COMMUNITY

HEALTH
NURSING
FINALS
2024 1
SCREENING
BEmoNC,
CEmoNC,
mhGAP, 2
 COGNITIVE
Describe the testing used for NBS
and for diagnosing inborn errors of
metabolism
Justify the purpose of newborn
screening.
Recognize the protocols of NBS.
Differentiate the difference
between Newborn Screening and
NBS
3
 AFFECTIVE PSYCHOMOTOR
Listen attentively
during discussion.
Listen
Take part in discussion
attentively and group activities.
during Apply health evaluation
appropriate for health
discussion. care needs of the
patient.
Express opinions and
thoughts about NBS
protocol.
4
NBS
 NBS
The Comprehensive Newborn Screening (NBS) Program was
integrated as part of the country’s public health delivery system
with the enactment of the Republic Act no. 9288 otherwise
known as Newborn Screening Act of 2004.
The Department of Health (DOH) acts as the lead agency in the
implementation of the law and collaborates with other National
Government Agencies (NGA) and key stakeholders to ensure
early detection and management of several congenital metabolic
disorders, which if left untreated, may lead to mental retardation
and/or death.
Early diagnosis and initiation of treatment, along with
appropriate long-term care help ensure normal growth and
development of the affected individual.
It has been an integral part of routine newborn care in most
developed countries for five decades, either as a health directive
or mandated by law.
5
It is also a service that has been available in the Philippines
NBS
 NBS
VISION

The National Comprehensive Newborn

Screening System envisions all Filipino
children will be born healthy and well, with
an inherent right to life, endowed with
human dignity; and reaching their full
potential with the right opportunities and
accessible resources
6
NBS
 NBS
MISSION

To ensure that all Filipino children

will have access to and avail of
total quality care for the optimal
growth and development of their
full potential.
7
NBS
 NBS
GOAL

To reduce preventable deaths of

all Filipino newborns due to more
common and rare congenital
disorders through timely
screening and proper
management NBS
8
 NBS
What is newborn screening?

Newborn Screening (NBS) is a simple

procedure to find out if your baby has
a congenital disorder that may
lead to mental retardation or even
death if left untreated.

9
NBS
 NBS
What is Expanded Newborn
Screening (ENBS)?
The expanded newborn screening pro
gram increased the screening panel
of disorders from six (6) to more than
twenty-eight.
Expanded newborn screening costs
₱1750 and is included in the Newborn
Care Package (NCP) for PhilHealth
NBS
10
 NBS
Why is it important?
Most babies with metabolic disorders
look “normal” at birth. By doing
ENBS, metabolic disorders may be
detected even before clinical signs
and symptoms are present. As a
result of this, treatment can be given
early to prevent consequences of
untreated conditions.
NBS
11
 NBS
When is it done?
ENBS is ideally done immediately after 24
hours from birth.

How is it done?
A few drops of blood are taken from the
baby’s heel, blotted on a special
absorbent filter card and then sent to
Newborn Screening Center (NSC).
NBS
12
 NBS
Who will collect the sample for
ENBS?
The blood sample for ENBS may be
collected by any of the following:
physician, nurse, medical
technologist or trained midwife.

Where is ENBS available?

ENBS is available in hospitals,
lying-ins, rural health units, health
NBS
13
 NBS
What is Newborn Care
Package?
NCP is a PhilHealth benefit
package for essential health
services of the newborn during
the first few days of life. It
covers essential newborn care,
expanded newborn screening,
NBS
14
 NBS
What are the eligibility conditions for
newborn to avail of the NCP?
Newborns are eligible for NCP if ALL of the
following are met:
• Either of the parents are eligible to avail
of the benefits,
• Born in accredited facilities that perform
deliveries, such as hospitals and birthing
homes; and
• Services were availed of upon delivery. 15
NBS
 NBS
How can results be claimed?
Results can be claimed from the health
facility where ENBS was availed. Normal ENBS results
are available by 7 - 14 working days from the time
samples are received at the NSC.
Positive ENBS results are relayed to the parents
immediately by the health facility. Please ensure that
the address and phone number you will provide to the
health facility are correct.

