�TYPES OF LEADERSHIP ● Successful communication

1. Autocratic - high control ➔ Clear message

2. Bureaucratic - based on following normative rules and adhering to lines of ➔ Careful listening
authority. ➔ Monitoring responses
3. The coaching style - define roles and tasks of followers but seeks their ➔ Providing feedback
input and suggestions too. ● Causes of distorted communication
4. Emergent leadership 1. Metacommunications - oral messages accompanied by nonverbal messages.
5. Laissez faire - leaders are hands-off and allow group members to make the 2. Intrasender conflict - non verbal communication can distort the meaning of the spoken words.
decisions. 3. Intersender conflict - person gets conflicting messages from different sources.
6. Situational - there are four options: telling, selling, participating and 4. Other causes:
delegating. - Using inadequate reasoning.
7. The servant leadership - putting the needs of the followers first. - Using strong, judgemental words
8. Charismatic - relies on the charm and persuasiveness of the leader. - Speaking too fast or too slowly
9. Democratic - also known as participative leadership, is a type of leadership - Using familiar words
style in which members of the group take a more participative role in the - Spending too much time on details
decision-making process. - Busy too much time on details
- Busy or distracted recipient
�TRANSFORMATIONAL [Focuses on goals not matter what] - Previous negative experience with sender
1. Identify and clearly communicate vision and direction. - Biased perception of message or sender.
2. Empower the work group to accomplish goals and achieve the vision. ● The role of communication in leadership
3. Impart meaning and challenge to work. 1. Leaders who engaged in frank, open, 2-way communication are seen as informative.
4. Are admired and emulated. 2. Communication is enhanced when the manager listens carefully and is sensitive to others.
5. Provide mentoring to individual staff members based on needs. 3. A major underlying factor is an ongoing relationship between the manager and employees.
�TRANSACTIONAL [Day to day bases] 4. Successful leaders are able to persuade others and enlist their support.
1. Focus on day-to-day operations and are comfortable with the status quo. ● Communicating with subordinates
(the existing states of affairs) 1. Good communication is the adhesive that builds and maintains an effective work group.
2. Reward staff for desired work. 2. Giving direction
3. Monitor work performance and correct as needed; or 3. Know the context of the instruction
4. Wait until problem occurs and the deal with the problem. 4. Get positive attention
�LEVELS OF MANAGEMENT 5. Give clear, concise instructions
1. Top level managers 6. Verify through feedback
2. Middle level managers 7. Provide follow-up communication
3. First line managers ● Communicating with superiors
1. Working effectively with a supervisor is important because this person directly influences personal success in a career
�3 TYPES: SKILLS OF MANAGERS and within the organization.
1. Technical skills - involves method, procedures, techniques and knowledge 2. Managing a supervisor is a crucial skill for nurses
of work being performed. 3. Managing upward is successful when power and influence move in both directions.
2. Human relation skills - ability to motivate and lead others and to manage 4. Understand the superior’s position from her/his frame of reference.
conflict.
3. Conceptual skills - requires analytical thinking and being able to perceive
trends of the organization. ● Improving communication skills
1. Consider your relationship to the receiver
�COMMUNICATION 2. Craft your message
● Factors affecting communication 3. Be clear about your goal
➔ Participant’s past conditioning 4. Decide on the medium to use
➔ The situation 5. Check your timing
➔ Each person’s purpose in the communication 6. Be prepared when you deliver your message
➔ Attitude toward self, the topic, and each other 7. Attend to responses
8. Reply appropriately
 9. Conclude when messages are understood ❏ Lose-lose
10. Evaluate the process - neither side wins
❏ Win-win
�CONFLICTS - focuses on goals and meeting the needs of both parties
1. Intrapersonal conflict - within 1 individual - Consensus involves attention to facts and the position of the other parties.
2. Interpersonal conflict - between 2 or more individual
3. Intragroup conflict - within 1 group 2. Other
4. Intergroup conflict - between 2 or more groups ❏ Confrontation [win-win]
- Considered the most effective means for solving
● Conflict is dynamic - Problem-oriented technique in which the conflict is brought out into the open
- It can be positive or negative - Attempts are made to resolve it through knowledge and reason
- A certain amount of conflict is beneficial to an organization - Goal is to achieve
- Aggressive behavior can occur ❏ Negotiation
- Scapegoating may occur - Involves give-and-take on various issues among the parties
- Conflict may be covert and inappropriate - Seeks to achieve agreement even though consensus will never be reached
● Conflict can inspire change by - Can be guided by levenstein’s ten commandments for negotiation.
- Increasing sensitivity to an issue ❏ Collaboration
- Inspiring people to develop new ideas or identify new methods for - Mutual attention to the problem, in which the talents of all parties are used
solving problems ❏ Compromise
- Helping people become more aware of trade offs, especially costs - Used to divide the rewards between both parties
versus benefits - Neither gets what he/she wants
- Motivating people to improve performance, effectiveness and ❏ Competing
satisfaction. - An all-out effort to win regardless of the cost
● Managing conflict ❏ Accommodating
- Conflict management begins with a decision regarding if and when - Unassertive, cooperative tactic used when individuals neglect their own concerns in favor of other’s
to intervene concerns
- Sometimes it is best to postpone intervention: increased intensity ❏ Suppression
can motivate participants to seek resolution. - In situations where conflict is discouraged
● Rules for mediating conflict - Could include elimination of one of the conflicting parties through transfer or termination.
- Protect each party’s self respect
- Do not put blame or responsibility for the problem on the
participants
- Allow open and complete discussion of the problem from each ❏ Avoiding
participant - Participants never acknowledge that conflicts exists
- Maintain equity in the frequency and duration of each party’s ❏ Withdrawal
presentation - Simply removes one party
- Help the participant’s develop alternative solutions ❏ Smoothing
- At an agreed-upon interval, follow up on the progress of the plan - Complimenting opponent, downplaying differences focusing on areas of agreement.
