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REPUBLIC OF THE PHILIPPINES


DEPARTMENT OF NATIONAL DEFENSE
CHIEF OF STAFF
ARMED FORCES OF THE PHILIPPINES
CAMP GENERAL EMILIO AGUINALDO, QUEZON CITY

15 August 2001

SUBJECT: Authority to Promulgate

TO: All Concerned

1. The PHILIPPINE ARMY NURSING SERVICE


ADMINISTRATION MANUAL (PAM) 1-05 was formulated/revised by the
OFFICE OF THE ARMY CHIEF NURSE assisted by the OFFICE OF THE
DOCTRINE CENTER, TRADOC, PA.

2. The Commanding General, Philippine Army recommends


approval for the promulgation of this manual.

3. The promulgation of the PHILIPPINE ARMY NURSING


SERVICE ADMINISTRATION MANUAL MAY 2001 by the Philippine Army is
hereby approved effective this date.

BY ORDER OF SECRETARY OF NATIONAL DEFENSE:

DIOMEDIO P VILLANUEVA
General AFP

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COMMANDING GENERAL
PHILIPPINE ARMY
Fort Andres Bonifacio, Metro Manila

FOREWORD

The modernization of the Philippine Army is centered on the acquisition


of high-tech equipment and weaponry and also, in the upgrading of technical
skills, management policies, and ethical standards. Among the areas affecting
our nursing service personnel are those involving skills development,
information technology and management systems.

It is therefore very appropriate that the Philippine Army Nursing Service


takes bold steps in seeking improvement in its role as it continuously
reassesses capabilities vis-à-vis the challenges of present and future security
requirements. As the PA Nursing Service seeks to maintain a highly
motivated, disciplined and competent pool of professional health workers, it
also adopts modern health care procedures and techniques.

The publication therefore of this revised Philippine Army Nursing


Service Administration Manual is very timely as it merges into correct
perspective the traditional theories and practices with the latest policies and
methodology. This Manual also simplifies and standardizes many ways to
accomplish the Nursing Service mission which is to provide the best nursing
care possible to all PA personnel, their dependents and authorized civilians
through efficient administration, supervision, training and evaluation of the
Nursing Service personnel in accordance with the standards of safe nursing
practice.

I therefore enjoin all those involved in health care to make use of this
Manual in the pursuant of professional development and technical excellence.

JAIME S DELOS SANTOS


Lieutenant General, AFP

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AMENDMENT CERTIFICATE

1. Proposals for amendment or additions to the text of this manual should


be made through the normal channels to the sponsor. A sample format of an
amendment proposal is found in Annex P of PAM 8-01.

2. It is certified that the amendments promulgated in the under-mentioned


amendment list have been made in this manual.

Amendment List Amended by Date of


Number Date (Printed Name and Initials) Amending
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

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PREFACE

1. Purpose.

This manual provides a doctrine for the planning, organization,


implementation and supervision of the Army-wide nursing service.

2. Scope and Applicability.

This publication includes basic guidance on the management of human


resources comprising of Army Officers, Enlisted Personnel and Civilian
Employees in relation to their roles and functions in the accomplishment of
mission. It also aims to provide guidance to line commanders and personnel
staff officers on the integration of personnel activities and functions to
strategically align them with the attainment of the PA’s vision, mission, goals
and objectives.

3. User Information.

The proponent of this manual is the Office of the Assistant Chief of


Staff for Personnel, G1, PA and is responsible in the review and update of this
publication. Send comments and recommendations to the said Office at Fort
Bonifacio, Makati City, 1201.

4. Reference.

The following references were used in this publication:

Strategic Doctrines

AFP Basic Doctrine, AFPM 0-1


Philippine Army Basic Doctrine, PAM 0-1, HPA, January 1996

Related Manuals

AFP National Military Strategy, 2001


Philippine Army Officers Career Management Manual, 2001
AIM Strategic Human Resource Management for the PA, 2002
USA FM 100-1 Personnel Management, 2001
Australian Command and Staff Course, People Management,
2001

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5. Recession

All publications, manuals and directives inconsistent with this manual


are hereby rescinded.

6. Gender

Unless this publication states otherwise, masculine nouns and


pronouns do not refer exclusively to men.

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CONTENTS

Letter of Promulgation i
Foreword iii
Amendment Certificate v
Preface vii
Contents ix

Section Title Page

CHAPTER 1 – INTRODUCTION

1-1 Vision, Mission, Goal and Philosophy 1-1


1-2 Historical Background 1-3
1-3 Composition and Exercise of Command 1-3

CHAPTER 2- ORGANIZATION AND FUNCTIONS

2-1 Organization 2-1


2-2 Office of the Army Chief Nurse 2-3
2-3 Organization of Nursing Services in PA Health Care 2-10
Facility
2-4 Military and Civilian Employee Assigned Nursing 2-10
Service of General/ Tertiary Hospital, Station/
Secondary Hospital and Medical Infirmary

CHAPTER 3 – HUMAN RESOURCE MANAGEMENT

3-1 Human Resource Management Function 3-1


3-2 Assignment and Utilization of Nurse Corps Officer 3-3
3-3 Extension of Tour of Active Duty/ Retention of Nurse 3-6
Corps Officers
3-4 Promotion of Nurse Corps Officers 3-8
3-5 Separation of Nurse Corps Officers 3-11
3-6 Evaluation of Nurse Corps Officers 3-14
3-7 Recruitment and Selection of Appointment of PA 3-21
Nursing Service Civilian Employees
3-8 Management and Utilization of PA Nursing service 3-22
Civilian Employees
3-9 Promotion of PA Nursing Service Civilian Employees 3-22
3-10 Termination of Employment of PA Nursing Service 3-23
Civilian Employees
3-11 Evaluation of PA Nursing Service Civilian Employees 3-24
3-12 Career and Personnel Development of PA Nursing 3-25
Service Civilian Employees
3-13 Morale and Welfare 3-26
3-14 Awards and Decorations 3-45
3-15 Uniform 3-53

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CHAPTER 4 – OPERATIONS

4-1 Nursing Service Administration and Management 4-1


4-2 Principles/Functions of Management 4-3
4-3 Total Quality Management 4-16
4-4 Nursing Process 4-24

CHAPTER 5 – MANAGEMENT OF CLIEN'T CARE

5-1 Extended Functions of Nurse Corps Officers 5-1


5-2 Emergency and Disaster Nursing Management 5-1
5-3 Health Service Support 5-4

CHAPTER 6 - HUMAN RESOURCE


DEVELOPMENT PROGRAM

6-1 Military Training and Education 6-1


6-2 Professional Advancement Program 6-3
6-3 In-Service Training Program 6-8
6-4 Paramedical Training in Army Health Care Facility 6-11

CHAPTER 7 - CONDUCT AND DISCIPLINE

7-1 Standards and Policies 7-1


7-2 Nursing Activities in the Ward 7-2
7-3 PA Nursing Service Personnel Discipline 7-3

CHAPTER 8 - NURSES AND THE LAW

8-1 Code of Ethics for Nurses in the Philippines (PNA 8-1


Code for Nurses)
8-2 Scope of Professional Nursing Practice (R.A No. 7164 8-2
“Philippine Nursing Act of 1991)
8-3 Nurse’s Legal Responsibility for Client Care 8-3
8-4 Right and Responsibilities 8-12

CHAPTER 9 - ADMINISTRATIVE TOOLS

9-1 Records/Reports 9-1


9-2 Forms 9-5
9-3 Documentation 9-12

A Organization A-1
B Uniforms B-1
C Utilization of Nurse Corps in Echelons of Medical C-1
Evacuation
D PA Nursing Service Medication Sheet D-1
E PA Nursing Service Nurses’ Progress Notes E-1
F AFP Officer Appraisal System F-1
G Career Development Program For Nurse Corps G-1

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Officers In The AFP
H Policies Governing Marriage, Pregnancy And H-1
Maternity Leave Of Female Members Of The Active
Force Of The AFP
I Circular Nr 01 AFP Technical Services Uniform I-1

Record of Changes
Recommendation for Changes

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CHAPTER 1
INTRODUCTION

Section 1-1 Vision, Mission, Goal and Philosophy

1. Vision. The Army Nursing Service envisions a globally competitive and


technologically driven caring Nursing Service.

2. Mission. The Nursing Service of the Army achieves its vision by


providing the best nursing care possible to all PA personnel, their dependents
and authorized civilians through efficient administration, supervision teaching
and careful evaluation of the nursing service, professional and non-
professional personnel in accordance with the standard of safe nursing
practice.

3. Goal. A Nursing Service capable of providing quality nursing care


encompassing the primitive, preventive, curative and rehabilitative spheres to
all PA personnel, their dependents and authorized civilians.

4. Philosophy. The PA Nursing Service is dedicated to reflect in all its


activities the promotion of health, prevention of diseases of all PA clients, their
dependents and authorized civilian and the advancement of professional and
administrative growth of all members of the nursing service.

To achieve excellence in Nursing Service, nursing practice and nursing


leadership, the PA Nursing Service is guided by the following beliefs:

a. Excellence in Nursing Service (Client Care).

1) Each client regardless of circumstances possesses


intrinsic value from God and should be treated with dignity and respect.

2) Each encounter with clients, their families and friends


should portray compassion and concern.

3) Each client should receive quality care that is prompt,


cost effective, responsive and. based on the latest technology.

4) The client confidentiality and privacy should be


preserved.

5) Meeting the needs of client should always be the primary


priority.

b. Excellence in Nursing Practice (Professional Growth).

1) Nursing is an art and science, the essence of which is


nurturing and caring.

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2) A nurse's primary commitment is the restoration and


promotion of health of our clients in a sprit of compassion and concern.

3) The Nursing Process is an integral part of a professional


nurse's practice.

4) Nurses should collaborate with other health care team


members to meet the holistic needs of their clients which include the physical,
psychosocial and spiritual aspects of care.

5) Client and family/significant others' education should be


aggressively promoted to allow each individual the opportunity to prevent
illness and achieve optimal health.

6) Nurses are accountable to their clients and their clients'


families as well as to each other for professional practice.

7) Monitoring and evaluating Nursing Practice is a


necessary responsibility to continuously improve care.

8) Professional growth and development should be pursued


through education, research and participation in professional organizations.

c. Excellence in Nursing Leadership (Administrative Growth)

1) Nurses should provide a progressive environment,


utilizing current technology.

2) Nurses should be guided by responsible stewardship to


promote the highest quality client care, and personal satisfaction.

3) Nurses should encourage and support collaborative


decision-making by those who are closest to the situation even at the risk of
failure.

4) Compassion should be demonstrated in day to day


personal interactions as well as a guide in decision-making.

5) Nurses should be sensitive to individual needs and give


support, praise and recognition to encourage professional and personal
development.

6) Nurses should possess an energy level and personal


style that empower and inspire enthusiasm in others.

7) Nurses should consider suggestions and criticisms as


challenges for improvement and innovation.

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8) Justice should be applied equitably in all employment


practices and personal policies.

Section 1-2 Historical Background

5. Early Beginnings. The forerunner of the Nurse Corps of the Armed


Forces of the Philippines was the Army Nurse Corps, which was created on 5
September 1938 by virtue of Commonwealth Act No. 385. This Act provided
that the Medical Service shall consist of the Medical Corps, the Dental Corps,
the Veterinary Corps, the Nurse Corps and the Medical Administrative Corps.
This Act was implemented by Executive Order No. 267 of April 1940, which
further provided for the qualifications, appointments, classification and
compensation of members.

Republic Act No. 203 dated May 12, 1948 made the Nurse Corps an
integral part of the Armed Forces of the Philippines directly under the Medical
Service, This law, among others, gave the members of the Nurse Corps equal
rights and privileges as any other member of the Armed Forces.

6. Expansion. When the Armed Forces of the Philippines were


reorganized, the Philippine Army became one of the four major commands.
As a result, the Office of the Chief Surgeon, Philippine Army was activated on
March 1965 with the Chief Nurse, Philippine Army as a staff officer to advice
on matters pertaining to Nursing.

7. The Philippine Army Nursing Service. With the implementation of


GO No. 510, GHQ, AFP dated 28 June 1973 the Nurse Corps was
administratively separated from the Medical Corps. Because of this
separation, The Office of the Chief Nurse for each of the Major Services was
activated. Effective 01 September 1973, Chief Nurse, Philippine Army
became a special staff to the Commanding General, Philippine Army.

Section 1-3 Composition and Exercise of Command

8. Composition. The PA Nursing Service is composed of three (3)


general categories of personnel:

a. Nurse Corps Officers.

1) Regular (RA 291). These are career NC officers whose


tenure of service can be terminated only for a cause or by request of the
individual.

2) Reserve (RA 6441). These are NC Officers who served


with either the Philippine Contingent (PHILCON) or the Philippine Civic Action
Group (PHILCAG) in Vietnam for a period of not less than six (6) months.

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Their tenure in the service is like the RA 291 officers and they can he
separated only for cause or by request of the individual.

3) Reserve (RA 2334). These are NC Officers on active duty


who are covered by RA 2334 and whose tour of active duty lasts three (3)
years (1st request) another three (3) years (2nd request) and four (4) years
(3rd request). After ten

4) Years of active duty" they are accorded the Security of


Tenure (SOT) wherein they can be separated only for cause or by request of
the individual.

b. Civilian Employees.

1) Nurses. These are graduates of Baccalaureate Program


in Nursing and are licensed to practice nursing in the Philippines. They may
be hired as regular, casual/ contractual.

2) Midwives. These are Midwifery Course graduates who


are licensed to practice midwifery in the Philippines. They may be hired as
regular, casual/contractual.

3) Nursing Attendants/Institutional Workers/Utility Workers.


These are the skilled and semi-skilled non-professional workers and may be
hired as regular, casual/ contractual.

These civilian employees maybe hired as:

1) Regular. Employees of the AFP who are covered by the


Civil Service Commission and appointed by the Department of National
Defense (DND). They can stay in the service until they retire and can be
removed from the service only for cause.

2) Casual/Contractual. Employees who may be promoted to


regular and whose tenure of service may be extended or terminated
depending on their performance and availability of funds.

c. Enlisted Personnel.

1) Medical Corpsmen. These are the highly trained male


enlisted personnel who may work in progression of responsibility according to
the degree of medical training and experience.

2) Women Auxiliary Corps (WAC). These are highly trained


female enlisted personnel who may work in progression of responsibility
according to the degree of medical training and experience.

9. Exercise of Command. Nurse Corps officers may exercise technical


and administrative functions only within their own branch of service and over
personnel placed under their control.

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CHAPTER 2
ORGANIZATION AND FUNCTIONS

Section 2-1 Organization

1. General. The provisions in this chapter are in accordance with AFPR G


161 - 192 dated 26 April 1989.

2. Organization. The organization of PA Health Care Facilities is


categorized according to capabilities.

a. General/Tertiary Hospitals. Hospitals that have capabilities and


facilities for providing medical care to cases requiring sophisticated diagnostic
and therapeutic equipment and expertise of trained specialists in their sub-
specialties.

b. Station/Secondary Hospitals. Hospitals that have capabilities


and facilities for medical care to cases requiring hospitalizations and have the
expertise of trained specialists.

c. Medical Infirmaries. Health care facilities intended primarily to


provide routine (out-patient/non-hospital) medical assistance and to confine
clients with acute cases of influenza, diarrhea, and other medical cases which
need two (2) to three (3) days confinement only.

Types of Medical Infirmaries:

1) Fixed or Station. These facilities are permanent and


situated/located inside camp or garrisons to provide health care and treatment
to all the personnel and their dependents in the area. They do not move nor
follow the movements of any military unit assigned in said area.

2) Field or Mobile. These facilities are organic to bigger


military units from battalions up and are required to move and follow where
the mother unit goes.

3. Organization of PA Nursing; The organization of PA Nursing


Services is composed of the Nursing Services of the various PA Health Care
Facilities (Annex AI) under the technical and administrative supervision of the
Office of the Army Chief Nurse.

a. Nursing Service, Fort Bonifacio General Hospital

b. Nursing Service, Army Station Hospital, 1ID

c. Nursing Service, Medical Company, lID

d. Nursing Service, Army Station Hospital, 2ID

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e. Nursing Service,. Medical Company, 210

f. Nursing Service, Army Station Hospital, 3ID

g. Nursing Service, Medical Company, 3ID

h. Nursing Service, Army Station Hospital, 4ID with a Satellite


Hospital Annex at Bancasi, Butuan City

i. Nursing Service, Medical Company, 4ID

j. Nursing Service, 4DTU Med Infirmary, 403rd Bde, 4ID

k. Nursing Service, Army Station Hospital, 5ID

l. Nursing Service, Medical Company, SID

m. Nursing Service, Army Station Hospital, 6ID (One ward is


Located in General Santos City District Hospital)

n. Nursing Service, Medical Company, 6ID

o. Nursing Service, Army Station Hospital, 7ID

p. Nursing Service Medical Company, 7ID

q. Nursing Service, FSRH. Medical Infirmary, SOCOM

r. Nursing Service, SFR Medical Infirmary, SOCOM

s. Nursing Service, Army Station Hospital 8ID

t. Nursing Service, Medical Company, 8ID

u. Nursing Service, LABde Medical Infirmary

v. Nursing Service, 51st EBde Medical Infirmary

w. Nursing Service, S2ml EBde Medical Infirmary

x. Nursing Service, 53rd EBde Medical Infirmary y. Nursing


Service, 54th EBde Medical Infirmary z. Nursing Service, 55th EBde Medical
Infirmary

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Section 2-2 Office of the Army Chief Nurse

4. Activation. The Office of the Chief Nurse, Philippine Army was


organized as a special staff of Headquarters; Philippine Army effective 01
September 1973 pursuant to GO Nr 112 HPA dated 30 August 1973.

5. Mission. The mission of the Army Chief Nurse is to ensure safe


nursing practice and the delivery of comprehensive, quality nursing care to the
PA wide clientele.

6. Command Relationship. The Office of the Army Chief Nurse (OACN),


is under the general supervision of the Chief of Staff, Philippine Army and
under the functional supervision of the Assistant Chief of Staff for Personnel,
G 1. (Annex A)

7. Organization. The organization of the Office of the Army Chief Nurse


;( Annex A2) as a Technical/Special Staff of the Office of the Commanding
General, PA. (Annex A)

8. Qualifications, Functions, and Responsibilities of Personnel,


Office of the Army Chief Nurse.

a. Army Chief Nurse.

1) Qualifications:

a) Rank of Colonel

b) AFPOS of Nursing Service, Administration with


Proficiency Designation of A

c) GSC eligible

d) Holder of Master's Degree in Nursing Major in


Nursing Service Administration/related health fields

e) Has at least eighteen (18) years practice in Military


Nursing

f) Holder of a current license to practice nursing in


the Philippines

g) Certified current IV Therapy train or

h) Demonstrated capability to organize, coordinate


and lead the PA Nursing Service

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2) Functions/Responsibilities:

a) Advises the Commanding General, Philippine


Army on all matters pertaining to and affecting the Nurse Corps, Philippine
Army.

b) Ensures that policies and standards of nursing


practice are maintained and to assess nursing service requirements in PA
Health Care Facilities through staff visits and inspections.

c) Formulates professional standards of safe nursing


practice in the Philippine Army Nursing Service.

d) Coordinates with The Chief Nurse Corps, Armed


Forces of the Philippines (TCN, AFP) on all matters regarding recruitment,
appointment, classification, promotion, retention and separation of PA Nurse
Corps Officers.

e) Coordinates/recommends to the Chief Surgeon,


PA policies pertaining to the PA Nursing Service for incorporation in the PA
Medical Service.

f) Attends staff conferences especially when PA


nurses are involved.

g) Coordinates with commanders of PA subordinate


units through their respective Chief Nurse or Nurse-In-Charge regarding
assignments and other personal matters affecting Army NC officers.

h) Plans, coordinates, and implements all training


programs for the Nursing Service.

i) Determines requirements for procurement,


retention and separation of Nurse Corps Officers assigned Nursing Service
and ensures a well maintained Management Information System (MIS) of the
Nursing Service

b. Deputy Army ,Chief Nurse.

1) Qualification: Same as Army Chief Nurse.

2) Functions/Responsibilities:

The Deputy Army Chief Nurse assists the Army Chief


Nurse in the performance of the latter's staff functions and acts in her behalf
during her absence and supervises the staff functions of the Administrative
and Personnel Management Branch, and the Plans, Organization and
Training Branch.

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c. Chief, Plans, Training and Organization Branch, OACN

1) Qualifications:

a) Rank of Lieutenant Colonel

b) GSC eligible

c) Holder of a current license to practice nursing in


the Philippines

d) Holder of Master's Degree in Nursing


Administration Major in Nursing Administration/related health fields

e) Certified current IV Therapy trainor

2) Functions/Responsibilities:

a) Coordinates, integrates and consolidates training


activities/programs of the Nursing Services of the various PA health care
facilities.

b) Prepares and coordinates the organization and


program of activities of all PA military and civilian employees assigned
Nursing Service

c) Reviews/recommends doctrines to ensure quality


nursing care.

d) Maintains PA Nurse Corps distribution list and


coordinates its updating for current planning.

e) Recommends priorities for personnel allocation


and training for PA Nurse Corps officers.

f) Assesses and programs Nursing Service


requirements in consonance with current trends in Nursing practice.

g) Conducts/participates in research to improve


nursing practice.

h) Chief Ensures implementation of standards


nursing practice. of safe

d. Chief, Administrative and Personnel Management Branch, ACN.

1) Qualifications

a) Rank of Major

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b) Demonstrated oral and written communication


skills.

c) Holder of a current license to practice nursing in


the Philippines

d) Holder of Master's Degree in Nursing Major in


Nursing Administration/related health fields.

e) Demonstrated the ability to supervise office


management.

f) Certified current IV therapist

g) Completed the Personnel Officers' Course

2) Functions / Responsibilities:

a) Responsible for the management of information


system in the office.

b) Ensures effective human resource planning and


development

c) Recommends to the Army Chief Nurse policies


affecting morale and welfare of PA Nurse Corps officers.

d) Establishes, interprets personnel policies and


promotes good personnel relations and morale.

e) Monitors for the Army Chief Nurse, the career


management of PA Nurse Corps Officers

e. Chief Clerk, OACN.

1) Qualifications:

a) Rank E-7

b) Undergone training in Advance NCO Course

c) With an AFPOS of Medical Specialist

d) A graduate of Advance NCO Course

2) Functions/Responsibilities:

a) Sorts / checks all incoming and out going


communication/message and other miscellaneous intended for the Office of
the Army Chief Nurse.

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b) Records a11 commitments/appointments and


other related activities of the Army Chief Nurse and staff in the daily journal
and to the bulletin board.

c) Coordinates with the assigned EP this office


regarding schedules of fatigue day, cleaning of the office and its surroundings.

d) Assists his Chief of Office in their respective job


assignments.

e) Type’s communication as the Army Chief Nurse


may direct.

f. Finance Sergeant, OACN.

1) Qualifications:

a) Rank of E-5

b) With an AFPOS of Medical Specialist

c) With Financial Management Training

2) Functions/Responsibilities:

a) Ensures that all vouchers/payrolls for whatever


claims in nature are properly coordinated/followed up with the office
concerned.

b) Draws salaries of OACN personnel from the


finance officer and give to all recipients.

c) Processes financial concerns of the Office of the


Army Chief Nurse.

d) Ensures that all financial matters are properly and


timely processed and accounted for.

g. Supply Sergeant, OACN.

1) Qualifications:

a) Rank of E-5

b) With an AFPOS of Medical Specialist

c) Knowledgeable in the management of office


equipment and supplies.

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d) With Logistics Management Training.

2) Functions/Responsibilities:

a) Ensures that all supplies and equipment of the


Office are properly maintained and accounted for.

b) Checks and maintains stock level of supplies and


ensures that all items are properly recorded.

c) Ensures that all books, magazines in the office are


properly accounted for. Maintains a borrower's card.

d) Maintains records of MRs and RIVs.

e) Presents and accounts all deliveries of supplies


and equipment.

h. Message Clerk.

1) Qualifications:

a) Rank of E-S.

b) With 2m AFPOS of Medical Specialist.

c) Knowledgeable in correspondence.

d) Demonstrated skill in the use of typewriters,


computers fax machine, copier machine.

2) Functions/Responsibilities:

a) Maintains file of outgoing. and communications

b) Updates roster of military personnel and MPFs.

c) Assists in the preparation of office reports.

d) Ensures that personnel policies and procedures


are properly compiled and secured.

e) Follows-up papers for commission, reversion,


separation and other matters pertaining to all military and civilian employees
assigned PA Nursing Service.

f) Ensures that all outgoing communications are


transmitted on time.

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i. Driver/Mechanic, OACN.

1) Qualifications:

a) Rank of EA.

b) With an AFPOS of Medical Specialist.

c) Demonstrated skills in proper and safe driving


acquired through formal training.

d) Knowledgeable in vehicle maintenance acquired


through formal training.

e) Knowledgeable of traffic rules and regulations as


mandated.

2) Functions/Responsibilities:

a) Maintains the road worthiness and cleanliness of


all vehicles.

b) Ensures that vehicles are registered and driven by


driver with license.

c) Reports all noted defects of vehicles to the Admin


Officer.

d) Secures vehicles in designated motor pools.

j. Civilian Clerk.

1) Qualifications:

a) Civil service eligible

b) With earned units in college level

c) A, graduate of Basic Civilian Personnel Course

2) Functions/Responsibilities

a) Encodes all communications of the Office of the


Army Chief Nurse.

b) Assists the message clerk in updating and


maintenance of MPFs of all PA Nurse Corps officers.

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c) Receives, sorts, records, files incoming


communications and presents them to ACN and staff for appropriate actions.

d) Maintains files of outgoing communications.

k. Janitor/Institutional Worker.

1) Qualifications:

a) High school graduate

b) Physically and mentally fit

2) Function/ Responsibilities

a) Maintains clean and sanitary conditions in


assigned area as directed according to the established standards, observing
proper cleaning and disinfec1ing techniques.

b) Exercises economical use of supplies and due


care of equipment.

Section 2-3 Organization of Nursing Services in PA Health Care Facility

9. Organizational Relationship of the Nursing Services "with the


other Services in PA Health. Care Facilities. The Nursing Service has a
clear distinct identifiable Structure in the organization which is on equal line
with the major services of the PA health care facilities e. g. Administrative,
Medical Services (Annex A3).

10. Organization of the Nursing Service of a General/Tertiary Hospital


(Annex A4)

11. Organization of the Nursing Service of Station/ Secondary


Hospital (Annex AS)

12. Organization of the Nursing Service of a Medical Infirmary ( Annex


A6)

Section 2-4 Military and Civilian Employee Assigned Nursing Service of


General/ Tertiary Hospital, Station/ Secondary Hospital and Medical
Infirmary

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13. General. The PA Nursing Service staff functions best when qualified
care givers, each knowing its functions and responsibilities are linked together
as members of a highly effective team group with mutual objectives.

14. Qualifications/Functions/Responsibilities of Professional Workers


of the Nursing Service. In order to have a Nursing Service that is efficient,
effective, relevant and responsive, the Army Chief Nurse has set the following
qualifications, functions, responsibilities of the different nursing service care
givers of all PA health care facilities.

15. General/Tertiary Hospital

a. Chief Nursing Service. This designation is given to a Nurse


Corps officer assigned in a general/tertiary hospital who is responsible for the
overall administration and supervision of the Nursing Service.

1) Qualifications:

a) Rank of COL

b) AFPOS of Nursing Administration

c) GSC eligible

d) Holder of a current license to practice nursing in


the Philippines.

e) Holder of Master's Degree in Nursing Major in


Nursing Service Administration/related health fields.

f) Certified current IV Therapy Trainor

g) With at least fifteen (15) years experience in


Military Nursing including two (2) years as Asst Chief Nurse of a General
Hospital.

2) Functions/ Responsibilities:

a) Assures client a quality care.

b) Evaluates Nursing Service needs and determines


staffing requirements and coordinates activities of the Nursing Service with
other sections.

c) Coordinates with Army Chief Nurse through the


Commanding Officer of the general hospital in matters pertaining to and
affecting the Nursing Service care givers.

d) Determines appropriate Nursing Service budget.

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e) Identifies and solves department and employees'


Problems.

f) Evaluate all military and civilian employees


assigned Nursing Service in accordance with AFP or Civil Service regulation
and standards of safe nursing practice

g) Updates, updates, and revises policies,


procedures and job descriptions to meet current objectives and standards.

h) Updates his knowledge and skills on current trends


in nursing through attendance of meetings, conferences, conventions,
seminar /workshops, in-service trainings and readings of current publications
pertaining to all aspects of client care.

b. Assistant Chief Nurse, Nursing Care Branch.

1) Qualifications:

a) Rank of COL

b) With appropriate AFPOS

c) GSC eligible

d) Holder of a current license to practice nursing in


the Philippines.

e) Holder of Master's Degree in Nursing Major in


Nursing Service Administration related health fields.

f) Certified current IV therapist

g) With at least twelve (1'2) years experience in


military Nursing including three (3) years as clinical supervisor,

2) Functions/Responsibilities

a) Plans and supervises over-all client care.

b) Receives daily report of ward activities and


communications from the different clinical supervisors.

c) Assesses nursing care in the wards and other


special areas.

d) Makes recommendations relative concerning client


care. to the problem

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e) Assists the Chief Nursing Service in the


supervision of nursing care.

f) Evaluates performance of all military and civilian


employees assigned Nursing Service.

c. Assistant Chief Nurse, Nursing Education and Training Branch.

1) Qualifications:

a) Rank of CO L

b) With AFPOS as Nurse Educator 32Q

c) GSC eligible

d) Holder of a current license to practice nursing in


the Philippines.

e) Holder of Master's Degree in Nursing Major in


Nursing Service Administration/related health fields.

f) Certified current IV therapy trainor/preceptor.

2) Functions/Responsibilities:

a) Plans, organizes and evaluates training programs


for all military and civilian employees assigned Nursing Service.

b) Formulates updates, publishes and disseminates


relevant nursing training programs.

c) Participates in the evaluation of Nursing Service


staff and renders OER/EPEM/NPES.

d) Establishes linkages with professional


organizations within and outside the military establishment.

e) Assists the Chief Nursing Service in identifying


training and learning needs of all military and civilian employees assigned
Nursing Service.

d. Assistant Chief Nurse, Nursing Research and Quality (


Assurance Branch).

1) Qualifications:

a) Rank of COL

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b) With appropriate AFPOS

c) GSC eligible

d) Holder of a current license to practice nursing in


the Philippines

e) Holder of Master's Degree in Nursing Major in


Nursing Service Administration/related health fields.

f) Certified current IV therapist

g) Demonstrated skill in research

2) Functions/Responsibilities:

a) Formulates and implements Continuous Quality


Improvement Program.

b) Participates/conducts researches on nursing and


related studies.

c) Assesses and recommends revision of policies,


standards of nursing practice, procedures and regulations.

e. Assistant Chief Nurse, Nursing Administrative Branch.

1. Qualifications:

a) Rank of LTC

b) With AFPOS of Nursing Administration 32A

c) GSC eligible

d) Holder of a current license to practice nursing in


the Philippines.

e) Holder of Master's Degree in Nursing Major in


Nursing Service Administration/related health fields.

f) Certified current IV Therapist

2. Functions/Responsibilities:

a) Responsible in the management information


system of the office

b) Recommends to the Chief Nursing Service policies


affecting morale and welfare of personnel

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c) Ensures effective human resource planning and


development.

f. Clinical Supervisor. This designation is given to a senior Nurse


Corps officer who supervises and coordinates ward activities and
administrative management to provide continuity of nursing care.

1. Qualifications:

a) Rank of Major

b) With appropriate AFPOS, Prefix A in nursing


specialty and Prefix B in Nursing Administration 32A.

c) Holder of a current license to practice nursing in


the Philippines.

d) Holder of a Master's Degree in Nursing Major in


Nursing Service Administration/related health fields.

e) A graduate of Technical Service Officers' Advance


Course

f) Certified current IV therapist

2. Functions / Responsibilities:

a) Directs and supervises nursing service of a group


of client care units to provide best care attainable.

b) Recommends/Participates/Coordinates in
preparation of nursing budgets.

c) Supervises, coordinates, development programs.


participates in staff

d) Evaluates the performance of military and Civilian


employees assigned Nursing Service utilizing the appraisal system
established by the Nursing Service (OER for NC Officers, EPEM for Enlisted
Personnel and NPES for Civilian Employees)

e) Gathers information pertinent to the status of staff,


unit equipment! Facilities, supplies and materials

g. Head nurse/Charge Nurse. This designation is given to the NC


Officer who is responsible for the nursing care in one nursing unit.

1. Qualifications:

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a) Rank of CPT

b) With appropriate AFPOS.

c) Holder of a current license to practice nursing in


the Philippines.

d) With at least nine (9) units in any management


courses at the graduate level.

e) At least seven (7) years experience in military


nursing to include five (5) years experience as a staff nurse.

f) A graduate of Technical Service Officers Advance


Course.

g) Certified current IV therapist.

2. Functions / Responsibilities:

a) Assesses/classifies the overall nursing care needs


of clients.

b) Formulates general program of nursing care based


on the clients' assessed needs.

c) Coordinates the implementation of each client's


nursing care plan with the different categories and levels of health care
professionals/entities.

d) Evaluates the efficiency and effectiveness of


nursing care delivered.

e) Determines/allocates equitable assignments in the


ward. Workload

f) Evaluates the performance of all military and


civilian employees assigned Nursing Service based on the established
evaluation parameters.

g) Employs individual employee conferences and


counseling techniques to promote positive work attitudes and to motivate the
staff to meet/exceed standards of performance.

h) Attends/coordinates/participates in staff
development activities.

i) Ensures adequacy of facilities/equipment/supplies


materials pertinent to meeting the needs of clients and care givers through
their sufficiently justified proposals.

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h. General Duty Nurse. This designation is given to a newly CAD


Nurse Corps Officer.

1. Qualifications:

a) Rank of 2LT

b) Holder a current license to practice nursing in the


Philippines

c) Certified current IV therapist

2. Functions and responsibilities:

a) Accomplishes nursing histories and assessments


in order to identify common variables affecting nursing care.

b) Identifies and analyzes common current client's


problems, symptoms and behavioral changes.

c) Plans, implements, documents and evaluates


individualized nursing care utilizing assessment data involving client/family
and significant others to include health education.

d) Participates in the educational program of clients


and significant others.

e) Participates in the educational program and


evaluation performance of nursing students and auxiliary workers.

f) Ensures availability of medicines, nursing supplies


and equipment at all times.

g) Provides safe, clear and orderly environment for


clients.

i. Public Health Nurse. This designation is given to a Nurse Corps


Officer with AFPOS of Public Health Nurse 32P.

1. Qualifications:

a) Rank of lLT

b) Has undertaken Special Courses trainings in


Public Health/ Public Health Nursing

c) Holder of a current license to practice nursing in


the Philippines.

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d) A graduate of Technical Service Officers Basic


Course

e) Certified current IV therapist

2. Functions/Responsibilities:

a) Collects and updates individual, family and


community data base in a systematic and complete manner.

b) Identifies common, recurrent and potential


problems relative to health status of the population, community resources arid
administration.

c) Sets priorities for health action based on criteria


set such as: magnitude of the problem, resources and community capabilities,
existing policies and guidelines.

d) Plans, programs the nursing care with the


identified and priotized problems to serve as guide for all those involved in the
nursing actions.

e) Carries out nursing activities which may include;


administration of direct services, monitoring activities, teaching, and
improvising, counseling, referrals to appropriate service/professionals.

f) Evaluates extent to which nursing activities and


outcomes of care to individuals and families are carried out or achieved.

j. Nurse Officer of the Day (NOD). This designation is given to the


NC Officer who goes on 24 hours duty in a general/station hospital.

1. Functions/ Responsibilities

a) Augments the afternoon and night shifts when


abnormally busy. In extreme emergencies, the supervisor. On duty may call
all available military nurses to include Nurse on Duty to augment any or all
shifts.

b) Ensures that Nursing Service personnel who are


sick in quarters (nurses' quarters/female BOQ) receive appropriate medical
and nursing management.

c) Communicates unusual/necessary activities of the


day to the Chief Nursing Service.

k. Civilian Staff Nurse I.

1. Qualifications:

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a) BSN graduate

b) A certified current IV Therapist

c) Holder of current license to practice nursing in the


Philippines

d) Have passed the competency and mental ability


tests and physical examination given by the appropriate AFP body, and
cleared by the proper military security agency.

2. Functions/Responsibilities:

a) Identifies, plans, implements and evaluates


nursing needs of clients.

(1) Obtains nursing history and performs


physical assessment

(2) Identifies subjective and objective problems


of clients.

(3) Detects abnormalities from the assessment


and result of diagnostic examinations and reports.

(4) Establishes nursing diagnosis

(5) Prioritized needs and problems of clients.

(6) Formulates short and long term objectives


based on the acronym SMART, Discharge Plan initiated based on the
acronym METHOD

(7) Executes plans of care/administers


prescribed medications and treatments and documents in the medication
sheet and nurses' progress notes.

(8) Documents client's response to care in the


nurses' progress notes.

(9) Revises plans of care as necessary

(10) Completes and accurately fills-up clinical


forms.

b) Participates in providing adequate, safe, orderly


and clean environment for clients and care givers.

l. Civilian Staff Nurse II.

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1. Qualifications:

a) BSN Graduate

b) Certified current IV Therapist

c) Holder of a current license to practice nursing in


the Philippines

d) Have passed the competency and mental ability


tests and physical examination given by the appropriate AFP body, and
cleared by the proper military security agency.

e) A graduate of Civilian Personnel Basic Course

2. Functions / Responsibilities:

Same as functions of Civilian Staff Nurse I

m. Civilian Staff Nurse III.

1. Qualifications:

a) Have earned at least nine (9) units in any


management courses at the graduate level.

b) Certified current IV Therapist

c) Holder of a current license to practice nursing in


the Philippines

d) Have passed the competency and mental ability


tests and physical examination given by the appropriate AFP body, and
cleared by the proper military (security agency.

e) A graduate of Civilian Personnel Supervisory


Course.

2. Functions /Responsibilities

In addition to functions of Civilian Staff Nurse I & II:

a) Plans/Conducts teaching development programs


of all nursing civilian employees assigned in the area.

(1) Orients nursing service civilian employees.

(2) Evaluates ward accomplishments/


performance of nursing service civilian employees.

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(3) Plots work/ duty schedules of nursing


service civilian employees

(4) Conducts nursing conferences. rounds and


monthly

(5) Conducts daily inventory of stock level of


supplies and requests medicines/supplies needed in the area.

n. Civilian Midwife I.

1. Qualifications:

a) Registered midwife with current license to practice.

b) Have passed the competency and mental ability


test and physical examinations given by the appropriate AFP body and
cleared by the proper military security agency.

2. Functions/Responsibilities:

a) Handles and assists normal deliveries and


performs neonatal care to newborn with supervision.

(1) Monitors client's vital signs, fetal heart beat


and record.

(2) Monitors client's progress of labor and


record.

(3) Handles normal deliveries.

(4) Assists doctors in abnormal deliveries.

(5) Assesses/renders neonatal care to newborn


to include cord dressing.

b) Renders direct care and evaluates care given to


obstetrical clients.

c) Participates in health education on prenatal and


post partum care.

d) Participates in providing adequate, safe orderly


and clean environment for clients.

e) Maintains accurate and complete records and


reports.

(1) Attends endorsement and ward rounds.

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(2) Maintains records of deliveries, dilatation


and curettage and other OB Gyne procedures and reports as required.

(3) Maintains updated consumption and


utilization reports and records of medical and nursing supplies.

(4) Maintains updated records of available


equipment and their status of serviceability.

(5) Assists the head nurse in the preparation of


reports.

o. Civilian Midwife II and III.

1. Qualifications:

a) Registered midwife with current license to practice.

b) Have passed the competency and mental ability


test and physical examinations given by the appropriate AFP body and
cleared by the proper military security agency.

c) A graduate of Civilian Personnel Basic Course.

d) Must have at least three (3) years length of service


for Midwife II and five (5) years for Midwife III.

e) Must have NPES ratings of Very Satisfactory for


two successive years immediately before consideration for promotion

2. Functions/Responsibilities: Same as the


functions/responsibilities of Civilian Midwife 1.

16. Non Professional Nursing Service Personnel.

a. Ward master. This designation is given to a senior enlisted


personnel in a nursing unit under the supervision and direct responsibility of
the head nurse.

1. Qualifications:

a) Rank of E-7

b) With AFPOS of Medical Specialist

c) A graduate of Medical Aidman Advanced Course

d) Demonstrated skills in performing simple


delegated basic nursing procedures

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2. Functions/Responsibilities:

a) Executes direct administrative supervision over


ward men and subordinates assigned in the area.

b) Ensures that a comfortable and safe environment


for clients is maintained at all times.

c) Ensures that all records of equipment and supplies


to include linen supplies found in the unit are complete and updated.

d) Warrants that adequate stock of supplies to


include linen supplies is always available.

e) Plans, publishes work/ off duty schedules for ward


men and auxiliary workers assigned in his unit, in coordination with the head
nurse.

f) Performs some simple, delegated, basic nursing


care under the supervision of the head nurse.

g) Enforces discipline among the clients and ward


men and subordinates in the nursing unit.

h) Assists the head nurse in acquainting the clients


on rules/regulations of the nursing unit/hospital.

b. Ward man. A designation is given to an enlisted personnel


assigned in the nursing unit.

1. Qualifications:

a) Rank of E-,3 to E-6

b) With AFPOS of Medical Specialist

c) Demonstrated the skill s in performing delegated


simple nursing procedures.

2. Functions/Responsibilities

a) Performs simple direct nursing care for the


physical comfort and safety of clients under the supervision of the nurse.

b) Assist the ward master in the performance of his


duties.

c. Nursing Attendant. This designation is given to a non


professional Nursing Service employee who assists the nurses and other care

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givers in the ward in providing indirect nursing care and some technical
nursing services / care under the direction and supervision of a professional
nurse.

1. Qualifications:

a) High school graduate

b) Physically and mentally fit

c) Has undertaken on-the-job training in basic


nursing procedures as temperature taking and others.

2. Functions/Responsibilities:

a) Assists/performs simple delegated nursing


procedures under the supervision of the nurse.

b) Checks stock levels of ward supplies.

c) Assists the ward master and ward men in making


requisition of ward supplies.

d) Participates in the cleaning of the ward.

d. Janitor Institutional Worker. This designation is given to a non-


professional worker who performs housekeeping and cleaning activities within
an assigned area under the supervision of the head nurse and/or ward
master.

1. Qualifications:

a) High school graduate

b) Physically and mentally fit

2. Functions/Responsibilities:

a) Ensures that assigned areas and surroundings are


kept clean and safe at all times.

b) Assists the ward man in collecting and sending


soiled linens to laundry.

c) Reports observations concerning structural and


equipment defect to head nurse or ward master

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17. Station/Secondary Hospitals. The military and civilian employees


assigned Nursing Service of station/secondary hospitals as well as its
qualifications are the same as that of the general/tertiary hospital except that
in a station secondary hospital there is no Assistant Chief Nurse, Nursing
Research Branch. The function of research is subsumed to the Chief Nursing
Service.

18. Medical Infirmary.

a. Nurse-in-Charge (NIC) .This designation is given to a Nurse


Corps officer assigned in a Medical Infirmary. He is responsible for the overall
administration and supervision of aU nursing and non nursing activities
related to the overall total nursing management of out patient services.

1. Qualifications:

a) Rank of 1LT

b) With an AFPOS 1S Public Health Nurse: 32P and


demonstrated the skills on epidemiological investigations.

c) Holder of a current licensure to practice nursing in


the Philippines.

d) Certified current IV therapist

e) A graduate of Technica1 Service Officers Basic


Course

2. Functions/Responsibilities:

a) Assists in the conduct of epidemiological


investigations of profile of military personnel and dependents and participates
and implementation of health impact program.

b) Estab1ishes and maintains linkages with GOs and


NGOs in the area of responsibility.

c) Conducts inspection of environmental sanitation


inside military camps

d) Renders evaluation of personnel as mandated.

e) Assessing training needs and appropriate training


programs. Implements

f) Warrants stock levels of supplies and efficient


functioning of requirements.

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g) Responsible to the Commanding Officer of the


Medical Infirmary and Army Chief Nurse

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CHAPTER 3
HUMAN RESOURCE MANAGEMENT

Section 3-1 Human Resource Management Function

1. General. This Chapter embodies procedures, policies and regulations


governing the recruitment and appointment of Nurse Corps Officers in the
Armed Forces of the Philippines in accordance with AFP Personnel Directive
Nr 08-72 dtd 07, Jan 72 and Circular Nr 30 dtd 07 Dec 87.

