PROFESSIONAL ADJUSTMENT INHOUSE  Quality Improvement

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

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

ELEMENTS OF NPA IMMEDIATELY RESIGN from:

 Definition of Professional Nursing  any teaching position in any school, college,
 Requirements for Licensure university/ institution offering Bachelor of Science
 Exemptions in Nursing and/or review program for the local
 Licensure Across Jurisdiction nursing board examinations or in
 Disciplinary  any office/ employment in the government or
 any subdivision, agency or instrumentality thereof,
RA 9173 – An act providing a more responsive including government-owned or controlled
nursing profession. corporations of their subsidiaries as well as
 those employed in the private sector
  He shall not have any pecuniary interest in or detailed account of its proceedings and
administrative supervision over any institution accomplishments during the years and making
offering Bachelor of Science in Nursing including recommendation for the adoption of measures
review classes. that will upgrade and improve the conditions
affecting the practice of nursing profession.
TERM OF OFFICE
 Shall hold office for a term of three (3) years REMOVAL/ SUSPENSION OF BOARD MEMBERS:
and until their successor have been appointed &  The President may remove/suspend any
qualified. member of the Board after having been given the
 Maybe appointed for another term opportunity to defend himself/herself in a proper
 Any vacancy in the Board occurring within the term administrative investigation.
of a member shall be filed for the unexpired
portion of the term only. GROUNDS FOR REMOVAL:
 Each Member of the Board shall take the proper  Continued neglect of duty/ incompetence.
oath of office prior to the performance of his/her  Commission/ toleration of irregularities in the
duties. licensure exam
 Unprofessional, immoral or dishonorable conduct.
COMPENSATION OF THE BOARD
 Shall receive compensation & allowances LICENSURE EXAMINATION
comparable to the compensation & allowances  All applicants for license to practice nursing shall
received by the Chairperson (SG 30) and be required to pass a written examination, which
members (SG 28) of other professional regulatory shall be given by the Board of Nursing in such
boards. places & dates as may be designated by the
Commission: Provided, that it shall be in
ADMINISTRATIVE SUPERVISION OF THE BOARD accordance with RA. 8981, (PRC
 Custodian of its records- including applications Modernization Act of 2000)
for examinations, administrative & other
investigative cases conducted by the Board QUALIFICATIONS FOR ADMISSION TO THE LICENSURE
 Secretariat & support services EXAMINATION
 The commission shall:  He/She is a citizen of the Philippines, or a
 designate the Secretary of the Board citizen or subject of a country which permits
 Provide Secretariat & other support Filipino nurses to practice within its territorial
services to implement the provision of this limits on the same basis as the subject or
act. citizen of such country.
Provided, that the requirements for
POWERS & DUTIES OF THE BOARD registration or licensing of nurses in said
 Conduct licensure examination for nurses country are substantially the same as
 Issue, suspend & revoke certificates of registration those prescribed in this Act.
for the practice of nursing.  He / She is of good moral character
 Monitor & enforce quality standards of nursing  He / She is a holder of Bachelor’s degree in
practice in the Philippines & exercise powers Nursing from a college/ university that complies
necessary to ensure the maintenance of efficient, with the standards of Nursing Education duly
ethical and technical, moral & professional recognized by the proper government agency.
standard in the practice of nursing taking into
FEES FOR EXAMINATION & REGISTRATION:
account the health needs of the nation.
 Applicants for licensure and for registration shall
 Conduct hearings & investigations to resolve pay the prescribed fees set by the Commission.
complaints against nurse practitioners for unethical
& unprofessional conduct & violations of this Act, or SCOPE OF EXAMINATION
its rules & regulations and in connection therewith,  The scope of Examination for the practice of
issue subpoena ad testificadum and Nursing in the Philippines shall be determined by
subpoena duces tecum. the Board
 Promulgate a Code of Ethics in coordination &  The Board shall take into consideration the
consultation with the accredited professional objectives of the nursing curriculum, the broad
organization within one (1) year from the areas of nursing and other related disciplines &
effectivity of this Act competencies in determining the subjects of the
 Recognize nursing specialty organizations in examinations.
coordination with the accredited professional
organization.

