Professional Adjustment and Nursing Jurisprudence

JAY LAPAZ ANDRES, RN, BSN, MAN©, MAEd. ©

I. PERSONAL AND PROFESSIONAL GROWTH AND DEVELOPMENT

a. Historical Perspectives in Nursing

The Philippine Nurses Association (PNA) established in 1922 was responsible

in lobbying our government for the adoption of the recommendations made by the
International Labor Organization in 1977 with regard the status of the economic
and social welfare of our nursing personnel. The Professional Regulation
Commission of the Philippines duly recognizes the PNA as the leading
Association of nurses in the country. In 1924, it published a standardized
curriculum for schools of nursing to adopt.

The following were the first groups interested and registered with the
Philippine Nurses’ Association (PNA), to wit:
Academy of Nursing of the Philippines, Inc. (ANPHI)
Association of Deans & Principals of Schools and Colleges of Nursing of the
Philippines (ADPSCNP)
Association of Nursing Administrators of the Philippines ( ANSAP)
Association of Private Duty Nurse Practitioners of the Philippines (APDNPP)
Critical Care Nurses’ Association of the Philippines (CCNAP)
Catholic Nurses Guild of the Philippines (CGNP)
Golden Age Nurses Association (GANA)
Ministry of Health National League of Nurses (MHNLN)
Occupational Health Nurses Association of the Philippines (OHNAP)
Operating Room Nurses Association of the Philippines (ORNAP)
Philippine Nurse Midwifery Society
Philippine Nursing Students Association (PNSA)
Philippine Orthopedic Nurses Society
Psychiatric Nursing Specialists Foundation of the Philippines, Inc. (PNSI)
Philippine School Nurses Association (PSNA)

The following are the later members of the PNA:

Association of Diabetes Nurse Educators of the Philippines (ADNEP)

Graduate Nurses Christian Fellowship (GNCF)
Integrated Nurses Association of the Philippines (IRNUP)
National League of Philippine Government Nurses (NLPGN)
Maternal and Child Nurses Association of the Philippines (MCNAP)
Military Nurses Association of the Philippines (MNAP)
Philippine Oncology Nurses Association (PONA)
Philippine Orthopedic Nurses Society (PONS)
 TIMELINE IN THE NURSING HISTORY:

 In the early dawn of human history, diseases or illness were often related to
superstitious beliefs and the treatment also often involved magical cures.
 The Sumerian Civilization is believed to have recorded in a clay-tablet 4,000
years ago some healing prescriptions but did not specify the illnesses.
 The Code of Hammurabi traceable to the Babylonian empire in 1900 BC
documented regulations pertaining to sanitation and public health, the practice of
surgery, differentiation in the practice of human against veterinary medicine, a
table of fees for operations and penalties for violation of the code. During these
early days, nursing practice was vaguely described as those who render comfort
and support to patient. In the Old Testament, it made mention of women as nurses
who provided care for infants and children, the sick and dying
 The Greek and Roman empires related the care of the sick and those injured to the
mythologies that they have created and believed that the gods and goddesses
possessed special healing powers. Hygeia, daughter of Greek god Asklepios, the
chief healer, was revered to be the embodiment of the nurse.

 Ancient India – Nursing functions were being carried out by male nurses provided they
meet the four qualifications:
1. knowledge of the manner in which drugs should be prepared for administration
2. cleverness
3. devotedness to the patient
4. purity of mind and body

 Christian Benevolence- “love thy neighbor as thyself” had a significant impact on the
development of Western Nursing.
 The principle of “Good Samaritan” is the basis of caring for most Christians that eventually
laid down some principles of nursing.
 During the time of the Roman Empire, rich matrons such as Fabiola used their wealth to
provide houses of care and healing that served as the early hospitals for the poor, sick and
the homeless.
 The Time of Crusades ( Holy mission or pilgrim to regain the Holy land by the Christians),
knights were trained to provide care for the wounded soldiers in the battle – this is perhaps
the earliest recognition of men providing nursing care.
 Camillus De Lellis – considered the patron saint of nurses was the founder of the Nursing
Order of the Ministries who provided care to the sick and the poor.
 Florence Nigthangle born from a wealthy family chose to dedicate her life in providing
care for the sick and injured especially during the Crimean War. She also started a school to
train nurses in 1860, which eventually sparked the development of Modern Nursing.

NURSING AS A PROFESSION
Profession - “ an occupation or calling requiring advanced training and experience in some
specific or specialized body of knowledge which provides service to society in that special
field.”
- It is a calling that requires special knowledge, skill and preparation.
- “ a calling in which its members profess to have acquired special knowledge, by
training or by experience or by both, so that they may guide or advice or serve
others in that special field.”

A profession is generally distinguished from other kinds of occupations/vocations by:

1. Requirement of prolonged, specialized training to acquire a body of knowledge
pertinent to the role to be performed usually entrusted to higher education.
2. An orientation of the individual toward service, either to a community or to an
organization.
3. The members must be united and identified through their membership and they must
be clearly separated from the laypeople or the ordinary congregations.
4. The society which it intends to serve has an indispensable need for such services and
which others cannot provide and the society accepts it.
5. The techniques or skills applied are the product of scientifically proven and long
experience.
6. Requirement to exercise discretion and judgment as to the time and manner of the
performance of the duty.
7. The presence of common values, cultures, and norms uniquely found among its
members which are also being guided by its own code of ethics.
8. The ability to continue its research to expand constantly its body of knowledge.

Characteristics of a profession:
1. Autonomy – (independence and self-governance) the ability to chart or carve its own
destiny independent from others.
2. Authority – possession of highly advanced and competent skills/mastery of such
knowledge and skills not available to the general public.
3. Accountability – responsibility/liability to own up its actions.

Nursing- “is primarily assisting the individual (sick or well) in the performance of those
activities contributing to health, or its recovery (or to a peaceful death) that he would perform
unaided if he had the necessary strength, will, or knowledge. It is likewise the unique
contribution of nursing to help individual to be independent of such assistance as soon as
possible.” (Virginia Henderson, 1958; 1978)
Nursing is putting “the patient in the best condition for nature to act.” This description/definition
was given by Florence Nightangle, dubbed as the first nursing theorist. She made use of the
environment (clean and healthy surrounding) in the recovery of an ill patient.

Nursing- is the diagnosis and treatment of human responses to actual and potential health
problems (ANA).

 The common focus of nursing is the need to provide humanistic and holistic care that
includes the four areas related to health:
1. Health Promotion
2. Health Maintenance
3. Health Restoration
4. Care of the Dying

RA 9173 or the Philippine Nursing Act of 2002 gives the meaning of nursing practice through
the following:

-alone or in collaboration with another, initiates and performs nursing services to individuals,
families and communities in any health care setting that includes:
1. nursing care during conception, labor, delivery, childhood, adulthood and old age

2., promotion of health and prevention of illness.

3. collaboration with other health care providers for the curative, preventive, and rehabilitative
aspects of cares, restoration of health, alleviation of suffering and when recovery is not possible
towards a peaceful death.

Nursing Practice – covers the three areas of nursing, namely: nursing education, nursing service,
and community health nursing (Rule 1 Sect. 3 (d) IRR RA 9173).

Professional Nurse – a person whose name and registration/professional license number is

entered in the Commission’s registry book and computerized database as legally authorized to
practice the nursing profession (Rule 1 Sect. 3 (e) IRR RA 9173).

Practicing Professional Nurse- a person who is engaged in the practice of nursing profession or is
performing acts or activities, whether regularly or occasionally, including one who is employed
in a government office or in a private firm, company or corporation whose duties require
knowledge and application of the nursing profession (Rule 1 Sect. 3 (f) IRR RA 9173).

Foreign Professional Nurses – foreign nationals who, being licensed professional nurses in their
own countries, are authorized by existing laws to practice their profession either as holders of a
certificate of registration and professional identification card or a special/temporary permit in the
Philippines subject to some provisions of RA 9173 (Rule 1 Sect. 3 (g) IRR RA 9173).
Nursing Specialty Program – a training and development program intended to develop/enhance
the skills, to which a registered nurse devotes himself /herself whether as a vocation or
profession to enable him/her to provide nursing service in specific areas in accordance with the
ethics of the profession and applicable law.

THEORETICAL FOUNDATION OF NURSING APPLIED IN HEALTH CARE

SITUATIONS
 Purposes of Nursing Theories and Conceptual Frameworks (Kozier et al.,45)

 Provide direction and guidance for:

a. structuring professional nursing practice, education and research
b. Differentiating the focus of nursing from other professions.

 Assist nurses to describe, explain and predict everyday experiences.

 Serves to guide assessment, intervention, and evaluation of nursing care
 Provide a rationale for collecting reliable and valid data about the health status of clients,
which are essential for effective decision making and implementation.
 Help to establish criteria to measure the quality of nursing care
 Help build a common nursing terminology to use in communicating with other health
professionals. Ideas are developed and works defined.
 Enhance autonomy (independence and self-governance) of nursing through defining its
own independent functions.
 Provide a general focus for curriculum design
 Guide curricular decision making
 Offer framework for generating knowledge and new ideas
 Assist in discovering knowledge gaps in the specific field of study
 Offer a systematic approach to identify questions for study, select variables, interpret
findings, and validate nursing interventions

Concepts – are abstract ideas or mental images of phenomena or reality. It can be concrete ideas
that can be mentally pictured (eg. Cars, cellphones, house); or it can be abstract ideas (eg.
Powerlessness, adaptation, nursing).

Nursing theories addresses the following four major concepts:

1. Person or client
2. Environment
3. Health/illness
4. Nursing

Conceptual Framework – group of related concepts. It can also be viewed as an umbrella under
which many theories can exist (Cresia & Parker 1991,p7).

Conceptual Model- is a system of related concepts or a conceptual diagram.

Model- graphic illustration of relationships.

Theory- is made up of concepts and propositions; however, a theory accounts for phenomena
with much greater specificity.

GENERAL THEORIES IN NURSING

Nightangle’s Environmental theory – Florence Nightangle, “the mother of modern nursing”

espoused her theory focusing on the environment. She linked health with five environmental
factors:

(1) pure or fresh air

(2) pure water
(3) efficient drainage
(4) cleanliness
(5) light

Henderson’s Definition of Nursing- The definition of nursing given by Virginia Henderson in

1955 became a milestone in the development of nursing as discipline apart from medicine. The
focus on her Nursing Concept is to help individuals and families gain independence in meeting
the 14 fundamental needs;
(1) Breathing normally
(2) Eating and drinking adequately
(3) Eliminating body wastes
(4) Moving and maintaining desirable position
(5) Sleeping and resting
(6) Selecting suitable clothes
(7) Maintaining body temperature within normal range by adjusting clothing and modifying
the environment
(8) Keeping the body clean and well-groomed to protect the integument
(9) Avoiding dangers in the environment and avoiding injuring others
(10)Communicating with others in expressing emotions, needs, fears, or opinions
(11)Worshipping according to one’s faith
(12) Working in such a way that one feels a sense of accomplishment
(13) Playing or participating in various forms of recreation
(14) Learning, discovering, or satisfying the curiosity that leads to normal development and
health, and using available health facilities.