2. Recruitment. This refers to the activities undertaken relative to the


appointment of a qualified nurse applicant as a Regular /Reserve Officer. It
does not include the call to active duty (CAD) or extended tour of active duty
(ETAD) of those already appointed. Neither does it cover procurement by
draft or compulsory military service.

a. The Chief Nurse, AFP shall process applications for


Commission in the Nurse Corps, Regular/Reserve Force, AFP. I-Ie shall
recommend the qualified applicants to the Chief of Staff, AFP through The
Adjutant General (TAG) AFP and. the Deputy Chief of Staff for Personnel
(DCSPER, Jl).

b. Qualifications for Commission in the Reserve Force, Nurse


Corps, AFP

1) Graduated from a recognized School/College of Nursing.

2) Passed the Board of Examination prescribed by law for


the practice of nursing with a rating of at least 80%.

3) Male and female candidates must be single and have


never been married. Female applicants must not be positively found to have
given birth to a living or still born child.

4) Must be a natural born Filipino citizen.

5) Must be mentally and physically fit for military service and


cleared by appropriate security agencies.

6) Must have a pleasing personality and of good moral


character.

7) Skillful in:

(a) Applying the nursing process in meeting health/


nursing needs of individuals, families, groups, communities.

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(b) Communicating and relating with others.

(c) Making sound/rational judgment in a given


situation.

(d) Interested and willing to work in both peacetime


and wartime conditions in any part of the country or abroad, if necessary.

8) Satisfies the following height requirements:

Male: minimum of sixty four (64) inches or 162.5


centimeters
Female: minimum of sixty two (62) inches or
157.5centimeters.

9) Must not be more than thirty two (32) years of age at the
time of commission.

3. Grades on Appointment. After having been qualified for commission


in the Regular or Reserve Force, a Nurse Corps Officer is appointed in the
grade of 2nd Lieutenant by the President of the Philippines.

a. Qualifications for Commission. In Regular Force, Nurse Corps,


AFP. In addition to the qualifications for commission in the Reserve Force,
Nurse Corps, AFP; numbers 1-9 the applicant must not be more than twenty
six (26) years of age at the time of Commission in the Regular Force as
prescribed in Circular .Nr 14 dtd 10 Nov 94.

b. Appointment into the Regular Force, Nurse Corps, AFP:

1) The appointment of a nurse into the Regular Force,


Nurse Corps, AFP shall satisfy the basic requirements prescribed by the
Nurse Corps, AFP.

2) The Chief Nurse (TCN) AFP is the recommending


authority for appointment into the Regular Force, Nurse Corps, AFP.

3) The Chief Nurse (TCN) AFP shall screen all applicants


and require the qualified applicants to take an appropriate competitive
examination for appointment. She shall select the applicants for submission to
the Technical Service Regular Commission Board by verifying the entries in
the application and determining the best qualified on the basis of the following
factors, the weight of each to be determined by the recommending authority
concerned.

(a) Result of competitive examination

(b) Performance as an officer, if applicable

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(c) Performance in service schools

(d) AFPGCT score (for those required to take) (e)


Educational attainment

(e) Board examination result

(f) Academic performance in college

(g) Professional experience

(h) Self-expression

c. Grades on Appointment: All appointments in the NC shall be in


the grade of 2LT

4. Qualifications for Call to Active Duty in the Nurse Corps.

a. Must be commissioned in the Nurse Corps, AFP

b. With at least one (1) year experience in a reputable health


agency

c. Must be cleared by appropriate security agencies

d. Passed the physical and mental examinations conducted by the


appropriate authorities.

Section 3-2 Assignment and Utilization of Nurse Corps Officer

5. Assignment and Rotation. The Chief Nurse, AFP is responsible for


the assignment/ rotation of the Nurse Corps officers. In like manner, the Army
Chief Nurse is responsible for the assignment/rotation of Nurse Corps Officers
assigned to the PA in accordance with the career management and
development program of Ute individual and needs of the PA.

NC officers who are in the following categories shall not be considered


for reassignment to combat zones or area of operations:

a. sick in hospital

b. pregnant

c. with pending case

d. Enjoying accumulated leave prior to separation/ Retirement.

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e. enjoying preferential assignment prior to compulsory
Retirement, and

f. undergoing schooling (local or abroad).

Rotation of NC officers shall be based on Armed Forces Occupational


Specialty (AFPOS) requirement, rank authorized for specific slots and needs
of the service.

Rotation of Nurse Corps officers in the Philippine Army conforms to the


prescribed career profile particularly for the three (3) periods of development
namely: Period of Clinical Development, Period of Professional Specialty
Development and Period of General Development.

6. Utilization of Nurse Corps Officers. PA Nurse Corps. Officers shall


be utilized in nursing duties either administrative or clinical appropriate to
efficient accomplishment of the mission of the PA Nursing Service.

NC Officers are considered appropriately assigned when they are


performing nursing duties. They shall not be designated to bear direct
responsibility for ward property nor be assigned to non nursing duties.

Newly CAD Nurse Corps officers who had already undergone


orientation/ familiarization training along their respective area of interest may
be assigned to medical installations located in combat areas.

Assignment of NC officers to medical installations in combat areas


shall be for a minimum of one (1) year and a maximum of two (2) years at
anyone time. NC officers who have signified their willingness to stay longer in
their field unit assignments may be allowed to do so subject to the approval of
the Army Chief Nurse/The Chief Nurse, AFP provided it shall be for a
maximum of two (2) terms or a total of four (4) years.

7. Designation of Chiefs of Technical Services in the Major Services


and GHQ post units / AFPWSSUs. Authority: AGPCR2 - Standing Operating
Procedure Nr 1 dtd 03 June 2004

a. References.

1) Implementing rules and regulations of RA 9188.

2) AFP Personnel Directive Nr. 5 GHQ, AFP dtd 08 Aug 90


as rescinded by SOP Nr 01 GHQ, AFP dtd 20 Jan 2004.

b. Purpose. The Standing Operating Procedures establishes the


policies and procedures on the designation of positions of Chiefs of Technical
Services in the Major Services and GHQ Post Units / AFPWSSU’s.

c. Policies.

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1) Designation of Technical Service Officers as Chief to the


following positions of the Major Services and GHQ Post Units/ AFPWSSUs is
subject to clearance/ approval of the Chief of Staff, AFP through the Major
Service Commanders and Chiefs of Technical Service at GHQ post units /
AFPWSSUs.

(a) Philippine Army

(1) The Army Chief Surgeon


(2) The Army Dental Surgeon
(3) The Army Chief Nurse
(4) The Army Chief Chaplain
(5) The Army Judge Advocate

(b) Philippine Navy

(1) The Chief Surgeon Navy


(2) The Naval Dental Surgeon
(3) The Chief Nurse Navy
(4) The Chief Chaplain Navy
(5) The Naval Judge Advocate

(c) Philippine Air Force

(1) The Chief Surgeon, Air Force


(2) The Chief Dental, Air Force
(3) The Chief Nurse, Air Force
(4) The Chief Chaplain, Air Force
(5) The Chief Air Judge Advocate

(d) GHQ Post Unit’s/AFPWSSU’s

(1) The Commanding Officer, CGEASH


(2) The Command Chaplain Service, CGEA
(3) The Commanding Officer, CGEA Dental
Dispensary
(4) The Command Nurse, AFPMC
(5) The Command Judge Advocate
(6) The Commanding Officer, AFPMC
(7) The Commanding Officer, AFP Dental
Service
(8) The Command Chaplain, AFPMC
(9) The Chief Nurse, PMA
(10) The Command Judge Advocate General,
PMA
(11) The Command Chaplain, PMA
(12) The Chief Nurse, PSG
(13) The Command Judge Advocate General,
PSG
(14) The Command Dental Surgeon, PSG

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(15) The Command Chaplain, PSG

2) Commanders of Major Services and TDCS for GHQ Post


Units/ AFPWSSUs, may designate an officer in an OIC capacity to any
position listed under para 3a if exigency of the service arises while waiting for
the approval/ clearance of the Chief of Staff, AFP.

3) Designation of all chiefs of personnel, technical and


special staffs at GHQ, AFP is subject to approval by CSAFP.

d. Procedures.

1) At least sixty (60) days to the projected relief or transfer


of the aforementioned officers, concerned Chiefs of Technical Services, shall
submit the names of one (1) principal and two (2) alternate candidates for the
positions in para 3a above.

2) Candidates for Chief of Technical Service Officers in the


Major Services and GHQ Post / AFPWSSUs shall be recommended by the
Chief, Technical Service concerned in consultation with the CGs and
commanders of Major Service taking into consideration the continuing
professionalization of the Technical Service Officer Corps, the career
development of Technical Service Officers and the needs of the cognizant
commands/ unit. In case of non-concurrence between the two recommending
authorities, separate recommendations may be forwarded to the Chief of Staff
for final decision.

3) For GHQ Post Units / AFPWSSUs, the same procedure


applies as in the above paragraphs except that coordination is made with
DCS for Personnel, J1.

4) Recommendation shall be fully justified and shall include


SOI and brief narrative career profile of the recommendees. This
recommendation shall be submitted to the Chief of Staff, AFP (Attn. DCS
PERS, JI). on the recommendation for positions in para 3a for subsequent
approval by CSAFP.

5) The Technical and Administrative Service BOSO (T/AS


BOSO) should pass on the recommendation for positions in para 3a for
subsequent approval by CSAFP.

Section 3-3 Extension of Tour of Active Duty/ Retention of Nurse Corps


Officers

8. General. The Army Chief Nurse shall recommend the ETAD of NC


officers assigned PA. Orders of ETAD will be issued at GHQ level. Likewise,
reversion to inactive status of NC officers’ assigned PA shall be

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recommended by the Army Chief Nurse thru channel to The Chief Nurse,
AFP. The NC Officer for ETAD shall submit the following requirements.

a. Commander's recommendation (Division or equivalent)

b. Personnel Action Form

c. Summary of Information

d. OERs for the last three (3) years

e. CAD Orders

f. Last ET AD Orders

g. Statement of Service (OTAG, AFP)

h. Annual Physical Examination

i. Physical Fitness Test

j. Worksheet (with over-all rating)

k. Command Clearances

1) GHQ (J2, J6, PEMRAD, TIG, TJAG, TPMG, and OESPA)

2) PA (G2. G6. G6 Mgmt, IG, JAG, PMG, OESPA)

3) DIVISION: (G2, G6, G6 Mgmt" IG, JAG, PMG, OESPA)

Submit requirements in ten (10) folders including the original, and all
reproduced copies must be authenticated.

9. Retention. Section I of Executive Order No. 79, s-86 states that a


reserve officer is initially called to active duty for a period of three (3) years.
Upon satisfactory completion of his tour of active duty, it shall be extended for
a period of another three (3) years.

A Reserve Nurse Corps officer who has rendered six (6) years of
continuous active military service shall, upon satisfactory completion of his
tour of active duty, be granted another extension for a period of four (4) years.

A Reserve Nurse Corps officer who has satisfactorily rendered ten (10)
years of continuous active commissioned military service shall have security
of tenure and shall not be reverted to inactive status except upon his own
request or for cause as may be adjudged by a court martial or by appropriate
bodies existing by provisions of law or by virtue of the operation of PD 1638,
as amended which provides for the forced lateral attrition of officers based on
exigencies of the service up to the time they reach the compulsory' retirement

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of thirty (30) years of service or fifty six (56) years of age which ever comes
later but not later that sixty (60) years of age.

Section 3-4 Promotion of Nurse Corps Officer

10. Promotion Guidelines. NC officer’s candidates for promotion shall be


evaluated and passed upon by the appropriate promotion board.

a. Medical Service Selection Board "A" - for promotion to 0-4 and


05

b. Medical Service Selection Board "B" - for promotion to 02 and


03

c. NC officer’s candidates for promotion to 0-6 shall be evaluated


and passed upon by the Technical Service Board of Senior Officers and AFP
Board of Generals.

11. Qualifications. Officers are qualified for promotion when they have
satisfactorily met the minimum time-in-grade, active commissioned service
(ASCS) and required career courses.

a. Time in Grade (TIG). The counting of the TIG shall commence


from the effective date of the last permanent promotion or appointment to the
active service up to the effective date of the contemplated promotion to the
next higher permanent grade.

GRADE LENGTH OF SERVICE/TIG REMARKS


02 3 yrs active Commissioned Service both regular
and reserve
03 7 yrs active Commissioned Service both regular
and reserve
04 2 yrs as O-3 no TIG for Reg
05 2 yrs as O-4 no TIG for Reg
06 3 yrs as O-5 1 yr TIG for
Regular

b. For NC Regular officers, the length of service requirement shall


be prescribed by See 6, 7, 8 and 9 of RA 291.

c. Nurse Corps Career Courses Requirements. A Nurse Corps


officer for promotion must have satisfactorily completed the required military
career courses for promotion to the grades as indicated:

Grade Career Courses


O-3 Technical Service Officers Basic Course

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O-4 and O-5 Technical Service Officers Advance


Course
O-6 Command and General Staff Course
O-7 MNSA or equivalent Masteral/ Doctorate
Degree

d. Zone of Consideration. A Nurse Corps officer to be eligible for


promotion to the next higher grade must have his name within the zone of
consideration prescribed.

e. Position Eligibility. A Nurse Corps officer to be eligible for


promotion to the next higher grade must be eligible to the position
assignments authorized to that next higher grade.

f. Seniority and Maturity. Pertains to the relative placement of a


Nurse Corps officer in the particular promotion.

g. Physical Fitness and Appearance.

h. Professional Preparation

i. Additional Criteria (for 0-6 and 0-7)

1) Qualitative

(a) Physical fitness and ability

(b) Professional development

(c) Record of performance

(d) Professional attributes and ethics

(e) Maturity

2) Quantitative

(a) Seniority

(b) Geographical assignments

(c) Type of assignments

(d) Troop command or equivalent

(e) Educational attainment

(f) Awards

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(g) Service reputation

(h) Career Courses

(1) Military Courses

(2) Non military Courses

(3) Special Courses

j. Addendum.

1) NC officers are disqualified for promotion when they are:

(a) Missing in Action (MIA).

(b) Due for separation for those who are on terminal


leave.

(c) Physically and psychologically unfit for military


service.

(d) Have been deferred twice for promotion to the


next higher rank.

(e) Twice removed by the President from the


promotion list.

(f) Removed by the President from the promotion list


and not selected by the succeeding board.

(g) Having been deferred once in grade O-1.

(h) Convicted by a court martial whose sentence


includes dismissal from the service.

(i) Recommended for lateral attrition.

(j) Separation or dismissal has actually been


recommended to the President.

2) NC officers are also disqualified for promotion when they


have administrative impediments such as the following:

(a) Carried in the Morning Report as AWOL

(b) Under arrest or confinement

(c) Those who have escaped arrest or confinement

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(d) Those with pending cases

Section 3-5 Separation of Nurse Corps Officers

12. Termination of Appointments. Appointments of Reserve NC Officers


of the AFP are automatically terminated by:

a. Death

b. Resignation

c. An approved administrative order d. Court martial decision

d. Physical disability

e. For cause

1) NC officers referred to and found by the AFP Efficiency


and Separation Board not fit for retention because of substandard
performance, low potential, doubtful integrity and/or acts Inconsistent with the
best interest of the service shall be separated upon approval of the President.

2) NO officer in the grade of O-1 who is deferred once for


promotion or an NC Officer in the grade higher than O-1 below that of O-6
who is deferred twice for promotion to the next higher grade shall be
separated.

13. Reversion. A Reserve Nurse Corps officer whose term of active duty
has not been extended shall be automatically reverted.

A Reserve Nurse Corps officer reverted to inactive status not for cause
nor shall retired, who has completed 4 1/2 years of service receive a reversion
gratuity equivalent to one (1) month base pay and longevity pay in the
permanent rank held at the time of reversion multiplied by his years of active
service. Reserve Nurse Corps officer for reversion shall submit the following
requirements.

a. Personnel Action Form

b. Basic Request

c. Physical Examination Report

d. Statement of Service from OTAG, GHQ

e. Leave Records from OTAG, GHQ

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f. Certificate of Non-Pending Case, No Money/Property
Accountability Unit Clearances/Statement of Last Payment g.

g. Clearances from IGPA, AJAG, PMPA

h. Clearances from SAO, PA; PA Housing Board; NAF, PA; G6


Mgmt; Actg Svc, 06; FCPA;ESB, PA; OESPA, PA

i. Affidavit of Non-Contractual Service with the AFP

j. Affidavit re: Effectively and Non-Revocation of Reversion Orders


k Affidavit that Counseling has been done

k. Latest Statement of Assets and Liabilities

l. Ombudsman Clearance

m. Last Promotion Orders

n. Circular No. 19 GHQ AFP Certificate

o. Reproduced Copy of Savings Account Number with LANDBANK


of the Philippines near permanent address

14. Retirement. Retirement may either be:

a. Optional - upon accumulation of at least twenty (20) years of


satisfactory active service.

b. Compulsory - upon attaining fifty six (56) years of age or upon


accumulation of thirty (30) years of satisfactory active service which ever
comes later, but not later than sixty (60) Years of age.

c. Upon death in line of duty with at least twenty (20) years of


active military service.

d. Upon incurring permanent disability in line of duty with at least


twenty (20) years of active military service.

15. Documentary Requirements for Retirement & Pension/Gratuity


Claims (per AFP Personnel Directive Nr 01-05 dtd 2 Jun 05)

a. Personnel Action Form (AFP AGO 110)


-with appropriate attachments
2 copies

b. Statement of Service signed by Major Service Adjutant


5 copies

c. Leave Records signed by Major Service Adjutant

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3 copies

d. Major Service Clearance from the following Offices


1 copy each

JAGO, Provost Marshal, IG, NAF


Housing, OESPA and Accounting

e. Ombudsman Clearance 3 copies

f. Retirees Data Sheet 1 copy

With necessary family documents

g. Physical Examination Report (CDD only)

h. Photocopy of LBP Savings Passbook Account 2 copies

Branch nearest residence during retirement

Addendum

a. LTR Endorsement from Major Service Commander 2 copies

b. Statement of Last Payment 3 copies

c. Retirement Order and CG’s approval for EP assign 3 copies


In their respective Major Service

Instructions

a. Application for retirement must reach BCD, OTAG NLT 6


months prior to the effective date of retirement.

b. Terminal Leave Application must reach BCD, OTAG NLT 3


months prior to the effective date of terminal leave.

c. Photo copies must be duly authenticated.

d. Reason for Action in Personnel Action Form (AGO F110) must


specify the following:

1) Type and effective date of retirement.

2) Mode of Payment: 36 months lump sum or direct monthly


pension.

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3) That optional retiree has contractual service or without
contractual service.

16. Separation of Regulars NC Officers. A Regular Nurse Corps officer is


separated for cause due to misconduct, willful failure, the intemperate use of
drugs O' alcoholic liquor and vicious/immoral habits.

Regular Nurse Corps officers who resigns his commission in the


Regular Force, May upon recoml1endation of the CS, AFP be appointed in
the Reserve Force in the last grade held. Such resignation from the Regular
Force and reappointment m the Reserve Force is upon approval by the
President and published in appropriate AFP orders.

Section 3-6 Evaluation of Nurse Corps Officers

17. Officer's Appraisal Report. ( Refer to Annex F)

18. Career Development Program for Nurse Corps Officers in the AFP.
(Refer to Annex G).

19. Maintenance of Qualification Files. The Army Chief Nurse shall


maintain the qualifications file of each PA Nurse Corps Officer assigned or
detailed under her technical jurisdiction. These records will be composed of
the initial curriculum vitae or classit1cation questionnaires for training details,
ratings or evaluation in assignments, reevaluation of AFPOS, orders for
AFPOS and subsequent changes thereof. Cover sheet for this file will be the
career pattern worksheet.. The Office of the Army Chief Nurse will be
provided with a copy of the qualifications file for each Army Nurse Corps
officer assigned or detailed under his. Jurisdiction. These records will be
composed of the initial curriculum vitae or classification questionnaires for
training details, ratings or evaluation in assignments, re-evaluation of AFPOS,
orders for AFPOS, and subsequent changed thereof. Cover sheet for this me
will be the career pattern worksheet.

20. AFPOS Standards for Nurse Corps Officer. The AFPOS


classification for Army Nurse Corps Officers follows the basic AFPOS
classification for AFP Nurse Corps Officer on the following Specialty areas.

a. Nursing Service Administration 32A

b. Flight Nurse 32B

c. Psychiatric and Mental Health Nurse 32C d. Communicable


Disease Nurse 32D

d. Pediatric Nurse 32E

e. Operating Room Nurse 32F

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f. Orthopedic Nurse 32G

g. Maternal and Child Health Nurse 321

h. Hemodialysis Nurse 32J

i. Neurotically Nurse 32K

j. General Duty Nurse 32L

k. Intensive Care Nurse 32M

l. Oncology Nurse 320

m. Public Health Nurse 32P

n. Nurse Educator 32Q

o. Trauma Nurse 32R

p. Neurosurgical Nurse 328

Officers classified as General Duty Nurse are qualified to perform


various nursing functions in a hospital, infirmary or other military health care
facilities, rather than being limited to one particular field. Therefore, these
officers pass a diversity of knowledge, skill in the general medical and surgical
fields" This AFPOS will not be used as primary or secondary classification
when it has been determined that an officer is classified in a specialty field.

The alphabetical prefixes will not be used an the following AFPOS:

a. Flight Nursing

b. General Duty Nursing

21. Proficiency Designation.

a. Prefix D - Award of the Prefix "D" indicates ability to' function as


Staff Nurse with potentials far growth in a specialty area. It will be awarded to'
the following:

1) Officers of varying professional competence who' have


completed a postgraduate course or appropriate studies in the farm of
Specialty Training/Formal Course of no' less than six months and have
sufficient successful professional practice of at least six months in the
specialty areas as fallows: Communicable Disease Nurse (32DD), Pediatric
Nurse (32ED),Operating Roam Nurse (32FD),Orthopedic Nurse (32GD),
Matermal & Child Health Nurse (32ID), Hemodialysis Nurse (32JD),

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Neurolagical Nurse (32 KB), Intensive Care Nurse (32MD), Neurosurgical
Nurse (32SD).

2) Psychiatric and Menm1 Health Nurses (32CD) who have


successfully completed the Nurse Specialty Training Course one (1) year (six
(6) months didactic and six (6) months practicum).

3) Officers classified as Flight Nurses (32BD) who have


graduated from an approved program of Flight Nurse Corps, who have shown
proficiency, and who have completed 100 hours certified flying time in military
aircraft while training or performing flight nurse duties. They have been
designated Flight Nurses by the Commanding General, Philippine Air Force.

4) Officers classified as Nursing Service Administrators


(32AD) or Nurse Educators (32QD) with two (2) years professional experience
in an administrative staff position/in an educational institution, have completed
nine (9) masteral degree units in Nursing Major in Nursing/Hospital
Administration, Nursing Education.

b. Prefix C - The award of the Prefix "C" indicates ability to function


as head nurse in the specialties listed in letter a number 1 above or as
assistant instructor or in a staff position with administrative judgment in the
supervision and development of nursing personnel.

1) Officers qualified as Psychiatric and Mental Health Nurse


(32CC), Communicable Disease Nurse (32DC), Pediatric Nurse (32EC),
Operating Room Nurse (32FC), Orthopedic Nurse (32GC), Maternal and Child
Health Nurse (32IC), Hemodialysis Nurse (32HC), Neurological Nurse
(32KC), Intensive Care Nurse (32MC), Oncology Nurse (320C), Public Health
Nurse (32PC), Trauma Nurse (32HC) , Neurosurgical Nurse (32SC); who
have a maximum of three (3) years professional experience in their specialty
at least one (I) year of which was in the capacity of head nurse or instructor
and with fifteen (15) masteral degree units preferably in clinical specialty.

2) Officers classified as Flight Nurse (32BC), who have at


least three (3) years continuous practice in the specialty whose records
indicate increase in competence in Flight Nursing, have two hundred (200)
certified flying times in a military aircraft while training or performing flight
nurse duties.

3) Officers classified as Nursing Service Administrator


(32AC) or Nurse Educator (32QC) who completed a minimum of twenty one
(21) masteral degree units in Nursing Major in Nursing Administration or
Nursing Education or related course as Masters of Hospital Administration. In
addition, the officer must have had a minimum of seven (7) years of
progressive professional nursing experience and have served in an
administrative staff position or in an educational institution for at least three (3)
years in a military hospital within the past five (5) years prior to
reclassification.

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c. Prefix B - The next award of prefix "B" indicates ability to


function as a supervisor capable of developing junior officers. Furthermore, it
identifies officers qualified academically and through experience to fill
positions as Chief Nurses or Administrative Staff Officers.

1) Officers who completed twenty one (21) masteral degree


units in Nursing preferably Major in the field of specialty listed in letter a,
number 1 above, have ten (10) years progressive nursing experience in the
specialty with five (5) years as Training Officer, have advance training in field
of specialty.

2) Officers classified as Flight Nurse (3288), have been on


cumulative flying status for seven (7) years prior to reclassification, preferably
with additional aero medical training as Flight Nurse abroad, whose records
indicate increasing competent as Flight Nurse preceptor, who have logged
800 hours certified flying time in military aircrafts while training or performing
flight nurse duties, designated Senior Flight Nurse by the Commanding
General, Philippine Air Force.

3) Officers classified as Nursing Service Administrators


(32AB)/Nurse Educators (32QB) who have a master's degree in Nursing
Major in Nursing/Hospital Administration/Education and have a minimum of
twelve (12) years progressive professional nursing experience, six (6) years of
which are in supervision, training or administration, where they have
demonstrated executive leadership qualities and smooth interpersonal
relationship among nursing personnel and allied groups. Moreover, the officer
must be competent in developing training programs for nurse educators and
providing professional growth opportunities for potential Nurse
Administrators/Educators.

d. Prefix A - The highest award of prefix "A" indicates outstanding


qualifications in the specialty, evidenced by ability as an instructor,
contribution to nursing science through research, professional articles or
books published and/or continued demonstration of exceptional professional
ability in the particular field.

1) Officers qualifying for the "A" prefix must have a master’s


degree from a recognized educational institution and must have completed
the Command and General Staff Course (CGSC) as minimum requirement.

2) Officers classified as Flight Nurses (32BA), have been on


flying status for fifteen (15) cumulative years, have demonstrated the qualities
of flight nurses, strategic planner, doctrine developer with exceptional
communication and collaborative abilities, have designated Chief Nurse Air
Force and Chief Flight Nurse by the Commanding General, Philippine Air
Force and have significantly contributed to the advancement of Flight Nursing.

3) Officers classified as Nursing Service Administrators


(32AA) /Nurse Educators (32QA), who have twenty (20) years progressive
professional experience, ten (10) years in supervision, administration or

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training, have demonstrated excellent executive leadership qualities, smooth
interpersonal relations, competent in developing leaders: belonged to the
upper 500/0 of the CGSC class, have masters degree in Nursing Major in
Nursing Administration or Masters of Hospital Administration.

4) Upon initial Call to Active Duty, Nurse Corps Officers are


assigned at AFP Medical Center and classified as General Duty Nurse (32L).

22. Primary AFPOS. Refers to the specialty currently practiced by the


Nurse Corps officer. In cases wherein said officer has two simultaneous
specialties, decision has to be made by the Army Chief Nurse as to which is
the primary and the secondarily AFPOS. Generally, the specialty which is
more practiced by the NC officer assumes the level of primary AFPOS while
the specialty which is less practiced, is relegated to secondary AFPOS

23. Secondary AFPOS. Refers to the specialty which is not currently


practiced by the Nurse Corps officer but wherein he already has received prior
proficiency designation.

24. Nurse Corps Career Pattern. Upon initial Call to Active Duty (CAD),
Army Nurse Corps officers are assigned at a general/station hospital/ medical
infirmary I medical center and designated general duty nurse.

25. Career Courses

a. All newly Called to Active Duty Nurse Corps officers should


attend the Technical Service Officers Basic Course preferably within the first
year of tour of active duty.

b. Between the 8th to the 12th year, Army NC officers should


attend title Technical Service Officers' Advance Course, local or abroad.

c. Selected Army NC Officers who have shown executive and


leadership abilities will attend the Command and General Staff Course local
or abroad, preferably between the 16th and 20th year of tour of active duty.

d. NC officers occupying top positions and who have demonstrated


exceptional professional ability may attend the Master of National Security
Administration Course or its equivalent, local or abroad, preferably on the 21
st year of tour of active duty.

26. Specialty Training/On the Job Training. Specialty Training/On the


Job Training is a continuous and on going process for any Army NC officer.

Army Nurse Corps officers who have been on active duty for two (2)
years are eligible to apply or may be recommended by the Army Chief Nurse,
for specialization training conducted at civilian or military installation, local or
abroad. These courses are: Nursing Service Administration; Flight Nursing;
Psychiatric and Mental Health Nursing; Communicable Disease Nursing;
Orthopedic Nursing; Maternal and Child Health Nursing; Hemodialysis

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Nursing; Neurological Nursing; Intensive Care Nursing; Oncology Nursing;


Public Health Nursing; Nursing Education; Trauma Nursing and Neurosurgical
Nursing.

27. Assignments. The Nurse Corps Career Pattern (Figure 3-1) depicts
the general development and career progression of an Army NC officer
brought about through planned and monitored assignment. Although not all
officers will receive diversified assignments, all are given opportunities to
progress in their chosen field.

28. Career Management. The Nurse Corps career pattern program is


designed to develop the utmost potentials of the NC officers. The is facilitated
by training them in professional specialties and command and staff functions
and by placing them in appropriate duty positions.

Re-evaluation of Army Nurse Corps officer's AFPOS shall be done


yearly (every first week of August). This evaluation is done by the Army Chief
Nurse or through designated cognizant representative.

A career pattern worksheet shall be prepared for each officer to include


all his previous assignments and the plan of his future assignment for the
normal career period up to age 56 or 30 years of active service, whichever
comes later. 11ris will form the cover sheet of this individual's classification
me.

The Chief Nurse, AFP ensures the effective and efficient management
of the career development of Nurse Corps officers.

At the end of the basic phase, Army Nurse Corps Officers who failed to
achieve the minimum level required, that is, a "C" proficiency in their chosen
career pattern, will be retained on such pattern

Requirements for Proficiency Designation in the Specialty Areas

AFPOS AFPOS PREFIX D PREFIX D PREFIX D PREFIX D


CLASSIFICATION CODE

Nursing Service 32A 2 yrs 7 yrs 12 yrs 20 yrs


Administrator professional progressive progressive progressive
nsg professional professional professional
experience, as nsg nsg nursing
distractive/ experience, 3 experience, 6 experience,
training staff yrs as yrs in 10 yrs in
administrative. supervision, supervision
9 masteral Trng staff administration administratio
degree units within past 5 training n, training,
MAN major in yrs prior to Demonstrated Demonstrate
Nursing reclassification executive d outstanding
Administration 21 master leadership executive
/ Education/ degree units qualities leadership
Master of MAN major in smooth IPR qualities
Hospital Nursing competent smooth IPR
Nurse Educator 32Q Administration Administration and competence

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/ Education, developing in developing
master of training leaders,
Hospital programs for Upper 50% of
Administration future leaders SGSC class,
. MAN. MHA MAN. MHA
graduate graduate

Flight Nurse 32B FN Crse 3 yrs 7 yrs 15 yrs


graduate continuous cumulative cumulative
Proficient, 100 flying status, flying status. flying status
hrs Certified Increasing Flight Nurse FN strategic
flying time in competence in Preceptor. planner,
military aircraft Flight Nursing Preferably doctrine
while training/ 200 hrs with developer,
per-forming certified flying additional with
FN duties. time in military aero-medical exceptional
Designated aircraft while trng abroad communicati
FN by CG, training/ 500 hrs ons and
PAF performing FN certified collaborative
duties flyiong time in abilities. 800
military certified flying
aircraft while time CN, PAF
trng Designated
performing Chief FN by
FN duties. CG, PAF
Designated Significantly
Senior FN by contributed to
CG, PAF the
advancement
of Flight
Nursing
Psychiatric & Mental 32C AFP Nurse 3 yrs 10 yrs 15 yrs
Health Nurse Specialty Trng progressive progressive progressive
Crse Graduate professional professional professional
6 mos nursing nsg nsg
successful experience in experience in experience in
practicum in specialty with the specialty the specialty
specialty area 1 yr as HN/ with 5 year as area.
at AFPMC Instructor. 15 trng officer in Outstanding
masteral the specialty. qualification
degree units in 21 degree as
Nursing units in Nsg professional
Preferably preferably nurse in the
major in field major in field specially as
of specialty of specialty evidenced by
Advance Trng ability as
in specialty. trainors,
contribute to
nsg science
through re-
search,
professional
article or
books publish
continued
demonstratio
n of expect
ional ability in
pertinent field
Graduate in

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MAN, MHA
preferably
major in field
of specialty.
Communicable 32D -do- -do- -do- -do-
Disease Nurse
Pediatric Nurse 32E -do- -do- -do- -do-
Operating room 32F -do- -do- -do- -do-
Nurse
Orthopedic Nurse 32G -do- -do- -do- -do-
Maternal & Child 32I -do- -do- -do- -do-
Health Nurse
Hemodialysis Nurse 32J -do- -do- -do- -do-
Neorological Nurse 32K -do- -do- -do- -do-
Intensive Nurse 32M -do- -do- -do- -do-
Oncology Nurse 32O -do- -do- -do- -do-
Public Health Nurse 32P -do- -do- -do- -do-
Trauma Nurse 32R -do- -do- -do- -do-
Neurosurgical Nurse 32S -do- -do- -do- -do-

Section 3-7 Recruitment and Selection of Appointment of PA Nursing


Service Civilian Employees

29. General. The Omnibus Rules Implementing Book V of Executive Order


No. 292 as of June 1995 Rule II Section I states that opportunity for
government employment in the career service shall be opened to qualified
Filipino citizens and positive efforts shall be executed to attract the best
qualified to enter on the basis of fitness to perform the duties and assume the
responsibilities of the position. The appointing authority shall be guided by the
Civil Service Law and Rules. In a11 PA health care facilities the Commanding
Officer through the Chief Nurse shall initially screen the applicants. All
recommendations shall be submitted through channels. No applicant shall be
allowed to work prior to the approval of their application papers by the
Department of National Defense and/or attestation by Professional Regulation
Commission. Applicants for Nursing Service positions shall pass the Mental
Ability Test (MAT) as prescribed in SOP Nr 2 GHQ, AFP dtd 03 October 1969
subject "Qualifying Examinations for Civilian Employees in the AFP."

30. Requirements. The applicant shall be required to accomplish and


submit to the appointing authority the following:

a. Personal Data Sheet (CS Form 212).

b. Civil Service Eligibility (RA 1080) - for professionals.

c. Transcript of Records.

d. Diploma.

e. Board Rating.

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f. Job Description Form (CS Form 122-d) to be signed by the


Recommending authority.

g. Availability of Funds.

h. Record of physical and medical examinations performed in any


available medical installation.

i. Clearances form NBI, Police.

j. ID pictures-4 copies.

k. Basic Request/Letter of Application.

Section 3-8 Management and Utilization of PA Nursing service Civilian


Employees

31. Assignment and Utilization. Civilian nurses/midwives/nursing


attendants shall be assigned in job8 involving direct and indirect patient care.
They shall be under the direct staff supervision of the Chief Nursing Service or
NIC of the PA health care facilities where they are assigned and shall be
governed by the civil service regulations.

Positions of nursing service civilian employees shall be included in the


workload management of any PA health care facility as
augmentation/compliment of military personnel. Requirements of such
positions are incorporated in the TOE of the installations. The positions shall
be classified as permanent, emergency or casual, subject to the existing civil
service and current civilian employee’s policies.

Section 3-9 Promotion of PA Nursing Service Civilian Employees

32. Definition. Promotion is the advancement of an employee from one


position to another with an increase in duties and responsibilities as
authorized by law, and usually accompanied by an increase in salary.

The Omnibus Rules Implementing Book V of EO Nr 292 Rule VI of Aug


1999 states that when a position in the first level becomes vacant, the
employee in the Nursing Service who holds a next in rank position that is
deemed the most competent and qualified possesses an appropriate Civil
Service eligibility, and meets the other conditions for promotion may be
promoted. However, the appointing authority may promote an employee who
is not next in rank position but possesses superior qualifications and
competence compared to a next in rank employee who merely meets the
minimum requirements for the position.

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The comparative degree of competence and qualifications of the


Nursing Service personnel shall be determined by the extent to which the
employees meet the following requirements at the time of appointment:

a. Performance -- this shall be based on the last performance


rating of the employee. However, no employee shall be considered for
promotion unless his last two (2) years performance rating is at least Very
Satisfactory.

b. Education and Training - these shall include educational


background and successful completion of training courses, scholarships,
training grants and others. Such education and training must be relevant to
the duties of the position to be filled.

c. Experience and Outstanding Accomplishments - these shall


include occupational history, work experience and accomplishments worthy of
special commendation.

d. Physical Characteristics and Personality traits - these refer to


the physical fitness, attitudes and personality traits of the individual which
must have a bearing on the position to be filled.

e. Potential- this takes into account the employee's capability not


only to perform the duties and assume the responsibilities of the positions to
be filled but also those of higher and more responsible positions.

A Selection/Promotion Board shall be established by the Office of the


Asst Chief of Staff for Personnel G1 which shall be responsible for the
adoption of a formal screening procedure and formulation of criteria for the
evaluation of. Candidates for promotion. The Board shall establish reasonable
and valid standards and methods of evaluating the competence and
qualification of all employees competing for a particular position. The criteria
establish for evaluation of qualification of candidates must suit the job
requirements of the position and should be applied fairly and consistently. The
Selection/Promotion Board shall maintain records of deliberations which shall
be available for inspection by the concerned authority.

The Selection/Promotion Board shall determine en bane the list of


employees recommended for promotion and submit to the appointing
authority that will choose the employee to be promoted.

Section 3-10 Termination of Employment of PA Nursing Service Civilian


Employees

Nursing Service Civilian Employee assigned in any PA health care


facility maybe separated from his employment by resignation, dropping from
rolls, dismissal, retirement or by death in accordance with

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a. Resignation - voluntary written notice of the nursing service
employee informing the appointing authority that he/she is relinquishing his
position and stating the date of such resignation shall take effect.

b. Dropping from the rolls - a civilian Nursing Service employee


who is absent for at least thirty (30) days without approved leave is
considered Absence Without Leave (AWOL) and may be dropped from the
service without prior notice.

c. Dismissal - involuntary termination from the employment for


cause.

d. Retirement - compulsory or optional termination of employment:

1) Compulsory/automatic. at the age of 65 years old if the


nursing service personnel has completed fifteen (I5) years of service or after
rendering a total service of thirty (30) years.

2) Optional. regardless of age, after rendering at least


twenty (20) years of service and provided the nursing service personnel is
physically mentally disabled.

Section 3-11 Evaluation of PA Nursing Service Civilian Employees

33. New Performance Evaluation System. The provisions of Rule IX


Section I of EO 292 dated February 14, 1992 which state that "There shall be
established performance evaluation systems in every department or agency
of the national 3-Dd local government.” The Performance Evaluation System
contains the following parts:

a. Objectives

b. Basic policies

c. Procedures/ Mechanics of the system d. Mechanics of Rating

All Civilian Nursing Service employees assigned to any PA health care


facility shall be evaluated using the AFP Evaluation System for civilian
employees which is est1blished and implemented based on LO 1469.

34. Submission of New Performance Evaluation System. The Army


Chief Nurse shall submit regularly the Performance Appraisal Report of all PA
Civilian Nursing Service Employees to G 1 on the following dates:

a. Regular and Casual Employees:

1st Semester Report NLT 15 July of each year


(1 Jan - 30 Jun)

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2nd Semester Report NLT 15, Jan of each year


(1 July - 31 Dee)

b. Contractual Employees:

1 at Quarter Report NLT 15 Apr of each year


(1 Jan-31 March)

2nd Quarter Report NLT 15 July 'of each year


(1 Apr -30 June)

3rd Quarter Report NLT 15 Oct of each year


(1 July - 30 Sep)

4th Quarter Report NLT 15 Jan of each year


(1 Oct - 31 Dec)

Section 3-12 Career and Personnel Development of PA Nursing Service


Civilian Employees

35. General. As provided for in Omnibus Rules Implementing Book V of


EO 292 of Aug 1999, Rule VIII states that all nursing service civilian
employees both professional and non-professional are assets or resources to
be valued, developed and utilized in the delivery of quality nursing care to all
clients admitted in any PA health care facility. Therefore, their development
and retention in the service shall be the main concern of the Chief Nursing
Service or NIC. The Chief Nursing Service shall establish a continuing
program for career and personnel development for all the nursing service
civilian employees. It is also the responsibility of the Chief Nursing Service or
NIC to create an environment or work climate conducive to the development
of employees' skills, talents and values for better service.

36. Career and Development Programs Designed for Civilian Nursing


Service Employees:

a. Induction Program - refers to the program for new entrants in


government to develop their pride, belonging and commitment to public
service.

b. Orientation Program- refers to activities and courses designed to


inform new civilian nursing service employees about the programs, thrusts
and operations of the nursing service as well as their duties and
responsibilities and benefits.

c. Reorientation Program - refers to courses designed to introduce


new duties and responsibilities, new policies and programs to civilian nursing
service employees who have been in the service for quite some time.

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d. Professional /Technical/ Scientific Program - refers to


substantial programs in specific professional/ technical / scientific areas for
enhancement of skills and knowledge of second level personnel in the career
service.

e. Employee Development Program - refers to courses aimed at


maintaining a high level of competence on basic workplace skills among
employees in the first level in the career service.

f. Middle Management Development Program - refers to a set or


series of planned human resource interventions and training courses to
provide senior professional nursing service employees and other employees
of comparable ranks with management and administrative skills and to
prepare them for greater responsibilities.

g. Value Development Program - refers to courses which are


designed to enhance and harness the public service values of the civilian
nursing service employees to become effective care givers.

h. Pre-retirement Program - refers to courses which are intended


to familiarize would be retirees on the government retirement plans and
benefits as well as available business opportunities or other productive
options/ pursuits.

i. Executive Development Program - refers to activities and


experiences and continuing education intended to enhance the managerial
skills of senior professional nursing service employees who belong to the third
level.

Section 3-13 Morale and Welfare

37. Benefits and Privileges.

a. In accordance with AFPRG-271 GHQ AFP dtd 25 Sep 87,


Military Personnel are entitled to avail the following leaves:

1) Vacation and/or sick leave may be granted to military


personnel after six months of continuous and satisfactory service on the basis
of fifteen (15) days vacation leave and fifteen (15) days sick leave for each
year of service. Vacation/ sick leave shall be cumulative and any part thereof
not taken within the calendar year in which earned, is caused over the
succeeding year. Military personnel can accumulate vacation and sick leave
credits in excess of ten (10) months of such leave credit.

2) Matemi1y Leave - married female military personnel shall


be entitled to two (2 months maternity leave absence with full pay if they have
rendered at least two (2) years of continuous active or half pay if they have

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rendered less than two (2) years of continuous active service. Matemi1y leave
shall not be chargeable against accumulated vacation and sick leave.

3) Convalescent Leave - authorized absence of military


personnel recovering from sickness or disability considered a part of hospital's
treatment and not chargeable against leave of military personnel. It is
authorized by special orders issued by AFPMC or General/Station hospitals
for a period not exceeding (15) days.

4) Compassionate Leave - this is granted to military


personnel confined in military hospitals to allow them to spend the rest of their
remaining days with their families at home after they have been declared
beyond recovery by hospital authorities. Commanders of APF hospitals who
are convinced that these sick military personnel may not live longer than two
(2) months, or unit commanders upon certification of an AFP Medical
Officer/Director of a civilian hospital, may authorize a compassionate leave
upon the request of the client or his next of kin. This leave shall not exceed
two (2) months and shall not be charged against the accumulated vacation
and sick leaves of the client.

5) Academic leave - granted to all military personnel on


formal study leave grant in an institution of learning without charging the said
leave against the vacation leave they have earned.

6) Paternity leave - granted to a married male military


personnel to be able to attend to the needs of his legal wife after childbirth/
miscarriage not to exceed fifteen (15) days inclusive Saturdays, Sundays and
Holidays.

