to Refuse Disclosure of information
- Doctor-patient, Lawyer-client, Husband-wife,
Priest-communicant
- Info can be disclosed if:
- If client is in danger (suicide)
- If client is a danger to others (threatens to
kill someone)
1) Incident Reports
• Records of sentinel events
• Sentinel event: Adverse event 🡪 patient
injury/death
• Parts
• Name of client
• Date, time, place of incident
• Facts only. NO interpretations/blame
• Client’s statements
• Written by: (1) committer of error OR (2)
witness to error
• Confidential. Not part of patient’s chart
(protects hospital, not patient)
2) Consent
• Implied vs Express Consent
• Implied: non-verbal
• Gestures/body language
• Express: verbal
• Spoken or written form (informed
consent form)
Informed Consent
• Voluntary
• Informed
• Competent: 18 y/o and above, coherent
• Signature: (1) patient, (2) 2 witnesses
• Nurse:
• X explains procedure
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