Pentagon

Professional Adjustment, Legal Management, Ethics & Research in Nursing

NURSING RESEARCH
Nursing Research
Kerlinger - the systematic, empirical, controlled and critical investigation of a
hypothetical proposition in relation to a natural phenomena/ problem
Conducted to affirm or deny a hypothesis
Phenomenon.
everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician)
Phenomenon + hypothesis = research problem
>(educated guess/scientific/ tentative answer)
Without hypothesis there is no research problem, only a problem
Major Characteristics of a Good or Major Research
Systematic
o conduct research in a step by step process or procedure
Empirical
o objective data should be observable/measurable or readily collected
using your senses
Controlled/ manipulated
o Methods/tool of controlling is research design
Critical investigation/fact finding investigation
o In order to answer the data is by using facts.
o Looking for human beings who can give us facts
Purpose of Research in Nursing Profession [DEED]
Descriptive
o observe, describe and record
o gain richer familiarity regarding the phenomena
o 100% known to RN
Exploratory
o Explore to those areas that are unknown
o Observe more
o 50%-50% (50%known to nurses and 50% unknown to the nurses
Experimental
o Active intervention, active manipulation
o Want to find out cause & effect
o Done something before observing results
Developmental
o To improve the system of care for the your patient.
o Develop and improve existing system
Conducting research is for the benefit the pt or patient care/pt focus
Florence Nightingale
Birthplace Italy
Training Ground Germany
Greatest Contribution environmental Theory, training RNs in Crimean
War
School Saint Thomas School of Nursing

Ethics of a Researcher
S Scientific Objective conductive research for a good purpose or object for
your pt
C Cooperation and Consent. Do not conduct data/experiment w/o a consent
(legally the patient owns the chart. However the hospital owns the chart)
I Integrity worked hard on the research
E Equitable acknowledging works or contribution of others
N Nobility protect the rights of your subjects
o Right not to be harmed
(physical, mental, moral harm) usually done during experimental
research
Physical Harm/ Negligence - undeliberate physical harm
Commission done outside the standard practice of
nursing (eg. urinary catheter placed on the nose of the pt)
Omission from the very start, you did not do something
about it.
Moral Harm
Assault mental fear/threat without physical harm
Battery physically you harm the pt
Restraint is never an independent nursing order
physical restraint eg. Jacket
chemical restraint eg. use of psychotropic drug
Moral harm
Slander oral defamation
Libel published or placed in the newspaper
o Right to self-determination
o Right to privacy
Anonymity identity of subject may not be disclosed. Privacy of
the Informant (pt) eg. conduct a study on HIV pt. but the pt wants
his name to be written in the newspaper as Mr. X, Mr. Y or Mr. W
Confidentiality information acquired must be disclosed. Privacy
of the information eg. conduct a study on HIV pt. but the pt wants
the nurse should only know
T Truthfulness put only the data you have collected
I Importance importance to the nursing profession
F Factual facts or data
I Ideal (follow the 11 steps of research)
C Courage
Steps in Nursing Research Process
Identification/formulation of research
o problem - anything that requires solution thru scientific investigation.
o Sources of problem :
C concepts (Ca, PTB, MI)
L literature, essays, books, journals
I Issues
E experience
N Nursing problems
T theories

Characteristics of a research problem

G general applicability and use
Re Researchable
F Feasible and measurable
F actors of a feasible research :
time, money, experience of the researcher, instruments,
population
I importance to nursing profession
N novelty/originality
Plagiarism/illegal replication unauthorized use of
anothers literary work without any consent or permission
S significance to nursing
2 types of research according to use
basic/pure research
only the research benefits the research
It is only for your personal necessity
Answers your own question
Applied research
problem solving
Solving the problems of the patient.
Variable subject to change
Kinds of variable
Independent variable
o use this to stimulate a target population
Dependent variable/Effectual variable
o results of the effects of the study
Intervening Variable
o Comes between dependent and independent
o Example: orghanism variable, internal factor, sex,
gender, color
Extraneous Variable
o External infuences that can be changed
o Example: citizenship, educational status
Dichotomous Variable
o 2 choices/ 2 results
o Example: Male/ Female
Polychotomous Variable
o Multiple choices
o Example: Preferred foods Chinese, Japanese,
American. . . . .

