PROFESSIONAL ADJUSTMENT Minds Nest by Doc Arce Prepared by: Joel R. Bulangkit, Jr.

, RN Adjustment An educational process referring to changes in behavior towards better life, better relationships and better contribution to society. Profession An occupation or calling by which members profess to have acquired special knowledge by training, experience or both so that they may guide or advice or serve others in that field. Professional Adjustment The growth of the whole individual and development of all his/her capacities: physical, mental, social and spiritual towards efficient and effective performance of his/her profession. The preparation of a student nurse for the responsibilities of professional and social life by the development of her /his capabilities in a way that would make her/him fit to enter upon the practice of nursing. Characteristics of a Profession A ltruism - doing without expecting in return; for the good of society A utonomy self-determination A uthority decision-making; nursing judgment A ccountability responsible for the decisions and actions C ode of Ethics professional and social values D istinct Identity common identity and subculture Professional Nurse A person whose name and registration/professional license number is entered in the Commissions registry book and computerized database as legally authorized to practice the nursing profession. Professional Nursing Performance for a fee to give services to individuals, families, communities in various stages of development toward: Promotion of health, prevention of illness, restorations of health and alleviations of suffering. Nursing Functions Independent actions which then nurse initiates herself (health teachings) Dependent based on physicians response to a medical diagnosis (drug administration) Interdependent require knowledge skill and expertise of multiple health care professionals. 3 Areas in Nursing I nstitutional Nursing Hospitals, institutions, clinics C ommunity Health Nursing Public health nursing E ducation Clinical instructors, deans
Minds Nest Review Center By Doc Arce jrbjr

FIELDS OF PRACTICE I. INSTITUTIONAL/ HOSPITAL NURSING a. General Staff nurse BSN / RN, first level position (medical, surgical, OB-gyne, pediatric) Toxic : Medical b. Nurse in Special Areas Diagnostic Nurse resp. for patients fo diagnosis, CT scan, MRI Hemodialysis Nurse care for patients with kidney dysfunctions Post Mortem Nurse hospice care, prepare death certificate of patients Advantages: Benefits, Area rotations, Staff development, Experience Problem: Understaffing II. COMMUNITY HEALTH NURSING Health promotion and illness prevention and vigor of people in the public and rural areas. Advantages: develop community relationships and better perspective of community health, resourcefulness utilized Disadvantages: exposure to different health cases, limited facilities and no fixed hours III. SCHOOL NURSING Responsible for the schools activities in the areas of health service, health educations and environment health and safety Advantage: regular working hours and salary Priority problem: Malnutrition IV. MILITARY NURSING Nurse Corps of the AFP. Provides comprehensive and quality nursing care to all military personnel, their dependents and authorized relatives. QUALIFICATIONS: SINGLE: 1. Must be a natural born Filipino citizen 2. Must have a pleasing personality and good moral character 3. Registered nurse with a Board rating of 80% or above 4. Must be single or never been married: For female applicants, must not be positively found to have given birth to a living stillborn child. 5. Not more than 32 years old at the time of commission 6. Height requirements: Female - at least 5' 2 Male - at least 5' 4" 7. Must be physically and mentally and physically fit for military service and cleared by the appropriate security agencies. MARRIED: 1) First priority shall be given to Enlisted Personnel who are registered nurses by profession with at least three (3) years of active military service and have successfully completed the Clinical Nursing Program for EP Nurses being conducted by the Office of The Chief Nurse, AFP 2. Second priority shall be given to other applicants who have satisfied the additional following additional requirements:

