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Profession
 A calling in which members profess to have acquired
special knowledge, by training or experience or both,
so that they may guide, serve or advice others in that
special field

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Characteristics of a profession
 Special Education
 Code of ethics
 Research
 Orientation
 Autonomy,
 Authority,
 Accountability
 Body of knowledge
 Service Orientation
 Professional organization

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Professional Nursing
The performance for salary or remuneration, of
professional nursing service, particularly that of
diagnosing and treating human responses and
potential health problems.

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Legal Basis of Professional Nursing
Practice
Republic Act 9173 or the nursing law of 2002
 Defines nursing, set standards for the nursing
profession and give guidance in the scope of practice.
 Contains general statements of appropriate nursing
actions
 Goal: protection of the general public

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Common Law
 is derived from principles or social mores rather than
from rules and regulations. It consists of broad,
interpretative principles based on reason, traditional
general and common sense.

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Nursing Jurisprudence
 Department of law which comprises all the legal rules
and principles affecting the practice of nursing the
study and interpretation of rules and principles and
their application in the regulation on the practice of
nursing

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Law
 Are rules and regulations established by a governing
authority (sovereign power) to institute and maintain
orderly coexistence by commanding what is right and
prohibiting what is wrong.

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Functions of Law in the Society
 define relationships among members of a society and
state which activities are permissible or not
 describe what forces maybe applied to maintain rules
and by when is to be applied.
 provide solutions to problems
 refine relationship between person and group when
conditions of life change.

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Basic Principle of Law
 Based on concern for justice and fairness
 Characterized by change
 Actions are judged on basis of universal standards of
what is similarly trained, reasonable and prudent
person would done rather in similar circumstances
 Each individual has right and responsibilities

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Types of Law
Law govern the relationship of private individuals with
government.

Public Law
 Refers to the body of law that deals with relationship
between individual and the government and the
governmental agencies.
 An important segment of public law is criminal law which
deals with actions against the safety and welfare of the
public
 Examples are homicide, manslaughter and theft.

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Private Law or Civil Law
 Is the body of law that deals with relationship among
private individuals. It can be categorized into a
variety of legal specialties such as contract law and
tort law
Contract law
 involves the enforcement of agreements among
private individuals
Torts
 Laws define and enforce and enforce duties and right
among private individuals that are not based on
contractual agreement.

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Sources of Law Constitution
 The constitution of the Philippines is the supreme law
of the country.
 It established the general organization of the
government, grants certain powers to the government,
and places limits on what government may do.
 The constitution created legal rights and
responsibilities and the foundation for a systems of
justice.

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Legislation (Statutory law)
 Laws enacted by any legislative body are called
statutory laws.

Administrative Law
 When a state legislature passes a structure, an
administrative agency is given the authority to create
rules and regulation to enforce the statutory laws.

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Functions of law in the profession
 Provides a framework for establishing what nursing
actions in the care of patients are legal.
 Delineates the nurse’s responsibilities from those of
other professionals.
 Helps to establish the boundaries of independent
nursing actions.
 Assists in maintaining a standard of nursing practice
by making nurses accountable to the law.

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Nurses and legal offenses
Crimes
 Actions/behaviours which violate law and is
punishable by fine, imprisonment or death

 There 2 types according to severity:


 Felonies
 Misdemeanour

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Felonies
 Relatively serious offenses punishable by
imprisonment, fines or even death. Offenders lose
their civil rights.

Misdemeanour
 Is less serious crime punishable by fine and short-term
jail sentence.

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Criminal liabilities can be classified according to:

Manner of commission
Dolo – deceit; deliberate intent
Culpa- fault; product of imprudence, negligence, lack of
foresight or skills

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Stage of execution
Consummated
 all elements for execution of the crime has been
completed
Frustrated
 offender performs every thing as intended but fails due
to external causes
Attempted
 overt actions to commit crime has been commenced,
but the elements were not completed due to reactions
other than this own spontaneous desistance.

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Degree of participation
Principals
 direct part in the execution of a crime; cooperate in
committing an act which crime will not be accomplished
Accomplice
 cooperate in execution of offences by previous/stimulation
acts
Accessories
 profit or assist offenders to profit from crime; conceals,
destroy the body of crime, effects, instruments to prevent
discovery of crime; harbor, conceals, and assists in escape
of principal with abuse of authority

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Contract
 An agreement between two or more persons upon
sufficient consideration to do or not to do some
lawful act.
 One binds self with respect to other give something
or to render some service.
 An agreement which creates an obligation
 Can be written or oral

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Expressed contract
 When two parties discuss and agree orally in writing
to its terms

Implied contract
 One in which there has been no discussions between
parties, but the law considers that a contract exists
 Law ascribes an objective intention to enter a contract
“facio ut des”( I do that you may give)

