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Nur 207: Nursing Jurisprudence and Professional Adjustment Lecturer: Ma. Nelia P. Silloriquez, M.A.N.

Nursing-is an art, a science, a social science An art: deals with skills and requires dexterity and proficiency A science: a systematic and well-defined body of knowledge which utilizes scientific methods and procedures and applies nursing process as a framework of care A social science: the primordial interest is man, sick or well, in the context of life and environment Nursing (Nightingale & Henderson)- it is the diagnosis and treatment of human responses to actual or potential health problems

Guide actions Regulate conduct of the people and impose sanctions for violations or non-compliance Tells us what we can do and cannot do Duralex sed lex- The law is harsh/hard, but it is the law We are a government of law, and not of men Branches of Law Divine Law Human Law General/Public Law International Law Constitutional Law Administrative Law Criminal Law Religious Law Individual/Private Law Civil Law Mercantile Law Procedural Law

Fundamental Responsibilities of Nursing:

[PPRA] 1. To promote health 2. To prevent illnesses 3. To restore health 4. To alleviate suffering

Characteristics of Nursing: [NICCI]

Nursing is caring Involves close, personal contact with recipient of care Concerned with services Committed without regard to color, creed, social/economic status Involves in ethical, legal, and political issues in the delivery of health care Nursing is a profession/occupation Profession- is the ability to grow and change as the world changes Professional Adjustment- refers to the growth of the individual and the development of his/her physical, mental, emotional, social, and spiritual capabilities Nursing Law lex- a set of rules established by a governing power to:

7 Laws Directly Related to Nursing

[CCCLACC] Constitutional Law Criminal Law Civil Law
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Labor Law Administrative Law Civil Service Law Case Law

Nursing Jursiprudence juris and prudenceapplication of the law

-a branch of law which deals with the study of nursing laws affecting nursing practice -knowledge of nursing law Nursing Ethics ethos- custom or particular behavior -the rules and standards governing the conduct of a person or the members of the profession: medical ethics Nursing as a profession Profession- a calling in which it members profess to have acquired special knowledge by training or experience so that they may guide others in that special field 3As Characteristics of Profession Autonomy Authority Accountability

n of its praction er to IHE Applies the body of knowled ge in practical services Function s autonom ously (w/autho rity) in the formulat ion of professi onal policy and monitori ng of its practice Guided by the code of ethics Distingui shed by the presenc e of special culture, norms and values common among it member s Clear standard of educatio nal preparat ion for entry and practice Attract individu als of
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Criteria of a Profession ( A Flexner) [UCEAFGDCAS] Utilizes in its practice a welldefined and wellorganize d body of knowled ge Constant ly enlarges that body of knowled ge and impose to remain current Entrust the educatio

intellect ual and personal qualities Strive to compen sate its praction ers by providin g freedom of action, professi onal growth and economi c security

Purpose: Protect the health of the people by establishing minimum standards which qualified practitioners meet Discourages certain persons who may be tempted to misinterpret themselves as nurses Important tool for legal control and enforcement of nursing practice Used to gather data about nurses and nursing on the country Registration Requirement Philippine Nursing Act of 1991, RA 7164the practice of nursing by any person is prohibited without a certificate of registration Registration by Reciprocity- mutuality in the grant and enjoyment of privileges between persons or nations Certification of Registration may be issued without the examination to nurses registered under the laws of foreign country, provided that: (for nonFilipinos/Asian/Foreigners) Proof of Reciprocity. Reciprocity is based on the principle of do ut des (for a country to expect a favor from another, it should be willing to give a corresponding favor) The applicant is a nurse registered under the law of his/her state country The requirement for registration in a foreign country are substantially the same as those prescribed by this act The applicant has resided in the Philippines for at least 3 consecutive years as provided by RA 5181
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Professional Nursing- practicing nursing

within the law singly or in collaboration with another, initiates and performs nursing services to the individuals, families, or communities in any health care setting )Philippine Act of 2002, RA 9173); -a person who completed a basic nursing educational program and is licensed in his/her country to practice professional nursing Qualifications and Abilities of a Professional Nurse Professional Preparation

Personal Qualities and Professional Proficiencies

Roles of a Professional Nurse: Direct Caregiver Client Advocate Case Manager Client/ Family Educator License to Practice Nursing License- a legal document given by the government that permits a person to offer to the public his/her skills and knowledge in a particular jurisdiction, where such practice would otherwise be unlawful without a license.