7) Leave to be spent abroad -- a military person may enjoy


leave to be spent abroad upon approval by the Secretary of National Defense
for a maximum of forty five (45) clays. The following are the Requirements for
leave to be spent abroad:

1) Personnel Action Form/Recommendation from the


unit (Indicate effective date of leave and specify the address abroad while on
leave)

2) Updated leave records

3) Certification that the applicant will not request for


separation/reversion while abroad.

4) Certification that no expense on the part of the


government will be involved.

5) Certificate of Non-pending Case from the unit.

6) Affidavit that the applicant has enough funds to


support himself and to purchase a round trip ticket for his travel.

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7) Command Clearance, DCS Intelligence clearance,


J2, AJAG, APM. AIG, G6. G6 Mgmt., Finance, PHS)

Application must be submitted to the CG, PA (Attn: G 1


PA Mowel Br) forty five (45) days prior to the affectivity. and must be placed in
one (1) long folder with fastener, four (4) copies each and with index
tabulation. Approving authority for 0-6- down, CG PA, for 0-7 GHQ.

b. Medical/Dental Services Active military personnel and their


direct dependents and member of CAFGUs can avail of the free
hospitalization benefits provided by the AFP health facilities situated in
various parts of the country. These benefits include the following:

1) Dispensary or Outpatient Service;

2) Hospitalization (professional services, medicine and


medical supplies)

3) Ambulance Service

4) Dental benefits are also given to military personnel and


their dependents. Active military personnel and their beneficiaries are entitled
to free dental treatment or services which may range from tooth extraction to
dentures.

5) Health Insurance.

(a) National Health Insurance Program/Philippine


Health Insurance Corporation. Republic Act 7875 or the National Health
Insurance Act of 1995 enacted on 14 Feb 1995 provides for a National Health
Insurance Program (NHIP) for all Filipinos. The NHIP replaced the
MEDICARE Program to provide insurance coverage to all Filipinos within 15
years. It also ensures comprehensive and effective health insurance coverage
and unifies the MEDICARE programs of GSIS, PMCC-SSS and OWWA. The
NHIP likewise provides cost-containment and anti-fraud mechanisms to
safeguard the health Insurance Fund. Republic Act further established the
Philippine Health Insurance Corporation or the PHIC that automatically
covered AFP Personnel.

(b) Comparison between the NHIP and MEDICARE.

(1) The NHIP is being handled by one agency,


the Philippine Health Insurance Corporation (PHILHEALTH) while MEDICARE
is being handled by four agencies which are the PMCC-SSS for private
employees, GSIS for government workers and OWWA for overseas workers.

(2) The NHIP The NHIP package covers a


wider range of benefits and services not catered by MEDICARE that includes
Emergency Transfer Services and other cost-effective mechanisms.

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(3) The NHIP covers all Filipinos while the


MEDICARE is limited to the four (4) types of beneficiaries as enumerated in
item 1 above.

(4) The NHIP requires payment of 3 months


contribution within six (6) months before hospitalization while MEDICARE
requires three (3) months payment of monthly contribution within one (1) year
prior to hospitalization.

(5) The NHIP includes Doctors, Nurses,


Midwives and other medical professionals as service providers while the
MEDICARE is limited to doctors only.

(c) NHIP Membership. All members of the MEDICARE


program are automatically members of the NHIP and are the following:

(1) SSS members (currently employed, self-


employed, voluntary and retirees 60 years old and above and have paid the
minimum 120 monthly contributions) and their dependents.

(2) GSIS members (permanent, casual,


temporary, pensioners and retirees 60 years old and above and have paid the
minimum 120 monthly contributions) and their dependents.

(3) OWWA members and their dependents.

(4) Uniformed personnel of the Armed Forces


of the Philippines (AFP), Philippine National Police (PNP), Bureau of Fire
Protection (BFP) and Bureau of jail Management and Penology (BJMP) and
their dependents.

(5) Indigent members enrolled under the


Indigent Program and their dependents.

(d) MEDICARE Benefits provided by the NHIP

(1) Room and Board- the member is allocated


45 days room and board for a year and additional 45 days intended for his/
her dependents.

(2) Medicines with prescription- a prescribed


amount is set by the NHIP to pay medicines incurred by the hospitalized
member or his dependents. If the amount is less than the prescribed limit, the
NHIP will pay for it but if it exceeds the limit, the member will shoulder the
excess amount.

(3) Diagnostic, laboratory and other medical


requirements- just like medicines there is also a prescribed amount that NHIP

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will shoulder intended for other hospital expenses for each confinement
period.

(4) Professional Fees- For a member to avail of


this benefit, he/she must ensure that the attending doctor/physician must be
accredited with the Phil Health. No benefits will be given to the member if the
attending physician is not accredited with the Phil Health.

(5) Other hospital facilities

(6) Surgical Family Planning Procedure –


Surgical procedures such as Vasectomy and Tubal Ligation is provided only
to the member and his/ her spouse.

(7) Outpatient Care Treatment – Some


outpatient care treatment supported by the NHIP are the following:

• Hemodialysis
• Radiotherapy
• Chemotherapy
• Surgical Operations

(e) Pre-requisites for MEDICARE benefits

(1) The hospital must be accredited with the


PHILHEALTH. In an emergency case where the member gets confined in a
non-accredited hospital, MEDICARE Benefits can still be availed provided it is
licensed by the Department of Health (DOH)

(2) The member has paid the minimum three


(3) months contribution within six (6) months before confinement. For
pensioners or retirees whose age are 60 years and above, a certification from
the employer that he/ she has paid the minimum 120 months contribution is
enough.

(3) The member/ dependent is admitted


because of sickness that needs confinement in a hospital.

(4) The 45 days hospitalization benefit provided


for the member is not yet exhausted. The same is true with the 45 days
hospitalization benefit for the member’s dependents.

(f) Conditions for non-payment by the NHIP

(1) Medicines without doctor’s prescription

(2) Outpatient psychotherapy or counseling for


mental disorders

(3) Drug/ alcohol rehabilitation

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(4) Cosmetic surgery

(5) Home and rehabilitation services

(6) Optometric services

(7) Normal delivery

(g) Others

(1) A member can file his/her claim with the


PHILHEALTH within 120 days after discharge from the hospital.

(2) Processing of claims is within 60 days.


Claims can also processed at the Regional Health Insurance Offices (RHIOS).

c. Housing Benefits.

1) On Base Housing. Major Service/Unit Housing Boards


assign quarters to Officers and enlisted personnel subject to the following
criteria:

(a) For eligibility. Any married military personnel in the


active service, who is head of the family, to include military personnel who are
widows/widowers but heads of their families.

(b) For priorities. Priorities in the assignment of


quarters shall be the responsibility of the Major Service Commanders through
their MSHB subject to the following order: seniority, maximum presence and
date of application.

(c) In the assignment of quarters, the Post


Commander shall consider the grade of the applicant. Except for officers
entitled to a positional quarters, no military personnel shall be allowed to
occupy more than one Officer/EP quarters regardless of location.

(d) The rental of military quarters is equal to the


quarter’s allowance of the occupants.

2) Off Base Housing. The overall administration of all AFP


Off-Base housing projects shall be the responsibility of the Chief of Staff, AFP.
In carrying out this responsibility, he shall be assisted by the AFP Housing
Board which shall oversee the entire AFP Off-Base Housing Program. The
Office of the Chief, Special Service through its Housing Development Division
shall process, evaluate and recommend for approval to the Chief of Staff, AFP
the awarding of Off-Base housing units to qualified occupants. Awarding of
housing units shall be order of priority as follows:

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(a) 1st Priority. Married military personnel including
widow, widower, separated or divorced in the active service who have no
house or lot of their own.

(b) 2nd Priority. Single military personnel in the active


service but head of the family who have no house or lot of their own.

(c) 3rd Priority. Retired married military personnel who


have no house or lot of their own.

(d) 4th Priority. Married civilian personnel of the AFP


who have no house or lot of their own.

(e) 5th Priority. Married military personnel in the active


service who already own a real state property.

(f) 6th Priority. Single military and civilian personnel of


the AFP who have no house and lot of their own.

The Housing Development Division shall utilize the


financing capacity of the AFPMBAI, AFPSLAI and PAG-IBIG for Off-Base
Housing projects.

d. Educational Benefits.

1) The Army Nurse Corps officer is privileged under the 22k


NDA Program at local civilian college or universities on full time or on part
time basis.

2) The Army Nurse Corps Officer is also privileged to


undergo foreign military training.

3) Under PD Number 577 dated 11 Nov 1974 educational


benefits are extended for dependents of deceased/ incapacitated military
personnel in line of duty in the form of payment of tuition/matriculation fees in
public schools, colleges, universities and other duly recognized educational
institutions.

e. Pay and Allowances

1) Base and Longevity Pays. As per Executive Order Nr 688


dtd 01 March 1981, military personnel are entitled to receive base and
longevity pay. Base pay is according to grade.

Longevity pay is equivalent to ten percent (10%) of the


monthly base pay compounded every five (5) years of active and meritorious
military service up to a maximum of 50% of monthly base pay.

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2) Incentive Pay. As per RA 3093 dtd 12 Jun 1961 and RA


5338 dtd 15 June. 1968, Nurse Corps officers are entitled to receive incentive
pay (IP).

3) Quarters' Allowances. As per Executive Order 262


implemented by GO Nr 10 dtd October 1972 all military personnel are entitled
to receive quarters allowance. Quarters allowance is according to grade.

4) Clothing Allowance. As per Cir Nr 5 dtd 8 Feb 1990. EO


755 dtd 21 Dec 81 as amended by EO 1003 dtd 25 Jan 85 further amended
by EO 1977 dtd 2 Dec 86, military personnel are entitled to receive clothing
allowance.

5) Winter Clothing Allowance As per Cir Nr 17 dtd 13 Aug


1990, military personnel assigned or detailed in temperate countries outside
the territorial limits of the Philippines are entitled to receive winter clothing
allowance.

6) Cold Weather Allowance As per Cir Nr 17 dtd 13 Aug


1990, military personnel assigned or on detached service (DS) and actually
performing duties in cold places within the country are entitled to receive cold
weather allowance.

7) Per diems/travel allowance As per Presidential Degree


(PD) 344 dated November 1974 military personnel are entitled to receive per
diems/travel allowance.

8) Combat Pay As per Cir Nr 7 dtd 23 Oct 1985, all military


personnel assigned in the fields are entitled to receive combat pay.

9) Hazardous Pay As per EO Nr 131 dtd 24 May 1968,


military personnel who are handling/exposed to hazardous or
radiation/radioactive materials such as those assigned to X-ray Dept. Nuclear
Medicine Dept and even those handling anesthetic agents are entitled to
receive hazardous pay.

10) Living and Subsistence Allowances As per EO Nr 257 dtd


25 July 1997, all military personnel are entitled to receive these allowances.

11) Magna Carta. As per DND Circular Number 20 dtd 09


December 1994, all Military Health Workers of the Department of National
Defense are entitled to receive this allowance.

12) Productivity Pay. Monetary compensation based on the


performance rating of the military personnel as per National Budget Circular
Number 426 dtd 11 April 1992.

13) Thirteenth Month Pay Additional monetary compensation


given to military personnel as per National Compensation Circular Number 73
dtd 27 December 1974.

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f. Rest and Recreation (R & R). Army Nurse Corps officers are
entitled to go on rest and recreation from a combat duty assignment.

g. Athletic and Sports Development - the different athletic and


sports facilities found in the military installations such as Pelota Court, Tennis
Court, Swimming pool, Gym and others can be availed of by military
personnel subject to unit regulations.

h. Commissary Privileges - Army Nurse Corps Officers could avail


of commissary privileges, such as to purchase tax free items from a Post
Exchange commissary inside the camp.

i. Transportation Facilities. Service. Cars/jeeps are being used by


Chief of Offices and buses that shuttle military personnel within the camp
radius. Army Nurse Corps officers are authorized free transportation either
military/civilian water, land or air transportation during official
function/missions/R & R.

j. Officer's Clubhouse. Army Nurse Corps officers can avail of the


Officers' club and its services subject to the club regulations.

k. Retirement and Separation Benefits.

1) PD 1638 and PD 16.50 are the references for payment of


separation and retirement benefits.

2) An Army Nurse Corps Officer covered under the


provisions of PD 1638 on retirement shall be retired in the grade next higher
than the permanent grade last held for purpose of pension.

3) If on date of separation an Army Nurse Corps officer who


has completed three (3) or more years but less than ten (10) years of active
service, be honorably discharged in the permanent grade then he will get a
separation pay equal to three (3) months base pay and longevity pay
computed on such grade.

4) If on date of separation, an Army Nurse Corps Officer


who has completed ten (10) or more years but less than twenty (20) years of
active service, be honorably discharged in the permanent grade then held will
receive separation pay equal to one (1) month base pay and longevity pay for
each year of active service computed upon such grade (RA 340 Title II Sec
8).

l. Financial Assistance. For the past years, several financial


packages have been prepared for the soldiers while they are still in the active
service. Listed below are different kinds of financial assistance and the
institutions offering these privileges

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1) Salary Loans.

(a) AFPSLAI. Any member can avail of salary loan


featuring the No Front Ending (NFE) scheme. Under this scheme, members
receive in full the amount he borrows, since no amount is deducted in
advance. Instead, the loan payment becomes lighter as the monthly interest is
based on the diminishing balance. The salary loan ceiling has likewise been
raised to P200, 000.00 and term extended up to five (5) years subject to the
Net Take Home Pay policy.

(b) Air Materiel Wing Savings & Loan Association Inc


(AMWSLAI) member can acquire a salary loan equivalent to gross pay times
twelve at 11% interest rate per annum.

(c) Philippine Army Finance Center Producers


Integrated Cooperative (PAFCPIC) new members are entitled to acquire P15,
000.00 salary loans while old members are entitled to P50, 000.00 at 12% per
annum.

(d) Philippine Navy Savings & Loan Association Inc


(PNSLAI) members are entitled to acquire salary loan equivalent to twelve
times the gross pay at interest rate of 12.5% per annum.

(e) PAG-IBIG members are entitled to acquire a Multi-


Purpose Loan (MPL). For eligibility, a member borrower must have made at
least 24 monthly contributions and is a contributing member upon loan
application. Loan interest is 10.75% per annum while the amortization period
is 24 months.

2) Policy Loans.

MBAI - A policy loan is granted to a holder of an


endowment plan on the sole security of a policy contract which has been
enforce at least one year at interest rate of 6% per annum.

3) Business Loans.

AFPSLAI – Commercial, Industrial and Agricultural loans.


For enterprising regular members, the association offers collateralized loan of
as much as P5M payable in 3-5 years through salary deduction and direct
payment through post dated checks. The interest rate varies from 16.47% to
19.13% per annum.

4) Housing Loans.

(a) AFPMBAI – Interested members who may want to


have a house and lot of their own may now avail of any of the two housing
loan that MBAI is currently offering. These are the Real Estate Housing Loan
and the Real Estate Mortgage Loan. The maximum loanable amount is P500,
000.00 with interest rate as follows:

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Loan Amount Interest (p.a)

Up to P150, 000.00 9%
Over P150, 000.00 to
P225, 000.00 12%
Over P225, 000.00 16%

(b) AFPSLAI – Members who would like to go into


commercial, agricultural and industrial ventures but are limited by the
maximum salary loan limit have an option through the real estate collaterized
loan.

(c) PAG-IBIG – the housing loan can be used for the


following purposes:

1) Purchase of residential unit.

2) Construction or completion of a residential


unit on a lot owned by the member borrower.

3) Purchase a lot and construction of a house


thereon.

4) Home improvement

A member is entitled to a maximum loan


amount which shall not exceed:

Fifty times (50x) the member’s Monthly


Compensation, for employees with employer’s counterpart, whether the
counterpart is shouldered by the member or his/her employer, or;

Twenty-five times (25x) the member’s


Monthly Compensation, for employees without employer’s counterpart.

The maximum loan amount is P500, 000.00

5) Savings.

AFP military personnel are entitled to opportunities


to save part of their salaries/allowances through the assistance of the
following institutions:

(a) AFPSLAI

(1) Capital Contribution Semi-Annually – this


account aims to establish membership and for members and for members to
deposit funds for at least one calendar quarter at 20% yield per year tax free.

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(2) Savings Deposit - a minimum balance of


100.00 is required. Gives an interest rate of 6% per annum tax free.

(3) Special Savings Account – a minimum


placement of P20, 000.00 for 30 days is required. Gives an interest rate of 1%
- 2% higher than the prevailing Treasury bill rates and requires no
documentary stamps.

(4) For particulars, members can inquire from


the nearest AFPSLAI Branch.

(b) PAFCPIC

(1) Capital Contribution

(2) Savings Deposit

(3) Time Deposit

(c) AMWSLAI

(1) Capital Contribution

(2) Savings Deposit

(3) Time Deposit

(d) PNSLAI

(1) Capital Contribution

(2) Savings Deposit

(3) Time Deposit

(e) PAG-IBIG

The member’s contribution, which is


equivalent to 2% of his base pay is doubled by his employer’s contribution
and his employer’s counterpart earned fixed dividends of 7.5% per annum,
plus variable dividend in case of surplus earning by the Fund.

6) Insurance. Insurance benefits and privileges for AFP


personnel are granted by the following institutions:

(a) AFPMBAI

(1) Automatic Insurance

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• With policy loan at 6% interest per
annum
• With cash value
• With disability benefit
• With death benefit

Amount of
Rank Monthly
Insurance
LTC/Cdr/Supt up P85, P60.00
600.00
2LT/Ens/Insp to P71, P50.00
MAJ/ Ltcdr/ CInsp 400.00
Sgt/PO3/SPO1 to P42, P30.00
CMS/CMPO/SPO4 800.00
Cpl/SN1/PO3 P35, P25.00
down 700.00

(2) Special Group Term Insurance (SGTI)

• P16, 000.00 coverage on all regular


members
• With maximum of P15, 000.00
disability benefit
• With additional benefit of )16, 000.00
if killed in action
• With additional P1, 000.00 funeral
benefit

(3) Members Educational Assistance Loan


(MEDAL)

• Maximum of P50, 000.00


• 7% interest per annum
• Payable within 1 year
• Loan beneficiaries could be anyone
the borrower designates

(4) Endowment at Age 56

• A life insurance savings and


investment plan for members 56 years and below.
• With salary loan at 8% interest per
annum
• With policy loan after 2 years it is
enforce at 6% interest per annum
• With permanent disability benefits
due to accident, military, police or related operations.
• Double insurance benefit in case of
accidental death

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• With maturity benefit upon reaching


age 56 given in lump sum or on staggered basis for 3 years while waiting for
the pension
• With funeral benefit of P10, 000.00

(5) Other additional/optional insurance

• Endowment at 10, 15, 20 years


• Anticipated 20 year Endowment

(b) AFPGIC

(1) Fire Insurance. Building, office furniture,


equipment and residential building and their contents can be covered against
loss/damage by fire, lightning and consequential losses thereof and allied
perils in conjunction with ordinary fire coverage.

(2) Motor Car Insurance. Private cars,


commercial vehicles and motorcycles can be insured in combination of
property, public liability and personal accident covers.

(3) Marine Insurance. Goods merchandise or


movables can be covered against damage or loss caused by the perils of the
sea while in transit.

(4) Aviation Insurance. Can be insured against


damage or loss from whatever cause while the aircraft is in flight, taxiing,
aground or moored. The company shall be liable to pay for accidental
property damage if such is caused directly by the impact of the aircraft
including articles dropped there from.

(5) Engineering Insurance. Building under


construction, civil engineering projects whose construction are in progress,
materials, plants and other items in the construction site can be insured
against loss or damage caused by specified perils and bad workmanship.

(6) Bonds. GIC caters to the bonding need of


its members, it can guarantee the performance of contractual and legal
obligation of a third party

(7) Personal Accident Insurance

7) Educational Assistance. Active military personnel and


qualified dependents of active, deceased and retired military personnel are
also entitled to educational assistance under the following programs.

(a) AFP Provident Trust Fund:

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(1) AFPPTF Educational Assistance Program –
awarded to qualified and deserving dependents of deceased, retired or active
AFP military personnel in any of the following educational levels with the
indicated amount of support per school year and corresponding duration:

For dependents of deceased/disabled AFP


members:

Level Amount
College/Vocational 8,000.00/yr
High School 3,000.00/yr
Elementary 2,000.00/yr

For dependents of active and retired AFP


members:

Level Amount
College/Vocational 5,000.00/yr
High School 2,000.00/yr
Elementary 1,000.00/yr

(2) AFPPTF Special Projects – Educational


Assistance Program for military personnel in the active service who plan to
pursue studies leading to the degree of Bachelor of Laws (LLB) or Bachelor of
Science in Engineering. Grantees must take the required full load of subject to
receive a stipend of P4, 000.00 per semester. Bar reviewers receive an
allocation of P8, 000.00 and P6, 000.00 respectively.

(b) MOA between CHED and DND/AFP for bright


sons/daughters of EP. This agreement provides children active enlisted
personnel (and of those who die or become incapacitated in line of duty) who
have excellent academic performance, scholarships in various educational
disciplines with degrees such as Engineering, Psychology, Statistics, Medical
Technology, Electronics, Computer Science, Economics, Agriculture,
Fisheries and Teacher Education major in Math, Science or Language.

(c) The AFP – MERALCO Foundation Inc (MFI)


Scholarship Program. The AFP-MFI through the bayanihan Alay Sa Anak
Bayani (BASAB) offers scholarship to qualified dependents of military
personnel who were killed or wounded in action against local communist and
secessionist rebels as well as other lawless groups. The scholarship allows
grantees to take up the three-year industrial technology course with
specialization in Electrical, Electronics, Instrumentation & Process Control and
Tool & Dye Technologies.

Interested applicants may file their


application at the office of AFP Educational Benefit Office (AFPEBSO) located
at Gate 6, LOGCOM Area, Cp Aguinaldo, Quezon City.

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(d) AFP – UA & P Scholarship Program. The AFP-UA


& P Scholarship Program was created under a Memorandum of Agreement
between the Armed Forces of the Philippines and the University of Asia and
the Pacific with offices located at the school of Management, 6th Floor, APEC
Communication Bldg., UA&P Campus, Ortigas Center, Pasig City. The
program received initial fund of P4M from former PJEE for the scholarship of
AFP Officers and dependents of Enlisted Personnel and to raise additional
funds through donations, sponsorship and other fund raising activities to build
up and sustain the program.

The program allows qualified senior officers


to take up M.S. in Strategic Business Economics Program and qualified EP
dependents to take up Bachelor of Science in Entrepreneurial Management at
the University of Asia & the Pacific.

Requirements:

• For the M.S. SBEP – Officers must have a


rank of LTC or higher and pass the criteria imposed by the AFP-UA&P Board.
• For the B.S. EM – Dependents must have
high scholastic grades and pass other requirements imposed by the AFP-
UA&P Scholarship Board.

8) Rice Allowance. Soldiers assigned on combat duty in


Mindanao are entitled to received one (1) sack of rice monthly from the
National Food Authority as contained in the provisions of Executive Order
No.88 dated 5 April 1999 Subject: Granting Rice Allowance to Soldiers on
Combat Duty in Mindanao.

(a) Tax Exemption for the members of the Armed


Forces of the Philippines. (Ref: Republic Act No 9040 dtd 22 Mar 2001)

An act exempting from tax certain


allowances and benefits granted to the members of the Armed Forces of the
Philippines. The law provides tax exemption on the AFP personnel’s collateral
and collateral allowances, as well as other benefits as provided by law.

The following Pay and Allowances of AFP


personnel shall not be included in the gross income and shall be exempt from
taxation:

(1) Longevity Pay

(2) Mandatory Allowances – such as Cost of


Living Allowance (COLA) Personnel Economic Relief Allowance (PERA) and
Hazardous Allowance.

(3) Collateral Pay – such as Specialist Pay,


Combat Pay, Flying Pay, Air Mechanic Pay, Sea Duty Pay, Parachutist Pay
and Hardship Pay.

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(4) Collateral Allowances – such as Special


Clothing Allowance, Cold Winters Clothing Allowance, Cold Weather Clothing
Maintenance Allowance, Initial Enlistment/Reenlistment Allowance and
Laundry Allowance.

(5) Retirement Benefits, Pensions, Death and


Disability Benefits.

(6) Exemption from Attachment, Levy and


Execution.

38. Nursing Service Civilian Employee’s Benefits

a. Leaves. All nursing service employees assigned in any PA


Health Care Facility are entitled to vacation and sick leave credits as well as
special leave privileges (Amended by CSC MC Nr 41, section 1998 and 14, s
1999).

1) Vacation and Sick Leaves. Officials/ employees of the


government are entitled fifteen (15) days vacation leave of absence with full
pay exclusive of Saturdays, Sundays and Holidays for each calendar year of
service and fifteen (1.5) days sick leave for each calendar year of service with
full pay exclusive Saturdays, Sundays and Holidays. All officials and
employees with ten (10) days or more vacation leave credits shall be required
to go on vacation leave whether continuous or intermittent for a minimum of
five (5) working days (mandatory leave). Mandatory annual five (5) days
vacation leave shall be forfeited if not taken during the year.

However, in cases when the scheduled mandatory


leave has been cancelled in the exigency of the service by the Chief Nursing
Service, the scheduled leave not enjoyed shall no longer be deducted from
the total accumulated vacation leave. Those with accumulated vacation leave
of less than ten (10) days shall have the option to go on forced mandatory
leave or not. However, official’s employees with accumulated vacation leave
of fifteen (15) days who availed of monetization for ten (10) days, hereof shall
still be required to go on forced leave. Hospital employees, whose work
schedules are irregular and at times include Saturdays, Sundays and legal
holidays and are instead off duty on other days, their off duty days regardless
or whether they fall on Saturdays, Sundays or holidays during the period of
their leave are to be excluded in the computation of vacation and sick leaves.
In other words, if an employee is off duty, say for two (2) days falling on
Saturdays, Sundays, or holidays, these days occurring within the period of
authorized leave are to be excluded in the deduction of the number of days of
leave from the earned leave credits of the employee.

(a) Application for Vacation Leave. All applications for


vacation leave of absence for one (1) full day or more shall be submitted by
the concerned officially employee on the prescribed form for action by the

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proper head of agency five days (5) days in advance whenever possible of the
effective date of such leave.

(b) Approval of Vacation Leave. Leave of absence for


any reason other than illness of an official or employee or of any member of
his immediate family must be contingent upon the needs of the service.
Hence, the grant of vacation leave shall be at the discretion of the head of
agency. Whenever, the application for leave of absence, including terminal
leave, is not acted upon by the Chief Nursing Service or his duty authorized
representative within five (5) working days after receipt thereof, the application
for leave of absence shall be deemed approved.

(c) Application for Sick Leave. All application for sick


leave of absence for one (1) full day or more shall be made on the prescribed
form and shall be f1led immediately upon employee's return from such leave.
Notice of absence, however, should be sent to the immediate supervisor and
or to the agency head. Application for such leave in excess of five (5)
successive days shall be accompanied by a proper medical certificate. Sick
leave may be applied in advance in cases where the officially employee will
undergo medical examination or operation or is advised to rest in view of ill
health duly supported by a medical certificate.

(d) Approval of Sick Leave. Sick leave shall be


granted only on account of sickness or disability on the part of the employee
concerned or of any member of his immediate family. Approval of sick leave
whether with payor without pay is mandatory provided proof of sickness or
disability is attached to the application in accordance with the requirements
prescribed. Unreasonable delay in the approval thereof or non approval
without justifiable reason shall be a ground for appropriate sanction against
the official concerned. When an official/ employee had already exhausted his
sick leave credits, he can use his vacation leave credits but not vice versa.
Hence an official/ employee who had already exhausted his vacation leave
credits cannot use sick leave credits.

2) Maternity Leave - Married women in the government


service who have rendered an aggregate of two (2) or more years of service,
shall in addition to the vacation leave and sick leave granted them, be entitled
to maternity leave of sixty (60) calendar days with full pay. Maternity leave of
those who have rendered one (1) year or more but less than two (2) years
shall be computed in proportion to their length of service, provided that those
who have served for less than one (1) year shall be entitled to sixty (60) days
maternity leave with half pay. A married woman may be granted maternity
leave more than once a year. Maternity leave shall be granted to female
married employees in every instance of pregnancy irrespective of its
frequency. (See Annex H)

3) Paternity Leave - Every married male employee is


entitled to paternity leave of seven (7) days for the first four (4) deliveries of
his legitimate spouse with whom he is cohabiting. Married male official/
employee with more than one (1) legal spouse shall be entitled to avail of

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paternity leave for an absolute maximum of four (4) deliveries regardless of
whichever spouse gives birth. Paternity leave is a non cumulative/non
commutative and strictly nOI1- convertible to cash. The same maybe enjoyed
either in a continuous or in an intermittent manner by the employee on the
days immediately before, during and after the childbirth or miscarriage of his
legitimate spouse.

4) Special leaves privileges. In addition to the vacation, sick,


maternity and paternity leaves, officials and employees are granted special
leave privileges such as:

(a) Personal milestone such as


birthdays/wedding/wedding anniversary celebrations/ death anniversaries; An
official/employee can still avail of his birthday or wedding anniversary leaves,
if such occasion falls on either a Saturday, Sunday or Holiday either before or
after the occasion

(b) Parental obligations such as attendance in school


programs, PTA meetings, graduations, first communions, medical needs
where a child of the government official! Employee is involved;

(c) Filial obligations to cover the employee's moral


obligations toward his parents and siblings for their medical and social needs.

(d) Domestic emergencies such as sudden absence


of a "yaya" or "maid"

(e) Paying taxes, court appearances

(f) Calamity, accident. Hospitalization

Three (3) day limits for a given year shall be strictly


observed. An official/employee can avail of one special privilege leave for
three (3) days or a combination of any of the leaves for maximum of three (3)
days in a given year. Special leave privileges are non-cumulative and strictly
non-convertible to cash.

b. Medicare. Medical Care Program (Medicare Act) was


promulgated to make adequate medical care available. The benefits granted
under the Medicare Act are:

1) Hospital expenses benefits

2) Surgical expenses / medical expenses (3) Dependents'


benefits

c. Employees Compensation Program

1) Tax exempt compensation program for civilian employees


and their dependents created under PD 626 and PD 891

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2) Cash incomes

3) Life and retirement insurances administered by the GSIS


under RA 4968 and RA 1146.

Section 3-14 Awards and Decorations

39. For Military Personnel. This section prescribes the policies, criteria,
and administrative instructions concerning granting of awards to deserving
persons/unit~/organizations in order to recognize actions or deeds of valor
and exceptional service or achievement as per AFP Regulations G-131-053
dtd 1 July 1986; to include its changes 1-4. The objective of awards and
decorations is to provide tangible recognition for acts of valor and heroism
exceptional and meritorious service or achievement, acts of heroism not
involving actual combat, and special skills and qualifications the awards and
decorations may be awarded to any personnel or unit/organization either
military or civilian, local or foreign, who distinguished himself in outstanding
achievement or service in activities relevant to the objectives of the AFP's
national security and development.

Recommendation for an award or decoration can be made by the


Commanding Officer of an organization, office or unit having knowledge of the
deed or act. To be fully effective, an award should be timely. Only one award
shall be made for the same act, achievement or service. For each succeeding
act, achievement or service that justifies the award of such decoration, same
decoration will not be awarded; instead an appurtenance will be awarded. A
recommendation for an award based on a period of meritorious service in a
given assignment shall not be made while the individual being recommended
is still performing or has not been relieved from such assignment. However, if
such individual has been performing for the last three (3) years he may be
recommended for an award.

40. Decorations

a. Medal of Valor. This is awarded by the President of the Republic


of the Philippines to military personnel of the Armed Forces of the Philippines,
including recognized guerilla forces. To earn this award, AFP personnel or
member of the recognized guerrilla forces must have been involved in actual
conflict with armed enemies, distinguishing himself conspicuously by gallantry
and intrepidity at the risk of life above and beyond the call of duty. To justify
an award of the Medal of Valor, one must perform in action a deed of personal
bravery or self-sacrifice above and beyond the call of duty as conspicuous as
to distinguish him above his comrades.

b. Distinguished Conduct Star. This is awarded by the Chief of


Staff, AFP to military personnel of the AFP and friendly allied armed forces for
conspicuous courage and gallantly in the face of an armed enemy. To warrant

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this award, a person must perform an act of heroism so notable and involving
risk of life as extraordinary as to set him apart from his comrades.

c. Distinguished Service Star. This is awarded by the Chief of


Staff, AFP to officers of the Armed Forces of the Philippines for eminently
meritorious and valuable service rendered in a position of major responsibility.
The performance of duty should be exceptional. A superior performance of
duties normal to the grade, branch, specialty of assignment, and experience
of an individual is not adequate basis for this award. Accordingly, the
accomplishment of the duty should have been completed prior to submitting a
recommendation, or a person being recommended has been transferred prior
to completion, the accomplishment must have progressed to what may clearly
be determined to be exceptional or significant.

d. Gold Cross. this is awarded by the Chief of Staff, Armed Forces


of the Philippines, Area Commanders and Major Service Commanders to
military personnel for gallantry in action not warranting the award of the
Distinguished Conduct Star.

e. Outstanding Achievement Medal - this is awarded by the


Secretary of National Defense to military personnel of the AFP and citizens of
the Republic of the Philippines, members of the Armed Forces and civilian
personages of friendly foreign nations for distinguished or extraordinary
achievement or service in the advancement of science or in socio-economic,
technical or military fields related to national defense, or for public service of
the highest order.

f. Gawad sa Kaunlaran. this is awarded by the Chief of Staff, AFP,


Area Commanders and Major Service Commanders to any citizen of the
Philippines, for conspicuously meritorious and valuable achievement in the
pursuit of socio-economic and other non-combat activities, or for
conspicuously exceptional service which contributed immensely in
accomplishing the peaceful objectives of the AFP, or in improving the quality
of life of the people within the military establishment.

It shall be awarded neither without regard to position held


nor to the duration within which the cited achievement or service is
accomplished. Severance from or actual completion of an enterprise is not a
consideration; rather, the conspicuity of the achievement is deemed to be end
in itself deserving recognition.

g. Bronze Cross. This is awarded by Chief of Staff, AFP,


Commanders of Major Services, AFPWSSU s, Area Commands,
Division/Brigade or their equivalent in the PAF and in the PN to military and
civilian personnel of the AFP and Armed Forces of friendly foreign nations for
heroism not involving actual conflict with an enemy. The performance or acts
of heroism must involve risk of life under conditions other than those of
conflict with the enemy.

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h. Military Merit Medal. this is awarded by the Chief of Staff, AFP,


Area Command and Major Service Commanders, Division and Major
Subordinate Unit Commanders with a TO rank of Brigadier General or higher,
to military personnel of the AFP for heroic achievement in combat or
meritorious achievement for service not involving participation in combat, in
connection with military operations against an enemy of the Philippines; for a
single act of meritorious service either in a duty responsibility or in direct
support of military operations. The required achievement or service for award
of MMM is less than that required for award of the DSS; nevertheless, it
should be accomplished with distinction. It may be awarded posthumously to
members of the AFP, who, while serving in any capacity with the AFP, are
killed in action by the enemy of the Philippines, or as a direct result of an act
of the enemy.

i. Military Commendation Medal. This is awarded by Commanders


of Major Services, Division, Brigade or their equivalent in the PAF and in the
PN, AFPWSSUs, and Area Commands to military personnel of the AFP for
demonstrated exemplary efficiency, devotion and loyalty to duty assignments.
Accordingly, five letters of commendation under one command line are
convertible to one MCM.

j. Wounded Personnel Medal. This is awarded to military


personnel of the AFP and civilian citizens of the Philippines serving with the
AFP by Commanders of Major Subordinate Units of Major Services down to
Battalion Commanders or their equivalent in the PAF and in the PN. In the
case of combat patients evacuated to AFP hospitals, the Commanding Officer
of AFP hospital is authorized to award this medal.

k. Military Civic Action Medal. This is awarded to military and


civilian personnel of the AFP and friendly foreign nations by the Chief of Staff,
AFP, Commanders of Major Services, Area Commands, AFPWSSUs,
Division/Brigades or their equivalent in the PAF and in the PN.

The award is intended to recognize meritorious


achievement in the field of civic action in duty responsibility or in direct
support to military operations.

l. Sagisag ng Ulirang Kawal. This is awarded to military personnel


of the AFP by the Chief of Staff, AFP, and Commanders of Major Services
and Area Commands. To earn the award, a military person must have
distinguished himself conspicuously in the performance of non-military
activates and community development programs and other related activities,
which merit public recognition.

41. Service Medals and Ribbons

a. Long Service Medal - this is awarded to military persoill1.el of


the AFP by the Chief of Staff, AFP and Major Service Commanders. To earn
this award, a military person must have completed 20 years of faithful and

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honorable service with the AFP and for each additional five (5) years, one
bronze star shall be affixed to the ribbon.

b. Disaster Relief and Rehabilitation Operation Ribbon - this is


awarded to military personnel of the AFP by the Chief of Staff, AFP,
Commanders of Major Services and other units authorized to grant awards,
for participation in the rescue, relief and rehabilitation operations connected
with typhoons, floods, earthquakes, conflagrations and disaster/calamities for
any period during and after said calamities.

c. Anti-Dissidence Campaign Medal & Ribbon - this is awarded to


military personnel of the AFP by the Chief of Staff, AFP and Commanders of
Major Services. To earn this award, a military person must have participated
in the anti-dissidence campaign and operations in any of the aforementioned
areas of the Philippines between 30 June 1946 and terminal date to be
designated later.

1) Luzon Anti-Dissidence Campaign Medal and Ribbon –


this medal is awarded to military personnel by the Chief of Staff, AFP,
Commanders of Major Services and other units authorized to grant awards,
for participation from 13 May 1948, in anti-smuggling/piracy and maritime law
enforcement in Luzon and the waters immediately adjacent thereto for at least
six (6) months; pacification campaign/operations in Luzon or Task Force
"Lawin", Isarog:, "Saranay" and Talna" and other Task Forces for at least six
months; and for service and paI1icipation from 4 July 1946 in law
enforcement, military and civic-action operations in Luzon and waters
immediately adjacent thereto for at least six months.

2) Visayas Anti-Dissidence Campaign Medal and Ribbon


this medal is awarded to military personnel by the Chief of Staff, AFP,
Commanders of Major Services and other units authorized to grant awards.
(Annex C4) The award is given to a deserving personnel in anti-smuggling/
piracy and maritime law enforcement operations in the Visayas and the
waters adjacent thereto for at least six months, from 8 November 1948; and
for his service and participation in law enforcement, military and civic action
operations in the islands comprising Visayas for at least six months, from 4
July 1946.

3) Mindanao Anti Dissidence Campaign Medal and Ribbon.


this is awarded to members of the AFP by the Chief of Staff, AFP,
Commanders of Major Services and other units authorized to grant awards,
for participation in the pacification campaign, operation in Lanao and Cotabato
and other provinces in Mindanao with Task Forces "LANCAF", " PAGARI" ,
"PAGKAKAISA", and such other similar Task Forces for a period of at least
six (6) months; and for service and participation in law enforcement, military
and civic action operations in the islands comprising Mindanao and Sulu and
waters immediately adjacent thereto from 4 July 1946 for a period of at least
six (6) months.

42. Badges

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a. Philippine Republic Presidential Unit Citation Badge - this is


awarded by the President of the Republic of the Philippines to: c;

1) Any unit of the Armed Forces of the Philippines that


distinguished itself with exceptionalloyal1:y and fidelity, extraordinary
accomplishment in the field of law enforcement in maintaining the security of
the land, participation in relief and rehabilitation and for advancement of
social-economic and political goals.

2) All members of the AFP for campaign against an enemy


of the Philippines; or participation in unit massive operations within a definite
period of time.

3) Units of friendly foreign nations for humanitarian service


to the Filipino people.

4) U nits of friendly foreign nations for humanitarian service


to the Filipino people.

b. Combat Commander's (Kagitingan) Badge - this is awarded by


the Commanding General, PA to PA officers and enlisted personnel who have
commanded combat and combat support units for at least one cumulative
year; all other PA military personnel who have rendered at least one
cumulative year of combat duty regardless of their assignment, including
those engaged in combat service support operations. Corresponding honorary
badges may be awarded to all other personnel from the PAF, PN and PM who
have been assigned to units engaged in combat, combat support and combat
service support operations for at least one cumulative year, regardless of duty
assignment or position.

c. Marksmanship Badge - this is awarded to officers, enlisted


personnel, trainees and cadets of the AFP by the Commanders of Major
Services, Unified Commands, AFPWSSUs, Division/Brigades and equivalent
units in the PAF and in the PN. This award is given to the qualified personnel
for his abili1y and proficiency in the handling of arms. Initially, the badge and
the additional bar shall be awarded to military personnel who may acquire any
qualification in the marksmanship training. And for each qualification, an
additional bar shall be attached to the badge. The bar denotes the weapon
and corresponding degree of qualification which may be a marksman,
sharpshooter or an expert.

d. Adjutant General's Service Badge - this is awarded by The


Adjutant General, AFP to all members of the AFP performing AGS functions.
For officers to be qualified for the badge, they should have taken AGS training
and performing AGS functions, or for those who have not taken the AGS
training but performing AGS function for at least one yea.r. For enlisted
personnel to be qualified, they should have taken administrative course, NCO
Course and performing other activities related to administrative functions for

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at least tv.ro (2) years or those who have no formal training but performed
AGS functions for at least two (2) years.

e. Tanglaw Badge - this is awarded to military and civilian


personnel of the AFP by the Chief of Staff, AFP, Commanders of Major
Services, Unified Commands, Divisions, AFPWSSUs, Separate Brigades and
similar size units with TO rank of Brigadier General.

The personnel who fall under any of the following are eligible for
the badge:

a. Graduated from TANGLAW course conducted under the


auspices and supervision of the CRS, AFP of not less than four (4) weeks in
accordance with GHQ approved program of instructions (POI).

b. Graduated from TANG LAW course conducted by the Major


Service Schools and AFPHDTC of not less than four (4) weeks in accordance
with GHQ approved program of instructions (POI)

c. Completed TANG-LAW Mini Course of Echo Seminar under the


auspices and supervision of the CRS, AFP, Major Services and other
AFPWSSUs and further actively participated in TANG LAW activities, projects
for six (6) months.

d. Actively participated with competence in policy formulation,


planning, direction, supervision and/or implementation of TANG LAW
activities, projects and programs for at least one (1) year.

43. Letters and Plaques.

a. Letter of Commendation. It is a written expression of


acknowledgment from a Commanding Officer or Head of Office given to
military and civilian employee of the AFP for meritorious achievements, which
do not meet the criteria for decorations.

b. Letter of Appreciation. It is a written expression of qualification


from a Commanding Officer or Head of Office given to military and civilian
employee of the AFP to recognize acts or services which do not meet the
criteria for decorations.

c. Major Service Commander’s Plaque. It is an award given by any


Unit Commander to military or civilian employee in grateful acknowledgement
of meritorious or outstanding accomplishment to the service command.

44. General. In accordance with Omnibus Rules Implementing Book V


of EO Nr 292 Rule X s. 99, the following are awards for Civilian
Employees:

a. Honor Awards. Honor awards shall consist of the following:

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1) Presidential or "Lingkod Bayan" awards is conferred on


an individual for consistent dedicated performance exemplifying the best in
any of the profession or occupation resulting in the successful implementation
of an idea or performance which is of significant effect to the public or
principally affects the national interest, security and patrimony.

2) Civil Service Commission or PAGASA Awards is


conferred on a group of individuals or team who has demonstrated
outstanding teamwork and cooperation which resulted in the successful
achievement of its goal and greatly improved facilitated the delivery or public
service, effected economy in operation, improved working condition or
otherwise benefited the government.

3) The Departmental Award or the "Kapwa" Award is given


to an individual or group of individuals in recognition of contributions from an
idea or performance resulting in direct benefits to a single department or
agency in the government. Nominations for this category need not be
submitted to the Civil Service Commission for screening and evaluation. The
Department or Agency Suggestions and Incentive Awards Committee shall
evaluate the nominations for this category and recommend to the head of the
department or agency the most qualified awardees.

4) Outstanding Public Official/Employees Award or "Dangal


ng Bayan" Award - it is granted to officials and employee in the government
who have demonstrated exemplary service and conduct on the basis of their
observance of the eight (8) norms of behavior as provided for under Republic
Act No. 6713. Administration of this Award and the procedures of nomination
shall be governed by Republic Act Nr. 6713 and its Implementing Rules.

b. The Incentive Award. The incentive awards shall consist of,


though not limited to the following:

1) Performance Incentive which shall be given to an


employee who has obtained an outstanding or very satisfactory rating based
on the Agency's Approved Performance Evaluation System for the last two
successive evaluation periods which consist of step increments in accordance
with the provisions of Joint CSC-DBM Circular No.1, s. 1990.

