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PRACTICES
The Rafael Lazatin Memorial Medical Center (Ospital Ning Angeles) was
founded on June 19, 1965. It was then known as the Angeles City General
Hospital. The hospital first operated in a hotel building that was converted
into a hospital in Barangay Balibago. It was later transferred to Barangay
Pampang and was situated near the Bank of the Abacan River.
On August 22, 1995 the hospital war renamed OSPITAL NING ANGELES
with the approval of City Council Resolution No.175-08, S-95
The Operating Room Complex was named Auberlin Hall after Irene M.
Auberlin, founder of the World Medical Relief. The new Pediatric building was
named Rafael L. Lazatin Building after former Pampanga Governor and
Angeles City Mayor. The rest of the new wards were collectively named
Ospital ni Erap Para sa Mahirap Wing.
Chief Nurse
A. Administrative Management
1. Evaluate the performance of Nurse Supervisors and Head Nurse and
participate in the validation of performance evaluations of lower
ranked nurses.
2. Orients newly employed Nursing Services personnel and provides them
with their needed training.
3. Sees to the observance of Hospital and Nursing Services policies and
procedures.
4. Prepares duty schedule of all subordinates.
5. Assist the Chief Nurse in conducting preliminary investigation of
complaints against or made by Nursing Services personnel.
6. Conducts meetings, in-house training and seminars.
7. Compliments the efforts of the Chief-Nurse in promoting good
interpersonal relationships between the Nursing Services personnel
and the patient and their relatives.
8. Sees to the punctual submission of Daily Time Records by subordinates
and coordinates with the Personal Service with problems regarding
this.
9. Assist the Chief Nurse in supervising housekeeping, ward clinical, and
ward utility workers.
10. Suggest to the Chief Nurse measures to further improve the
Nursing Services.
11. Helps the Chief Nurse to prepare the monthly Nursing Audit and
Quality Assurance Reports.
12. Reports to the Chief Nurses cases of personnel who needs
counseling and join the former in the counseling session.
13. Notifies the Supply, Maintenance, and other hospital units for
their services.
14. Coordinates with the Security Service for the authorization
presence of persons in the Nursing 1 areas and for other immediate
security concerns.
15. Enters the data concerning Area1 in the Nursing Board in the
absence of the Chief Nurse
16. Coordinates with the other hospital personnel for mutual
concerns.
17. Receives leave applications from Head Nurses and disallows or
endorses them to the Chief Nurse.
18. Does other task assigned from time to time.
This long range goal of improved nursing care which is spread over 3
½ years may be broken down into short range goals.
Six months increments devoted to:
1. An assessment program.
2. Selection and priority setting.
3. Increase in discharge plans and referrals.
4. Upgrading of the psychological and emotional components of care.
5. Improved physical care.
6. Incorporation of rehabilitation techniques.
7. Evaluation of progress in the achievement of these short range goals.
MISSION
OUR MISSION
VISION
1.2 All must remain on post when duty or on official working hours.
a. The section and division chief duty approve it and the PPAO is
officially notified.
1.5 Sleeping is not allowed during working hours except for those on
24 hours duty whose tempo and demands of works allow them to
sleep. Those assigned at the ER-ambulance Nurse by the virtue
of the preceding work characteristics and previous agreements
are not allowed to sleep.
Discipline:
1. Dishonesty
3. Grave misconduct
4. Insubordination
5. Habitual Drunkenness
2. Simple misconduct
3. Insubordination
4. Habitual Drunkenness
1. Neglect of duty
Dress code:
c. Violation of the dress code falls the light offense as a violation of office
rules and regulation.
1. Because we are concern with giving care to those who are sick or
injured, a lot of patience and understanding should be given patients
and their relatives.
5. Unethical and corrupt practices, which lead to the detriment and loss
of opportunities or income from the hospital and the city government
or committed against patients or their relatives will be dealth with
sternly.
7. Gambling and drinking are prohibited anywhere in the hospital and its
premises.
9. Soliciting favors, money, gifts and the like from patients or their
relatives is strictly prohibited.
10 . Donations of any kind from private or public sources for use in the
hospital are obligatory properties of the hospital.
4. Orient relatives about hospital rules and policies. Tell them whom to
approach for any questions or problems/location of Nurse’s station.
5. The nursing section will notify the dietary service of the prescribed
diet. The dietician coordinates with the meal concessionaire regarding
the prescribed diet.
