PROFESSIONAL ADJUSTMENT

NURSING IS A PROFESSION Defined by PNA adapted from ANA

“A calling which its members profess to have acquired a unique body of knowledge and skills for purpose of guiding and caring others”

Calling – service oriented Unique – special body of knowledge Members – RN Others – patients – recipient of care

CHARACTERISTICS OF NURSING PROFESSION A – accountability – liability of own actions A – autonomy – PRC, BON C – caring profession CENTRAL FOCUS; core of nursing practice C – competency – continuing education to update KSA E – ethics – under BON Res 220; 1982 S – service oriented or Altruism – genuine service, not profit oriented S – specialized scientific body of knowledge and skills

DEFINITION OF PROFESSIONAL NURSE Completed a basic nursing program (BSN) Licensed in the country to practice nursing

PROFESSIONAL DUTIES OF A NURSE (RA 9173) INDEPENDENT FUNCTIONS

Promotive, Preventive, Curative, Rehabilitative in all health care settings Health education Utilizes nursing process (ADPIE) Links patients in different health care services or community resources Collaborate with other health care providers for continuity of pt care Training of nursing students and supervision of subordinates Observation of S/S – provide proper intervention Accurate recording and reporting Perennial Suturing after training

Perform IE if antenatal bleeding is absent and before full delivery

DEPENDENT FUNCTION Execution of valid doctor’s order RN can’t give meds w/o doctor’s order otherwise will be held liable for

malpractice. A doctor’s order is valid when giving medication is when it is put into writing

and signed by the physician. Whatever is not put into writing is considered not ordered by the physician.

GOOD SAMARITAN ACT Universal law that protects any person who give an aid to another person whose life

is in danger. During emergency, national calamity, national epidemic if there is no doctor around

the life or the patient is in possible danger, you can give drugs alone provided you know the drugs for the patient.

RA 8344 No deposit policy during emergency cases only Emergency care first before asking for deposit

AREAS OR FIELDS OF NURSING PRACTICE INSTITUTIONAL NURSING

H – ospital Based Venue D – Duties are routinary and supervised A – Acquired different learning and technical skills C – Coordination with HCT S – Specialized areas

o Nurse Specialist – staff nurse First Level Position: staff nurse

General Staff Nurseo General Wards, Surgical Ward, Medical Ward, Pedia Ward, OB Ward

Nurse in Special Areaso ER Nurse, ICU Nurse, OR Nurse, Nurse Anesthetist, DR Nurse, Nursery,

Diagnostic Nurse, Psychiatric Nurse, Hemodialysis Nurse, Post Mortem Nurse, CD Nurse, Ortho Nurse

PUBLIC HEALTH NURSING / COMMUNITY HEALTH NURSING Practice of nursing in local, national, and city health departments including

health centers and public schools. It also includes parish nursing. PUBLIC SCHOOL NURSE PUBLIC HEALTH NURSE

o Nurse Generalist – cater on all types of pt; broader; variety of roleso Focus of Care

– Promotion of Health and Prevention of Illness because this is the mandate of Primary Health Care Law

– Family and Community Health especially among RURAL POORo 1st PHC

– 1978 in Alma Ata, Russia– Local version of F. Marcos after 1yr of Alma Ata– LOI 949: all public workers to have a duty of promotive and

preventive care for the patient. PROMOTION OF PUBLIC HEALTH

o PD 8976 – MICRONUTRIENT SUPPLEMENTAL ACT– Vit. A, iron supplements, iodine

o PD 825 (ENVIRONMENTAL SANITATION LAW OF THE PHILS) – Cleanliness of environment outside institution (ex. proper

disposal of excreta and drainage systemo PD 856 (SANITATION CODE OF THE PHILS.)

– Proper sanitation inside institution that engage in food and water supply (canteen, mineral water store, public market, Sex shop: ADONIS, PEGASUS, CHICOS) not applicable to private sex practitioners)

PREVENTION OF DISEASESo PD 996 (EPI law)

– Compulsory Immunization of children below 9 y/o o RA 7160 (Local Autonomy Code or Local Government Code)

– Decentralization or devolution of care. – DOH together with DILG and local government units (brgy,

provincial) together with community participation they made a local health board which is the MAYOR.

– Purpose of local health board : makes quality health care available, accessible and proximal for all

INDUSTRIAL OR OCCUPATIONAL HEALTH NURSING Industrial or Company Health Nurse Provides healthcare to labourers 1st Occupational Nurse: Magdalena Valenzuela Duties

o Promotive/Preventive N – nutritional S – safety and sanitation C – Counseling

o Curative/Rehabilitative C – care for sick/injured labourers R – Referral V – Visit and ff. ups (home visits)

IN SERVICE EDUCATION Training and dev’t of nurses in hospitals and improve quality of service in own

institution

PRIVATE DUTY NURSING Self – employed and reach out and offer their service Make referrals and collaborates with Physicians

NURSING EDUCATION (NURSE EDUCATOR) Academic – teaching nurse education programs (BSN) in schools Career Ladder: CI’s Dean of a College of Nursing