Registration by Examination- dates and

places of the licensure examination-NLE shall be given by the Board of Nursing not earlier than one month but not later that two months after closing of the semester The Professional Regulation Commission (PRC) pursuant to PD 657 has the power to administer and conduct licensure exam in the various Boards according to the rules and regulations promulgated by it.

PRC determines and fixes the place and date of exam The number of examinees must be limited to 15,000 and on the firstcome fist-serve basis Requirements for Examination: 1. Should be filed @ PRC ten days prior to the first day of examination 2. Original transcript of records with special order from CHED 3. For state colleges and universities, original transcript of records with picture and date of graduation 4. Record of actual RLE for the entire BSN program duly signed by the Chief Nurse 5. Actual number of operating room scrubs, handled deliveries, assisted, baby care duly signed. 6. Birth Certificate (SECPA) 7. Marriage Certificate 8. Alien Certificate of Naturalization 9. Clearance showing dismissal of case from the court/prosecutor office if any. Citizenship Requirements Doctrine of Nationality @ Birth Jus soli doctrine- the nationality of the person is determined by the law of the place of birth Jus sanguine doctrine- the nationality of the person is determined by the law of his descendent or parentage

Rating of the Examination (PNLE) Passed: general average of at least 75% or higher with rating not below 60% in any subject Conditioned: average rating of 75% or higher but gets a rating below 60% in any subject and must take the exam again only in the subject where he/she is rated below 60% Failed: general average rating is < 75%

Renewal Examination Shall be taken w/in 2 years after the last failed examination Reconsiderations of rating must be entertained only on the grounds of mechanical, clerical or clear error Request must be filed in the PRC w/in 90 days from the date of the official release of the exam results Oath-taking All successful examinees shall be required to take an oath of profession before the Board/any government officials prior to entering the nursing profession Mass oath-taking is within 15 days upon the release of the results Renewal of License- license shall be renewed every 3 years within the PRC Legal Bases of Nursing Education, Nursing Regulation and Nursing Practice Nursing Education Article XIV, Sec. 1, 1987 Constitution- everyone has the right to nursing education RA 9173 (Oct. 21, 2002) Philippine Nursing Act of 2002aims to provide professional foundation for practice through quality education (signed by PGMA) Mutual Recognition Agreement on Nursing Services (MRANS)Filipino nurses have easier access to the job markets of ASEAN members

Naturalization- is the act of adopting a

foreinger and giving him the privileges of a natural citizen Expatriation- giving up citizenship Repatriation- getting citizenship back Scope of Examination Five Broad Areas: Funadamentals of Nursing MCN CHN Nursing of the Adolescents, Adults, and the Aged Mental Health and Psyche Nursing




RA 7164 (Philippine Nursing Act of 1991)- the provision of the upper 40% admission requirement o Passed 35 years after the enactment of RA 887 Approved by Pres. C.C.Aquino

c. MA in major field/allied subject d. 3 years clinical experience e. Members of the accredited national association Accreditation and Sanctions a. Nursing S/C are required to undergo accreditation process within 5 years after recognition b. CHED is mandated to order outright closure of the nursing SUC if its board performance in 3 NLE within 5 years is 3% ad below, gradual face out, if 410%. Curriculum 1967-77- implementation of BSN Curriculum pursuant to DECs order No. 41, s. 1976 and the facing out of Graduate Nursing(GN) program.

CHED Memo No. 30 [CMO] o Updated policies and standards for nursing education Contains rules and regulations for the authorization to open or permit to actually operate nursing schools

1. Authorization to open nursing SUC shall be based on: Written recommendation of the BON, PRC, NSAC Approval of the CHED

2. Administration and Faculty

Nursing SUC must have a full time Dean and Faculty Members Qualifications of the Dean a. Filipino Citizen

1993- Revised Nursing Curriculum that

intends to produce competency-based and community-oriented nursing graduate. Competency-based: train and educate nursing students to demonstrate desired behavior when given opportunities to practice such behavior. Community-oriented: the client is I the community promotion, prevention and rehabilitation

b. RN in the Philippines c. Masters in Nursing d. 5 years tracking & supervisory experience e. Members of ADPCN and accredited nurses association Qualifications of the Faculty Members a. Filipino Citizen b. RN in the Philippines