Discharge of Patient
3. The nurse, in-patient nursing service submits the patient’s chart to the
billing section after it has been checked for its completeness.
6. Collect all the patient’s medicine in one container and give him the
discharge instruction on how to take his medicine, his/her date time of
visit
1. The nurse should tactfully explain the reason for transfer (to other
institution) as ordered by the ROD.
Release of Corpses
a. Ask the family and patient if they want clergy service and they may
do so according to their beliefs.
e. use of the holding area for corpses as for privacy and for separation of the
corpses from the patient ward.
Procedures on the Release of Corpses to Funeral Parlor
a. A log book shall be kept for the purpose and signature of the
nearest kin.
Angeles City
INTRODUCTION
Senior nurses, those who have had the most numbers of years in ONA,
have been assigned to every shift. The skill, wisdom, and decisiveness
should enhance the capability of the entire ER staff to meet the challenges in
the ER.
This manual may not provide all the answers. In time, however,
concerted efforts led by the Senior Nurses assigned at the ER will truly
established the ER as the showcase of our hospital’s competence and quality
of care.
Section 1. Receiving Patients and Their management and Disposition in
General
a. Emergency cases
b. Non-emergency cases
Patients are seeking help and must be assisted. The management and
disposition may differ but no patients will be turned away. They will all be
seen by the Duty Physician and their visits to the ER properly
documented.
The financial disposition of the patient rests with the Duty Physician
and the Duty Nurse should see to it that all pertinent data are entered in
the logbook.
If the duty Physician refuses to enter the date of the patient in the
logbook, the Charge Nurse should be notified.
The Charge Nurse shall then ask the Duty Physician to complete the
logbook entries. If the Duty Physician refuses to do so, the Charge Nurse
should notes the incident in his/her logbook. This shall be the basis of the
incident report that will be filed after his/her shift. The Charge Nurse may,
likewise, report the matter at once at the Senior House Officer on Duty.
Hemorrhage
Cyanosis
Cardiac arrhythmias
Profuse bleeding
Shock
Status epilepticus
Aspiration
Asphyxia
Poisoning
Myocardial infarction
Hemothorax
Pneumothorax
Severe pain
Severe dehydration
Lightning injuries
Drowning
Choking
Neck injuries
Metabolic acidosis/alakalosis
Heat strokes
2.a.2. Conditions which may not be acutely life threatening but may rapidly
deteriorate to cause death or complications are also emergency cases.
Seizures
Lacerations
Amputating injuries
Injuries to organs of the senses like the eye, ears, and nose
Swallowed or inhaled foreign bodies
Fractures
Ascending paralysis
Strokes in evolution
CNS infections
Dyspnea
Drug overdose
Tetanus
Electrolyte imbalance
2.a.3. Emergency cases also include distressing conditions which may signify
more serious conditions particularly if experience by the patient for the first
time.
Post-ictal states
Abnormal movements
Vomiting
Diarrhea
Abdominal pain
Dizziness or vertigo
The general dictum is still “first – come, first serve”. However, at any
given time, patients belonging 2.a.1. receive the top priority followed by
2.a.2., etc. However, rape is a special case which will discussed in a later
section.
What happens if all four Er stretchers are full and a priority patient
arrives?
The above question drives home the point that non-emergency cases
should be seen elsewhere. Presently, non-emergency patients should be
seen at emergency patients come to the ER.
When all four stretchers are full and a more priority patient arrives
and needs to be placed in the recumbent position, quickly assess which of
the patients can be asked to sit down or be transferred to the examining
tables at the adjoining OB/GYN Examination Room.
A – irway
B- reathing
C – irculation
2.c.2. Call for the Duty Physician/ Institute basic CPR. It is presumed
that more than one nursing personnel are attending the patient.
3.b. Alleged victims of sex crimes are to be treated with extra “sensitivity”.
They should be shielded from further embarrassment and
psychological trauma.
Some persons are by nature difficult to deal with. This personality trait
is made worse by tension and anxiety over an illness or injury. The best way
to deal with them is to prevent a misunderstanding and to cut it short when
it does.
6.c. Do not argue or quarrel with the person. Before things become
nasty, ask help from the ER NSOD to pacify the person. The help of the
ER Physician should be sought if the ER NSOD is unable to reason with
the person.
6.d. Ask the help of the Security Guard if the “quarrel” is escalating. If
the person is not the patient, he may be ask may be asked to leave the
ER.