- Give positive feedback to participants
- Encourage full expression of positive and negative feelings in an �PRIORITIZATION AND DELEGATION
accepting atmosphere ● What is delegation?
- Make sure both parties listen actively to each other’s words - It is a process of assigning responsibilities and authority of co-worker and ensuring his accountability [Basavanthappa]
- Identify key themes in the discussion - Transfer of responsibility for the performance of a task from one individual to another [ANA]
- Encourage the parties to provide frequent feedback. - Transfering of the authority to a competent individual to perform.
● Strategies dealing conflicts ● Components of delegation
1. Filley’s strategies 1. Care outcomes
❏ Win-lose 2. Accountable and responsible
- one party exerts dominance, the other party 3. Sharing activities
submits and loses. 4. Appropriate authority
● Essential aspects/dimension of delegation 6. The RN delegates based on the knowledge and skill of the person selected to perform the tasks.
1. Assignment of the duty 7. The RN cannot delegate an activity that requires the RN’s professional skills and knowledge.
2. Grant of authority 8. The RN is accountable for the delegated task.
3. Creation of accountability 9. The RN must evaluate patient outcomes resulting from the delegated activity.
● Principles of delegation 10. Health care facilities can develop specific delegation protocols, provided they meet the state boards delegation guidelines.
1. Assignment of authority 11. Delegation requires critical thinking by the RN
2. Parity of authority
3. Clarifications of limits if authority ★ PATIENT NEEDS
4. Unity of command - Tasks can be delegated, nursing practice cannot.
● Rights of delegation - The functions of assessment, evaluation, and nursing judgement cannot be delegated
1. Right task - Tasks that can be delegated may also carry with them a nursing responsibility.
2. Right circumstances
3. Right person ★ ACTIVITIES THAT THE NURSE MAY NOT DELEGATE INCLUDE:
4. Right communication - Initial nursing assessment and any subsequent assessment that requires professional nursing knowledge, judgement and skill.
5. Right supervision - Determination of nursing diagnoses, establishment of nursing care goals, development of the nursing plan of care, and evaluation
of the patient’s progress with the nursing plan of care.
● Responsibilities of delegators - Any nursing intervention that requires professional knowledge, judgement, and skill.
1. Have a view of the big picture in the care of the assigned patients.
2. Select the appropriate activities to delegate
3. Select the appropriate staff to carry out the activities
4. Clearly communicate the expectations and required follow up. ★ PROVIDE APPROPRIATE SUPERVISION
5. Follow up periodically while the task is being completed - Monitor performance to ensure compliance with established standards of practice, policies, and procedures.
6. Evaluate and provide feedback on the effectiveness of the - Obtain and provide feedback.
delegation to staff. - Intervene if necessary.
● Responsibilities of delegatee - Ensure proper documentation.
1. Accepting the delegated activities as directed by the nurse
supervisor ★ UAP/PCT/NA
2. Give report to supervisor on the delegated task - 6 mos. training/OJT/certificate
3. Give feedback to the delegator on the effectiveness of the - Can do the following.
delegation process. Vital signs taking
● Legal authority to delegation Assists in ambulation
1. Nursing practice act Assist in ADL’s
2. Employer’s statement including job descriptions, policies and - Reports to LPN
procedures.
● Delegation is a two-way process ★ LPN/LVN
1. The RN requests that a qualified staff member (UAP, LPN/LVN) - 2yrs education
perform a specific task. - Can do the following.
2. A task is delegated , the delegator shares with the delegatee the Mostly medication
ultimate responsibility and authority for the accomplishment and 3 days post op, stable patient
outcome of the task. Standard and unchanging treatment
3. The RN remains accountable in every tasks given to subordinates. Everything that UAP/PCT/NA can perform
- Reports to RN
★ POLICIES COMMON TO MANY NURSING PRACTICE ACTS
1. Only nursing tasks can be delegated, not nursing practice. ★ RN/ADN
2. The RN must perform the patient assessment to determine what can be - 4yrs education for RN/ 2yrs for ADN
delegated. - ADN can do everything except documentation
3. The LPN/LVN and UAP do not practice professional nursing.
4. The RN can delegate only what is within the scope of nursing practice. �DO NOT DELEGATE!!!
5. The LPN/LVN works under the direction and supervision of the RN - Assessment
 - Health teaching
- Evaluation
�PRIORITY RANKING OF PATIENTS
● First level patient problems
- These are threats to a patient’s immediate survival or safety and
demand immediate nursing intervention.
- AIRWAY, BREATHING, CIRCULATION
● Second level patient problems
- Concerns such as mental status change
- Acute pain
- Acute urinary elimination
- Untreated medical problems requiring immediate attention [Diabetic
needing insulin]
- Abnormal pathology lab results
- Risk of infection, safety or security
● Third level patient problems
- Those that do not fit into the above 2 categories such as monitoring
for medication side effects, lack of patient knowledge, longer-term
problems with living activities, etc.
- When no life-threatening problems exist, the nurse used both
professional judgement and the patient to set priorities and
determine planning.
- This is a continually changing aspect of assessment of patients.
�ADDITIONAL PRINCIPLES OF PRIORITIZATION
✓ Know need and priorities of each patient
- To identify which clients need assessment first, the nurse uses
information from the change of shift report and the patient’s acuity
level.
- After initial nursing assessments are completed, the nurse ranks
individual client needs in terms of priority or urgency.
✓ Consider all factors
- Available resources and staff
- Qualifications of staff
- What things can be delegated to others
- How much time is involved in some skills
✓ Always remain flexible
- During the course of the shift priorities may need to be reevaluated
and recognized depending on changes in acuity levels, new
admissions, etc.
✓ Use of creativity
- Emphasize patient’s abilities and strengths so that they may learn
to assume more self-care
- Encourage family participation in care
�PROFESSION
- A calling in which members to have acquired special knowledge, by training or experience or both, so that they may guide, serve or
advice others in that special field.
● Characteristics of a Profession
Accountability/liability for the result
Caring profession
Competent
Ethics
Service oriented
Specialized scientific body of knowledge and skills
�NURSING
- A discipline involved in the delivery of health care to the society
- A helping profession
- Service-oriented to maintain health and well-being of people
- An art and a science.
