Professional Adjustment and Nursing Jurisprudence

PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE Professional  A calling in which its members profess to have acquired special values, knowledge, training or by experience so that they may guide others in that special field. Nursing is a profession  Calling – service oriented  Others – patients Characteristics by profession  A – accountability/liability for the result  C – caring profession  Central Focus  C – competent  E – ethics  S – service oriented  S – specialized scientific body of knowledge and skills PROFESSIONAL DUTIES OF A NURSE UNDER RA 9173 All are independent nursing actions  Promotive, preventive, curative and rehab care in all health care service  health education  utilizes nursing process  link of patients in different health care services  collaboration of patient’s care for continuity of patient care  train nursing students  supervision of subordinates  accurate recording and reporting  execution of valid doctor’s order (the only one that is dependent nursing action)  Perennial Suturing after training  Perform IE if antenatal bleeding is absent and before full delivery 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  During emergency, national calamity, national epidemic there is no doctor around the life or the patient is in possible danger, then you can give drugs alone provided you know the drugs for the patient. RA 8344 – No deposit policy during emergency cases only Areas of Nursing Practice 1. Institutional Nursing  Hospital Based Venue  D – Duties are routinary and supervised  A – Acquired different learning and technical skills  C- Coordination with HCT  S – Specialized areas o Nurse Generalist – community nurse o Nurse specialist – staff nurse 2. Public Health Nursing  Once a Public nurse in the community, you are focus on the preventive and promotive of health because this is the mandate of Primary Health Care Law.  1st PHC o Date : 1978

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Place : Alma Ata Country : Russia Local version of F. Marcos after 1yr of Alma Ata Conference: Letter of Instruction 949 that mandates that all public workers to have a duty of promotive and preventive care for the patient. Promotion of Public Health o PD 8976 – Micronutrient Supplement Act  Vit. A, iron supplements, iodine o PD 825 (Environmental sanitation law of the Phils.)  It is cleanliness of the environment. Outside the institution (eg. proper disposal of excreta, proper drainage system) o PD 856 (sanitation code of the Phils.)  Involves proper sanitation of an institution that engage in food and water supply. Inside the institution. (eg. canteen, mineral water store, public market, Sex shop : ADONIS, PEGASUS, CHICOS) not applicable to private sex practitioners. Prevention of Disease o PD 996 (EPI law)  Compulsory Immunization of children below 9 y/o Psychological and social adjustments because you will be taking care of numerous clients o RA 7160 (local government code)  decentralization or devolution of care. The 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 : it makes quality health care available, accessible and proximal for all Participation is maintained with all members of the community, health care team and family o o o o

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3. Occupation Health Nursing  industrial or company health nurse  Duties : o Curative/rehabilitative  C – care for sick/injured laborers  R – Referral  V – Visit and ff. ups (home visits) o Promotive/Preventive  N – nutritional  S – safety and sanitation  C – Counseling 4. Clinical Instructor o Qualifications :  A – accredited nursing Org  M – MAN in nursing or other health courses  O – One yr clinical experience  R – R.N. PHILIPPINE NURSES ASSOCIATION o When was PNA founded : Oct. 22, 1922 (10-22- 22) o Who is the founder PNA : Anastacia G. Guiron Tupas o Purposes :  P – professional well-being  U - unity  P – promotes reciprocity even outside the Phils.  A – advancement of the knowledge and skills of the nurse  E – ethics promulgation Proclamation Order 539

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Declared by Pres. Garcia law declaring the last week Oct as the official nurses week.

School of Nursing in the Philippines  UPCN – 1st  Schools originated in the Phil. o Iloilo Mission hospital o PGH o St. Luke’s o Mary Johnston Hospital o St. Paul Hospital o San Juan de Dios Contracts and Consents Characteristics of a Valid Consent  V – voluntariness  O – Opportunities to ask questionbe explained to pt  T – treatment explained to the patient  U – understood by pt  M – matured both physically and mentally Criteria of a good consent :  18 y/o – above  Mentally capacitated (absence of insanity and imbecility)  If below 18 y/o and mentally incapacitated a proxy consent : in chronological order o Parents o Guardian o physician (if parents and guardian are dead)  Guardian Ad Litem – social worker or Surgeon Nurses and Illegal Detention  it happens if someone will limit the freedom of the patient to move or travel from one place to another.  HIV Patient – should be kept in one room o Felacio – oral sex – most fastest mode of transfer o Cannalingus – tongue on clitoris o Analingus – tongue on anus – least mode of transfer Last Will and Testament  Act whereby a person is permitted by the law to have control in the manner of disposing/ giving his estate but will take effect at the time of his death  Testate Succession – son or daughter will inherit the last will of the parents  Intestate Succession – without last will and testament  2 types of Last Will and Testament o Property  Notarial/ Ordinary Will  Check LOC  Check proper location of the signature – end part of all the pages at the side  Nurses can be a witness  Holographic Will  During emergency cases  No witness involved call a persdon who knows and familiar with the handwritten of the testator  Entire last will and testament is hand written dated and signed by the testator o Life Body  Advance Directives