What is the meaning of the newborn screening re

sult?
A NEGATIVE SCREEN means that the ENBS result is no
NBS
16
 NBS
What must be done when a baby has a positi
ve ENBS result?
Babies with positive results must be referred at
once to a specialist for confirmatory testing and
further management.
What happens to the dried blood samples aft
er screening?
After the dried blood spot has been tested, it will
be stored in a secure locked area.
The stored sample is retained to allow for normal
quality assurance and may be used for ethics
committee approved researches for the benefit
17
NBS
NBS

18
NBS
BEmoNC,
CEmoNC,
19
BEmoNC, CEmoNC
Basic Emergency Obstetric and Newborn Care
(BEmONC) provider Facilities
A BEmONC provider facility is a primary level health
facility tasked to provide the integrated MNCHN
service package that include basic emergency
obstetric and newborn care (BEmONC) and is either a
–
a. Barangay health station (BHS),
b. Rural health unit (RHU),
c. Lying-in clinic,
d. Birthing home,
e. District hospital, or
f. Any other similar structure.
BEmoNC, CEmoNC
20
 BEmoNC, CEmoNC
To enable the BHS and RHU BEmONC providers to
respond to the access factors and function effectively, the
following amenities should be considered in its structural
design:
a. Delivery room
b. At least a 2-bed capacity Ward: 1 bed for the mother
and newborn and another bed with a “pull-a-bed”
feature for the birth companion and small children. The
ward also doubles as a labor room.
c. A small kitchen appropriately furnished.
d. A toilet and bath with appropriate fixtures.
e. A sleeping quarter for health staff.
f. A waste management facility that includes a placenta
BEmoNC, CEmoNC
21
 BEmoNC, CEmoNC
Hospital BEmONCs Hospital BEmONC providers shall
offer the same amenities except for the structural
design which should include:
a. Labor room appropriately furnished
b. Delivery room
c. A scrub room for the doctors and nurses
d. A maternity ward with rooming-in feature for the
newborn
e. A toilet and bath with appropriate fixtures
f. A sleeping quarter for health staff
g. A waste management system that includes a
placenta pit BEmoNC, CEmoNC
22
 BEmoNC, CEmoNC
BEmONC provider facilities are made
attractive and comfortable with privacy and
space for an accompanying “birth companion”
(family member, friend, TBA or BHW) as well
as for minor children in cases where leaving
them at home is not possible.

CEmONC provider facilities are

departmentalized according to medical
specialties and are usually large, adequately
and appropriately equipped and staffed by
competent CEmONC Teams (CTs). Clients
BEmoNC, CEmoNC
23
 BEmoNC, CEmoNC
The CEmONC Teams and the Itinerant Teams (ITs) are based in
these facilities. Its structural design features the following
amenities:
a. Emergency Room
b. Admission Room
c. Pharmacy
d. Well equipped laboratory
e. Blood station appropriately equipped and furnished
f. Labor room
g. Delivery room
h. An obstetric operating room
i. Sterilization or autoclave room
j. A recovery room
k. A Newborn Intensive Care Unit
l. A breastfeeding lounge
m. A scrub room for the doctors and nurses 24
BEmoNC, CEmoNC
 BEmoNC, CEmoNC
All health facilities providing emergency obstetric and
newborn care (BEmONC and CEmONC) should be
equipped with:
a. Radio or telephone for easy contact with a
designated higher-level facility should advice or referral
be needed
b. An emergency transport system that is based at the
facility or community for a reasonable fee.