● Nursing as a profession
- Bachelor of science in nursing
- Licensed to practice nursing in the country
● Nursing is a profession
- Calling: service oriented
- Others: patients
I attribute my success to this - I never gave or took any excuse. F.Nightingale
�REPUBLIC ACT 9173 [NURSING ACT OF 2002]
★ Legal basis of professional nursing practice
★ Defines nursing, set standards for the nursing profession and give guidance in the scope of practice.
★ Contains general statements of appropriate nursing actions.
★ Protect the general public.
�QUALIFICATIONS FOR ADMISSION TO PNLE
a. he/she is a citizen of the Philippines, or a citizen or subject of a country which permits Filipino nurses to practice within its territorial
limits;
b. he/she is of good moral character; and
c. he/she is a holder of bachelor’s degree in nursing from a college or university that complies with the standards of nursing education
duly recognized by the proper government agency.
● Subjects of PNLE
NP1 community health nursing
NP2 care of healthy/at risk mother and child
NP3 care of clients w/ physiologic and psychosocial alterations (A)
NP4 care of clients w/ physiologic and psychosocial alterations (B)
NP5 care of clients w/ physiologic and psychosocial alterations (C)
● RATINGS
- An examinee must obtain a general average of at least 75% with a rating of not below 60% in any subject.
- An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject must take the
examination again but only in the subject or subjects where he/she is rated below 60%.
�LAW
 ● REGISTRATION OF NURSES
- All nurses whose names appear at the roster of nurses shall be
automatically or ipso facto registered as nurses under this Act upon its
effectivity.
● REGISTRATION BY RECIPROCITY
- A certificate of registration/professional license may be issued without
examination to nurses registered under the laws of foreign state or country.
- The requirements for registration or licensing of nurses in said country are
substantially the same as those prescribed under this act.
- The laws of such state or country grant the same privileges to registered
nurses of the Philippines on the same basis as the subject or citizens of
such foreign state or country.

● NON-REGISTRATION AND NON-ISSUANCE OF CERTIFICATES OF �LAW [BATAS 101]

REGISTRATION/PROFESSIONAL LICENSE ❗ REPUBLIC ACT 9173 [NURSING ACT OF 2002]
- No person convicted by the final judgement of any criminal offense involving - Legal basis of professional nursing practice
moral turpitude or any person guilty or immoral or dishonorable conduct or - Defines nursing, set standards for the nursing profession and give guidance in the scope of practice.
any person declared by the court to be of unsound mind shall be registered - Contains general statements of appropriate nursing actions.
and be issued a certificate of registration/professional license or a - Protect the general public.
special/temporary permit. ❗ Good Samaritan Act
- The board shall furnish the applicant a written statement setting forth the - During emergency, national calamity, national epidemic there is no doctor around the life or the patient is in possible danger, then
reasons for its actions, which shall be incorporated in the records of the you can give drugs alone provided you know the drugs for the patients.
board. ❗ RA 8344
- No deposit policy during emergency cases only
● REVOCATION AND SUSPENSION OF THE CERTIFICATE OF ❗ PD 8976
REGISTRATION/PROFESSIONAL LICENSE - Micronutrient supplement act.
A. Unprofessional and unethical conduct; - Vit. A, Iron supplements, Iodine
B. Gross incompetence or serious ignorance; ❗ PD 825
C. Malpractice or negligence in the practice of nursing; - Environmental Sanitation Law of the Philippines
D. Use of fraud - It is cleanliness of the environment. Outside the institution
(eg. proper disposal of excreta, proper drainage system)
�INDEPENDENT NURSING ACTIONS ❗ PD 856
1. Promotive, preventive, curative and rehab care in all health care service. - Sanitation Code of the Philippines
2. Health education - Involves proper sanitation of an institution that engage in food and water supply. Inside the institution. (eg. canteen, mineral water
3. Utilizes nursing process store, public market, sex shop (adonis, pegasus, chicos) not applicable to private sex practitioners.)
4. Link of patients in different health care services ❗ PD 996
5. Collaboration of patient’s care for continuity of patient care - Expanded Program on Immunization [EPI] Law.
6. Train nursing students - Compulsory immunization of children below 9y.o
7. Supervision of subordinates ❗ RA 7160
8. Accurate recording and reporting - Local Government Code
9. Execution of valid doctor’s order (the only one that is dependent nursing - Decentralization or devolution of care. The DOH together with DILG and local government units (brgy.,provincial) together with
action) community participation they made a local health board which is the MAYOR.
10. Perennial suturing after training - Purpose of local health board: It makes quality health care available, accessible and proximal for all.
11. Perform IE if antenatal bleeding is absent and before full delivery. ❗ PO 539
★ ALERT: a doctor’s order is valid when giving medication is when it is put into - Nurses Week
writing and signed by the physician. Whatever is not put into writing is - Declared by Pres. Garcia: law declaring the last week of October as the official nurses week.
considered not ordered by the physician. ❗ RA 6675
 - Generic Act - Hospital based venue
- All prescribed drugs must be written in generic and brand name or generic - Duties are routinary and supervised
name but never the brand name alone - Acquired different learning and technical skills
- PURPOSE: for the patient to choose what brand name they want - Coordination with HCT
❗ RA 6425 - Specialized areas
- Dangerous drug act of 1972 ➢ Nurse generalist - community nurse
- The administration and regulation of the manufacture, distribution, ➢ Nurse specialist - staff nurse
dispensing of controlled drugs. ● NURSING ADMINISTRATOR
- Persons authorized to prescribe or dispense these drugs are required to Qualifications:
register and have a special license for this purpose. - BSN and RN
1. Prohibited drugs - Accredited Philippine org
2. Regulated drugs - Nine units of masters
❗ RA 7877 - Experience of 2yrs.