2002-BSN Curriculum intends to produce

a full functioning critical thinking nurse. Only S/C which have given level III accreditation or SUCS are authorized to make modifications or revisions in the curriculum CMO No. 9 (2002)- guidelines to be followed in the admission of professionals entering nursing program CMO No. 4 (2009)- policies and standards for BSN program
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o Purpose: rationalizing nursing education in the country in order to provide relevant and quality health services locally and internationally CMO No. 14, s. 2009 o Objective: The BSN program aims to produce fully functioning nurse who is able to perform the competencies under each key areas of responsibility. o Graduates of this program as beginning practitioners may pursue the ff. career paths but not limited to: 1. Clinical Nursing 2. CHN 3. Occupation Health Nursing 4. Military Nursing 5. Entrepreneurship 6. Research 7. Private Duty Nurse 8. School Nursing 9. Health Education Prescribed ratio of students to client: Level III- 1:1 (1st sem) 1:1-2 (2nd sem) Level IV- 1:2-3 (1st sem) 1:3-5 (2nd sem) Faculty to student ratio Level III- 1:8-10 (1st sem) 1:8-12 (2nd sem) Level IV- 1:12-15 (1st sem and 2nd sem)

o o

Repeals RA 7164 Prevailing law regulating nursing practice in the Philippines

6 Main Features of RA 9173 Organization of BON Examination and Registration Nursing Education Nursing Pracice Health Human Resource Production, Utilization and Development Renal and Miscellaneous Provisions

A. Professional Regulatory Board of Nursing (PRBON) The primary agency responsible for the regulation of the admission, regulation and practice of the nursing preofession Composition: 1 chairperson appointed by the president of the Philippines (EO 496); 6 members

PRBON Qualifications Citizen and resident of the RP Member of accredited professional organizational RN and Masters degree in Nursing Education and other allied profession 10 years of continuous nursing practice No conviction of any offense
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Nursing Review Centers CHED Memo 13, s. 2006- prohibiting HEIs from forcing their graduate and graduating students to enroll in their own review centers and/or review centers of their preference EO No. 556 Nursing Regulation RA 9173 (Philippine Nursing Act of 2002) o October 21, 2002- signed into law by Pres. GMA

PRBON Term of Office 3 years until their successive are appointed and qualified; oath of office prior to performance of duties PRBON Powers and Function Conduct the licensure exam for nurses Issues and suspends or revoke certificates of registration for the practice of nursing

PRBON MUST KNOW! PRC has the power to order a re-take or re-conduct of NLE To become a licensed nurse is a privilege not a right, thus requires strict observance of the law The government regulate the licensure (RA 8981), after due process, to suspend, revoke, reinstate or reissue certificate of registration No person shall be deprived of life, liberty or property without due process of law 1987 Constitution Due process requires notice and hearing Requirements for the issuance of Certificate of Registration Passing the NLE Taking the oath Payment of prescribed fees Requirements before a nurse can practice nursing in Philippines PRBON: Monitoring and Enforcing Quality Standards Conduct ocular inspections of various health agencies Mandate: Monitor condition affecting the practice of the profession and maintenance of high professional, ethical, and technical standards

Standards and Guidelines of Nursing Practice 1. Standard of Safe Management Nursing Practice (SSNP) 2. Competency Standard for Nursing Practice


3. Standard for Specialty Certification Program 4. SSNP on Internal Exam and Suturing on Perineal Laceration 5. Nursing Standard on IV Practice (renewable every 3 years) 6. Ensuring Quality Nursing Educationexamines S/C for those seeking permission to open nursing courses to ensure that standard care are complied. CHED has the authority to close nursing S/C. 7. Conduct hearing and investigationsresolve complaints against NP for unethical and unprofessional conduct and violation; issue subpoena ad testificandum (appear and testify if necessary); subpoena duces tecum (produces documentary evidence) 8. Promulgated the code of ethics- two important standards of ethical conduct that Filipino nurses should know: Code of Ethics for Nurses (2004) o 1982-formulation of the 1st code of ethics for Filipino nurses o July 14, 2004- promulgation of the new Code of Ethics for Nurses by the PRBON o Important feature: adaptation of the Code of Good Governance & Recognition of Patients Bill of Rights International Council Nurse Code of Ethics (2006) 9. Recognize nursing specialty organization Philippine Nurses Association (Filipino Nurses Association)accredited as the biggest and the earliest nursing professional organization o Formed in 1992 in a meeting held in the nurses dorm of PGH, presided by Ms. Anastacia Giron Tupas o Last week of OctoberNurses Week declaration made by President Carlos Garcia (1955) First organization to be joined after passing the PNLE & OathtakingWVSU Alumni First professional organization to be joined after passing the PNLE & Oathtaking- PNA 10. Recognize nursing specialty organization: 1 ANSAP- Association of Nursing Service Administrators of the Philippines 2 APDNP- Association of Private Duty Nurses of the Philippines 3 CCRN- Critical Care Registered Nurses 4 MCNAP-Maternal and Child Nursing Association of the Philippines 5 MNAP- Military Nursing Association of the Philippines 6 RNAP- Renal Nursing Association of the Philippines 7 PONA- Philippine Oncologic Nursing Association