Since CEmONC and hospital BEmONC providers also

caters to other cases, small children are not allowed to
accompany their mothers to the hospital. This is to
protect them from hospital- acquired infections. In this
25
regard, an arrangement should be made with the
BEmoNC, CEmoNC
 BEmoNC, CEmoNC
B. Equipment Requirements Emergency
Obstetric and Newborn Care (EmONC)
provider facilities should have the required
vital equipment to enable them to deliver
quality WHSM services to clients. Vital
equipment are the most basic equipment
needed to operate BEmONC and CEmONC
provider facilities in accordance with the
standards of the service delivery model
and are considered “first priority” in
BEmoNC, CEmoNC
26
BEmoNC, CEmoNC
Basic Emergency Obstetric and Newborn Care Equipment
a. Vital Equipment
1) Vaginal speculum set of 6
2) NSD Kit (that contains: artery forceps or clamp, dissecting
forceps, needle holder, scissors, sterile disposable gloves,
urinary catheter, sponge forceps, vaginal speculum, sterile
blade, absorbable sutures, sterile cord clamp, plastic sterile
disposable sheet for the mother)
3) Adult ambubag
4) Pediatric ambubag + mask
5) Simpson’s forceps (optional)
6) Suction machine portable 2 L capacity
7) Oxygen tank with regulator/gauge
8) Spare oxygen gauge
9) Kelly pad
10) Bassinet 27
BEmoNC, CEmoNC
BEmoNC, CEmoNC
Basic Emergency Obstetric and Newborn Care Equipment
a. Vital Equipment
11) Cervical inspection set
12) NSV (no scalpel vasectomy) set
13) IUD (intra-uterine device) kit
14) Cut down or minor surgical set
15) Microscope
16) Nebulizer
17) Pediatric stethoscope
18) Doppler
19) Baby weighing scale
20) Non-mercury pediatric sphygmomanometer
21) Non- mercury body thermometer
22) Mucus extractor (bulb suction apparatus)
28
BEmoNC, CEmoNC
BEmoNC, CEmoNC
Basic Emergency Obstetric and Newborn Care
Equipment
b. Furniture and Fixtures
1) Delivery bed with stirrups
2) Bassinet
3) Revolving stool
4) Droplight
5) Emergency light
6) Ward beds with side railings
7) IV stand
29
BEmoNC, CEmoNC
BEmoNC, CEmoNC
Comprehensive Emergency Obstetric and Newborn Care
Equipment
1.) Vital Equipment
1.) Vaginal speculum set of 6
2.) Laparotomy pack (caesarian section kit)
3.) Portable anesthesia machine
4.) Incubator
5.) Transport incubator (optional)
6.) Curettage set
7.) NSD kit (that contains: artery forceps or clamp,
dissecting forceps, needle holder, scissors, sterile
disposable gloves, urinary catheter, sponge forceps,
vaginal speculum, sterile blade, absorbable sutures,
sterile cord clamp, plastic sterile disposable sheet for
30
the mother) BEmoNC, CEmoNC
BEmoNC, CEmoNC
Comprehensive Emergency Obstetric and
Newborn Care Equipment
1.) Vital Equipment
9.) Suction machine (portable 2 L capacity)
10.) Pediatric ambubag + mask
11.) Simpsons forceps
12.) Suction machine (mobile 6 L capacity)
13.) Oxygen tank with regulator /gauge
14.) Nitrous oxide with regulator/gauge
15.) Cervical inspection set
16.) BTL (bilateral tubal ligation) set
17.) IUD (intra-uterine device) kit
18.) Microscope
31
BEmoNC, CEmoNC
BEmoNC, CEmoNC

32
BEmoNC, CEmoNC
BEmoNC, CEmoNC

33
BEmoNC, CEmoNC
mhGAP
34
 COGNITIVE
Describe the Mental Health
Global Action Program
List several objectives of
mhGAP.
Enumerate the Rights of
Mental Health Professionals
35
 AFFECTIVE PSYCHOMOTOR
Listen 1. Take part in
attentively discussion and
during group activities.
discussion. 2. Confidently
Demonstrate express personal
tact and opinion about the
respect when topic.
challenging
other people’s
opinion and 36
 mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