- Anti sexual harassment law ● CHIEF/DIRECTOR
- Committed by any person who exercises authority. (eg. Teacher to student, Qualifications:
head nurse to staff nurse) - RN
- That person who is in authority is asking for a sexual favor in an exchange of - Experience of 5yrs (supervisory)
another favor. - MAN
❗ PD 223 ● OCCUPATIONAL HEALTH NURSING
- PRC act - Industria; or company health nurse
❗ RA 1080 - Duties:
- Board/Bar eligibility ❏ curative/rehabilitative
❗ RA 7600 - Care for sick/injured laborers
- Baby friendly hospital (ROOMING IN) - Referral
❗ EO 51 - Visit and follow ups (home visits)
- Milk code (Breast milk) ❏ promotive/preventive
❗ RA 8981 - Nutritional
- PRC modernization act of 2000 - Safety and sanitation
❗ RA 11223 - Counselling
- Universal healthcare act ● CLINICAL INSTRUCTOR
❗ RA 11166 Qualifications:
- An act strengthening the Philippine - Accredited nursing org
- Comprehensive policy on human - MAN in nursing or other health courses
- HIV and AIDS prevention, treatment, care, and support, and reconstituting - One yr clinical experience
the Philippine national AIDS council (PNAC). Repealing for the purpose RA - RN
8504, otherwise known as the “Philippine AIDS Prevention and Control Act” ● DEAN
and appropriating funds therefor. Qualifications:
❗ RA 8504 - RN
- Philippine AIDS prevention and control act - Experience of 5yrs
- MAN

�PUBLIC HEALTH NURSING

● FIRST PHC
- Date: 1978
- Place: Alma Ata
- Country: Russia
- Local version of F. Marcos after 1yr of Alma Ata
�AREAS OF NURSING PRACTICE - Conference: Letter of Instruction 949 that mandates that all public workers to have a duty of promotive and preventive
● INSTITUTIONAL NURSING care for the patient.
 ○ TESTATE SUCCESSION - son or daughter will inherit the last will of the parents
�SCHOOL OF NURSING IN THE PHILIPPINES ○ INTESTATE SUCCESSION - without last will and testament
● UP - 1st with 4yrs ● Will - it is legal declaration of a person’s intentions upon death.
● First Nursing School [6months] ➢ PROPERTY
- Iloilo Mission Hospital (1906) 1. Notarial/Ordinary will
- PGH School of Nursing (1907) - Check LOC
- St. Luke’s School of Nursing (1907) - Check proper location of signature - end part of all the pages at the side
- Mary Johnson’s School of Nursing (1907) - Nurses can be a witness
- St. Paul Iloilo (1907) 2. Holographic will
- San Juan de Dios (1907) - During emergency cases
- No witness involved call a person who knows and familiar with the handwritten of the testator
�PHILIPPINE NURSES ASSOCIATION - Entire last will and testament is handwritten dated and signed by the testator.
● When was PNA founded: Oct. 22, 1922 (10-22-22) ➢ LIFE BODY
● Who is the founder PNA: Anastacia G. Guiron Tupas 1. Advance Directives
● Purposes: - Respectful death
- Professional well-being - direction/instruction of the patient in advance
- Unity - DNR, donate organ, cremation
- Promotes reciprocity even outside the Philippines
- Advancement of the knowledge and skills of the nurse �MEDICATION AND PRESCRIPTION
- Ethics promulgation ● Only registered medical, dental and veterinary practitioners are authorized to prescribe drugs.
● 3 information
�CONTRACTS AND CONSENT 1. Name of the MD, address of the clinic/hospital and PRC license #
● Characteristic of a valid consent 2. Name of the patient, age, sex
- Voluntariness 3. Drug name, frequency, duration of the drug
- Opportunities to ask questions be explained to patients ● ROLE OF THE NURSE IN DRUG ADMINISTRATION
- Treatment explained to the patient - The nurse is also responsible for ensuring that they have the knowledge to ensure the correct administration of drugs.
- Understood by patient This includes pharmacology, anatomy and physiology, and legal issues.
- Matured both physically and mentally - Medication charts are legal documents and must be completed accurately and unambiguously in order to ensure that
● Criteria of a good consent patients receive safe and optimal drug therapy.
- 18y.o and above ● SCOPE OF DUTIES AND RESPONSIBILITIES IN IV THERAPY
- Mentally capacitated (absence of insanity and imbecility) - Interpretation of the doctor’s orders for IV therapy
- If below 18y.o and mentally incapacitated a proxy consent in - Performance of venipuncture, insertion of needles, cannulas except TPN and cut down.
chronological order: - Preparation, administration, monitoring and termination of intravenous solutions such as additives, intravenous
1. Parents medications, and intravenous push.
2. Guardian - Administration of blood/blood products as ordered by the physicians.
3. Physician (if parents and guardian are dead) - Recognition of solutions and medicine incompatibilities
- Guardian Ad Litem: social worker or surgeon - Maintenance and replacement of sites, tubing, dressings, in accordance with established procedures
- Establishment flow rates of solutions, medicines, blood and blood components
�NURSES AND ILLEGAL DETENTION - Utilization of thorough knowledge and proficient technical ability in the use/care, maintenance and evaluation of
● It happens if someone will limit the freedom of the patient to move or travel intravenous equipment.
from one place to another. - Nursing management of total parenteral nutrition, out-patient intravenous care
● HIV patient: should kept in one room (all HIV pt in 1 room) - Maintenance of establish infection control and aseptic nursing interventions
- Maintenance of appropriate documentation, associated with the preparation, administration and termination of all forms of
Felacio - oral sex - most fastest mode of transfer
intravenous therapy.
Cannalingus - tongue on clitoris
Analingus - tongue on anus - least mode of transfer �DOCUMENTATION, RECORDING AND CHARTING
�LAST WILL AND TESTAMENT ● Purpose of patient’s chart
● Act whereby a person is permitted by the law to have control in the manner - Communication and continuity of care
of disposing/giving his estate but will take effect at the time of his death. - Assurance of quality of care
 - Research ● According to source of authority
- Legal document ❏ DIVINE LAW
- Statistics of disease - Laws authority by God
● Do’s in charting ❏ HUMAN LAW
- Full, factual and objectively accurate - Laws authored by men
- Legible ❏ PRIVATE OR CIVIL LAW
- Immediate - Body of law that deals with relationship among private individuals.