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Respectful death Direction/ instruction of the patient in advance DNR, donate organ, cremation

Medications and prescription  only registered medical, dental and veterinary practitioners are authorized to prescribe drugs  3 information o name of the AMD, address of his clinic/hosp and PTRC license # o name of the pt, age, sex o drug name, frequency, duration of the drug  RA 6675 Generic Act o all prescribe drug must be written in generic and brand name or generic name but never the brand name alone) o Purpose : for the pt to choose what brand name they want  Remember the 10 R’s of medication  Right patient name by checking the pt wrist tag  Verbal or telephone – only done during emergency  doubts or error – in case there is doubt in medication, refer to the physician  IV drugs – in proper training Documentation, recording and charting  Patient Chart – absolutely legal  Purpose of a patient Chart o Communication and conitinuity of care o Assurance of quality of care o Research o Legal document o Statistics of disease  Subpoena – order coming from the court o Subpoena Duces Tecum – any documents, objects, papers, materials o Subpoena Ad Testificandum – person who will testify (witness)  Do’s in Charting o F – full, factual and objectively accurate o L – legible o I – immediate o P – Personal  Adendum – late entry/late documentation  Don’ts in charting o L – language, jargons or words which are unacceptable o I – improper corrections o S – Spaces and skips o Abbreviation LEGAL DOCTRINES IN NURSING Professional Negligence Negligence  failure to do something which are reasonable and prudent nurse should have done something under a particular situation. (eg. failure to raise side rales when the pt is unconscious)  3 elements of negligence o duty on part of the nurse o failure to do said duty o injury, harm, death – most important negligence Malpractice  injury, harm or death is not important in malpractice  The nurse is allowed to perform episiorrhapy  with proper training but not episiotomy

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The nurse is allowed to perform IE but with 2 conditions : o fetal aberration/ abnormal delivery o prior to complete delivery

Crimes affecting nurses  Types of crime :  Manner of Commission o DOLO – crimes committed with deceit. Crime with real criminal intention o CULPA – crimes committed under negligence. Crimes that are intentional  stages of execution o consummated  when the crime intended is totally committed or perfected o frustrated  the offended performs everything to consummate the crime but it did not happen o attempted  crime has not happened (overt acts – acts merely showing the intention to commit the crime)  degree of participation o principal  degree of participation is very important/indispensable because he is the primary author of the crime.. If no principle, there is no crime. o accomplice  participation is merely dispensable.  Usually performs before (eg. referral by the nurse of a abortionist to a pregnant women) or during the crime eg. OB nurse is to perform abortion. The nurse is look out for police. The nurse is the accomplice. o accessory  usually performs after the crime (eg. stole a nebulizer in the hospital. Sold the nebulizer to an asthmatic pt) This is an accessory because he benefited from the crime RA 7877 – Anti sexual harassment law  committed by any person who exercises authority. (eg. teacher to student, head nurse to staff nurse).  That person who is in authority is asking for a sexual favor in an exchange of another favor. Types of Rape  Ordinary rape o a forcible penetration of an organ for copulation to another organ for copulation. (eg. women are only the victim)  sexual assault o anything that is forcible inserted to a body orifice with sexual malice. o Also form of rape (eg. hand or an object is being inserted in the anal. Committed in both female or male) o Intervention :  S – safety (emotional or physical safety)  R – report (↓ 18 – report to brgy.)  R – referral (if father is the rapist, refer to DSWD) Abortion  is the expulsion or termination of a product of conception before the stage of viability. (3-6month/12-24weeks) Infanticide  kill the person in less than 3days or 72hrs of life. Parricide  killing another person to whom you have a relationship (mother, father, husband)