2) Length of Service Incentive which shall be given to an


employee who has rendered at least three years of continuous satisfactory
service in a particular position and which shall consist of step increments in
accordance with the provisions of Joint CSC-DBM Circular No.1, s. 1990.

3) Productivity Incentive that shall be given to an employee


or group of employees who has exceeded their targets or has incurred
incremental improvement over existing targets.

4) Most Courteous Employee Award which is given to an


employee in accordance with tile criteria and standards established under

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CSC MC No. 15, s. 1990 which instituted the Courtesy Campaign Program in
the Civil Service, known as the "Ang Magalang, Bow!"

5) Loyalty Award which shall be granted to an employee


who has completed at least ten (10) years of continuous and satisfactory
service in the government. This service award shall consist of cash bonus and
a lapel emblem or loyalty pin differential as follows:

10 and 15 years -. bronze service pin

20 and 25 years - silver service pin 3

0, 35 and 40 - gold service pin

6) Retirement Award which shall be given to a retiree who


had rendered at least fifteen (15) years of satisfactory government service.
This award shall be in the form of a plaque of appreciation, the design and
citation of which shall be determined by the office concerned.

7) Year-end Benefits or Thirteenth Month BODUS Plus One


Thousand Cash Gift which shall be granted to officials and employees in the
national and local governments, including state colleges and universities, and
government-owned and controlled corporations in recognition of their
dedication to government service and in keeping with the spirit of Christmas.
The grant of these year-end benefits shall be governed by the Compensation
Circular issued by the Department of Budget and Management in accordance
with the provisions of Republic Act 6686.

8) Monetary Award which shall be granted to an employee's


contribution in terms of suggestions or invention or performance of functions
which results in monetary savings. When an employee's contribution can not
be quantities in terms of monetary savings, or results in combined monetary
savings and intangible benefits, the amount of cash award shall be
determined in terms of a certain percentage of its estimated total value or
benefit but not to exceed 20%.

9) Distinguished Honor Medal - this is awarded to an


individual for outstanding contribution which has national significance in any of
the following: demonstration of outstanding service, or contribution to the
public administration in the form of exemplary achievement or through
sustained interest and development; accomplishment of major operation or
staff responsibilities which are clearly exceptional; and demonstration of
outstanding courage and voluntary risk of life or honor under extremely
adverse condition which result in direct benefit to the government or the
protection of public interest.

10) Superior Honor Medal- this is awarded to an employee in


recognition of significant contributions of unusual value not only to the agency
but also to the public service in general. The criteria are any of the following:
superior service leading to the achievement of agency program objectives;

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exceptional leadership in the fulfillment of agency program objectives;


exemplary or courageous handling of an emergency situation; and superior
creative service such as the development of a new and highly effective
program which contributes to the agency's benefits or savings

11) Civilian Merit Medal - this is awarded to an employee in


recognition of accomplishment worthy of commendation in the discharge of
assigned tasks excelling normal position requirements or quality of their
predominance; initiative in developing a new system or work methods;
improvement of devices which results in substantial saving in manpower,
material, cost and time; specific accomplishment for which an employee is
responsible for the improvement in the agency operations or service,
substantial savings in government funds and significant technical process;
extraordinary devotion to duty under adverse conditions, and outstanding
scientific, technical supervisory and executive ability.

45. Letters and Plaques.

a. Letter of Commendation - it is a written expression of


acknowledgement of a Commanding Officer or Head of Office given to military
and civilian personnel of the AFP for meritorious achievements, which do not
meet the criteria for decorations.

b. Letter of Appreciation - it is a written expression of gratification


of a Commanding Officer or Head of Office given to military and civilian
personnel of the AFP to recognize acts or services which do not meet the
criteria for decorations.

1) Major Service Commander's Plaque - it is an award given


by any Unit Commander to military or civilian personnel or private persons,
corporation or entity in grateful acknowledgement of meritorious or
outstanding accomplishment to the service command.

2) Certificate of Honorable Service - this is awarded by The


Adjutant General, AFP and the Major Service Adjutant to all military and
civilian personnel of the AFP who are honorably separated from the service,
in recognition of their faithful and honorable service with the Armed Forces of
the Philippines.

Section 3-15 Uniform

46. General. In accordance with Letter Directive dtd 21 Feb 1994.

47. AFP Technical Service Uniform (Refer to Annex I).

48. Dress Code Prescribed for all Nursing Service Civilian Personnel

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a. The office uniforms as prescribed hy the different government
agencies/offices shall be the official attire of all government officials and
employees that shall be worn in accordance with the assigned schedule.

b. On those days when the officials/ employees are exempted from


wearing the prescribe office uniform, they must be dressed appropriately;
preferably business clothes. Party attires, picnic clothes, sandos or T-shirts
without collars shall not be worn at work.

c. The following are prohibited/not allowed to be worn while at


work:

1) Tight, fitting, seductive, micro mini, gauzy/transparent


dresses by female employees

2) Walking shorts, pedal pushers, leggings, tights, jogging


and maong pants.

3) Costume jewelry, flashy bangles and similar accessories.


Ostentatious display of expensive jewelry is strongly discouraged and
prohibited except for special occasions and official celebrations.

4) Wearing of heavy or theatrical make up

5) Wearing of slippers, sandals, "bakya" in office premises,


only appropriate footwear shall be allowed. For those assigned in all PA
Nursing Services, the following are the prescribed uniforms:

(a) Female Nurses

(1) Whole Dress (For 7-3 Shift)


Cloth - plain white, not too thin cloth man/
gabardine/cotton
Collar - sports collar 2 3,4" wide
Front - with three (3) pin tucks
Sleeves - tailored 1 Y2" fold
Belt - no buckle, 1 Y2" with two (2) plastic
round white buttons Skirt - "A" line; length is
3" below the knee Pocket - slide

(2) Blouse and Pants for 3-11 & 11-7 Shift


(Annex B9)
Cloth - Plain, white, not too thin, c1othman/
gabardine cotton single breasted with six (6)
white medium round plastic buttons. Length
of blouse shall not be less than 8" from the
waistline
Collar -- sports collar 2 3,4" wide
Front - with three (3) pin tucks
Sleeves - tailored 1 Y2 " fold

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Pocket - lower slide pockets 4 Y2 -5 Y2 "


wide by 6"
Pants -Cloth is plain white gabardine
straight cut with waistband and with inside
front pocket five (5) inches long diagonally
set on both sides of the iliac region with a fly
front opening secured by zipper and slide
fastener :closure. Pants should be floor
lengths bare footed

(3) Caps - white; style will follow that of the


college/school where the civilian nurse
graduated. Linen paper cap is not allowed

(4) Name Plate - indicate full name and


designation. Should be worn with uniform

(5) Jewelry - jewelries except gold/pearls stud


0.6 cm in diameter and wristwatch with
second hand and wedding/ engagement/
college ring are not allowed.

(6) Stockings - plain white stockings

(7) Shoes - rubber sole; plain white; with or


without shoe lace

(b) Male Nurses

(1) Polo shirt


Cloth - plain white, gabardine jc10thman or
cotton Collar - sports collar
Sleeves - short
Pocket - patched pocket with flap cover

(2) Pants - white gabardine j c10thman cotton

(3) Shoes - rubber sole, plain white. White


rubber shoes not allowed.

(c) Midwife Nursing Attendant

(1) Dress
Cloth - plain white, not too thin
cloth/gabardine cotton
Cut - one whole dress "A" line
Collar - sports collar 2 '12" wide
Front - with three (3) pin tucks
Sleeves - tailored 1 ~" fold

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Pocket - patch pocket
Length - 3" below the knee;

(2) Name Plate - indicate full name and


designation

(3) Jewelry - jewelries except gold/pearls stud


0.6 cm in diameter and wristwatch with
second hand and
wedding/engagement/college ring arc not
allowed.

(4) Shoes - rubber sole; plain white \with or


without shoe lace

(5) Stockings - shade of skin tone

(d) Male Institutional Worker

(1) Polo Shirt


Color - plain light blue Cloth -
gabardine/cotton Collar - V-neck shaped
Sleeves - short
Pocket - patched pocket

(2) Pants - denims

(3) Shoes - rubber shoes, any color

(e) Female Institutional Worker

(1) Uniform
Cut - one whole dress
Color - plain light blue
Cloth - gabardine/ cotton Collar - sports
collar, 2 %" wide Front - with three (3) pin
tucks Sleeves - tailored 1 7-2" fold Pocket -
patched pocket Length _. 3 " below the
knee

(2) Jewelry - jewelries except gold/pearls stud


0.6 in diameter and wristwatch with second
hand and wedding/ engagement/ college
ring are not allowed.

(3) Shoes - Rubber sole, plain white

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CHAPTER 4
OPERATIONS

Section 4-1 Nursing Service Administration and Management

1. General. To effectively manage the pillars of the Army Nursing


Service, nurses as leaders or as subordinates must understand and apply the
fundamental principles/functions of management.

2. Objectives of Nursing Service Management

a. To provide nursing care within the standards of safe nursing


practice in the Phil Army Nursing Service.

b. To prepare nursing budget which will meet the requirements of


the Nursing Service in terms of personnel, supplies, equipment outlay and
capital expenditures.

c. To maintain communication coordination and collaboration with


other professional and support services.

d. To provide planned and continuous in-service programs for


military and civilian employees assigned Nursing Service.

e. To promote research in nursing and to encourage participation


in investigation of related disciplines.

3. Leadership - is the art of influencing the will of others in such a


manner as to command their obedience, their confidence, their respect, their
loyalty cooperation to create good discipline and healthy esprit-de-corps. The
roles and responsibilities of today's leader are more complex than a century or
even a decade ago.

4. Military Leader. An individual endowed with the basic concept of


military leadership, being aware of his responsibilities, capabilities or his
strong traits, guides himself by the principles of leadership. To accomplish this
goal successfully, the leader must understand his men. He must also learn to
recognize and evaluate the indicators of leadership proficiency, discipline,
morale, and esprit de corps. Military laws and regulations enable the leader to
compel outward obedience, respect" and cooperation, however, only
personality can command the genuine confidence, respect and loyalty
essential to successful leadership.

The true leader is one who by his qualities can create a worthy
aspiration, and by precept 811d example can convert others to that aspiration,
and lead them in an unselfish cause. The great military leader is the man who
can inspire his men to do things they don't want to do and can make them

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enjoy doing them. The Nurse Corps officer endowed with the basic concept of
military leadership as well as the pre requisites of leadership namely, physical
proficiency, intelligence, and character. The first, physical proficiency is the
resiliency which will enable the Nurse Corps leader to quickly recover under
times of exceptional stress and immediately continue on with a new mission.
The second, intelligence enables the leader to thoroughly understand from
objective point of view and anticipate the problems which will be critical in the
accomplishment of his mission. The third, character, will strongly determine
the individuality of the leader; it will also be the basis of his attitude toward his
responsibilities. Identified with character are such traits as loyalty, devotion to
duty, and honor. Aside from the prerequisites mentioned a military leader
must also possess the different traits of a good military nurse leader namely,
knowledge, courage, initiative, decisiveness, tact, justice, dependability,
bearing, endurance, enthusiasm, unselfishness, integrity, loyalty and
judgment. The Nurse Corps officer as a leader must follow the Principles of
Leadership enumerated:

a. Be technically and tactically proficient.

b. Know yourself and seek improvement.

c. Know your men and look out for their welfare

d. Keep your men informed.

e. Set the example.

f. Ensure that the task is understood, supervised, and


accomplished.

g. Train your men as a team.

h. Make sound and timely decisions.

i. Develop a sense of responsibility among subordinates.

j. Employ your command in accordance with its capabilities. (11)


Seek responsibility and take responsibility for your action.

In order to attain the ultimate objective of military leadership success in


the mission, the leader must first develop in the individuals of his organization
four (4) basic characteristics which will promote an efficient working team.

a. Proficiency. The measure of the individual and the unit's ability


to perform their job or mission. The technical, tactical, and physical ability to
do a job well

b. Discipline. The prompt obedience to orders and in the absence


of orders, obedience to what the man believes the order would have been.
Training is a part of the basis of discipline in which a military nurse must have

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an understanding of what is to be done and then be able to do it. Even more


important to effecting discipline among subordinates may be the example that
the military leader sets for his men.

c. Morale. The individual's state of mind how he feels about


himself, his fellow workers and all other things that seem important to him.

d. Esprit de Corps. The opinion that the members of an


organization have of themselves and their units. It is shown in loyalty and
pride.

5. Excellent executive nursing leadership is vital to the survival of


health care agencies in the current turbulent environment. Excellent nursing
leadership attributes include administrative competence with adequate
educational background, business skills and clinical expertise combined with
the global understanding of leadership principles. As nursing leaders they
emphasize nursing responsibility to influence the practice environment. They
stress the importance of creating an environment in which the professional
nurse can participate at both the Organizational and the professional level.
The nurse executive whether as a military leader or as a nursing leader must
perform all the tour (4) major management functions of planning, organizing,
leading and controlling?

Section 4-2 Principles/Functions of Management

6. Planning. Entails forecasting or setting the broad outline of work to be


done. It is formulating activities necessary to achieve the desired results in the
Nursing Service. Planning is more crucial at the top management. The Army
Chief Nurse plans for the broad organizational activities and are phrased in
general terms. Strategic planning at the top level should be based on the
mission, opportunities, threats, strengths and weaknesses of the organization.
The Chief Nursing Service implements specific programs and projects. The
Assistant Chief Nurse, Clinical Branch will follow up the implementation of
programs/projects/ activities related to service, while the Assistant Chief
Nurse, Admin Branch will follow-up programs/projects/ activities related to
leadership and Assistant Chief Nurse Training and Education Branch will
follow-up implementation of programs/projects/activities related to
professional growth of military and civilian employees assigned Nursing
Service.

7. Organizing - is the establishment of formal authority to meet the


objectives of the organization. This entails the setting-up of Organizational
structure, staffing and development of job description. Organizing is the
process of grouping the necessary responsibilities and activities into workable
limits, determining the line of authorities and communications and developing
patterns of coordination. The Nursing Service constitutes the single largest
group of hospital employees. It is the workforce of the hospital in supporting
administrative policies, providing client care and promoting good public

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relations. There are title major concerns in organizing a Nursing Service,


namely: organizational structure, staffing, and job descriptions. These are
basically concerned with people and its quality, what they are supposed to do
and how they are related to each other within the Nursing Service. At the
middle management level, the supervisors formulate policies, rules and
regulations, methods and procedures. At the lower or first management level,
the head nurse/charge nurse schedules/ prepares/plans daily and weekly
activities for the administration of client care for his ward.

a. Organizational structure - refers to the way a group is formed


depicting its lines of authority, span of control, and channels of
communication. The formal structure of an organization is the official
arrangement of positions or working relationships that will coordinate efforts of
workers of diverse interests and abilities. The philosophy and objectives of the
Nursing Service and the goals of the hospitals are the bases for the formal
organizational structure. This structure specifies how each position in the
Nursing Service is related to each other and how the entire Nursing Service is
related to other parts of the hospital,

b. Types of Formal Organizational /Lines of Communications:

1) Line - is the simplest and most direct type of organization


where each position has general authority over lower positions in the
hierarchy in the accomplishment of the main goals/objectives of the nursing
service.

2) Functional - this type of organization permits a specialist


to aid line positions within a limited and clearly-defined scope of authority. It
decreases the line manager's problem because it permits orders to flow
directly to lower levels without going through the routine technical problems of
line positions.

3) Staff-this is purely advisory and recommendatory to the


line structure with no authority to put recommendations into action.

RELATIONSHIPS INDIVIDUAL
1. Line- those that exist between a Chief Nursing Service to Supervisor;
supervisor; superior and subordinates Supervisor to Head Nurse; Head
immediately and directly responsible nurse to Staff Nurse
to him.
2. Functional- those which arise to Chief nursing Service with Admin
when duties are divided on a Officer; Head nurse with the Clinical
functional basis, i.e. when an Instructor; Chief Nursing Service with
individual exercise authority on one the Ward Officers.
particular subject by special skill or
knowledge.
3. Staff- those which arise when an Supervisor acting in behalf of the
individual is acting as the Chief Nursing Service when the
representative of superior. This Nursing Service is not around after

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individual is not vested with but is office hours. Staff Nurse acting on
acting for and on behalf of the person behalf of the Head nurse when the
on which authority lies. His function is Head nurse is off duty.
one of transmission and interpretation
couple with the duty of ascertaining
that the orders given are carried out.

c. Principles of Organization. Organization principles provide


simple groups of statements that provoke thinking among administrators.

1) Unity of Command - No member of the organization


should report to more than one superior on any given function. This prevents
conflict arising from orders from different people and simplifies superior-
subordinate relationships.

2) Proper delegation of responsibility and authority. For work


to be accomplished, responsibility and authority should be delegated.
Responsibility is work assigned to a position. Authority, on the other hand,
gives the one delegated the right to command a subordinate who, in turn has
an obligation to obey or perform the duties specified by his position.

3) Span of control - refers to the number of people one can


directly supervise, assist, and teach to achieve the objectives of their own
jobs. It ensures the appropriate number of persons needed to make the
assignment manageable. (4) Departmentalization or similarity of assignments
- Workers of similar activities is grouped together based on the likeness of
personal qualifications or common purpose. This includes functions that
require close coordination. Departmentalization specializes activities,
simplifies the administrator's work and maintains control.

d. Organizational Charts. Organizational Charts are fundamental to


effective administration because they illustrate the lines of authority and
responsibility, the major channels of formal communication, and the inter-
departmental, as well as, the intra-departmental relationships. For the
systematic and effective administration of the Nursing Service, the nursing
department must be organized within the framework of the hospital's
objectives and sound organizational principles. There are different types of
organizational charts, namely:

1) Structural Chart - shows the various components of the


organization and outlines their basic interrelationships.

2) Functional Chart - reflects the functions and duties of the


components of the organization and indicates the interrelationships of these
functions.

3) Position Chart - specifies the names, positions, and titles


or ranks of the workers who are part of the organizational structure.

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e. Staffing. It is a process of determining and placing the right


person to the right job. It is the process of determining and providing the
acceptable number and mix of nursing givers to produce a desired level of
care to meet the client's demand for care 24 hours divided into three (3) shifts.
Staffing methods attempt to establish a set of patterns for distributing nurses
to client areas based upon some predicted average workload conditions.
There are several factors that affect staffing and other administrative
requirements peculiar to the military service. Among them are:

1) Number of client

2) Acuity of illness

3) Characteristics of staff - what is the mixture of skill levels?


Are many on the staff young and experienced?

4) Domain and boundaries of Nursing Service- What


services are the Nursing Service responsible for?

5) Latitude of flexibility - Is there flexibility for the delivery of


care by different methods?

6) Turn-over of personnel

7) Group cohesiveness - How closely knit are the unit staff?


(8) Resources available within the Nursing Service - Are these persons skilled
in the staff development and in-service program?

8) Standards of care - Are the standards clearly spelled out


and available to all staff?

9) Professional activity - How much active involvement is


there with professional organization?

f. Client Classification - it is a means of clinically categorizing


clients on the basis of certain needs that can be clinically observed by the
nurse. It serves as a basis for staff planning. In most client classification
systems clients are divided into four (4) categories on the basis of their
dependency needs and the level of care givers required satisfying their needs.
A four (4) category classification system consists of:

1) Level I - Self care/minimal care or nominal care category.


Under this category the client is capable of carrying out daily activities as long
as the nurse provides the necessary materials and supplies. The client needs
only 1.5 nursing care hours/day or nurse client ratio conversion of one (1)
nurse is to five (5) clients.

2) Level II - Intermediate/moderate or partial care category.


Under this category the client can feed, bathe, toilet and dress him without
help but requires some assistance from the nursing staff for special treatment

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or certain aspect of personal care. The client needs 3.0 nursing care
hours/day or nurse client ratio conversion of one (1) nurse to three (3) clients.
e.g partial care client might require assistance from the nursing staff to
perform wound debridement or dressing, catheterization, or give intravenous
fluid therapy, intramuscular or subcutaneous injection, etc.

3) Level III - Total care/intensive care category. Under this


category the bed ridden client lacks the strength or mobility. Needs nursing
assistance with all his daily activities, such as feeding, bathing dressing,
moving, positioning, eliminating, comfort - seeking and injury avoidance. The
client needs 4.5 nursing care hours/day or nurse client ratio conversion of one
(1) nurse to two (2) clients. e.g. newborns are totally dependent on the mother
or the nurse.

4) Level IV - Critical care/highly specialized care clients. An


acute or critically-ill client who is in constant danger of death or serious injury
would require critical care. The client needs 6.0 nursing care hours/day or
nurse client ratio conversion of one (1) nurse to one (1) client.

The percentage of nursing hours to be given by


professional nurses and by non professional nursing care giver depends on
the client's condition and in the setting in which the care is being given.

For Level I clients, the ratio is fifty five percent (55%)


professional nurses to forty five percent (45%) non professional nursing care
givers. For Level II clients the ratio is 60% to 40%; For Level III intensive care
clients the ratio of 650/0 to 35% while Level IV clients needing highly trained
nurses the proportion is 700/0 to 30%, or even 80% to 200/0.

Client’s Category Classification System


LEVELS OF CARE Nursing Care Hours Ratio of Professional to
Needed Per Patient per Non-professional
Day
LEVEL I – Minimal Care 1.5 55:45%
LEVEL II – Intermediate 3.0 60:40%
Care
LEVEL III – Intensive/ 4.5 65:35%
Total Care
LEVEL IV – Highly 6.0 70:30% or 80:20%
Specialized/ Critical
Care

g. Scheduling. Providing client care every day around the clock


using nursing care givers who generally work five (5) days a week, one (1)
shift per day for thirty (30) days. Scheduling or preparation of schedules for
nursing care givers is usually done by the supervisors of each unit or floor for
which they are responsible, if supervisors for each floor are available. In the
PA Nursing Service for general and station hospitals, only one supervisor for
each shift is on duty. In this set-up, head nurses should participate actively in

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the scheduling of nursing care givers. Since the head nurses are held
accountable for workers expenditures over which they have control, they are
therefore required to determine the stailing: needs for their individual
units/wards. Therefore head nurses will prepare the staffing for their individual
units/wards. In the preparation of monthly schedule by the head nurse. the
head nurse should remember that the objectives of scheduling are to assign
working days and days off to individual members of the nursing service so
that adequate client care is ensured, while overstaffmg/understa.ffmg is
avoided; that a desirable distribution of days off is achieved; that individual
members of the nursing staff are treated fairly and lastly that the individuals
know well in advanced what their schedules are.

h. PA Nursing Service has Formulated the Guidelines to be


Followed in Scheduling of Nursing Care Givers:

Consider that different levels of nursing care givers (registered


nurses, registered midwives, nursing attendants) have different capabilities
and that midwives and nursing attendants are legally allowed to perform only
certain functions.

1) Nursing coverage must be provided 24 hours a day, 7


days a week. Nursing requirements are typically lower during the afternoon
shift (3-11) and night shift (11-7) than during the day shift (7-3). Saturday and
Sunday requirements tend to be twenty to thirty percent (20% to 30%) lower
than week days requirements, due to lower client census.

2) Long stretches of consecutive working days usually


defined as more than five (5) days in a row are undesirable.

3) Schedules should represent a balance between the


needs of the nursing care givers and the client (nursing care). When cont1icts
arise, client care should have priority.

4) All military and civilian employees assigned Nursing


Service should adhere to the established rotation policy. All requests and
exceptions should be in writing and should specify the reason for the request.

5) Time schedules should be posted in advanced at least


one (1) week before the change of schedules so that the nursing employees
will be able to plan their personal lives.

6) Schedules should be established to provide correct


numbers and mix of workers, allowing continuity, which is essential for quality
care.

7) Schedules must conform to all labor laws as well as


hospital and departmental policies.

8) Schedules must provide for rotation of shifts. The day


shift (7-3) nursing staff must work on the afternoon shift (3-11) on the second

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month then on the night shift (11- 7) on the third month (if possible). Since no
staffing scheduling method is perfect, there will always be problems; therefore
staffing adjustments should always be considered when preparing the
monthly schedules of the nursing care givers. Staffing adjustments should not
be confused with regular scheduling. Staffing adjustments are concerned with
undisputed conditions, the day to day variations in need or situations that
result in over staffing or understaffing. Staffing adjustments are done each
shift, with the assignment of the reliever nurses (if available) and / or the
pulling of nurses from the units/wards where they were originally scheduled.

i. Determining the Number of Military and Civilian Employees


Assigned Nursing Service Needed. The number of nursing care givers to staff
the various units/ departments should be sufficient to cover the service even
when some of the workers are off-duty, absent or are on vacation/sick leave,
or off on legal holidays.

The number of working hours and off-duties is largely dependent


on the Forty-Hour-Per-Week law (RA 5901). Relievers are needed because
each Nursing Service care giver is entitled to fifteen (15) days vacation leave
and fifteen (15) days sick leave, 2 off duties a week, and during holidays
every year.

j. Distribution by Shifts. Studies have shown that more nursing


care is given during the day (7-3) and afternoon (3-11) shifts. The day shift
requires the most number of nursing workers at forty-five percent (45%), the
afternoon shift requires about thirty-seven percent P7%) and the night shift
only about eighteen percent (18%).

k. Formula for Computing the Number of Staff Needed in the In-


Patient Areas of the Hospital. The Philippine Army Nursing Service has
adopted the following computation prescribed in the Department of Health
Nursing Service Administration Manual based on the Levels of Care:

1) Step 1. Categorize the number of clients multiply by the


percent of each level of care needed by hospital classification (whether
minimal, intermediate, intensive or highly specialized.

Ex: 50 clients X .66 = 33 clients requiring minimal care


or (66%)
50 clients X .24 = 12.0 clients requiring intermediate
care or (24%)
50 clients X .06 = 3 clients requiring intensive care
or (6%)
50 clients X .04 = 2 clients requiring highly specialized
care or (4%)

2) Step 2. Find the total number of Nursing Care Hours


(NCH) needed by client per day at each categorized level.Number of clients at
each level multiplies by the average nursing care hours needed per day.

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* Note: The NCH needed by the client per day at each


level
(Refer to Figure 4-1)

33 clients (Minimal) X 1.5 NCH = 49.5 NCH needed by 33


clients
12.0 clients (Intermediate) X 3 NCH = 36 NCH needed by
12 clients

3 clients (Intensive) X 4.5 NCH = 13.5 NCH needed by 3


clients

2 clients (highly specialized) X 6 NCH = 12 NCH needed


by 2 clients

3-et the sum of the NCH in the various levels 49.5 + 36 +


13.5 + 12 = 111 ~CH needed by the 50 clients

3) Step 3. Find the total number of working hours needed by


these clients per year.

Total number of NCH needed per day x 365 days (total


number of days in a year).
111 NCH X 365 days = 40,515 Total NCH needed by 50
clients per year

4) Step 4. Find the total number of working hours rendered


by each nursing care givers each year.

Hours on duty per day multiply by the actual working


days per year.
365 days/year
104 off duties days/year (@ 2 off duties
days week)
261 (working days/year)
8 hrs x 261 days = 2,088 working hours/year

5) Step 5. Find the total number of nursing workers needed.

Divide the total number of nursing care hours (NCH)


needed by number of clients per year by the actual
number of working hours rendered per year.

Total NCH needed by the 50 clients per year + actual


number of working hours rendered per year.
= 40,515 NCH + 1,848 hrs = 19.40 or 19
= 21.9 or 22 workers needed

Find the relief. Multiply the number of nursing workers


needed by .095 (Constant)

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23 nursing workers X .095 = 2.09 or 2 nursing


Workers as relief

Add the number of relievers to the number of nursing


workers needed.

2 workers as relief + 23 nursing workers needed workers


needed 25 total nursing

6) Step 6. Categorize into professional and non


professional.

Multiply the number of nursing workers according to the


ratio of professional (60%) to nonprofessional personnel
(40%).

25 nsg personnel x .60 = 15 prof (nurses)


25 nsg personnel x .40 = 10 non prof (nsg attendants)

7) Step 7. Categorize the professional nurses into NC


Officers and Civilian Nurses. Multiply the total number of nurses by the ratio of
Nurse Corps Officers (60%) to civilian nurses (40%)

15 nurses x .60 = 9 Nurse Corps Officers


15 nurses x .40 = 6 Civilian Nurses

8) Step 8. Distribute by shifts. * See distribution by shift (sub


sec 4.14)
7 -3 = 15 prof x.45 = 6.75 or 7 nurses
= 10 non prof x .45 = 4.5 or 4 nursing attendants
3-11 = 15 profx .37 = 5.5 or 5 nurses
= 10 non prof x .37 = 3.7 or 4 nsg attendants
11-3 = 15 prof x .18 = 2.7 or 3 nurses
= 10 non prof x .18 = 1.8 or 2 nsg attendants
Total of 15 nurses and 10 nursing attendants

Based on bed capacity:

a) Step 1. Multiply the number of bed capacity by the


nursing care hours (NCH) needed per client per day.

Ex: 150 bed capacity x 1.5 NCH (Level I) = 225


NCH needed by 150 clients per day

b) Step 2. Find the total number of working hours


needed by 150 clients per year by multiplying the number of NCH by 365
days.

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225 NCH x 365 days/year = 82,125 NCH needed


by the 150 clients per year.

c) Step 3. Find the total number of working hours


rendered by each nursing care giver each year by subtracting 149 days from
365 days.

365 days - 149 days = 216 Total Number of


Working days/year.

To determine the number working hours per year


multiply the total number of working days per year
by 8 hours

216 working days x 8 hours = 1,728 number of


working hours/year.

d) Step 4. Find the total number of Nursing Service


Personnel needed to care for 150 clients. Divide the total number of NCH
needed by the clients per year by the actual number of working hours
rendered by the workers per year.

82,125 NCH
1,728 working hours

e) Step 5. Find the number of reliever needed.


Multiply the number of Nursing Svc workers needed by .095 (constant).

= 47,5 or 47 workers needed

47 workers x .095 = 4.46 or 4 relievers needed

Add the number of relievers to the total number of


Nursing Svc workers needed.

47 workers + 4 relievers = 51 Nursing Svc workers


needed

f) Step 6. Categorize into professional and non-


professional. Multiply the total number of Nursing Svc workers according to
the ratio of professional (60%) to non-professional (40%).

51 x .60 = 30.6 or 31 nurses


51 x .40 = 20.4 or 20 non-professionals

g) Step 7. Categorize into Nurse Corps Officers and


Civilian Nurses. Multiply the total number of nurses by the ratio of Nurse
Corps Officers (60%) to civilian nurses (40%).

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31 x .60 = 18.6 or 19 Nurse Corps Officers 31 x


.40 = 12.4 or 12 Civ Nurses

h) (8) Step 8. Section 4.7j)

Distribute by shifts (see distribution by shift (sub

7-3 = 31 prof x .45 = 13,95 or 14 nurses


= 20 non prof x .45 = 9 nursing attendants
3-11 = 31 prof x ,37 = 11.47 or 11 nurses
= 20 non prof x .37 = 7.4 or 7 nsg
attendants

11-7 = 31 prof x .18 = 5.5 or 5 nurses


= 20 non prof x .18 = 3.6 or 4 nursing
attendants

Total of 31 nurses and 20 nursing attendants.

l. Modalities Used in the Assignment of Nurses in the Care of


Clients.

1) Functional method - this method implements the


assigning of tasks to individual nursing service workers, such tasks are
divided into sections or portions such as giving medications are assigned to
nurses while giving bath, taking vital signs etc. are given to nursing
attendants. This method is the most applicable when the nurses are limited in
numbers. However, this method has some disadvantages - since the work is
done piece by piece, the clients have to deal with so many nurses and
therefore the clients find difficulty in relating to several nurses. Another
disadvantage is that the nurses fail to identify the clients' needs.

2) Team Nursing Method - the head nurse or the


professional nurse acts as the leader of the group, she performs the highest
degree of nursing care such as assessment, formulation of the nursing
diagnosis, planning, directing nursing care and evaluating the nursing care
outcomes. The head nurse presides over a daily care planning conference,
wherein all the members are required to attend. During this conference all the
members of the team are encouraged to discuss the case and suggest
measures that 'will improve the care of the client. Each member is assigned a
particular task to perform. The focus of this method is on the client, the
nursing care givers and the work.

3) Primary Nursing Method - involves accountability for a


small number of clients from admission to discharge. It allows a one to one
nurse client relationship. Primary nursing utilizes the nursing process. The
nurse is accountable to the client twenty four (24) hours. The nursing care
plan (NCP) is reviewed and evaluated through the daily care planning

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conference. The nurse is able to identify the client's needs and therefore the
nurse can deliver better quality nursing care. Under this modality, care is
focused on the client. How-ever, the disadvantage of this type of nursing
modality is its higher cost because more nurses are needed.

4) Case Management - it is a clinical system for the strategic


management of cause and quality outcomes. It provides clients and their
families with a collaborative plan based on standards of care yet,
individualized by groups of clinicians who have expertise in their case types.

m. Job Description. A statement setting forth the duties and


Responsibilities of a specific job and the characteristics of the individual
needed to perform the job successfully. Job descriptions have become
increasingly important as a management tool - a tool that management needs
to make certain that responsibilities are wisely delegated, work efficiently
distributed, talents fully used and morale maintained.

8. Leading. Refers to the manner of delegating assignments, orders, and


instructions to the military and civilian employees assigned Nursing Service
such that the latter is made aware of the work expected of him. The nursing
service both military and civilian employees should be properly guided so they
can contribute effectively and efficiently to the attainment of the nursing
service goals.

a. Communication. Is the string that binds an organization by


ensuring a common understanding? Communication of the different groups in
the organizational structure is usually tri-dimensional because it portrays three
dimensions of vision. Down wards communication means flow comes from
higher to lower authority. On the nursing service, the Chief Nursing Service
communicates with all the Assistant Chief Nurses (Clinical, Admin, Education
& Training and Research) and supervisors. In their absence, the person next
in rank takes their places. Written communications from the Chief Nursing
Service to the nursing care givers are usually concerned with general nursing
service policies, directives, and activities. These are coursed across the line
through the Assistant Chief Nurses down to the supervisors and head nurses
for interpretation, when needed.
Upward communication is a flow of information. It is a
communication circuit wherein the message of the sender is taken by the
receiver. The receiver responds back to the sender.

When a supervisor receives a communication from the Chief


Nursing Service, supervisor also gives back written reports of information
within his area as to how this communication was acted upon. The
supervisor's close association with his subordinates gives him the opportunity
to communicate back botl1 in action and/or verbally, the impressions,
interpretations, conclusions of the nursing care giver about the communication
or any difficulty they may have encountered in the implementation of the
communication.

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1) Horizontal communication is the type of communication


used during conferences or discussions between the different members of the
health team. It is the exchange of ideas, information and feelings and such
exchange usually take place during rounds and conferences. Nursing care
giver should take advantage of this kind of communication, as it maximizes
the interchange of ideas for better understanding. This type of communication
also includes the discussion of the total care of clients. In the Nursing Service,
communications/instructions are carried out through oral and written reports
following standard lines of communication.

(a) Oral communication - is the most effectual' means


of informing the Nursing Service care givers of the plans, developments,
changes and problems within the hospital and of the Nursing Service.

1) Client contact -- nursing care givers who are


in regular and frequent contact with the clients can explain to the clients
through verbal communication all the policies, regulations, hospital services
as well as the nursing care plan for the clients.

2) Individual/ group conferences - plans,


problem, and activities of the Nursing Service are better explained and
discussed during these conferences.

(b) Written Communication - serves as a reference for


Nursing Service care givers to get instructions or guidance. It also serves as a
record of standards of practice. Written communications in the Nursing
Service usually are in the forms of:

1) Policies - are written guides or basic rules


that govern actions of nursing workers.

2) Memoranda or memos - are written notes or


information exchanges between the Nursing Service staff and its workers. i.e.
Chief Nursing Service sends a memo to the supervisors to inform all nursing
care givers of the weekly activities.

3) Directives - are administrative orders which


give instructions to all military and civilian employees assigned Nursing
Service and initiate actions for them to be followed on certain situations, i.e.
Chief Nursing Service sends out a directive concerning standards of care.

4) Manual of Operations - are written


procedures and techniques of the Nursing Service wards which are kept on
me for ready reference, i.e. Nursing Procedure Manuals which are kept in the
Nurse's Station for ready reference.

5) Records and Reports - accounts or


information on facts/events in written forms as an anecdotal or spot report.

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b. Coordinating. The Nursing Service serves to unite the hospital's


various functions ""ith other departments and other community agencies
through proper coordination. Coordination helps the Nursing Service achieves
its mission and objectives when each workers complements the work of the
other.

9. Controlling. Is the use of formal authority to assure the attainment of


the Objectives of the action to the maximum? Through controlling the Chief
Nursing Service views the rendering of quality nursing care as the institutional
control of process that brings sick clients back to good health. Controlling also
paves the way for the Chief, Nursing Service to examine carefully the devices
used to control their service. The following are the control measures used by
the Nursing Service:

a. Total Quality Management

b. Staff Visit

c. Performance Appraisal d. Records and Reports

d. Quality Circles

e. Nursing Rounds

f. Bedside Clinic

g. Risk Management

Section 4-3 Total Quality Management

10. Definition. Total quality management is a philosophy in maintaining


and improving quality through a well functioning system that provides quality
while keeping costs to a minimum.

11. Activities of total Quality Management. To assure the provision of


quality care, the Total Quality Management consists of the following:

a. Developing the vision and values of the organization

b. Leadership development

c. Standard Development - based on professional practice and


provides content for criteria development.

1) Develop written standards

2) Conduct chart reviews to validate documentation on


implemented standards

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d. Continuing Education

1) Maintain ongoing CE events list

2) Use mandatory CE events list

3) Create individual CE attendance records

e. Credentialing

1) Conduct annual licensure validation

2) Maintain certification list

3) Develop special procedure approval

f. Performance Appraisal. Track staff performance basis and


incorporate QA findings.

g. Audit

1) Conduct six (6) compliance reviews per year: structure,


process, outcome

2) Conduct non-compliance reviews as needed

3) Review unit documentation twice per year

4) Perform one (1) annual staff survey for satisfaction/


dissatisfaction

5) Perform one (1) annual client survey for client satisfaction

6) Conduct one (1) annual generic nursing review

h. Concurrent Monitoring. Plan & conduct mini-reviews on current


topics

i. Risk Management

1) Conduct one (1) environ safety review per quarter,


Alternate with infection control review

2) Perform regular checks on equipment and drugs (3)


Record preventive maintenance

3) Track incident occurrence and records trends

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j. Continuous Quality Improvement (CQI) A management style.


That supports and enhances the efforts of quality assurance. The focus is on
improving care and service. CQI requires examination of the Processes of
care and service in order to improve outcomes. Quality assurance and CQI
are complementary. Quality assurance activities enable identification and
resolution of problems. CQI goes beyond the problem-oriented approach; the
data derived from monitoring is used to continuously improve - even in the
absence of problems. For the CQI concept to succeed quality must be a
priority at all levels within the organization. Staff must be encouraged to
improve care. There must be multi disciplinary and interdisciplinary review of
systems and service with efforts focused on improvement of processes and
systems.

k. Utilization review.

1) Maintain unit log for tracking

2) Create utilization records for productivity and utilization


(3) Maintain budgetary records

l. Active Problem Identification! Ongoing Monitors and Problem


Solving.

1) Create problem ill report sheets

2) Track trend problems with written log

3) Problem solving and implementation

4) Conduct area conferences and track results

5) Conduct supervisory rounds weekly and complete report


sheet

6) Delegate monitoring and follow-up QA actions

12. Framework for Evaluation. The evaluation of quality nursing care is


determined by the appropriate combination and interaction of structure and
process. The basic assumption is that an adequately supported structure and
process ensure the attainment of desired outcomes. Evaluation standard is
set within these three (3) areas: structure, process and outcome.

a. Structure - refers to the conditions and mechanisms that support


or facilitate the delivery of nursing care which include among others, physical
facilities number and quality of workers, its qualifications, functions,
organization and administration of the Nursing Service, communication
system and staff development.

b. Process - Process Standards are used to describe the activities


of the nurse necessary to provide care. This is the nursing process; it

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identifies what constitutes and monitors actual performance of the care giver
and focusing primarily on behavior directly related to clients.

1) Job description

2) Performance appraisal

3) Standards of Performance

4) Procedures

5) Protocols

6) Guidelines

c. Outcome - Outcome Standards are goal statements which may


be written as client or nursing goals with the purpose of specifying end results
to be achieved by the client as a result of nursing care given, assessing client
status, physical and otherwise, particularly in relation to the problems that
caused hospitalization or breakdown in health. Outcomes are the results of
care to those served and the ultimate validators of care.

13. Steps in Developing a Quality Assurance Program

a. Formulation or review of the Nursing Service philosophy and


objectives. The basic assumption is that the Nursing Service's philosophy and
objectives are congruent with those of the health care facilities and the
Department of National Defense and Department of Health.

b. Formulation or review of standards. The nursing administration


should lead in the formulation, review, or revision of nursing standards is it in
the area of clinical practice and/ or service administration.

c. Formulation of evaluation tools. The evaluation instruments are


formulated to determine the attainability of the standards set. These may be in
the form of questionnaires, interview schedules, or observation checklists.

d. Data collection. Prior to actual collection, a good sample should


be established randomly. Data gatherers should also be trained particularly on
the mechanisms of random sampling, interviewing, administering
questionnaires and observation.

e. Data analysis. Results of the evaluation are statistically


presented and summarized in the form of measures of central tendency
mean, median and mode. Prior to data analysis, the Quality Assurance
Program Committee must first determine the expected performance level and
which corrective actions are taken. What is the "acceptable" or "safe" nursing
care? The definitions will definitely reflect the standards set by the institution
and identify possible corrective actions.

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f. Taking action/Implementation. Based on the analysis of findings,


corrective actions should be recommended to the Chief Nursing Service. In
cases where identified deficiencies require a higher level of intervention,
recommendations are submitted by the Chief Nursing Service to the
Commanding Officer. Resolution of the problems necessitates the
administration's commitment and the agency's available resources.

14. Quality Circle. A group of people (usually 4 to 15) who work in the
same or similar area who voluntarily meet on a regular basis to identify
assess and solve problems in their area of work.

15. Monitoring and Evaluation Process. There are ten steps that are
necessary for effective monitoring and evaluation in the Nursing Service.

a. Assign responsibility

b. Delineate scope of care

c. Identify important aspects of care

d. Identify indicators related to these aspects of care

e. Establish thresholds for evaluation related to the indicators

f. Collect and organize data

g. Evaluate care when thresholds are reached

h. Take action to improve care

i. Assess the effectiveness of the action and document


improvement

j. Communicate relevant information to the organization wide QA


program

16. The Nursing Service Audit. The Nursing Service Audit is an official
examination of nursing records, physical facilities and employees involved in
client care for the purposes of evaluation, verification and improvement. It is a
tool in analyzing and evaluating nurses' bedside records and physical
facilities. It serves as a means of improving nursing care by revealing existing
deficiencies.

17. Nursing Service Audit Committee. The Nursing Audit Committee


should consist of a chainman, a co-chairman, a qualified secretary, and a
Number of selected members. The committee may be composed of the
following: the Assistant Chief Nurse Clinical Branch (as the chairman), staff
from the Nursing Education, Clinical Supervisor, staff from the Nursing Admin
Branch and a general duty nurse/staff nurse. The Chief Nursing Service on

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the other hand, is an ex-officio member. Selection of the committee members


is done on a rotation basis with overlapping tenure of service. The Chairman
of the Audit Committee and the Chief Nursing Service should be appointed to
fill vacancies that may occur. Regular audit committee meeting should be held
at least once a month. However, special meetings may be called as the need
arises. Minutes of the meetings should always be kept on meso

18. Functions of the Nursing Service Audit Committee.

a. Phase One which include:

1) Specifying purpose and objectives

2) Establishing criteria and standards

3) Establishing the guidelines for conducting audits

4) Deciding upon necessary forms (adapting forms to


needs)

5) Practice auditing to become proficient

6) Keeping brief pertinent minutes of all meetings including


date, place, time, members and guests present, topics discussed, actions
agreed upon, recommendations and progress on previous recommendations.

b. Phase Two which include:

1) Establishing new criteria and standards

2) Measuring actual practice against criteria

3) Evaluation of results

4) Action taken to correct deficiencies

5) Prepare and distribute summary reports

19. Committee Activities. The Nursing Service Audit Committee should


meet to review the records of discharged clients. The audit may be conducted
on a segregated service. The records of all clients discharged from one unit
may be audited in one meeting. The time and period of the audit may vary
depending on the size of the institution. However, all succeeding audits
should be conducted on the same period to make comparison of the various
reports possible. Equipment and supplies as well as the nurses' clinical
records must be appraised. The appraisal would determine their quantitative
values and to make provisions for all the needs involved in quality client care.