- Personal ❏ PUBLIC LAW
● Don’ts in charting - Bod of law for the welfare of the general public: relationship between individuals and the government agencies.
- Language, jargons or words which are unacceptable ➢ PUBLIC LAW
- Improper corrections ➔ Department of law which is concerned with the state in its political or sovereign capacity. It is a law that applies generally
- Spaces and skips to people of the state adopting or enacting it.
- Abbreviation ★ CRIMINAL LAW
- Treats the nature, extent and degree of every crime and adjust to it the adequate and necessary penalty.
�LEGAL DOCTRINES OF NURSING ★ INTERNATIONAL LAW
● Responsibility - The law which the intercourse of nations.
- Is the obligation to perform duties, tasks or roles using sound - PUBLIC INTERNATIONAL LAW - control the conduct of independent state in their relation to each other.
professional judgement and being answerable for the decisions - PRIVATE INTERNATIONAL LAW - conflict law
made in doing this. ★ POLITICAL LAW
● Accountability - Regulates the relation between state and individuals that compose it.
- Is being able to give an account of one’s nursing judgements, - CONSTITUTIONAL LAW - law that relates the constitution, as permanent system of political and juridical
actions and omissions. Accountability is about maintaining government as distinguished from statutory and common law, which relate to matters subordinate to such
competency and safeguarding quality patient care outcomes and constitution.
standards of the profession. ★ ADMINISTRATIVE LAW
● Accountability to the client - The body of rules and regulations and orders and decisions created by administrative agencies of government.
- The foremost accountability of the nurse is to the client. You hold ★ LAW OF PUBLIC ADMINISTRATION
yourself out to the client as someone having the special knowledge, ★ LAW OF PUBLIC CORPORATION
training and skills associated with nursing.
➢ PRIVATE LAW
➔ Law that relates the private matters which do not concern the public at large.
★ CIVIL LAW - organizing the family and regulating the property
● Accountability to the employer ★ COMMERCIAL LAW - relates to the rights of property and the relations of persons engaged in commerce.
- As an employee you have the responsibility to work within the ★ REMEDIAL LAW - methods of enforcing rights or obtaining redress (correcting the wrong)
scope of employment as defined by the employer. You are ● LAWSUIT
responsible to know your terms of employment, and to work within - Proceeding in court for a purpose.
those terms. - Purpose:
● Accountability to the profession 1. Enforce a right
- As a nurse you are accountable to meet the standards of your 2. Redress a wrong
profession. These standards may be contained in the nursing act ● PARTIES TO A CASE
itself or in regulations accompanying that act. - Complainant vs Defendant: CIVIL CASE
- Plaintiff vs Accused: CRIMINAL CASE
�NURSING JURISPRUDENCE ● WITNESS
- Department of law which comprise all legal rules and principles affecting the - An individual held upon to give necessary details either for the accused or against the accused.
practice of nursing ● STATUTE OF LIMITATIONS
�NURSING LEGISLATION - Refers to the length of time following the event during which the plaintiff may file a suit.
- The making of laws, or the body of laws already affecting the practice of ● DUE PROCESS
nursing. - A fair and orderly process which aims to protect and enforce a person’s right.
- requirement:
�LAW 1. Right to be informed
 2. Right to remain silent - The employer is liable upon finding that he has been negligent in the selection of his (culpa in eligiendo) or in the supervision of his
3. Right to competent counsel employees (culpa in vigilando).
4. No use of violence, threat, torture �FORCE MAJEURE
5. Right to know the witness face to face - Essentially fees both parties from liability or obligation when an extraordinary event or circumstance beyond the control of the
● WRITTEN ORDERS OF COURT parties, such as a war, strike, riot, crime, or an event described by the legal term act of God (hurricane, flood, earthquake, volcanic
a. Summon - a writ commanding an authorized person to notify a party to eruption, etc.), prevents one or both parties from fulfilling their obligations under the contract.
appear in court to answer a complaint made against him. �MALPRACTICE
b. Warrant - a writing from a competent authority in pursuance of law, directing - Injury, harm or death is not important in malpractice
the doing of an act addressed to a person competent to do it. - The nurse is allowed to perform episiorrhapy with proper training but not episiotomy
❏ Types of warrant - The nurse is allowed to perform IE but with 2 conditions:
1. Warrant of arrest - a court order to arrest or detain a ✓ fetal aberration/abnormal delivery
person ✓ prior to complete delivery
2. Search warrant - a court order to search for properties. �INCOMPETENCE
- Is the lack of ability, legal qualifications or fitness to discharge the required duty
- Although a nurse is registered, if in the performance of her duty she manifests incompetency, there is ground for revocation or
�LIABILITY - is an obligation or debt that can be enforced by law. A person who is suspension of her certificate of registration.
liable for malpractice is usually required to pay for damages. �TORTS
- A legal wrong, committed against a person or property independent of a contract which renders the person who commits it liable for
�NEGLIGENCE damages in a civil action
- Failure to do something which are reasonable and prudent nurse should - A person who has been wronged seeks compensation for the injury or wrong he has suffered from the wrong doer.
have done something under a particular situation. (eg. failure to raise side
rails when the pt is unconscious) �ASSAULT AND BATTERY
- 3 elements of negligence: A. Assault – is a unjustifiable to touch another person or even the threat of doing so.
1. Duty on part of the nurse B. Battery – is the actual carrying out of the threatened physical contact.
2. Failure to meet the standard of due care
3. Injury, harm, death - most important negligence �DEFAMATION OF CHARACTER
- Types of negligence: - Occurs where a person discusses another individual in terms that diminish reputation.