Rogers’s Science of Unitary Human Beings - Martha Rogers views the person as an irreducible
whole, the whole being greater than the sum of its parts. Her Key concepts in describing the
individual are energy fields, openness, pattern and organization, and multidimensionality. She
described the Unitary Man as:
(1) Irreducible, four-dimensional energy field identified by pattern.
(2) Manifesting characteristics different from the sum of the parts
 (3) Interacts continuously and creatively with the environment
(4) Behaving as a totality
(5) Participating creatively in change

Orem’s Self Care Deficit Theory – Dorothy Orem developed the self-care deficit theory that
includes self-care, self-care deficit and nursing system. She believed that the self-care of the
individuals and the self-care of dependents are learned behaviors that individuals initiate and
perform on their own behalf to maintain life, health, and well-being. According to Rogers, there
are three kinds of self-care requisites:
(1) Universal requisites ( common to everybody like maintenance of air, water etc…)
(2) Developmental requisites
(3) Health deviation requisites

Roy’s Adaptation Model – Sister Callista Roy focuses on the individual as a biophysical
adaptive system. Both the individual and the environment are sources of stimuli that require
modification to promote adaptation, an ongoing purposive response. Roy identified three classes
of stimuli:
(1) Focal Stimulus: the internal or external stimulus most immediately confronting the
person and confronting the behavior.
(2) Contextual stimuli: all other internal or external stimuli present
(3) Residual Stimuli: beliefs, attitudes, or traits having an intermediate effect on the person’s
behavior but whose effects are not validated.

King’s Goal Attainment Theory – Imogene King based her theory from the conceptual
framework of three dynamic interacting systems:
(1) personal system concepts: perception, self, body image, growth and development, space
and time
(2) Interpersonal system concepts: interaction, communication, transaction, role, and stress.
(3) Social system concepts: organization, authority, power, status, and decision making.

Neuman’s Health Care Systems Model – Betty Neuman views the client as an open system
consisting of a basic structure or central core of energy resources (physiologic, psychologic,
sociocultural, developmental, and spiritual) surrounded by two concentric boundaries or rings
referred to as lines of resistance. She identified individual’s response to stress and the nursing
interventions to be carried out on three preventive levels:
(1) Primary prevention
(2) Secondary prevention
(3) Tertiary Prevention

Johnson’s Behavioral System Model - Dorothy Johnson defines a system as a whole that
functions as a whole by virtue of the interdependence of its parts. A behavioral system is
patterned, repetitive and purposeful. Johnson’s key concepts describes the individual as a
behavioral system composed of seven subsystems:
 (1) attachment-affiliative subsystem provides survival and security.
(2) Dependency subsystem promotes helping behavior that calls for a nurturing response.
(3) Ingestive system satisfies appetite.
(4) Eliminative subsystem excretes body wastes.
(5) Sexual subsystem functions dually for procreation and gratification.
(6) Achievement subsystem attempts to manipulate the environment.
(7) Aggressive subsystem protects and preserves the self and society within the limits
imposed by the society.

Peplau’s Psychodynamic Nursing Theory- Hildegard Peplau introduced and defined

psychodynamic nursing as understanding one’s own behavior to help others identify felt
difficulties and applying principles of human relations to problems arising during the experience.
She also described the nurse-patient relationship in four phases:

(1) Orientation – patient seeks help and the nurse assists patient to understand the problem
and the extent of need for help.
(2) Identification - patient assumes a posture of dependence, interdependence, and
independence in relation to the nurse
(3) Exploitation - patient uses available services on the basis of self interest and needs
(4) Resolution - old needs and goals are put aside and new ones adopted.

Leininger’s Transcultural Care Theory – Madeleine Leininger established the transcultural

nursing which she defined as a major area of nursing that focuses on comparative study and
analysis of different cultures and subcultures in the world, with respect to their:
(1) Caring behavior
(2) Nursing care
(3) Health values
(4) Beliefs
(5) Patterns

Watson’s Philosophy and Science of Caring – Jean Watson believes the practice of caring is
central to nursing; it is a unifying focus for practice. According to her, there are two major
assumptions that underlie human care (carative factors):
(1) care and love constitute the primal and universal psychic energy
(2) care and love are requisite for our survival and the nourishment of the society
FIELDS OF NURSING

The Fields of Nursing may be classified in general as follows:

1. Hospital Nursing or the Institutional Nursing

2. Public Health Nursing
3. Community Health Nursing
4. School Nursing or Nursing Education
 5. Occupational Health Nursing or Industrial Nursing
6. Military Nursing
7. Clinic Nursing
8. Independent Nursing Practice
9. Private Duty Nursing

Institutional Nurses- those employed as staff nurses or nursing personnel in a hospital setting or
similar institutions.

Public Health Nurse – is one who provides nursing care and counsel to persons and families,
either to individual or groups in clinics, in their homes, in school, and at their place of work, and
cooperates with others in health promotion.

Community Health Nurse – a nurse whose work combines the element of nursing and public
health practice and takes place outside the therapeutic institutions.

School Nurse – a registered nurse employed to work in educational institutions to participate in

health programmes for school-aged children. Responsibilities include monitoring growth and
development, screening health problems and supporting those pupils with special needs.

Occupational Health Nurse/ Industrial Nurse – one employed in industry that gives
immediate care to ill or injured workers, follows up on the sick and the injured, and helps
develop accident prevention and health programs for the workers.

Maternal and Child Health Nurse – one who cares for and safeguards the health of mothers
and children.

Nurse Educator – a nurse employed in the teaching or administrative staff of a school of

nursing or other educational institution for nurses.

Pediatric Care Nurse – a registered nurse qualified in the nursing care of the sick child.

Private Duty Nurse – is a registered nurse who independently contracts with a patient; a private
duty nurse is responsible for the total nursing care of the patient during the period she is with
him.

Nursing Administrator – is a professional nurse who is a member of the administrative staff of

a hospital, medical center, public health agency, or a similar institution and who, as a member of
the administrative staff, participates in formulating the policy and objectives of such.
Clinical Nurse Specialist – A professional nurse, who has had special training and experience in
a particular clinical specialty, often holds a degree, and is prepared to give expert care to the
acutely or chronically ill and to assist clients to maintain health.

ETHICO-MORAL RESPONSIBILITY

Ethics – part of philosophy that deals with systematic approaches to questions of

morality.
- a term for the study of how we make judgments regarding right and wrong.
- a system of MORAL PRINCIPLES or moral standards governing conduct.
Morals- human conduct in the application of ethics. Concerned with JUDGMENT PRINCIPLES
of right and wrong in relation to human actions and character.

Nursing Ethics – the code governing the NURSE’S BEHAVIOR, especially towards patients,
employing authority and to the profession.

Beneficence - any action that would BENEFIT others. The principle that imposes upon the
practitioner to seek the good for the patients under all circumstances. Beneficence connotes
positive action toward preventing or removing harm and promoting good such as:
(1) One ought to prevent evil or harm
(2) One ought to remove evil or harm
(3) One ought to do or promote good.

Nonmaleficence – states the idea to REFRAIN from inflicting harm. “one ought NOT to inflict
evil or harm. The admonition of nonmaleficence is stated in the negative manner while the
beneficence is in the positive.

Justice – The basic principle that deals with FAIRNESS, just deserts, and entitlements in the
distribution of goods and services. In health care, justice seems to point to distributive justice
that deals with the allocation of scarce resources. ARTICLE XIII of the 1987 Constitution
provides: The State shall adopt an integrated and comprehensive approach to health development
and shall endeavor to make essential goods; health and social services available to all people at
affordable cost. There shall be priority for the needs of the underprivileged, the sick, the elderly
and the disabled, the women and the children. The State shall endeavor to provide free medical
care to paupers, establish and maintain an effective food and drug regulatory system, and
undertake appropriate health manpower and development and research responsive to the
country’s health needs and problems. It shall establish a special agency for disabled persons for
their rehabilitation.

Some methods of distributing goods and services in our society are as follows:
(1) To each, an equal share
(2) To each, according to need
(3) To each, according to effort
(4) To each, according to contribution
(5) To each, according to merit
(6) To each, according to ability to pay

Autonomy - In health care, it means the form of personal LIBERTY, where the individual is free
to choose and implement ones’ own decisions, free from deceit, duress, constraint, or coercion.
Three Basic elements involved:

(1) ability to decide

(2) power to act upon your decisions
(3) a respect for the individual autonomy of others.
Stewardship – refers to the actions made for by the health practitioner IN BEHALF of the
patient and for the greater benefit of the patient.

Truth Telling/Veracity – The patient must tell the truth in order that appropriate care can be
provided. The health practitioner needs to disclose FACTUAL INFORMATION so that the
patient can exercise personal autonomy.

Confidentiality - is also known as PRIVILEGED COMMUNICATION which refers to any

information obtained by the nurse or the health team during the course of caring for the patient.
The information gathered may only be disclosed under the following:
(1) the patient agrees to divulge such information with written consent
(2) the information is material in a criminal case investigation
(3) if public safety is jeopardized (communicable disease)
(4) such information is relevant to his care to be utilized by other health team

Priviliged Communication may be divided into two classes:

(1) Absolute privileged communication – is one made in the interest of the public service or
the due administration of justice and is practically limited to legislative and judicial
proceedings and other actions of the state.
(2) Qualified privileged communication – is a slanderous statement uttered in good faith, and
made on a proper occasion, from a proper motive, based upon a probable cause and in
honest belief that such statement is true.

MORAL PRINCIPLES

 GOLDEN RULE – “ Do unto others what you would like others do unto you”. It is a
basic moral principle that if you want others to respect you, you must also accord respect
to them.
 THE TWO FOLD-EFFECT - facing a situation which would have good and bad effects
requires the following basis for arriving a decision:
a. that the action must be morally good
b. that the good effect must be willed and the bad effect merely allowed
 c. that the good effect must not come from an evil action but from initial action itself
directly; and
d. that the good effect must be greater than the bad effect.

 THE PRINCIPLE OF TOTALITY – states that the whole is always greater than its
parts. To save the patients’ life as a whole, it is justified under this principle to surgically
cut-off a disease body part of the patient.
 EPIKIA – “exception to the general rule”. It is reasonable presumption that the authority
making the law will not wish to bind a person in some particular case, even though the
case is covered by the letter of the law.
If a mentally ill patient becomes berserk and the doctor could not be contacted, the
patient may be restrained by virtue of epikia.
Another example of this is allowing a relative to see a seriously ill patient who expresses
the desire the relative although it is not yet visiting hours
 THE END DOES NOT JUSTIFY THE MEANS – giving a sleeping tablet to a
chronically ill person so he/she can de in peace is morally wrong.
 THE GREATEST GOOD FOR THE GREATEST NUMBER – during an epidemic,
immunization against communicable diseases is administered to the people. Although
there may be some who may have slight reactions to the vaccine, the greater majority of
the population shall be considered.
 NO ONE IS HELD TO THE IMPOSSIBLE – the doctors and nurses are not
guarantors of life. They cannot be held liable as long as they have done everything that
modern medicine can afford to save a patient from dying.
 THE MORALITY OF COOPERATION – formal cooperation in an evil act is never
allowed. A nurse shall not participate upon immoral operations such as abortion even if
the doctor commands it.
 PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION OF LIFE –
mercy killing or euthanasia is not allowed because it will lessen the incentive to medical
research. The state recognizes the sanctity of life. It shall protect the life of the mother
and the unborn since conception. Any direct attack on the life of a fetus for whatever
cause is immoral. A fetus shall be buried in consecrated grounds. If it is dead and came
from dead mother, it shall be buried with the mother.

Privacy – the right to be left alone or be apart from others. This right is guaranteed by most
civilized state laws and enshrined also in the patients’ bill of rights. The patient has the right to
every consideration of his privacy concerning his own medical care program. Case discussion,
consultation, examination and treatment are confidential and should be conducted discreetly.
Those not directly involved in his care must have the permission of the patient to be present. This
right also includes privacy of one’s thoughts, opinions and physical presence and privacy of
one’s records.
Informed Consent –The patient UNDERSTANDS the reason for the proposed intervention,
with its benefits and risks, and agrees to the treatment by affixing his signature in the consent
form. It generally contains the following elements:
(1) disclosure
(2) understanding
(3) voluntariness
(4) competence
(5) permission giving

 In our present jurisdiction under the 1987 Constitution, the age of majority is 18 years
old. It means that only 18 years old and above can sign for themselves in legal matters
such as the signing of consent (hospital admission, contracts, will etc..)