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Elements of a valid contract
 Agreement/ Mutual consent – contracts must be
binding for both parties
 Legal Subject matter – nothing in the contacts is
contrary to law or public order
 Cause of the obligation which is established
 Contractual capacity – parties are eligible to enter
a contract

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Objects of contracts
 All things which are within the commence of man
 All rights which are transmissible
 Future inheritance

Prerequisites in entering a contract


 Be of legal age
 Be sound of mind
 Not under the influence of intoxicating substances or
fear of bodily harm
 Mentally competent

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Termination of Contract
Most nurse – patient contracts end when
 Treatment is complete
 Bills has been paid
 Waiver to discharge against medical advise has been
signed

Legal offense
 Breach of Contract is the failure to perform an
agreement whether expressed or implied, without
cause

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Legal excuse or defence
Torts
 A civil wrong committed against a person or
property, excluding breach of contact, which calls for
compensation in damages
 The wrongdoing can be inflicted by commission or
omission
 Can be intentional or unintentional

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Unintentional Torts Negligence
 Doing an act which a prudent person would not do or
not taking an act which a prudent person would do in
the same situation
 Can be considered as grave felony if done with
obvious disregard of the safety of others, or
indifference to injury that is bound to follow one’s act,
specifically when it results to injury or death
 Nurses are liable for poor outcomes if and only if there
conduct is negligent.

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Gross Negligence/ Reckless Imprudence
 Involves extreme breach of care, in which the
damage caused was not immediate or danger is not
evident or manifested

Simple Negligence
 Manifesting lack of precaution in which the damage
caused was not immediate or the danger is not
evident or manifested.

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Malpractice
 Professional negligence
 Failure to meet the standards of acceptable care which
results to harm to other person
 Negligence that occurred while the person was
performing as a professional

Elements of Negligence and Malpractice


1. Duty
2. Breach of Duty
3. Foresee ability & Causation
4. Harm or injury
5. Damages

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Doctrines Applicable To Negligence Suits
Respondeat Superior
“let the master answer for the subordinates”
where an agent acts through the agency of another
(superior), the latter is himself acting through the
former

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Res Ipsa Loquitor
 “ the thing speaks for itself”
 when a thing which has caused an injury is shown to
be under the management of the party charge with
negligence, the accident is as such as in the ordinary
course of thing will not happen if those who have
such management used proper care, the accident
itself affords reasonable evidence in the absences of
an explanation by the parties charge that is those
from the want of proper care.

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Three elements
(1) the event would have not occurred if the nurse
exercised prudent care,
(2) the accident occurred within exclusive control of
the nurse,
(3) no voluntary action was done by the injured party.

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Force Majeure
 “irresistible or superior force”
 no one shall be held liable for negligence done due
to an event that human prudence cannot foresee,
prevent or control
 pertains to act of God and of nature

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Definition of Terms
 Murder
killing of another person other than relative with
proven malice or premeditation
 Parricide
killing of father, mother or child, whether
legitimate or illegitimate, or any of his ascendants
or descendants including the spouse.
 Homicide
killing of any human creature. It is not necessarily a
crime, committed without criminal intent and
without criminal consequence.

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 Infanticide
killing a child less than 3 days of age
 Abortion
expulsion of fetus so early that it has not yet acquired
the power of sustaining independent life
 Simulation of Birth
substituting one child to another, falsification of
birth favoring adoption
 Burglary
entry into building with intent to commit a theft or
felony inside the building

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 Robbery
direct taking of property from another by the use of force,
intimidation or fear
 Arson
burning a building or structure with malicious intent
 Rape
Forcible penetration of organ ocopulation or any
inanimate object to any body orifice of the offended party
 Child molestation
engaging in any sexual act with a person under age 18
 Drug charges
possession and/or trade of control substance
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Considerations to Criminal Liability Justifying
Circumstances (there is no crime in the eye of
the law)
 unlawful aggression on the part of the offended or
injured party reasonable necessity of the means
employed by the offender lack of sufficient
provocation on the part of the offender

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Exempting Circumstances (there is crime
committed but no criminal on account of absence
of free will or voluntariness)
 imbecile or insane person, unless the latter has acted
during a lucid interval under nine years old over
nine and under fifteen years old (unless acted on
discernment)

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 under the compulsion of an irresistible force any
person who while a performing a lawful act with due
care, causes an injury by mere accident, without
fault or intention of doing it acting on impulse of an
uncontrollable fear of an equal or greatly injury
failure to perform an act required by law when
prevented by some insuperable cause

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Mitigating Circumstances (penalty is lessened)
 circumstances otherwise justifying or exempting
under 18 years of age; over 70years old offender had
no intention to commit so grave a wrong as that
committed sufficient provocation or threat on the
part of the offended party immediately preceded the
act

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 the act was committed in the immediate vindication
of a grave offense to the committing felony, his
spouse, relatives whether legitimate or not acted on
impulse so powerful as naturally to have produced
passion or obfuscation surrendered himself or
voluntarily confessed his guilt