1. As a crime (CULPA CRIMINAL) A. Slander – oral defamation of a person by speaking unprivileged or false words by which his reputation is damaged
- Felony committed by culpa or fault due to imprudence, B. Libel – defamation by written words, cartoons or such representations that cause a person to be avoided, ridiculed or held in
lack of foresight, lack of skills, negligence. contempt or tend to injure him in his work.
2. As torts (CULPA CONTRACTUAL)
- MALFEASANCE - performance of an act which ought not �FALSE IMPRISONMENT
to be done - It is making someone wrongfully feel that he/she cannot leave the leave the place.
- MISFEASANCE - improper performance of some act - The unjustifiable detention of a person without a legal warrant within boundaries fixed by the defendant by an act or violation of
which might lawfully be done duty intended to result in such confinement.
- NONFEASANCE - omission of some act which ought to
be performed. �USE OF RESTRAINTS
3. As quasi-delict (CULPA AQUILIANA) - Restraints should be used w/ caution and discretion.
- No pre-existing contractual relations - All patients should have the right to independence and freedom of movement.
- Negligence, lack of due care - Restraints require a physician’s order.
- If a patient or his legal guardian refuses to be restrained, this should be documented in the patient’s medical record.
�RES IPSA LOQUITOR
- Doctrine that infers negligence from the very nature of an accident or injury �INVASION OF RIGHT TO PRIVACY AND BREACH OF CONFIDENTIALITY
in the absence of direct evidence on how any defendant behaved. - The right to privacy is the right to be left alone, the right to be free from unwarranted publicity and exposure to public view as well
�RESPONDEAT SUPERIOR as the right to live one’s life without having anyone’s name, picture or private affairs made public against one’s will.
- Doctrine that a party is responsible for (has vicarious liability for) acts of their - Nurses may become liable for invasion of right to privacy if they divulge information from a patient’s chart to improper sources or
agents. unauthorized persons.
�BONUS PATER FAMILIAS �CRIME
- Act committed or omitted in violation of the law.
 - Criminal offenses are composed of two element:
1. Criminal act
2. Evil/criminal intent
- A conspiracy to commit a crime exists when two or more persons agree to
commit a felony and decide to do it.
�CONSPIRACY TO COMMIT A CRIME
- Principals = Are those who are those who take a direct part in the execution
of the act, who directly force or induce others to commit it; or who cooperate
in the commission of the offense by another act without which it would not
have been accomplished.
- Accomplices = Are those who not being principals, cooperate in the
execution of the offense by previous and simultaneous act.
- Accessories = Are those who having the knowledge of the commission of
the crime. Assisting the offender to profit from the crime either by disposing
the body, concealing or assisting in escape of the principal of the crime.
�CRIMINAL NEGLIGENCE
- Reckless imprudence = when a person does an act or fails to do involuntary
without malice, from which damage results immediately.
- Simple imprudence = means that the person or nurse did not use precaution
and the damage was not immediate or the impending danger was not
evident or manifest.
�CRIMINAL INTENT
- Is the state of mind of a person at the time the criminal act is committed, that
is, he/she knows that an act is lawful and still decided to do it anyway.
- Deliberate intent includes two other elements without which there can be no
crime. These are freedom and intelligence.
- When a person accused of the crime offers evidence showing insanity,
necessity, compulsion, accident, or infancy the court will decide if he did not
commit a criminal offense and will declare the person not guilty.
�CLASSES OF FELONIES
- Consummated = when all the elements necessary for its execution and
accomplishment are present.
- Frustrated = when the offender performs all the acts or execution which will
produce the felony as a consequence but which nevertheless, do not
produce it by reason of causes independent of the will of the perpetrator.
- Attempted = when the offender commences the commission of the same
directly by overt acts, and does not perform the acts which shall produce the
felony.
�JUSTIFYING CIRCUMSTANCE
- There is no mens rea or criminal intent
- The circumstances pertain to the act and not the actor. Hence all who
participated in the will be benefited. Thus if the principal is acquitted there
will be no accomplices and accessories.
- These apply only to intentional felonies, not to acts by omissions or to
culpable felonies or to violations of special laws.
- When he acts in defense of strangers rights and that the person defending is not induced by revenge or evil motives.
- When any person who, in order to avoid an injury does an act which causes damage to another provided that an evil sought to be
avoided actually exists.
- When he acts the fulfillment of a duty or in lawful exercise of a right or office.
�EXEMPTING CIRCUMSTANCES
- The basis is the lack of any of the elements which makes the act/omission voluntary, i.e freedom, intelligence, intent or due care.
- They apply to both intentional and culpable felonies and they may be available in violations of special laws.
- These defenses pertain to the actor and not the act.
- They are personal to the accused in whom they are present and the effects do not extend to the other participants. Thus if a
principal is acquitted, the other principals, accessories and accomplices are still liable.\
- An imbecile or an insane person, unless the latter has acted during a lucid interval.
- A person under nine years of age.
- A person over nine year of age and under fifteen unless he acted with discernment.
�MITIGATING CIRCUMSTANCES
- Circumstances which are otherwise justifying or exempting were it not for the fact that all requisites necessary to justify the act or to
exempt the offender from criminal liability in the respective cases are not attendant.
- When the offender has no intention to commit so grave a wrong as the one committed.
- When the offender is under eighteen years of age or over 70 years old.
- When the act is committed in the immediate vindication of grave offense to the one committing the felony, his/her spouse,
ascendants, descendants, legitimate, natural or adopted brothers, r relative by affinity within the same degree.
- When a person acts upon an impulse so powerful as naturally to have produced obfuscation.
- When the offender voluntarily surrenders himself to a person in authority or confesses before the court prior to the presentation of
the evidence for the prosecution.
- When the defender is deaf and dumb, blind or otherwise suffering from physical defect
- Lack of education is not mitigating in:
1. Rape
2. Forcible abduction
3. Arson
4. Treason
5. In crimes against chastity like seduction and acts of lasciviousness
�AGGRAVATING CIRCUMSTANCES
- When the offender takes advantage of his public position.
- When the crime is committed in contempt of or with insult to public authorities.