In 2008, WHO launched the mental health gap

action programme (mhGAP) in response to the
wide gap between the resources available and
the resources urgently needed to address the
large burden of mental, neurological, and
substance use disorders globally. Through
mhGAP, WHO aims to provide health planners,
policy-makers, and donors with a set of clear
and coherent activities and programmes for
scaling up care for mental, neurological and
substance use disorders.
mhGAP 37
 mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

WHO recognizes the need for action to reduce

the burden, and to enhance the capacity of
Member States to respond to this growing
challenge.
mhGAP is WHO’s action plan to scale up services
for mental, neurological and substance use
disorders for countries especially with low and
lower middle incomes.
The priority conditions addressed by mhGAP are:
depression, schizophrenia and other psychotic
disorders, suicide, epilepsy, dementia, disorders
due to use of alcohol, disorders due to use of
illicit drugs, and mental disorders in children.
The mhGAP package consists of interventions for
mhGAP 38
mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

Successful scaling up is the joint

responsibility of governments, health
professionals, civil society, communities,
and families, with support from the
international community.
The essence of mhGAP is building
partnerships for collective action.
A commitment is needed from all
partners to respond to this urgent public
health need and the time to act is now!
mhGAP 39
 mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

THE TREATMENT GAP

Mental, neurological, and substance use
disorders are highly prevalent in all
regions of the world, and they are major
contributors to disease, premature death,
and disability worldwide.
They are also frequently associated with
high levels of stigma and human rights
violations, particularly in low- and middle-
income countries. mhGAP 40
mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

Objectives of mhGAP
The development of the mental health action
programme (mhGAP) reflects WHO’s
commitment to closing this gap by scaling up
care for mental health and substance use
disorders. The key objectives of the action
programme are:
to reinforce the commitment of governments,
international organizations, and other
stakeholders to increase the allocation of
financial and human resources for care of
mental health and substance use disorders.
mhGAP 41
 mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

Objectives of mhGAP
to achieve much higher coverage with key
interventions in the countries with low and
lower middle incomes that have a large
proportion of the global burden of mental
health and substance use disorders.
Through these objectives, mhGAP provides
evidence-based guidance and tools to
advance toward achieving the targets of the
mental health action plan 2013-2020.
mhGAP 42
 mhGAP (MENTAL HEALTH GLOBAL ACTION
PROGRAM)

[REPUBLIC ACT NO. 11036]

