LEGAL ASPECTS OF CUSTOMER

CARE FOR NURSES

By: Atty. Mai Endico-Ruez

RECALL
your
Nursing Laws

Question No. 1
What law currently governs Nurses and
Nursing Practice in the Philippines?
a) Philippine Nursing Act of 2002
b) Comprehensive Nursing Law of 2013
c) Philippine Nursing Practice Reform Act of
2013

The Correct Answer is:

A
Philippine Nursing Act of 2002
or Republic Act 9173

Question No. 2
What is the penalty provided for by law for
those who violate the Code of Ethics for
Nurses?
a)
b)
c)

Suspension of License
Revocation of License
Both a & b

The Correct Answer is:

C
Suspension of not more than 4 years or
Revocation of License

Question No. 3
Under RA 9173, a nurses professional license may
be suspended or revoked on the following
ground:
a) Unprofessional and unethical conduct
b) Gross Incompetence or Serious Ignorance
c) Malpractice or negligence in the practice of
Nursing
d) All the above

The Correct Answer is:

D
All of the above

Question No. 4
Liability of nurses for negligence in the
practice of their profession include:
a) Administrative Liability
b) Criminal Liability
c) Civil Liability
d) Only a & c
e) Letter a, b & c

The Correct Answer is:

E
Administrative, Civil and Criminal Liability

Question No. 5
The governing body for the regulation of the
Nursing Profession in the Philippines is
called:
a) Board of Trusted Nurses in the Philippines
b) Jurado ng mga Manggamot
c) Professional Regulatory Board of Nursing

The Correct Answer is:

C
Professional Regulatory Board of Nursing

Tie-Breaker Question
Unauthorized practice of the nursing
profession in the Philippines is
punishable by:
a)
b)
c)

Fine of P50,000 to not more than P100,000

Imprisonment of 1 year to not more than 6 years
Either of the 2 or Both,
at the discretion of the court

The Correct Answer is:

C
Fine of P50k-100k and/or Imprisonment of 1
year to 6 years

What the speaker will be sharing with

you:

Fundamentals of Law
Importance of Knowing Your Laws
Highlights of RA 9173 or the Philippine Nursing
Act of 2002
Types of Liabilities
Philippine Jurisprudence on Medical
Malpractice/Medical Negligence
Some Tips to Avoid Complaints & Law Suits

Fundamentals of Law

Law defined

A body of rules and regulations enacted by

the law-making body of the State in order to
control relationships between the State and
the individuals and between the individuals
themselves.

Fundamentals of Law

Types of Law

Natural Laws
Divine Laws
Positive Laws RA 9173 is a positive law. It
allows injured parties to go to court and ask
remedy

Why is it important to know your

laws?

Ignorantia Legis Non

Excusat (Ignorance of the
law excuses no one)
Lawsuits are very costly
and time-consuming
Liabilities include
administrative, civil and
criminal which could lead to
imprisonment

R.A. 9173 Philippine Nursing

Act of 2002

Comprehensive Nursing Law of 2013

(Binay)
Philippine Nursing Practice Reform Act of
2013 (Angara)

R.A. 9173 Philippine Nursing Act

of 2002

An act providing for a more responsive

Nursing Profession
Authorizes the creation of a Professional
Regulatory Board of Nursing (PRBON)
Enumerates the Powers and Duties of the
Board
Requirements for Licensure Examination

R.A. 9173

Requirements for Nursing

Licensure Exam

Citizen of the Philippines or a citizen of a

country with whom the Philippines have
reciprocity benefits
Good Moral Character
BS Nursing graduate of a duly recognized
college or university

Grounds for Revocation and

Suspension of Certificate of
Registration/Professional License
(Section 22 & 23):
Sec. 22 Conviction by final judgment of any criminal
offense involving moral turpitude
Person guilty of immoral or dishonorable
conduct
Person declared by court to be of unsound
mind

Sec. 23

Unprofessional and unethical conduct

Gross incompetence or Serious Ignorance
Malpractice or Negligence in the Practice of
Nursing
Fraud, deceit or false statements in obtaining his
certificate of registration
Violation of this Act, IRR, Code of Ethics for
Nurses
Practice of profession during Suspension period

Suspension vs. Revocation

The former means that the nurse is not
allowed to practice temporarily until final
judgment of the case is rendered. The
license is not confiscated.
Revocation means the license to
practice is confiscated either temporarily
or perpetually.