- When the act is committed with insult or disregard of the respect of the offended party on account of his rank, age, sex.
- When the act is committed with abuse or confidence or obvious ungratefulness.
- When a crime is committed in a place of worship.
- When the crime is committed on the occasion of conflagration, shipwreck, earthquake, epidemic pr other calamity or misfortune.
- When the crime is committed in consideration of a price, reward or promise.
- When the crime is committed by means of inundation, fire, poison, explosion, standings of vessel or intentional damage.
- When the act is committed with evident premeditation or after unlawful entry.
- When craft, fraud, or disguised is employed when the wrong done in the commission of the crime is deliberately augmented by
causing other wrong not necessary for its commission.
�MORAL TURPITUDE
 - Is an act of baseness, vileness or depravity in social or private duties which
a man owes to his fellow man or to society in general, an act contrary to the
accepted and customary rule of right and duty between men.
�MURDER
- Is the unlawful killing of a human being with intent to kill. It is a very serious
crime.
- Nurses should keep in mind that death resulting from a criminal abortion is
murder.
- Euthanasia is also considered murder.
�HOMICIDE
- Is the killing of human being in another.
- It may be committed without criminal intent, by any person whom kills
another, other than his father, mother, or child or any of his ascendants or
descendants, or his spouse, without any of the circumstances attendant the
crime of murder enumerated above being present.
�ABORTION
- Is illegal according to the revised penal code. The patient should assume
responsibility for her abortion.
- She should be made to sign a statement relieving the hospital and its
personnel from liability.
�INFANTICIDE
- Is the killing of a child less than 3 days of age. The mother of the child who
commits this crime shall suffer penalty of imprisonment ranging from 2yrs
and 4months and 1day to 6yrs.
�PARRICIDE
- Is a crime committed by one who kills her/his father, mother or child whether
legitimate or illegitimate, or any of his/her ascendants or descendants or
his/her spouse.
�TYPES OF RAPE
- Ordinary rape = a forcible penetration of an organ for copulation to another
organ for copulation. (eg. Women are only the victim)
- Sexual assault = anything that is forcible inserted to a body orifice with
sexual malice. Also form of rape (eg. Hand or an object is being inserted in
the anal. Committed in both male and female)
�COMMON LEGAL TERMS
- Affidavit = is a written statement made under oath before a notary public or
other person duly authorized.
- Contempt of court = is the willful disobedience to, or open disrespect for the
rules of court.
- Defendant = the person being accused for wrongdoing; the therefore needs
to defend themselves.
- Day in court = the of a person to appear in court and be heard concerning his compliant/defense.
- Due process = is fair and orderly process which aims to protect and enforce a person’s rights
- False testimony = is punishable both criminal and civil law.
- Hearsay evidence = is evidence that is derived from something the witness heard from others.
- Inquest = is the legal inquiry into the cause or manner of death.
- Perjury = is the willful telling of a lie under oath.
- Plaintiff = the person who files the lawsuit and is seeking for perceived wrong doing.
- Prima facie evidence = evidence, which if unexplained or uncontradicted would establish the fact alleged.
- Privileged communication = statements uttered in good faith. These are not permitted to be divulged in court justice.
- Statute of limitations = define the length of time following the event during which the plaintiff may file lawsuit.
- Subpoena = is an order that requires a person to attend at a specific time and place to testify as witness.
- Subpoena ducas tecum = is a subpoena that requires a witness to bring required papers/documents and the like which may be in
his possession.
- Summons = is a writ commanding an authorized person to notify a party to appear in court to answer a complaint made against
them.
- Warrant = is writing from a competent authority in pursuance of law, directing the doing of an act, and addressed to a person
competent to do it.
�LEGAL PROTECTIONS IN THE NURSING SERVICE
- Be very familiar with the Philippine Nursing Law
- Beware of laws that affect nursing practice
- At the start of employment, get a copy of your job description, the agency’s rules, regulations and policies
- Upgrade your skills and competence
- Accept only such responsibility that is within the scope of your employment and your job description
- Do not delegate your responsibility to others
- Determine whether your subordinates are competent in the work are assigning them.
- Develops good interpersonal relationships with your co-workers, whether they be your supervisors, peers, or subordinates
- Consult your superiors for problems that may be too big for you to handle
- Verify orders that are not clear to you or those that seem to be erroneous
- The doctors should be informed about the patient’s condition
- Keep in mind the value and necessity of keeping accurate and adequate records
- Patients are entitled to an informed consent
�EVOLUTION OF NURSING LAW
- Republic act no. 2493 (dated February 5,1915)
 The first law affecting the practice of nursing in the Philippines.
a. Sec. 7 – states that every person desiring to practice nursing in the Philippines shall apply to the director of health for a
certificate of registration as a nurse.
b. Sec. 8 – states that shall be unlawful for any person to practice as a nurse in any of its branches in the Philippines until
the proper certificate of registration has been obtained.
c. This is also an act that provides for the examination and registration of nurses in the Philippines.
- Republic act no. 2808 (dated March 1, 1919)
 An act regulating the practice of nursing profession in the Philippines otherwise known as the nursing law.
 Significance of this law
 o The first board examinees for nurses was created
composed of 3 members appointed by the secretary of
interior (1 doctor of medicine as chairman and 2 members
who are registered nurses, had experience in the nursing
profession for at least 5yrs of reputable character.
 The board has the following powers:
1. Issue and revoke certificates of registration for practitioners of
the nursing profession.
2. Study the conditions affecting the practice of the nursing
profession in all parts of the Philippines.
3. Exercise the power conferred by the law to maintain efficient,
ethical and technical standards in nursing profession.
4. Promulgate regulations governing the nurse examination and
standards to be attained.
- Republic act no. 4007 (dated December 5, 1931)
 Reorganization law
 Took effect the conduct of board examination and placed the direct
supervision of the bureau of civil service.
- Republic act no. 465
 Standardized the fees charge by the examining board.
- Republic act no. 546
 Reorganized and placed all the board examinees under the direct
supervision of the president of the Philippines.