ORNAP- Operating Room Nurses Association of the Philippines

Nursing Law - the boundaries in which a nurse can practice Law - The sum total of rules and regulation by which the society is governed - A rule of conduct pronounced by controlling authority which may be enforced - Laws are part in place to assure that behavior that could threaten public safety is controlled Three Essential Characteristics: 1. Authority or the right to declare that the rule exists 2. Such rule is pronounced or expressed and that source can be identified. 3. A right to enforce the same must be provided. Source of Law

Nurses and Criminal Liability Liability an obligation/debt that can be enforced by law payment for damages to the other person actual cost of care, legal services, loss of earnings (present/future), compensation for emotional and physical stress suffered; legally determined by the court Crime Acts contrary to the law or statute Wrongs committed against the state Punishable by the state and usually demonstrate that intent was present Criminal Liability Can be incur either by committing a felony or by performing an act which would be an offense against a person or property Ignorance of the law is not an excuse for failure to comply therewith Elements of Deliberate Intent (without which there can be no crime)

1. Freedom- a person who acts without

freedom cannot act with deliberation. The law exempts from criminal liability any person who commits an unlawful act under the compulsion of an irresistible force 2. Intelligence- a person is incapable of distinguishing what act is good or bad and what act is right or wrong Types of Liability: 1. Personal Liability - an educated professional is always liable, use therefore your education to make a sound judgment 2. Employer Liability- they are responsible for the torts or crime committed by their employees under Respondeat Superior Doctrine 3. Supervisory- supervision should exercise sound judgment. Three important tasks: supervision, delegation, direction Classes of Felonies (According to the Degree of Act) 1. Consummated- when all the element necessary for its execution and accomplishments are presented 2. Frustrated- when the offender performs the action of execution which would produce the felony as a consequence but which do not produce it by reasons of causes not




related to the will of the perpetuator ( a person who committed an evil deed) 3. Conspiracy to commit a crime: A crime can be committed: Conspiracy- exists when two or more persons concur to an agreement concerning the commission of a felony and decide to commit it. Proposal- when the person who has decided to commit a felony propses its execution to some other person or persons Classification of Persons Criminally Liable to Felonies: 1. Principals Take a direct part in the execution of the act Those who directly force or induce others to commit; those who cooperate in the commission of the offense by another act without the crime would not have been accomplished 2. Accomplices Known as accessible before the fact/ accessories before the fact Persons who not being principals by direct anticipation, inducement or cooperation through another act essential to the consummation of the crime 3. Accessories - Known as accessories after the fact - Those having knowledge of the commission of the crime and without having participated either as principals of accomplices of the thing take part subsequent to its commission - One can be accessory: - By profiting themselves or assisting the offender to profit by the effects of the crime - By concealing or destroying the body of the crime or the effects or instruments to prevent its discovery - By harboring, concealing or assisting in the escape of the principal crime CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY Justifying circumstances Mitigating circumstances Aggravating circumstances Alternative circumstances Justifying Circumstances Self defense Defense of spouse, relative or stranger Accident Fulfillment of duty Obedience to an order issued by superior for some Lawful purpose

The Law Exempts from criminal liability the following: Imbecile or insane person (unless he acted during the lucid intervals) Person under nine years of age A person over nine years and under fifteen (unless acted with discernment/keenness of insight or understanding) Injury by mere accident without fault or intention of causing it Person who acts under impulses of an uncontrollable fear of an equal or greater injury Person who fails to perform an act required by law, when prevented by some lawful or insuperable cause Mitigating Circumstances