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Homicide  unintentionally killing another person without any relationship (eg. negligence in giving meds) Murder  intentionally killing another person without any relationship Simulation of birth  committed by any person who shall substitute one child to another child or alter his identities for the purpose of losing his civil status. (eg. the midwife failed to report the birth of the baby, giving wrong information of the gender of the baby) PD 651 (Birth registration act)  law any person who assist in giving birth to report within 30 days to the Local Civil Registration Office

Law Affecting Nurses  Act 2808 (yr. 1919) – first true nursing law o It removed from the doctor the control of nurses with 3 man team (1 chairman and 2 members all nurses)  1920 – 1st official board exam  1st nursing school (6months) o Iloilo Mission Hospital (1906) o PGH School of Nursing (1907) o St. Luke’s school of nursing (1907) o Mary Johnson’s school of Nursing (1907) o St. Paul Iloilo 1907) o San Juan de Dios (1907)  1st college of nursing (4years) – UP  RA 7164 (1991)  RA 9173 (Oct 21, 2002) o Board of Nursing  Old o M – MAN o A – Accredited Nursing Org (PNA) o F – five MAN team (1 chairman, 4 members) o S – 65 y/o – 1 year interim period o N – Not convicted of any crime o P – Pecuniary interest (Absence) o T – 10 years nursing practice o C- Citizen of R.P.  New o M – MAN o A – Accredited Nursing Org (PNA) o S – 7 MAN team (1 chairman, 6members) o I – immediately resigned upon appt. o N – Not convicted of any crime o P – Pecuniary interest (Absence) o T – 10 years nursing practice but 5 yrs must be in the Phils. o C- Citizen & resident of R.P.  Who formulates the question of the Board Exam? – Board of Nursing  In having a license it is a Privilege not a Right  Board of Nursing issues the license  PRC issues the certificate of registration  CHED are the ones who has the power to open and close a nursing school  BON just inspects 5 consecutive years of below 80% passing rate, the school will be closed  Powers and Functions of BON o L – Licensure exam

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Dean  R.N.,MAN  5 years nursing experience Clinical Instructor  A – allied in nursing or any allied health courses  M – member of PNA  O – 1 yr experience  R – R.N.

Nursing Administrator

Supervisor/Manager H    

Community

Military Hosp

Add only master’s in PHN or CHN

MAN + GSC (Gen. Staffing Course)

B – BSN RN A – Accredited Org N – 9 units T – 2 yrs

Chief/Director RN + MAN + 5 yrs supervisor experience (N.B. if primary hosp)

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I – Issue COR M – Monitor standards of nursing practice E – Education C – Code of ethics H – Hear and decides cases of negligence and malpractice A – Accredits different organizations G – Guides Nursing Practice in the phils

o Examinees CGM (Good Moral Character) Proofs of Valid Holder of Filipino Citizenship  Proofs of valid holder of a BSN Degree only from schools whose curriculum is approved by the CHED  3 docs sub to PRC  RLE certificate  TOR with Scanned picture  List of cases  Examination fee is P900  Last day Is : Other related laws  PD 223 – PRC Act  RA 1080 – Civil Service exam Cum Laude, Board passer – eligible in taking CSE  RA 6425 – Dangerous drugs Act o punishable with 2 chemical substances  Prohibited drugs  chemical substance totally, abosultely can’t be consumed by human being (eg. Shabu, Mariana, Cocaine, Opium)  Regulated drugs  you can use this drug provided the pt has the prescription and the AMD has appropriate license coming from the BFAD or Dangerous Drugs  RA 7600 – Baby Friendly Hospital.

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Early bonding for mother is Early Rooming in and early baby breast technique for early bonding Early bonding for father is thru cuddling E.O. 51 – Milk Code (Breast Milk) o Avoid manufactured or formula milk How to be an R.N. under 9173 o Have all qualifications o take the exam o acquire the required ratings o In order to pass the examination, an examinee must obtain a general average of at least 75 % with a rating of not below sixty percent (60%) in any subject o An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject must take the examination again but only in the subject or subjects where he/she us treated below 60 % (60%). In order to pass the succeeding examination, an examinee must obtain a rating of at least 75% in the subject or subjects repeated.” RA 8981 –Modernization Act. For every 5,000, results will be released after 5days PRC rating NAME Text to 263 (smart) 233 (globe) o

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What are the grounds for nurse not to be registered? o D – Dishonorable conduct o U – Unsound mind o M – moral turpitude o I – Indecent immortal conduct

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