Police assistant must be sought with person threatening violence and
persons under he influence of alcohol to whom reasoning with useless.
6.e. Notify the SHO of untoward incidents and ask for his interventions,
if necessary.
On the third block, the admitting nurse should affix her signature
opposite the ER Nursing service line.
7.b. Send the relative of the patient to the Admitting Office for
admission process. If the clinical record contains sensitive data or
which might cause anxiety, i.e. a diagnosis of cancer, the admitting
nurse should be the one to forward the patient’s chart to and receive it
from the Admitting Officer.
7.d. All orders carried out in the ER must be noted down as carried on
the Nurses’ Remarks column.
8.a. ER Charges
8.b. Donations
8.b.2. Donations must be placed directly into the locked donation box
by the patients or relatives themselves.
Donations are not to be spent for personal benefits except for buying
medicines for indigent patient.
8.2. The Ambulance attends to patients being conducted if they are patients
of ONA. Non-patients of ONA who are to be conducted by the ONA
ambulance are to be advised to secure their own ambulance nurse or
physicians.
8.3. After twelve hours of work, the Ambulance Nurse is given rest subject to
call if his service is needed at the ER or in a patient conduction.
This section enumerates the various details of work that may seem to
be routinely done or those with significance. However, these are the things
that make ER operations work efficient and effective.
Do the Following:
• Take your snacks or meals at the canteen or ER office and not at the
Nurses Stations especially when there are patients in the ER.
• Dress wounds and control bleeding before patients are sent out of the
ER for X-ray exams, etc.
Angeles City
A. ADMISSION
1.a. In instance when any of the above are lacking or unavailable and
the family of the patient insist that the patient is admitted to the ONA
ICU or when it is inadvisable to transfer the patient, a responsible
member of the family must sign a waiver or consent.
The above document shall state lack or unavailable of any of the ICU
resources and that the family consents nevertheless confine the
patients on the ONA ICU.
1.c. Referring nursing units shall be preferably advise the ICU staff at
least five minutes ahead of time before transferring their patients to
the ICU, particularly if circumstances allow such time.
1.d. Nursing units are to inform ICU staff of any potential admission.
When informed as such, the ICU staff shall get the necessarily patient
information to evaluate if the ICU has available manpower and
equipment to manage the patient.
If the ICU lacks staff or equipment, the ICU shall notify the Nurse
Supervisor on duty who shall discuss the problems or conditions at the
ICU with the family. If the family insists that their patient be admitted
to the ONA ICU, refer to paragraph 1.a. above.
1.e. The minimum nurse: patient ratio in the ONA ICU is given below.
An actual ratio worse that the minimum means that there is a lack of
nurse at the ICU at the present time.
1.e.1 (1) nurse to (3) moderately serous patients where a
moderately serious patient is defined as one who needs routine
attention three times an hour.
2.e.4. If these patients are not admitted to the ONA ICU, they are
to be transferred to another hospital or will remain in their ward,
depending on what is best for the patient given the
circumstances present as determined by the Chief of Clinics of
the Senior House Officer.
3. The ICU isolation Rooms shall be reserved for the following patients:
4. The ICU Staff shall notify the Admitting Service regarding admissions of
inpatients.
1. The back door is for the entry of ICU personnel only. It must always be
locked. This is to ensure the safety of the ICU supplies and medicines
and the personal belongings of the staff.
2. All persons entering ICU must wear the provided gowns and slippers.
3. The anteroom at the front of the ICU is not a place where families of
ICU patients can stay, much less sleep, or eat. Benches are provided
for them outside of the ICU areas.
The anteroom is place where the provided slipper and gowns are
placed and where are worn by persons entering the ICU. This is place
where Staff can be briefly assess incoming patients for unusual
behavior or conditions before they are finally allowed to the ICU
proper.
4.b. Their help should be solicited in the general care of their patients.
Proper instructions shall be given to them in them in this matter.
4.c. Only one watcher is allowed per patient. However, the privilege of
being a watcher can be suspended by the ICU Nurse on Duty if he/she
does not always follow ICU rules and regulations.
6. Watchers and visitors are not allowed to eat inside the ICU. Only fruits
and plain crackers are allowed to be brought to patients of the ICU as
cooked food may be contrary to the diet prescribed to the patient.
ICU Staff should preferably take their meals and snacks at the Rear
Service area that is for their exclusive use.