The Patients Bill of Rights (Filipino)

1. The patient has the right to considerate and respectful care, irrespective of socioeconomic
status
2. The patient has the right to obtain from his physician complete current information
concerning his diagnosis, treatment and prognosis in terms the patient can reasonably be
expected and understand. When it is not medically advisable to give such information to
the patient, the information should be made available to an appropriate person in his
behalf. He has the right to know by name and in person, the physician and nurse
responsible in coordinating his care.
3. The patient has the right to receive from his physician information necessary to give
informed consent prior to the start of any procedure and/or treatment. Except in
emergencies, such information for informed consent should include but not necessarily
limited to the specific procedure and/or treatment, the medically significant risks
involved, and the probable duration of incapacitation. Where medically significant
alternatives for care or treatment exist, or when the patient requests information
concerning medical alternatives, the patient has the right to such information. The patient
has also the right to know the name of the person responsible for the procedures and/or
treatment.
4. The patient has the right to refuse treatment/lifegiving measures, to the extent permitted
by law, and to be informed of the medical consequences of his action.
5. The patient has the right to every consideration of his privacy concerning his own
medical care program. Case discussion, consultation, examination and treatment are
confidential and should be conducted discreetly. Those not directly involved in his care
must have the permission of the patient to be present.
6. The patient has the right to expect that all communication and records pertaining to his
care should be treated confidential.
7. The patient has the right to expect that within its capacity, a hospital must make
reasonable response to the request of patient for services. The hospital must provide
evaluation, service and/or referral as indicated by the urgency of care. When medically
 permissible a patient may be transferred to another facility only after he has received
complete information concerning the needs and the alternatives to such transfer. The
institution to which the patient is to be transferred must first have accepted the patient for
transfer.
8. The patient has the right to obtain information as to any relationship of the hospital to
other health care and educational institutions in so far as his care is concerned. The
patient has the right to obtain information as to the existence of any professional
relationship among individuals, by name, who are treating him.
9. The patient has the right to be advised if the hospital proposes to engage in or perform
human experimentation affecting his care or treatment. The patient has the right to refuse
or participate in such research project.
10. The patient has the right to expect reasonable continuity of care; he has the right to know
in advance what appointment times the physicians are available and where. The patient
has the right to expect that the hospital will provide a mechanism whereby his physicians
or a delegate of the physician of the patient’s continuing health care requirements
following discharge informs him.
11. The patient has the right to examine and receive an explanation of his bill regardless of
source of payment.
12. The patient has the right to know what hospital rules and regulations apply to his
conduct as a patient.

The PATIENTS RESPONSIBILITIES towards his care in the hospital:

1. Providing information – It is a responsibility of the patient to provide the staff

with accurate and complete information, to the best of his knowledge, about the
history of his illness, complaints. If the patient is unable to do so, then her
immediate family member may give such information.
2. Complying with instructions – the patient is responsible for complying with the
treatment recommended by the attending physician or health team that is
primarily responsible for his care.
3. Informing the physician of refusal to treatment – A patient who refuses
treatment or to be compliant with the treatment regimen must inform the
physician of his decision.
4. Paying the hospital charges – upon admission, the patient understands that he or
she must pay the charges that he or she may incur in th course of her treatment.
The exception is of course if the patient is admitted on charity hospitals giving
everything for free.
5. Adherence to hospital rules and regulations – the patient is also governed by
the rules and regulation of the hospital which he or she is seeking medical help for
his/her condition. The patient or the immediate family member must read the rules
or must be informed about the policy of the hospital and must adhere to them.
 6. Consideration and respect for others – the patient must also show respect for
other patients admitted in the hospital.

NURSES’ BILL OF RIGHTS

(1) Nurses have the right to practice in a manner that fulfills their obligation to
society and to those who receive nursing care.
(2) Nurses have the right to practice in environments that allow them to act in
accordance with professional standards and legally authorized scopes of practice.
(3) Nurses have the right to a work environment that supports and facilitates ethical
practice, in accordance with the code of Ethics for nurses and its interpretive
statements.
(4) Nurses have the right to freely and openly advocate for themselves and their
patients, without fear or retribution
(5) Nurses have the right to a fair compensation for their work, consistent with their
knowledge, experience, and professional responsibilities.
(6) Nurses have the right to a work environment that is safe for themselves and their
patients.
(7) Nurses have the right to negotiate the conditions of their employment, either as
individuals or collectively, in all practice settings.

BASIC HUMAN RIGHTS ON RESEARCH SUBJECTS:

(1) Right to informed consent

(2) Right to refuse and/or withdrawal from participation
(3) Right to privacy
(4) Right to confidentiality
(5) Right to be protected from harm

CODE OF ETHICS IN NURSING

 The fundamental responsibility of the nurse is fourfold: to promote health, to prevent

illness, to restore health and to alleviate suffering.
 The need for nursing is universal. Inherent in nursing is respect for life, dignity and the
rights of man. It is unrestricted by consideration of nationality, race, creed, color, age sex,
politics, or social status.
 Nurses render health services to the individual, the family and the community and
coordinate their services with those of related groups.
 The following Code for Nurses, adopted by the Council of National Representatives of the
International Council of Nurses was also adopted by the Board of Nursing and became an
integral part of the amended “Code of Nursing Ethics in the Philippines”:

Nurses and People

- The nurse’s primary responsibility is to those people who require nursing care.
The nurse, in providing care, promotes an environment in which the values, customs
and spiritual beliefs of the individual are respected.
The nurse holds in confidence personal information and uses judgment in sharing this
information.

Nurses and Practice

- The nurse carries personal responsibility for nursing practice and for maintaining
competence by continual learning.
The nurse maintains the highest standards of nursing care possible within the reality of
a specific situation
The nurse uses judgment in relation to individual competence when accepting and
delegating responsibilities.
The nurse when acting in a professional capacity, should at all times maintain
standards of personal conduct which reflect credit upon the profession.

Nurses and Society

- The nurse shares with other citizens the responsibility for initiating and supporting
action to meet the health and social needs of the public.

Nurses and the Profession

- The nurse plays the major role in determining and implementing desirable standards
of nursing practice and nursing education.
The nurse is active in developing a core of professional knowledge.
The nurse, acting through the professional organization, participates in establishing
and maintaining equitable social and economic working conditions in nursing.

AMENDED CODE OF ETHICS FOR NURSES

Their conduct should be such that would bring credit to the profession. Just like any other
professional, nurses are looked upon with respect in the community. They should therefore
endeavor to live a life that would uphold their self-respect.

Especially when nurses are on duty, they should try to look neat and attractive. Female nurses
are advised to use moderate make-up and have a neat hairstyle. They should wear uniforms that
are not too short or tight fitting that would tend to restrict movements, nor expose unnecessarily
any part of the body while giving care to the patients. Clean uniforms and clean bodies tend to
enhance the image of nurses. Use of anti-perspirant is advised most specially during hot summer
months.

Male nurses are likewise advised to be clean, shaven, hair clipped close to the nape of the
neck instead of flowing to the shoulders.

The use of the uniform should be specified in the policy of the hospital/agency. It should be
worn only when on duty. Dining in the public, shopping or going to the market while in uniform
is discouraged. Nurses’ caps are worn only while on duty. These are either carried in bags or are
left in their places of assignment.

Jewelry, such as earrings, necklaces or bracelets are not allowed while on duty. However,
wedding rings, school rings or school pins may be worn.

Nurses are looked upon by nursing students as their role models. Therefore, especially while
they are on duty, they should act in a manner that is worth emulating. Sincere and compassionate
attitudes toward patients are caught by those around them. Soon their working environment
becomes permeated with good working relationships that are so vital in dealing with patients.

LEGAL RESPONSIBILITY

Legal Aspects in the Practice of Nursing

- The law has always governed the practice of modern nursing. This what makes the every
erroneous nursing action liable to the law, either answerable to the Civil Law or the
Criminal Law or both. The key word to remember in the legal responsibility of nurses is
ACCOUNTABILITY. The professional nurse is expected to render reasonably competent
nursing care to avoid getting entangled with the long arm of the law. Anything short of
such standard required that would cause harm or injury to the patient makes the nurse
 responsible or liable to the law by way of negligence or even malpractice suit. The safe
way to avoid such potential legal problems is amplified in the Philippine Nursing Act of
2002 (RA9173) – that is, for nurses to utilize the nursing process in the performance of
their function and observe the provision of RA 9173 which governs the practice of nursing
in the Philippines.

The Philippine Nursing Act of 2002 (RA 9173) Article VIII Section 35 enumerates the
prohibitions in the practice of nursing: A fine of not less than 50,000.00 nor more than
100,000.00 or imprisonment of not less than 1 year nor more than 6 years, or both, upon the
discretion of the court, shall be imposed upon:

(a) any person practicing nursing in the Philippines within the meaning of RA 9173 of 2002:
(1) without certificate of registration/professional license and professional identification card
or special temporary permit or without having been declared exempt from examination in
accordance with the provision of this Act; or
(2) who uses as his/her own certificates of registration/ professional license and professional
identification card or special/temporary permit of another; or
(3) who uses an invalid certificate of registration/professional license, a suspended or
revoked certificate of registration/professional license, or an expired or cancelled
special/temporary permit; or
(4) who gives any false evidence to the Board in order to obtain a certificate of
registration/professional license, a professional identification card or special permit; or
(5) who falsely poses or advertises as a registered and licensed nurse or uses any other means
that tend to convey the impression that he/she is registered and licensed nurse; or
(6) who appends B.S.N./R.N. or any similar appendage to his/her name without having been
conferred said degree or registration; or
(7) who, as a registered and licensed nurse, abets or assists the illegal practice of a person
who is not lawfully qualified to practice nursing.

(b) any person or the chief executive officer of a juridical entity who undertakes in-service
educational programs or who conducts review classes for local and foreign examination
without permit/clearance from the board and the Commission; or
(c) any person or employer of nurses who violate the minimum base pay of nurses and the
incentives and benefits that should be accorded them as specified in Sections 32 and 34;
or
(d) any person or the chief executive officer of a juridical entity violating any provision of
this Act and its rules and regulations.
 THE PHILIPPINE NURSING ACT OF 2002 OR RA 9173

- An Act providing for more responsive nursing profession, repealing for the purpose
Republic Act 7164, otherwise known as the “Philippine Nursing Act of 1991” and for
other purposes.

(Note: The following presentation is the reproduction of RA 9173 with explanation on selected
articles appearing in the italics)

ARTICLE I

TITLE
 SECTION 1. Title – This Act shall be known as the Philippine Nursing Act of 2002.”

ARTICLE II

DECLARATION OF POLICY

SECTION 2. Declaration of Policy. – It is hereby declared the policy of the State to assume
responsibility for the protection and improvement of the nursing profession by instituting
measures that will result in relevant nursing education, humane working conditions, better career
prospects and a dignified existence for our nurses.

The State hereby guarantees the delivery of quality basic health services through
an adequate nursing personnel system throughout the country.