Sec. 28 Scope of Nursing Practice

Those who singly or in collaboration with

another initiates and performs nursing
services to individuals, families and
communities in any health care setting;
Nursing care during conception, labor,
delivery, infancy, childhood, toddler,
preschool, school age, adolescence,
adulthood and old age.

Sec. 28 Scope of Nursing Practice

cont.

This section shall not apply to Nursing

students who perform nursing functions
under the direct supervision of a qualified
faculty;
Provided further, that the nurse is duty
bound to observe the Code of Ethics for
Nurses and uphold the standards of Safe
Nursing Practice.

CHARTING DONE BY
STUDENT NURSES
When a nurse or clinical instructor

counter signs the charting of the

nursing student, he/she has personal
knowledge of information and that
such is accurate and authentic.
Anyone who countersigns without
verification commits herself to
possible legal risks.

Liabilities of nurses for the

work of nursing aides
Nurses should not delegate their

functions to nursing aides since the

Philippine nursing act specifies the
scope of nursing practice of
professional nurses.
Nurses are enjoined to supervise their
subordinates and see to it that they
perform only those which they been
authorized and those which they are
capable of doing.

Sec. 28 Scope of Nursing Practice

continued..

The nurse is required to maintain

competence by continual learning through
Continuing Professional Education
provided by an accredited professional
organization

Sec. 35 Prohibitions in the Practice

of Nursing

Practice without valid license

Uses as his/her own another persons license
Falsely poses or advertises as RN even if he/she
is not
Appends BSN/RN to his/her name even if such is
not the case
Abets or assists in the illegal practice of a person
who is not qualified to practice nursing

Penalties for violation of Section 35:

Fine of not more than

P50,000 to not more
than P100,000
Imprisonment of one
1 year to not more
than 6 years
Both at the discretion
of the court

Progress of Discussion:

Fundamentals of Law
Importance of Knowing Your Laws
Highlights of RA 9173 or the Philippine Nursing
Act of 2002
Types of Liabilities
Philippine Jurisprudence on Medical
Malpractice/Medical Negligence
Some Tips to Avoid Complaints & Law Suits

Baby scotch taped in Cebu

Patient shoots doctor dead

Types of Liabilities:

Administrative Liability

Suspension
Revocation of License
Payment of Fine
PRBON

Civil Liablity

Payment of Damages
Civil Courts

Types of Liabilities cont:

Criminal Liability (under Art. 365, RPC)

Imprisonment
Payment of Fine
Suspension of Rights
Criminal Courts

Company Liability

File Cross-claims
Termination from employment

Just causes for Termination of Employment

under the Labor Code
(Art.
282):

Serious Misconduct
Willful Disobedience to a Lawful Order
Gross and Habitual Neglect of Duties
Fraud or Willful Breach of Trust/Loss of
Confidence
Commission of a crime against employer or
the latters immediate family
Analogous cases

Some Philippine Jurisprudence on

Medical Malpractice/Medical
Negligence

Medical Malpractice/Medical
Negligence

Negligence, general
refers to the commission or omission of an

act, pursuant to a duty, that a reasonably

prudent person in the same or similar
circumstances would do or not do; and
which resulted to the injury to another
person or his property.

Some Philippine Jurisprudence on

Medical Malpractice/Negligence:

Reyes, et. Al vs. Sisters of Mercy Hospital,

G.R. No. 130547, Oct. 3, 2000 Medical malpractice is a form of
negligence which consists in the failure of
a physician or medical practitioner to
apply his skill which is ordinarily
employed by the profession (standard)
generally under similar conditions.

Some Philippine Jurisprudence on

Medical Malpractice/Negligence:

a)
b)
c)
d)

Reyes, et. Al vs. Sisters of Mercy Hospital, G.R.

No. 130547, Oct. 3, 2000 The standard is based on several factors:
State of medicine and science at that time
The standards of the locality
The general principles of medicine which he
follows
Nature of the case and condition of the patient

Some Philippine Jurisprudence on Medical

Malpractice/Negligence cont.
Garcia-Rueda vs. Pascasio, et. Al, G.R. No.
118141, Sept. 5, 1997 Four (4) elements of Medical Negligence (DBIC):

1.) There is a duty on the part of the medical

practitioner.
2.) There was breach of that duty.
3.) The patient suffered death or injury.
4.) There is a causal relation that the death or injury
was due to the breach of duty by the medical
personnel.

Philippine Jurisprudence cont.