3.a. Especially when there is only one personnel on duty, the ICU staff
should arrange for her/his meals and snacks to be brought to the ICU
before starting her/his shift, or before the outgoing personnel leaves.
3.b. Supplies and other needed items should be acquired after the shift
endorsement by the outgoing staff.
3.c.1. The lone ICU Staff must inform the Nurse Supervisor on
Duty (NSOD) of the necessity and ask fro permission to leave the
ICU temporarily.
4.d. When the inventory level of an item is only good for two weeks, it
should be requested from the Supply Service.
5.a. The person in the family who are primarily responsible for the
patient should be identified. It is important that they are aware of the
condition of their patient and are familiar with the management plan.
6.a. The Chief Nurse or the NSOD shall be informed of their presence.
6.d. It should always be remembered that the best way to deal with
difficult person is to let them know that everything to be done is being
done.
7.a. The ICU Staff will provide special pass for them that will
enable them to enter the ICU when they are needed during
emergencies.
7.b. Families of Pay Patients can get a private room that they
have to pay for separately. Those who would want to avail this
privilege are to be referred to the Admitting Office.
F. Organizational structure
ORGANIZATIONAL STRUCTURE
1. Group of Services
RLMMC is a department directly under the Office of the Mayor. The
Hospital Director is the head of the hospital assisted by the Assistant
Hospital Director. Chiefs of services head various groupings of
services. There are five main groupings of services, namely:
Administrative Services
Medical Services
Nursing Services
Ancillary Services
2. Number of Personnel
3. Committees
Accreditation Committee
HIV/AIDS Committee
4. Employee Organization
Two organizations exist in the hospitals that are open to all hospital
employees. Both are independent from each other and the hospital
management, the hospital director not being a member of either
organization.
MEDICAL CENTER
CHIEF
CHIEF DEAN
NURSE COLLEGE OF NURSING
SENIOR
NURSE STUDENTS
NURSE
LEGEND:
Direct line of authority & responsibility
Supervisor
Coordinated relationship
ORGANIZATIONAL STRUCTURE
OF THE NURSING SERVICE
SHOWING LEVELS OF POSITION
CHIEF OF
HOSPITAL
CHIEF NURSE
III/II
Angeles City
General Description
Performs the nursing tasks in the Operating Room
1. Assisting the OR Head Nurse in the completion of her tasks and takes
her place if she is not present.
11. Helps recovery and delivery room personnel as the need arises.
Job Description
General Description
Job Description
General Description
1. Receives admitted patients and orients them and their relatives of the
basic nursing and hospital policies and procedures.
2. Carries out doctor’s orders, accomplishes monitoring charts, and writes
down the pertinent notes and nursing care plan.
3. Gives the necessary instructions and information to the patients or
their relatives regarding hygiene, precautions, and chores that they have to
do themselves.
4. Performs the various nursing tasks like giving medications, venoclysis,
monitoring vital signs, fluid input and output, etc.
5. Sees to the proper performance of tasks by nursing attendants.
6. Coordinates with attending physicians and resident in-charge
regarding the management of patients
7. Proper ancillary service request and prescriptions and gives the proper
instructions to relative of patients.
8. Sees to the proper preparations of patients who are undergo surgery
and other special procedures.
9. Assists doctors on their rounds or work.
10. Sees to the completion of the pertinent part of the admission and
discharge record.
11. Incorporates laboratory and diagnostic reports and results in the chart.
12. Helps her superior in maintaining cleanliness in the station and wards
and in the implementation of nursing and hospital policies and procedures
13. Enters into a logbook untoward incident and immediately notifies
superior about them.
14. Coordinates with other hospital personnel for mutual concerns.
15. Receives endorsement from, and I turn endorses to, co-nurses duties
and responsibilities.
16. Prepares to the proper charges for the use of supplies and equipment,
if applicable.
17. Sees to the safekeeping of supplies, equipment and instruments.
18. Operates the various equipment issued to the station and notifies
immediate superior of malfunctioning instruments and equipment non
availability of supplies.
19. Gives discharged instructions to patient and relatives.
20. Submit to the chief nurse the performance appraisal of nursing
attendant every four months.
21. Does other tasks assigned from time to time.
Job Description
General Description
1. Receives admitted patients and orients them and their relatives of the
basic nursing and hospital policies and procedures.
2. Carries out doctor’s orders, accomplishes monitoring charts, and writes
down the pertinent notes and nursing care plan.