RATINGS
 General Average: at least 75% with a rating of not
Who has the authority to OPEN & CLOSE colleges below 60% in any subject.
and/or nursing education programs?  Average rating of 75% or higher but gets a rating
 shall be vested on the Commission on Higher below 60% in any subject must take the
Education upon the written recommendation of the examination again but only in the subject/
Board subjects where he/she is rated below 60%
ANNUAL REPORT  In order to pass the examination, an examinee
 The Board shall at the close of its calendar year must obtain a rating of at least 75% in the
submit an annual report to the President of the subject/subjects repeated.
Philippines through the Commission giving a
OATH GROUNDS FOR NON-REGISTRATION & NON ISSUANCE
 ALL successful candidates shall be required to OF CERTIFICATES OF REGISTRATION/ PROFESSIONAL
take an oath of profession before the Board or any LICENSE OF SPECIAL/ TEMPORARY PERMIT
government official authorized to administer oaths  convicted by final judgment of any criminal offense
prior to entering upon the nursing practice. involving moral turpitude
 guilty of immoral or dishonorable conduct
ISSUANCE OF CERTIFICATES OF REGISTRATION/  declared by the court to be of unsound mind.
PROFESSIONAL LICENSE & PROFESSIONAL
IDENTIFICATION CARD. GROUNDS FOR REVOCATION & SUSPENSION OF
 A certificate of registration / professional license as CERTIFICATE OF REGISTRATION/ PROFESSIONAL
a nurse shall be issued to an applicant who passed LICENSE & CANCELLATION OF SPECIAL/ TEMPORARY
the examination upon payment of the prescribed PERMIT
fees.  Any of the causes under no registration
 Unprofessional & unethical conduct
CERTIFICATE OF REGISTRATION/ PROFESSIONAL  Gross incompetence / serious ignorance
LICENSE  Malpractice/ negligence in the practice of nursing
 Use of fraud, deceit, or false statements in
Shall show the ff:
obtaining a certificate of registration/ professional
 Full name of the registrant
license or a temporary/ special permit.
 Serial number
 For practicing his/her profession during his/her
 Signature of the Chairperson of the Commission suspension from such practice
and Members of the Board  Provided, however, that the suspension of the
 Official seal of the Commission certificate of registration/ professional license shall
be for a period not to exceed four (4) years.
PROFESSIONAL IDENTIFICATION  For violation of this Act, the rules & regulations,
CARD Code of Ethics for nurses & technical standards for
nursing practice, policies of the Board and the
 Duly signed by the Chairperson of the Commission
Commission, for the conditions and limitations for
 Date of Registration
the Issuance of the temporary/ special permit.
 License Number
 Date of Issuance
 Date of Expiration
RE-ISSUANCE OF REVOKED
CERTIFICATED & REPLACEMENT OF
AUTOMATIC REGISTRATION OF LOST CERTIFICATES.
 The Board may, after the expiration of a maximum
NURSES four (4) years from the date of revocation of a
 All nurses whose names appear at the roster of certificate, for reasons of equity & justice and
nurses shall be automatically or IPSO FACTO when the cause for revocation has disappeared
registered as nurses under this Act upon its or has been cured and corrected, upon
effectivity. application thereof and the payment of the
required fees, issue another copy of the certificate
REGISTRATION BY RECIPROCITY of registration/ professional license.
A certificate of registration/ professional license
may be issued without examination to nurses WHEN REGISTRATION CARDS/ ID’s ARE
registered under the laws of a foreign state or LOST/ DAMAGED
country; Provided, that the requirements for  A new certificate of registration/ professional
registration or licensing of nurses in said country license to replace the certificate that has been lost,
are substantially the same as those prescribed destroyed or mutilated may be issued subject to
under this Act. the rules of the Board. (Affidavit of Loss or
Provided, further, that the laws of such state or Affidavit of Destruction)
country grant the same privileges to registered
nurses of the Philippines on the same basis as the
REQUIREMENTS FOR INACTIVE NURSES
subjects or citizens of such foreign state or country.
RETURNING TO PRACTICE
PRACTICE THROUGH TEMPORARY PERMIT  Nurses who have not actively practiced the
profession for five (5) consecutive years are
Licensed nurses from foreign countries/ states
required to undergo 1 month of didactic training
whose services are either for a fee or free if they
& 3 mos of practicum.
are internationally well-known specialists or
outstanding experts in any branch or specialty of QUALIFICATIONS OF THE FACULTY
nursing.  RN in the Philippines
Licensed nurse from foreign countries/states on  At least 1 year of clinical practice in a field of
medical mission whose services shall be free in a specialization
particular hospital, center or clinic.  Member of good standing in the APO
Licensed nurses from foreign countries/ states  Holder of Master’s degree in nursing, education or
employed by school/ colleges of nursing as other allied medical & health sciences conferred by
exchange professors in a branch or specialty of the college or recognized university.
nursing.
Provided, however, that the special/temporary QUALIFICATIONS OF THE DEAN
permit shall be effective only for the duration of the In addition to aforementioned qualifications;
project, medical mission or employment contract. Must have Master’s degree in nursing
At least 5 years’ experience in Nursing
QUALIFICATIONS OF NURSING SERVICE LEGAL RIGHTS- A claim that can be enforced by
ADMINISTRATORS legal means against the persons or the community whose
 RN in the Philippines duty is to respect it.
 At least 2 years’ experience in general nursing
service HUMAN RIGHTS – Are items which are a
 BSN degree & at least 9 units in management person’s due as a member of a society
and administration courses at the graduate level
 Member of good standing of APO.
ACCOUNTABILITY- being answerable when
carrying out professional responsibilities
QUALIFICATIONS OF CHIEF NURSE OR DIRECTOR OF
NURSING SERVICE
In addition to aforementioned qualifications: LIABILITY- Being legally bound
 At least 5 years of experience in a supervisory
or managerial position in nursing RESPONSIBILITY- an obligation to perform some
 Master’s degree in nursing act for which one can be held answerable.
 General Staff Course for chief nurse in a military
hospital
 Those occupying such positions are given 5 years
PATIENT’s BILL OF RIGHTS
to qualify.
1. Right to Medical Care & Humane Treatment
DUTY OF THE NURSE: 2. Right to Informed Consent- right to clear
 Provide nursing care through utilization of nursing explanation, in lay man’s term all proposed procedures
process including identity of the person who will perform such
 Nursing care include but not limited to, procedure, the risks and benefits involved in the procedure.
traditional and innovative approaches, 3. Right to Privacy- the right to be left alone when this
therapeutic use of self, executing health care will not prejudice the provision of necessary medical care.
techniques & procedures, essential primary 4. Right to Information- right to clear, complete and
health care, comfort measures, health accurate evaluation of the nature and extent of his disease,
teachings & administration of written the contemplated medical treatment and surgical
presentation for treatment, therapies, oral, procedure.
topical and parenteral medications, internal
5. Right to Privileged Communication- to expect all
examination during labor in the absence of
communication and records pertaining his care should be
antenatal bleeding and delivery.
treated confidential.
 In case of SUTURING of PERINEAL
LACERATION, special training shall be 6. Right to Choose Physician to serve him - except
provided according to the protocol established. when he is confined in a charity ward, when he has entered
 Establish linkages with community resources into contract with a health maintenance organization or any
and coordination with health team health insurance org. which stipulates that his doctor should
 Provide health education be affiliated with them.
 Teach, guide and supervise students in nursing 7. Right to Self Determination- the right to refuse
education programs treatment or diagnostic procedures.
 Undertake nursing & health human resource 8. Right to Religious Belief
development, training and research, which shall
9. Right to Medical Records- a summary of his
include, but not limited to, the development of
medical history and condition to be accomplished by his
advanced nursing practice.
attending physician
COMPREHENSIVE NURSING SPECIALTY PROGRAM 10. Right to Leave- to leave the hospital regardless of
The Board in coordination with the APO, his physical condition.
recognized nursing specialty organizations and 11. Right to Refuse Participation in Medical
DOH- formulate or develop nursing specialty Research
programs upgrade level of skill and
12. Right to Correspondence and Receive
competence of specialty nurse clinicians.
Beneficiaries are obliged to serve in any Visitors
Philippine hospital for a period of at least 2 13. Right to Express Grievances about the care &
years of continuous service. services received
14. Right to be Informed of his Rights and
THE 5 ESSENTIAL DRUGS UNDER THE MDRP
 Amlodipine for hypertension Obligations as a patient
15. Right to choose his own physician.
 Atorvastatin for anti-cholesterol
 Azithromycin as antibiotic/ antibacterial
 Cytarabine & Doxorubicin and all its salt
NURSE’S BILL OF RIGHTS (ANA Board of
Directors, JUNE 26, 2001)
form both for anti-neoplastics/ anti-cancer
Nurses have the right:
1. To practice in a manner that fulfills their obligations to
LEGAL RESPONSIBILITIES OF THE NURSE
society.
2. To practice in environments that allow them to act in
LAW- rules made by humans that regulate social conduct accordance with professional standards and legally
in a formally prescribed & legally binding manner authorized scope of practice.
3. To a work environment that supports and facilitates
DEFINITION OF TERMS ethical practice in accordance with the Code of Ethics for
Nurses.
4. To freely and openly advocate for themselves and their  Delegate tasks to persons with the knowledge and
patients without fear of retribution. skill to carry them out.
5. To a fair compensation for their work, consistent with  Build and maintain good rapport with patients.
their knowledge, experience and professional
responsibilities. DAMA (Discharge Against Medical Advice)
6. To a work environment that is safe for themselves and
 The right to refuse treatment includes the right to
their patients.
leave the hospital against medical advice.
7. To negotiate the conditions for their employment, either
as individuals or collectively, in all practice settings.  Recognize a potential patient walk-out