3.) With at least three (3) years of current and continuous professional experience in hospital/clinic settings and or as member of a faculty of a recognized School of Nursing. 4.) Preferably with Master in Nursing or at least nine (9) units of post graduate studies leading to Master in Nursing. nd Rank: 2 Lieutenant Advantage: good salary V.CLINIC NURSING the nurse acts as a receptionist, answers phone, does the billing, takes x-rays and ECGs, changes dressing, gives injections and assist in physical examinations. The nurse keeps records, order and store supplies, makes follow up calls and referrals for patients. VI. OCCUPATIONAL HEALTH NURSING Looks after the health of the employees. Maintain a high standard of nursing service in the company, interpret, develop, and administer the health programs emanating from the health unit. Advantages: Benefits, good salary RA 1054 requires employment of nurse in a commercial industrial/agricultural establishment having employee not less than 30 or not more than 200 personnel, employees and laborers. VII. PRIVATE DUTY NURSING Give comprehensive nursing care to a client on a one-to-one ratio. Independent Contractor negotiate salary General Private Duty Nurse bedside nursing care at home Special Private Duty Nurse advanced cases Advantage: Salary, opportunity to travel VIII. FLIGHT NURSING provide comprehensive prehospital and emergency or critical nursing care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft. IX. NURSING EDUCATOR The career ladder in nursing education starts with a Clinical Instructors position up to the Dean of a College of Nursing. X. NURSE ENTREPRENEURS XI. NURSE RESEARCHERS XII. NURSE MIDWIFE, RN, RM a nurse in the hospital at midwife at the same time Qualifications: Midwifery Licensure Exam 20 cases NSD, 5 IV push and 5 cases suturing Scope of Practice: Normal deliveries IE without antenatal bleeding (placenta previa) Administer oxytoxic drug Suturing perineal lacerations XIII. FORENSIC NURSE is a field wherein a nurse has specialized training in forensic evidence collection, criminal procedures, legal testimony expertise, and more. The Forensic nurse becomes that liason between the medical profession and that of the criminal justice system. XIV. PARA-LEGAL NURSE
Minds Nest Review Center By Doc Arce jrbjr

work on cases involving legal issues surrounding the medical profession, such as medical malpractice, pharmaceuticals, medical patents, insurance, risk management and licensing. They may serve as consultants to insurance companies, hospitals, private law firms, nonprofit organizations or government agencies. NURSE AND THE LAW NURSING JURISPRUDENCE Department of law which comprises all the legal rules and principles affecting the practice of nursing. Includes the study and interpretation of rules and principles and their application in the regulation of the practice of nursing. Law - rule of conduct; made by competent authorities; for common observance and benefit; just and obligatory 3 Branches of the Law Executive -Implement laws (President, Police force PNP, AFP; Cabinets) Judicial - Interpret and apply laws (Supreme Court) Legislative -Makes laws (Senate and Congress) Law-Making Procedure Legislative branch passes a Bill for approved of the President House of Rep House bill Senate Senate Bill A bill becomes a law if: 1. President approves it Republic Act 2. President vetoes bill but it was approved by Congress & Senate 2/3 vote approved 3. President fails to veto the bill within 30 days after receiving the bill. Presidential decree an order of the President in his capacity to act as legislator. Philippine Nursing Laws Act 2493 of 1915 Medicine Act Examination and registration of nurses Requirements: 21 years old ; good physical health ; good moral character Act 2808 of 1919 FIRST TRUE NURSING LAW Created Board of Examiners for Nurses BON (composed of 3 members) First Board Examination was given in 1920 93 takers, 68 passers st Dr. Juan Cabarrus 1 Chaiirperson RA 4704 of 1966- BON increased from 3 to 5 Requirement for BON (Masters degree, 65 yo age limit) Requirement for Dean ( MAN) 18 yo legal age to take the NLE RA 7164 Philippine Nursing Act of 1991 BON required to resign from faculty Masters degree required for faculty Unethical conduct added as grounds for revocation RA 9173 Philippine Nursing Act of 2002 (October 21, 2002)

Article 3 Composition: Chairman and 6 members Appointmentl: PNA nominates 3 per vacancy PNA recommends 2 1 appointment by the President of Phils Qualifications: 1. RN 2. APO member PNA 3. Masters Degree Nursing, Public Health, Education, Allied Sciences 4. Filipino 5. Resident of the Philippines 6. With at least 10 yrs of continuous practice provided that the rest of 5 years in the Phil 7. Not convicted of any offense Represent the 3 Areas of Nursing: CHN, Nursing Education, Nursing Service, Requirements upon Qualification Resign from any teaching position,office,employment,university, review center No pecuniary interest in or administrative supervision offering BSN. Term of Office: 1 term 3 years Maximum 2 terms Replacement shall only take over the unexpired position of term Powers and Duties of the Board 1. conduct licensure examinations for nurses 2. issue, suspend, revoke COR 3. monitor and enforce quality standards of nursing practice in the Phil 4. ensure quality 5. conduct hearings and investigations 6. promulgate code of ethics 7.prescribe, adopt, issue regulations and guidelines Removal or Suspension of BON Incompetent neglect of duty Comission toleration of irregularities Unprofessional- immoral or dishonorable conduct Article 4 Examination and Registration Licensure Examination in accordance with PRC Modernization Act of 2000 (RA 8981) Qualifications: BSN degree holder school complies with the standards of nursing education (TOR) Citizen of the Philippines by jus soli, jus sanguinis, naturalization Good moral character Scope of Exam: determined by the BON. Ratings: A general average rating of at least 75% with a rating of not below 60% in any subject Conditional 1 NP failed, retake the failed subject in 2 years. COR issued to board passers which contains the full name of registrant, serial number, signature of