Examples
A comparative Study in the Income of Filipino Nurses
Employed in P.G.H. and N.Y.G.H.
Independent variable : PGH and NYGH (place of work)
Target population : Filipino nurses
Dependent variable : income

Research:
1. Identify the Problem
2. Purpose objective using SMART (Systematic, Measurable, Attainable,
Realistic, Time Bounded)
3. Define Terms
a. Conceptual Definition dictionary definition
b. Operational Definition defined in accordance on how the researcher
used the word
4. Revision of Terms

Review of related literature

o Purposes :
to have an update regarding your topic
to have a basis of theoretical and conceptual framework
o Main sources of literatures
Conceptual
Formulated
Authors
Can be sold
Books general use
Research
Researcher
Research works only
Future research purpose only
Formulation of conceptual and theoretical framework
o Thery relationship between concepts
o Conceptual framework
diagrammatic and structural presentation of the problem
hypothesis
o Paradigm
actual structural presentation of your conceptual framework
Formulating hypothesis
o 5 types of hypothesis
Null/statistical hypothesis
shows no relationship or difference between an
independent variable and dependent variable.
ID = DV
Eg. There is no difference regarding professional
opportunities of Filipino Nurses working in the Philippines
from those working in USA.
Simple/Operational hypothesis/Alternative hypothesis
this shows relationship between a single independent
variable from single dependent variable.
Eg. Filipinos Nurses working in USA has more
professional opportunities than those working in the
Philippines.
Complex hypothesis

this shows a relationship between two or more

independent variable from two or more dependent
variable.
Eg. Filipino nurses who worked for 5yrs and passed the
CGFNS, TORFL, TSE, NCLEX has greater opportunities in
NY as compared to those in Manila
Directional hypothesis
specifies the direction of the relationship between variables
Eg. Filipino Nurses working in the USA has more
professional opportunities than those working in the Phils.
Non-directional
only predicts the relationship, but has no specific direction
between variables.
Eg. There is a big difference between a Filipino Nurses
working in USA than those working in the Phils.
Selecting research design
o Systematic controlled plan for finding the answer to a problem
o Roadmap, blueprint of the study
o Should have a proper resign design
o If improper research design, there will be improper collection of data
o Purpose : key or tool for proper collection of data
o Types
According to Application
Basic/ Pure
o For personal knowledge, curiosity
Applied
o Based on problem solving approach
According to Methods
Experimental
o performing active manipulation, observe and record
the result.
o Types of Experimental Reseach
control
divide grp into 2.
Group a control/comparison grp
will use the same soap everyday
Group b experimental grp those
who will use the sample soap
randomization
using sample by chance.
Choose randomly to avoid
redundancy of result
Manipulation
Performing intervention
Validation
comparison of the effects
Quasi-experimental
false experiment.
No control sample.

Non-experimental
o No manipulation is done. Only observation,
describe and record down the result.
o Types of non-experimental research design
base on time element
Retrospective (Ex Post Facto)
Getting actual experience
Studies a group of people after its
occurrence, experience or facts.
Experience of people in the past
Descriptive
Observe, describe & record.
Study of current events.
Prospective
Study of research about future
occurrence or future events.
Historical
Past that is written, documented,
published and recorded
Primary Data
o Observe
o 1st hand information
o person himself
Secondary Data
o 2nd Hand Information
About the past using records,
journals, books.
Study of the dead people thru his
written materials, facts
o according to data
quantitative
data base on numerical
interpretation, datas that are
measurable, using your senses, data
that are observable.
qualitative
subjective data, feelings, perception,
beliefs, culture, attitude
o Survey Research Design
Group
Small
Face to face
Large not good result
Methods
Mailed survey
Face to face
Telephone survey
o According to Time Orientation
Cross Sectional

