�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 - A calling in which members to have acquired special knowledge, by training or experience or both, so that they may guide, serve or
- Evaluation advice others in that special field.

�PRIORITY RANKING OF PATIENTS ● Characteristics of a Profession

● First level patient problems Accountability/liability for the result
- These are threats to a patient’s immediate survival or safety and Caring profession
demand immediate nursing intervention. Competent
- AIRWAY, BREATHING, CIRCULATION Ethics
● Second level patient problems Service oriented
- Concerns such as mental status change Specialized scientific body of knowledge and skills
- Acute pain
- Acute urinary elimination �NURSING
- Untreated medical problems requiring immediate attention [Diabetic - A discipline involved in the delivery of health care to the society
needing insulin] - A helping profession
- Abnormal pathology lab results - Service-oriented to maintain health and well-being of people
- Risk of infection, safety or security - An art and a science.
● Third level patient problems ● Nursing as a profession
- Those that do not fit into the above 2 categories such as monitoring - Bachelor of science in nursing
for medication side effects, lack of patient knowledge, longer-term - Licensed to practice nursing in the country
problems with living activities, etc.
- When no life-threatening problems exist, the nurse used both ● Nursing is a profession
professional judgement and the patient to set priorities and - Calling: service oriented
determine planning. - Others: patients
- This is a continually changing aspect of assessment of patients. I attribute my success to this - I never gave or took any excuse. F.Nightingale

�ADDITIONAL PRINCIPLES OF PRIORITIZATION �REPUBLIC ACT 9173 [NURSING ACT OF 2002]