Chairperson of Commission and Board members and seal of Commission PRC Card chairperson, date of registration, license number, date of issuance and expiration. Renewal of license 1. every 3 years coincides on your birth date 2. APO member PNA 3. 60 CPE unit per 3 years Grounds for Suspension and Revocation Suspension temporary Revocation license confiscated G ross incompetence A cquired COR because you cheated G ot suspended but still practicing U nprofessional conduct End of Revocation: 1. maximum of four years from date of revocation 2. case has disappeared, cured and corrected Registration by Reciprocity RN from foreign countries can practice in the Philippines if their country has a reciprocity agreement with the Philippines. Practice by Special Temporary Permit Internationally well known specialists service if for a fee or for free Medical mission Exchange professors of a nursing school Permit shall be effective only for the duration of project, medical mission or employment contract. Article 5 Nursing Education Inactive nurses 1. five years not practicing license expired 2. license is suspended, name dropped in the roster 3. return to practice; 1 month didactic training, 3 months practicum Qualifications of faculty Holder of masters degree in nsg education, other medical sciences At least one year clinical experience RN Member of good standing in the APO (PNA) Position BON Faculty Dean Chief nurse/NSD Supervisor Staff nurse CN, primary hosp Same none Qualification MA (E, N,, AS) same MA in NSg same Yrs of experience 10 Yrs 1 yr 5yrs adm position same Same none

9 units mgt and admin 2 yrs admin positon

Article VI
Scope of Nursing Practice Provide nursing care: different stages of life Practitioner: promotion of health and prevention of illness Performs nursing services: IFC Collaborate with other health care providers DUTIES OF NURSES: P -rovide nursing care U-ndertake nursing training and research

Minds Nest Review Center By Doc Arce jrbjr

P-rovide health education to IFC E-stablish linkages with community resources and coordination with the health team T-each, guide and supervise students S-trictly observe the Code of Ethics Article VII. Health, Human Resources Production, Utilization and Department - Studies for nursing by BON & PNA Comprehensive Nursing Specialty Program Aim: to upgrade the level of skill and competence of specialty nurse clinicians in RP Three Areas: critical, oncology, renal Funding: PCSO, PAGCOR Participants: staff nurse of government hospitals Agreement: 2 yrs to serve the Philippines Article VIII. Penal and Miscellaneous Provisions S -ign name & attach BSN, RN (not true) O -wn( using as your own license of another F alsification of documents (diploma, experiences) F alsely posing as someone without due accreditation P -racticing without a license A -ssist another in illegal practice of nursing Penalty: Imprisonment 1-6yrs Fine: 50,000 to 100,000

Laws Affecting Nursing Practice

Laws that Provide the Responsibility of Employees RA 6713 Code of Conduct and Ethical Standards for Public Officials and Employees RA 7160 Local Government Code devolution Local Chief Executive has power over: Budgets for health Implementation of Programs Personnel Appointment RA 9257 (RA 7432) Expanded Senior Citizens Act RA 8344 Penalties for hospitals who refuse emergency treatment due to no down payment Laws Promoting Nurses Well-Being & Welfare RA 7305 Magna Carta of Public Health Workers Has provisions on benefits, rights and responsibilities of public health workers PD 442 Labor Code of the Philippines - Right to self-organization and collective bargaining Benefits of workers in Private Sector +10% = Night Shift Differential +25% = Overtime Pay +30% = Special Holiday +100% = Legal or Regular Holidays PD 48 Limits Paid Maternity Leave to 4 children NSVD 60 days CS 90 days