ARTICLE III

ORGANIZATION OF THE BOARD OF NURSING

SECTION 3. Creation and composition of the Board - There shall be created a created a
Professional Regulatory Board of Nursing, hereinafter referred to as the Board, to be composed
of a Chairperson and six (6) members. They shall be appointed by the President of the Republic
of the Philippines from among the two (2) recommendees, per vacancy, of the accredited
professional organization of nurses in the Philippines who possess the qualifications prescribed
in Section 4 of this Act.

NOTE: The structure of the members of the Board of Nursing was augmented from 5 members
under RA 7164 to 7 members in RA 9173. The chairperson shall have six members, shall cover
the three areas of nursing, namely: nursing education, nursing service, and community health
nursing. The members now are selected from two recommendees coming from the endorsement
of Accredited Professional Organization (Philippine Nursing Association) which also pre-
selected their endorsement not later than three months prior to expected vacancy from three
nominees per vacancy unlike under RA 7164 where the President appoints the members from 12
nominees. The 7 positions in the Board of Nursing does not ( mandatory) require that all
positions be filled up in order to function ,if the majority positions are occupied then it
constitute the Board to function.

SECTION 4. Qualifications of the Chairperson and the Members of the Board. – The
Chairperson and the Members of the Board shall, at the time of their appointment, possess the
following qualifications:

(a) Be a natural born citizen and resident of the Philippines;

NOTE: Natural born Filipino citizen are those Filipino who, since birth did not make any
positive act to perfect their citizenship.

(b) Be a member of good standing of the accredited professional organization of

nurses;

NOTE: The Accredited Professional Association (APO) recognizes the Philippine Nurses
Association (PNA) as mentioned in the Implementing Rules and Regulation of RA 9173. The
other existing members of PNA mentioned in the preliminary chapter of this reviewer are
deemed also accredited to satisfy this requirement.

( c ) Be a registered nurse and holder of a master’s degree in nursing, education or

other allied medical profession conferred by a college or university duly recognized by the
government: Provided, That the majority of the Members of the Board shall be holders of a
master’s degree in nursing: Provided, further, That the Chairperson shall be a holder of master’s
degree in nursing.

NOTE: The new requirement for the members of the Board is a departure from the previous
requirement requiring all members of the Board to be master’s degree holder in Nursing. RA
9173 provides that only the chairperson and a majority (not all the members) of the members
must be master’s degree holder in nursing and the other members may be master’s degree
holder in education or other allied health profession.

(d) Have at least ten years (10) years of continuous practice of the profession prior to
appointment: Provided, however, That the last five years (5) of which shall be in the
Philippines; and

NOTE: This new provision which was silent in the previous law allows the member of the Board
to qualify as a nominee even if she practiced nursing abroad, only that, the last five years before
the appointment, that member must have practiced her nursing profession in the Philippines.

(e) Not have been convicted of any offense involving moral turpitude;

Provided, That the membership to the Board shall represent the three areas of nursing,
namely: nursing education, nursing service and community health nursing.

NOTE: Take note of the key word, convicted. An ongoing prosecution in a criminal case does not
constitute a hindrance to being nominated as a member to the Board because the law speaks of
conviction which means that a competent court had rendered already its final decision on the
case. If such member was convicted in the past for crime involving moral torpidity, even if the
penalty was served, is a prohibition to be nominated in the Board.
 SECTION 5. Requirements Upon Qualifications as Member of the Board of Nursing. – Any
person appointed as Chairperson or Member of the Board shall immediately resign from any
teaching position in any school, college or university or institution offering Bachelor of Science
in Nursing and/or review program for the local nursing board examinations or in any office or
employment in the government or any of its subdivision, agency or instrumentality thereof,
including government-owned or controlled – corporations or their subsidiaries as well as those
employed in the private sector. He/she shall not have any pecuniary interest in or administrative
supervision over any institution offering Bachelor of Science in Nursing including review
classes.

NOTE: The qualification required by this Act means that they must be satisfied at the time of
Appointment. The President is the only person who can appoint such member of the Board and
such appointment commences only after the President approves through her signature in the
appointment paper. This further means that even if the nominee is not yet qualified during the
recommendation period, he/she shall have time to perfect or satisfy all the requirements before
the President signs her appointment. A member may continue to teach in a nursing institution
and may only resign during the time that she is appointed.

SECTION 6. Term of Office. The Chairperson and Members of the Board shall hold office for
a term of three (3 years) and until their successors shall have been appointed and qualified:
Provided, That the Chairperson and Members of the Board may be reappointed for another term.

Any vacancy in the Board occurring within the term of a member shall be filled
for the unexpired portion of the term only. Each Member of the Board shall take the proper oath
of office prior to the performance of his/her duties.

The incumbent Chairperson and Members of the Board shall continue to serve
for the remainder of their term under RA 7164 until their replacements have been appointed by
the President and shall have been duly qualified.

NOTE: The maximum number or years that a member can stay as a member of the Board is six
years because from their original appointment of three years, they are still eligible to be re-
appointed for another three years. However, the Hold-over doctrine applies to this provisions
because it specifically provides that a member shall continue to hold office until their
successors shall have been appointed and qualified.

SECTION 7. Compensation of Board Members. – The Chairperson and Members of the

Board shall receive compensation and allowances received by the Chairperson and Members of
other professional regulatory boards.
 SECTION 8. Administrative Supervision of the Board, Custodian of its Records, Secretariat
and Support Services. – The Board shall be under the administrative supervision of the
Commission. All records of the Board, including applications for examinations, administrative
and other investigative cases conducted by the Board shall be under the custody of the
Commission. The Commission shall designate the Secretary of the Board and shall provide the
secretariat and other support services to implement the provisions of this Act.

SECTION 9. Powers and Duties of the Board. – The Board shall supervise and regulate the
practice of the nursing profession and shall have the following powers, duties and functions:

(a) Conduct the licensure examination for nurse;

(b) Issue, suspend or revoke certificates of registration for the practice of nursing;
(c) Monitor and enforce quality standards of nursing practice in the Philippines and exercise
the powers necessary to ensure the maintenance of efficient, ethical and technical, moral
and professional standards in the practice of nursing taking into account the health needs
of the nation;
(d) Ensure quality nursing education by examining the prescribed facilities of universities or
colleges of nursing or departments of nursing education and those seeking permission to
open nursing courses to ensure that standards of nursing education are properly complied
with and maintained at all times. The authority to open and close colleges of nursing
and/or nursing education programs shall be vested on the Commission of Higher
Education upon written recommendation of the Board.
(e) Conduct hearings and investigations to resolve conduct and violations of this Act, or its
rules and regulations and in connection therewith, issue subpoena ad testificandum and
subpoena duces tecum to secure the appearance of respondents and witnesses and the
production of documents and punish with contempt persons obstructing, impeding and/or
otherwise interfering with the conduct of such proceedings, upon application with the
courts;
(f) Promulgate a Code of Ethics in coordination and consultation with the accredited
professional organization of nurses within one (1) year from the effectivity of this Act;
(g) Recognize nursing specialty organizations in coordination with the accredited
professional organization; and
(h) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and decisions as
may be necessary for the improvement of the nursing practice, advancement of the
profession and for the proper and full enforcement of this Act subject to the review and
approval by the Commission.

NOTE: The adoption and regulation of a Code of Ethics and Code of Technical Standards for the
practice of nursing are new addition in the powers of the Board included in this law. The Board
also exercises quasi-judicial powers because they can issue subpoena duces tecum (court
ordering the person to bring documents with himself to appear before the court) and subpoena
ad testificandum (court ordering the person to be present before the court). The Board can also
punish a person by way of contempt. This power is exercised only by competent courts but the
law delegates such powers to the Board of Nursing through the legislation of RA 9173.Under
this Act, the Board of nursing now recognizes specialty organizations with the accredited
professional organizations.
 SECTION 10. Annual Report. – The Board shall at the close of its calendar year submit an
annual report to the President of the Philippines through the Commission giving a detailed
account of its proceedings and the adoption of measures that will upgrade and improve the
conditions affecting the practice of the nursing profession.

SECTION 11. Removal or Suspension of Board Members. – The President may remove or
suspend any member of the Board after having been given the opportunity to defend
himself/herself in a proper administrative investigation, on the following grounds:

(a) Continued neglect of duty or incompetence;

(b) Commission or toleration of irregularities in the licensure examination; and
(c) Unprofessional, immoral or dishonorable conduct.

NOTE: Only the President of the Philippines has the sole power to remove or suspend the
members of the Board of Nursing. The members of the Board being Presidential appointees are
the alter ego of the President, which means that they are under the whims and caprices of the
appointing officer with respect to their stay in the office.

ARTICLE IV

EXAMINATION AND REGISTRATION

SECTION 12. Licensure Examination. – All applicants for licensure to practice nursing shall
be required to pass a written examination, which shall be given by the Board in such places and
dates as maybe designated by the Commission: Provided, that it shall be in accordance with
Republic Act No. 8981, otherwise known as the “PRC Modernization Act of 2000.”

NOTE: Specific dates as provided for in the previous law are no longer mentioned in the new
law. It used to be not earlier than one month and not later than two months after the closing of
each semestral term.

SECTION 13. Qualifications for Admission to the Licensure Examination. – In order to be

admitted to the examination for nurses, an applicant must, at the time of filing his/her
application, establish to the satisfaction of the Board that:

(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 limits on the same basis as the subject or
citizen of such country:
Provided: That the requirements for the registration or licensing of nurses in said country
are substantially the same as those prescribed in this Act;
 (b) He/she is good moral character; and

(c) He/she is a holder of a Bachelor’s Degree in Nursing from a college or university that
complies with the standards of nursing education duly recognized by the proper
government agency.

NOTE: Under the previous law, no examinee shall take the licensure exam below the age of 18.
It is no longer included in the new nursing law.

SECTION 14. Scope of Examination. – The scope of the examination for the practice of
nursing in the Philippines shall be determined by the Board. The Board shall take into
consideration the objectives of the nursing curriculum, the broad areas of nursing and other
related disciplines and competencies in determining the subject examinations.

NOTE: The scope of examination for nursing is determined by the Board of Nursing alone and
not in conjunction with the PNA or the PRC.

SECTION 15. Ratings. – In order to pass the examination, an examinee must obtain a general
average of at least seventy-five percent (75%) with a rating of not below sixty percent (60%) in
any subject. An examinee who obtains an average rating of seventy-five (75%) or higher but gets
a rating below sixty-percent (60%) in any subject must take the examination again but only in the
subject or subjects where he/she is rated below sixty percent (60%). In order to pass the
succeeding examination, an examinee must obtain a rating of at least seventy-five percent (75%)
in the subject or subjects repeated.

NOTE: specific number of times, which an examinee can take the licensure exam, is now
abolished under the new nursing law. It also deleted the mandatory requirement of attending a
refresher course after failure to pass the nurse licensure examination in three takes. The removal
to take the examination is within two years after the last failed examination. The examinee who
failed may take only the subject which she failed if his/her average is 75 % but with a grade of
below 60% in any subject. The law however is silent about the prohibition of the examinee in
taking the entire set of examination. In the interpretation of laws – if the law is silent on a matter,
then it must be construed in favor to a side that is not onerous or burdensome to the people. To
retake the examination in a subject matter that the examinee failed the last time and to target a
rating of 75% in that subject area rather than 60% only if the person retakes the entire set, is
onerous on the part of the examinee. This provision must be construed in favor of the examinee.
He/She must have the option to retake the entire examination with the original passing rate of
75% average with no grade below 60% in any subject area or he/she may retake only that
subject area where he/she failed the last time provided he/she obtained an average of 75% or
above
 SECTION 17. Issuance of Certificate of Registration/Professional License and Professional
Identification Card. – A certificate of registration/professional license as a nurse shall be issued
to an applicant who passes the examination upon payment of the prescribed fees. Every
certificate of registration/professional license shall show the full name of the Commission and of
the Members of the Board, and the official seal of the Commission.