MILITARY NURSING Founder: Col. Pearl Tucker Started before the outbreak of WW II NURSE CORPS, AFP

o Foundation Day: Sept 5o 1st Military Nurse Brigadier General: Elvegia Mendozao Need to study in military for 6 mos (GSC-General Staff Course) Rank of

2nd Lieutenant o High Salary according to ranko Hospitalization and free medical benefits to parents and dependents

FLIGHT NURSING / AEROSPACE NURSING For patients, military, or otherwise, who have been evacuated from battle areas Commissioned officer in Nurse Corpse - assigned in Philippine Air Force (PAF)

NURSE ENTREPRENEUR – nursing homes, review centers NURSE RESEARCHER

NURSING ORGANIZATIONS OR ASSOCIATIONS IN THE PHILIPPINES ALUMNI ASSOCIATIONS – 1st association upon graduation which fosters loyalty

among members Raise money - endow room in hosp for sick members Put up scholarships Acquaint or assist students Conduct scientific meetings for updates Publish newsletters

PROF ORGANIZATION: PHILLIPPINE NURSE’S ASSOCIATON (PNA) Former Name : Filipino Nurses Association Date founded : 10-22- 22 Founder: Anastacia Guiron –Tupas First President: Rosario Delgado

First Editor in Chief: Socorro Diaz; 1st Publication: “The Message” Journal: The Filipino Nurse The Phil. Journal of Nursing Purposes

o P – professional growth to attain highest standards of nursing (AIM)o U - unityo P – Promotes reciprocity even outside RPo A – advancement of knowledge and skills of nurseo E – ethics promulgation

Other Professional Org: ANSAP, CCNAPI, IRNUP, ORNAP, ONAP PHILLIPINE NATIONAL RED CROSS (PNRC)

Blood Letting, relief operations, assists in disasters, calamities, and emergencies, first aid during special occasions (ex. holy week, fiesta)

Disaster Nursing – nursing curriculum BLS, CPR; ACLS

BRIEF HISTORY OF PHILIPPINE NURSING LAW 1915 RA 2493 – PHILIPPINE MEDICAL ACT

Regulated medical practice 1st law that mentioned nursing provided examination and registration of nurses

1919 RA 2808 – FIRST TRUE NURSING LAW created 3 BON under Department of Interior

o Chairman: Doctor Juan Cabarus o Nurses: Anastacia – Giron Tupas, Belen Del Rosario

Examination date on 2nd Monday of June and December

1920 – FIRST OFFICIAL BOARD EXAM Theoretical exam held in amphitheater of college of medicine &surgery in UP Practical exam held in library of PGH Topnotcher : Anna Dahlgen – 93.5%

1950 RA546 - Examination for nurses under the Office of Pres

1953 RA 877 – PHILIPPINE NURSING LAW 1st Comprehensive Nursing Law Required registration of nurses before they can practice Penal provisions for those nurses practicing without COR Provisions of nursing schools and colleges, examinations

1966 RA 4704 - amended RA877 Increased BON to 5 members BON appointed by President BON educational qualification: Masteral Degree BON age limit of 65 y/o Lowered minimum age of applicants to NLE from 21 to 18 yo

1970 RA 6136 Abolished GN program (3yr) BSN (4yr) Allowed nurses to perform IM injections w/o MD’s supervision

1973 PD 223 - PRC

1991 RA 7164 – PHILLIPINE NURSING ACT (OLD) Introduced by Sen. Heherson Alvarez and approved by Pres. Cory Aquino Only students who are among top 40% of graduating class can be admitted in a

nursing course Expanded role of nurses: IVT training BON

M – MAN A – Accredited Nursing Org (PNA) F – five MAN team (1 chairman, 4 members) S – 65 y/o – 1 year interim period N – Not convicted of any crime P – Pecuniary interest (Absence) T – 10 years nursing practice C- Citizen of R.P.

2002 - RA 9173 PHILIPPINE NURSING ACT OF 2002 Approved by President Arroyo

I. BOARD OF NURSING Composition: 7 members (1 chairperson, 6 members) Appointment: president of the republic of the phils. Qualifications

R – RN, Masters N – Not connected in any moral turptitude M – Member of PNA A – At least 10 yrs in nursing, last 5 yrs in RP N – Natural born citizen and resident of RP

Requirements upon qualification Immediately resign upon appointment in any teaching position in any

institution, government or private employment. Absence of Pecuniary Interest or administrative supervision in any

institution offering BSN or review classes. Shall represent 3 areas of nursing

CHN, Nursing Education, Nursing Service Term of office

Appointed for 3 years, reappointment (max of 2yrs or terms) Salary: QUANTUM MERUIT – as much as they deserve Powers, functions and duties

L – licensure exam I – Issue, suspend or revoke COR M – monitor standards of nursing practice E – ensure quality nursing education C – code of ethics promulgation H – hear and decides cases of negligence and malpratice A – accredits different nursing organizations G – guides nursing practice in Phil

Grounds for Removal or suspension of a member

o I – ncompetence or neglect of duty o C – ommission or tolerance of irregularities in NLEo U – nprofessional, immoral, and dishonourable conduct