20. Responsibilities of the Committee. All members of the Audit


Committee must have free access to the evaluated record forms. The

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Chairman of the Audit Committee should inform each individual concerned


regarding the latter's deficiencies and suggest ways or means by which these
deficiencies may be improved. The deficiencies of the individual nurses
should be recorded on individual file cards. A regular system of follow-up on
the concerned nursing care giver's performance should be established.

21. Some Guidelines in Implementation of Nursing Audit

a. Qualifications of Nursing Audit Committee Members:

1) Demonstrated skills in applying the nursing process,


communications and in relating to others.

2) Interest and willingness to work for quality client care

3) High level of integrity and respected by the staff.

b. Criteria of Clients Qualifying for Audit.

1) Clients considered SIL and have been in the hospital for


at least 2-3 days.

2) Intermediate care clients who have stayed in the hospital


for at least a week.

3) Those that have undergone medical or surgical


procedures.

c. Method of Selecting Clients for Audit- Random.

d. Frequency of Audit and Time of Audit - Once a month or


quarterly, but the actual date should not be known to the staff.

e. Reporting. The Nursing Audit Results should be submitted to the


Chief Nursing Service of the general/ station hospital for appropriate action.
The Office of the Army Chief Nurse should also be furnished with a copy of
said result together with action taken for monitoring and for further actions if
necessary.

22. Organizing for Nursing Service: Audit. It is the responsibility of the


Chief Nursing Service to:

a. Initiate and maintain a Nursing Audit Program

b. Organize for audit using a method decided upon within the


scope of nursing practice

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c. Utilize the basic steps in the audit procedure.

d. Evaluate the kind of service being given within the direction of


the Nursing Service.

23. Performance Appraisal. Performance appraisal is done to help an


employee improve his work methods to ensure the achievement of
organizational goals. Each employee should be evaluated by the line
supervisor. Thus, the Assistant Chief Nurses are evaluated by the Chief
Nursing Service. The supervisors will be evaluated by the Asst Chief Nurse
for Clinical Branch, the head nurses by the supervisors, the staff nurses and
the nursing attendants by the head nurses.

24. Evaluation Principles

a. For a worker's performance evaluation to be valid, it must be


based on his job description and performance standards.

b. An adequate and representative sampling of the nursing care


giver's behavior should be observed in the process of evaluating performance.
Care must be taken to evaluate his usual or consistent behavior. Focusing on,
or magnifying an isolated instance of either extremely capable or extremely
inept behavior on the part of the nurse should be avoided.

c. The nursing care givers should be provided with a copy of his


job description, performance standards and evaluation form to review prior to
the scheduled evaluation conference so that nursing care giver and his
supervisor can discuss the evaluation from the same frame of reference.

d. In documenting the employee's performance appraisal, the


superior should indicate clearly those areas wherein the care giver's
performance is satisfactory and those which need improvement. The superior
should refer to specific instances of the care giver's satisfactory and
unsatisfactory behavior in order to clarify exactly what types of changes are
required in his performance.

e. If there is a need to improve the care giver's performance in


several areas, the superior should indicate which area(s} should be given
priority by the care giver.

f. The evaluation interview should be scheduled at a time


convenient for both the care giver and the supervisor. It should be held in a
pleasant surrounding and should allow time for both parties to ask questions
and discuss the evaluation at length.

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Chief Nursing Service

Asst Chief Nurse Clinical Branch

Nursing Supervisor

Head Nurse

Staff Nurse

Wardman/midwife/ nursing
Attendant/ utility worker

Section 4-4 Nursing Process

25. General. Republic Act Nr 7164 Article V Sec 27 states that the
scope of nursing practice includes the utilization of the Nursing
Process. Nursing Process is a problem solving framework for planning and
delivering nursing care to clients and their families. It is a way of thinking as a
nurse. It is a framework of interrelated activities resulting in competent nursing

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care. It is dynamic and cyclical in nature, requiring repeated review. It is a


scientific, problem-Oriented approach to client.

26. Steps in Nursing Process. The nursing process is divided into five (5)
steps

a. Assessment. Let me have a look at that. Tell me about it

Assessment is the first step in nursing process and the one step
which is a part of every step in the nursing process. The nursing assessment
which the nurse completes upon the client's admission to the hospital is
focused on the client's response to actual or potential health problems. During
the assessment the nurse collects data by interview, observation, and
examination. The nurse does not make judgments or conclusions at this time
but focuses on establishing a comprehensive data base which reflects the
health status of the client. The nurse seeks to gather only data, not judgments
and conclusions, from the client.

b. Diagnosis. What is the problem? What is the cause? How do I


know it?

The process of making a nursing diagnosis consists of three (3)


activities namely: data analysis, problem identification, and formulation of
nursing diagnosis. During data analysis the nurse makes decisions based on
the data regarding the health status of the client. Next, the nurse identifies
problem focus areas and finally states a nursing diagnosis. The nursing
diagnosis includes the client problem and cause or etiology if known. The
statement may also include signs and symptoms if the nurse is using the PES
format. If it is a potential nursing diagnosis, the nurse includes the
identification of risk factors which determine the diagnosis.

c. Planning. What are we going to do about it? What is the best


strategy? What do we want to happen?

During the planning phase of the nursing process, the nurse and
the client set priorities among the identified problems; establish goals showing
reduction, prevention; or elimination of the problem; and plan interventions to
achieve the goals. A goal is the desired outcome of nursing care in the form of
changed client behavior. For actual nursing diagnosis, the goals identify client
behavioral outcomes demonstrating a lessening or elimination of the problem.
For potential nursing diagnosis, the goals demonstrate the client maintaining
the current level of functioning or prevention of the problem. Goals give
direction to nursing actions as do the nursing diagnosis. Long term goals often
demonstrate the maximum level of functioning for the client or restoration of
normal functioning and may take days to months to achieve. Short term goals
describe client outcome behavior in smaller steps. They might be more
appropriate in a critical care setting or when the client is unstable and the
problem must be reduced or eliminated rapidly. Short term goals may be set

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in a time frame from hours to days. Progressive short term goals can be used
to show continued progress, in terms of improved level of client functioning in
the direction of long-term goal achievement. A goal statement contains the
client's behavior, the criteria of acceptable performance of that behavior, the
time frame in which the goal should be achieved, and the conditions, if any,
under which the behavior will be demonstrated. Goals are realistic,
observable, congruent with other health professional's plan of care, and
directly related to the nursing diagnosis.

Nursing interventions are those specific activities the nurse


plans and implements to help the client achieve a goal. There are four (4)
broad categories of nursing interventions, and the plan of care often
incorporates actions from several of these groups: environmental
management, physician initiated and ordered interventions, and nurse
initiated/nurse ordered interventions. The last group of interventions is solely
within the realm of nursing practice and includes health teaching, counseling,
and referral; specific nursing treatments; assisting with ADLs; assessment of
client status, progress, and response, assistance with problem solving and
providing encouragement and support. Nursing interventions deal with the
etiology or risk factor of the problem Identified in the nursing diagnosis and try
to reduce or eliminate them. If that is not possible, interventions are aimed at
lessening the problematic signs and symptoms to assist the client cope with
the problem.

Nursing interventions are safe for the client, specific congruent


with plans of other health professionals and realistic for the client, the nurse,
and the health care setting.

d. Implementation. Move into action. Carry out the plan Do it!

It is the fourth step in the nursing process and the focus is on


the nurse working with the client to carry- out the plan of care. Implementation
consists of validating the care plan (is it safe, reasonable plan indicating
quality nursing care?), documenting and communicating it, but the primary
component is actually giving care to the client. The nurse documents this care
and the client)s response to it in the chart. As the nurse gives care,
assessment of the client continues. Documentation is done in order to see the
client's response to the interventions and to provide information for revising
the plan of care as client status changes. The client is an active participant in
care working out with the nurse to adapt interventions as they are given and
having the right to refuse or request interventions. The nurse is flexible, open
to suggestions and changing client priorities but committed to helping the
client understand and accept nursing care to promote health and reduce,
eliminate, or prevent problems.

e. Evaluation.

Did it work? Why didn't it work?


Did we end up where we wanted to?
Are we done or is there more? What is the problem?

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It is the [mal step in the nursing process. The first part of


evaluation involves evaluation of goal achievement. This goal evaluation is
documented in the chart "with a description of the client's outcome behavior
as evidence of the degree of goal achievement.

The second part of evaluation is to review the plan of care. This


involves updating the data base, deciding if original diagnosis are still
accurate, adding new diagnosis or identifying original ones as resolved,
revising the goals and interventions based on more complete information on
the client and the effectiveness of the original plan, and finally implementing
the updated plan. This is again followed by goal evaluation and care plan
review to reflect the dynamic state of the client.

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CHAPTER 5
MANAGEMENT OF CLIEN'T CARE

Section 5-1 Extended Functions of Nurse Corps Officers

1. General. The AFP cognizant of the complications that arise in


emergency and mass casualty situations particularly in the absence of a
medical officer has defamed additional specific duties and responsibilities of
Nurse Corps officers as indicated in the AFP Policy on the Extended
Functions of Military Nurses. This means more trainings, assignments, and
utilization of Nurse Corps officers on the performance of functions normally
performed by medical officers. These are the extended functions of Nurse
Corps officers in accordance with AFP Directive on Extended Functions of
Military Nurses dtd 17 April 1975.

a. Administration of anesthesia in normal elective surgery and


emergency cases of military personnel, their dependents and authorized
civilians confined in military hospital units, installations and in other instances
with military missions in the absence of a Medical Officer.

b. Maintenance of patent airways, suction, intubations, artificial


respiration and tracheotomy, if trained to perform such procedures in extreme
emergencies in the absence of a medical officer;

c. Institution of life saving measures such as oxygen inhalation,


administration of stimulants and external cardiac massage in extreme
emergencies pending arrival of a medical officer;

d. Management of normal deliveries;

e. Catheterization of both male and female patients;

f. Administration of immunizing agents under the supervision of a


medical officer; and

g. Sorting of patients in mass casualty situations.

Section 5-2 Emergency and Disaster Nursing Management

2. General. The need for professional nurses to be prepared in


emergency and disaster nursing becomes more evident as the complexity of
our lives increases owing to the discovery of new scientific knowledge and the
needs of the populace. Professional nurses need to be prepared to meet
everyday emergencies in terms of first aid and lifesaving measures. Nurses'
functions are expanded further on .the case of mass disasters, either resulting

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from natural or man-made phenomena, including enemy attack. This section
deals with disaster planning, organization and management of mass casualty
situations in armed con11icts and disasters.

3. Planning Considerations for Disaster Nursing. There are three


fundamental preparations needed to cope with disasters regardless of type or
magnitude.

a. The adaptations of all skills to any emergency situations.

b. The ability to resettle resouvcefu1ness with both supplies and


equipment a realistic approach to the selection of the essential nursing
procedures and the courage to eliminate the non-essentials.

c. The ability to utilize and teach auxiliary nursing personnel

4. Management of Mass Casualties

a. Sorting - The care of mass casualties is based on the greatest


good for the greatest number at the right time and place. The key to
management of disasters is triage or sorting of casualties according to an
understood plan.

1) In general situations, the serious/critical clients on a given


unit will be cared for first, with semi-ambulant client’s next and ambulatory
patients or those requiring the least care, last;

2) In emergency or disaster situations, the principle of first


caring for those requiring lifesaving measures, then for those who are
seriously injured, leaving minor injuries last, shall be practiced;

3) In the case of thermonuclear situations, triage assumes a


different function based on the principle of providing the simplest measures
that will save the greatest number of lives. Instead of concentration on the
most critical casualties, available manpower and supplies should be used for
the maximum number of people who can be saved. While the hopelessly
injured should not be abandoned but made as comfortable as possible, efforts
must be directed toward treating the thousands who may respond quickly to
lifesaving treatment; and

4) Combat Situation. The wounded are sorted at the first


level health care facilities, the battalion aid station. Here, the casualties from
the front lines receive first treatment and are assembled for collection. From
this area, they are collected by elements of the evacuation section, and
evacuated by land, air or water to the clearing stations which could either be a
fixed or a mobile medical infirmary, a station hospital, or in the absence of
both, could be a public or private clinic or regional hospital, whichever is
available in the locality. These health care facilities serve as holding units
where casualties are treated and accumulated in preparation for evacuation to

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the final or ultimate health care facilities in the chain of evacuation, the
general hospital and/ or AFP Medical Center.

5. Treatment of Mass Casualties

a. First aid and rescue;

b. Emergency medical treatment - the prime objective is to


preserve life and limb and to prevent or arrest physical deterioration until more
definitive treatment can be given; and

c. Definitive medical/ surgical care.

6. Principles in the Care of Mass Casualties

a. All medical management must be directed toward the good of


serving the greatest number with resources.

b. No casualty is to be considered abandoned, but concentration of


medical effort in the few, denies appropriate care to the many.

c. Time is an important factor. The longer the delay of medical


cares for a seriously injured casualty, the less is his chance for recovery. The
system should be organized so that immediate first aid can be provided,
through self help, neighbor help, and teams from first aid stations.

d. Casualties must be transported carefully and quickly to the


nearest health care facility for further management by skilled personnel.

e. Skilled medical personnel with essential diagnostic and


therapeutic equipment should be brought as close to areas having casualties
as circumstances will permit.

f. Initial medical and surgical supplies and equipment must be


available immediately and large reserve stocks are made ready for movement
to affected areas

g. The magnitude of the supply needs, demands uniformity in the


management of specific types of injuries.

h. Adequate transportation will be required to move casualties from


disaster areas to first aid or clearing stations, and then to local and distant
hospitals.

i. Communication between casualty service units is a prerequisite


to an orderly movement of casualties and supplies between facilities.

j. Skilled medical personnel should not be used for first aid and
rescue operations.

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k. The use of narcotics should be held to the minimum. Nothing
should be done to a casualty that will decrease his capacity to care for
himself.

l. Triage or sorting is the key to the successful management of


mass casualties.

Section 5-3 Health Service Support

The objective of the Health Service Support (HSS) System is to


conserve trained manpower through the prevention of adverse effects
produced on combat efficiency by unevaluated clients. Accomplishment of this
objective involves the careful evaluation (sorting) of the wounded in relation to
the capabilities of the medical echelon involved and the treatment of such
wounded on their evacuation to the rear. The health service support system
provides a continuum of care which starts at the point or area of injury or
wounding and continues through the area of operations to the hospitals for
treatment or to other installations for disposition. The general plan of
evacuation and hospitalization within the area of operation is the responsibility
of the surgeon in accordance with the evacuation and hospitalization policies.
These policies will determine which clients will be evacuated and will
designate a maximum number of days for allowable period of hospitalization
within the area of operations. The time set may vary from 30 to 120 days an
increment of 30 days. This does not mean that the client is held at each level
of medical treatment for the limit of the time set, but that his total fixed
hospitalization time in the theater does not exceed the number of days
specified. In conformity with the theater evacuation policy, subordinate
commanders establish evacuation policies subject to the approval of the
theater commander, indicating the maximum period that clients may be held
in their particular areas or installations. For example, a shorter evacuation
policy may be established for striation hospitals than for general hospitals. In
the area of operations, the policy may vary from hour to hour and day to day.
If a client is admitted to a station hospital but whose recovery is likely to
require more than the number of days of policy would be evacuated to a
general hospital. Wounded soldiers must not be permitted to go farther to the
rear than his physical condition requires. Soldiers with minor wounds and
minor illnesses are returned to duty as soon as possible from as far forward
as possible in the evacuation system. Generally the evacuation flow begins at
the unit level from the moment clients receive aid from the company aid man
and walk back or are carried to a collecting point or aid post. These clients
follow the primary line of evacuation to a point as far rearward as is consistent
with their injuries and the tactical situation. From the company collecting point
or aid post clients are taken (usually by ambulance) to the battle group aid
station, the first medical station in the evacuation system. Transportable
clients via ambulances proceed to the division clearing station and later to an
evacuation hospital. Non transportable patients and those who must have
immediate surgery are moved or evacuated via Phil Air Force aircraft, to a
Mobile Army Surgical Hospital (MASH) located in the division or they may be

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evacuated directly to a station hospital via Phil Air Force aircraft where they
will rejoin the primary flow of evacuation. From there, they may be further
evacuated to an army general hospital. If further evacuation is needed they
are brought to the AFP Medical Center. From the MASH, clients may be
directly evacuated to AFP Medical Center. It must be remembered that at any
point in the evacuation system, the soldier will be returned to duty if it is
possible.

The availability of sufficient transportation (ship, plane, helicopter, or


motor vehicle/ ambulance) determines the degree to which evacuation can be
accomplished. For the health service support system to achieve the
systematic and prompt evacuation of the sick and wounded soldiers. Health
Service Support System is tailored into echelons or levels of care of the
medical evacuation. The echelons of medical evacuation are as follow;
(Annex E)

a. Echelon 1, unit level, HSS system is provided by designated


elements or individuals organic to the unit. These individuals are found in the
combat, combat support and combat service support units. Major emphasis at
this level of support is to stabilize and evacuate the casualty. Necessary
measures are taken to treat and medically stabilize the casualty for
evacuation to the next level of care. The combat medic or medical aid man is
the first individual in the HSS system who makes medically substantial
decisions based on his special training as a medical specialist.

b. Echelon II, division level, HSS is usually conducted at the


clearing station. The clearing station initially examines the casualty. The
wounds and the general status of the casualty are evaluated. This evaluation
determines priority for treatment or evacuation. Emergency care including
initial resuscitation continues. If necessary, additional emergency measures
are instituted.

c. Echelon III, a medical treatment facility (MTF) provides Echelon


III HSS. Tills facility is staffed and equipped to provide resuscitation, initial
wound surgery and post operative treatment. Clients whose wounds/injuries
are life threatening may receive surgical care in a mobile army surgical
hospital (MASH) in the division rear area.

d. Echelon IV. A medical treatment facility also provides Echelon


IV HSS. This facility is staffed and equipped for general and specialized
medical and surgical care and reconditioning rehabilitation for return to duty.

7. Utilization of Nurse Corps Officer in Echelons of Medical


Evacuation. The Army Nurse Corps officer may be assigned in medical
infirmaries which is located in Echelon II. The number of Army Nurse Corps
officer assigned in medical infirmaries varies depending on the number of
troops to be catered by the medical infirmary. As the level of echelon goes
higher, the number of Nurse Corps officers assigned as well as their level of
knowledge and skill also go up.

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CHAPTER 6
HUMAN RESOURCE DEVELOPMENT PROGRAM

Section 6-1 Military Training and Education

1. General. The Army Nurse Corps officer being a military officer


undergoes military training to provide the appropriate knowledge, high level of
skills, discipline, motivation- required of the expanded role of the military
today. These are the following courses given to Army Nurse Corps Officers in
the active service.

2. Lower Level Courses

a. PA Nurse Corps Orientation Course. This orientation course is a


three (:3) week course conducted by the Office of the Army Chief Nurse to all
Nurse Corps officers newly assigned PA. This course is designed to acquaint
the nurse to the basic rudiments of military organization particularly the
Philippine Army.

b. Technical Service Officers' Basic Course - The Technical


Service Officers' Basic Course (TSOBC) is a 16 week course conducted by
the PA TRADOC. Its objective is to provide basic military training to all military
officers belonging to the Technical Service so that these officers will have a
working knowledge of the duties and responsibilities expected of them in the
military service. This training consists of two (2) phases. The Military Phase is
an eight (8) week course conducted at PA TRADOC, The Specialization
phase is an eight (8) week course conducted at the Armed Forces of the
Philippines Medical Service School (AFPMSS) (for the Nurse and Medical
Corps officers only), in AFP Medical Center.
1) Prerequisites.

(a) No pending administrative and/ or criminal case


before any Efficiency and Separation Board, Civil Court or Court Martial.

(b) Must not be due for reversion.

(c) Must not be pregnant (for female)

(d) Physically and mentally fit.

c. Technical Service Officers' Advance Course. This course is a 16


week course conducted at the PA TRADOC. It is designed to provide
Technical Service Officers the knowledge and skills in staff procedures and
functions to qualify them to staff positions which correspond to their rank and
to expose the Army Nurse Corps officer to the concepts of management

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which are considered necessary tools in policy formulation and decision


making process.

1) Prerequisites:

(a) A graduate of Technical Service Officers' Basic


Course

(b) Must be physically and mentally fit

(c) Must be available for full time training

(d) No pending civil, administrative, criminal or court-


martial case; and

(e) Not due for reversion/retirement during the period


of training.

d. Personnel Officers' Course - This course is a twelve (12) week


course offered at the PA TRADOC. It is designed to produce qualified
administrative and personnel officers for the PA Nurse Corps.

1) Prerequisites

(a) Graduate of Technical Service Officers' Basic


Course

(b) Rank of Captain

(c) No pending civil/administrative/criminal or court


martial case;

(d) Not due for reversion; and

(e) Must possess above average aptitude for


administrative functions

3. High Level Courses

a. Command and Staff Course/Technical and Administrative


Service Command and Staff Course (TASCSC). This is a 24 week course
conducted at the Armed Forces of the Philippine Joint Command and Staff
College (AFP.JCSC). It is designed to prepare Technical Service senior
officers for the various troop commands and staff positions in the AFP.

1) Prerequisites:

(a) Graduate of Technical Service Officers' Advance


Course with the rating of 85% and above

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(b) Must have occupied a position calling for the rank


of 0-4 for at least one (1) year

(c) Must have no pending civil, administrative, criminal


or court martial case; and

(d) Must have current security clearance for access to


at least "secret" documents/materials

(e) Must have at least five (5) more years of service


before compulsory retirement after the completion of the course.

(f) Must be physically and mentally fit

(g) Must pass the required entrance examination

b. Master in National Security Administration. This is a one (1) year


post graduate course conducted at the National Defense College of the
Philippines leading to a degree of Masters in National Security Administration.

1) Prerequisites:

(a) Rank of field grade officer

(b) Must be GSC eligible

(c) Must have at least five (5) or more years of service


before compulsory retirement after the completion of the course

(d) Must pass the qualifying entrance exam

(e) Must be physically and mentally fit

(f) Must be recommended by the Chief Nurse, AFP

Section 6-2 Professional Advancement Program

4. The 22-KIDA Program and Other Similar Grants

a. Nurse Corps Officers are given the opportunity to develop their


potentials through the acquisition of knowledge and expertise for career
growth and development through the AFP scholarship program and other
similar grants. This program is governed by Circular Number 4 MND dated 01
September 1982.

b. Nurse Corps officers who are grantees under Section 22K NDA
and other similar grants are allowed to pursue graduate or post graduate
studies in certain academic disciplines in certain local educational institutions

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to be periodically determined by the Higher Headquarters. These courses


should be geared towards the attainment of AFP I unit's goals and objectives.
1) Prerequisites

(a) Must have been in the active service for at least


five (5) years;

(b) Must not be due for retirement within five (5) years
or during the period of mandatory service after the completion of study.

(c) Seniority

(d) Job performance based on the three (3) most


recent evaluation by three (3) different raters with rating of very satisfactory

(e) Awards and decorations covered by appropriate


orders

(f) Must not have availed of previous scholarship


grants

(g) Must be recommended by the Office of the Army


Chief Nurse.

2) Application shall include

(a) Statement of circumstances of the candidate to


include name, rank, AFPSN, date of birth, effective date of present rank,
length of government service (military and civilian separately indicated), and
statement of educational qualifications, outstanding academic achievements
and related accomplishments.

(b) Course Duration (in number of semester/ trimester/


summer sessions)

(c) A transcript of records for all Collegiate Courses


completed or partially completed

(d) A statement as to the nature of any scholarship


(full or partial) previously granted the candidate.

(e) A statement of the future utilization of the


candidate, relating the education or training to be acquired with the future
assignment.

3) Utilization

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After completion of the course; the grantee shall


be assigned to units/positions in line with or allied to the course pursued for
such period of time as may be deemed most beneficial or advantageous to
the service or where he may be assigned/tasked to do a staff study on any
major problem of the AFP wherein his new knowledge will be utilized.

5. Local Schooling in Civilian Schools. The Philippine Army shall pay


for the tuition and school fees only, subject to the usual accounting and
auditing procedures.

a. Qualifications: an applicant must have the following:

1) Must not be due for compulsory retirement within the


period of contractual service;

2) Must not be enjoying any similar scholarship or


educational assistance grant from the AFP or any government entity;

3) Must not have any pending administrative and/or criminal


case before any Efficiency and Separation Board, civil court or court martial;

4) Should not be serving contractual service because of a


previous scholarship grant;

5) Must possess the appropriate educational qualifications;


(6) Must have good scholastic standing;

6) Must have a performance rating of at least very


satisfactory for the last three (3) years

7) Seniority

b. Grantees may enroll in any state university or school to be


approved by PA Selection Board for Local Schooling.

c. Grounds for termination.

1) If the grantee is discovered to be a beneficiary of a similar


scholarship program sponsored by the AFP or any government entity;

2) Failure to meet the prescribed academic standards

3) Voluntary withdrawal from the course by the grantee.

4) Non submission of grades before the start of the next


semester

d. Contract/Mandatory Service. Any officer detailed to study under


the provisions of Circular Number 4 MND dated 01 September 1982, shall
prior to enrollment, execute a written promise to serve the Armed Forces of

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the Philippines for a prescribed period of mandatory service (number of years


for every year of study or a fraction thereof but not less than two (2) months)
based on the degree of financial support or assistance/scholarship given by
the government. (Figure 6-1)

Contract of Mandatory Service

Table 6-1
Source of Funds Period of Mandatory Service
1. Government Funds
a. Local Schooling 2.5 years
b. Schooling Abroad 3 years
2. Private Institutions (no funds
involved other than
salary/allowance) 2 years
a.. Local Schooling 2.5 years
b. Schooling Abroad

6. International Military Education and Training Program (IMETP). It


is a training program open to all military personnel on active duty. This training
is under the Mutual Aid Program of the United States Armed Forces.

a. Criteria for Foreign Training.

1) Previous training and experience- Only those with


excellent performance in the previous schoolings both civilian and military
shall be recommended;

2) Level of schooling - age, rank, past and present


assignments shall be considered;

3) Equity of the alternate - an officer selected as alternate


for a course becomes the principal for the same course the next time it is
offered, unless he is no longer qualified.

4) Age limit -younger officers shall normally be given


preferential consideration.

5) Frequency of Schooling - no military personnel shall be


considered for another foreign schooling until he has completed a time
interval between schoolings as follows:

Frequency of Schooling
Table 6-2

Previous Course Duration Time Interval


1) Eight (8) week to 6 months 3 years
2) more than 6 months to 1 year 4 years

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3) more than 1 year to 2 years 5 years


4) more than 2 years 6 years

6) Career Personnel- career personnel with long


expectancyfor continued service shall be given priority for consideration for
foreign training. However, if there are no career personnel who are qualified
and/ or available for particular courses, deserving reserve Nurse Corps
officers who fall under the purview of Section 3 RA 2334 may be considered
for the course.

7) Only military personnel assigned Phil Army will be


considered in the selection of candidates;

8) Training in foreign schools should complement military


education received in local schools. It should not duplicate training previously
received.

b. Mandatory Prerequisites.

1) Must have completed at least three (3) years of active


service in the Phil Army.

2) Satisfy rank requirement of the school catalog

3) Have completed prerequisite course(s) if required

4) Have completed the required time interval, if applicable

5) Have not taken the same or similar (in scope) course in


local service schools.

6) Have at least five (5) more years of service before


compulsory retirement after the completion of the course thereof

7) Have no pending case before any military/civilian


courts/boards and other investigating agencies.

8) No property and money. accountability/responsibilities

9) Have appropriate security clearance for schooling abroad


pursuant to the provisions of AFOR G 200-52 or appropriate clearance
required of the students by the recipient school.

10) Be academically qualified to excel on the


coursecontemplated, and not merely to pass it.

11) Have passed the ALCPT and or ECI Test! Applicable to


2LT/ENS up to Major/LCDR. Except for health courses where officers up to
LTC/CDR are required to take the test.

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c. Selection Procedures.

1) A Selection Board for Foreign Schooling in the Phil Army


shall be created. The Chief of Staff, PA will head this board.

2) The Board shall screen and rate all qualified candidates


in a prescribed rating form. However the action offices/ units may devise their
rating scale. In case two or more candidates obtained the same ratings, the
most senior shall be selected.

3) To insure the filling up of training spaces a principal and


alternate shall be selected for each space. When there are two or more
spaces, the candidates shall be recommended in the order of priority.

d. Utilization. After completion of a course, the graduate shall be


assigned/placed DS in AFPWSSUs/Major Service Primary Training unit as an
instructor or in field staff positions where maximum utilization can be made of
the training received for a period of at least one (1) :year.

Section 6-3 In-Service Training Program

7. Components of the Human Resource Development Programs

a. In Service Training Programs.

1) Job Induction/Orientation. This type of in service training


program is designed to equip the newly assigned Nurse Corps
officer/personnel to the PA Nursing Service with the basic organization
information needed to adapt to the work situation. It has the following
components:

(a) Orientation to the HPA. The following may be


included but not limited to:

(1) HPA orgn and objectives/mission/goals

(2) Philosophy of HPA

(3) Functions of the different staffs

(b) Orientation to tile Office of the Army Chief Nurse


(OACN) and other Health Service component. May include the following but
not limited to:

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(1) Organization, Objectives, Mission, Goal,


Vision and Philosophy

(2) Functions of the different staffs

(c) PA Nursing Services

(1) Historical Background and Organization of


General/ Station Hospitals and Medical Infirmaries.

(2) Functions of Staff and Personnel of


General/ Station Hospitals and Medical Infirmaries

(d) AFP Regulations/Command Policies

(1) Uniform

(2) Leaves: Local and Abroad ill. Maternity


Leaves/Report of Pregnancy

(e) PA Nursing Services Policies/ SOP’s

(1) Admission/ transfer in-out/ discharges

(2) Referrals/ Consultations

(3) Death

(4) Medication Policies

(5) Staffing/ Assignment of Mil and Civ


Employees

(6) assigned Nursing Service

(7) Policies affecting Military Civ Employees


assigned Nursing Service

(8) Government Hours

(9) Leaves

(10) Legal Responsibilities of Mil Civ Employees


assigned Nursing Service.

(11) Nursing Records and Reports

b. Skills Training Program. This training program is designed to


develop the competence of the Nursing Service care givers in order to
improve their efficiency and performance.

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c. Leadership Training. This training designed to prepare senior


Nurse Corps officer for supervisory positions and level management and
enhance the capabilities of those already on the job.

8. In Service Education Provides To All Military And Civilian


Employees Assigned Nursing Service With The Opportunity To Learn
How To Perform Effectively And Efficiently.

a. The quality of nursing care rendered by the nursing service care


giver is dependent on their knowledge, skills and attitudes (KSA). There is

b. Need for an effective human resource development program


because of the rapid turn-over of Nursing Service personnel, the continuous
implementation of service and technology as well as the social cultural
changes and the unpredictable patterns on morbidity and mortality.

c. Human Resource Development (HRD) provides for a continuing


education that will fully develop the care givers' potentials. This includes:

1) Orientation

2) In service training programs

3) Conferences

4) Seminar/workshops

5) Book clubs

6) Case presentation

7) Journal readings

d. Human Resource development is the responsibility of both the


Chief Nursing Service and the care giver concerned. In the planning of the
program the nursing service care givers should be involved so that the
program will be responsive to their needs. General/Tertiary hospitals with
training capabilities should have the Nursing Service Education and Training
Branch. It will be the responsibility of the training staff together with the Chief
Nursing Service for the planning, implementation and evaluation of the
program. Attendance of the Nursing, Service care givers to the programs
should be a must and should be made on rotation basis to give equal
opportunities to all the nursing service care givers.

9. Factors to be Considered in the Development of an the Service


Education Program

a. Identification of the learning/training needs of the nursing service


care givers

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b. Course objectives

c. Course content

d. Selection of participants

e. Schedule of the training program (date and time and duration)

f. Choice of the venue for the training program (1) Adequately


spaced room (2) Well ventilated and lighted - conducive for learning

g. Accommodation of the participants (for live - in seminars)

h. Accreditation of the training program

i. Selection of speakers

j. Availability of training facilities

k. Course evaluation

Section 6-4 Paramedical Training in Army Health Care Facility

10. General. GHQ Cir No. 18 dtd 7 Jun 71 provides for the Paramedical
Internship Training for Medical Interns, Medical Technicians and Nursing
Students in AFP Hospitals. For NC Officers assigned in PA health care
facilities offering training to these paramedical trainees, it is their duty to help
provide an environment conducive to learning in the respective wards or units.
NC officers should coordinate and cooperate 'with the clinical instructors in
supervising and giving spot instructions as needed to nursing students in their
units.

11. Nursing Affiliates. The PA Nursing Service is guided in the


management of nursing affiliates as per SOP No. 12 HPA dtd 26 Oct 76.
Affiliates are students of nursing/midwifery health aides who are undergoing
training internship with Army General/Station Hospitals as approved by higher
headquarters while clinical instructors are professional nurses designated by
the school to follow up and supervise nursing affiliates.

12. Objectives

a. To assist in and facilitate initial orientation of both student


nurses/midwives and their clinical instructors to military environment;

b. To provide guidance and assistance to bring about uniformity


and correlation of experience of all student nurses regardless of school and
college; and

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c. To serve as an effective tool in assisting the student to adjust to


the varying clinical situations they may encounter in Army Hospitals.

13. Policies. Affiliation for internship training is extended to educational


institutions duly recognized by the government. A contract between the
affiliating school and the designated military health care facility is approved by
the Chief of Staff, AFP subject to the following conditions:

a. That the interest and welfare of the clients shall at no time be


subordinated to the conduct of the affiliation training program;

b. That no special rooms or space be designated for the use of


students or by the hospital for the same purpose out of government funds;

c. That the rules and regulations prescribed by the different


affiliating institutions for their respective training programs be coordinated first
with the Commanding Officer of the military health care facility before they are
implemented in the clinical area; and

d. That the military health care facility he provided with security


clearance for each student and clinical instructor which can be obtained from
the nearest intelligence agency within the area.

14. Policies and Regulations of the designated Health Care Facility

a. All newly assigned clinical instructors to PA health care facility


with training capabilities shall undergo two week orientation program prior to
their following up of students in the clinical areas.

b. All nursing and midwifery students who will be fielded in a PA


health care facility shall undergo a general orientation program once every
year prior to their exposure in the clinical areas.

c. Student's schedule in the clinical areas shall be submitted to the


Office of the Chief Nursing Service thru the Asst Chief Nurse for Education
and Training Branch at least a week prior to scheduled duty dates.

d. Clinical instructors shall wear proper uniform (white dress,


brown stockings and white shoes) when they are in the clinical areas.

e. Students shall only be admitted in the clinical areas upon


presentation of a coordination slip signed by the Asst Chief Nurse for
Education and Training or his authorized representative.

f. Billing of affiliation fees shall be given to the respective colleges


one week prior to the end of their scheduled clinical exposure.

g. Plotting of master rotation plan in the clinical areas shall be done


once a year

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h. Nursing/ Midwifery students scheduled for DR/Nursery duty shall


undergo throat swabs as precautions.

15. Responsibilities of the Clinica1lnstructors

a. Clinical Instructors are appointed by their respective


College/School of Nursing. Their professional competence to follow up and
supervise the students is the school's responsibility;

b. Clinical Instructors are required to sign in and out at the Office of


the Chief Nursing Service everyday during their tour of duty;

c. Clinical Instructors are supposed to undergo two week period of


familiarization and orientation in his specific area of assignment before be is
allowed to follow-up students in the health care facility;

d. Clinical Instructors are directly responsible for the learning


experience and performance of students while on affiliation with the hospital.
Therefore, their duties and responsibilities include the following:

1) Together with the head nurse, plan and prepare students


assignments where they can put into full practice what they have learned in
the classroom;

2) Plan, supervise, guide and give instructions in the form of


ward classes, ward conferences, nursing rounds or bedside clinics;

3) Prepare programs of activity that would help develop right


attitudes of the students as well as enable them to acquire skills in giving
appropriate nursing care;

4) Evaluate the student's strengths and weaknesses and


find out ways to improve their overall learning experience;

5) Final evaluation of students' performance is primary


responsibility of the clinical instructor, however, this may be done jointly by the
head nurse and clinical instructors;

e. Clinical instructors are responsible for the behavior of their


students and any misconduct should be reported to the Chief Nursing Service,
who in turn shall refer the matter to the School Authorities for appropriate
action;

f. Attendance in all students' dialogue, clinical instructor head


nurse conferences and other professional activities of the health care facility
especially of the nursing service is a must for clinical instructors; and

g. Set an example of good professional decorum for student to


take as. a model.

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h. Observe secrecy discipline at all times when inside the camp.

16. Responsibilities of Students.

a. Students should observe their duty hours specified in their


Assignments and schedules prepared by their respective schools. Tardiness
or absences should be dealt with in accordance with the policies of the
particular school.

b. Courtesy and mutual respect towards clients, visitors and


hospital care giver should be observed at all times. While kindness and
friendliness are excellent virtues, familiarity and intimacy with any of the
above persons should be carefully avoided.

c. Social visits or attending to personal activities during duty hours


is not allowed except when extremely necessary and prior permission has
been secured from their clinical instructors.

d. Students are expected to behave like ladies and gentlemen


observing the unwritten rules of ethics and proper decorum at all times.

e. Gambling, drug and alcohol intoxications are strictly prohibited


and may be punishable if found guilty.

f. Students are not allowed to accept gifts or presents from clients


and/or relatives of clients.

g. Bringing playing cards or radio for self amusement of clients is


not allowed.

h. Observe utmost courtesy in answering calls, the telephone in


the ward is strictly for clinical business only.

i. Observe secrecy discipline at all times when in the compound.


Do not issue any information or give out statement to the press and to
unauthorized persons about any clients or activity in hospital.

j. Refrain from giving out undue comments or advice to clients and


their relatives about illness or prognosis which may adversely affect their
mental or emotional disposition.

k. Safety measures should be observed at all times to prevent loss


or injury not only to the clients but also to the visitors, and care givers of the
health care facility. Existence of firearms at the client's bedside should be
reported at once to the head nurse.

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l. Coffee breaks and snacks are allowed for 30 minutes; however,


students shall ask permission from the head nurse or clinical instructor before
leaving.

m. Cooperate in the enforcement of the hospital rules and


regulations such as visiting hours, cleanliness of surroundings and proper use
of toilets and washrooms.

n. Be properly equipped with basic nursing tools (scissors,


wristwatch with second hand and red/blue pens). Avoid displaying excessive
use of jewelries and large amount of cash.

o. Proper use of hospitals supplies and equipment should be


observed. Students will be required to replace in cash or in kind breakages or
loss of hospital supplies and equipment due to carelessness and negligence
unless justified otherwise in writing.

p. Students must be acquainted with policies affecting Nursing


Service care givers and practices of the ward or area where they are
assigned. Students and clinical instructors have no jurisdiction over any
professional/non-professional Nursing Service care givers of the ward.
Relationships with the care givers are on a coordinative basis. Any complaints
against them should be made to the Chief Nurse thru the head nurse if this
could not be resolved in area.

q. It is the responsibility of the student to complement experience


by reading and discussing for profundity of knowledge.

17. Phases of the Instructional Programs.

a. General Orientation Phase. It is to acqu8Lflt student affiliates


and clinical instructors with general information on the institution, and other
standard information applicable to all clinical areas of the hospital. Activities
would include a briefing and physical tour of the hospital;

b. Unit Organization Phase. This phase is usually conducted by the


head nurse of the unit. It is: to acquaint the student nurse of her role in a
particular unit and how she can function as part of the health care service
team. Orientation on the physical set.-up of the ward includes introduction to
inter-relationship of student nurses and staff;

c. Student Development Phase. This is usually accomplished by


means of the follow-up and supervision of the clinical instructor in order to
assist the student nurse to gain experience and skills in her application of
classroom theory to clinical activities and/or cases. Activates are dependent
on the daily plan of activities and specific objectives of the clinical instructor
and the student nurse; and

d. Evaluation Phase. Submission of affiliation evaluation reports by


student nurses and conferences among clinical instructors, student nurses

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and the Assistant Chief Nurse for Education and Training (or equivalent) is
undertaken. Above reports and conferences are to measure experience
gained by the students against their particular objectives. Discover existing
problems which might have been overlooked; and suggestions which may add
to their solutions.

18. General Requirements.

a. There should be an organized training program of affiliation


prepared by the health care specificity in consultation with the affiliating
College of Nursing;

b. The Asst Chief Nurse for Education and Training (or equivalent)
shall be responsible for the implementation of the training program for nursing
affiliates

c. The training shall include the following:

1) Course Objectives

2) General learning objectives

3) Course Contents

4) Syllabus

5) Methodology

6) Schedule

7) Monitoring and Evaluation

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CHAPTER 7
CONDUCT AND DISCIPLINE

Section 7-1 Standards and Policies

1. Nursing Service Policies. Policies are guidelines or fundamental


bases that dictate all actions of both military and civilian employees assigned
Nursing Service in the performance of their duties and responsibilities.
Policies are formulated to accomplish predestined objectives. All those
affected and covered by policies should participate in the preparation and
formulation of the policies. Policies should be approved by the approving body
and when approved should be written down, reviewed, updated and revised if
needed.

a. Forty Hours Work A Week. All Nursing Service civilian


employees assigned in any PA health care facilities are required to render
eight (8) working hours a day for five (5) working days a week or a total of
forty (40) hours a week exclusive of time for meals. (CSS Res. No. 91-671 dtd
June 1991).

b. Time In/Time Out. All Nursing Service civilian employees shall


record their daily attendance on the proper form or whenever possible, have
them registered on the Bundy clock. Any other means of recording attendance
may be allowed provided their respective names and signatures as well as the
time of their arrival to and departure from office are indicated, subject to
verification. The record of attendance which shall be kept in a conspicuous
place shall be in the custody of a responsible person who will monitor their
arrival and departure. Offsetting of tardiness or absences by working the
equivalent number of minutes or hours by which a civilian nursing service
employee has been tardy, beyond the regular or approved working hours of
the employee concern shall not be allowed.

c. Absenteeism and Tardiness.

1) Habitual Absenteeism

(a) A civilian Nursing Service employee shall be


considered habitually absent if he incurs unauthorized absences exceeding
the allowable 2.5 days monthly leave credit under the leave law for at least
three (3) months in a semester or at least three (3) consecutive months during
the year.

(b) Any civilian nursing service employee shall be


considered habitually tardy if he incurs tardiness, regardless of the number of
minutes, ten (10) times a month for at least two (2) consecutive months during
the year.

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(c) Tardiness and under time are deducted against


vacation leave credits and shall not be charged against sick leave credits
unless the under time is for health reasons supported by medical certificate
and application for leave. (Provided under CSC MC Nr. 41, s. 1998).

(d) A civilian nursing service employee shall not be


entitled to receive his salary corresponding to the period of his unauthorized
leave of absence. It is understood, however that his absence shall no longer
be deducted from his accumulated leave credits, if there are any (Amended
CSC MC Nr 41 s. 1998).

(e) Absence on a regular day for which suspension of


work is announced. When a civilian nursing service employee fails to report
for work on a regular day for which suspension of work was declared after the
start of regular working hours, the personnel should not be considered absent
for the whole day. Instead he shall only be deducted leave credits or the
amount corresponding to the time when official working hours start up to the
time the suspension of work is announced.

(f) Leave of absence without pay on a day


immediately preceding or succeeding Saturday, Sunday or Holiday. When the
employee regardless of whether he has leave credits or not, is absent on a
day immediately preceding or succeeding a Saturday, Sunday or Holiday
whether such absence is cotillions or not, he shall not be considered absent
on said Sundays and Holidays and shall not be deducted leave credits. He
shall neither receive salary for those days (Amended CSC MC Nr 41, s 1998.)

Section 7-2 Nursing Activities in the Ward

2. Oral Endorsement

a. It is an oral report by the outgoing shift to the incoming shift on


the significant evaluation of each patient's condition in the nursing unit. It is
the transfer of responsibilities from one shift to the other for the purpose of
achieving continuity of patient care.

b. It is done at least fifteen (15) minutes before the shifting time,


however for areas which require longer time, endorsement is done 30 minutes
before the shifting time.

c. All nursing personnel should join the endorsement. They are


required to have a small notebook to note down important data received
during the endorsement.

d. What to endorse in the endorsement sheet:/notebook.