AN ACT ESTABLISHING A NATIONAL MENTAL
HEALTH POLICY FOR THE PURPOSE OF
ENHANCING THE DELIVERY OF INTEGRATED
MENTAL HEALTH SERVICES, PROMOTING AND
PROTECTING THE RIGHTS OF PERSONS
UTILIZING PSYCHIATRIC, NEUROLOGIC AND
PSYCHOSOCIAL HEALTH SERVICES,
APPROPRIATING FUNDS THEREFOR, AND FOR
OTHER PURPOSES
mhGAP 43
PUBLIC
HEALTH
LAWS
44
 COGNITIVE
Describe the Public Health Laws
under the Community Health
Nursing
List several Public Health Laws that
affects the people in the
Community.
Enumerate the types of water
sanitation PUBLIC HEALTH LAWS 45
 AFFECTIVE PSYCHOMOTOR
1. Take part in
Listen discussion
attentively
during and group
discussion. activities.
Demonstrate 2.
tact and Confidently
respect when
challenging express
other people’s PUBLIC HEALTH LAWS personal 46
 LAWS
Laws Affecting Public Health and Practice of CHN
R.A. 7160 – or the Local Government Code
This involves the devolution of powers, functions and
responsibilities to the local government both rural & urban.
The Code aims to transform local government units into
self-reliant communities and active partners in the
attainment of national goals thru’ a more responsive and
accountable local government structure instituted thru’ a
system of decentralization. Hence, each province, city and
municipality has a LOCAL HEALTH BOARD (LHB) which is
mandated to propose annual budgetary allocations for the
47
operation and maintenance of their own health facilities.
PUBLIC HEALTH LAWS
 LAWS
Composition of LHB
Provincial Level
Governor- chair
Provincial Health Officer – vice chairman
Chairman, Committee on Health of
Sangguniang Panlalawigan
DOH representative
NGO representative
48
PUBLIC HEALTH LAWS
 LAWS
City and Municipal Level
Mayor – chair
MHO – vice chair
Chairman, Committee on Health of
Sangguniang Bayan
DOH representative
NGO representative
49
PUBLIC HEALTH LAWS
 LAWS
Effective Local Health System
Depends on:
The LGU’s financial capability
A dynamic and responsive political
leadership
Community empowerment 50
PUBLIC HEALTH LAWS
 LAWS
R.A. 2382 –
Philippine Medical
Act.
This act defines the
practice of medicine in
51
PUBLIC HEALTH LAWS
 LAWS
R.A. 1082 – Rural Health Act.
It created the 1st 81 Rural Health Units.
amended by RA 1891; more physicians,
dentists, nurses, midwives and sanitary
inspectors will live in the rural areas
where they are assigned in order to raise
the health conditions of barrio
people ,hence help decrease the high
incidence of preventable diseases
PUBLIC HEALTH LAWS
52
 LAWS
R.A. 6425 – Dangerous
Drugs Act
It stipulates that the sale,
administration, delivery,
distribution and
transportation of prohibited 53
PUBLIC HEALTH LAWS
 LAWS
R.A. 9165 – the new Dangerous Drug Act of
2002
This Act repealed Republic Act No. 6425,
otherwise known as the Dangerous Drugs Act of
1972, as amended, and providing funds for its
implementation. Under this Act, the Dangerous
Drugs Board (DDB) remains as the policy-making
and strategy-formulating body in planning and
formulation of policies and program on drug
prevention and control.
54
PUBLIC HEALTH LAWS
 LAWS
P.D. No. 651
Requires that all health
workers shall identify and
encourage the registration
of all births within 30 days
following delivery. 55
PUBLIC HEALTH LAWS
 LAWS
P.D. No. 996
Requires the compulsory
immunization of all children
below 8 yrs. of age against
the 6 childhood
immunizable diseases. 56
PUBLIC HEALTH LAWS
 LAWS
P.D. No. 825
Provides penalty for
improper disposal of
garbage.
57
PUBLIC HEALTH LAWS
 LAWS
S.A. 8749 – Clean Air Act
of 2000
a comprehensive air quality
management policy and
program which aims to
achieve and maintain 58
PUBLIC HEALTH LAWS
 LAWS
P.D. No. 856 – Code on
Sanitation
It provides for the control of all
factors in man’s environment that
affect health including the quality
of water, food, milk, insects,
animal carriers, transmitters of
disease, sanitary and recreation
PUBLIC HEALTH LAWS
59
 LAWS
R.A 6758
Standardizes the salary
of government
employees including the
nursing personnel.
60
PUBLIC HEALTH LAWS
 LAWS
R.A. 6675 – Generics Act of
1988
Which promotes, requires and
ensures the production of an
adequate supply, distribution,
use and acceptance of drugs
and medicines identified by their
PUBLIC HEALTH LAWS
61
 LAWS
R.A. 6713 – Code of Conduct and Ethical
Standards of Public Officials and
Employees
It is the policy of the state to promote high
standards of ethics in public office.
Public officials and employees shall at all times
be accountable to the people and shall
discharges their duties with utmost
responsibility, integrity, competence and
loyalty, act with patriotism and justice, lead
PUBLIC HEALTH LAWS
62
 LAWS
R.A. 7305 – Magna Carta for Public Health
Workers
This act aims: to promote and improve the
social and economic well-being of health
workers, their living and working conditions
and terms of employment; to develop their
skills and capabilities in order that they will be
more responsive and better equipped to
deliver health projects and programs; and to
encourage those with proper qualifications and
PUBLIC HEALTH LAWS
63
 LAWS
R.A. 8423
Created the Philippine
Institute of Traditional
and Alternative
Health Care.
PUBLIC HEALTH LAWS
64
 LAWS
P.D. No. 965
Requires applicants for
marriage license to
receive instructions on
family planning and
responsible parenthood.
PUBLIC HEALTH LAWS
65
 LAWS
P.D. NO. 79
Defines, objectives,
duties and functions
of POPCOM
66
PUBLIC HEALTH LAWS
 LAWS
RA 4073
advocates home
treatment for leprosy