Applicable to 2 or more identical

group
Short term
For comparison
Longitudinal
1 group only
with initial and follow up survey
long term study
for developmental study
Selecting your population and samples
o sample
part of population, data is collected.
The recipient of the experimental treatment in experimental design
or the individuals to be observed in a non-experimental design
o Types of sampling
Probability - equal presentation/ chances in the population.
Simple random technique
o Used a single/identical group.
o Fish bowl technique
Stratified random sampling
o You will first going to create a sub population from
the whole population before doing randomization.
o One population, you divide it.
Cluster random sampling
o You will first create a sub area in a population
before doing the randomization. In one population,
you make it smaller
Systematic random sampling
o choosing a sample every nth name in the
population.
o Multiple of 100 names
o Sampling frame list of names appearing as your
population
Non-probability sampling you are not choosing by chance.
Accidental/ convenience sampling
o Base on the accessibility/availability of your
sample.
o Kung sino pinakamalapit syo, yun ang kukunin mo.
Purposive/judgmental sampling
o base on the common knowledge or popular
knowledge.
Snow-ball sampling
o get sampling base on last referral
Quota Sampling
o Setting criteria and getting samples fitting the
criteria
Conducting pilot studies
Collecting data
o types :

questionnaires use of pen and paper method

dichotomous divided into two. Eg. true orfalse. Yes or no
rating scale poor 1, good 2, better 3, best 4
multiple choice
Interview use of oral method of collection of data. Use of active
listening
Structured with checklist, formal talk, list of question
Unstructured informal talk, no pattern, anything goes
records pre existing data
observation use of ocular method using your senses
participant observation
non-participant observation
Problems :
o Hawthornes effects
The data you get from your sample is not
accurate.
The sample has a problem
Solution : double blind research they
should not be conscious that they are being
studied
o Halo effect
The researcher has a problem.
He is manipulating the data collection.
It is affected by special feelings/treatment
between the researcher and the sample.
Analysis of Data
o part of research when the researcher is forming a body of knowledge out
of data collected for the purpose of affirming or denying your hypothesis
o Methods
Nominal method
get data by means of categories.
eg. male, female, income
Ordinal method base on rank eg. mild, moderate, severe
Interval
base on the distance between 2 numerical values
eg. BP 150/100 120/80, wt, circumference, ht
ratio 3:10 children are malnourish
Interpretation of Data
o 2 Methods
quantitative method base on numerical or graphical standards
qualitative method use of narrative words
Communicating your conclusion
o Explaining the results of your work to the public
o Conclusion final answer to your research
o Recommendation suggestion to others
o Dissemination of Information
Methods :
thesis/book written form
symposia/symposium oral presentation

publish a lot will be able to read your research

LEADERSHIP
Nursing Leadership
style or process whereby a person is called by a nurse leader were influence of
group of people called his followers for the purpose of attaining only one
goal/objective.
Principle for Effective Leadership
Unity of Command one group given by one leader
Unity of Direction one group should always have one objective
Subordination of your personal to your general interest patient first policy
o R rescue your patient
o A alert the fire alarm
o C confine the fire in one area
o E extinguisher application
o Esprit d corp/team spirit - Fault of one is the fault of all
Respondeat Superior/Command responsibility
o let the master or the superior answer for the negligence of his
subordinates in half of his patient who suffer from injury or death.
o you can delegate responsibility but not the accountability
Theories of Nursing Leadership
Great-Man theory born as a leader
Trait theory develop characteristics or born with the characteristics
o 3 traits of a leader
P personality (adaptability, independence, creative/assertive,
advocate) ability to adjust to the need of the pt
I intelligence (proper judgment, proper decision making, proper
communication)
A ability (influence others, respect others, participate and
cooperate) Proper way to influence is thru health teaching
Charismatic theory becomes a leader because of the charm
Situational theory/case to case basis
o a person can be a leader in one situation but only a follower in another
situation. (eg. becomes a leader in where he specializes)
Leadership styles
Authocratic/Authoritarian/dictatorial/hard leader
o unilateral style of leadership. Only the leader here performs the decision
making without getting the inputs from his members.
o One sided style of leadership Behavior :
A apathy insensitive to others
B Boisterous speech
C consistency
D Dominating