- Republic act no. 877 (dated June 19, 1953)
 Was enacted as an entirely new law created by the Filipino Nurses
Associated (PNA) namely: Ms. Abdulia Kabigtingas Chairman;Dean
JV Sutejo and Conchita Ruiz. The act was sponsored by Sen.
Geronima Pecson.
 The purpose is to “regulate the practice of nursing in the
Philippines and to set up provisions for the registration of the
nurses for the establishment and maintenance of standards of
nursing education and practice.”
- Republic act 1080 (dated June 15, 1954)
 An act declaring the bar and BOARD OF EXAMINATION as “Civil
service examination”
-Rpublic act no. 9173 (dated October 21, 2002)
 An act providing for a more responsive nursing profession repealing
for the purpose RA # 7164, otherwise known as the Philippine
Nursing Act of 1991.
 Legal basis of professional nursing practice
 Defines nursing, set standards for the nursing profession and give
guidance in the scope of practice.
 Contains general statements of appropriate nursing actions
 Protect the general public.
�BOARD OF NURSING
- The board is now composed of chairman and six members instead of a
chairman and four members.
- Submission of names of qualified nominees by the accredited professional organization (APO) to the commission, 3 nominees
per vacancy, not later than three months before vacancy.
- The commission submits to the office of the president two nominees per vacancy not later that two months before the vacancy
occurs. The appointment must be issued not later than 30 days before scheduled licensure examination.
Board of nursing
M – MAN
A – accredited nursing org (PNA)
S – seven MAN team (1 chairman, 6 members)
I – immediately resigned upon appointment
N – not convicted of any crime
P – pecuniary interest (absence)
T – ten years nursing practice but 5yrs must be in the Philippines
C – citizen and resident of republic of the Philippines
Powers of Board of Nursing
L – licensure exam
I – issue COR
M – monitor standards of nursing practice
E – education
C – code of ethics
H – hear and decides cases of negligence and malpractice
A – accredits different organizations
G – guides nursing practice in the Philippines.
Added the powers and duties of the board
 Adopt and regulate a code of ethics and code of technical standards for the practice of nursing within one year from the
effectivity of this act.
 Recognize specialty organization in coordination with accredited professional organization.
Licensure examination and registration
 Specific dates of examination has been deleted.
 Specific dates of examination – not earlier than 1 month and not later than 2months after the closing of each semestral
term.
 Specific age of applicants has been deleted.
Ratings
 Specific number of times an examinee may take the licensure examination has been deleted.
 Removal examination shall be taken within 2yrs after last failed examination.
Laws and organizations protecting nurses
 International labor organization convention 149
 ILO recommendation 1977
 International council of nurses
 Philippine nurses association
 Code of ethics for nurses
 Magna carta for health workers (RA 7305)
 Philippine nursing law
 Philippines constitution
�CONTINUING EDUCATION IN NURSING
Master’s Degree
- Prepares leaders in nursing who will influence the practice and study of the nursing profession.
Doctoral Degree
- Prepares nurses for positions such as:
 1. Administrators of nursing colleges 10. Sharing or allocation of resources – applies when resources are scanty or very limited.
2. Nursing research specialists
3. Consultants of nursing services �ETHICAL DILEMMAS
4. Nursing education programs or hospital services  Artificial insemination
 Continuously improve the quality of registered professionals by updating - Is a procedure or process whereby the fertilization of an egg is the result of the sperm being introduced into the female
them with latest scientific/technology/ethical trends in the practice of reproductive system other than the natural, that is, other than the sexual act or intercourse.
profession.
 Support to lifelong learning in the enhancement of competencies of
professionals.  In vitro fertilization
 Deliver quality CPD activities aligned with the Philippine Qualifications - Laboratory procedure whereby one or a few eggs are surgically taken from a woman’s ovary, fertilized with sperm in a petri dish,
Framework for national relevance and global competitiveness. and transferred to and implanted in the woman’s uterus, hoping for a normal pregnancy to happen.
 Human cloning
�NURSING ORGANIZATIONS - Refers to the production of one or more living human beings that are genetically identical to an original human being.
 Ang Nars  Contraception
 Association of Deans of Philippine Colleges of Nursing (ADPCN) - Is any act done before, during, or after the act of intercourse that purposely frustrates begetting of new life.
 Association of Diabetes Nurse Educators of the Philippines (ADNEP)
 Association of Nursing Service Administrators of the Philippines (ANSAP)
 Association of Private Duty Nurse Practitioners Philippines (APDNPP)
 Critical Care Nurses Association of the Philippines (CCNAP)
 Gerontology Nurses Association of the Philippines (GNAP)
 Military Nurses Association of the Philippines (MNAP)
 Mother and child nurses association of the Philippines (MCNAP)
 National league of Philippine government nurses (NLPGN)
 Occupational health nurses association of the Philippines (OHNAP)
 Operating room nurses association of the Philippines (ORNAP)
 Philippine hospital infection control nurses association (PHICNA)
 Philippine nursing informatics association (PNIA)
 Philippine nursing research society (PNRS)
 Philippine oncology nurses association (PONA)
 Philippine society of emergency care nurses (PSECN)
 Renal nurses association of the Philippines (RENAP)
 Society of cardiovascular nurse practitioners of the Philippines (SCVNPPi)
 Philippine association of public health nursing faculty
 Psychiatric nursing specialist foundation of the Philippines
 Integrated registered nurses of the Philippines (IRNUP)

�ETHICS
1. Beneficence – means to do good and not do harm
2. Non-maleficence – one ought not to inflict evil or harm
3. Autonomy – means self-determination
4. Justice – refers to the obligation be fair to other people
5. Stewardship – not harm our body because it is God’s not ours
6. Totality – body should function as a whole
7. Fidelity – refers to the obligation to be faithful to the agreements,
commitments and responsibilities that one has made to oneself and others.
8. Veracity – refers to telling the truth or not intentionally deceiving or
misleading patients
9. Respect – treat all individuals as persons with rights with or without
abnormality