RA 9442 (RA7277) Magna Carta for Disabled Persons RA 5901 Maximum of 40 hours a week of work for nurses in agencies with 100 bed capacity and/or in an area with 1M population PD 541 Practice of former Filipino professionals in Philippines. Balikbayan Act RA 7877 Anti Sexual Harassment Act W ork related E ducation related T raining related RA 9262 Anti Violence Against Women and their Children PD 851 TH 13 Month Pay RA 8187 Paternity Leave Act of 1995 Laws Affecting Health Status PD 825 Garbage Disposal Act (RA 9003) Ecological Solid Waste Management PD 856 Code of Sanitation RA 8749 Philippine Clean Air Act of 1999 RA 6675 Generic Drug Act of 1988 RA 9502 Cheaper Medicine Bill of 2009 RA 9165 Comprehensive Dangerous Drugs Act of 2002 RA 953 Narcotic Drug Act PD 651 Birth Registration within 30 days PD 996 Compulsory Immunization for Infants & Children below 8 PD 603 Child and Youth Welfare Code RA 7610 Anti Child Abuse Law RA 7658 No employment of Children below 15 yo 3 Conditions (exception): Parental consent Non-dangerous occupation DOLE RA 7600 Rooming In and Breastfeeding Act of 1992 EO 51 Milk Code Legal Aspects and the Nurse 2 Subdivisions of Law I. Civil Law (Man Vs. Man) deals with relationships between private individuals Contract and Torts

Minds Nest Review Center By Doc Arce jrbjr

II. Criminal Law (Man Vs. Society) Deals with actions against the safety and welfare of the public Misdemeanor and Felony

CIVIL LIABILITY VS. CRIMINAL LIABILITY

CIVIL LIABILITY
Compensation for damages are sought by person filing the suit You versus Another Person Payment for Damages

CRIMINAL LIABILITY
Punishment is sought by the court for the wrongdoing You versus People of the Phils Payment for damages, court and gets imprisoned

A. CONTRACT

Meeting of minds between two persons whereby one binds himself, with respect to the other, to give something or to render some service An agreement between two or more competent persons upon sufficient consideration to do or not do some lawful act Can be written or oral 3As: Agreement, Acceptance, At least 2 parties TYPES OF CONTRACT FORMAL CONTRACT refers to an agreement among parties involved and is required to be in writing by some special laws. INFORMAL CONTRACT include all contracts not under seal or of record. Does not require to be in writing. EXPRESS CONTRACT Formal or informal agreement wherein it states the salaries, benefits, the terms and conditions of contract. IMPLIED CONTRACT Happens during emergency situations No explicit agreement and yet the law recognizes that it exist VOID CONTRACT One that is inexistent from the very beginning and therefore may not be enforced ILLEGAL CONTRACT One that is expressly prohibited by law Essential Requisites Consent legal age & sound mind Object is certain the service rendered Cause the reason for entering into contract BREACH OF CONTRACT failure to perform an agreement, whether expressed or implied, without cause Legal wrong committed calling for compensation in damages. Tortus, twisted, bad
Minds Nest Review Center By Doc Arce jrbjr

INTENTIONAL TORTS deliberately perform the act 1. Assault threatening a person 2. Battery unlawful touching of another person 3. Illegal detention/false imprisonment unjustifiable detention of a person not liable if: communicable disease public is at risk mentally ill 4. Invasion of privacy Privacy right to be alone, free from unwarranted publicity Reminder: T ake photographs without consent R elease the information about the client to a non-health care team I nterview the client wherein the conversation can be overheard P ublish embarassing facts/info about the ct. 4. Defamation stripping of clients dignity character assassination slander: oral defamation libel : defamation in writing UNINTENTIONAL TORTS Professional Negligence Negligence refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person would do. existence of a duty on the part of the person charged to use due care under circumstances failure to meet standard of due care the foreseability of harm resulting from failure to meet the standard the fact that the breach of this standard resulted in an injury to the plaintiff Examples of Negligence Burns resulting from hot water bags, heat lamps, vaporizers or sitz baths Objects left inside the patients body such as sponges Drugs given to the wrong person wrong medicine, wrong concentration, wrong route or wrong dose Doctrine of RES IPSA LOQUITURthe thing speaks for itself Three conditions required to establish a defendants negligence without proving specific conduct. that the injury was of such nature that it would not normally occur unless there was a negligent act on the part of someone that the injury was caused by an agency within control of the defendant that the plaintiff himself did not engage in any manner that would tend to bring about the injury.