67
PUBLIC HEALTH LAWS
 LAWS
Letter of Instruction No.
949
legal basis of PHC dated
OCT. 19, 1979
promotes development of
health programs on the
PUBLIC HEALTH LAWS
68
 LAWS
RA 3573
Requires reporting of all
cases of communicable
diseases and
administration of
prophylaxis
PUBLIC HEALTH LAWS
69
 LAWS
Ministry Circular
No. 2 of 1986
includes AIDS as
notifiable disease
70
PUBLIC HEALTH LAWS
 LAWS
R.A. 7875 – National Health
Insurance Act
An act instituting a national health
insurance program for all Filipinos
and establishing the
Philippine Health
Insurance Corporation for the
71
PUBLIC HEALTH LAWS
 LAWS
R.A. 7432 – Senior Citizens
Act
An act to maximize the
contribution of senior citizens to
nation building, grant benefits
and special privileges and for
other purposesPUBLIC HEALTH LAWS
72
 LAWS
R.A. 7719 – National Blood
Services Act
promotes voluntary blood
donation to provide sufficient
supply of safe blood and to
regulate blood banks. This act aims
to inculcate public awareness
73
PUBLIC HEALTH LAWS
 LAWS
R.A. 8172 – Salt Iodization Act
(ASIN LAW)
This Act requires the addition of
iodine to all salt intended for animal
and human consumption in order to
eliminate micronutrient
malnutrition in the country.
74
PUBLIC HEALTH LAWS
 LAWS
R.A. 7277- Magna Carta
for PWD’s
provides their rehabilitation,
self development and self-
reliance and integration into
the mainstream of society 75
PUBLIC HEALTH LAWS
 LAWS
A. O. No. 2005-0014- National Policies
on Infant and Young Child Feeding:
All newborns be breastfeed within 1 hr
after birth
Infants be exclusively breastfeed for 6
months.
Infants be given timely, adequate and
safe complementary foods
Breastfeeding be continued up to 2 years
PUBLIC HEALTH LAWS
76
 LAWS
EO 51- Phil. Code of Marketing
of Breast milk Substitutes
regulates the marketing of
infant milk formula,
other milk products, foods and
beverages, as well
as feeding bottles and teats
77
PUBLIC HEALTH LAWS
 LAWS
R.A. – 7600 – Rooming In and
Breastfeeding Act of 1992
An act providing incentives to all
government and private health institutions
with rooming-in and breastfeeding practices
and for other purposes.
This law is in promotion of the State policy
to encourage the practice of breastfeeding in
the Philippines 78
PUBLIC HEALTH LAWS
 LAWS
R.A. 8976- Food Fortification Law
provided the policy on
mandatory fortification of
staple foods and
voluntary fortification of
processed foods or food product
s
PUBLIC HEALTH LAWS
79
 LAWS
R.A. 8980
promulgates a
comprehensive policy
and a national system for
ECCD
80
PUBLIC HEALTH LAWS
 LAWS
A.O. No. 2006- 0015
Defines the
Implementing guidelines
on Hepatitis B
Immunization for Infants
81
PUBLIC HEALTH LAWS
 LAWS
R.A. 7846
Mandates Compulsory
Hepatitis B Immunization
among infants and
children less than 8 yrs
82
PUBLIC HEALTH LAWS
 LAWS
R.A. 2029
Mandates Liver
Cancer and Hepatitis
B Awareness Month
Act (February)
PUBLIC HEALTH LAWS
83
 LAWS
A.O. No. 2006-0012
Specifies the Revised
Implementing Rules and
Regulations of E.O. 51 or Milk
Code, Relevant International
Agreements, Penalizing
Violations thereof and for other
PUBLIC HEALTH LAWS
84
 CORE
VALUES
85
 COGNITIVE
Understand the Values and Beliefs
of Filipino when it comes to health.
Define the difference between
culture, beliefs and practices
3. Recognize the role Nurses in the
Culture and Beliefs of patients.