A professional identification card, duly signed by the Chairperson of the Commission, bearing
the date of registration, license number, and the date of issuance and expiration thereof shall
likewise be issued to every registrant upon payment of the required fees.

SECTION 18. Fees for Examination and Registration. – Applicants for licensure and for
registration shall pay the prescribed fees set by Commission.

SECTION 19. Automatic 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.

NOTE: Though the law provides for the automatic enrolment in the roster of nurses after passing
the licensure examination, the Code of Ethics formulated under this Act invites the nurse to
become a member of the PNA.

SECTION 20. Registration by Reciprocity. – A certificate of registration/professional license

may be issued without examination to nurses registered under the laws of a foreign state or
country: Provided, That the requirements for registration or licensing of nurses in said country
are substantially the same as those prescribed under this Act: Provided, further, That the laws of
such state or country grant the same privileges to registered nurse of the Philippines on the same
basis as the subjects or citizens of such foreign state or country.

SECTION 21. Practice Through Special/Temporary Permit- A special/temporary permit may

be issued by the Board to the following persons subject to the approval of the commission and
upon payment of the prescribed fees:

(a) Licensed nurses from foreign countries/states whose service are either for a fee or free if
they are internationally well-known specialists or outstanding experts in any branch or
specialty of nursing;
(b) Licensed nurses from foreign countries/states on medical mission whose services shall
be free in a particular hospital, center or clinic; and
(c) Licensed nurses from foreign countries/states employed by school/colleges of nursing as
exchange professors in a branch or specialty of nursing;

Provided, however, That the special/temporary permit shall be effective only or the duration of
the project, medical mission or employment contract.

SECTION 22. Non-registration and Non-issuance of Certificates of Registration/Professional

License or Temporary Permit. – No person convicted by final judgment of any criminal offense
involving moral turpitude or any person guilty of immoral or dishonorable conduct or any person
declared by the court to be of unsound mind shall be registered and be issued a certificate of
registration/professional license or a special/temporary permit.

The Board shall furnish the applicant a written statement setting forth the reasons for its
actions, which shall be incorporated in the records of the Board

SECTION 23. Revocation and Suspension of Certificate of Registration/Professional License

and Cancellation of Special/Temporary Permit.- The Board shall have the power to revoke or
suspend the certificate of registration/professional license or cancel the special/temporary permit
of a nurse upon any of the following grounds:

(a) For any of the causes mentioned in the preceding section;

(b) For unprofessional and unethical conduct;
(c) For gross incompetence or serious ignorance;
(d) For malpractice or negligence in the practice of nursing;
(e) For the use of fraud, deceit, or false statements in obtaining a certificate of
registration/professional license or a temporary/special permit; or
(f) For practicing his/her profession during his/her suspension from such practice
.

Provided, however, That the suspension of the certificate of registration/professional license

shall be for a period not to exceed four (4) years.

NOTE: Section 23 (f) is an addition in this new law. The suspended nurse cannot practice
nursing profession while serving his/her suspension orders. Take note of the maximum period of
suspension, it cannot go beyond four years.

SECTION 24. Re-issuance of Revoked Certificates and Replacement of Lost Certificates.-

The Board may, after the expiration of a maximum of four (4 ) years from the date of revocation
of a certificate, for reasons of equity and justice and when the cause for revocation has
disappeared or has been cured and corrected, upon proper application therefore and the payment
of the required fees, issue another copy of the certificate of registration/professional license.

A new certificate of registration/professional license to replace the certificate that has been
lost, destroyed or mutilated may be issued, subject to the rules of the Board.

ARTICLE V

NURSING EDUCATION
 SECTION 25. Nursing Education Program. – The nursing education program shall provide
sound general and professional foundation the practice of nursing.

The Learning experiences shall adhere strictly to specific requirements embodied in the
prescribed curriculum as promulgated by the Commission on Higher Education’s policies and
standards of nursing education.

SECTION 26. Requirement for Inactive Nurses Returning to Practice. – Nurses who have not
actively practiced the profession for five (5) years are required to undergo one month of didactic
training and three months of practicum. The Board shall accredit hospitals to conduct the said
training program.

NOTE: this is a new provision providing for the guidelines of inactive nurses who wish to return
to practice their nursing career. Didactic training means a lecture program.

SECTION 27. Qualifications of the Faculty. – A member of the faculty in a college of nursing
teaching professional courses must:

(a) Be a registered nurse in the Philippines;

(b) Have at least one (1) year of clinical practice in a field of specialization;
(c) Be a member of good standing in the accredited professional organization of nurses; and
(d) Be a holder of a master’s degree in nursing, education, or other allied medical and health
sciences conferred by a college or university duly recognized by the Government of the
Republic of the Philippines.

In addition to the aforementioned qualifications, the dean of a college must have a master’s
degree in nursing. He/she must have at least five (5) years of experience in nursing.

NOTE: The requirement for the clinical experience of a faculty was reduced from three years
in the previous law to only one year in the new law. The requirement for the dean was
increased from three years to five years in teaching and supervising a nursing education
program.

ARTICLE VI

NURSING PRACTICE
 SECTION 28. Scope of Nursing. A person shall be deemed to be practicing nursing within
the meaning of this Act when he/she singly or in collaboration with another , initiates and
performs nursing services to individuals, families and communities in any health care setting.
It includes but not limited to, nursing care during conception, labor, delivery, infancy,
childhood, toddler, pre-school, school age, adolescence, adulthood and old age. As
independent practitioners, nurses are primarily responsible for the promotion of health and
prevention of illness. As Members of the Health Team, nurses shall collaborate with other
health care providers for the curative, preventive, and rehabilitative aspects of care,
restoration of health, alleviation of suffering, and when recovery is not possible, towards a
peaceful death. It shall be the duty of the nurse to:

(a) Provide nursing care through the utilization of the nursing process. Nursing care includes,
but not limited to, traditional and innovative approaches, therapeutic use of self,
executing health care techniques and procedures, essential primary health care, comfort
measures, health teachings, and administration of written prescription for treatment,
therapies, oral, topical and parenteral medications, internal examination during labor in
the absence of bleeding and delivery. In case of suturing of perineal laceration, special
training shall be provided according to protocol established;
(b) Establish linkages with community resources and coordination with the health team;
(c) Provide health education to individuals, families and communities;
(d) Teach, guide and supervise students in nursing education programs including the
including the administration of nursing services in varied settings such as hospitals and
clinics; undertake consultation services; engage in such activities that require the
utilization of knowledge and decision-making skills of a registered nurse; and
(e) Undertake nursing and health and health human resource development training and
research, which shall include, but not limited to, the development of advance nursing
practice;

Provided: That this section shall not apply to nursing students who perform nursing functions
under the direct supervision of a qualified faculty: Provided further, That in the practice of
nursing in all settings, the nurse is duty-bound to observe the Code of Ethics for nurses and
uphold the standards of safe nursing practice. The nurse is required to maintain competence
by continual learning through continuing professional education to be provided by the
accredited professional organization or any recognized professional organization or any
recognized professional nursing organization: Provided, finally, That the program and
activity for the continuing professional education shall be submitted to and approved by the
Board.

NOTE: The new law deleted already the special requirement of undergoing IV therapy
training before a nurse can administer IV medications. However, the Nursing Service
Administrator still requires formal training in this aspect. The new law also added the
special training for suturing the lacerated perineum being undertaken by the Association of
Nursing Service Administrators with the Maternal and Child Association of the Philippines
( MCNAP ).
 SECTION 29. Qualifications of Nursing Service Administrators.- A person occupying
supervisory or managerial positions requiring knowledge of nursing must:

(a) Be a registered nurse in the Philippines;

(b) Have at least two (2) years experience in general nursing service administration;
(c) Possess a degree of Bachelor of Science in Nursing, with at least nine (9) units in
management and administration courses at the graduate level; and
(d) Be a member of good standing of the accredited professional organization or nurses;

Provided, That a person occupying the position of chief nurse or director of nursing service
shall, in addition to the foregoing qualifications, possess:

(1) At least five (5) years of experience in a supervisory or managerial position in nursing;
and
(2) A masters degree major in nursing;

Provided, further, That for primary hospitals, the maximum academic qualifications and
experiences for a chief nurse shall be as specified in subsections (a),(b), and (c) of this
section: Provided, furthermore, That for chief nurses in the public health agencies, those who
have a master’s degree in public health/community health nursing shall be given priority.
Provided, even further, That for chief nurses in military hospitals, priority shall be given to
those who have finished a master’s degree in nursing and the completion of the General Staff
Course (GSC): Provided, finally, That those occupying positions before the effectivity of this
Act shall be given a period of five (5) years within which to qualify.

ARTICLE VII

HEALTH HUMAN RESOURCE PRODUCTION, UTILIZATION AND DEVELOPMENT

SECTION 30. Studies for Nursing Manpower Needs, Production, Utilization and
Development.- The Board, in coordination with the accredited professional organization and
appropriate government or private agencies shall initiate, undertake and conduct studies on
health human resource production, utilization and development.

SECTION 31. Comprehensive Nursing Specialty Program.- Within ninety (90) days from the
effectivity of this Act , the Board in coordination with the accredited professional organization,
recognized specialty organizations and the Department of Health is hereby mandated to
formulate and develop a comprehensive nursing specialty program that would upgrade the level
of skill and competence of specialty nurse clinicians in the country, such as but not limited to the
areas of the critical care, oncology, renal and such other areas as may be determined by the
Board.

The beneficiaries of this program are obliged to serve in any Philippine hospital for a period of
at least two (2) years of continuous service.

NOTE: The Board is mandated to formulate and develop a comprehensive nursing specialty
program that would upgrade the levels of skills and competency of specialty nurse clinicians in
the country. This is a new provision of the Nursing law.

SECTION 32. Salary. – In order to enhance the general welfare, commitment to service and
professionalism of nurses, the minimum base pay of nurses working in the public health
institutions shall not be lower than the salary grade 15 prescribed under Republic Act No. 6758,
otherwise known as the “Compensation and Classification Act of 1989”. Provided , That for
nurses working in local government units, adjustments to their salaries shall be in accordance
with Section 10 of the said law.

SECTION 33. Funding for the Comprehensive Nursing Specialty Program. – The annual
financial requirement needed to train at least ten percent (10%) of the nursing staff of the
participating government hospital shall be chargeable against the income of Philipine Charity
Sweepstakes Office and the Philippine Amusement Gaming Corporation, which shall equally
share in the costs and shall released to the Department of Health subject to the accounting and
auditing procedures: Provided, That the Department of Health shall set the criteria of this
program.

SECTION 34. Incentives and Benefits.- The Board of Nursing, in coordination with the
Department of Health and other concerned government agencies, association of hospitals and the
accredited professional organization shall establish an incentive and benefit system in the form of
free hospital care for nurses and their dependents, scholarship grants and other non-cash benefits.
The government and private hospitals are hereby mandated to maintain the standard nurse-
patient ratio set by the Department of Health.

