PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE

Professional A calling in which its members profess to have acquired special values,

knowledge, training or by experience so that they may guide others in that special field.

Nursing is a profession Calling – service oriented Others – patients

Characteristics by profession A – accountability/liability for the result C – caring profession Central Focus C – competent E – ethics S – service oriented S – specialized scientific body of knowledge and skills

PROFESSIONAL DUTIES OF A NURSE UNDER RA 9173

All are independent nursing actions Promotive, preventive, curative and rehab care in all health care service health education utilizes nursing process link of patients in different health care services collaboration of patient’s care for continuity of patient care train nursing students supervision of subordinates accurate recording and reporting execution of valid doctor’s order (the only one that is dependent nursing action) Perennial Suturing after training Perform IE if antenatal bleeding is absent and before full delivery

A doctor’s order is valid when giving medication is when it is put into writing and signed by the physician. Whatever is not put into writing is considered not ordered by the physician.

Good Samaritan Act During emergency, national calamity, national epidemic there is no doctor around

the life or the patient is in possible danger, then you can give drugs alone provided you know the drugs for the patient.

RA 8344 – No deposit policy during emergency cases only

Areas of Nursing Practice1. Institutional Nursing

Hospital Based Venue D – Duties are routinary and supervised A – Acquired different learning and technical skills C- Coordination with HCT S – Specialized areas

o Nurse Generalist – community nurseo Nurse specialist – staff nurse

2. Public Health Nursing Once a Public nurse in the community, you are focus on the preventive and

promotive of health because this is the mandate of Primary Health Care Law. 1st PHC

o Date : 1978o Place : Alma Atao Country : Russiao Local version of F. Marcos after 1yr of Alma Ata

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o Conference: Letter of Instruction 949 that mandates that all public workers to have a duty of promotive and preventive care for the patient.

Promotion of Public Healtho PD 8976 – Micronutrient Supplement Act

Vit. A, iron supplements, iodineo PD 825 (Environmental sanitation law of the Phils.)

It is cleanliness of the environment. Outside the institution (eg. proper disposal of excreta, proper drainage system)

o PD 856 (sanitation code of the Phils.) Involves proper sanitation of an institution that engage in food and

water supply. Inside the institution. (eg. canteen, mineral water store, public market, Sex shop : ADONIS, PEGASUS, CHICOS) not applicable to private sex practitioners.

Prevention of Disease o PD 996 (EPI law)

Compulsory Immunization of children below 9 y/o Psychological and social adjustments because you will be taking care of

numerous clientso RA 7160 (local government code)

decentralization or devolution of care. The DOH together with DILG and local government units (brgy, provincial) together with community participation they made a local health board which is the MAYOR.

Purpose of local health board : it makes quality health care available, accessible and proximal for all

Participation is maintained with all members of the community, health care team and family

3. Occupation Health Nursing industrial or company health nurse Duties :

o Curative/rehabilitative C – care for sick/injured laborers R – Referral V – Visit and ff. ups (home visits)

o Promotive/Preventive N – nutritional S – safety and sanitation C – Counseling

4. Clinical Instructoro Qualifications :

A – accredited nursing Org M – MAN in nursing or other health courses O – One yr clinical experience R – R.N.

PHILIPPINE NURSES ASSOCIATIONo When was PNA founded : Oct. 22, 1922 (10-22- 22)o Who is the founder PNA : Anastacia G. Guiron Tupaso Purposes :

P – professional well-being U - unity P – promotes reciprocity even outside the Phils. A – advancement of the knowledge and skills of the nurse E – ethics promulgation

Proclamation Order 539 Declared by Pres. Garcia law declaring the last week Oct as the official nurses

week.

School of Nursing in the Philippines UPCN – 1st

Schools originated in the Phil.

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o Iloilo Mission hospitalo PGHo St. Luke’so Mary Johnston Hospitalo St. Paul Hospitalo San Juan de Dios

Contracts and Consents

Characteristics of a Valid Consent V – voluntariness O – Opportunities to ask questionbe explained to pt T – treatment explained to the patient U – understood by pt M – matured both physically and mentally

Criteria of a good consent : 18 y/o – above Mentally capacitated (absence of insanity and imbecility) If below 18 y/o and mentally incapacitated a proxy consent : in chronological

ordero Parentso Guardiano physician (if parents and guardian are dead)