Additional Right from the Nurse’s Lounge Website If the patient insist on leaving…
(Nursing Power Website – Accessed 1/31/05)  Follow the policy of the hospital regarding DAMA
8. Not to be abused in any form by physicians, pharmacists,  If the hospital doesn’t have a policy about DAMA:
administrators or nursing directors. 1. Contact the patient’s SO and explain
9. Not to be exploited and abused by being floated to areas 2. Explain the hospital’s DAMA procedure to the
of practice they are not familiar with. patient
10. To refuse any assignment that they feel is unsafe. 3. Give the client a DAMA form and ask the
patient to sign
4. Provide routine discharge care.
IMPLEMENTING MEDICAL ORDERS
OR REFERRALS Dealing w/ an ESCAPEE / ABSCONDEE
 Notify the nursing supervisor and security
RA 6675 - Only valid registered medical, dental and immediately
 Notify patient’s family
veterinary practitioners are authorized to prescribed drugs.
 Collect patient’s belongings and document it.
 prescribed drugs be written for their GENERIC
NAMES.
INFORMATION should include:
RA 2832 & RA 4419 – Prescriptions made by  Description of the treatment procedure
 Name and qualification of the person who will
unauthorized persons constitute illegal practice of medicine,
perform the procedure.
dentistry and veterinary medicine.
 Benefits and risks involved
 Alternative treatment or procedure
CARRYING OUT PHYSICIAN’S ORDER
 Possible effects of not having the treatment or
 ONLY when the orders concerning treatment and
procedure.
medications are IN WRITING and bear the MD’s
SIGNATURE does the nurse have the legal right to
follow it. SENIOR CITIZENS ACT
 It is expected that nurses know the basic
information about procedures and medications
RA 7432
ordered by the physician.  Senior Citizens Act, gives honor and justice to the
 It is the responsibility of the nurse to clarify elderly, giving them 20% discount in all public
ambiguous or seemingly erroneous orders from establishments such as restaurants, pharmacists,
the prescribing MD and/then to other sources. public utility vehicles and hospitals.