CORE VALUES 86
 AFFECTIVE PSYCHOMOTOR
Take part in discussion
and group activities.
Listen Apply health evaluation
attentively appropriate for health
during care needs of the
patient.
discussion. Use appropriate
strategies/ approaches
to plan in dealing with
the practices of
patient’s care.

PUBLIC HEALTH LAWS 87

 Work Ethic
As a group, Filipino nurses are well liked because
they are hardworking.
They place high value on responsibility and seldom
complain. “Many [Filipino nurses] work nights,
holidays and/or overtime.
So, during this time of nursing shortage, one can
rely on a Filipino nurse to volunteer to cover the
shift”. It is not unusual to find Filipino nurses who
work two jobs. The financial rewards, job security,
and personal advancement that U.S. jobs provide
to Filipino nurses are valued.
CORE VALUES 88
 Spirituality
Filipino nurses are very religious people.
There is a deep faith in God that is
reflected in the expression of bahala na
“it is up to God” or “leave it to God.”
This tends to be incorrectly equated with
an expression of fatalism and a passive
acceptance of or resignation to fate.
Bahala na may also apply to acceptance
of illness or malady.
CORE VALUES 89
 Sensitivity
Unmarried Filipino nurses recoil at the question,
“Are you pregnant?” when they go for a
medical checkup.
Because the Philippine society considers sexual
relationships not to occur outside of marriage,
it seems odd to them that they would be
questioned, although they are aware that this
is part of a routine health assessment.
Filipinos are generally sensitive and equally
sensitive to the feelings of others, so they try
to find a way to say things diplomatically.
CORE VALUES 90
Interpersonal Relationships
Filipinos are generally quiet.
Very conservative families do not allow their
younger members to join the conversation of adults
without an invitation.
They are sometimes hesitant to articulate their
views, especially if it is different from the majority,
as it might indicate discordance with the team or
group.
Engaging in arguments, especially with someone
who is older or holds an authority position, is
considered uncivilized. Filipinos also have difficulty
turning down requests from supervisors to whom
they feel obligated. CORE VALUES 91
Respect and Reverence
One’s position in society, professional
achievements, and age carry a lot of weight
in the Philippine society.
Physicians, lawyers, priests, engineers,
teachers, and nurses are among the well-
respected professionals in the Philippines.
Hence, their opinion is generally accepted
without question. Filipino values and
traditions provide a framework for conduct
and mode of communication.
CORE VALUES 92
Modesty
Filipino nurses find it uncomfortable to
accept even a well-deserved compliment.
For example, if someone gives a
complement like, “Your dress is beautiful!”
the answer might be, “Not really. I bought it
cheap.” Or if someone says, “You are so
knowledgeable,” the answer might be, “Not
really, I just happen to know it.” Yet they
are proud of their accomplishments in a
sort of quiet way. As a result, many have
culture-based barriers to marketing
CORE VALUES 93
Language
Respect is integrated in the Filipino language.
Reference to the elderly is the use of the third
person.
Hence, when spoken to assertively in a direct
way, Filipinos feel offended.
There is no gender differentiation in the Filipino
language.
Although they are fully aware of the male and
female genders, their native language is what
hinders them from precisely using he or she in
spoken English. Frequently, this leads to
confusion. CORE VALUES 94
Close Family Ties
Filipino nurses have strong family ties.
While in the United States, their close
friends become their family members.
As a result, they perpetuate the cultural
burden (as a downside) thus making it
more difficult and taking them longer to
assimilate into the mainstream culture of
their adopted country.
They tend to eat the same food and
mingle with individuals of the same
CORE VALUES 95
Preventive Health
Because most of their time is devoted to work,
going for preventive health checkups takes a
backseat. Yet, one may hear a Filipino extolling the
importance of preventive health to her patients or