1) Pertinent orders to be followed up for each client.


Particularly new orders in medications, laboratory exams and others.

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2) Expected transfer in-out of the units, discharges

3) Articles to be changed or repaired

4) Non-functioning, missing or bon-owed equipment and


from whom

5) Critically ill clients, sudden changes in their condition,


death of clients.

6) Any nursing errors reportable to the head


nurse/supervisor.

7) Latest vital signs of febrile/ cardiac clients

8) Latest assessment of client's condition

9) Orders not carried out during the shift

10) Information to be relayed to doctor

11) Time schedule of' surgery and brief pre-op checklist

12) Other pertinent information.

3. Nursing Rounds. Activities wherein nurses who received the oral


endorsement assumes responsibility of clients, visiting all of the clients briefly
before the start of the shift, assessing each client's particular problems as
basis for meeting his/her needs. During these rounds nurses give special
attention to the critically ill, the post-op and newly admitted clients. This
nursing round is important guide in the planning, executing and evaluating the
Nursing Care Plan (NCP).

Section 7-3 PA Nursing Service Personnel Discipline

4. General. Technique of controlling an employee's behavior is by


enforcing sanctioned/approved disciplinary procedures. All military and civilian
employees assigned Nursing Service believe that discipline is a form of self
control through which the individual's cause is in accordance with the nursing
service code of behavior while the supervisor believes that discipline is the
process of bringing about their compliance with the rules and regulations of
the Nursing Service.

5. Military Nurses Code of Conduct. Our military establishment is


governed by rules and regulations which emanate from four (4) sources;

a. Laws of Congress.

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b. Army Regulations and other Directives.

c. Presidential Directives.

d. Code of Practices as custom of the service.

6. Many of the traditions, customs and courtesies of the AFP are


written down as Army Regulation. Customs of the service are the long
established practices or usages of constant and repeated observance,
acquired the character of unwritten norms of conduct. Despite the possible
changes in customs to suit the needs of modern living, these established
precedents remain as the minimum accepted practices in the military. The
following Code is issued to provide our officers with an official guide on
military behavior.

a. Courage, Loyalty, and Integrity - Have faith in God, in the


greatness of your God and in the capacity of your people. Act at all times in
accordance with the call of courage, loyalty, and integrity.

b. Officers Speech - Avoid profane and obscene language in your


utterances. He who swears or indulges in blasphemy exhibits his inability to
express himse1f forcefully in proper language and betrays his lack of decency
and se1f-control.

c. Sanctity of Official Statement. - Do not lie, quibble, or make


evasive statements. An officer’s official statement, whether written or oral,
should be so sacred as to be accepted without question.

d. Servility Is Scored. - Avoid servility and bootlicking. Deliberate


courting of favors is below the standards of conduct expected of officers. He,
who stoops to these reprehensible acts, whether openly or covertly, debases
himself and incurs the scorn of his associates.

e. Depending upon Oneself - Rely upon yourself, your ability and


personality. Keep rank and authority in the background. Take pride in your
men, maintain ideal friendship with them, and derive satisfaction from their
work. Be a leader who inspires and not a boss who exasperates.

f. Leaning of Rank. - Do not lean on your rank in your actuations.


If you are on the top level, do not brag that you are on top of a mountain.
Instead, strive to place yourse1f in such a position that you could sense and
feel the feelings of those above and below you.

g. High Morale Character. - Lead an honorable and upright life.The


officer by virtue of his position is responsible for regulating the moral life of
those under him. On occasions, he is called upon to punish them for moral
lapses. He cannot do this honestly and justly unless he himself possesses a
moral character which is beyond question.

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h. Consideration for Others - Be considerate of the feelings of


others no matter what their station in life may be he who licks the boots of
those above him and kicks the faces of those below him on the social ladder,
is an illustration of what a gentleman is not.

i. False Standards. - Avoid spending excessively to maintain false


standards beyond your means. You are not expected to make an expression
in the matter of spending money. It is enough that you do not disgrace the
uniform.

j. Borrowing Money. - Never incur indebtedness, except in


extremely unavoidable circumstances. If you have incurred debt, remember it
is a debt of honor which must be paid without fail and as promptly as possible.

k. Courtesy. - Be courteous to subordinates. It is as important as


courtesy to superiors.

l. Punctuality. - Be punctual in all your engagements. Remember


that punctuality is the courtesy of leaders.

m. Respect. - Pay the same respects to officers of the Armed


Forces of other nations, and to officers of the Reserve Force, when in uniform,
as those rendered to officers of the Armed Forces of the Philippines.

n. Cheap Places. - Avoid cheap places. It is disgraceful for officers


to visit cheap places, such as questionable houses and untidy restaurants,
especially while in uniform.

o. Officer's Uniform: The uniform identifies the wearer as a


member of the Armed Forces of the Philippines; Officers are required to
provide their uniforms and uniform equipment at their own expense. Uniforms
are required to conform. In every respect to specification approved by General
Headquarters.

1) The uniform will be kept clean, neat and in good repair.

2) Missing insignia will be promptly replaced.

3) Insignia and buttons will be bright Finished.

4) Overcoats, coats and shirts will be worn in regulation


shape.

5) Service hats will be worn in regulation shape.

6) No civilian decoration, watch chain or other jewelry will be


exposed on the uniform.

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7. Officer's Code

a. The Code of Duty well performed, of Honor in all things, of


Country above self is the unwritten 1m", on which the official acts of officers of
the entire army are based.

b. Any Officer's official word is his bond, and is accepted without


question.

c. Every officer, on active duty or in a civilian component must


always be ready for a greatly increased responsibility.

d. Every officer must work toward maximum efficiency and must


provide effective leadership, impartial justice, and a wise human interest in his
men.
e. An officer who provides for his men need never fear for his own
well being or conduct.

8. Attributes of Rank: The responsibilities that go with rank and


experience naturally produce certain rights and privileges.

a. It is customary for juniors to yield to their seniors. This is not


servility. It is poor taste in any walk of life for junior to rush pell-mell ahead of a
senior.

b. It is a violation of common courtesy for juniors to seize the best


accommodations.

c. When a CO states that he v;,'1shes or desires that something


must be done, his desire has all the force of an order.

d. The word "Sir" is used in military conversation by a junior


addressing a senior.

e. The salute is not only a gesture of greeting, but also an


expression of mutual trust and respect.

f. Courtesy Call - The matter of making calls on the post


commander has sometimes perplexed junior officers about to enter the
service.

1) An officer arriving at a station, whether for duty or for a


visit longer than 24 hours, must call on the CO at his office without delay.

2) One of the oldest customs of the service is that all officers


of a unit or a garrison shall call on the CO on New Year's Day.

g. Walking Outdoors

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1) For military personnel, when two officers are walking


together the junior watch’s on the left of the senior and keeps in steps with the
senior setting the pace.

2) When overtaking, a senior pass to the left if possible,


(otherwise to the right) salute and say "By your leave, Sir/Ma'am.”Do not
proceed until the senior says, "Carry on."

h. When opening doors junior officer opens a door for his or her
senior, stands aside for the s senior to pass through then follows.

i. At the change encounter with a senior or ranking person, one


should not feel obligated to pay for lunch or dinner of the other.

j. Introductions

1) An officer is always presented to a lady regardless of his


rank with the exception of the president of any country, a king or dignitaries of
the church.

Example: "Mr President, may I present Ms. Cruz" or "Mrs.


Cruz, may I present General Saludo.”

2) The higher making military person's name is stated first


then the name of the military\ person being presented.

Example: "Gen Saludo, Sir, may I present Maj Castro.”

3) Younger people are presented/introduced to older people


of the same sex.

Example: “General Saludo, may I present Major Cruz?”


(Mr Saludo is older than Mrs. Cruz) or “Mrs. Cruz, this is may daughter, Eva.”

k. In the Military Service, a junior officer at official or very important


functions ,guest of honor or the high ranking or most senior officer/ guest
leaves. However, the junior officer or anyone who reason to leave before the
guest of honor should explain such to the host before departure.

l. Senior officers should be addressed by their title and name


rather than by the impersonal "Sir" or "Ma'am". A sign of respect to military
seniors will him automatic by saying "Sir" or "Ma'am", thank you for the gift.
Seniors should never forget that they are exemplars to their subordinates by
treating respectfully everyone they come in contact with.

m. Handshake should be brief with a feeling of strength and warmth


in the clasp and by looking into the face of the person shaking hands with.
Gentlemen shake hands whenever they are introduced or taking their leave
with the senior making the first move. A man usually waits until an officer her
hand before extending his hand.

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n. When in civilian dress, military' personnel should stand at


attention, place their right hand over their hearts whenever the national
anthem is played.

o. Military courtesy in cars. The senior officer enters last and the
junior enters first. The senior officer sits on the right and accorded the most
desirable scat. If three persons are seated at the back seat, the most junior is
at the middle. When the car is full, the most junior sits in front.

9. Military Discipline.

a. Military Discipline is a state of order and obedience existing


within the command. It involves ready subordination of the will of the
individual for the good of the group. Discipline demands habitual but reasoned
obedience to command, an obedience that preserves and functions
unfalteringly even in the absence of command. Discipline is instituted in
accordance \with AFP Code or Discipline, Letter Directive from CS, AFP dtd
14 Mar 83 and AFP Regulations G 131-013 DND dtd 24 Sep 87 through:

1) Training.

2) Judicious use of punishments Had reward.

3) Instilling a sense of confidence and responsibility in each


individual.

4) Discipline is best inculcated on an individual by appealing


to his sense of reason. In instance’s \where appeal to reason fails, the use of
punishment is effects in causing the recalcitrant individual to conform and
perhaps appreciate the need of discipline.

5) Commendations and earned! Praise from the senior to


his subordinates either individually or collectively for a task well done; serve to
strengthen the disciplinary bonds which bind together the smooth functioning
team.

6) In dealing with civilian populace, populace should be in


conformity \with the ideal norm of social behaviors, designed to win the
confidence and support of the people of the AFP,

b. Discipline is developed by'

1) Assigning subordinate’s specific duties, with


responsibilities and authority commensurate with their capabilities on the job.

2) Not demanding more of subordinates than they are


trained to give.

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3) Being subordinates Understand exactly what is expected


of them and ensuring that they do what is assigned them

4) Standardizing procedures as tar as possible

5) Ensuring that the subordinates know the system of


rewards and punishment

(a) Rewards commendation, job satisfaction, other


privileges, promotions and others

(b) Punishment group censure, admonition,


punishments under Article of War 105, Court Martial, demotion, and others.

(c) Rewards and punishments must be carefully and


skillfully handled for best results

(d) Rewards and punishments must be administered


equitably and constructively

6) Building discipline deliberately and progressively.

7) Giving extensive practice in desired behavior to order to


develop habits of ready obedience to commands

8) Fostering "unit opinions" so strong that men will not


hesitate to conform to them.

9) Some occasions in which disciplinary action may be


taken:

(a) Abuse of military personnel

(b) Misconduct while on leave/furlough

(c) Abuse or inordinate display of wealth

(d) Arrogance, recklessness and discourtesy in driving

(e) Drunkenness

(f) Unauthorized carrying and indiscreet displaying of


firearms

(g) Absence without Leave (AWOL)

(h) Frequenting premises of places of ill repute

(i) Improper wearing of uniform

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(j) Rumor mongering and spreading wrong


information

10. Guidelines in the Exercise of Military Authority

a. Military authority shall be exercised with promptness, firmness


and justice;

b. Trial by Court Martial, Administrative proceeding or punishment


under Article of War 105 shall not be resorted to in cases of trivial offenses;
except when less drastic methods of discipline have been tried but without
results (offenses which have been corrected when brought to the attention of
the officer concerned shall be considered as closed incidents and need not to
be noted on the offender's records.)

c. Superiors should avoid any display of anger or administer


reproof when dealing with their subordinates in the presence of their juniors.

d. It is the duty of every superior to assist in the preservation of


good order and discipline in the service. The superior is responsible for any
negligence or impropriety observed by them among subordinates whether on
or off duty.

11. Nursing Service Civilian Employees Code of Conduct. The Civil


Service Commission Memorandum Circular No. 30 series of 1989, classifies
administrative charges as "grave" and "light" and provides for the
corresponding penalties. Administrative offenses with corresponding penalties
are classified into grave, less grave or light, depending on their gravity or
depravity and effects on the government service.

12. Grave Offenses with Dismissal as the Penalty on First Offense:

a. Dishonesty.

b. Gross neglect of duty.

c. Grave misconduct.

d. Being notoriously undesirable.

e. Physical or mental incapacity or disability due to immoral or


vicious habits.

f. Falsification of official document.

g. Receiving for personal use of a fee, gift or other valuable things


in the course of official duties or in connection therewith when such fee, gift or
other valuable thing is given by any person in the hope or expectation of
receiving a favor or better treatment than that accorded to other persons.

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13. Grave Offenses with the Corresponding Penalties of:

a. 1st Offense - Suspension (6 months & 1 day to 1 year)

b. 2nd Offense – Dismissal

1) Oppression

2) Disgraceful and immoral conduct

3) Inefficiency and incompetence in the performance of


official duties

4) Frequent unauthorized absences or tardiness in reporting


for duty, loafing or frequent unauthorized absences from duty during regular
office hours.

5) Refusal to perform official duty

6) Gross insubordination

14. Less Grave Offenses with the Corresponding Penalties of:

a. 1st Offense -- Suspension (l month & 1 day to 6 months)

b. 2nd Offense – Dismissal

1) Simple neglect of duty

2) Simple misconduct

3) Gross discourtesy in the course of official duties

4) Violation of existing civil service law and rules of serious


Nature

5) Insubordination

6) Habitual drunkenness

7) Unfair discrimination in rendering public service due to


party affiliation or preference

8) Failure to file sworn statements of assets, liabilities and


net worth, and disclosure of business interest and financial connections
including those of their spouses and unmarried children less than eighteen
(18) years of age living in their households.

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15. Light Offenses with Corresponding Penalties of:

a. 1st Offense - Reprimand

b. 2nd Offense - Suspension

c. 3rd Offense - Dismissal

1) Discourtesy in the course of official duties

2) Violation of reasonable office rules and regulations

3) Frequent unauthorized tardiness (Habitual tardiness)

4) Gambling prohibited by law

5) Refusal to render overtime service

6) Borrowing of money by superior officers from


subordinates

7) Lending money at usurious rates of interest

8) Failure to attend to anyone who wants to avail


himself/herself of the spouses of the office or act promptly and expeditiously
on transactions

16. Principles of Discipline

a. Discipline should be administered promptly, thoroughly,


consistently, and non punitory.

b. Discipline should be progressive in nature and should be


preceded by counseling.

c. Disciplinary procedures should be instituted with extreme


caution because of some extremely serious consequences for the employee.

17. Disciplinary Action. Problem solving efforts may significantly minimize


if not totally eliminate future employee discipline infractions, however, in some
instances, these efforts may no longer be effective. At this point, a disciplinary
action should be taken. The sequence of steps under "progressive" or
"corrective" discipline is as follows: (Figure 7-1)

a. Oral Warning. It should be conducted in an informal atmosphere


to encourage the employee to relate his view of the problem with an
opportunity for a reasonably complete statement of the facts the way the
employee sees the problem. During the discussion, the supervisor may ask
questions, however, if possible, avoid interrupting the employee. It is
important to obtain all relevant facts. After all the facts have been gathered,

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analyzed, and evaluated against the employee's past records, the employee
_should be informed of the supervisor's determination. This includes any
expected improvement in future behavior assistance, if appropriate;
disciplinary penalty (if any) being imposed and others.

b. Written Warning. It is the second step and is preceded by an


interview similar to the oral warning type discussion (Disciplinary Conference)
at the end of the conference the employee is informed that a written warning
will be issued. The statement of the problem, the rule which was violated,
consequences of continued deviant behavior, and the employee's
commitment to make corrections (if any) and any follow-up action that may be
taken should be included in the written warning.

c. Suspensions. Suspensions can only occur for minor discipline


violations after there has been record of oral and written warnings
established. Suspension can be applied even in the absence of oral and
written warnings if a major disciplinary infraction has occurred. Suspension,
instead of dismissal is used by the Chief Nurse when he feels that there is still
some hope for "rehabilitating" the employee.

d. Dismissal. The move to discharge/dismiss/terminate the,


employee should only be invoked, when all problem solving and disciplinary
efforts have failed. There should be accurate documented record of the oral
and written warnings and suspension (if any) received by the employee. The
Supervisor/Chief Nurse should be very sure that the reason for the
termination conforms to the organization's criteria of a major discipline
violation and that he can effectively support the case when needed.

Steps of Progressive Discipline

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CHAPTER 8
NURSES AND THE LAW

Section 8-1 Code of Ethics for Nurses in the Philippines (PNA Code for
Nurses)

1. General. These fundamental concepts are in accordance with Sec 3 of


RA Nr 877 and Sec 6 of PO Nr 223 dtd 1989.

a. Health is a fundamental right of every individual. Therefore, the


nurses' primary responsibility is to preserve health at all cost. This
responsibility encompasses promotion of health, prevention of illness,
alleviation of suffering and restoration of health.

b. Basic nursing is knowledge and understanding of man. For


effective health care, knowledge of man's cultural, social, path physiological,
psychological and ecological aspects of illness and the therapeutic process is
essential. Differences in ethnicity, political, and social status are not barren to
effective nursing care.

c. Standards of practice vary in different settings.

d. Respect for the rights and dignity of individuals is basic to the


practice of nursing profession.

e. Society is ever-changing and the nurse responses to change.

2. Nurses and People

a. Values, customs, and spiritual beliefs held by individuals are to


be respected.

b. Nurses hold in strict confidence personal information acquired in


the process of providing nursing care. Nurse discriminate judgment in sharing
this information.

3. Nurses and Practice

a. Nurses are advocates of the clients. They take appropriate steps


to safeguard the client's rights and privileges.

b. Nurses are aware that their nursing actions have professional,


ethical, moral and legal dimensions. They shave to perform their work in the
best interest of all concerned.

c. Nurses are accountable for their own nursing practice. They are
responsible for their personal and professional growth and development.

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d. Nurses observe personal and professional decorum at all times.

e. Nurses maintain or modify standards of practice within the


reality of any given situations. Quality care is their goal.

4. Nurses and Co workers

a. Nurses maintain collaborative working relationships with their co


workers and other members of the health team.

b. Nurses recognize their capabilities and limitations in accepting


responsibilities and those of their co-workers when delegating responsibilities
to them.

5. Nurses and Society

a. Nurses are contributing members of society. They assume


responsibilities inherent to being a member and citizen of the community /
society in which they live or work.

b. Nurses recognize the need for change and initiate, participate,


and support activities to meet the health and social needs of the people.

6. Nurses and the Profession

a. Nurses are expected to be members of the nursing professional


organization. Inherent in this responsibility is to support and uphold its
constitution and by-laws.

b. Nurses participate actively in the development and growth of the


nursing profession.

c. Nurses help to determine and implement desirable standards of


nursing practice and nursing education.

d. Nurses strive to secure equitable socio economic and work


conditions in the nursing practice through appropriate legislation and other
means.

Section 8-2 Scope of Professional Nursing Practice (R.A No. 7164


“Philippine Nursing Act of 1991)

7. Nursing Practice. In the Scope of Nursing - A person shall be deemed


to be practicing nursing within the meaning of this Act when he, for a fee,
salary or other reward or compensation, singly or in collaboration with
another, initiates and performs nursing services to individuals, families and
communities in various stages of development towards the promotion of

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health, prevention of illness, restoration of Health, and alleviation of suffering


through:

a. Utilization of the nursing process, including assessment,


planning, implementation and evaluation of nursing care shall be required
according to Resolution No. 08 s. 1994 Sec 10 Art III of RA. 7164 which
states that a registered nurse is prescribed or prohibited from administering
intravenous injections to a patient unless he has undergone a special training
at least under a nursing administrator who is a member of A.NSAP and who is
qualified under Sec 28, Art V of R.A. 7164 thereon either before or after his
registration as a nurse. By becoming aware of professional standards and
laws related to administering IV therapy, the nurse can both provide the best
care for clients and protect himself legally.

b. Establishment of linkages with community resources and


coordination of the health team;

c. Motivation of individuals, families and communities, resources,


and coordination of services with other members of the health team;

d. Participation in the teaching, guidance and supervision of


students in nursing education programs, including administering nursing
services in varied settings, such as hospitals, homes, communities and the
like; undertaking consultation service; and engaging in such other activities
that require the utilization of knowledge and decision-making skills of a
registered nurse; and

e. Undertaking nursing and health manpower development training


and research and soliciting finance therefore, in cooperation with the
appropriate government or private agency. Provided however, that this
provision shall not apply to nursing students who perform nursing functions
under the supervision of qualified faculty members.

Section 8-3 Nurse’s Legal Responsibility for Client Care

8. General. Every nurse is expected to care for patients within dreamed


limits. If a nurse gives care beyond those limits, he becomes vulnerable to
charges of violating the nursing practice law and will be held liable as
stipulated in the Code of Ethics for Nurses in the Philippines

9. Negligence. One of the liabilities that a nurse may incur is the


omission (not doing) or the commission (doing) of an act that a reasonably
sensible person would or should not do under normal circumstances. Specific
examples of professional negligence are:

a. Failure to properly administer drugs, treatment, medications and


failure to report its adverse reactions

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b. Failure to exercise reasonable judgment in the performance of


duty.

c. Failure to verity a subordinate's competence prior to the


assignment of duty.

d. Failure to supervise subordinates.

e. Failure to record and report unusual behavior of clients.

f. Improper charting.

g. Failure to provide safety measures resulting in the injury of


clients.

h. Inability to forecast possible harm to clients, such as in suicidal


or psychiatric cases or from other elements.

i. Carelessness in applying hot water bag treatment and other


nursing measures.

j. Allowing clients' easy access to medicine cabinets and sharp


instruments.

k. Improper handling of equipment.

l. Loss of or damage to client's property.

m. Overlooking sponges, needles, and others. Inside the abdomen.

n. Escape of clients from the hospital

o. Leaving the unit without a reliever and proper endorsement.

10. Incompetence. Incompetence refers to a person's inability to perform


a required duty. Although a nurse is registered if she manifests incompetence
in the performance of her duty, her certificate of registration may be revoked
or suspended.

11. Malpractice. Malpractice refers to the negligent act committed in the


course of performing ones duties. For nurses, malpractice may come in the
form of giving the client improper or unskilled care.

12. Res Ipsa Loquitur. Res Ipsa Loquitur means "the thing speaks for
itself'. Three conditions are required to establish negligence under this
doctrine:

a. The injury would not have occurred normally unless someone


was negligent.

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b. The injury was caused by something within the exclusive control


of the defendant.

c. The injured party did not contribute in any way to his injury ex.,
burns resulting from hot water bags, fractures, injuries sustained by the
elderly, confused, unconscious or sedated clients.

13. Respondent Superior. Respondent Superior means "let the master


answer for the acts of the subordinates". Under this doctrine, the liability is
expanded to include the superior as well as the subordinate. It is not a shift of
responsibility from the employee to the master. The employee still remains
fully responsible for the act.

Nursing students take care of clients within their level of preparation. If


the nursing student performs a task she is not capable of doing, the
designated clinical instructor can be held liable.

Nursing supervisors/head nurses should likewise utilize competence


with corresponding authority as the basis for delegating responsibilities to
subordinates. New and inexperienced nurses should therefore be under close
supervision.

The supervisors/head nurses will be measured against the standard of


what a competent and prudent supervisor/head nurse does in the
performance of his duties. Ward men, nursing attendants/aide, and
institutional workers perform selected nursing activities under the direct
supervision of the nurses. Their responsibilities usual]y pertain to routine care
of chronically ill clients. After attending Courses on Basic Nursing Procedures
conducted by the Nursing Service they are already liable for their own actions.
However, if a nurse delegates her functions to the ward man, nursing
attendant/aide and the latter commits a mistake, the nurse should be held
liable for the mistake.

14. Liability of Nursing Attendants. Nursing attendants perform selected


nursing activities under the direct supervision of the nurses. Their
responsibilities usually pertain to routine care of chronologically-ill clients. The
nursing attendants are usually given in service trainings and on the job
trainings by the nursing staff. .After sufficient trainings, the nursing attendants
are already liable for their own actions. If a nurse delegates her functions to
the nursing attendant and the latter commits mistake, the former should be
held liable for the mistake.

15. Guidelines for Reducing Liability. While following these guidelines is


not a guarantee of nurses not being involved in litigation but at least it should
reduce their chances of being involved in malpractice lawsuit.

a. Be knowledgeable in your clinical specialty;

b. Demonstrate concern for clients in day to day care for them;

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c. Learn how to correct medical record entry errors;

d. Question any physician/ doctor's order, which is not understood


or agreed with

e. Document appropriately and accurately;

f. Understand the equipment used at the health care facility;

g. Be familiar "with and follow the health care facilities' written


policies and procedures.

h. Collaborate and communicate with other members of the health


care team.

16. Giving and Charting Medications

a. Whoever prepares the medications should give them and sign


the chart as having given them.

b. Check all medications and treatment cards against medication


sheet to be sure all cards are there. The

c. Chart immediately after giving narcotics given as "STAT". pre-op


medications and

d. For PRN laxatives - check first if client really needs it before


giving

e. Chart on Remarks column site where injection is given, i.e,


LUOQ gluteus muscles, and right deltoid muscles.

f. Be specific in recording IV & IV push which are given by the


doctor or the nurse in the presence of the doctor assuming responsibility for it.

g. Skin testing is done to clients who will be given antibiotics and


Vit B preparations. The skin test result is read or interpreted by ROD and first
dose of antibiotic IV push is given by the doctor or the nurse in the presence
of the doctor assuming responsibility for it.

h. Medicine cards with cut at the center are used for injectable
medicines, while slanted cut are used for treatments. Medicine cards without
any cut arc used for oral medications.

17. Rules for Administering Drugs Safely.

a. Administer the right drug.

b. Administer the right drug to the right client

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c. Administer the right dose.

d. Administer the drug by its right route.

e. Administer the right drug at the right time.

f. Document each drug upon administration.

g. Teach your client about the drugs he/she is receiving.

h. Take a complete client drug history. (There is a risk of adverse


drug reactions when a number of drugs are taken or when client is taking
alcoholic drinks)

i. Find out if the client has any drug allergies.

j. Be aware of potential drug-drug or drug-food interactions to


protect your clients and your license. Follow these guidelines for avoiding
medication errors.

18. Nurses Responsibilities In Drug Administration

a. Basic principles of drug administration are to be observed


carefully at all times. A standard time of administering medication is followed
except for those orders with specified hour or time of administration. Standard
colors are used in conjunction with this standard time of drug administration.
The color code would indicate a certain number of hours or frequencies within
the 24 hour period.

b. Standard color medication card or treatment card should always


accompany any medication or treatment being administered to make sure that
the right dose and kind of medication or treatment is given to the right client.

c. All medicine/treatment cards are signed and dated by the nurse


who transcribed the medical orders on the cards.

d. All medications are started as soon as possible but the


succeeding doses are administered and accordingly adjusted to the standard
time as practiced.

e. Standing order medications and treatments cancelled/


discontinued under the following circumstances: are

1) When client goes to surgery or for laboratory


examinations,

2) When the client manifest signs of allergic reactions to the


drug,

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3) According to the policy for narcotics and antibiotics


approved by the Medical Staff.

f. Observe the color index for medicine cards: (Figure 8-1)

g. Follow the standard hours for administering drugs: (Figure 8-2)

h. Follow the shape of the Medicine cards: (Figure 8-3)

i. Self administration of medications by client is not permitted


except for emergency drugs with special orders from the physician.

j. Medication errors and drug reactions are immediately reported


to the client's physician and an entry thereof made in the client's clinical
record as well as an incident report;

k. Client's medications must be' properly labeled;

l. Client's medications having an expiration date are removed from


usage after such date and properly disposed of.

m. A narcotic record book is maintained. Narcotics and other


controlled drugs are counted on each shift by one nurse coming on shift and
one nurse going off shift.

n. Use only standards abbreviations. When in doubt, write out the


word or phrase.

o. After administering the first dose, sign your full name and
initials-in the appropriate space.

p. Record drugs immediately after administering them so another


nurse doesn't inadvertently repeat the dose.

q. If a specific assessment parameter must be monitored during


administration of a drug, document this requirement. For example, when
Digoxin is administered, the client's pulse rate/cardiac rate needs to be
monitored, so the client's pulse rate/cardiac rate should be documented.

r. Follow the Therapy important points in the administration of IV

1) All IV fluids are calibrated as ordered: cc/hr and gtts/min.


Late or delayed IV fluids must be reinserted and adjusted accordingly.

2) Separate IV sheets are used for recording the main N


fluids from side drip or piggy back IV fluids received by a client.

3) When IV drugs are to be incorporated into the IV


Solution:

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(a) Use newly opened disposable sterile syringe and


needle.

(b) Write on a card (IV tag), with the following data:


name of client, name of IV + medication incorporated (if there is), date and
time N fluid hooked.

(c) Attach card IV tag to the IV infusion bottle where it


could easily be read.

(d) IV tape placed on the site IOf IV insertion with the


following data: date, time and site of insertion, type of needle used.

Table 8-1
COLORED INDEX FOR DRUG ADMINISTRATION
Color (Legend) Frequency
White OD once a day
Yellow BID Twice a day
Pink TID Three times a day
Green QID Four Times a day
Blue q Every 2-3-4-6-8-12
hrs
Red PRN when necessary
Orange H.S at bed time

Table 8-2
STANDARD TIME FOR DRUG ADMINISTRATION
FREQUENCY TIME
OD - 0800H
BID - 0800H – 2000H
TID - 0800H – 1300H – 1800H
QID - 0800H – 1200H – 1600H – 2000H
AC - 30 minutes before meals
PC - 1 hour after meals
HS - 2000H
q 2 hrs - 0800H – 1000H – 1200H – 14000H etc
q 3 hrs - 0900H – 12000H – 1500H – 1800H – 2100H etc
q 4 hrs - 0800H – 1200H – 1600H – 2000H – 2400H –
q 6 hrs 0400H
q 8 hrs - 0600H – 1200H – 1800H – 2400H
q 12 hrs - 0800H – 1600H – 2400H
- 0800H – 2000H

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Table 8-3
DIFFIRENT SHAPES OF MEDICINE CARDS

ORAL MEDICATION

TREATMENT

PARENTAL

Table 8-4
Format/ Guide in filling up medicine card

Bed No: ________ Date Started


Surname: First Name MI
Medicine: Frequency
Time
Signature
Printed Name of Med Nurse

Bed No: 3 Date Started 26 June


2000
Porlante, Marea G
Paracetamol 1 tab TID
0800H – 1300H -1800H
Time
edna c ching
EDNA E CHING RN

19. Medication errors takes the following forms:

a. Omission error. The failure administers an ordered dose.


However, if the client refuses to take the medication, no error has occurred.
Likewise, if the dost" is not administered because of recognized
contraindications, no error occurred.

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b. Unauthorized drug error. Administration to the client of a


medication dose not authorized the client. This includes a dose given to the
wrong client, duplicate doses, and administrator of an unordered drug and a
dose given outside a stated set of 'C. meal parameters (e.g. Medication order
to administer only if the clients blood pressure falls below a predetermined
level).

c. Wrong dose error any dose that is the wrong member of


preformed units (e.g. tablets) or any dose below or above the ordered dose by
a predetermined amount (e.g. 20 percent). In the case of ointments, topical
solutions and splays., an error occurs only if the medication order expresses
the dosage quantitavely (e.g. 1 inch of ointment or two (2) second Sprays)

d. Wrong route error. Administration of a drug by a route other than


t11at ordered by the physician. Also included are doses given via the correct
route but the wrong site (e.g. right eye instead of left eye.)

e. Wrong rate error. Administration of a drug at the wrong rate,


other than the connect rate being given based on the physician's order or as
established by hospital policy.

f. Wrong dosage form error Administration of a drug by the correct


route but in a different dosage form other than that specified or implied by the
physician. (e.g. use of an ophthalmic ointment when a solution was ordered.)
Purposeful alteration or substitution of an oral dosage form to facilitate
administration is generally not an error. (e.g. crushing of a tablet; substituting
a liquid for a tablet).

g. Wrong time error. Administration of a dose of drug at a time


greater than X hours from the scheduled administration time, X being as set
by the administration/hospital policy.

h. Wrong preparation of a dost", incorrect preparation of the


medication dose, (e.g. incorrect dilution or reconstitution, not shaking a
suspension, using an expired drug and mixing drugs that are physically and
chemically incompatible:

i. Incorrect administration techniques situations when the drug is


given via the correct route, site and so forth but technique is wrong. (e.g. not
using the Z-track injection when indicated for a drug, incorrect -installation of
an ophthalmic ointment and incorrect use of an administration device.)

20. Handling Procedures in Medication Errors. Recognizing the need to


correct any deficiency in the administration of medications, the Nursing
Administrator,/Supervisor win counsel the nurse who has committed an error
in order to develop sensitiveness and awareness to the events leading to the
error,

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a. Disciplinary action as H. result of medication error will be


handled by and at the discre1ion of her immediate supervisor. The judgment
resulting in disciplinary action vv-ill be based on the:

1) Severity of the medication error

2) Involved a period of time.

3) The number of Indication errors in a period of time.

4) If irreversible (Image to the client is present or has the


possibility of such damage, the Chief Nurse reserves the right to institute
recommend immediate suspension from work or termination for medication
error.

5) If the nurse demonstrated negligence or irresponsibility in


her reaction to the error.

Section 8-4 Right and Responsibilities

21. The Nurse's Responsibility for the Client's Safety. Nurses are
responsible for providing safe care both physically and psychologically to all
clients under their care. Likewise, care givers within the clients' care unit
should promote an environment conducive to early recovery.

22. Rights and Responsibilities of Clients. The basic rights of human


beings for independence of expression, decision, and action and concern for
personal dignity and human relationships-are always of great importance.
During sickness-s. The presence or absence of these rights becomes a vital,
deciding factor in the client's survival and recovery. Thus, it is the hospital's
prime responsibility to assure that these rights are preserved for their clients.
In the provision of care, the hospitals have the right to expect behavior on the
part of clients and their relatives and friends which considering the nature of
their illness, is remarkable and responsible.

23. Clients Rights

a. Access to Care. Individual shall be accorded impartial access to


treatment or accommodations that are available or medically indicated,
regardless of race, creed, sex, national origin or sources of payment for care.

b. Respect and Dignity. The client has the right to a considerate,


respectful care at all times and under all circumstances 1Mth recognition of
his personal dignity.

c. Privacy and Confidentiality. The client has the right within the
law, to personal and informational privacy, as manifested by the following
rights:

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1) To refuse to talk with or see anyone not officially


connected with the hospital including visitors or persons officially connected
with the hospital but not directly involved in his care,

2) To wear appropriate personal clothing and religious or


other symbolic items as long as they do not interfere with diagnostic
procedures or treatment.

3) To be interviewed and examined in surroundings


designed to assure reasonable visual and auditory privacy. This includes the
right to have a person of one's own sex present during certain parts of a
physical examination, treatment, or procedure performed by a health
professional of the opposite sex and the right not to remain disco bed any
longer than is required for accomplishing the medical purposed for which the
client was asked to disrobe.

4) To respect that any discussion or consultation involving


his care will be conducted discreetly and that individuals not directly involved
in his care wilt not be present without his permission.

5) To have his medical record read only by individuals


directly involved in his treatment or in the monitoring of its quality and by other
individuals only by individual written authorization or that of his legally
authorized representative

6) To respect all communica1ions and other records


pertaining to his care, including the Sucre of payment for treatment to be
treated as confidential.

7) To request a trampers to another room if another client or


a visitor in the room is unreasonab1y disturbing him.

8) To be placed in protective necessary for personal


safety.privacy when considered

d. Personal Safety. The client has the right to reasonable safety


insofar as the hospital practices and environment are concerned.

e. Identity. The client has the right to know the identity and
professional status of individuals providing service to him and to know which
physician or other practitioner is primarily responsible for his care. This
includes the client's rights to know of the existence of any professional
relationship to any other health care or educational institutions involved in his
care. Participation by clients in clinical training programs or in the gathering of
data for research purposes should be voluntary.

f. Information. The client has the right to obtain, from the


practitioner responsible for coordinating his care, complete and current
information concerning his diagnosis (to the degree known) treatment and any

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known prognosis. This information should be communicated in terms the


client can reasonably be expected to understand. When it is not medically
advisable to give such information to the client the information should be
made available to legally authorized individual.

g. Communication. The client has the right of access to people


outside the hospital by means of visitors and by verbal and written
communications

When the client does not speak or understand the


predominant language of the community, he should have access to an
interpreter. This is particularly true where language barrier is a continuing
problem.

h. Consent.

The client has the right to reasonable informed participation in


decisions involving his health care. To the degree possible, this should be
based on a clear, concise explanation of his condition and of all proposed
technical procedures, including the possibilities of any risk of mortality or
serious side effects, problems related to recuperation, and probability of
success. The client should not be subjected to any procedure without his
voluntary, competent, and understanding consent or that of his legally
authorized representative. Where medically significant alternatives for care or
treatment exist, the client shall be so informed.

The client has the right to know who is responsible for


authorizing and performing the procedures or treatment. The client shall be
informed if the health care facility proposes to engage in or perform human
experimentation or other research/educational projects affecting his care or
treatment, and the client has the right to refuse to participate in any such
activity.

i. Consultation. The client, at his own request and expense, has


the right to consult with a specialist.

j. Refusal of Treatment. The client may refuse treatment to the


extent permitted by law. When refusal of treatment by the client or his legally
authorized representative prevents the provision of appropriate care in
accordance with professional standards, the relationship with the patient may
be terminated upon reasonable notice.

k. Transfer and Continuity of Care. A client may not be transferred


to another facility unless he has received a complete explanation of the need
for the transfer and of the alternatives to such a transfer and unless the
transfer is acceptable to the other facility. The client has the right to be
informed by the practitioner responsible for his care, or his delegate, of any
continuing health care requirements following discharge from the hospital.

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l. Health Care Facilities' Charges for Authorized Civilians.


Regardless of the source of payment for his care, the civilian patient has the
right to request and receive an itemized and detailed explanation of his total
bill for services rendered in the health care facility. While the Registrar of the
health care facility is responsible for assigning values to the goods and
services provided to the client, the Nursing Service is responsible for
submitting the itemized list of particulars, which will cover some if not all of the
following:

1) Name of civilian client and inclusive dates admitted and


discharge

2) Medications used and date/time/ dosages

3) Nursing supplies used and date/time of issue

4) Special feedings (if any)

5) Laboratory' procedures done

m. Health Care Facilities' Rules and Regulations. The client should


be informed of the hospital rules and regulations applicable to his conduct as
a client. Clients are entitled to information about the hospital's mechanism for
the initiation, review, and resolution of client's complaints.

24. Clients’ Responsibilities

a. Provision of Information. A client has the responsibility to


provide, to the best of his knowledge, accurate and complete information
about present complaints, past illnesses, hospitalizations, medications, and
other matters relating to his health. He has the responsibility to report
unexpected changes in his condition to the responsible practitioner. A client is
responsible for repor1mg whether he clearly comprehends a contemplated
course of action and what is expected of him.

b. Compliance with Instructions. A client is responsible for following


the treatment plan recommended by the practitioner primarily responsible for
his care. This includes following the instructions of nurses and allied health
care workers as they carry out the coordinated plan of care and implement the
responsible practitioner's orders, and as they enforce the applicable rules and
regulations. The client is responsible for keeping appointments and, when he
is unable to do so for any reason, for notifying the responsible practitioner of
the health care facility.

c. Refusal of Treatment. The client is responsible for his actions if


he refuses treatment or does not follow the practitioner's instructions.

d. Hospital Rules and Regulations. The client is responsible for


following hospital rules and regulations affecting client care and conduct.

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e. Respect and Consideration. The client is responsible for being


considerate of the rights of other clients and hospital personnel and for
assisting in the control of noise, smoking and the number of visitors. The
client is responsible for being respectful of the property of other persons and
of the hospital.

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CHAPTER 9
ADMINISTRATIVE TOOLS

Section 9-1 Records/Reports

1. General. Records are hospital administrative tools used in collecting


data directed towards the attainment of the objective of its sections and
department. They are the sources of cumulative and relevant information that
may be used as basis for client management and the effective programming
of activities for research and decision-making. Reports are prepared accounts
of important activities of the Nursing Service within a particular period. They
must always be dated.

2. Importance of Records and Reports

a. It is a legal document which provides evidence of the care given


to a client in a particular health agency.

b. It is a communication linkage or system by which members of


the health team exchange views and information about the client, his therapy
and his response to therapy.

c. It is used extensively for research and statistical purposes.

d. Utilized for audit purposes to determine the quality and quantity


of care a client has received.

e. Health care professionals reading a client's chart can learn a


great deal about the clinical manifestations of a particular health problem,
effective treatment modalities and factors affecting client goal achievement.

f. Historic document - because dates of entries on records are


specified, the record has value as a historic document. Years later,
information may become pertinent concerning a client's past health care.

3. Nursing Service Office Records. For effective administration of the


Nursing Service, the Chief Nursing Service should provide complete and up-
to-date records. The following should be available in the Office of the Chief
Nursing Service:

a. Personal Record (Form 201). This includes a copy of the


personal data, appointments, references, achievements, staff and
professional activities and confidential information of both military and civilian
employees of the Nursing Service.

b. Master Staffing Pattern. This is a daily assignment of the nursing


personnel which will help the Chief Nursing Service visualize the coverage of

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all nursing units, serving as a guide and support for proposing additional
positions in the Nursing Service. It contains the actual number of nursing staff
on sick leave, on-the-job training and on study leave and others.

c. The Daily Census of Clients. This includes a detailed list of


actual clients in the different wards/units and the total census for 24 hours.

d. Daily Time Record or Bundy. Card This indicate the time each
personnel reported to and from duty.

e. Nursing and Hospital Policies. All directives affecting the


Nursing Service are compiled in a loose-leaf manual, which is available for
reference. These may refer to policies on admissions, discharges, transfers,
fire regulations, time and work schedules, charging of clients, etc. Directives
are dated and signed by the sender.

f. Manual of Procedures. A set of standard operating procedures


such as those for:

1) Carrying out verbal/ telephone orders for medications

2) Errors in medication

3) Omission of treatment

4) Preventive measures, such as, use of side rails and


restraints

5) Assembling of the client's clinical charts

6) The transfer of doctor's orders to the nurses' record

7) Preparation of medicine cards, established medication,


time and other client related procedures.

8) Minutes of the Nursing Service Meetings

9) Nursing Affiliation Record (for training and teaching


hospitals)

(a) The school/college folder contains approved


affiliation contract with the list of student’s including the date and time for
affiliation and the clinical instructors.

(b) Records of payments provide the number of


students; date and length of affiliation, and payments each with corresponding
receipt number and date such were paid.

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(c) Quarterly Report of Affiliation.

(d) Performance Evaluation Record of Affiliation.

10) Records of Staff Development Programs conducted

11) Quality Assurance Program Record

12) Record of Nursing Researches conducted

13) Record of Turnover. This includes the following


information:

(a) The dates of appointment and resignation of


military and civilian employees of the Nursing Service.

(b) Accumulated leave credits and the date the


resignation letter was filed and the result of the exit interview.

14) Records of Activities of the various departments

4. Nursing Office Reports

a. Monthly Reports. Monthly Reports are prepared by the Chief


Nursing Service and NIC to be submitted to the Office of the Army Chief
Nurse for compilation. Date of submission is according to SOP.

The monthly reports of all PA Nursing Service will be


submitted to the OTCN on date specified according to SOP.

b. Quarterly j Semi Annual Reports. Quarterly I Semi annual


reports are prepared by Chief Nursing Service and NIC and submitted to the
Office of the Army Chief Nurse on dates of submission according to SOP.

5. Nursing Unit Reports

a. Time slip

1) Time slip reports are prepared by head nurses/senior


staff nurses on duty every shift and submitted to the supervisor on duty.

2) The purpose of the time slip is to determine if there is a


need to augment the nursing staff of a ward or if there is more than what is
actually needed.

3) The time slip includes the ward census, number of clients


in the ward and clients out on pass; status of military and civilian employees
of the Nursing Service for the shift (duty, off duty, leave, absent and others)

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b. 24 Hours Report. Twenty four (24) hours report is accomplished


by the night shift duty nurse and is submitted to the supervisor on duty for
consolidation and compilation. It includes the following:

1) Number of clients of each ward

2) Number of admissions/discharges/evacuations/trans-in,
Trans-out, SIL and deaths.