Malpractice implies the idea of improper or unskillful care of a patient by a nurse. Also denotes stepping beyond ones authority with serious consequences. It is a term for negligence or carelessness of professional personnel. If proven: 1. Criminal liability 2. Damages 3. Ground for suspension or revocation of license. Doctrine of FORCE MAJEURE means an irresistible force, one that is unforeseen or inevitable. Circumstances such as floods, fire earthquakes and accidents falls under this doctrine and nurses who fail to render service during these circumstances are not held negligent. Doctrine of RESPONDEAT SUPERIOR let the master answer for the acts of the subordinate. Rule: The master is responsible for the want of care on the part of the servant toward those to whom the master is under the duty to use care, provided the failure of the servant to use such care occurred in the course of his employment. Captain of the Ship Doctrine surgeon liable for the acts of people working in OR. An act committed or omitted in violation of societal law and punishable by a fine and/or imprisonment or death CRIME Three elements Criminal act Criminal intent / evil in Freedom and Intelligence CRIMINAL ACTIONS Deal with acts or offenses against public welfare. Misdemeanor minor offenses; punishment is usually a fine or imprisonment for a term of less than one year. Felony a public offense; liable to be sentences to death or imprisoned; committed with deceit and fault. Deceit (Dolo) exists when the act is performed with deliberate intent Fault (Culpa) when wrongful act results from imprudence, negligence or lack of foresight Felonies according to degree of punishment GRAVE: Capital punishment death sentence Reclusion Perpetua 20 yrs & 1 day-40 yrs Reclusion Temporal12 yrs & 1 day -20 yrs Prison Mayor 6 yrs & 1 day to 12 yrs LESS GRAVE: Correctional 6 mos.& 1 day to 6 yrs Arresto Mayor 1 month & 1 day to 6 mos. LIGHT: Arresto Menor 1 day to 30 days (1 month) Felonies according to the degree of the acts of execution 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; expected results did not happen. Attempted when the offender began the acts,but does not perform all the acts or execution which shall produce the felony. Felonies according to conspiracy Principals are those who take a direct part in the execution of the act; who directly force or induce others to commit it Accomplices are those persons who cooperate in the execution of the offense by previous or simultaneous act. cooperates before the act Accessories are those who, having knowledge of the commission of the crime; by profiting themselves or assisting the offender to profit from the effects of the crime. cooperates after the act destroying or concealing body of the crime, or the effects or instruments, in order to prevent its discovery or by harboring, concealing or assisting in the escape of their principal of the crime. Crimes Concerning the Nurse Homicide killing of human being without intent Murder Intentional killing Parricide killing of father, mother, children or spouse Infanticide killing of child less than 3 days of age Abortion expulsion of a fetus from the womb before viability with the intention of prematurely ending a pregnancy Giving assistance to suicide Mutilation depriving a person of organ of reproduction Physical injuries other than the organ of reproduction Rape RA 8353 MARITAL RAPE victim: wife STATUTORY RAPE victim: boy or girl below 12yo Rape of Oral orifice Rape of Anal Orifice Robbery getting of property with force, violence, intimidation , without consent Theft getting of property without violence, force & consent Circumstances Affecting Criminal Acts Justifying Circumstances - act does not incur any criminal liablity D efended other people F ulfillment of Duty N o revenge S elf defense O bedience to superior

Minds Nest Review Center By Doc Arce jrbjr

Exempting Circumstances exempted from criminal liability I nsane I mbecile I dad (below 9 yo) I xtreme Fear I ndi Intention; accident Mitigating Circumstances -there is crime but lessens sentence or punishment P owerful impulse P hysical defects (blind, deaf, mute)

Partner for sterilization, both must sign the consent

P rovoked E dad: less than 18 yo & greater than 70 S urrender voluntarily Aggravating Circumstances -increases penalty or punishment G et a reward for doing the crime R eligious place / residence of victim cA lamities (typhoon, earthquake H older of public position B ombs, arson, explosive devices I nsult or contempt to public authorities Alternative Circumstances sometimes mitigating or aggravating intoxication of offender mitigating if unintentional (one time) aggravating if habitual education of offender mitigating if low level aggravating if high level relationship of offender to victim mitigating in crimes against property (robbery,theft) aggravating in crimes against persons ( chastity, adultery) SAFE PRACTICE IN NURSING Consent to Medical and Surgical Procedures Consent refers to the provision of approval or assent, particularly and especially after thoughtful consideration. - free and rational act that presupposes knowledge of the thing Informed Consent is established principle of law that every human being of adult years and sound mind has the right you determine what shall be done with his own body. Elements of Informed Consent Full Disclosure All information must be given to the patient Risks, benefits, procedures, treatments and alternatives Competence Patient of legal age and sound mind Voluntary Not forced or coerced Who must consent? Patient legal age and sound mind Parents if a minor 17 yo.