II. EXAMINATION AND REGISTRATION QUALIFICATION FOR ADMISSION TO NLE

Citizen of RP or by Reciprocity BSN degree holder from school or university whose curriculum is

approved by CHED DOCUMENTS REQUIRED

Original TOR RLE certificate List of cases (scrubs and deliveries assisted) NSO Birth Certificate Marriage Certificate, if applicable

EXAM FEE: P900 LAST DAY OF APPLICATION AT PRC: 10 days prior NLE SCOPE OF EXAM

BON formulated the exam 5 board areas

o NP1 – Funda, Prof Ad, Leadership and Mgt, Nsg Researcho NP2- CHN, MCN, Coparo NP3- Respi, Cardio, GITo NP4 – Oncology, Immunology, ABC, Emergency, Trauma Nursingo NP5- Neuro, EENT, PsychiaTRIC

RATINGS General average at least 75% with rating of not < 60% in any subjects If >75% but with a subject <60%, must repeat that subject with a rating

> 75% Renewal of exam shall be taken within 2 years after last failed exam Reconsideration of ratings request may be entertained only on grounds

of mechanical, clerical, or clear errors. Should be filed with the PRC within 90 days from the date of the official release of the exam results

OATH TAKING OF PASSERS- --- 15 days upon the release of NLE ISSUANCE OF COR OR PROFESSIONAL LICENSE

Issued by BON In having a license, it’s PRIVELEGE not a right

a. Bearing of CORo full name of the registranto serial numbero signature of the Chairperson and members of the Boardo official seal of the Commission and the Board

b. Bearing of PRC CARD o Date of Registrationo License Numbero Date of Issuance and Expiration Date

RENEWAL OF LICENSE: Every 3 years on birth month GROUNDS FOR REVOCATION OR SUSPENSION OF COR OR LICENSE

Conviction of any moral turptitude Unprofessional or unethical conduct Gross incompetence or serious ignorance Malpractice or negligence Use of fraud, deceit or false statements in obtaining COR Violation of RA 9173, Code of Ethics for nurses BR 220 Practicing profession during suspension

RA 1080 – CIVIL SERVICE ACT automatic civil service eligible once you pass PRC NLE exam

RA 8981 – PRC MODERNIZATION / COMPUTERIZATION ACT after 5 days, result of board will come out

REGISTRATION BY RECIPROCITY “DO UT DES”: for the country to expect favor from another it should be willing to

give correspond favor Conditions before RN’s in a foreign country can practice in RP

Registration in their country are substantially same in our country

Under their laws, Filipino nurses are granted the same privileges and on the same basis as their citizens.

applicant is a nurse registered in his country applicant has resided in the Phil. for at least 3 consecutive year

SPECIAL OR TEMPORARY PERMIT TO PRACTICE FOR LICENSED FOREIGN NURSES: well-known specialists or outstanding expert or lecturer on a medical mission exchange professors** Permit valid for the duration of the project, mission or employment contract.

Other Licensure Exams US RN – Nclex KSA – Prometric UK / Australia – NMC / UKCC UAE – HAAD

III. NURSING PRACTICE SCOPE OF NURSING PRACTICE

Provide nursing care from delivery up to old age Promotion of health Prevention of illness initiate and perform nursing services in any health care setting collaborates with other members of health team

DUTIES OF NURSES

IV. NURSING EDUCATION Inactive nurses for a period of Five (5) Consecutive years can return to practice

after one month didactic training and three months of practicum. The Board shall accredit hospitals to conduct said training.

RA 7164 RA9173To be a FacultyAt least 3 yrs clinical experience

1 year clinical experienceMaster’s

To be a Dean3 yrs teaching supervision and teaching

Same with faculty +5 years in teaching and supervising a

of nursing education programMaster’s

nursing education program

Penalty for practicing w/o licenseo P10,000 – P40,000

Imprisonmento 1-6 yrs

P50,000 – P100,000

1-6 yrs

QUALIFICATIONS OF NURSING ADMINISTRATORS

Supervisor/Manager Community Military Hospo B – BSN, RNo A – Accredited professional Org

of nurses (PNA)o N – 9 units in management and

administrationo T – 2 yrs in nursing

administration Chief Nurse/Directoro BANTo Masteralo 5 yrs supervisory/managerial

position (N.B. if primary hosp)

+ master’sin PHN or CHN

+ completion ofGen. Staffing Course

(GSC)

V. COMPREHENSIVE NURSING SPECIALTY PROGRAM 10% of staff shall be trained in nursing competency program Funds: PCSO, PAGCOR DOH will set criteria Beneficiaries are:

Issued a Certificate of Completion Must serve in any Phil. Hospital for at least 2 years of continuous service

Incentives and benefits free hospital care for nurses and their dependents

scholarship grants

VI. PENAL AND MISCELLANEOUS PROVISIONS Imprisonment – 1 – 6 yrs Fine: P50 – P100K

Practicing without COR or License Using other license as your own Using Invalidated, revoked, suspended COR or license Falsification of documents (diploma, experiences)) Falsely poses that he is an RN Appends BSN, RN without authority Assists illegal practice of a non-qualified person Underwaging Review centers not accredited by government