E Exploitative behavior
F ferocious behavior, to coerce or compel the group to follow him
o not a good style of leadership but only best style during emergency or
intensive crisis
Permissive, ultra-liberal, laissez faire, free-rein
o Loose style of nursing leadership.
o Giving excess freedom or liberality towards your subordinates if to lenient
in your subordinates, there will be control and power = negligence
Democratic/participative
o best style of leadership. Mutual style of nursing leadership

5 Power of a Good Leader

Legitimate/ Formal/ exclusive Power
o Exercise because you are appointed to a higher position
Expert Power
o You acquire extra ordinary skills, talent or ability
Referent Power
o Charisma and charm
Reward Power
o + power for the part of the leader
o gives rewards, bonus, promotion, compensation
Coercive Power
o power on the part of the leader
o reprimand, suspend, terminate
ABCs skills, qualities and abilities
A Authority
o basis of the leader to delegate tasks, responsibilities, jobs to be
performed by his subordinates
o 2 types of authority
Centralized top to bottom for proper management
Decentralized Bottom, to manage directly
B Behavioral
o S specialized body of knowledge and skills to do safe care
o P patient centered
o A accountability liable for the results of your actions
o C confidentiality nurse-patient relationship
Exceptions to confidentiality of the contract :
P patient consent, if there is
I inform/report to healthcare team for purpose of
precautionary measures
C Communicable disease
o RA 3573 Law on Notifiable Disease
o 24 Polio/ Measle
o 1 Week SAD/ HIV/Tetanus Neonaturom
C Crimes
o Child Abuse 48 hours, Baranggay, NGO
E ethics

10

IV THERAPIST: Old RN, Training, 50 Insertion, ANSAP

New RN, Training

C Communication skill
o transfer of information with understanding
o Communication barriers/communication backlog eg. Dialect differences,
noise, deaf, high level of anxiety, hallucinating
D Decision making skills
o Steps
identify the problem
identify person affected
gather options/alternative
brainstorming
delphitechnique gathering solutions outside the group
(eg. specialized nurse)
choose and implement
Evaluation
E Ethics
o Principles
o Principle of Autonomy
independent judgment or decision making
in all situation the pt himself is the one who should decide for his
own care
Consent
respect the decision of the pt
explain the risk to the patient/SO
waiver - a legal doc when the pt refuse for treatment.
o Principle of Veracity
telling the truth to the patient
#1 the patient has the right to know from the PHYSICIAN (not the
nurse)
o Principle of Double Effects
if the pt is made to choose between 2 equal danger and he only
needs to choose one, choose the one that will produce one good
effect and less evil effect.
o Principle of Beneficence
doing good to the patient (eg. providing therapeutic
communication, providing privacy)
o Principle of Non-Maleficence
do no harm
3 types of Harm
Physical negligence by commission
Mental assault and battery
Moral slander and libel
o Principle of Justice
Prioritize the needs of the patient.
To be able to provide nursing care to the patient, provide the
nursing process.
Nursing Process characteristics :

11

A acceptable universally
B - based patients assessment needs
C client focused
D dynamics base on the ever changing needs of the pt
E equitable care
F familiarity/rapport to the patient
G goal directed towards solving the assess needs of the
patient (SMART)
o Principle of Respect/Inviolability of life
Suicide and abortion is violation of this principle
F Face/solve Conflicts
o any clash of ideas resulting to crisis
o Methods of resolving conflict
avoidance by paying attention
smoothing appealing to ones conscience and kindness
unilateral action use of forced fear or threat
negotiation best method in resolving conflict. The head nurse
should offer negotiation between conflicting parties.