✓ Know need and priorities of each patient ★ Legal basis of professional nursing practice
- To identify which clients need assessment first, the nurse uses ★ Defines nursing, set standards for the nursing profession and give guidance in the scope of practice.
information from the change of shift report and the patient’s acuity ★ Contains general statements of appropriate nursing actions.
level. ★ Protect the general public.
- After initial nursing assessments are completed, the nurse ranks
individual client needs in terms of priority or urgency. �QUALIFICATIONS FOR ADMISSION TO PNLE
✓ Consider all factors 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
- Available resources and staff limits;
- Qualifications of staff b. he/she is of good moral character; and
- What things can be delegated to others 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
- How much time is involved in some skills duly recognized by the proper government agency.
✓ Always remain flexible ● Subjects of PNLE
- During the course of the shift priorities may need to be reevaluated NP1 community health nursing
and recognized depending on changes in acuity levels, new NP2 care of healthy/at risk mother and child
admissions, etc. NP3 care of clients w/ physiologic and psychosocial alterations (A)
✓ Use of creativity NP4 care of clients w/ physiologic and psychosocial alterations (B)
- Emphasize patient’s abilities and strengths so that they may learn NP5 care of clients w/ physiologic and psychosocial alterations (C)
to assume more self-care ● RATINGS
- Encourage family participation in care - 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
�PROFESSION 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: - When he acts in defense of strangers rights and that the person defending is not induced by revenge or evil motives.
1. Criminal act - 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
2. Evil/criminal intent avoided actually exists.
- A conspiracy to commit a crime exists when two or more persons agree to - When he acts the fulfillment of a duty or in lawful exercise of a right or office.
commit a felony and decide to do it.
�EXEMPTING CIRCUMSTANCES
�CONSPIRACY TO COMMIT A CRIME - The basis is the lack of any of the elements which makes the act/omission voluntary, i.e freedom, intelligence, intent or due care.
- Principals = Are those who are those who take a direct part in the execution - They apply to both intentional and culpable felonies and they may be available in violations of special laws.
of the act, who directly force or induce others to commit it; or who cooperate - These defenses pertain to the actor and not the act.
in the commission of the offense by another act without which it would not - They are personal to the accused in whom they are present and the effects do not extend to the other participants. Thus if a
have been accomplished. principal is acquitted, the other principals, accessories and accomplices are still liable.\
- Accomplices = Are those who not being principals, cooperate in the - An imbecile or an insane person, unless the latter has acted during a lucid interval.
execution of the offense by previous and simultaneous act. - A person under nine years of age.
- Accessories = Are those who having the knowledge of the commission of - A person over nine year of age and under fifteen unless he acted with discernment.
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. �MITIGATING CIRCUMSTANCES
�CRIMINAL NEGLIGENCE - Circumstances which are otherwise justifying or exempting were it not for the fact that all requisites necessary to justify the act or to
- Reckless imprudence = when a person does an act or fails to do involuntary exempt the offender from criminal liability in the respective cases are not attendant.
without malice, from which damage results immediately. - When the offender has no intention to commit so grave a wrong as the one committed.
- Simple imprudence = means that the person or nurse did not use precaution - When the offender is under eighteen years of age or over 70 years old.
and the damage was not immediate or the impending danger was not - When the act is committed in the immediate vindication of grave offense to the one committing the felony, his/her spouse,
evident or manifest. 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.
�CRIMINAL INTENT - When the offender voluntarily surrenders himself to a person in authority or confesses before the court prior to the presentation of
- Is the state of mind of a person at the time the criminal act is committed, that the evidence for the prosecution.
is, he/she knows that an act is lawful and still decided to do it anyway. - When the defender is deaf and dumb, blind or otherwise suffering from physical defect
- Deliberate intent includes two other elements without which there can be no - Lack of education is not mitigating in:
crime. These are freedom and intelligence. 1. Rape
- When a person accused of the crime offers evidence showing insanity, 2. Forcible abduction
necessity, compulsion, accident, or infancy the court will decide if he did not 3. Arson
commit a criminal offense and will declare the person not guilty. 4. Treason
5. In crimes against chastity like seduction and acts of lasciviousness
�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 �AGGRAVATING CIRCUMSTANCES
produce the felony as a consequence but which nevertheless, do not - When the offender takes advantage of his public position.
produce it by reason of causes independent of the will of the perpetrator. - When the crime is committed in contempt of or with insult to public authorities.
- Attempted = when the offender commences the commission of the same - When the act is committed with insult or disregard of the respect of the offended party on account of his rank, age, sex.
directly by overt acts, and does not perform the acts which shall produce the - When the act is committed with abuse or confidence or obvious ungratefulness.
felony. - 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.
�JUSTIFYING CIRCUMSTANCE - When the crime is committed in consideration of a price, reward or promise.
- There is no mens rea or criminal intent - When the crime is committed by means of inundation, fire, poison, explosion, standings of vessel or intentional damage.
- The circumstances pertain to the act and not the actor. Hence all who - When the act is committed with evident premeditation or after unlawful entry.
participated in the will be benefited. Thus if the principal is acquitted there - When craft, fraud, or disguised is employed when the wrong done in the commission of the crime is deliberately augmented by
will be no accomplices and accessories. causing other wrong not necessary for its commission.
- These apply only to intentional felonies, not to acts by omissions or to
culpable felonies or to violations of special laws. �MORAL TURPITUDE
 - Is an act of baseness, vileness or depravity in social or private duties which - Day in court = the of a person to appear in court and be heard concerning his compliant/defense.
a man owes to his fellow man or to society in general, an act contrary to the - Due process = is fair and orderly process which aims to protect and enforce a person’s rights
accepted and customary rule of right and duty between men. - False testimony = is punishable both criminal and civil law.
- Hearsay evidence = is evidence that is derived from something the witness heard from others.
�MURDER - Inquest = is the legal inquiry into the cause or manner of death.
- Is the unlawful killing of a human being with intent to kill. It is a very serious - Perjury = is the willful telling of a lie under oath.
crime. - Plaintiff = the person who files the lawsuit and is seeking for perceived wrong doing.
- Nurses should keep in mind that death resulting from a criminal abortion is - Prima facie evidence = evidence, which if unexplained or uncontradicted would establish the fact alleged.
murder. - Privileged communication = statements uttered in good faith. These are not permitted to be divulged in court justice.
- Euthanasia is also considered murder. - 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.
�HOMICIDE - Subpoena ducas tecum = is a subpoena that requires a witness to bring required papers/documents and the like which may be in
- Is the killing of human being in another. his possession.
- It may be committed without criminal intent, by any person whom kills - Summons = is a writ commanding an authorized person to notify a party to appear in court to answer a complaint made against
another, other than his father, mother, or child or any of his ascendants or them.
descendants, or his spouse, without any of the circumstances attendant the - Warrant = is writing from a competent authority in pursuance of law, directing the doing of an act, and addressed to a person
crime of murder enumerated above being present. competent to do it.

�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.
�LEGAL PROTECTIONS IN THE NURSING SERVICE
�INFANTICIDE - Be very familiar with the Philippine Nursing Law
- Is the killing of a child less than 3 days of age. The mother of the child who - Beware of laws that affect nursing practice
commits this crime shall suffer penalty of imprisonment ranging from 2yrs - At the start of employment, get a copy of your job description, the agency’s rules, regulations and policies
and 4months and 1day to 6yrs. - 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
�PARRICIDE - Determine whether your subordinates are competent in the work are assigning them.
- Is a crime committed by one who kills her/his father, mother or child whether - Develops good interpersonal relationships with your co-workers, whether they be your supervisors, peers, or subordinates
legitimate or illegitimate, or any of his/her ascendants or descendants or - Consult your superiors for problems that may be too big for you to handle
his/her spouse. - 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
�TYPES OF RAPE - Keep in mind the value and necessity of keeping accurate and adequate records
- Ordinary rape = a forcible penetration of an organ for copulation to another - Patients are entitled to an informed consent
organ for copulation. (eg. Women are only the victim)
- Sexual assault = anything that is forcible inserted to a body orifice with �EVOLUTION OF NURSING LAW
sexual malice. Also form of rape (eg. Hand or an object is being inserted in - Republic act no. 2493 (dated February 5,1915)
the anal. Committed in both male and female)  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
�COMMON LEGAL TERMS certificate of registration as a nurse.
- Affidavit = is a written statement made under oath before a notary public or 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
other person duly authorized. the proper certificate of registration has been obtained.
- Contempt of court = is the willful disobedience to, or open disrespect for the c. This is also an act that provides for the examination and registration of nurses in the Philippines.
rules of court. - Republic act no. 2808 (dated March 1, 1919)
- Defendant = the person being accused for wrongdoing; the therefore needs  An act regulating the practice of nursing profession in the Philippines otherwise known as the nursing law.
to defend themselves.  Significance of this law
 o The first board examinees for nurses was created - Submission of names of qualified nominees by the accredited professional organization (APO) to the commission, 3 nominees
composed of 3 members appointed by the secretary of per vacancy, not later than three months before vacancy.
interior (1 doctor of medicine as chairman and 2 members - The commission submits to the office of the president two nominees per vacancy not later that two months before the vacancy
who are registered nurses, had experience in the nursing occurs. The appointment must be issued not later than 30 days before scheduled licensure examination.
profession for at least 5yrs of reputable character. Board of nursing
 The board has the following powers: M – MAN
1. Issue and revoke certificates of registration for practitioners of A – accredited nursing org (PNA)
the nursing profession. S – seven MAN team (1 chairman, 6 members)
2. Study the conditions affecting the practice of the nursing I – immediately resigned upon appointment
profession in all parts of the Philippines. N – not convicted of any crime
3. Exercise the power conferred by the law to maintain efficient, P – pecuniary interest (absence)
ethical and technical standards in nursing profession. T – ten years nursing practice but 5yrs must be in the Philippines
4. Promulgate regulations governing the nurse examination and C – citizen and resident of republic of the Philippines
standards to be attained. Powers of Board of Nursing
L – licensure exam
- Republic act no. 4007 (dated December 5, 1931) I – issue COR
 Reorganization law M – monitor standards of nursing practice
 Took effect the conduct of board examination and placed the direct E – education
supervision of the bureau of civil service. C – code of ethics
- Republic act no. 465 H – hear and decides cases of negligence and malpractice
 Standardized the fees charge by the examining board. A – accredits different organizations
- Republic act no. 546 G – guides nursing practice in the Philippines.
 Reorganized and placed all the board examinees under the direct Added the powers and duties of the board
supervision of the president of the Philippines.  Adopt and regulate a code of ethics and code of technical standards for the practice of nursing within one year from the
- Republic act no. 877 (dated June 19, 1953) effectivity of this act.
 Was enacted as an entirely new law created by the Filipino Nurses  Recognize specialty organization in coordination with accredited professional organization.
Associated (PNA) namely: Ms. Abdulia Kabigtingas Chairman;Dean Licensure examination and registration
JV Sutejo and Conchita Ruiz. The act was sponsored by Sen.  Specific dates of examination has been deleted.
Geronima Pecson.  Specific dates of examination – not earlier than 1 month and not later than 2months after the closing of each semestral
 The purpose is to “regulate the practice of nursing in the term.
Philippines and to set up provisions for the registration of the  Specific age of applicants has been deleted.
nurses for the establishment and maintenance of standards of Ratings
nursing education and practice.”  Specific number of times an examinee may take the licensure examination has been deleted.
- Republic act 1080 (dated June 15, 1954)  Removal examination shall be taken within 2yrs after last failed examination.
 An act declaring the bar and BOARD OF EXAMINATION as “Civil Laws and organizations protecting nurses
service examination”  International labor organization convention 149
 ILO recommendation 1977
-Rpublic act no. 9173 (dated October 21, 2002)  International council of nurses
 An act providing for a more responsive nursing profession repealing  Philippine nurses association
for the purpose RA # 7164, otherwise known as the Philippine  Code of ethics for nurses
Nursing Act of 1991.  Magna carta for health workers (RA 7305)
 Legal basis of professional nursing practice  Philippine nursing law
 Defines nursing, set standards for the nursing profession and give  Philippines constitution
guidance in the scope of practice.
 Contains general statements of appropriate nursing actions �CONTINUING EDUCATION IN NURSING
 Protect the general public. Master’s Degree
�BOARD OF NURSING - Prepares leaders in nursing who will influence the practice and study of the nursing profession.
- The board is now composed of chairman and six members instead of a Doctoral Degree
chairman and four members. - 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