Guardian Ad Litem – social worker or Surgeon

Nurses and Illegal Detention it happens if someone will limit the freedom of the patient to move or travel from

one place to another. HIV Patient – should be kept in one room

o Felacio – oral sex – most fastest mode of transfero Cannalingus – tongue on clitoriso Analingus – tongue on anus – least mode of transfer

Last Will and Testament Act whereby a person is permitted by the law to have control in the manner of

disposing/ giving his estate but will take effect at the time of his death Testate Succession – son or daughter will inherit the last will of the parents Intestate Succession – without last will and testament 2 types of Last Will and Testament

o Property Notarial/ Ordinary Will

Check LOC Check proper location of the signature – end part of all the

pages at the side Nurses can be a witness

Holographic Will During emergency cases No witness involved call a persdon who knows and familiar

with the handwritten of the testator Entire last will and testament is hand written dated and

signed by the testatoro Life Body

Advance Directives Respectful death Direction/ instruction of the patient in advance DNR, donate organ, cremation

Medications and prescription only registered medical, dental and veterinary practitioners are authorized to

prescribe drugs 3 information

o name of the AMD, address of his clinic/hosp and PTRC license #

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o name of the pt, age, sexo drug name, frequency, duration of the drug

RA 6675 Generic Acto all prescribe drug must be written in generic and brand name or generic

name but never the brand name alone)o Purpose : for the pt to choose what brand name they want

Remember the 10 R’s of medication Right patient name by checking the pt wrist tag Verbal or telephone – only done during emergency doubts or error – in case there is doubt in medication, refer to the physician IV drugs – in proper training

Documentation, recording and charting Patient Chart – absolutely legal Purpose of a patient Chart

o Communication and conitinuity of careo Assurance of quality of careo Researcho Legal documento Statistics of disease

Subpoena – order coming from the courto Subpoena Duces Tecum – any documents, objects, papers, materialso Subpoena Ad Testificandum – person who will testify (witness)

Do’s in Chartingo F – full, factual and objectively accurateo L – legibleo I – immediateo P – Personal

Adendum – late entry/late documentation Don’ts in charting

o L – language, jargons or words which are unacceptableo I – improper correctionso S – Spaces and skipso Abbreviation

LEGAL DOCTRINES IN NURSING

Professional NegligenceNegligence

failure to do something which are reasonable and prudent nurse should have done something under a particular situation. (eg. failure to raise side rales when the pt is unconscious)

3 elements of negligenceo duty on part of the nurseo failure to do said dutyo injury, harm, death – most important negligence

Malpractice injury, harm or death is not important in malpractice The nurse is allowed to perform episiorrhapy with proper training but not episiotomy The nurse is allowed to perform IE but with 2 conditions :

o fetal aberration/ abnormal deliveryo prior to complete delivery

Crimes affecting nurses Types of crime : Manner of Commission

o DOLO – crimes committed with deceit. Crime with real criminal intentiono CULPA – crimes committed under negligence. Crimes that are intentional

stages of executiono consummated

when the crime intended is totally committed or perfected

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o frustrated the offended performs everything to consummate the crime but it

did not happeno attempted

crime has not happened (overt acts – acts merely showing the intention to commit the crime)

degree of participationo principal

degree of participation is very important/indispensable because he is the primary author of the crime.. If no principle, there is no crime.

o accomplice participation is merely dispensable. Usually performs before (eg. referral by the nurse of a abortionist

to a pregnant women) or during the crime eg. OB nurse is to perform abortion. The nurse is look out for police. The nurse is the accomplice.

o accessory usually performs after the crime (eg. stole a nebulizer in the

hospital. Sold the nebulizer to an asthmatic pt) This is an accessory because he benefited from the crime

RA 7877 – Anti sexual harassment law committed by any person who exercises authority. (eg. teacher to student, head

nurse to staff nurse). That person who is in authority is asking for a sexual favor in an exchange of

another favor.

Types of Rape Ordinary rape

o a forcible penetration of an organ for copulation to another organ for copulation. (eg. women are only the victim)

sexual assaulto anything that is forcible inserted to a body orifice with sexual malice. o Also form of rape (eg. hand or an object is being inserted in the anal.

Committed in both female or male) o Intervention :

S – safety (emotional or physical safety) R – report (↓ 18 – report to brgy.) R – referral (if father is the rapist, refer to DSWD)

Abortion is the expulsion or termination of a product of conception before the stage of

viability. (3-6month/12-24weeks)Infanticide

kill the person in less than 3days or 72hrs of life.