12

NURSING MANAGEMENT
NURSING MANAGEMENT
choosing the right person and giving them the appropriate task for the purpose of
achieving their goal/objective in achieving total care
Frederick Taylors Scientific Management Theory
Elements
o choosing the appropriate person (TAO)
o choosing the appropriate team
o choosing the appropriate training
o choosing the appropriate tools
Human Relations theory
the be a good manager, there should be a good interpersonal relationship
between the leader and follower
Douglas Mc Gregors Motivational theory
Theory X
o Negative workers
o negligence, inefficient, ineffective workers
Theory Y
o Positive workers
o diligent, effective, efficient worker
theory X should be given focus because they are prone to negligence and
malpractice.
Max Webers Bureaucratic/ authoritarian Theory
whoever is on the top would perform the management function
centralized
Elton Maytos Behavioral Theory
overtime pay, rest day, day off
provide physical needs of the workers
Hawthornes Effect
o If workers knows they are observed they become more efficient
Henry Fayols Principle of Management
Unity of Command one leader, one command
Unity of Direction one group should always have one goal
Remuneration of Personnel patient first policy
Esprit de corps team spirit
Command responsibility/Respondeat Superior let the superior answer the
fault of his subordinates even harm or death
Balance between centralization and decentralization
Security tenure

13

Delegation of responsibility
Proper Compensation of workers
o RA 7305 (Magna Carta Law) salary grade 50 P13,000/month
o Overtime pay additional of 25%/hr
o Night Differential additional of 10%/hr
o Legal holiday x 2
o Philhealth - Benefit of worker both related and non-related work
(aesthetic, dental and cosmetics are not included)
o Maternity leave 60days leave is NSD, 78days if CS only to first 4
pregnancy only to legitimate spouse
o Paternity leave 7day/1week leave
o Senior Citizens Act 20% discount

5 steps in Management Process

Planning stage
o looking ahead of time.
o Formulating future goals/objective
o Types of plan
Standard/Operational Plan (NCP)
plans for everyday or ordinary activities
Strategic/Contingency Plan
plan used during sudden or acute crisis
Long-range/future Plan
plans which you cant evaluated immediately.
Usually last months or yrs.
Used for chronic pt which requires longer period of care.
o Stages of Planning Process
Mission present reason when established your organization
Vision - statement of your future purpose of your future
organization
Philosophy set of values and beliefs of your organization
Goal general statement of your purpose
Objectives more specific statement of your purpose
Policies set of rules and regulations in your organization
Procedures
Budgeting proper allocation of your resources
o 3 types
Personnel
Compensation for salaries of
workers
Operational
everyday use of equipment and
facilities (gloves, water, electricity)
Capital
long term use equipment (MRI, CT
Scan, hospital beds, hospital
buildings)
Organizing
o 4 stages

14

Organize your team RN Subordinates

Duties of the RN
Only assessment can perform the nurse
Only the nurse can perform HT
Only the nurse should explain the procedure to the patient
Preparation, administration, treatment of drugs to the
patient
The nurse can only perform evaluation
The nurse can only do judgment
Delegate Task
They can only delegate to subordinates the Routinary task
(standard, unchanging procedure) eg. monitoring of I&O,
bathing, ambulating, toileting, shampooing, transporting,
feeding, clothing, wiping
Stable patient - predictable outcome (eg. postmortem care
with direct supervision of the nurse only)
Supervision need guidance
Staff Schedule/ Staffing
Schedules (How many hours)
o Traditional 8hrs a day/40hrs/wk
o Ten hour shift/4 days a week
o Baylor plan it consist of two shifting nurses
traditional mon-fri 8hrs
2nd shift 12hr shift during weekends
o Part-time work fewer working hours per day and
may choose the day or work. Less than 8hrs job
o On call during shortage of nurses/staff but
increase in the number of patients.
Methods of Nursing care Delivery
Different Methods
o Primary 24hrs a day
Primary nurse is the only nurse who is
responsible to make a care plan of the
patient from the moment of admission till the
moment of discharge. (eg. private duty
nurse or special nurse)
o Functional Method
DOH format/government hospitals
Assign nurse :
Duty/task
One nurse, one task
Highly recommended during a
period of shortage of nurses and
budget
poorest method of delivery because
communication is hindered
o Case Method/Case Nursing
provide total care within your shift. Used in
ICU department
C Case Method