3. Gives the necessary instructions and information to the patients or their
relatives regarding hygiene, precautions, and chores that they have to do
themselves.
4. Performs the various nursing tasks like giving medications, venoclysis,
monitoring vital signs, fluid input and output, etc.
5. Sees to the proper performance of tasks by nursing attendants.
6. Coordinates with attending physicians and resident in-charge regarding
the management of patients
7. Proper ancillary service request and prescriptions and gives the proper
instructions to relative of patients.
8. Sees to the proper preparations of patients who are undergo surgery and
other special procedures.
9. Assists doctors on their rounds or work.
10. Sees to the completion of the pertinent part of the admission and
discharge record.
11. Incorporates laboratory and diagnostic reports and results in the chart.
12. Helps her superior in maintaining cleanliness in the station and wards
and in the implementation of nursing and hospital policies and procedures
13. Enters into a logbook untoward incident and immediately notifies
superior about them.
14. Coordinates with other hospital personnel for mutual concerns.
15. Receives endorsement from, and I turn endorses to, co-nurses duties
and responsibilities.
16. Prepares to the proper charges for the use of supplies and equipment,
if applicable.
17. Sees to the safekeeping of supplies, equipment and instruments.
18. Operates the various equipment issued to the stations and notifies
immediate superior of malfunctioning instruments and equipment non
availability of supplies.
19. Gives discharged instructions to patient and relatives.
20. Does other tasks assigned from time to time.
Designation and Classifications
Job Description
General Description
Job description
General description
Job description
General description
Designation Qualifications
Licensed nurse with at least two years operating room work
experience; with leadership and managerial abilities; preferably, with at least
12 master units in nursing
General description
Supervises Nursing activities and Nurse Station III and sees to the
proper performance of tasks and responsibilities by her subordinates.
Designation Qualifications
Job description
Designation title: Charged Nurse, Nurse Station III
Immediate Supervisor: Head Nurse, Nursing Area III
Unit: Nurse Station III
Nursing Area: Nursing Area I
Service: Nursing services
General description
Job description
General description
1. Receives admitted patients and orients them and their relatives of the
basic nursing and hospital policies and procedures.
2. Carries out doctor’s orders, accomplishes monitoring charts, and writes
down the pertinent notes and nursing care plan.
3. Gives the necessary instructions and information to the patients or
their relatives regarding hygiene, precautions, and chores that they
have to do themselves.
4. Performs the various nursing tasks like giving medications, venoclysis,
monitoring vital signs, fluid input and output, etc.
5. Sees to the proper performance of tasks by nursing attendants.
6. Coordinates with attending physicians and resident in-charge
regarding the management of patients
7. Proper ancillary service request and prescriptions and gives the proper
instructions to relative of patients.
8. Sees to the proper preparations of patients who are undergo surgery
and other special procedures.
9. Assists doctors on their rounds or work.
10. Sees to the completion of the pertinent part of the admission and
discharge record.
11. Incorporates laboratory and diagnostic reports and results in the
chart.
12. Helps her superior in maintaining cleanliness in the station and
wards and in the implementation of nursing and hospital policies and
procedures
13. Enters into a logbook untoward incident and immediately notifies
superior about them.
14. Coordinates with other hospital personnel for mutual concerns.
15. Receives endorsement from, and I turn endorses to, co-nurses
duties and responsibilities.
16. Prepares to the proper charges for the use of supplies and
equipment, if applicable.
17. Sees to the safekeeping of supplies, equipment and instruments.
18. Operates the various equipment issued to the station and
notifies immediate superior of malfunctioning instruments and
equipment non availability of supplies.
19. Gives discharged instructions to patient and relatives.
20. Submit to the chief nurse the performance appraisal of nursing
attendant every four months.
21. Does other tasks assigned from time to time.
Job Description
Designation Qualification
Job Description
Designation Qualification
Licensed Nurse with at least ten years of hospital work. Must possess
managerial and leadership qualities, a vision and direction for the Nursing
Services, and must have finished at least academic units required in the
Master in Nursing course.
OSPITAL NING ANGELES
Angeles City
Job Description
General Description
Oversees the operations and activities of the Nursing Area I that is
comprised of Wards 1 to 6, Pay Wards, and NICU
Designation Qualifications
Licensed nurse with at least seven years of hospital work. Must
possess managerial and leadership qualities and preferably, must have
finished at least 12 units in the Master in Nursing Care.