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 deaf, dumb, blind or other physical defects that
restricts better communication
 illness that would diminish the exercise of his will
power without however depriving him of
consciousness of his acts

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Aggravating Circumstances (penalty is increased)
 advantage taken by the offender of his public
possession crime committed in contempt or with
insult to public authorities act committed with abuse
of confidence or obvious ungratefulness crime
committed during conflagration, shipwreck,
earthquake, epidemic or misfortune

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 crime committed in consideration of a piece, reward,
or promise crime committed by means of inundation,
fire, poison, explosion, standing of a vessel or
anything involving great waste or ruin act committed
with evident premeditation fraud or disguise are
employed

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Self-Protection of the Nurse
 familiarity with the laws, code of ethics, rules and
regulation, and standards of practice clinical
competence cultural sensitivity and respect self-
awareness sound management concept of personal
liability documentation/recording

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Documentation
Principles of documentation
 Records are legal documents and are admissible as
evidence in a court of law
 Nurses must accurately document each step of the
Nursing Process in the client’s records
 Records entries should be brief, accurate, legible
chronologic, made on consecutive lines and
appropriately signed
 Falsification is illegal, including omission of relevant
information

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Incidents Reports
Purpose of incident reports:
 to memorize in writing any unusual event at time
of its occurrence by a person who was a direct
personal witness.
 It is generally used for management and
documentation purposes only.
 The whole purpose of incident reporting is to
LEARN from the mistakes and how to eliminate,
reduce and manage the risks we have to deal with
on a daily basis.
 It cannot be used as evidence in lawsuits.

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What an incident report should contain
 The date
 The place
 The position of the individual reporting (not
necessarily the name)
 A description of the incident or issue
 Whom it is reported to

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 What should be done to correct it
 What has been done to correct it
 A space for follow up reporting
 The signature of the individual reporting
 The date and time the reporting is received by the
Risk Manager
 Action of the Risk Manager

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Common situations that require Incident report
 Break in aseptic technique
 Incorrect sponge count in surgery
 Medical – legal incident
 Client or family refuses treatment as ordered and
refuses to sign consent

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 Client or family voices dissatisfaction with care and
situation, cannot be or has not been resolve
 Complication from diagnostic or treatment
procedures ( e.g. Blood sample stick, biopsy, x-ray,
invasive procedure)
 Failure to report change inpatient’s condition
 Falls
 Patient is burned

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Nursing Ethics
Morality
 usually refers to private, personal standard of what is
right and wrong.
 Moral issues involve important social values and
norms

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Ethics
 refers to a method of inquiry about the rightness or
wrongness as a human actions; the practices or
beliefs of a group; and the standards of moral
behavior described in the group’s formal code of
ethics

Bioethics
 ethics as applied to “life situations “(e.g. decisions
about euthanasia, prolonging life, abortion)

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Nursing ethics
 ethical issues that occur in the context of nursing
practice – questions that must address with regard
to their own actions
Values
 freely chosen, long-lasting beliefs or attitudes about
the worth of something (e.g. a person or an idea)
Value system
 a personal set of beliefs on a continuum from most
to least important, thus providing the basis for
decisions and choices

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 Moral theories guide nurses in ethical decision
making
 Consequence based– judge the rightness of the
action based on the consequences it produces (the
end justifies the means)

Utilitarianism– views a good act as one that brings


the least harm and the most good to the people
“choose the lesser evil”

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Principle based– emphasis on individual rights,
duties and obligations. An action is moral if it follows
an impartial, objective principle

Relationship based–stresses courage, generosity,


commitment and the need to nurture and maintain
relationships, promote the common good or the
welfare of all group, rather than stressing the
individual rights.

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 Bioethical Principles Autonomy – from the Greek
work “autos” meaning self and “nomos” meaning
rule or law, thus refers to self law. Implies individual
rights, privacy and choice. Autonomy entails the
ability to make a choice from external constraints.

 Beneficence - the duty to do good and the active


promotion of benevolent acts(e.g. goodness,
kindness, charity)

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Confidentiality – relates the concept of privacy.
Information obtained from an individual will not bed
is closed to another unless it will benefit the person or
there is a direct threat to the social good.

Double effect– a principle that may morally justify


some actions that some may produce both good and
evil effect.

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 Fidelity– promise keeping; duty to be faithful to
one’s commitments and promises
 Justice– fair, equitable and appropriate treatment
according to what is due or owed to persons.
 Non maleficence– the duty not to inflict as well as
to prevent and remove harm.
 Sanctity of Life– the perspective of that life is the
highest good. Thus all forms of life, including mere
biologic existence should take precedence over
external criteria for judging quality of life.

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 Veracity– the obligation to tell the truth and not to
lie or deceive others

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