3) Category of clients according to status (Officers, enlisted


personnel, dependents, civilians and others).

4) Category of clients according to their needs

6. Client's Chart. Client's chart is a systematic compilation of all records


and reports of individual client admitted in the hospital which shows the
changes/development in his condition.

7. Contents of a Client's Chart

a. Standing Order sheet

b. Cover sheet

c. Admission notes

d. Problem List

e. Referral/Consultation sheet

f. Laboratory results

g. Doctor's Order sheet

h. Medication sheet

i. TPR sheet

j. Nursing AsseS8ment Guide/Systems Review k. Nurses' notes 1.


Miscellaneous

1) Consent

2) Pre-op checklist

3) Anesthesia record

4) OR Technique

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The arrangement/ sequence of the contents during hospitalization


varies according to the ward officer's prerogative. However, upon discharged,
the chart to be submitted will be arranged according to the health care
facility's policy. A clinical record for each client admitted with all entries kept
current, dated and signed. The chart contains all necessary forms required for
treating or caring for a client. Daily information concerning the client is charted
by the nurse carrying out the order, e.g. treatments, medications,
observations and others.

8. Nurses' Reports. Nurses' reports are legal documents, which are


important elements of the client's chart, thus the record should be truly
reflective of what transpired during the client's hospitalization. The objectives
of Nurse's Reports are:

a. To keep a current, concise and accurate record of the client's


hospitalization.

b. To provide the health team with a guide for future care in the
rehabilitation of a particularly.

Section 9-2 Forms

9. General. Forms are documents with blanks for the insertion of


requested/required/needed information. The following are the standard forms
used in all PA Nursing Service

10. Medication Sheet. A form wherein all the medications administered to


a client are charted or recorded except "STAT" medications and injections.
(Annex D) The nurse writes her full printed name and signature at the lowest
space. Proper notation of the date and changes in medications and
treatments like:

DC - discontinued
Shifted to IV or p.o
Out of stock; "changed
Dose increased and decreased Frequency changed
Hold

"Dose completed" which shall appear after specific number of doses. Encircle
time when medicines or treatments are not given with appropriate remarks
indicated in nurses' notes.

11. TPR Sheet. A form where clients' temperature, pulse rate and
respiratory rate, blood pressure taken on certain hours during the whole
twenty four (24) hours are recorded and illustrated in the graph. It also
contains data such as number of voiding and bowel movement and the
patient's weight. (Annex D 1)

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a. TPR Sheet shall include:

1) properly dated column

2) Properly indicated hospital days A 1st hospital day is


counted 24 hours after admission

3) Date, type of surgery indicated above a diamond ( )


written in red and numbered succeeding post-op days.

4) Properly recorded TPR

(a) Temperature and respiratory rate are all recorded


in blue or black ink

(b) Identify oral temperature with a dot (.)

(c) Identify axillary’s temperature with "a.x" written


above the dot (a. x)

(d) Identify the rectal with an encircled dot ( . )

(e) Pulse rate or cardiac rate recorded in red ink.

(1) Broken lines indicating changes in


temperature after nursing measures.

(2) Number of bladder and bowel eliminations


recorded every shift: "IC" - indwelling catheter "CC" - Condom catheter " E" -
Enema

b. Routine in Taking Vital Signs (Temp. PR, RR, BP)

1) A febrile clients - once during each shift unless specified


by the attending physician.

2) Febrile clients - every four (4) hours until the temperature


is back to normal unless specified by the attending physician.

3) Post operative clients - every four (4) hours regularly for


the first 48-72 hours unless specified by the attending physician.

4) Duration of time the following route of temperature is


taken.

(a) Oral temperature- taken for 7 minutes

(b) Auxiliary temperature - taken for 5 minutes iii.


Rectal temperature - taken for 3 minutes

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5) Keep BP records as long as they are ordered. It may be


discontinued only by the doctor. When pulse and respiration are to be
checked, count both for one whole minute. Variations are diagnostic
according to the patient's condition or disease entity.

12. Intake and Output Sheet. A form wherein intake and output are
accurately recorded every shift or as ordered (Annex D2) It shall include the
following:

a. Accurately recorded I & 0 every shift

1) Intake includes oral and parenteral IV fluids like blood,


plasma. mannitol, and others.

2) Output includes urine, vomitous, NGT drainage, wound


drainage and others

b. Twenty four (24) hours intake and output shall be summed up by


the night duty nurse. If there is a big discrepancy between the intake and
output, the nurse should refer to the ROD immediately. Clients on hourly
urine/output measurement should be referred if the output is less than 30 cc /
hour.

c. Keep 1&0 as long as ordered. Nurses failing to complete this


record shall be called back to complete them. It is from this record that the
doctor computes the fluid requirement of the client.

13. Doctor's Order Sheet. This sheet contains the written, copied, verbal
or telephone orders of the attending physician in charge of the medical case
of a particular client. Nursing care is planned according to these orders.
(Annex D3)

a. Nurses' responsibility is transcribing and carrying out doctors'


orders.

b. The nurse takes down verbal telephone orders as follows:

1) Writes the date, time, when order was given.

2) Reads back the orders to the physician concerned as


accuracy and clarity.

3) Have the orders signed by the doctor concerned as soon


as possible.

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4) Signs her name as the nurse who received the orders.


Verbal telephone order is tolerated only on emergency and not to be
considered as routine.

c. All orders must be carefully checked before transcribing to the


Kardex, medications sheet, medicine cards or other departmental request
forms.

d. Bracket the written orders as the nurse checks the orders and
the nurse signs her name as the one who carried out the orders, the date and
time the orders were carried out.

e. All transcribed orders are properly dated, timed and initiated by


the nurse on the left hand corner of the order and after each line of doctors
order initialed using red ink.

f. Verbal orders, telephone orders, copied orders properly initialed


as V.o., t.o., and countersigned by the receiving nurse ex., T. 0.., Col
Guerrcro/Magabo.

1) In case of direct admission, the order sheet from the


doctor shall also be countersigned by the receiving nurse.

2) Verbal orders, telephone orders, copied orders are


countersigned by the physician giving the order within 24 hours.

3) For a clear collection of mistakes, enclose the word or


words in a parenthesis: Write "ERROR" over it in such a way that the original
mistakes could be identified.

g. All medicine cards and treatment cards that were carried out
and when discontinued must be immediately discarded.

14. Nurses Progress Notes Sheet. This form is used in charting or


recording the significant observations and evaluations of a client's condition
during each tour of duty. (Annex D4) It shall include the following.

a. All admission information entered accurately in the Nurses'


Notes

b. Immediate client's condition and needs

c. Recording of pertinent observations and communications

d. Properly recorded and accurately timed stat or single dose


medications and treatments using red ink.

e. Accurate recording of nursing interventions and evaluations of


the effectiveness of care

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f. Any further information that communicates necessary nursing


activities to the next shift. "Needs attended", "Nothing unusual notes'" "Slept
fairly" "ambulatory" and the likes should never be written as observations.

g. Signature on top of printed name at the end of all recordings per


shift. Do not leave blank lines in between Nurses' notes or between shifts.

h. Discharge names shall use the Acronym "METHOD"

M - Medication- refers to the medicines that the client is taking.

• The nurse must find out if the client is aware of the


indications of these medicines and their side effects, if any. Also, does the
client have any medication allergies?

E - Economic status of the client - the home environment


considered and the possible problems he may have regarding follow-up
Cfu1ic visits.

T. - Treatme'1.t to be done at home - the client receives


instructions on the prescribed activities the nurse must have the answer to
two (2) questions:

To what extent can the client carry on the prescribed


activity? Who: 8 available to help carry out the necessary treatment?

H - Health Teaching to be given to the patent includes general


instructions on personal hygiene, activity, rest, sleep" exercise and
elimination.

O - Out - patient follow-up of client

D - Diet prescribed for the client (foods allowed and not allowed)

S - Spiritual

The head nurse or charge nurse goes over the charting of all clients
before the shift ends in order to supplement whatever is lacking or to make
corrections.

Corrections in nurse's notes are made by drawing a straight line


through and across the word/words and the connection is written above or
following the line. The signature of the one who corrected it should appear
clearly.

15. Intravenous Flow sheet/Intravenous Fluid Sheet. This form is used


to record all intravenous fluids infused. (Annex DS) It shall include the
following:

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a. Name of solution and amount to be infused and the rate of flow

b. Date and time the solution was inserted and infused

c. Medicine added if any

d. Date and time the solution was consumed/ discontinued or out


of vein

e. The amount of solution infused

f. Remarks/ comments

Ex. Out of vein - client refused reinsertion

If the nurse received the fluid at 300 cc levels at the beginning of the
shift and the 300 cc was consumed before the end of the shift and another
500 cc per bottle is followed up, indicate as such to include how much fluid
was consumed prior to the end of the shift.

16. Standing Order Sheet. (Annex D6) The form includes the following

a. Medications/treatment, route dosage frequency ordered

b. Date/Time ordered and discontinued/changed

c. Signature of nurse who filled up Standing Order Sheet

d. If revised then state as such

17. Nursing Problem List Form. (Annex D7) It includes the following

a. Date of Onset - the approximate date the client/ significant


others had noticed/felt the complaint/s

b. Date identified - the date the problem was identified by the nurse

c. Problem No. - The number assigned to one particular problem.

18. Vital Signs Monitoring Sheet. Forms used for critically ill/post-op
clients where vital signs need to be monitored regularly are recorded. (Annex
D8). It should include:

a. Properly dated column

b. Properly recorded BP, Temp, Pulse Rate, CVP, Level of


Consciousness

19. Kardex. The PA Nursing Service uses nursing Kardex as a system of


organizing care plans. A nursing Kardex is a me that contains the nursing

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care plans. Each plan is recorded on an oversized index card or large folded
sheet of paper. The form of the written care plan may vary from institution to
institution, but it should be an l1seful tool for communicating care plans of
clients among health care workers. Most Kardex will include space of nursing
diagnoses, goals, nursing orders and evaluation in an abbreviated form.
(Annex D9)

The written care plan should be used to communicate goals that cover
several shifts or more and require the coordinated efforts of several nurses
over a period of time.

20. Pointers in writing a nursing care plan on a Kardex:

a. Abbreviate whenever possible, using standardized medical or


English symbols;

b. Choose key words to communicate ideas. Do not write whole


sentences;

c. Refer people to procedure books rather than trying to include all


the steps for a procedure in a written plan.

d. Category headings should include nursing diagnosis, goals,


nursing actions al1d evaluation;

e. The nursing diagnoses with the related goals and nursing


actions should appear next to each other;

f. Include a date for evaluation of each goal;

g. All long term goals should be written. Nursing actions directly


related to long term goals should be written;

h. Short term goals that can not be met within an 8- hour shift
should be written in order that other nurses can continue the plan of care.

i. Long term goals being met by a series of short term goals have
both the long term goals and the progressive short term goals on the Kardex.
The accompanying actions for short term goals are included;

j. When goals are evaluated they should be signed and dated by


the responsible nurse;

k. All nursing interventions (actions, orders) should be signed by


the responsible nurse; The Kardex is a means of keeping standing medical
orders written and the nursing care plan based from these orders for a client
as a ready source of reference for the nursing staff of the unit. It is utilized in
the giving of reports OT endorsement by all three shifts. The information
written in the Kardex should be sufficient and clear enough to give the

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supervisors and other members of the team of what happened to the client
during the previous shift or during the time they were off or absent.

Section 9-3 Documentation

21. Charting. All client record systems provide a section for writing
descriptive nursing progress notes about the client's status and progress.
There are several methods of writing nursing progress notes however, the
most common methods are (1) chronological/traditional narrative, (2) SOAP
format, (3) Focus charting, and (4) charting by exception. The PA Nursing
Service has adopted the Traditional narrative charting as the method used in
documenting the client's status and progress.

22. Traditional Narrative Carting. (Annex E) The traditional narrative


charting is a chronological account of the client's status, the nursing
interventions performed and the client's responses. In the traditional narrative
system, data are recorded as progress notes, with flow sheets supplementing
the narrative notes. When and what to document and how to organize the
data are the key elements of effective narrative charting in the progress notes.
Specific and descriptive narrative such as: a) a change m the client's condition
(progression or regression) example. Mrs S.A. can ambulate with a walker for
three (3) minutes before feeling tired. b) a lack of improvement in the: client's
condition. Example. Mrs S.A. verbalizes that her abdominal pain was relieved
one (1) hour after receiving medication. She is smiling and able to turn in bed
without difficulty. c) a client's or family member's response to teaching.
Example. Mrs S.A. was able to demonstrate crutch walking using the proper
technique.

A charting format called AIR may help the nurses to organize and
simplify their narrative charting. AIR is an acronym for:

Assessment -Summarize the physical assessment findings. Begin by


specifying each issue that you address, such as nursing diagnosis, admission
note, and discharge planning. Rather than simply describing the patient's
current condition, document trends and record your impression of the
problem.

Intervention - Summarize your actions and those of other care givers in


response to the assessment data. The summary may include a condensed
nursing plan of care or plans for additional patient monitoring.

Response - Summarize the outcome or the patient's response to the


nursing interventions. Because a response may not be evident for hours or
even days, this documentation may not immediately follow the entries. In fact,
it may be recorded by another nurse, which is why titling each of your
assessments and interventions is so important.

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ANNEX A

HEADQUARTERS PHILIPPINE ARMY

PERSONAL STAFF
OCG
AIG ACESPA ACPA
OVC
AIDE ASM

OCS

SAGS AOC

COORDINATING STAFF

G1 G2 G3 G4 G5 G6 G7 G8 G10 G11

SPECIAL AND TECHNICAL STAFF

AC, SURG ACN AJAG ACE ACA ACCS ACI

ADS AAG APM ACOCS ACQM MIPO

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A-2 RESTRICTED
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ORGANIZATION OF PA NURSING SERVICES

ACN

DEP ACN

NS, NS, NS, NS, NS, NS, NS, NS, NS,


FBHG FMASH CPSH CESH CSSH CLSH CMDCSH KCSSH CCSH

DTU CESH MIL


MED ANNEX WARD

51ST EBDE 54TH EBDE 52ND EBDE SOCOM LABDE 2ID


MED INF MED INF MED INF MED INF MED INF

SFR FSRR
MED INF MED INF

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A-4 RESTRICTED
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ORGANIZATION OF THE OFFICE OF THE ARMY CHIEF NURSE

ACN
Dep, ACN

C, ADMIN & PERS BR C, PLANS & TRAINING BR

NCOIC/C, CLERK

SUPPLY SGT FINANCE SGT FILLING CLERK/ DRIVER


GEN MSGE CTR
CLERK

ENCODER/TYPIST

INST’L WORKER

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A-6 RESTRICTED
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ORGANIZATIONAL RELATIONSHIP OF THE NURSING SERVICE WITH OTHER SERVICES IN PA HOSPITALS


(Tri-Service)

PA HOSPITAL

ADMIC SVC MED SVC NURSING SVC

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A-8 RESTRICTED
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NURSING SERVICE OF A
GENERAL/ TERTIARY HOSPITAL

NURSING SVCS

NSG EDUC & NURSING CARE NSG RESEARCH & NSG ADMIN
TRNG BR BR QTY ASSURANCE BR

CLINICAL SEC AMBULATORY SUPPORT SEC


SEC

FAMILY OPERATING
SURGICAL WD
PLANNING RM
CLINIC
MED WD DELIVERY
WELL/SICK RM
OB-GYNE WD BABY
CLINIC CSR

PEDIA WD CONSULTN
LINEN RM
TREATMENT
RM
LAUNDRY RM
EMERGENCY
RM

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A-10 RESTRICTED
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NURSING SERVICE OF A
STATION/ SERCONDARY HOSPITAL

NURSING SVCS

NSG EDUC & NURSING CARE NSG RESEARCH & NSG ADMIN
TRNG BR BR QTY ASSURANCE BR

CLINICAL SEC AMBULATORY SUPPORT SEC


SEC

FAMILY OPERATING
SURGICAL WD
PLANNING RM
CLINIC
MED WD DELIVERY
WELL/SICK RM
OB-GYNE WD BABY
CLINIC CSR

PEDIA WD CONSULTN
LINEN RM
TREATMENT
RM
LAUNDRY RM
EMERGENCY
RM

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A-12 RESTRICTED
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NURSING SERVICE OF
A MEDICAL INFIRMARY

MOBILE
FIXED OR
STATION

CONSULTATION/
TREATMENT
OBSERVATION
RM
MEDICAL
MILITARY

SURGICAL DEPENDENTS

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A-14 RESTRICTED
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ANNEX B

UNIFORMS

GOA UNIFORM FOR MALE OFFICER

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B-2 RESTRICTED
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GOA UNIFORM FOR FEMALE NC OFFICER

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B-4 RESTRICTED
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GOA (PANTS) UNIFORM FOR FEMALE NC OFFICER

RESTRICTED B-5
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B-6 RESTRICTED
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GRAY BLOUSE UNIFORM FOR MALE NC OFFICER

RESTRICTED B-7
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B-8 RESTRICTED
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GRAY BLOUSE UNIFORM FOR FEMALE NC OFFICER

RESTRICTED B-9
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B-10 RESTRICTED
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HOSPITAL UNIFORM FOR MALE NC OFFIICER

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B-12 RESTRICTED
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HOSPITAL UNIFORM FOR FEMALE NC NC OFFICER

RESTRICTED B-13
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B-14 RESTRICTED
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HOSPITAL UNIFORM FOR PREGNANT NC OFFICER

RESTRICTED B-15
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B-16 RESTRICTED
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HOSPITAL UNIFORM FOR FEMALE


CIVILIAN NURSE

RESTRICTED B-17
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B-18 RESTRICTED
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HOSPITAL UNIFORM FOR FEMALE


CIVILIAN NURSE (PANTS)

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B-20 RESTRICTED
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HOSPITAL UNIFORM FOR MALE CIVILIAN NURSE

RESTRICTED B-21
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B-22 RESTRICTED
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HOSPITAL UNIFORM FOR MIDWIFE AND NURSING


ATTENDANT

RESTRICTED B-23
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B-24 RESTRICTED
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HOSPITAL UNIFORM FOR MALE INSTITUTIONAL WORKER

RESTRICTED B-25
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B-26 RESTRICTED
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HOSPITAL UNIFORM FOR FEMALE INSTITUTIONAL WORKER

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B-28 RESTRICTED
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ANNEX C

UTILIZATION OF NURSE CORPS IN ECHELONS OF MEDICAL


EVACUATION

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ANNEX D

PA NURSING SERVICE
MEDICATION SHEET

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D-2 RESTRICTED
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PA NURSING SERVICE
TPR SHEET

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D-4 RESTRICTED
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PA NURSING SERVICE
FLUID INTAKE OUTPUT SHEET

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D-6 RESTRICTED
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DATE/TIME DOCTOR’S ORDERS SHEET

LAST NAME, FIRST NAME, MIDDLE NAME Rank AFPSN

DIAGNOSIS Ward# Bed# Sex Age Date Adm Reg

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D-8 RESTRICTED
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PA NURSING SERVICE
NURSES’ PROGRESS NOTES

Date/Time/ Progress Notes Date/Time/ Progress Notes


Shift Shift

DIAGNOSIS LAST NAME, FIRST NAME ,MIDDLE NAME RANK AFPSN

WARD# Bed# Sex Age Date Adm Reg#

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D-10 RESTRICTED
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PA NURSING SERVICE
INTRAVENOUS FLUID SHEET

DATE/TIME SOLOTION/AMOUNT RATE AMOUNT DATE/TIME AMOUNT SIGN


MEDS ADDED INFUSED FINISHED ENDORSED

PATIENT FIRST NAME LAST NAME MI REG NO. WARD/B ED NO.

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D-12 RESTRICTED
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PA NURSING SERVICE
STANDING ORDER SHEET

DATE Ordered Date Disc Medication and Remarks


Treatment

Last Name, First Name, Middle Name Rank AFPSN

DIAGNOSIS Ward # Sex Bed# Age Date Adm Reg

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D-14 RESTRICTED
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PA NURSING SERVICE
NURSING PROBLEM LIST

PROBLEM Nr DATE NOTED NURSING DATE


PROBLEM RESOLVED

Rank Last Name MI First Name Hosp Wd Reg Nr

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D-16 RESTRICTED
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PA NURSING SERVICE
VITAL SIGN MONITORING SHEET

DATE/ BP PR CR RR T CVP LEVEL OF REMARKS SIGN


TIME CONSCIOUSNESS

Last name First Name MI Hosp: Reg No: Ward No


Diagnosis:

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D-18 RESTRICTED
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PA NURSING SERVICE
NURSING CARE PLAN (I)

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D-20 RESTRICTED
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RESTRICTED D-21
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D-22 RESTRICTED
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PA NURSING SERVICE
NURSING SYSTEM REVIEW CHART

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D-24 RESTRICTED
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PA NURSING SERVICE
NURSING ADMISSION HISTORT AND ASSESMENT

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D-26 RESTRICTED
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PART II

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D-28 RESTRICTED
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ANNEX E

PA NURSING SERVICE
NURSES’ PROGRESS NOTES

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E-2 RESTRICTED
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ANNEX F

TITLE: AFP OFFICER APPRAISAL SYSTEM


Authority: Circular #4 dtd 05 May 2003

1. PURPOSE: This Circular prescribes the policies and


procedures in evaluating and .measuring the performance effectiveness and
value of an officer to the service including the different report formats to be
used for the said purpose.

2. DEFINITION OF TERMS: For the purpose of this Circular, the


following terms shall be construed to mean:

a. Officer Appraisal System - This refers to an organized or


established scheme or method of evaluating or measuring the performance,
effectiveness and potential of an officer in the AFP.

b. Personal Attributes - This refers to the quality and


characteristics necessary and essential for an officer to perform his duties and
responsibilities and to accomplish the assigned tasks.

c. Performance of Duty - This refers to the manner by which


an officer carries out and accomplishes the assigned tasks.

d. Adjectival Rating - This refers to the actual description


and evaluation of the raterl indorser through his own words and handwriting of
the performance effectiveness and the potential of an officer.

3. OBJECTIVES:

a. To provide the AFP with information on an officer's


performance, effectiveness and value which, together with other available
data, can be used as a guide in personnel actions.

b. To establish an effective scheme of rating individual


officer for every period of active service except while on leave prior to
retirement, to be used as a tool for measuring the officer's value to the service
as a basis for personnel action such as promotion, selection for training,
assignment, reassignment, designation to key position, separation and to
monitor the rated officer's performance.

4. GENERAL: Appraisal reports are of such far-reaching


importance to the AFP and to the individual officer such that greatest care
must be exercised in their preparation. Close attention to instructions
contained in the form and to those in this Circular is mandatory to insure
proper completion. All unit commanders must take appropriate steps to insure

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that all officers under them will be able to read and understand the contents of
this Circular. All Commanders

a. Commanders will require officers under them to sign a


Certificate (Incl E) which will be included in the MPF that they have read and
understood the contents of the Circular, within one month from the effective
date of publication or within one month after the appointment and/or call-to-
active duty of an officer.

b. Disciplinary action will be taken by the appropriate


Commanders of the Major Services and the Deputy Chief of Staff (in case of
officers assigned at GHQ and AFPWSSUs) against officers concerned who
shall fail to accomplish the Appraisal Reports in accordance with this Circular.
Report of disciplinary action taken will be transmitted to TAG, AFP.

c. All officers should be impartial, accurate, objective and All


officers should be impartial, accurate, objective and judicious in rendering
Appraisal Reports and should realize the serious necessity of a realistic officer
appraisal or evaluation in the AFP. Reporting officers should not let close
personal association; animosities, prejudices and bias influence them. Given
a rating higher than that merited by job performance is unfair not only to other
officers but to the individual himself. Over-rating an officer may lead to
assignment of duties for which he is not qualified. The ideal therefore, is to
give ratings that are neither higher nor lower than merited.

The current efficiency status of organization shall not be


the sole basis for judgment by a military superior as to the effectiveness of the
commander thereof. The degree to which the effectiveness of an officer is
reflected is the efficiency of his organization considering the time element and
with the due allowance for factors beyond the control of the rated individual.

d. The Appraisal Report may be used by superiors as a tool


in counseling subordinates toward improved performance. Rates shall
continuously correct deficiencies and stimulate improvement among
subordinates.

e. Evaluation by the rater and endorser must be based on


facts and actual observation throughout the rating period. It should not be
based only on few isolated incidents. In the absence of facts on which to base
a rating, no rating should be made.

Rated officer will be evaluated vis -a- vis the


effectiveness with which he has discharged the responsibilities assigned to
him, preferably based on a performance fist (i.e., duties and responsibilities)
presented to him upon his assumption of duty- Designated raters shall not
delegate the duty of performing the rating of an officer to other subordinate
staff officer for any reason.

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5. ON WHOM RENDERED AND FORMS TO BE USED.

a. Appraisal Reports win be rendered on every officer of all


grades except GeneraV Flag Officers in the active service.

b. Appraisal Reports for Officer-students at local military


schools will be made in AFP AGO Form 67-5 (Revised) (Incl A) in three (3)
copies

c. quested by TAG, AFP from head of the institution in AFP


AGO Form 67-5 (revised) in three (3) copies.

d. Appraisal Reports for Officer -students at local or foreign


schools will be requested by TAG, AFP from head of the institution in AFGP
AGO Form 67-U (Revised) (Iod B) in three (3) copies.

e. Appraisal Reports for Officers on duty outside the AFP or


who are serving immediateiy under' non-AFP officiais win be requested by
TAG, AFP from the head of the office, organization, or agency in AFP AGO
Form 67-C (Revised) (Incl C) in three (3) copies.

On all officers, reports will be made in AFP AGO Form


67-M (Revised (Incl D) in three (3) copies..

6. BY WHOM RENDERED - Appraisal Report will be rendered by


a rater and an endorser. The rater is the immediate superior, who has
immediate supervision under the pertinent chain of command of staff structure
of the rater. Officers on detail with military and civilian schools, local or
foreign, or on detail with civilian agencies, win be rated by their respective
Heads of Office based on AFP AGO Forms.

7. WHEN RENDERED:

a. Periodic - All officers will be rated at the end of June and


December.

b. Relief of Rated Officer - It will be rendered upon relief of


the rated officer from his primary duty assignment in a military unit or in a
civilian agency or when the rated officer is placed on temporary duty (TDY) or
detached service (OS) in another unit for more than 30 days as specified by
orders.

c. Relief of the Rater - Upon relief of the rater who has


served for more than thirty (30) days.

d. Relief of the Endorser - Upon relief of the endorser who


has served for more than thirty (30) days.

e. On special occasions as follows:

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1. On completion of MDT, duty as a student (local or


foreign) or duty outside the AFP.

2. When, in the opinion of the rater, an individual is


so deficient in ability or performance of duty as to require reassignment,
adverse personnel action, or disciplinary action.

3. When, in the opinion of the rater, the manner of


performance of duty is so outstanding as to justify submission of a special
report.

4. When, in the opinion of the rater, the manner of


performance of duty is so outstanding as to justify submission of a special
report.

8. FORM ACCOMPLISHMENT:

a. Preparation

(1) Entries on items 1 to 9, 12 & 13 and 16 to 20 of


Form 67 -M (Revised) will be typewritten or printed in ink. All other entries will
be in the rater's or endorser’s (as applicable) own handwriting. Any changes
or erasures will be initialed by the rater or endorser, as appropriate.

(2) In the event that additional space is required for


entries under Item Nr 15, "ACTUAL OBSERVATION", enter in the appropriate
item the word "oontinued", resume on (M) bond paper, and attach as a
continuation sheet.

b. Responsibility in Preparation and Handling

(1) Appraisal Reports will not be folded and will be


placed in an envelope suitab1e for. flat mai1ing. On1ythree (3) copies will be
prepared; copies or extract will not be made at any echelon of command.

c. Forwarding

(1) When completed, the original will be forwarded to


the Adjutant General, AFP and the duplicate to the Adjutant General of the
parent Major Service of the rated officer and the triplicate to the rated officer.
For JAGS, MC, DS, CHS, NC, MAC, VC,WAC, Corps of Prof and DOL
officers assigned to the Major Service and AFPWSSUs, the original will be
forwarded to TAG, AFP and the duplicate will be returned to the unitJ division
where they are placed on duty and the triplicate to the rated officer.

(2) The accomplished report shall be


classified"Confidential" and shall contain a cover sheet for such classification.
It shall be handled "safehand" by only four personnel in the command, i.e.
Rater, Indorser, Rated Officer and Unit Personnel Officer prior to submission

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to the Major Service Adjutant andl or the Adjutant General, AFP.

(3) In case the report contains unfavorable entries that


need reference to the rated officer, the report will be forwarded as prescribed
in paragraph 11 below. Report should reach the Adjutant General, AFP and
the Major Service Adjutant General not later than thirty (30) days after the last
date of the period reported. Any report not forwarded within this time limit will
have, attached thereto, an explanation or reason for the delay. If during
combat 0 other emergency conditions an Appraisal Report is not completed
when due, the responsible commander wilt ensure that the report is
completed and submitted at the first opportunity.

(4) Since battle or other conditions or stress are the


most important tests of the necessary qualities of leadership, it is of
paramount importance that commanders render reports at the earliest
possible time.

(5) The Adjutant General, AFP and the Adjutant


General of the Major Services win designate an officer in their respective
offices to take charge of the receipt, recording, and filing of all Appraisal
Reports. TAG, AFP will make appropriate arrangements as to preparation and
forwarding of Appraisal Reports rendered by reporting officers of schools and
civilian agencies.

9. ADMINISTRATIVE INSTRUCTIONS IN ACCOMPUSHMENT


OF AFP OFFICER APPRAISAL REPORT FORM AFP AGO 67 -M revised -
(If there is not enough basis on which to rate the officer, items 9-13 win not be
filled up)

a. Item 1 - Enter the name of the rated officer exactly as it appears


in the official roster of the AFP.

b. Item 2 - Enter the rated officer's permanent grade. If the officer


is hOlding a temporary grade, indicate it in parenthesis.

c. Item 3 - Enter the rated officer's Armed Forces Serial Number.

d. Item 4 - Enter the branch of service (PA. PAF, PN and Technical


Services)

e. Item 5 - Enter the rated officer's unit, organization and station.

f. Item 6 - Enter the period covered by the report, i.e. from the date
the rated officer is on duty with the unit if this is the first Evaluation Report to
be rendered for him in that unit, or the date following the last day covered by
the last Evaluation Report if he has previously been rated in the same unit, to
the end of the period the report is accomplished. Indicate also the number of
days the rated officer performed the duties covered by the report.

g. Item 7 - Enter the duty assignment assumed by the rated officer

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for the period of the report, status of the duty position as to whether it is
primary or additional (given in addition to his primary or main duty
responsibility), period rendered in such duty, and the authorized T/O grade for
the duty position.

h. Item 8 – Mark with an “X” the appropriate block as described in


paragraph 5.

i. Item 9 - Mark with an 'X" the appropriate space or spaces


provided for depending on the basis for entries in this report.

j. Item 10 - Rate the officer on the various attributes and


performance of duties in the degree you consider applicable to him and place
the appropriate number as given in the space provided for in items 11-12.

k. Items 11 & 12 - Mark the appropriate space provided for with the
corresponding rating as indicated in item 10. Use the Unknown (0) only if the
nature of contact makes it impracticable to make an estimate of his probable
performance in a particular duty. Making Unknown (0) does not prejudice the
rated officer.

l. Item 13 - Reflect the average rating obtained from items 1112 in


the space provided. Compute separately the rater's and the endorser are
overall average and put it in the space provided. In case .Unk" is included in
the rating, the average must be based on items with numeric ratings only. The
average is the sum of all numeric ratings, divided by the number of numeric
ratings entered. The quotient shall be rounded to the first decimal.

m. Item 14 - Reflect the overall observation on the actual


performance, potentials for promotion and assignment and value to the
service of subject officer. The observation shall be made by the Rater and
Endorser in their own words and handwriting.

n. Item 15 - Input any comment which will increase the objectivity


of the rating. Include strengths and weaknesses not covered elsewhere in the
report. Give factual and specific information. Comments will reflect major
strengths, weaknesses, behavior, personality, character or other qualities
which distinguish the rated officer. Mark an “X" on the appropriate space as
applicable.

o. Item 16 - Certification by the rater and the endorser that entries


in the OAR conform with this Circular.

p. Item 17 - This space is to be accomplished by the rated officer if


any item in the report is marked a 1" or when any serious deficiency or
misconduct is stated in item 16 (comments).

q. Item 18 - If there are enclosures like reports of commendation or


adverse performance, attach a copy of each to this report. The number of
enclosures will be indicated in Arabic numerals when there are no enclosures,

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the word "NO" will be entered in the space provided.

r. Item 19 - Upon receipt of the Appraisal Report, the appropriate


unit personnel officer will examine the entries for accuracy and correctness,
especially for errors in the personal data of the officer concerned. He will enter
the rating in the appropriate space of the AFP AGO Form 66 for the rated
officer and indicate the date.

s. Item 20 - Enter the unit personnel officer's grade, name, and


Armed Forces serial number. He will sign over printed name.

10. ADMINISTRATIVE GUIDE - To educate and guide the raters or


endorsers, following are the parameters and their adjectival equivalents.
Rating Adjectival Equivalent
5 (Outstanding) - Maintains high standard of performance in
all areas of his job. Contributes very well in
other areas of his job.
4 (Very Satisfactory) - Always meets all job-requirements and
excels in most areas of his job.
3 (Satisfactory) - Meets normal requirements and job
standards. Needs further training and self-
improvement to be able to assume higher
responsibilities
2 (Unsatisfactory) - Sometimes deficient on important job
requirements and standards. Needs further
training and self- improvement to remain in
. the present job.

- Rater has no knowledge about the


UNK (Unknown)
performance or service reputation of the rated
.
officer

11. UNFAVORABLE ENTRIES - Whenever an Appraisal Report


contains entries of “1” which is considered in any sense unfavorable, the
reason for the entry will be clearly stated. The rater shall refer the entire report
direct to the rated officer for his remarks. The rated officer will immediately
return it to the rating officer by endorsement with his remarks pertaining to the
unfavorable entries only. The report will then be forwarded to the endorser by
the rater with his remarks with reference to the remarks on the rated officer.
The rated officer will forward the entire report with his comments and or
explanations to the endorser through the rater. If the report is delayed for
more than fifteen (15) working days when referred to the rated officer or the
rater, a brief memorandum explaining the delay will be attached. Likewise, a
rating of "5" (Outstanding) needs justification (s) by the rater/endorser in a
separate paper which must be indicated in item 18 of the OAR.

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12. RELEASE OF INFORMATION - Appraisal Report will be


furnished only to personnel boards and career management authorities for
use at Major Service headquarters level and above for personnel action and
also to the rated officer. The Report shall be classified as “Confidential”.

13. FORMAL INSTRUCTION - The PMA, PAFFS and all service


schools in the AFP will include this in the curricula of all officer courses being
conducted. At least a two (2) hour formal instruction shall be spent on the
proper preparation and accomplishment of Appraisal Reports.

14. RESCISSION - Circular Nr 22, this Headquarters dated 14 Oct


1987 is hereby rescinded.

15. AFP OFFICER APPRAISAL REPORT ON AFP STUDENT


OFFICERS.

AFP OFFICER APPRAISAL REPORT


(To be accomplished on AFP Student-Officers)

1. LAST NAME FIRST NAME MIDDLE INITIAL 2.GRADE 3.AFPSN 4. BR OF SVC

5. PARENT UNIT 6. COURSE PURSUED 7. DURATION OF


COURSE

8. PERIOD OF DETAIL WITH SCHOOL 9. GRADUATED NOT GRADUATED


(State reasons)
10. SCHOOL RECORD PASSING GRADE MAXIMUM MINIMUM

SUBJECT TAKEN MAXIMUM POINTS POINTS RECEIVED GRADE IN


PERCENT

FINAL RATING

11. HONORS AND AWARDS RECEIVED 12. GRADUATION STANDING


NR________ IN A CLASS OF
_______

13. POTENTIAL INSTRUCTOR 14. RECOMMENDED FOR HIGHER


SCHOOLING

15.COMMENTS ON THE WEAKNESSES, STRENGTHS, BEHAVIOR,


PERSONALITY, CHARACTER AND OTHER ATTRIBUTES OF THE OFFICER
WHICH MAY BE DEEMED NECESSARY TO BE INCLUDED IN THIS REPORT.

16. REPORTING OFFICER’S GRADE, NAME, SERIAL NUMBER, BR OF SVC,

POSITION AND ORGANIZATION.

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17. DATE ACCOMPLISHED 18. SIGNATURE OF REPORTING OFFICER

19. DATE ENTERED ON AGO FORM NR 66 20. PERSONNEL OFFICER


GRADE
NAME, AFPSN AND SIGNATURE

AGO FORM NO 67-U (REVISED)


INCL B TO CIR NR 4 GHQ, AFP DTD 05 MAY 2003

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ANNEX G

AFP REGULATIONS AFPRG


G-112-610
(approved by SND 18 Apr 05)
DEPARTMENT OF NATIONAL DEFENSE
GENERAL HEADQUARTERS
ARMED FORCES OF THE PHILIPPINES
Camp General Emilio Aguinaldo, Quezon City

CAREER DEVELOPMENT PROGRAM


FOR NURSE CORPS OFFICERS IN THE AFP

Paragraph

General -------- 1
References -------- 2
Purpose -------- 3
Definition of Terms -------- 4
AFP Occupational Specialty Standards for Nurse Corps -------- 5
Maintenance of Qualification Files -------- 6
Nurse Co0rps Career Pattern -------- 7
Career Management -------- 8
Exemption Clause -------- 9
Rescission -------- 10
Effectivity -------- 11

1. GENERAL:

This AFPR prescribes the Career Development Program for Nurse


Corps Officers in the Armed Forces of the Philippines. It establishes the
regulatory guidelines aimed to enhance the professional capabilities for
positional advancement in line with their projected designations through the
implementation of training courses and progressive duty assignment under
the supervision of the Office of The Chief Nurse, AFP.

2. REFERENCES:

a. RA 9173, the Philippine Nursing Act of 2002

b. AFPR G 125-022, RP DND GHQ AFP dated 15 June 1991,


Subject: AFP Occupational Classification and Structure

c. Board of Nursing Board Resolution no. 425 Series of 2003;


Implementing Rules and Regulations of the Philippines Nursing
Act of 2002, RA 9173

d. AFPR G 161-072 dtd May 1991, Subject: Table of Organization


and Equipment Nr G 08-9.

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e. AFPR G 100-012 dtd 1 April 1986, Subject: AFP Regulations


General Provisions.

f. Cir Nr 4 GHQ, AFP dtd 05 May 2003, Subject: AFP Officer


Appraisal System. (Cir Nr 4 GHQ, AFP dtd 05 May 2003)

g. AFP Standards of Nursing Practice 1987.

h. PAM 1-05 Philippine Army Nursing Service Administration


Manual (March 2001).

i. Philippine Air Force Manual, PAM-17-1, Aircrew Management,


July 1978.

j. Nursing Specialty Certification Program Board of Nursing


Resolution No. 14 S1999

k. Guidelines for Implementation BON Resolution No.118 S2002.

3. PURPOSE:

This regulation prescribes the procedures for the classification,


proficiency designation, career pattern and management, awarding of AFP
Occupational specialty, and accreditation of non – AFP specialty training of
Nurse Corps Officers.

4. DEFINITION OF TERMS:

a. Career Development Pattern/ Career Ladder - progressive


levels of command and staff positions where the Nurse Corps Officer has to
be trained and assigned upon entry and while in the active service.

b. Armed Forces of the Philippines Occupational Specialty


(AFPOS) - Term used to identify duty positions for NC Officers stated in
Annex A, AFPR G 125. The basic classification has three (3) digits, namely:
the numerical 32 which is assigned to the Nurse Corps and the alphabetical
digit that corresponds to the field of concentration, e.g. Nursing Service
Administrator is 32A.
c. Standards of Nursing Practice – AFP doctrine that incorporates
the structure, process and outcome components of the delivery of quality and
safe nursing care as based on the PNA and AFP Standards of Nursing
Practice (AFP Standards of Nursing Practice, 1987

d. Qualifications File – Documents maintained at the Office of the


Chief Nurse Major Services/ AFPWSSUs for every Nurse Corps Officer within
their jurisdiction. It is composed of the career pattern worksheet, initial
curriculum vitae, classification, training, evaluations in assignments, re-
evaluation of AFPOS, changes, and accompanying orders. Duplicate copies

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are available at the Office of The Chief Nurse, AFP to ensure that the
prescribed career patterns are followed.
e. Proficiency – Level of competence in the occupational nursing
specialty based on educational preparation, work experience, satisfactory
performance in the profession, and scientific contribution for the improvement
of the Nursing Specialty through research. There are four (4) levels: beginner
(Delta), competent (Charlie), proficient (Bravo), and expert (Alpha). These
proficiency designations are spelled out after the three digit AFPOS separated
by the symbol dash. This does not apply to the Flight Nurse and

General Duty Nurse. e. g. Nursing Service Administrator, proficiency D


is written 32A – Delta.

f. Nursing specialties – different fields of specialization in nursing


where Nurse Corps Officers may choose to train and serve, as enumerated in
para 5a (except General Duty Nurse).

g. Primary AFPOS –refers to the specialty currently practiced by


the NC Officer in which he is most qualified to perform.

h. Secondary AFPOS - refers to the specialty which is less


practiced by the Nurse Corps Officer after having been designated as such.

i. Additional AFPOS – The AFPOS which an AFP nurse is next


best qualified to perform after the secondary AFPOS.

j. Career Courses - mandatory military courses (Basic, Advance,


General Staff Course).

k. Officer Appraisal Report (OAR) – Semi-annual report for officers’


evaluation and measurement of his effectiveness and value to the service as
embodied in GHQ Cir Nr 4 dated 05 May 2003, Subject: AFP Officer
Appraisal System.

l. Competency Assessment Checklist – current tool used to


measure the AFP nurses’ competency level in the professional nursing skills
required at different specialties.

5. AFP OCCUPATIONAL SPECIALTY STANDARDS FOR NURSE


CORPS:

a. The following are the basic AFPOS classification for military


nurses:

(1) Nursing Service Administrator 32A


(2) Flight Nurse 32B
(3) Psychiatric Nurse 32C
(4) Communicable Disease Nurse 32D
(5) Pediatric Nurse 32E
(6) Operating Room Nurse 32F

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(7) Orthopedic Nurse 32G
(8) Anesthesist 32H
(9) Obstetrical Nurse 32I
(10) Renal Nurse 32J
(11) Neurosurgical Nurse 32K
(12) General Duty Nurse 32L
(13) Critical Care Nurse 32M
(14) Cardiac Catheterization Nurse 32N
(15) Nuclear Nurse 320
(16) Community Health Nurse 32P
(17) Nurse Educator 32Q
(18) Trauma Nurse 32R
(19) Oncology Nurse 32S

b. AFPOS 32B Flight Nurse and 32L General Duty Nurse are
exempted from proficiency designations stated herein. General Duty Nurse is
an entry classification for a newly called to active duty (CAD) Nurse Corps
officer who has no training in other nursing specialties indicated in para 5a.
On the other hand, Flight Nurse shall follow the standard three level
designations, with requirements as indicated:

(1) Flight Nurse-awarded to those who have successfully


completed the Flight Nurse Course locally or abroad or its equivalent;
received the certificate of proficiency after completion of at least one hundred
(100) hours of certified flying time in military aircraft either in training or
actually performing flight nurse duties aboard the aircraft; and on flying status
to perform flight nurse duties or as student flight nurse.

(2) Senior Flight Nurse-awarded to the Flight Nurse who has


been designated for at least seven (7) years as Flight Nurse in the Armed
Forces of the Philippines, has logged at least eight hundred (800) hours
certified flying time in military aircraft performing primary flight nurse duties
and on flying status as a flight nurse.

(3) Senior Flight Nurse-awarded to the Flight Nurse who has


been designated for at least seven (7) years as Flight Nurse in the Armed
Forces of the Philippines, has logged at least eight hundred (800) hours
certified flying time in military aircraft performing primary flight nurse duties
and on flying status as a flight nurse.