Job Description
General Description
Designation Qualifications
Job Description
General Description
Job Description
General Description
Designation Qualifications
Job Description
General Description
11. Provides nursing care to her assigned patients and accomplishes the
required nursing task.
12. Receives the endorsements of, and in turn endorsers to the
following shift, the station’s furniture, instruments, equipment, and
supplies.
13. Acts on, or refers accordingly, nursing and administrative
problems encountered by their station.
14. Sees to the observance of Nursing and Hospital Policies and
Procedures.
15. Forward charts of discharged patients to concerned hospital unit
for billing of hospital charges.
16. Sees to the completeness of supplies, cleanliness and orderliness
of the station.
17. Sees to the proper use of semi-isolation cubicles and isolation
rooms.
18. Coordinates with other hospital personnel for mutual concerns.
19. Submits to Assistant Chief Nurse the performance appraisal of
her subordinates every four months.
20. Does other task assigned from time to time.
Designation Qualification
Job Description
General Description
1. Receives admitted patients and orients them and their relatives of the
basic nursing and hospital policies and procedures.
2. Carries out doctors’ order, accomplishes monitoring charts, and writes
down the pertinent notes and nursing care plan.
3. Gives necessary instructions and information to patients or their
relatives regarding hygiene, precautions and chores that they have to
do themselves.
4. Performs various nursing task like giving medications, venoclysis,
monitoring vital signs, fluid input and output, etc.
5. Sees to the proper performance of tasks by nursing attendants.
6. Coordinates with attending physicians and resident-in-charge
regarding the management of patients.
7. Prepares ancillary service request and prescriptions and gives the
proper instruction to relatives of patients.
8. Sees to the proper preparations patients who are to undergo surgery
and other special procedures.
9. Assist doctors on their ward rounds or work.
10. Sees to the completion of the pertinent part of the Admission and
Discharge Record.
11. Incorporates laboratory and diagnostic reports and results in the
chart.
12. Helps her superiors in maintaining cleanliness in the station and
wards and in the implementation of Nursing and Hospital policies and
procedures.
13. Enters into a logbook untoward incident and immediately notifies
superior about them.
14. Coordinates with other hospital personnel for mutual concerns.
15. Receive endorsement from, and in turn endorses to, Co-nurses
duties and responsibilities.
16. Prepares the proper changes for the use of supplies and
equipment, if applicable.
17. Sees to the safekeeping of supplies, equipments, and
instruments.
18. Operates the various equipments issued to the station and
notifies immediate superior of malfunctioning instruments and
equipment non-availability of supplies.
19. Gives discharge instruction to patients and their relatives.
20. Submits to the Chief Nurse the performance appraisal of nursing
attendants every four months.
21. Does other task assigned from time to time.
Designation Classification
Job Description
General Description
Designation Qualification
Angeles City
Job Description
General Description
Designation Qualifications
Angeles City
Job Description
General Description
Designation Qualifications
Angeles City
Job Description
Area: Area II
General Description
2. Enters identifying and other pertinent patient data in the logbook and
reminds duty physicians to complete clinical data of patients.
9. Draws blood and other specimen for laboratory examinations when the
medical technologist on duty csnnot response to ER on call on time.
10. Assist the duty physicians in filling up request forms and giving
instructions to the patients or their relatives.
17. Notifies the Nurse Supervisor of the need for ER medicines and
supplies, repair instruments and equipment, and reprtable incidences.
18. Accompanies seriously ill or injured patients to and from the ER.
Designation Qualifications
Angeles City
Job Description
General Description
Goes with the ambulance during conduction of patients and when the
ambulance is responding to emergency calls providing nursing and
paramedical care.
Designation Qualifications
Angeles City
Job Description
Area: Area II
General Description
Designation Qualifications
Angeles City
Job Description
Designation Title: Midwife
Area: Area II
General Description
7. Sees to the cleanliness and orderliness of the OB-ER area and its
instruments and furniture.
Designation Qualificatiion
Angeles City
Job Description
Area: Area II
General Description
10. Sees to the cleanliness and orderliness of the ICU and its
equipment and instruments.
Designation Qualifications
Licensed nurse with at least one year of ICU nursing experience, with
leadership and managerial abilities; preferably, with at least 12master units
in nursing.
OSPITAL NING ANGELES
Angeles City
Job Description
General Description
Designation Qualifications
Angeles City
Job Description
General Description
Designation Qualifications
Angeles City
Job Description
Area: Area II
General Description
5. Enforces the dress code for the operating room complex and
recommends sactions againts its violators.