Ramos vs. Court of

Appeals, GR No. 124354,
Dec. 29, 1999 -

Doctrine of Res
Ipsa Loquitur
(The thing speaks for
itself)

Conditions for Res Ipsa

Loquitur:

That the injury was of such nature

that would not normally occur

unless there was somebody
negligent
That the injury was caused by an
agency within the control of the
defendant
That the plaintiff/complainant himself
did not engage in any manner that
would tend to bring about the injury
(no contributory negligence)

Some Philippine Jurisprudence on Medical

Malpractice/Negligence cont.
Cruz vs. Court of Appeals, GR No. 122445, Nov.
18, 1997 Some acts or omissions constituting negligence or
malpractice:
Wrong diagnosis due to lack of skill or care;
Operating without patients or guardians consent
Failing to give the patient or his family proper and
necessary instructions as to the care to be given
to patient

Cont.

Allowing a foreign substance to enter or

remain in the body of the person operated
(i.e. sponges, pads, gauzes, etc.)
Abandonment of a case without providing
notice to patient or providing another
medical attendant

Other Acts of Negligence:

Burns
Objects left inside the patients

body
Falls of elderly
Falls of children
Failure to observe and take
appropriate action as needed

Acts of Negligence Cont.

Failure to report observations to

attending physicians
Failure to exercise the degree of
diligence which the circumstances
of the particular case demands
Mistaken identity
Wrong medicine, wrong
concentration, wrong route and
wrong dose.

Negligence cont.
Injury to patient
Sponge left in the patients abdomen
Safety pin left in patients abdomen
Death of patient who jumped from

window of his room

Negligence cont.
Rupture of surgical wound
Burns from hot water bags
Death of infant resulting from

wrongful injection of digitalis

Basis for Liability under the Civil

Code:

Art. 19. Every person must, in the exercise of

his rights and in the performance of his
duties, act with justice, give everyone his due,
and observe honesty and good faith.

Art. 20. Every person who, contrary to law,

willfully or negligently causes damage to
another, shall indemnify the latter for the
same.

Basis cont.

Art. 2176. Whoever by act or omission causes damage to

another, there being fault or negligence, is obliged to pay
for the damage done. Such fault or negligence, if there is
no pre-existing contractual relation between the parties,
is called a quasi-delict and is governed by the provisions
of this Chapter.

Art. 2177. Responsibility for fault or negligence under the

preceding article is entirely separate and distinct from
the civil liability arising from negligence under the Penal
Code. But the plaintiff cannot recover damages twice for
the same act or omission of the defendant.

Some Tips to Avoid Law

Suits & Liabilities:
1. Read and be very familiar with the
Philippine nursing law.
2. Beware of
laws that affect nursing practice
3. Upgrade you skills and competence
4. Do not delegate your responsibilities
to others.
5. Determine whether your
subordinates are competent in the
work you are assigning them.

Some Tips to Avoid Law Suits &

Liabilities cont.
6. Develop good interpersonal
relationships with everyone:
primarily your customers, peers,
supervisors and subordinates.
7. Consult your superior for
problems that maybe TOO BIG for
you to handle.
8. Verify orders that are not clear to
you or those that seem to be
erroneous. Follow rules on taking

Some Tips to Avoid Law Suits &

9. Practice thecont.
5 Rights of Medication:
Liabilities
The 5 Rights in Giving Medication:
1. Right Medication
- Is this the medication the provider ordered?
2. Right Dose
- How may milliliters, tablets, or does are to given?
3. Right Time
- What time of day should the medication be taken?
4. Right Route
- Should the medication be given by mouth, via feeding tube, or is it
an injectable medication?
5. Right Patient
- Is the medication for this patient or is it for someone else?

Some Tips to Avoid Law Suits &

Liabilities cont.
10. The doctors should be informed about the
patients conditions
11. Keep in mind the values and necessity of
keeping accurate and adequate records
12. Patients are entitled to an informed
consent and confidentiality of records

13. Always remember your Code

of Ethics by heart.

Preamble of Code of Ethics of

Nurses 2004
Health

is a fundamental right of
every individual. xxx believing in
the worth and dignity of each
human being. xxx

Patients are less likely to sue when

They feel respected.

Most patients understand that everyone makes an

honest mistake. Personality becomes more important
than technical ability when it comes to lawsuits.

The medical staff is candid and spends more

time answering their questions.
Medical staff apologizes for the event and
empathizes with the patient or his family.

Does not necessarily mean admission of a wrong

Genuine Customer Care

-ENDThank you for actively listening!

You are now ready to become world-class
customer care providers.
Congratulations!