clients. Filipino nurses have a tendency to self-
diagnose, self-medicate, and seek alternative
therapies. In rural areas in the Philippines, people
go for Hilot for relief of pain and aches instead of
seeking medical attention. In an alternative context,
Hilot may refer to a practitioner or the practice of
chiropractic manipulation and massage for the
diagnosis and treatment of musculoligamentous
and musculoskeletal ailments.
CORE VALUES 96
Home Remedies
Three concepts underlie Filipino American health beliefs
and practices: flushing, heating, and protection.
Each identifies a basic process used to promote good
health.
Flushing keeps the body free from debris, heating
maintains a balanced internal temperature, and
protection guards the body from outside influences.
Although Western and scientific concepts are similar,
Filipino theories are founded on different premises.
Flushing is based on the notion that the body is a
container that collects impurities, heating means that
hot and cold qualities must be balanced in the body,
and protection involves safeguarding the body’s
boundaries from supernatural as well as natural forces.
CORE VALUES 97
Pain Tolerance
Generally speaking, Filipino nurses have a high
tolerance to pain. For example, one of the author’s
sisters has severe arthritis, yet she continues to do
housework regardless of her pain.
Filipino nurses normally use home remedies such as
liniments and topical ointments and manage pain
before seeking medical care or while under medical
treatment.
Health care providers need to probe more into the
cause and degree of pain from Filipino patients to elicit
more information. The elderly group, in particular, is
unlikely to complain about their pain because they do
not want to have extra burdens being imposed on
caregivers. CORE VALUES 98
Privacy
Filipinos are mostly reserved and private
people.
As patients, they may not readily reveal their
personal and health information. Women in
particular are sensitive to touching another
individual as well as being touched. “Young
female service providers should practice
discretion with regard to touching older Filipino
male patients such as laying one’s hand on the
patient’s hand or shoulder to reassure comfort
in moments of distress”
CORE VALUES 99
5 ESSENTIAL SKILLS FOR DELIVERING
COMPASSIONATE CARE IN NURSING:
1. Emotional
intelligence. Strive for high
emotional intelligence to handle
interpersonal relationships with
coworkers and patients.
Awareness and mastery of your
emotions and others’ emotions
CORE VALUES 100
5 ESSENTIAL SKILLS FOR DELIVERING
COMPASSIONATE CARE IN NURSING:
2. Resilience. Maintain personal
resilience through participation in reflective
activities to explore personal values and
others’ perspectives. An article published by
the American Journal of Critical Care shows that
participating in these types of self-exploration
activities can improve a nurse’s resilience
which is “associated with increased hope and
reduced stress.” With increased resilience and
reduced stress, nurses are ready to provide
quality and compassionate patient care.
CORE VALUES 101
5 ESSENTIAL SKILLS FOR DELIVERING
COMPASSIONATE CARE IN NURSING:
3. Critical thinking.
Demonstrate the ability to think critically
and solve problems quickly to achieve
high-yielding results in patient
satisfaction and care. Nurses who can
find solutions deliver compassionate care
effectively to patients and families.

CORE VALUES 102

5 ESSENTIAL SKILLS FOR DELIVERING
COMPASSIONATE CARE IN NURSING:
4. Cultural awareness.
Maintain cultural awareness as it relates
to patient-centered care. Culture can
influence a patient’s view of treatment,
overall health, and death. Knowing the
patient well enough to determine their
cultural view can augment the nurse-
patient relationship in a positive way.
CORE VALUES 103
5 ESSENTIAL SKILLS FOR DELIVERING
COMPASSIONATE CARE IN NURSING:
5. Confidence.
A nurse with the ability to communicate
any instances of abatement in quality of
patient care is critical to fostering the
culture of the caring environment within
the healthcare organization.
Nurses must be able to discuss issues
and indicate a clear vision of how
compassionate organizations should
function with both peers and leaders.
CORE VALUES 104
TAKE
CARE
105