ARTICLE VIII

PENAL AND MISCELLANEOUS PROVISIONS

SECTION 35. Prohibitions in the Practice of Nursing. - A fine of not less than 50,000.00 nor
more than 100,000.00 or imprisonment of not less than 1 year nor more than 6 years, or both,
upon the discretion of the court, shall be imposed upon:
 (a) any person practicing nursing in the Philippines within the meaning of RA 9173
of 2002:

1. without certificate of registration/professional license and professional

identification card or special temporary permit or without having been
declared exempt from examination in accordance with the provision of
this Act; or
2. who uses as his/her own certificates of registration/ professional license
and professional identification card or special/temporary permit of
another; or
3. who uses an invalid certificate of registration/professional license, a
suspended or revoked certificate of registration/professional license, or
an expired or cancelled special/temporary permit; or
4. who gives any false evidence to the Board in order to obtain a
certificate of registration/professional license, a professional
identification card or special permit; or
5. who falsely poses or advertises as a registered and licensed nurse or uses
any other means that tend to convey the impression that he/she is
registered and licensed nurse; or
6. who appends B.S.N./R.N. or any similar appendage to his/her name
without having been conferred said degree or registration; or
7. who, as a registered and licensed nurse, abets or assists the illegal
practice of a person who is not lawfully qualified to practice nursing.

(b.) any person or the chief executive officer of a juridical entity who undertakes in-service
educational programs or who conducts review classes for local and foreign examination
without permit/clearance from the board and the Commission; or
( c ) any person or employer of nurses who violate the minimum base pay of nurses and the
incentives and benefits that should be accorded them as specified in Sections 32 and 34; or
( d ) any person or the chief executive officer of a juridical entity violating any provision of
this Act and its rules and regulations.

NOTE: The new law also increased the penal provisions regarding violations of the Nursing law.
The fine was raised from the minimum 10,000 and maximum of 40,000 to a minimum of 50,000
and maximum of 100,000.00.

ARTICLE IX

FINAL PROVISIONS

SECTION 36. Enforcement of this Act. – It shall be the primary duty of the Commission and
the Board to effectively implement this Act. Any duly law enforcement agencies and officers of
national, provincial, city or municipal governments shall, upon the call or requests of the
Commission or the Board render assistance enforcing the provisions of this Act and to prosecute
persons violating the same.`
 SECTION 37. Appointments. – The Chairperson of the Professional Regulation Commission
shall immediately include in its program and issue such rules and regulations to implement the
provisions of this Act, the funding of which shall be included in the Annual General
Appropriations Act.

SECTION 38. Rules and Regulations. – Within ninety (90) days after the effectivity of this
Act, the Board of Commission, in coordination with the accredited professional organization, the
Department of Health, the Department of Budget and Management and other concerned
government agencies, shall formulate such rules and regulations necessary to carry out the
provisions of this Act. The implementing rules and regulations shall be published in the Official
Gazette or in any newspaper of general circulation.

SECTION 39. Separability Clause. – If any of this Act is declared unconstitutional, the
remaining parts not affected thereby shall continue to be valid and operational.

SECTION 40. Repealing Clause. – Republic Act No. 7164, otherwise known as the
“Philippine Nursing Act of 1991” is hereby repealed. All other laws, decrees, orders, circulars,
issuances, rules and regulations and parts thereof which are inconsistent with this Act are hereby
repealed, amended or modified accordingly.

SECTION 41. Effectivity. – This Act shall take effect fifteen (15) days upon its publication in
the official publication in the Official Gazette or in any two (2) newspapers of general circulation
in the Philippines.
 RELATED LAWS AFFECTING THE PRACTICE OF NURSING

Act # 1931 – Created for the ESTABLISHMENT OF NURSING SCHOOLS in the

country under the Bureau of Education in 1909.

Act # 1975 – An act that transferred the school of NURSING UNDER THE BUREAU OF
HEALTH.

Act # 2468 – An act that authorized the GRANTING OF THE TITLES of graduate in
nursing and midwifery from the school of nursing of Philippine General Hospital in 1915.

Act # 2808 – This act provided for the earliest and TRUE NURSING LAW that served as the
basis of the practice of nurses in the Philippines in 1919 and a year after its passage, the first
local licensure or board examination for nurses was held in 1920. The First Board Examiners
were created under act # 2808 composed of three members then appointed by the Secretary
Interior. The chairman was a doctor of medicine and the other two are registered nurses who
must possess an experience in the nursing profession for at least five years and with a reputable
character.

RA # 649 – provided for the standardization of nurses’ salaries both in institutions and in
public health.

RA # 465 – an act which STANDARDIZED THE FEES charged by the Examining Boards
for Examination and Registration.

RA # 546 – An act that reorganized and placed all the BOARD OF EXAMINERS under the
direct supervision of the President of the Philippines.

RA # 877 – An Act also known as the “Philippine Nursing Law of 1953” approved on June
19, 1953. This Law was sponsored by Senator Geromina T. Pecson which enacted “ to regulate
the practice of nursing in the Philippines and to set up provisions for the registration of nurses,
for the establishment and maintenance of standards of nursing education and nursing practice”.

RA # 1080 – This act approved on 1954 is also known as, An Act Declaring the Bar and Board
Examinations as “ CIVIL SERVICE EXAMINATIONS” which means that when a four year
degree course graduate had passed the board examinations or the Bar examinations for lawyers
they automatically become first grade civil service eligible.

RA # 997 – This Republic Act in 1954 ABOLISHED THE DIVISION OF NURSING and
created a decentralized organization with a chief Public Health Nurse consultant in the office of
the Secretary of Health, and five consultant positions in nursing; namely, in Maternal and Child
 Health, in Preventable Diseases, in Institutional Nursing, in Nursing Education, and in Hospital
Standardization.

RA # 4704 – This act in 1966 AMENDED THE PHILIPPINE NURSING LAW OF 1953
otherwise known as RA 877 and introduced some minor revisions of the said act due to some
developments of the practice of nursing in the country.

RA # 6136 – In 1971, This Republic Act introduced other MINOR REVISIONS IN THE
NURSING LAW of 1966 thus amending RA 4704 of 1966.

RA 7164 – PHILIPPINE NURSING ACT OF 1991 was sponsored by Senator Heherson

Alvarez and was approved and signed by President Corazon Aquino on November 21, 1991.

ILO convention 149 and Recommendations 157 – In 1977, the Philippine Nurses
Association, formerly known as the Filipino Nurses Association established in 1922 lobbied
our government for the adoption of ILO 149 and Recommendations 157 that were adopted in
Geneva. It set the concerns of employment of nursing personnel and the CONDITIONS OF
THE LIFE AND WORK OF NURSES and in 1978; the PNA passed The Declaration on the
Economic and Social Welfare of Filipino Nurses.

Proclamation No. 539 – The President of the Philippines declared on October 17, 1958
that the last week of October (through this proclamation ) as the “NURSES WEEK”

Presidential Decree No. 223 – This decree formed the PROFESSIONAL

REGULATION COMMISSION on June 23, 1973. Among its power is the regulation of
different profession which used to be under the Civil Service Commission.

RA 6511 – This Act Amended RA 465 in 1972, which STANDARDIZED the examination
and REGISTRATION fees charged by the various Board Examiners.

Letter of Instruction No. 1000 – this required that the members of Accredited Professional
Organizations (eg. PNA) shall be given PRIORITY in the HIRING of employees in the
government service and in the engagement of professional services.

RA 1612 – Refers to the payment of PRIVILEGE TAX before any business or occupation
can be lawfully begun or pursued.

RA 7392 – This Act provided that only licensed midwives could practice and that nurses
must pass first the MIDWIFERY EXAMINATION before they can practice midwifery
 RA 2382 – PHILIPPINE MEDICAL ACT ; defines the practice of medicine in the
Philippines. Section 10 of this Act provides: Act constituting the practice of medicine. A person
shall be considered as engaged in the practice of medicine who shall for compensation, fee,
salary, or reward in any form paid to him directly or through another or even without the same
may physically examine any person, and diagnose, treat, operate or prescribe any remedy for any
human disease, injury, deformity, physical, mental, physical condition or ailment nature, real or
imaginary, regardless of the remedy or treatment administered, prescribed or recommended.

RA 5181 – An act that prescribes PERMANENT RESIDENCE and reciprocity as

qualifications for any examination or registration for the practice of any profession in the
Philippines

Presidential Decree 541 – a decree allowing former Filipino (BALIKBAYANS)

professionals to practice their respective profession in the Philippines.

RA 6425 – “DANGEROUS DRUG ACT” enacted in 1972 declaring that sale,

administration, delivery, distribution, and transportation of prohibited drugs are punishable by
law.

Act No. 3573 – This Act in 1929 declared that all COMMUNICABLE DISEASES shall be
REPORTED to the nearest health station, and that any person may be inoculated, administered
or injected with prophylactic preparations.

RA 1082 – creation of RURAL HEALTH UNITS in the Philippines.

RA 4073 – liberalizes the LEPROSY TREATMENT. No person shall be confined in

leprosarium unless such disease requires institutional treatment.

Presidential Decree 996 – COMPULSORY IMMUNIZATION for all children below eight
years old.

RA 8981 – “ PRC MODERNIZATION ACT OF 2000” This Act gave the Professional
Regulatory Commission its regulatory powers and is now an agency of its own.

Presidential Decree 825 – provided penalty for improper disposal of GARBAGE and other
forms of unclealiness.

Presidential Decree 856 – CODE OF SANITATION, provides for control of all factors in
man’s environment that affect health including the quality of water, food, milk, control of insects,
animal carriers, transmitters of disease, sanitary and recreation facilities, noise, unpleasant odors
and control of nuisance.
 Presidential Decree 148 – “ WOMAN AND CHILD LABOR LAW” The employable age is
16 years and above and further provides for the privileges of working women.

RA 6365 – established a National Policy on Population and created the Commission on

Population (POPCOM).

PD 791 – revised population Act. Empowered nurses and midwives to provide, dispense and
administer acceptable METHODS OF CONTRACEPTION after having undergone training
and having been granted authorization by POPCOM.

PD 166 – Strengthened FAMILY PLANNING programs through participation of private

organizations and individuals in the formulation and implementation of the program planning
policies.

General Order No. 18 – enjoins all citizens of the Philippines, universities, colleges, schools,
government offices, mass media, voluntary and religious organizations of all creeds, business
and industrial enterprises to promote the concept of family welfare, responsible parenthood and
family planning.

Letter of Instruction No. 47 – directs all schools of medicine, nursing, midwifery and allied
medical professions and social work to prepare, plan, and implement the INTEGRATION OF
FAMILY PLANNING in their curricula and to require from their graduates sufficient
appropriate licensing examination.

Department of Labor Order No. 7 – requires all industrial establishments to provide

FAMILY PLANNING SERVICES.

PD 48 – limits paid MATERNITY LEAVE privileges to four children.

PD 69 – limits the number of children to FOUR for TAX EXEMPTIONS purposes.

PD 965 – requires that couples intending to get married must first undergo a family planning
and responsible PARENTHOOD INSTRUCTION prior to the issuance of marriage license.

RA 1054 – requires the owner, lessee or operator of any commercial, industrial or agricultural
establishment to furnish free EMERGENCY, medical, and dental ASSISTANCE to his
employees and laborers.

RA 4226 – HOSPITAL LICENSURE ACT requires all hospital in the country to be

licensed before it can offer to serve the community. The licensing agency is the Office For
Hospital and Medical Services, Department of Health.
 RA 5901 – nurses working in agencies with 100-bed capacity and/or above and are working
in area of one million population are supposed to WORK 40 HOURS A WEEK.

PD 442 – LABOR CODE OF THE PHILIPPINES provides the right of the workers to self-
organization and collective bargaining agreement.

PD 603 – CHILD AND YOUTH WELFARE CODE protects and promotes the rights and
welfare of children and youth.

PD 651 – decrees the REGISTRATION OF BIRTH of a child within 30 days with the Civil
Registrar.

PD 1519 – MEDICARE BENEFITS TO ALL GOVERNMENT EMPLOYEES regardless

of status of appointment.