Emergency situation Implied consent is given based in actions of the patient WHO CANNOT GIVE CONSENT? Minor Mentally ill Medicated with sedative effects Malay ay wala (unconscious) HOME AGAINST MEDICAL ADVICE Explain the risks and consequences to the client Have the client sign the HAMA form Record on chart TELEPHONE ORDERS AP or resident not around 2 nurses Read back to physician Record the time received Signed by physician within 24 hours INCIDENT REPORTS for quality assurance and maintenance of standards should be submitted within 24 hours after the incident NOT INCLUDED in patients chart IMPORTANT TO NOTE: Note the time, date, place, client, witness or equipment Do not give opinions in IR Will legal declaration of a persons intentions upon death - called a testamentary document because it takes effect after the death of its maker - disposition of properties by a person after his death

Advance Directives
Living Will specifies in advance, the treatment a patients wants or does not want - legal age with sound mind Durable Power of Attorney assigns a person to make decisions in the event the patient is not capable of making a decision - health care proxy - legal age and sound mind Kinds of Wills Holographic will entirely written by hand Notarial will signed; witnesses; notarized Nuncupative will oral will decedent person who has properties to dispose or transmit through succession testator/testatrix person died living a will intestate person died without a will heir a person is called to succession through a will or by law Legal Requirements Testator: 18 yo or older ; of sound mind; free from undue influence Witness: 18 yo or older; not blind, deaf , or dumb; able to read and write

Minds Nest Review Center By Doc Arce jrbjr

Nurse Obligations: Note the soundness of patients mind Make sure that the client signed the will and was not forced Witness shall be present Record on the chart the mental & physical condition of patient upon making and fact of making his will

ETHICS
Method of inquiry that assists the person to understand moralities of human behavior. Came from the Greek word ethos which means moral duty. It is a science of ideals which guides our judgment concerning morality of human acts. Morals Subjective perception of right and wrong refers to the human conduct of ethics; the application of ethics. Bioethics Ethics applied to life; focuses on moral issues in the field of health care Nursing Ethics a system of principles for the conduct of nurses; her relationship to the patient, patients family, fellow nurses and society. Reinforces the nurses ideals and motives in order to maximize the affectivity of their service. Importance of Ethics Makes clear why one act is better than another Moral conduct and ethical system must be intelligently and appraised and criticized. Moral sense is stimulated and the true value of life is discovered and gained Means of deciding a course of action. Without it, our actions would be random and aimless. Five Elements of the Code of Ethics for Nurses nurses and people, nurses and practice, nurses and co-workers, nurses, society and environment and, nurses and the profession BON Resolution 220, S. 2004 Code of Ethics for Registered Nurses ARTICLE I Nurse preserve health at all cost, protect life and dignity of man. The fundamental responsibility of every nurse is four fold: promotion of health, prevention of illness, alleviation of suffering and restoration of health

Nurses render service without discrimination Nurse works in collaboration with other health care professionals. ARTICLE II Nurses and People Respect to: Values, customs and spiritual beliefs Individual decisions Personal Information Guidelines to be observed: Consider individuality and totality of clients Uphold the rights of individuals Respect their spiritual beliefs & practices Express consideration to their culture & values. Article III Nurses and Practice Professional dimensions (ELM) perform their professional duties in conformity with existing laws, rules, regulations. measures, and generally accepted principles of moral conductand proper decorum. b. not allow themselves to be used in advertisement that should demean the image of the profession c. decline any gift, favor or hospitality which might be interpreted as capitalizing on patients. d. not demand and receive any commission, fee or emolument for recommending or referring a patient to a physician, a co-nurse or another health care worker; not to pay any commission, fee or other compensations to the one referring or recommending a patient to them for nursing care Accountable for his/her own nursing practice acquire and develop the necessary competence in knowledge, skills, and attitudes to effectively render appropriate nursing services through varied learning situations. Responsible for his/her personal and professional growth & development Ensure excellent and quality care Hallmark of Accountability Accurate documentation Assure confidentiality of records Safeguard patients rights and privileges and serve as advocates of patient Article IV Nurses and Co- Workers Healthy working relationships Actively participate in professional organizations Maintain professional role and solidarity honor and safeguard the reputation and dignity of the members of nursing and other professions; refrain from making unfair and unwarranted comments or criticisms on their competence, conduct, and procedures; or not do anything that will bring discredit to a