(4) Chief Flight Nurse-awarded to the duly designated Chief


Nurse Air Force, or those who have been designated for fifteen (15) years as
flight Nurse and or Senior Flight Nurse, have logged one thousand five
hundred (1,500) hours of certified flying time in military aircraft performing
primary flight nurse duties and on flying status as a Senior Flight Nurse.

c. Proficiency Designation (Enclosure 1)

(1) Proficiency Delta – lowest level of proficiency awarded to


the beginner (1 year) in the specialty. Requirements include satisfactory

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ratings in performance (Officer Appraisal Report) and competency


(Competency Assessment Checklist); and certified successful management of
the required number of cases in the specialty: (50 cases in Communicable
Disease, Renal, Neurosurgical Nursing; 75 cases in Psychiatric, Pediatric,
Operating Room, Obstetric, Critical Care, and Oncology Nursing; 100 cases in
Trauma Nursing and 1,000 clients in Community Health Nursing. Additional/
other requirements are needed for the following AFPOS classifications:

(a) Nursing Service Administrator (32A-Delta) – Five


(5) years minimum active military service, satisfactory performance in any of
the following positions for one (1) continuous year and nine (9) units post
graduate requirements for the degree leading to Master of Arts in Nursing:

• Chief Nurse of twenty -five (25) bed hospital


• Supervisor of fifty (50) bed hospital
• Chief Administrative / Chief Personnel
Management Branch of a fifty (50) bed
hospital.
(b) Nurse Educator (32Q-Delta)- Five (5) years
minimum active military service, completion of the Nurse Educator Course or
its equivalent as determined by the Board, and satisfactory performance as
Training Officer in any AFP training facility for at least six (6) continuous
months .
(2) Proficiency Charlie – awarded to those competent (3
years) in the specialty, have completed nine (9) units post graduate course
leading to Master of Arts in Nursing, have accumulated 30 contact hours of
training in the specialty, have received very satisfactory ratings in
performance (Officer Appraisal Report) and competence (Competency
Assessment Checklist), and have been certified to successfully manage the
required number of clients (100 in Communicable Disease, Renal,
Neurosurgical Nursing; 150 in Psychiatric, Pediatric, Operating Room,
Obstetric, Critical Care, Oncology Nursing; 200 in Trauma Nursing and 2,000
clients in Community Health Nursing). Other requirements needed for the
following AFPOS classifications are as follows:

(a) Nursing Service Administrator (32A-Charlie) Ten


(10) years minimum active military service, successful completion of the
Career Advance Course and academic requirements of post graduate course
leading to Master of Arts in Nursing, and very satisfactory performance for
one (1) continuous year in any of the ff positions:

• Chief Nurse of fifty (50) bed hospital


• Assistant Chief Nurse of a hundred (100)
bed hospital
• Supervisor of tertiary hospital
• Chief Administrative and Personnel
Management Branch in the Major Service.

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(b) Nurse Educator (32Q-Charlie)-Ten (10) years
minimum active military service, satisfactory performance for two (2) years as
Nurse Educator/ Trainer, completion of the Career Advance Course and
eighteen (18) units of Master in Nursing/ Education course from
college/university duly recognized by the government of the Republic of the
Philippines.

(3) Proficiency Bravo – awarded to those proficient (5 years)


in the specialty, have completed the academic requirements for Master of Arts
in Nursing, have received excellent ratings in performance (Officer Appraisal
Report) and competency (Competency Assessment Checklist), and
successfully completed five hundred (500) certified teaching/training hours in
the specialty. Other requirements needed for the following AFPOS
classifications include:

(a) Nursing Service Administrator (32A-Bravo) -


Eighteen (18) years minimum active military service, successful completion of
the General Staff Course and Master in Nursing degree, and very satisfactory
performance for two (2) continuous years in any of following positions:

• Deputy Chief Nurse, Major Services / AFP Medical


Center
• Chief Nurse of a hundred (100) bed hospital
• Assistant Chief Nurse of tertiary hospital
• Chief Administrative and Personnel Management
Branch, Office of The Chief Nurse, AFP

(b) Nurse Educator (32Q-Bravo) - ten (10) years


minimum active military service, completion of the General Staff Course and
Master of Arts in Nursing / Education, and have satisfactorily designed/
implemented/evaluated training programs for nursing and paramedical
personnel for five (5) continuous years.

(4) Proficiency Alpha – – awarded to the experts (10 years)


in the specialty, NC officers who achieved prominence comparable with
civilian nursing leaders. With Master of Arts in Nursing degree, with individual
scientific contribution to Military Nursing through research and / or significant
publication, have received outstanding ratings in performance (Officer
Appraisal Report) and competency (Competency Assessment Checklist),
and have successfully completed eight hundred (800) certified teaching /
training hours in the specialty. Other requirements needed for the following
AFPOS classifications include:

(a) Nursing Service Administrator ( 32A-Alpha ) -


awarded to The Chief Nurse, AFP upon assumption, and to others with
twenty five ( 25 ) years minimum active military service, completed the
General Staff Course and Master of Arts in Nursing degree, preferably with
Master in National Security Administration ( MNSA ) or Doctorate degree,

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with individual scientific contribution to Military Nursing through research


and/or other significant publication, and have served very satisfactorily in any
of the following positions for two ( 2 ) continuous years:

• Chief Nurse of Major Services / VLGH


• Chief Nurse of Major Services / VLGH
• Command Nurse, AFP Medical Center /
Area Commands
• The Deputy Chief Nurse, AFP

(b) Nurse Educator (32Q-Alpha) – awarded to NC


Officers with twenty- five (25) years minimum
active military service, completed the General Staff
Course and Master of Arts in Nursing / Education
or degree, with individual scientific contribution
through research and/or significant publication,
and have served very satisfactorily in any of the
following positions for two (2) continuous years:

• Chief, Education and Training Branch


OTCN
• Assistant Commandant of AFP Training
School
• Assistant Chief Nurse, Education and
Training Branch of a tertiary hospital.

6. MAINTENANCE OF QUALIFICATION FILES:

a. Chief Nurses of the Major Services/ AFP Wide Service Support


Units shall maintain the qualifications file of each Nurse Corps Officer
assigned or detailed within their technical jurisdiction. These records will be
composed of the initial curriculum vitae or classification questionnaires for
training details, ratings or evaluation in assignments, re-evaluation of AFPOS,
orders for AFPOS, and subsequent changes thereof. Cover sheet for this file
will be the career pattern worksheet.

b. The monitoring office, Office of The Chief Nurse( OTCN), Armed


Forces of the Philippines will be provided a copy of the qualifications file for
each Nurse Corps officer by the Major Service/ AFPWSSUs Chief/ Command
Nurses and with all subsequent data that belong to the file as prescribed.

7. CAREER PATTERN:

a. General: Upon Call to Active Duty, Nurse Corps Officers


shall be assigned at a general hospital / medical center and designated
General Duty Nurse.

b. Training Courses:

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(1) All newly Called to Active Duty officers shall attend the
Technical Services Officers Basic Course preferably within the first year of
tour of active duty.

(2) Between the fifth to eighth (5th-8th) year, NC officers shall


attend the Technical Service Officers Advance Course or its equivalent,
locally or abroad.

(3) All NC Officers who have shown executive and


leadership abilities shall attend the General Staff Course , locally or abroad,
preferably between the twelfth to fifteenth (12th-15th) year of active duty and
with the rank of Major only.

(4) NC Officers occupying top positions who have


demonstrated exceptional professional ability may attend the Master of
National Security Administration (MNSA), locally or abroad, preferably on the
twenty- first (21st) year of tour of active duty (rank of LTC to COL).

c. Specialty Training/ On-the-Job Training:

(1) NC Officers who are in active service and have


graduated from the Technical Service Officers Basic Course, are eligible to
apply or may be chosen by the Chief Nurse, Major Service / AFPWSSUs for
specialty training conducted at civilian or military installations, locally or
abroad. These courses include Nursing Service Administration, Flight
Nursing, Psychiatric Nursing, Communicable Disease Nursing, Pediatric
Nursing, Operating Room Nursing, Orthopedic Nursing, Anesthesia Nursing,
Obstetrical Nursing, Renal Nursing, Neurosurgical Nursing, Critical Care
Nursing, Cardiac Catheterization Nursing, Nuclear Nursing, Community
Health Nursing, Nursing Education, Trauma Nursing, and Oncology Nursing.
(2) Specialty Training/ On-the-Job Training is a continuous
and ongoing process for the NC Officers.

d. Developmental Profile: The Nurse Corps Career Pattern


tabulated in enclosure 2 shows the phases of professional advancement,
training requirements and progressive positional assignment of NC officers
commensurate to their military ranks, based on the empirical data monitored
throughout the various regions in the country. NC officers are expected to
have an excellent foundation in clinical nursing before receiving diversified
assignments. Although not all NC officers maybe slated for diversified
assignments, they are nevertheless, given the opportunity to advance in their
chosen field of specialization.

e. Requirements:

(1) This administrative function shall be assumed by the


office of the Chief Nurse from the different Major Services, to include
AFPWSSUs, with the task of ensuring the strict compliance to the

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established regulations and facilitating the required training and projected


assignments for Nurse Corps Officers envisioned to develop their utmost
potentials.

(2) Training and duty assignment shall be progressive as


indicated in para 7.

(3) Re-evaluation of officers’ AFPOS shall be done yearly, at


the same time as the officers’ evaluation at the end of the year, by the Chief
Nurse of Major Services and AFPWSSUs or through a designated cognizant
representative.

(4) A career pattern worksheet shall be prepared for each


NC Officer to include his/ her previous assignments and the plan for his/ her
future assignment for the normal thirty-(30) year career period or up to the
time he/ she reaches fifty six (56) years of age. This will form the cover sheet
of the individual classification file.

f. Awarding of the AFPOS:

(1) Chief Nurse of Major Services and AFPWSSUs will


submit their recommendations using the prescribed format (Enclosure 3) to
The Chief Nurse, AFP Attention: Chief, Training Branch exactly first quarter
(1st Qtr) of the year.

(2) The Chief Nurse, AFP upon receipt of the


recommendations will convene the Board to deliberate on the recommendees
in the second quarter of the year. The Board shall be composed of the
following: The Deputy TCN, AFP; Chief, Administrative and Personnel
Management Branch OTCN; Chief, Training Branch, OTCN; Deputy Chief
Nurse of Major Services and the Command Nurse of the AFP Medical Center
and representatives from J1 and J3.

(3) The Board will deliberate and recommend prospective


awardees to The Chief Nurse, AFP for approval.

(4) Appropriate orders will be issued in the third quarter of


the same year.

(5) Certification from previous unit/ employer as to how many


hours was spent in the practice and the list of cases handled/ assisted,
training designs implemented, and others which the Board may require.

g. Responsibilities:

(1) Deputy Chief of Staff for Personnel, J1 in coordination


with The Chief Nurse, AFP monitors the career development for Nurse Corps
officers of the Armed Forces of the Philippines.

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8. CAREER MANAGEMENT:

a. Requirements:

(1) This administrative function shall be assumed by the


Office of The Chief Nurse, AFP and Chief Nurses from the different Major
Services, to include AFPWSSUs, with the task of ensuring strict compliance to
the established regulations and facilitating the required training and projected
assignments for Nurse Corps officers envisioned to develop their utmost
potentials.

(2) Training and duty assignment shall be progressive as


indicated in para 8.

(3) Re-evaluation of officers’ AFPOS shall be done yearly, at


the same time as the officers’ evaluation at the end of the year by the Chief
Nurse, Major Services and AFPWSSUs or through a designated cognizant
representative. A career pattern worksheet shall be prepared for each NC
officer to include his/ her previous assignments and the plan for his/ her
future assignment for the normal thirty- (30) year career period or up to the
time he reaches 56 years of age. This will form the cover sheet of the
individual classification file.

b. Awarding of the AFPOS:

(1) Chief Nurse of Major Services and AFPWSSUs will


submit their recommendations using the prescribed format (Enclosure 3) to
The Chief Nurse, AFP Attention: Chief, Training Branch exactly first quarter
(1st Qtr) of the year.

(2) The Chief Nurse, AFP upon receipt of the


recommendations will convene the Board to deliberate on the recommendees
in the second quarter of the year. The Board shall be composed of the
following: The Deputy TCN, AFP; Chief, Administrative and Personnel
Management Branch OTCN; Chief, Training Branch, OTCN; Deputy Chief
Nurse of Major Services and the Command Nurse of the AFP Medical Center
and representatives from J1 and J3.

(3) The Board will deliberate and recommend prospective


awardees to The Chief Nurse, AFP for approval.

(4) Appropriate orders will be issued in the third quarter of


the same year.

c. Accreditation of Non-AFP Specialty Training: NC officers who


have undergone specialty training prior to call to active duty (CAD) shall be
classified accordingly upon satisfaction of the following requirements:

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(1) Completion of the Didactic Phase of the AFP Specialty


Training Course.

(2) Certification from previous unit/ e

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NC CAREER MANAGEMENT

The Chief Nurse, AFP under the authority of the Chief of Staff, AFP
and the technical supervision of Deputy Chief of Staff for Operations, J3,
monitors, supervises and coordinates the career development of NC
Officers. Major Services/ AFPWSSUs Chief Nurses are responsible for the
continuous review of AFPOS of military nurses under their supervision.
Nurse Corps officers concerned are equally responsible in assuring that
their assignments and training follow the prescribed career pattern.

1. Military Education

a. Technical Service Officers Basic Course (TSOBC) - is a


military training conducted in two phases- the general military and
specialization phases. This course gives emphasis on AFP health policies,
procedures, practices and Field Medical Service Support to AFP operations.

1) Course Location:

Military Phase: Combat Arms School, Philippine


Army Training Command, Fort Magsaysay, Palayan
City, Nueva Ecija.
Specialization Phase: AFP Medical Service School,
V Luna Rd, Quezon City.

2) Duration: 14 wks

3) Prerequisites:

(a) NC Officers in the active service of the AFP who


have not undergone TSOBC or its equivalent.

(b) Must be physically and mentally fit for general


military service.

(c) Has no pending case both in civil or military court.

(d) Must not be due for ETAD during the duration of


training for reserve officers.

(e) Female officers must not be pregnant during the


duration of the course.

b. Technical Service Officers Advanced Course (TSOAC) - is a


two-phased military training ( Military and Nurse Specialization) designed to
equip Nurse Corps Officers with the needed military leadership, managerial
and administrative skills as middle level managers.

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1) Course Location:

Military Phase: Combat Arms School, Philippine Army


Training Command Fort Magsaysay, Palayan City,
Nueva Ecija
Specialization Phase: AFP Medical Service School, V.
Luna Rd, Quezon City

2) Duration: 14 weeks

3) Prerequisites:

(a) Must be with the rank of O-3 to O-4 and in the


active service

(b) Has no pending administrative, criminal or


court martial case

(c) Physically and mentally fit for training

(d) Physically and mentally fit for training

(e) Must have satisfactorily completed the


Technical Service Officers Basic Course.

(f) Must not be due for ETAD during the duration


of training.

(g) Female officers must not be on the family way


during the duration of the course.

c. Command and General Staff Course (CGSC) - is designed to


prepare selected senior officers to assume command and staff positions in
their respective organizations.

1) Course Location:

AFP Command and Staff College, Camp Gen Emilio


Aguinaldo, Quezon City

2) Duration: 10 months

3) Prerequisites:

- Recommendation from Major Services Command and


Chiefs of Technical

Services:

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(a) Must have satisfactorily completed the Technical


Service Officers’ Advance Course;

(b) Must have at least five (5) more years of service


remaining before his/ her compulsory retirement reckoned from graduation
date of the course;

(c) An average of “satisfactory” performance or


rating of 3 in one’s OARs for the last 3 years;

(d) Has no pending civil, administrative, criminal or


court-martial case;

(e) Must secure security clearance for access at


least to “SECRET” documents/materials;

(f) Cleared from all property and money


accountability responsibilities;

(g) Must be physically and psychologically fit;

(h) Must pass the qualifying examination being


administered by AFP CGSC.

d. Masters in National Security Administration – This course


broadens the perspective of officers at an early stage in their career aside
from providing preferential consideration for assignment to key and sensitive
military positions.

1) Prerequisites:

(a) Must be recommended by Major Service


Commander and Chief, Technical Service.

(b) Must have a minimum rank of O-5.

(c) Must be CGSC eligible and belongs to the upper


50% of his class.

(d) Must not be more than 51 years of age upon


admission with 3 years of service remaining prior to compulsory retirement,
to be reckoned from date of graduation.

2. Professional Nursing Education.

a. AFP Nurse Specialty Training Course.

(1) Purpose: To prepare Nurse Corps officers and AFP


civilian nurses to function in specific nursing specialties at staff level position.

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(2) Location: Nursing Service Training Hall, V Luna General
Hospital and AFP Medical Service School, AFP Medical Center, V Luna
Road, Quezon City

Cross-training: UP-PGH; Philippine Orthopedic


Center, Philippine Children’s Medical Center, Asia Renal
Care Philippines, Inc.

(3) Duration: 48 wks

(4) Prerequisites:

(a) Rank of O-1, O-2, O-3

(b) Must have completed the required basic career


course.

(c) Must have current valid RN license.

(d) Must have a current IV Therapy license

(e) Must be willing to serve in any AFP medical


installation after graduation for the period as stipulated in GHQ, AFP Circular
No. 14 dtd 10 July 1990, subject: Contractual Service Obligation.

(5) Areas of Specialization:

(a) Community Health Nursing


(b) Operating Room Nursing
(c) Neuropsychiatric Nursing
(d) Renal Nursing
(e) Orthopedic Nursing
(f) Neurosurgical Nursing
(g) Critical Care Nursing
(h) Maternal and Child Health Nursing
(i) Pediatric Nursing
(j) Trauma Nursing
(k) Communicable Disease Nursing
(l) Nursing Education
(m) Nursing Administration
(n) Flight Nursing

b. Flight Nurse Course - applicable to all NC officers on active


duty selected for training for Flight Nursing abroad.

(1) Prerequisites:

(a) Must be an active commissioned NC officer from


any major service on GHQ & AFPWSSU’s.

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(b) Physically and mentally fit as determined by


authorized AFP Medical Examining Board.

(c) Must have the rank of 1LT to Major

(d) Must be a graduate of the Technical Officers


Basic Course or its equivalent in the Major Service commands.

(2) Utilization of Flight Nurse Graduates

(a) Upon completion of the course, the student shall


be assigned in areas/ units where he/ she can be utilized in aero-medical
evacuation missions for at least two (2) years for maximum utilization.

(b) Must serve as instructor in Basic Flight Nurse


Courses conducted locally and in military schools where his/ her services are
needed.

(c) Must comply with the contractual service


prescribed for foreign schooling.

c. Short- Course Programs

(1) Pre-Chief Nurse Course - to enhance the knowledge,


skills and attitudes of senior military nurses in preparation for position as
Chief Nurse of AFP Hospitals

(a) Prerequisites:

• Must be with the rank of O-3 to O-5 with 4


years TIG to LTC.

• Must have completed the Basic and


Advanced Courses for Technical Service Officers.

• Must be projected to assume the Chief


Nurse position in any AFP medical installation.

(2) Clinical Head Nurse Course - to prepare NC officers to


function as head nurses in AFP medical facilities.

(a) Prerequisites:

• Must be with the rank of O-3 to O-4 with


actual or anticipated assignment to a clinical head nurse position within any
AFP medical facility.

• Must have a current valid RN license.

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• Must be recommended by respective Chief
Nurses of the different Major Services and AFPWSSUs.

(3) Advanced Nursing Admin Course - to prepare NC


officers to function in advance management roles in AFP medical
installations.

(a) Prerequisites:

• Must be with the rank of O-5 to O-6

• Must have an actual or anticipated


assignment that involves advance nursing administration.

• Must have completed the Technical


Service Officer’s Advanced Course.

• Must have a current and valid nursing


license.

(4) Faculty Development Course- is a two-phased program


designed to equip potential Nurse Corps officers with the necessary
knowledge, skills and attitude required of a trainer.

(a) Location: AFP Medical Service School,


AFPMC V Luna Rd Quezon City.

(b) Duration: 2 weeks

(c) Prerequisites:

• Must be with the rank of O-3 to O-6.

• Must have an actual or anticipated


assignment in areas involving nursing education.

• Must have completed the Nurse Corps


Officer Advanced Course.

• Must have a current and valid nursing


license issued by PRC.

3. CIVILIAN POST GRADUATE EDUCATION

a. Masters Degree in Nursing- this course is designed to improve


the quality of nursing education and practice by developing and increasing
the competence of nurse managers. This is mandated by RA 9173
“Philippine Nursing Act of 2002” with 2005 as year of implementation.

(1) Prerequisites:

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(a) Must have a valid and current PRC license.

(b) Must qualify in the admission examination


administered by the school.

(c) Must possess knowledge and ability to carry on


an investigation of a significant problem or the application of a theory in a
certain field.

(2) Additional Requirements: Must comply with academic


requirements of the program as.

(a) Must have a general weighted average of


“2.0”,”B”,”86” or better in the undergraduate program.

(b) Must have at least two years of successful


professional experience in education or in allied fields.

(c) Must have passed the graduate admission


examinations prescribed by the college.

(d) Must have a superior command of the English


language, both in oral and written form.

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ANNEX H
POLICIES GOVERNING MARRIAGE, PREGNANCY AND MATERNITY
LEAVE OF FEMALE MEMBERS OF THE ACTIVE FORCE OF THE AFP

AUTHORITY: AFP Regulations G 131-352 dtd 22 Jun 95

Marriage

1. Any female member of the Armed Forces of the Philippines who


contracts marriage, is allowed to continue her service provided that prior to
such marriage, she has already completed at least three (3) years of
continuous active military service.

2. Any female member of the AFP who shall many before


completing three (3) years of continuous active service, shaft automatically be
reverted discharged from the service, provided further, that any female
member of the AFP who W8$ previously separated reverted discharged
honorably by reason of marriage may be called to active duty or reinstated if
such marriage was contracted after three (3) years of continuous active
military service.

3. Marriage between commissioned officer and enlisted personnel


is permitted, provided, that the female member of the Armed Forces of the
Philippines shall have completed at least three (3) years of continuous active
military service. Provided further that separation of unit assignments of
prospective couple who are assigned with the same unit shall be effected
upon contracting the marriage.

4. Military personnel who contract marriage without written


permission from appropriate authority shall:

a. Be referred to the appropriate Efficiency and Separation


Board in case of regular officers.

b. Be reverted to inactive status upon expiration of current


tour of duty in case of reserve officers.

5. Any unmarried female commissioned officer who becomes


pregnant or has been positively found to have given birth or had a miscarriage
or abortion shall be reverted discharged from the service. Provided that in
case of a regular or reserve officer who has satisfactorily rendered a total of
ten (10) years of continuous active commissioned military service, her case
shall be referred to the appropriate ESB.
Maternity Leave

1. Married female member of the AFP shall be entitled to sixty (60)


days of maternity leave with fun pay. It shall be granted in every instance of
pregnancy, irrespective of frequency.

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2. Any married female member of the AFP who has suffered
miscarriage or abortion, shall be made to apply for maternity leave which is
effective one (1) month prior to the expected date of delivery or confinement
or on the date of occurrence and/or confinement or hospitalization.

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ANNEX I
GENERAL HEADQUARTERS
ARMED FORCES OF THE PHILIPPINES
Camp General Emilio Aguinado Quezon City

14 January 2005
(Date)

Circular Nr 01

SUBJECT: AFP Technical Services Uniform

TO: See Distribution

To achieve uniformity and strong sense of identity and pride among


members of the AFP Technical Services, a common uniform is hereby
prescribed for all members.

1. Formal Dress Uniforms

a. Evening Dress Uniform (Mess Jacket). Also known as


Black & White uniform, the mess jacket is the standard formal evening
uniform for the Technical and Administrative Services of the AFP. Male
officers shall wear the black jacket white the female officers shall wear the
white jacket blouse. This is worn during formal military evening dinner’s
receptions and balls and such other functions that can for the wearing of the
mess jacket, equivalent to the civilian formal coat and tie attire. It is a three-
piece ensemble consisting of black white coat jacket a black long pants, ankle
length skirt and white inner long sleeves shirt blouse.

(1) Jacket - The shade is black/white coat jacket made


of 55% polyester and 45% tropical wool fully lined straight back and single
breasted with 6 big AFP brass buttons attached on both sides and 2 small
AFP brass buttons connected to a 5 an chain for front closure.

(2) Trouser - The trousers is in deep back shade of


matching material with the jacket. It is high-waist without pockets. The bottom
of the male trousers' legs rests on the front of the shoes with a slight break in
creases. The back of the trouser legs extends approximately 1.27 cm longer
than the front.

(3) Shirt- For male personnel, the shirt is long sleeves


trubenized-style, conventional dear white soft dress with standing turn down
collar and French cuffs. It is front-pleated w front-pleated with open edge of
pleats facing inward. The front opening is secured by black rounded buttons.
For female personnel, the inner blouse is the same as for the male, except

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that the pleats are replaced by 3 rows of ruffles with gold trimming at the
edge. The buttons at the center are rounded black buttons. Approximately 0.6
cm of the cuffs protrudes from the sleeves of the jacket when the hand hangs
naturally on the side. The shirt is tucked-in to the skirts.

(4) Skirt - The skirt is of deep black shade of matching


material with the jacket. The skirt is ankle length, straight hanging on pencil
cut with no flare from hip to hem. The over lapping slit at the back should
measure from 38 to 46 cm.

(5) Headgear- Pershing cap for males and black felt


cap for females.

(6) Tie- For female personnel, a black satin crescent


neckband is attached under the front collar of the inner shirt. For males, deep
black, silk satin, pre- tied bow tie.

(7) Cummerbund - A sash 12.7 em wide, in deep


yellow, satin shade, pleated without design for female officers and black sash
for male officers. It is worn with open edge of pleats facing upward, and joined
by a hook at the back.

(8) Footwear - The male personnel use the low


quarter black dress shoes. For female personnel, the shoes are of tapered
heel not more than 7.62 em and not less than 5.10 cm in height in black
shade, light gloss leather and skin tone nylon hosiery.

(9) Bag - Plain black patent leather clutch bag.

(10) Accoutrements:

(a) Shoulder boards with rank insignias


(b) Miniature service specialty rating or service
command badge
(c) Miniature medals worn centered on the left
lapel with the top of the holding bar at the lapel's widest part.

b. Dress White - Known as the White Duck, is a formal


daytime uniform for all officers. It is worn during formal daytime military
receptions and weddings, formal calls, ceremonies, during daytime state
functions and formal affairs and when serving as pallbearers during
interments and or neurological services. It is a three-piece ensemble
consisting of a white single- breasted coat, white long pants or pencil - cut
knee-length skirt and white long sleeves inner shirt or blouse.

(1) Coat - The coat is of traditional tailored design with


collar and lapel. It is made of clear white 55% polyester and 45% tropical wool
material. The coat for females is single-breasted and conforms to the contour
of the body but allows ease of movement. It has 2 hanging lower pockets
without flaps and with arms hanging naturally, the sleeves end approximately

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1.27 cm from the heel of the thumb. The coat is fully lined, with white sleeve
braid, 1.27 cm wide for company grade officers and 1.9 cm wide for field
grade officers. The length of the coat is proportionate to the height.

(2) Trousers - The trousers is of matching shade and


material with the coat. The trouser for males is full-cut, straight hanging, with
two side and back pockets and belt loops, cuffless and without pleats. The
two back pockets are covered with flaps. The bottom front of the trousers' legs
rests on top of the shoe with a slight break in the creases. The back of the
trousers legs extends approximately 1.27 cm longer than the front.

(3) Skirt - The skirt is of matching shade and material


as the coat. It is knee high length, and should fit snugly but not tightly around
the waist and hips. It has no pockets and with overlapping back slit and back
closed by zipper.

(4) Shirt - The shirt is dear white, plain woven and


secured with small transparent plastic buttons. It has short pointed standing,
turndown collar without button. When hanging naturally, approximately 0.6 cm
of the cuffs of the sleeves protrudes from the sleeves of the coat. The shirt is
tucked-in to the pants skirt.

(5) Headgear- Pershing cap for male personnel and


black felt cap for female personnel.

(6) Tie - The tie for female personnel is black satin


crescent neckband with 1.5 cm width attached under the front collar of the
shirt. The tie for male personnel is black satin and plain woven. It is a 4- hand
tie without decoration and when worn, should hang naturally from the neck
collar down to the waist and secured to the shirt with an AFP regulation cravat
clasp.

(7) Footwear - the male personnel use the low quarter


black dress shoes. For female personnel, the shoes is of tapered heel not
more than 7.62 cm and not less than 5.1 cm in height in black shade, light
gloss leather and skin tone nylon hosiery.

(8) Bag - Plain black patent leather bag.

(9) Accoutrements

(a) Shoulder boards with rank insignias


(b) AFP coat of arms
(c) Awards and decorations
(d) Service and special badges
(e) Flight badge
(f) Nameplate
(g) Highest military schooling badge

c. Technical Service Blouse - This is the standard semi-

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formal day and evening attire for alt NC office uniform for all Technical Service
officers. It is worn during semiformal day and night military functions and
receptions. It is also worn during the AFP and major service anniversaries and
fn other traditional military ceremonies which honor or have as principal
guests a$ the President and Vice President or Heads of States, of
government of other countries. It is a three-piece ensemble consisting of a
dark-gray single-breasted coat, dark-gray pants pencil cut knee-length skirt
and an inner off-white long sleeves shirt blouse. A black crescent neckband
for is attached under the front collar female of the inner blouse for females
and black tie for the males.

(1) Coat - The coat 15 of trad1tional tailored design,


made of dark gray 55% polyester and 45% tropical wool. The coat is single-
breasted with no breast pockets, and conforms to the contour of the body but
allows ease of movement. It is also closed with 4 large gilded brass AFP
buttons and has 2 hanging pockets without flaps. With arms hanging naturally
on the side, the sleeves will end approximately .06 cm from the heel of the
thumb. The coat is fully lined, with black sleeve braid 1.27 cm wide for
company grade officers and 1.9 cm wide for field grade officers. The length of
the coat is proportionate to the height.

(2) Trousers and skirt - The trousers, and skirt for .the
Technical .Service Blouse are of matching shades and material with the coat.
The design and cut of the trousers and shirt are same as prescribed for the
Dress White. There is however, a .30 cm black stripping of black shade along
the outer seams of the trousers and the skirt of the Technical Service Uniform.

(3) Shirt - The shirt for the Technical Service Blouse is


of the same' design and material as "prescribed for the Dress White but shade
is off white.

(4) Headgear - Pershing cap for male personnel and


black felt cap for female personnel. However, for foreign traveling purposes
and other special occasions as ,prescribed; the oversea cap is the standard
headgear for mare and female personnel

(5) Tie - The tie for female, personnel is black satin


crescent neckband with 5.1 cm width attached under the front collar of the
shirt. The tie for male personnel is black satin and plain woven. It is a 4 hand
tie without decoration and when worn, should hang naturally from the neck
collar down to the waist. It is secured to the shirt with an AFP regulation
cravat clasp.

(6) Footwear - The mates use the tow quarter black


dress shoes. For females, the pump shoes is of tapered heel not more than
7.62 cm in height in black shade, light gloss leather and skin tone nylon
hgosiery.

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(7) Accoutrements:

(a) Metal rank insignia fastened on shoulder


strap
(b) AFP coat of arms
(c) Awards and decorations
(d) Service and specialty badges
(e) Flight badge
(f) Nameplate
(g) Highest military schooling badge

d. Bush Coat - Same as prescribed by higher headquarters


except that the color is dark gray and that female officers wear the skirt with
2.54 cm black cloth piping at the sides and overlapping slit is prescribed.

(1) Footwear- the males use the low quarter black


dress shoes. For females, the pump shoes is of tapered heel not more than
7.62 and not less than 5.1 cm in height in black shade, light gloss leather and
skin tone nylon hosiery.

(2) Accoutrements:

(a) Metal rank insignias on the shoulder strap


(b) Awards and decorations
(c) Service and specialty badge
(d) Flight badge
(e) Nameplate
(f) Highest military schooling badge

2. Casual Dress Uniforms

a. General Office Uniform (GOU) - is the standard military


uniform for general office work and day-to-day duties and activities. It is worn
only with the basic accoutrements and without the display of decorations and
honorary badges on the shirt It is worn on occasions and functions of casual
nature. It consists of a 2-piece ensemble made of an off- white short sleeves
polyester and dark gray tropical wool long pants skirt.

1) Trousers - a full-cut straight banging, cuffless and


without pleats. It has 0.31 cm black stripping along outer seams. The bottom
front of the trouser legs rests on top of the shoes with a slight break in the
creases. The back of the trousers legs extends approximately 27 cm longer
than the bottom front.

2) Skirt - The skirt is knee-length which fits snugly but


not tightly around the waist and the hips. It is one-piece semi-pencil cut with
overlapping back slit and the back closed by zipper. There is a .03 cm black
stripping along the outer seams of the skirt.

3) Shirt - The male shirt is short sleeve of 55%

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polyester and 45% cotton material and off-white shade. The shirt is of
commercial type with standing turndown collar secured in front by six 1.27 cm
round transparent 2 holed plastic buttons. It has shoulder straps and two
breast pockets with flaps secured by matching plastic buttons. It is tucked-in
to the pants when worn.

4) Blouse - The female blouse is of same material


and shade as the shirt. It has a round collar and short sleeves and five (5)
rounds off- white plastic buttons to close the front opening. It has shoulder
straps secured by matching plastic buttons. It has no pockets, with level
bottom and worn under the skirt.

5) Headgear- Overseas cap. Pershing or black felt


cap is used as prescribed.

6) Belt and Buckle - The black web belt is worn along


the waistline over the shirt. The insignia logo for respective Technical Service
and Administrative Services should be embossed on the silver buckle front
surface.

7) Footwear - The males use the low quarter black


dress shoes. For females the shoes are of tapered heel not more than 7.62
cm and not less than 5.1 cm in height, in black shade light gloss leather and
skin tone nylon hosiery.

8) Bag - Plain black patent leather bag.

b. Office Maternity Uniform - This is another modification of


the office uniform and shall be sworn by female members who are pregnant
white on office duty. This is used during maternity period when the use of
standard uniforms is deemed inappropriate.

1) Blouse- Off-white polyester 55% and tropical wool


45%. Round collar and short sleeves with horizontal cut both front and back.
Front has 2.54 an two way pleats meeting at the center each on both sides
and another one at the center of the back. The length is up to the end of the
torso.

2) Skirt - Dark gray semi-pencil cut, with 20 cm


overlapping slit at the back. Front upper portion is replaced by a stretchable
dark gray cotton doth.

3) Paraphernalia and accessories are the same as


that on the General Office Uniform (Class 81).

c. Cold Weather Uniform - the cold weather uniform is long


sleeve version of the General Officer Uniform. It is worn with the prescribed
regulations necktie. Cold weather attire is worn in cold areas, particularly
when on schooling or assigned in cold-weather countries.

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1) Trousers and skirts - The trousers and skirts are


the same as prescribed for the General Office Attire.

2) Shirt - The shirt is long sleeve, with French cuff, off


shade as prescribed for the shirt of the General Office Attire made of 55%
polyester and 45% tropical wool. It is of commercial type, trubenized style with
standing turn down collar and shoulder strap and secured in front by small
transparent p1astic buttons. 1t has 2 breast pockets with flaps and closed by
matching plastic buttons. The female personnel wear the same shirt material
as that of the male personnel. The shirt is tucked in to the pants or the skirt.

3) Trousers and Skirts- the same as prescribed for


the GOU.

4) Headgear - Oversea cap is the prescribed


headgear, when worn with basic accoutrement while Pershing cap for males
and black felt cap for female personnel when worn with complete
accoutrements and as prescribed.

5) Tie -The tie for female personnel is black crescent


neckband with 5.1 cm width attached under the front collar of the shirt. The tie
for male personnel is black satin and -plain woven. It is a 4- hand tie without
decoration and when worn, should hang naturally from the neck collar down to
the waist. It is secured to the shirt with an AFP regulation cravat clasp.

6) Belt I buckle - the same as prescribed for the


GOU.

7) Footwear -the same prescribed for the GOU

d. Cold Weather Jacket- Black and tailored and patterned


using the same materials of the major service jacket. 1t has flat cuffs with 2
snap buttons. .'t is used when assigned in places requiring the use of
additional clothing such as during cold weather seasons and while in regions
of colder climate.
.
3. Functional Dress Uniform

a. Battle Dress Uniform (BDU) - The BDU is the standard


combat uniform for both male and female military personnel of the Technical
and Administrative Services. It is normally worn for maximum cover and
concealment in the hostile environment. It is also worn as a field formation
uniform for practiced drills and ceremonies and filed training exercises. It is
also the standard uniform in disaster relief, search and rescue Operations and
on red alert status. The BDU consists of the following:

1) Trouser - The rip- stop trouser is made of 100%


cotton fabric in woodland camouflage' pattern. It is full-cut, straight hanging
and cuffless. Aside from the normal seam pockets, and 2 back pockets with
flaps, the trouser has also 2 patch pockets secured with flaps below the seam

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pockets. The trouser has belt loops. When worn, the lowest part of the trunks
must be secured with a garter on top of the upper edge of the combat boots.

2) Shirt - The shirt is of the same material and


camouflaged pattern as the trousers. It is long-sleeved, single-breasted, with
2 breast patch pockets and 2 bottom patch pockets, all covered with flaps. It
has a straight cut bottom sleeve tabs, and side body panels with take-up tabs.
It may be worn with rolled-up sleeves during ordinary occasions or unrolled
sleeves when situations require protection. The patch of respective Technical
Service is sewn on the left upper arm sleeve. The name cloth shall be
secured above the right breast pocket.

3) Headgear - The camouflage cap with cloth rank


insignia sewn at the center of the front of the cap is the prescribed headgear
for the Battle Dress Attire.

4) Belt and Buckle - The olive drab web belt is worn


along the waistline over the shirt. The respective Technical Service and
Administrative service insignia logo shall be embossed on the silver buckle
front surface.

5) Footwear - the tropical combat boots with black


upper canvass and black woolen socks shall be worn.

b. Flight Duty Uniform- is the standard uniform of Technical


Service officers on flying status such as flight surgeon nurse. This uniform is
lightweight made of polyamide, sage green in color and is fire resistant. This
is worn while engaged in flight duties performing aero- medical evacuation
functions and during flight alert days. Flight wings, name and rank will be
printed on plain black leather patch and shall be attached above the right
breast pocket.

c. Hospital Duty White Uniform (For Nurses) - There is two


(2) types of Duty White Uniform for Nurses: one for male nurses, and the
other for female nurses. The Nurses Duty White Uniform is the standard
uniform for nurses while on hospital duty. It consists of the following:

1) Shirt - The shirt is of dear white shade, made of


55% polyester and 45% cotton, with quarter length sleeves and open collar. It
has one left breast slit pocket and 2 lower patch pockets. The bottom is level,
and the shirt is worn outside the trousers.

2) Trousers - The trousers for male nurses is the


same as prescribed for the General Office Uniform.

3) One-piece Dress - One Piece-Dress is prescribed


for female nurses. It is made of 55% polyester and 45% clean white cotton,
one-piece material, open from neckline to hem and overlapping towards the
left. The upper half of the uniform has shoulder yoke with 5 cm pleats on each
side. It is dosed with 3 large white plastic buttons, equally spaced, and

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detachable 5 cm waistband, buttons set 12.5 cm apart. The collar is tailored


notched lapel with pointed corners, while the sleeves are short with pointed
cuffs and fastened with small white round plastic back to back buttons equally
spaced. The slit pockets are set diagonally on both sides of skirts panels.

4) Headgear- White nightingale cap for females.


There is no prescribed headgear for male nurses when wearing the uniform.

5) Footwear - Male nurses shall wear the low quarter


black dress shoes and plain black cotton socks. Female nurses shall wear
white-laced soft leather shoes, plain rounded toe without perforations or
decorations and white nylon hosiery.

4. Athletic Uniform

a. Physical Fitness Uniform

1) General use for athletics as prescribed

2) Occasions for wear- use when engaged in athletic


activities

3) Description:

(a) Shirt- plain white short sleeves with sports


collar
(b) Shorts- plain white mid- thigh in length
(c) Footwear- white rubber shoes and white
socks

b. Sports Competition Uniform- as prescribed by


commanders

5. Uniform Items

a. Headgear - The headgear prescribed for officers are the


Pershing Cap, oversea garrison cap and camouflage patrol cap for males;
and the black felt cap, oversea garrison cap and the white nightingale cap for
females.

1) Pershing Cap - is a black visor-type, the crown in


matching shade and material. It has a braid of open mesh construction
chinstrap running on top of the visor and connected to the side, together with
the black plastic back strap, by 2 small gilded buttons. The mesh-constructed
braid and the gilded buttons are of brass shade. The AFP coat of arms is
placed at the front center of the crown. For Pershing cap of field grade officers
(Major to 9o10nel), the visor and side strap is adorned with gold shaded laurel
bullion.

2) Black Felt cap - is the counterpart of the Pershing

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Cap for female military personnel. It is made of black felt material and
rounded crown with rolled sides forming a front brim. The black felt cap of field
grade officers (Major to Colonel), the visor is adorned with gold shaded laurel
bullion.

3) Gray Oversea! Garrison cap - is made of 55%


polyester and 45% tropical wool in matching service color with the brass AFP
Coat of Arms pinned on the left front side and the miniature metal rank on the
right front side.

4) Camouflage cap- It shall be the same as that


issued with the Battle Dress Uniform and normally worn when using the said
uniform, or as prescribed by the commander.

5) White Nightingale cap- this is secured at the back


by three small white plastic back to back buttons and used when on duty in
hospitals.

b. Raincoat- This is made of black waterproof, polyvinyl


nylon loose fitting with coat extending to between kneecap and midcalf and
the sleeves extending to the base forefinger. It has 6 buttons, double-
breasted with matching belt and plastic clip buckle, with button throat closure
and shoulder and sleeve strap.

c. Umbrella- It is plain black for all military personnel. For


male military personnel, it is only authorized during rainy days.

d. Sweater- It is plain white for hospital duty uniform.

e. Handbags - both the clutch bag and shoulder bag are


prescribed for female officers only.

1) Clutch bag -It is plain black leather clutch bag. It


measures 25.4 cm long, 14 cm wide and 5.08 cm thick.

2) Shoulder bag - It is plain black made either of


calfskin or kid leather, with fold over flap and a plain fastener. It measures
25.4 cm long, 17.5 cm wide and 6.4 cm thick. It is provided with 2.5 cm width
adjustable strap.

f. Name Plate - The standard nameplate on the military


uniform is black plastic, laminated, with white letter, block style engraved on
the plastic. The tag is 3 inches long, and '% inch wide and % lettering. Only
the surname will appear in capital block letters in the nameplate. For hospital
duty uniform, the surname on black letters is 1 cm embroidered on white doth
measuring 8.3 cm long and 2 cm wide background and is sewn above the
right breast pocket.

g. Grade Rank Insignia - For hospital duty uniform, it shall


be embroidered on white cloth background and sewn on the right collar. For

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male HC Officers, rank insignias shall be worn vertically while female NC


officers shall wear it horizontally. This is applicable to hospital duty uniform
only. For flight nurses, the grade rank insignia shall be sewn on both left and
right collar.

h. Nurse Corps Caduceus- For hospital duty uniform, it


shall be embroidered on white cloth background and sewn on the left collar.

i. Earrings - The standard material and size of earring to


be worn with all types of female uniforms is made of pearl and must be only
0.6-0.7 cm in diameter. For the evening dress uniform diamond or pearls
earrings bigger in diameter but not more than 1 cm can be used.

j. Awards and Decorations - military personnel shall wear


their medals and ribbons as prescribed.

k. Protective Equipment and Clothing - military personnel


are authorized to wear protective or reflective items (vest, jackets, armbands,
or other occupations health or safety equipment) with the uniform when
safety or health consideration makes it appropriate.

CONCLUDING PROVISIONS

RECISSION CLAUSE. All AFP directives and policies not in


consonance with this letter Directive are hereby rescinded and/or modified
accordingly.

EFFECTIVITY: This letter-Directive is effective upon publication.

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RECORD OF CHANGES

Identification of change or Date By Whom entered


Correction and Reg. No. (if Entered (Signature, Rank, Grade,
any) Name or Rate, Name of
Command)

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RECOMMENDATION FOR CHANGES

_____________________________________
________________________________
_________________________
(Originating Agency)

________________
(Date)

SUBJECT: Recommendation for Changes

TO: Commanding Officer


Doctrine Center, TRADOC
Fort Bonifacio, Makati City

The following recommendation is submitted for improvement of


_____________________________________________________________
(Short Title)

________________________________ __________________________
(Long Title) page
________________________________ __________________________
Article Para. No. Line Sentence

________________________________
Figure No.

Comment:

Recommendation:

_____________________________
(Signature of CO)

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