20. Assists the Assistant Chief Nurse in making the duty schedule of
OR Nursing Services personnel.
Designation Qualifications
Angeles City
Job Description
General Description
Designation Qualifications
I. Scheduling
The number of working hours and off-duties in RLMMC (ONA) is largely
dependent on the Forty-Hour-Per-Week Law, otherwise known as R.A. 5901.
This law specifies that personnel working in agencies with a population of
one million and in hospitals with a one hundred bed capacity and over are
entitled to work forty hours per week. On the other hand, nursing personnel
who work in agencies with a population of less than one million, will have to
render forty-eight working hours a week, therefore, only getting one day off
a week.
Step 2. Find the number of Nursing Care Hours (NCH) needed by the
patient per day at each categorized level.
78 x 1.5 (Nsg. Care hrs. needed = 117 nsg. Care hrs. needed
Per day at level 1) by 78 patients
36 x 3 (Nsg. Care hrs. needed
Per day at level 2) = 108 nsg. Care hrs. needed by
36 patients
6x 4.5 (Nsg. Care hrs. needed
Per day) = 27 nsg. Care hrs. needed by
6 patients
Total = 252 Nursing Care Hours/day
Step 3. Find the actual number of NCH needed by 120 patients per
year
252 x 365 = 91,980 total NCH needed per year.
J. Modalities of care
Nursing modalities of patterns of care in RLMMC (ONA):
2. Under the same method, a nurse is assigned for eight (8) hours to take
care of the needs of one or two patients. This is done when the nurses
outnumber the patients. Under this arrangement, the patient is able to relate
with his nurse and vice versa. A disadvantage, however, is that the nurses
are not given the opportunity to know other patients in the unit. This can be
reminded through nursing rounds. Special duty nurses or those in intensive
care units usually practice this method.
3. In team nursing, leadership comes from the team leader who is usually the
professional nurse, since he/she performs the highest degree of nursing skills
including assessment, making the nursing diagnosis, planning and directing
nursing care. He/she is assisted by auxiliary nursing personnel.
The team works with a group of patients. Each member performs the
tasks he/she has been assigned to perform. The team has a daily planning
care conference wherein the case is discussed and all members are
encouraged to suggest measures to improve patient care. This joint effort
improves nursing care plans for the patients. Under this modality, the
emphasis is on the patient, the worker and the work.
Under this modality, care is focused on the patient. The nurse knows
the needs and could be more responsive and effective in her nursing care.
He/she also has a greater capacity to utilize his/her functions and skills.
5. Acuity of Illness- under this modality, care is focused on the degree of care
for illness or condition of the patient wherein the nurse/team utilizes the
progression patient care concepts.
II. PROBLEM (Problem and Analysis)
The following are the discrepancies that we as researcher have seen in the
institution RLMMC (ONA):
2. Political factor is the second discrepancies in the said institution. The said
institution is a government hospital. Wherein most of the management
process is affected. Planning is affected for the reason that whoever in
incumbent mayor and the new mayor will always have a different planning,
organizing, staffing, directing and controlling. New Mayor means new Staff…
meaning there is no permanent staffing in the said institution.
LACK OF FUNDS:
NEGLIGENCE:
This would have been the most common problem in different hospitals
and also the most wanted to prevent its occurrence into either in private or
in public hospitals. As one of the public hospitals where most of the time also
has a tremendous amount of population and through this, it is possible that
sometimes nurses can not implement to ideal nursing care for the entire
patient who are confine in the hospital. Through this type of situation, it is
hard to prevent negligence because of the over crowded population
especially whenever there is only few nurses who are handling a large
amount of patients. They have also mentioned that the presence of large
amount of student nurses could also lead into such negligence because of
having a hard time in controlling or keeping track with those large amount of
students. Thus sometimes some student nurses do not have to will to give
care with the patients and have the mentally attitude of just doing
something although the management that they are giving is no longer
appropriate for their patients. Also in giving medicine where sometimes the
students gives delayed medicine or wrong medicine to their patients. As
researchers, we came out with the possible solution for this problem such as
first; if possible, maybe it is appropriate to give a sufficient amount of time
for training or giving assistant for those who are new into the job that are not
that yet confident in different nursing management. Secondly, it might be
also helpful to also assist the student nurses in performing special nursing
procedure to the patients as it could also help in preventing the occurrences
of negligence.