Minds Nest Review Center By Doc Arce jrbjr

colleague and to any member of other professions. respect the rights of their co-workers. conform with group activities as those of a health team should be based on acceptable, ethico-legal standards. Article V Nurses, Society & Environment Preservation of life, healthy environment and respect for human rights Establishment of linkages with the public in promoting local, national, and international efforts to meet health and social needs of the people. be conscious of their obligations as citizens and, as such, be involved in community concerns. actively participate in programs, projects, and activities that respond to the problems of society. be equipped with knowledge of health resources within the community,and take active roles in primary health care. Article VI Nurses and Profession Maintain loyalty to nursing profession Compliance to by-laws of PNA Commitment to CPE Contribute for the improvement of socio-economic and general welfare of nurses. be members of the Accredited Professional Organization (PNA). strictly adhere to the nursing standards. participate actively in the growth and development of the nursing profession. assert for the implementation of labor and work standards. Basis: Code of Good Governance for Professors in the Philippines Violation of Code: Grounds for suspension, revocation of COR Date of Effectivity: July 14, 2004

Avoiding harm as a consequence of doing good Examples: Not assisting in performing abortion Not harming patients reputation by revealing confidential information Not giving harmful meds

Autonomy Freedom to choose or decide for ones self Comes from the Greek word autos meaning self and nomos meaning governance Example Informed consent Advance directives DNR requests Justice Refers to the right to demand to be treated justly, fairly and equally Obligation to be fair to other people. Examples National Health Insurance Act Senior Citizens Act First come, first served Paternalism Person acts as a parent in the event the patient is judge to be incompetent to make a decision. Confidentiality Keeping patient information private Except: Medico-legal case Communicable disease Members of health team directly concerned with care. Patient permits revealing the information Double Effect The act itself must be good The good precedes the evil effect Reasonable necessity of the performance of the act The motive of agent must be holy and honest. Example Uterine cancer patient needs Hysterectomy good effect saves life bad effect - infertility Fidelity Faithfulness & loyalty Examples Keeping ones promise to patients Veracity Truth telling Not to give unbiased information even its against your principle. Examples Telling patient the nature of his/her illness Stewardship Not harm our body because it is Gods not ours Example: Abortion Totality body should function as a whole The whole is greater than the sum of its parts Example: Abortion

Ethical Principles of Nursing

Respect for persons regard for each individual human being. Conveys a broad range of meanings as dignity, ultimate worth, significance, and importance of the person. Beneficence Doing acts of kindness and mercy that directly benefit the patient Positive form Doing good for others Prevent harm Examples: giving oxygen providing food bathing the client Non maleficence Do no harm Negative form No action

Minds Nest Review Center By Doc Arce jrbjr

 Patients Bill of Rights The patient has the right to considerate and respectful care irrespective of socio-economic status. The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment and prognosis. When not to tell: contradicts spiritual beliefs and it causes danger to patient Know the medical team handling the case. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment. The patient has the right to refuse treatment/life giving measures. Head injuries Stroke Terminal illness Psychiatric illness

The patient has the right to know what hospital rules and regulation apply to his conduct as a patient.

The patient has the right to every consideration of his privacy concerning his own medical care program. The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential. The patient has the right that within its capacity, a hospital must make reasonable response to the request of patient for services. The hospital must provide evaluation, service and/or referral as indicated by the urgency of care. The patient has the right to obtain information as to any relationship of the hospital to other health care and educational institutions The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment. The Nuremberg Code is a set of research ethics principles for human experimentation Declaration of Helsinki: A set of guidelines on acceptable conditions for medical research involving human participants (research subjects) that was approved by delegates to a meeting in Helsinki of the World Medical Association (WMA) in 1964; this declaration was the response of the WMA to the findings of the Nuremberg trials of Nazi war criminals. The patient has the right to expect reasonable continuity of care The patient has the right to examine and receive an explanation of his bill regardless of source of payment.

Minds Nest Review Center By Doc Arce jrbjr