15

T total care to the patient

O one is to one ratio

Directing/Delegation stage
o a job or a task is done or performed by another perform for you
o What you cannot delegate:
you cannot delegate total control of the procedure
you cant delegate discipline of subordinates or staff members.
Confidential task
Technical task
Medical task performing surgical procedure is done by the doc not
the nurse
Coordination/Collaboration
o the nurse needs to collaborate to other members of the health care team.
o Multi-interdisciplinary approach to be able to provide holistic approach
to the patient.
o Types of Collaboration
Interpersonal/Intradepartmental
One patient, one unit.
Collaboration between one nurse to another healthcare
team in one unit/department
Eg. MI patient - nurse, dietary, specialized in cardio
Interdepartmental
4 units in one hospital.
Coordination of the patients care between 2-more
units/departments but still under one same hospital or
institution
Eg. patient due for appendectomy is transferred to the OR
Inter Agency/Institutional
Coordination of patients care between 2 or more
hospitals/health care institution for the benefit of the patient
Eg. lying in due for C/S and was transferred to a hospital
Evaluation/Controlling
o stage wherein you determine whether or not your plans for your patient is
met or achieved
o Methods of evaluating staff performance
Checklist
it is being evaluated higher than you. (eg. nurse
manager/supervisor or head nurse)
Nursing rounds
it is being evaluated higher than you. (eg. Nurse
manager/supervisor or head nurse)
Psychiatric ward is not done by nursing rounds
Peer review
same rank or level is being evaluated you
poor method
Performance appraisal
the patient evaluates you
best method in evaluation

16

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 patients care for continuity of patient care
train nursing students
supervision of subordinates
accurate recording and reporting
execution of valid doctors 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 doctors 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

17

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
o Place : Alma Ata
o Country : Russia
o Local version of F. Marcos after 1yr of Alma Ata
o 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
3. Occupation Health Nursing
industrial or company health nurse
Duties :
o Curative/rehabilitative

18

C care for sick/injured laborers

R Referral
V Visit and ff. ups (home visits)
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
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. Lukes
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 questionbe 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

19

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
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

20

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 Rs 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
o

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)
Dos in Charting
o F full, factual and objectively accurate
o L legible
o I immediate
o P Personal
Adendum late entry/late documentation
Donts 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
The nurse is allowed to perform IE but with 2 conditions :

21

o
o

fetal aberration/ abnormal delivery

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.)

22

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)
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. Lukes school of nursing (1907)
o Mary Johnsons 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

23

A Accredited Nursing Org (PNA)

S 7 MAN team (1 chairman, 6members)
I immediately resigned upon appt.
N Not convicted of any crime
P Pecuniary interest (Absence)
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
o I Issue COR
o M Monitor standards of nursing practice
o E Education
o C Code of ethics
o H Hear and decides cases of negligence and malpractice
o A Accredits different organizations
o G Guides Nursing Practice in the phils
o
o
o
o
o
o

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
masters 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)

24

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 cant 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.
o 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)

What are the grounds for nurse not to be registered?

25

o
o
o
o

D Dishonorable conduct
U Unsound mind
M moral turpitude
I Indecent immortal conduct

26