PD 626 – EMPLOYEE COMPENSATION AND STATE INSURANCE FUND

RA 6675 – GENERICS ACT OF 1998

RA 6758 - standardized the salaries of government employees which include the nursing
personnel.

RA 7160 – LOCAL GOVERNMENT CODE OF 1991devolution of powers from national to

local government.

RA 7305 – MAGNA CARTA FOR PUBLIC HEALTH WORKERS

RA 7600 – ROOMING-IN AND BREASTFEEDING ACT OF 1992 provides that babies

born in private and government hospitals should be roomed-in with their mothers to promote
breastfeeding and ensure safe and adequate nutrition to children.

EO 51 – MILK CODE

RA 7432 – SENIOR CITIZENS ACT does honor and justice to our people’s long tradition of
giving high regard to elderly. 20% discount in all public establishments such as restaurants,
pharmacies, public utility vehicles and hospitals.

PRC Resolution No. 2004-17 Series of 2004 – RE-IMPLEMENTED CONTINUING

PROFESSIONAL EDUCATION requiring sixty (60) credit units for three years for
professionals with bachelor’s degree
 NURSES AND CONTRACTS

Contract – (Article 1305 New Civil Code) defines contract: A contract is a meeting of minds
between two persons whereby one binds himself, with respect to the other, to give something or
to render some service.

 A contract, from the Latin word “contractus” and from the French word “contract,” is “ a
juridical convention manifested in legal form, by virtue of which, one or more persons ( or
parties) bind themselves in favor of another or others, or reciprocally, to the fulfillment of
a prestation to give, to do or not to do.”
 It is the agreement of two or more persons ( or parties ) for the purpose of creating,
modifying, or extinguishing a juridical relation between them.

Characteristics of Contract
(a) Freedom ( or liberty) to stipulate provided not contrary to law, morals, good customs,
public order, or public policy
(b) Obligatory force and compliance in good faith
(c) Perfection by mere consent as a rule
(d) Both parties are mutually bound
(e) Relatively ( Generally it is binding only between parties, their assigns, and heirs)

 The contracting parties may establish such stipulations, clauses, terms as they may deem
convenient, provided they are not contrary to law, morals, good customs, public order, or
public policy. (1306 NCC)

 The contracts must bind both contracting parties; its validity or compliance cannot be left
to the will of one of them.(1308 NCC)

 stipulates that contract takes effect only between the parties, their assigns and heirs.(1311
NCC)

 any third person who induces another to violate his contract shall be liable for damages to
the other contracting party.

 Contracts are perfected by mere consent and from that moment the parties are bound not
only to the fulfillment of what has been expressly stipulated but also to all the
consequences which, according to their nature, may be in keeping with faith, usage and the
law. (1315 NCC)
ESSENTIAL REQUISITES OF A CONTRACT

There is no contract unless the following requisites concur:

1. CONSENT
2. OBJECT certain which is the subject matter of the contract
3. CAUSE of the obligation which is established

 CONSENT is manifested by the meeting of the offer and the acceptance upon the thing
and the cause which are to constitute the contract.
 Consent must be given freely and voluntarily
 Consent must be given by a capacitated person
 Consent must not be vitiated
 Under the 1987 Constitution, the age of majority is now fixed at 18 years old. This is now
the legal age where a person can sign or give consent to contracts or any valid legal acts.
Thus, by this provision of the constitution, there are no more emancipated minors who can
give consent in the Philippines.
 Insane or demented persons, and deaf-mutes who do not know how to write cannot give
consent.
 Contracts entered into during lucid intervals are valid
 Contracts agreed to in a state of drunkenness or during hypnotic spell are voidable
 A contract where consent is given through mistake, violence, intimidation, undue
influence, or fraud is voidable.
 There is violence when in order to wrest consent, serious or irresistible force is employed.
 There is intimidation when one of the contracting parties is compelled by a reasonable and
well grounded fear of an imminent and grave evil upon his person or property, or upon the
person or property of his spouse, descendants or ascendants, to give his consent.
 There is undue influence when a person takes improper advantage of his power over the
will of another, depriving the latter of a reasonable freedom of choice.
 There is fraud when, through insidious words or machinations of one of the contracting
parties, the other is induced to enter into a contract which, without them, he would not
have agreed to.

 OBJECT of contracts are all things which are not outside the commerce of men,
including future things

 All rights which are not intransmissible may also be the object of contracts

 All services which are not contrary to law, morals, good customs, public order, or public
policy may likewise be the object of contract.

 Impossible things or services cannot be the object of contracts.

 The object of the contract must be determinate as to its kind

 FORMS OF CONTRACT. (1356 NCC) Contracts shall be obligatory, in whatever form
they may have been entered into, provided all the essential requisites for their validity are
present

 However, there are times when the law requires that a contract be in some form in order to
be valid or enforceable.

 The following are void or inexistent contracts:

1. When the cause, object or purpose of the contract is contrary to law, morals, good customs,
public order, or public policy
2. When the contract is absolutely simulated or fictitious
3. When the cause or object of the contract did not exist at the time of the making of the
contract
4. If the object of the contract is outside the commerce of men
5. If the contract contemplates or intends a performance of an impossible service
6. If the intention of the contracting parties cannot be ascertained
7. If the contract is expressly prohibited by law or declared by laws as invalid or ineffective

 Voidable contracts are valid contracts until annulled by a competent court

 The action to annul voidable contracts shall be brought within four years. This period
begins: In cases of intimidation, violence or undue influence, from the time the defect of
the consent ceases.

NURSES AND WILLS

SUCCESSION – is a mode of acquisition by virtue of which property, rights, and obligations to
the extent of the value of the inheritance, of a person are transmitted through his death to another
or others either by his will or by operation of law. (774 NCC)

DECEDENT – is the general term applied to the person whose property is transmitted through
succession, whether or not he left a will. If he left a will, he is also called the testator.

TESTATOR – a male decedent

DEVISEE – is a person to whom a gift of real property (eg. Land, house) is given by virtue of a
will

LEGATEE – is a person whom a gift of personal property (eg. Money, Jewelry) is given by
virtue of a will

 The inheritance includes all property, rights and obligations which are not extinguished
by his death

 The rights to succession are transmitted from the moment of death of the decedent.

 An HEIR is a person called to succession either by the provision of a will or by operation

of the law.

WIILL – is an act whereby a person is permitted, with the formalities prescribed by law, to
control to a certain degree the disposition of his estate, to take effect after his death.

 The making of a will is strictly personal act; it cannot be left in whole or in part to the

discretion of a third person, or accomplished through the instrumentality of an agent or

attorney.

 All persons who are not expressly prohibited by law may make a will

 Persons of either sex under eighteen years of age cannot make a will
 In order to make a will it is essential that the testator be of sound mind at the time of its

execution.

 To be of sound mind, it is not necessary that the testator be in full possession of all his

reasoning faculties, or that his mind be wholly unbroken, unimpaired, or unshattered by

disease, injury or other cause.

It shall be sufficient if the testator was able at the time of making the will to know the

nature of the estate to be disposed of, the proper objects of his bounty, and the character

of the testamentary act.

 The law presumes that every person is of sound mind

 Testamentary Capacity is the capacity to comprehend the nature of the transaction in

which the testator is engaged at the time to recollect the property disposed of and the

persons who would naturally be supposed to have claims upon the testator and to

comprehend the manner in which the instrument will distribute his property among the

objects of his bounty.

 a married woman may make a will without the consent of her husband, and without the

authority of the court

 a married woman may dispose by will of all her separate property as well as her share of

the conjugal partnership or absolute community property.(802 NCC)

 Every Will must be in writing and executed in a language or dialect known to the

testator(803 NCC)
 NOTARIAL WILL is a will that must be signed by the testator or if written by some

other person, it must be done in his presence and under his express direction

 A notarial will or an ordinary will must be subscribed and attested by three or more

credible witnesses

 A notarial will must be acknowledged before a notary public

 If the testator be deaf, or a deaf-mute – he must personally read the will if he is able to do

so; otherwise, he must designate two persons to read it and communicate to him in some

practicable manner its contents. If the testator is blind, the will must be read to him twice;

once, by one of the subscribing witnesses and again, by the notary public before whom

the will is acknowledged.

 The requirement of the will must be in writing but it does not mean that the testator must

himself perform the mechanical work of writing the will, except in the case of a

holographic will, which must be entirely written, dated and signed by the hand of the

testator himself.

 The requirement that the testator must sign the will is satisfied by the use of his thumb

mark, the sign of the cross, or the initials or portion of the name of the testator.

 Where the testator directs another person to sign his name, it is essential that the person

so directed write the testator’s name; it is not sufficient for the other to write his name

only.

 HOLOGRAPHIC WILL is a will entirely written dated and signed by the testator

 Any person of sound mind and of the age of eighteen years or more, and not blind, deaf

or dumb, and able to read and write, may be a witness to the execution of a will.
 The following are disqualified from being witnesses to a will:

(1) any person not domiciled in the Philippines

(2) Those who have been convicted of falsification of a document, perjury or false testimony

 A will may be revoked by the testator at any time before his death. Any waiver or
restriction of this right is void

The following Will shall be disallowed in any of the following cases:

(1) If the formalities required by law have not been complied with;

(2) If the Testator was insane, or otherwise mentally incapable of making a will, at the time

of its execution

(3) If it was executed by undue through force or under duress, or the influence of fear, or

threats;

(4) If it was procured by undue and improper pressure and influence, on the part of the

beneficiary or of some other person;

(5) If the signature of the testator was procured by fraud;

(6) If the testator acted by mistake or did not intend that the instrument he signed should be

his will at the time affixing his signature thereto.

 The law provides for the following kinds of Will:

(1) Ordinary or Notarial Will

(2) Holographic will

(3) Mixed will

NURSES AND CRIMINAL LAW

Criminal law – is that branch of law which defines crime and treats of their nature.

 Ignorance of the law excuses no one from compliance therewith

 Laws take effect after 15 days from the publication in the official gazette or any

newspaper of national circulation. It serves as a constructive notice to all persons so that

no one is exempted from complying with the law or to claim that he or she is ignorant

from the passage of that law.

 The power to define and punish an act is within the powers of the Legislative Department

(House of Congress) where the legislative power is vested in the fundamental law and

has the power to define and punish an act or omissions as a crime. The Chief Executive

has also the prerogative.

 Limitations in enacting Penal Laws

(1) Generality
(2) Territoriality
(3) Irretrospectivity or prospectivity

 Limitations in enacting Penal Laws

(1) it cannot enact an ex post facto law nor a bill of attainder

(2) it must be of general application
(3) it cannot provide for a cruel, degrading or inhuman punishment nor can it impose
excessive fines.

 Theories of Criminal Law

(1) Classical Theory –

 a. man is essentially a moral creature with an absolutely free will to choose between

good and evil and therefore more stress is placed upon the result of the felonious

act

b. Basic criminal liability is human free will and the purpose of penalty is

retribution.

c. Crime is a juridical entity and penalty is an evil and a means of juridical tutelage

(2) Positivist Theory – Man is subdued occasionally by strange and morbid phenomenon

which conditions him to do wrong in spite of or contrary to his volition. The basis of

criminal responsibility of the criminal is his dreadfulness or dangerous state.

 The major source of our criminal law is Act # 3815 otherwise known as the Revised

Penal Code of the Philippines that took effect on January 1, 1932.

 Crime consists of internal and external acts. Internal acts are not punished in our

jurisdiction.

 Voluntariness is an element of felony because if an act is committed or performed with

deliberate intent then it implies that the act is voluntary or freely committed.