THE ORDERS THAT NURSES MUST RA 9257

QUESTION TO PROTECT THEMSELVES  Expanded Senior Citizens Act of 2003
amending RA 7432
LEGALLY:
 Question any order the patient questions
 Question any order if the patient’s condition has
PRIVILEGES FOR THE SENIOR CITIZENS
changed.  20% discount for all establishments relative to
the utilization of services in hotels or similar lodging
 Question and record verbal orders to avoid
miscommunications establishments, restaurants and recreation
centers, purchase of medicines in all establishment
 Question standing orders especially if the nurse is
inexperienced. for the exclusive use or enjoyment of senior
citizens including funeral and burial services for the
IMPLEMENTING DELEGATED & death of senior citizens.
INDEPENDENT NURSING INTERVENTIONS  EXCEPTION from payment of income taxes
 Function within the scope of your education, job  FREE medical and dental services, diagnostic
description and area nurse practice act. and laboratory fees in government facilities; 20%
 Follow the procedure and policies of the employing discount in private facilities.
institution  20% discount in fare for domestic air and sea
 Observe and monitor the patient accurately travel, public railways, skyways and bus fares.
 Communicate and record significant changed in  Provision for express lanes for senior citizens
the patient’s condition to the physician.
 Check any orders that a patient questions. RA 9994
 Identify patients before initiating interventions
 Protect patients from falls and preventable injuries
 Amended RA 7432 exemption from paying
 Document all nursing assessments and the Value Added Tax for goods and services
interventions accurately produced by a senior citizen.
 Ask for assistance and supervision in situations for
which you feel inadequately prepared. LEGAL LIABILITIES IN NURSING PRACTICE
The Judicial Process  Employee or contractor for service
 Citizen
 functions to settle disputes peacefully and in
accordance with the law
AREAS OF POTENTIAL LIABILITY IN
STEPS IN THE JUDICIAL PROCESS NURSING

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

(3) DISCOVERY Classification

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

LEGAL DEFENSE IN NEGLIGENCE

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

SOME QUESTIONS

1. As a registered nurse, which of the following

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

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

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

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

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

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

30. When a politician takes advantage of his

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

31. Each professional nurse must be legally

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

32. Which of the following principles apply to

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