Parricide killing another person to whom you have a relationship (mother, father, husband)

Homicide unintentionally killing another person without any relationship (eg. negligence in

giving meds) Murder

intentionally killing another person without any relationshipSimulation of birth

committed by any person who shall substitute one child to another child or alter his identities for the purpose of losing his civil status. (eg. the midwife failed to report the birth of the baby, giving wrong information of the gender of the baby)

PD 651 (Birth registration act) law any person who assist in giving birth to report within 30 days to the Local

Civil Registration Office

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Law Affecting Nurses Act 2808 (yr. 1919) – first true nursing law

o It removed from the doctor the control of nurses with 3 man team (1 chairman and 2 members all nurses)

1920 – 1st official board exam 1st nursing school (6months)

o Iloilo Mission Hospital (1906)o PGH School of Nursing (1907)o St. Luke’s school of nursing (1907)o Mary Johnson’s school of Nursing (1907)o St. Paul Iloilo 1907)o San Juan de Dios (1907)

1st college of nursing (4years) – UP RA 7164 (1991) RA 9173 (Oct 21, 2002)

o Board of Nursing Old

o M – MANo A – Accredited Nursing Org (PNA)o F – five MAN team (1 chairman, 4 members)o S – 65 y/o – 1 year interim periodo N – Not convicted of any crimeo P – Pecuniary interest (Absence)o T – 10 years nursing practiceo C- Citizen of R.P.

Newo M – MANo A – Accredited Nursing Org (PNA)o S – 7 MAN team (1 chairman, 6members)o I – immediately resigned upon appt.o N – Not convicted of any crimeo P – Pecuniary interest (Absence)o T – 10 years nursing practice but 5 yrs must be in the

Phils.o C- Citizen & resident of R.P.

Who formulates the question of the Board Exam? – Board of Nursing

In having a license it is a Privilege not a Right Board of Nursing issues the license PRC issues the certificate of registration CHED are the ones who has the power to open and close a

nursing school BON just inspects 5 consecutive years of below 80% passing rate,

the school will be closed Powers and Functions of BON

o L – Licensure examo I – Issue CORo M – Monitor standards of nursing practiceo E – Educationo C – Code of ethicso H – Hear and decides cases of negligence and malpracticeo A – Accredits different organizationso G – Guides Nursing Practice in the phils

o Dean R.N.,MAN 5 years nursing experience

o Clinical Instructor A – allied in nursing or any allied health courses M – member of PNA O – 1 yr experience R – R.N.

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o Nursing Administrator

Supervisor/Manager H Community Military Hosp

B – BSN RN A – Accredited Org N – 9 units T – 2 yrs

Chief/DirectorRN + MAN +5 yrs supervisorexperience(N.B. if primaryhosp)

Add onlymaster’s inPHN orCHN

MAN +GSC(Gen.StaffingCourse)

o Examinees CGM (Good Moral Character) Proofs of Valid Holder of Filipino Citizenship Proofs of valid holder of a BSN Degree only from schools whose

curriculum is approved by the CHED 3 docs sub to PRC RLE certificate TOR with Scanned picture List of cases Examination fee is P900 Last day Is :

Other related laws PD 223 – PRC Act RA 1080 – Civil Service exam Cum Laude, Board passer – eligible in taking CSE RA 6425 – Dangerous drugs Act

o punishable with 2 chemical substances Prohibited drugs

chemical substance totally, abosultely can’t be consumed by human being (eg. Shabu, Mariana, Cocaine, Opium)

Regulated drugs you can use this drug provided the pt has the prescription

and the AMD has appropriate license coming from the BFAD or Dangerous Drugs

RA 7600 – Baby Friendly Hospital. o Early bonding for mother is Early Rooming in and early baby breast

technique for early bonding Early bonding for father is thru cuddling E.O. 51 – Milk Code (Breast Milk)

o Avoid manufactured or formula milk How to be an R.N. under 9173

o Have all qualificationso take the examo acquire the required ratingso In order to pass the examination, an examinee must obtain a general

average of at least 75 % with a rating of not below sixty percent (60%) in any subject

o An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject must take the examination again but only in the subject or subjects where he/she us treated below 60 % (60%). In order to pass the succeeding examination, an examinee must obtain a rating of at least 75% in the subject or subjects repeated.”

RA 8981 –Modernization Act. For every 5,000, results will be released after 5days PRC rating NAME Text to 263 (smart) 233 (globe)

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What are the grounds for nurse not to be registered?o D – Dishonorable conducto U – Unsound mindo M – moral turpitudeo I – Indecent immortal conduct

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