 Felony is an act or omission punishable by the law

 A felony may be committed by means of DOLO (deceit) or CULPA (fault)

 The distinction of dolo and culpa: while both are voluntary, dolo is intentional, whereas

culpa is not. Where there is intent there can be no negligence. In culpable felonies, intent

is replaced by fault.
 Dolo (deceit) involves malice or deliberate intent; culpa (fault) results from negligence ,

imprudence, lack of foresight or lack of skill.

 Imprudence is deficiency in action

 Negligence is deficiency of perception.

 Negligent act must be voluntary- example ( an incidental dropping of pistol and fired and

hit someone, there is no liability )

Elements of Dolo:

(1) Freedom

(2) Intelligence

(3) Intent

Elements of Culpa:

(1) Freedom

(2) Intelligence

(3) Negligence or imprudence

 Intelligence – is the moral capacity to determine what is right from what is wrong and to

realize the consequences of one’s acts.

 Intent – is a mental state, the existence of which is shown by the overt acts of a person.

 A crime may be committed without criminal intent by means of culpa and offenses

punishable by special laws.

  Criminal liability shall be incurred by any person committing a felony although the

wrongful act done be different from that which he intended. By any person performing an

act which would be an offense against persons or property, were it not the inherent

impossibility of its accomplishment or on account of the employment or inadequate or

ineffectual means.

STAGES OF FELONY

(1) Consummated – all elements necessary for execution and accomplishment are pesent.

(2) Frustrated – the offender has performed all the acts of execution to produce the felony

as a consequence but the crime does not result due to some cause independent of the will

of the offender.

(3) Attempted – the offender begins the commission of the felony by direct overt acts but

does not perform all the acts of execution which should produce the felony as a

consequence by reason of some cause or accident other than his own spontaneous

desistance

SUBJECTIVE & OBJECTIVE PHASE OF FELONY: The subjective phase is that portion

of execution of the crime starting from the point where he still has the control of his acts. If it

reaches the point where he has no more control over his acts, the subjective phase has passed. If

the subjective phase is not yet passed, the felony would be mere attempt. If it has already passed

but the felony is not yet produced, as a rule it is frustrated.

Objective phase is the result of the acts of execution that is the accomplishment of crime.

Consummated.

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

(1) Justifying Circumstance – the acts of the actor are in accordance with the law , hence he

incurs no criminal and civil liability ( no crime, no criminal).

(2) Exempting Circumstance – those wherein there is an absence in the agent of the crime

any of all the conditions that would make an act voluntary and hence, although there is no

criminal liability, there is civil liability ( no criminal but there is crime ).

(3) Mitigating Circumstances – those that have the effect of reducing the penalty due to the

lesser perversity of the offender.

(4) Aggravating Circumstance – those which increases the penalty.

(5) Alternative Circumstance – either aggravating or mitigating depending on the facts of

the situation.

JUSTIFYING CIRCUMSTANCES:

(1) Self- defense

(2) Defense of Relative

(3) Defense of stranger

(4) State of necessity

(5) Fulfillment of duty

(6) Obedience to superior order

 EXEMPTING CIRCUMSTANCE

(1) Imbecility and Insanity

(2) Minority

(3) Accident

(4) Compulsion of Irresistible force

(5) Lawful causes

(6) Instigation and entrapment

MITIGATING CIRCUMSTANCES

(1) Passion or obfuscation

(2) Voluntary Surrender

(3) Voluntary plea of guilty

(4) Deaf, and dumb, blind

(5) Illness that diminishes the exercise of will power

(6) Lack of instruction

(7) Incomplete self-defense

(8) Offender is below 18 or over 70 years old

(9) When the act is committed in the immediate vindication of a grave offense

AGGRAVATING CIRCUMSTANCES

(1) Taking advantage of official position

 (2) Crime is committed in contempt of or with insult to public authorities

(3) Crime committed with insult or disregard due to offended by age, sex or rank

(4) Crime is committed in the dwelling of the offended

(5) Abuse of confidence or obvious ungratefulness

(6) Nighttime

(7) Band

(8) Uninhabited place

(9) Crime committed during calamity

(10) Recedivism

(11) Habituality

(12) Crime committed in consideration of price, promise or reward.

(13) By means of fire,explosion,poison and stranding of a vessel

(14) Evident premeditation

(15) Craft, fraud or disguise is employed

(16) Advantage taken of superior strength

(17) Means employed to weaken defense

(18) Treachery

(19) Adds ignominy to the natural effects of the crime

(20) Unlawful entry

ALTERNATIVE CIRCUMSTANCE

(1) degree of relationship

(2) intoxication
(3) illiteracy or lack of education

* CLASSIFICATION OF FELONIES

(1) grave

(2) less grave

(3) light felonies

PERSONS CRIMINALLY LIABLE FOR FELONIES

 When several persons take part in the commission of a crime it does not necessarily

follow that their participation in it is equal. Some may have a greater or more important

in it than others. Consequently, their liability also varies according to the position they

occupy in the commission of the felony, that is, whether they are principals, accomplices,

or accessories
 This classification of offenders does not apply when there is conspiracy to commit a

crime because of the rule that the act of one is the act of all.

 A Juridical person cannot be punished like a natural person because they are only acting

through their officers, generally, an officer of a corporation who commits a violation is

the one criminally liable.

1. (Art. 16) The following are criminally liable for grave and less grave felonies:
a. principal
b. accomplice
c. accessories

for light felonies:

a. principals
b. accomplices

2. The following are considered Principals (Art. 17) :

a. those who take a direct part in the execution of the act;

*to be considered as a principal by direct participation, it is essential that the

offender (a) participated in the criminal resolution as shown by his prior or
simultaneous acts (b) carried out the plan and personally took part in its execution,
and (c) performed acts tending directly to the same end. Accordingly, if he was not
present at the scene of the crime, he cannot be deemed to be a principal by direct
participation.
b. those who directly force or induce others to commit it;

* Principal by inducement presupposes that the offender himself is determined to

commit the felony; he must have persistently clung to his determination; he offers the
strongest of temptations sufficient to induce the commission or exercises ascendancy
to compel obedience and the inducement must be the determining cause for the
commission of the crime.
Where the inducer only made remarks or gave an order after the fatal blow had been
struck, he cannot be punished as a principal by inducement.

c. those who cooperate in the commission of the offense by another act without
which it would not have been accomplished;
* principal by indispensable cooperation must have concurred in the criminal
resolution and cooperated by performing another act indispensable for the
commission of the felony agreed upon. His cooperation is similar to that of an
accomplice but is of greater degree because of its indispensability to the
accomplishment of the offender’s objective, while that of an accomplice is of a lesser
and minor importance.

3. Accomplices (Art. 18) - are those persons who, not being included in article 17,
cooperate in the execution of the offense by previous or simultaneous acts

* Under American law, accomplices are accessories before the fact

* to be considered an accomplice, the offender must have known of the criminal

design of the principal by direct participation and concurs therein. The acts of the
accomplice should not produce the most serious effect on the victim, otherwise he
will be a principal. The acts of an accomplice is similar to those of a principal by
cooperation, but may be distinguished from the latter in that, although the acts of the
accomplice are necessary for the commission of the crime, they are not indispensable.
An example would be if a nurse agrees to prepare a 20 cc lethal drug to be used by
the nurse’s friend on victim A and did inject a 10 cc killing victim A but the other 10
 cc was injected on another victim B to which the nurse does not know about, the
nurse cannot be held criminally liable to the second victim B but an accomplice to
victim A only.

3. Accessories (Art. 19) – are those who, having knowledge of the commission of the
crime, and having participated therein, either as principals or accomplices, take part
subsequent to its commission in any of the following manners:

a. by profiting themselves or assisting the offender to profit by the effects of the

crme.
* the acts of an accessory are always performed after the commission of the crime by
the principal and that the accessory had no participation therein in any form
(accessory after the fact). An example is a daughter who stole an earrings and the
mother pawned them, the mother is guilty as an accessory.

b. by concealing or destroying the body of the crime, or the effects or instruments

thereof, in order to prevent its discovery.

* The prescribed acts of the accessory must have been intended to prevent discovery
of the crime , hence mere silence does not make one an accessory. The body of the
crime is equivalent to the corpus delicti.

c. by harboring , concealing, or assisting in the escape of the principal of the

crime, provided the accessory acts with abuse of his public functions.
* this provision distinguishes a person either as a public officer or a private individual. They

may have different penalties.

NURSES AND CRIMES

 The professional practice of a nurse entails with it the legal responsibilities that he or she
must know and understand in order to avoid liabilities in the discharge of her functions.

The following are crimes that a nurse must be familiar with:

ASSAULT – An unlawful attempt or offer to beat or to do bodily injury to another.

BATTERY – The unlawful beating or touching of another person. The unlawful beating or
use of force upon a person without his consent.
MURDER – is the unlawful killing of a human being by another with intent to kill (DOLO is
an element).

HOMICIDE – is the killing of a human being by another without deliberate intent to kill.

ABORTION – Termination or expulsion of the product of conception even before the age of
viability. Abortion is a crime penalized in our jurisdiction. A nurse who advises a woman on
what drugs to take is criminally liable.

INFANTICIDE - killing of a child less than three days of age.

PARRICIDE – is committed by one who kills his/her father, mother or child whether
legitimate or illegitimate, or any of his/her ascendants or his/her espouse.

SEXUAL HARASSMENT – is committed by a person who, having authority, influence or

moral ascendancy over another in a work, training or education environment, demands,
requests or otherwise requires any sexual favor from the other regardless of whether such
demand, request or requirement for submission is accepted.

ILLEGAL DETENTION – any private individual who shall detain another or, in any other
manner, deprive him of his liberty.

ARBITRARY DETENTION – any person in authority (public officer) who shall detain
another or, in any other manner, deprive him of his liberty.

SIMULATION OF BIRTH – any person who shall substitute one child for another or who
shall conceal or abandon any legitimate child with intent to cause such child to lose its civil
status.

 CRIMINAL NEGLIGENCE – is negligence of such character or occurring under such

circumstances, as to be punishable as a crime by statute.
 PROFESSIONAL NEGLIGENCE – breach of professional duty. Negligence
committed in the practice of a profession.
 NEGLIGENCE - is often referred to as that “doing of a thing which a reasonably
prudent man would not have done and not doing a thing which a reasonably prudent man
would have done”. It also refers to the commission or omission of an act, pursuant to a
duty, that a reasonably prudent person in the same or similar circumstance would do or
would not do, and acting or the non-acting of which is the proximate cause of injury to
another person or his property

 The elements of professional negligence are:

(1) existence of a duty on the part of the person charged to use due care under circumstances
(2) failure to observe such duty
(3) such failure resulted to injury or harm

 The test for negligence: “ would a prudent man, in the position of the person to whom
negligence is attributed, foresee harm to the person to whom negligence is attributed,
foresee harm to the person injured as a reasonable consequence of the course about to be
pursued; if so, the law imposes a duty on the actor to refrain from that course or to take
precaution against its mischievous results, and the failure to do so constitutes negligence.
 Reasonable foresight of the harm and ignoring such foresight is constitutive fact in
negligence.

 If such negligence is the proximate cause of the injury or harm, then the person causing
such negligence is liable for damages under the law
 A failure of the nurse to apprise or report to the physician his/her observation like sudden

increase in BP or sudden drop of vitals signs and such failure to report resulted to the

death or injury to the patient, then the nurse is liable for negligence.

 Observance of the standard of care as prescribed by RA 9173 is the only for nurses to

avoid negligence/malpractice suits in the practice of their profession in the Philippines.

 Wrong medication or wrong drug given to another patient constitute negligence on the

part of the nurse

 MALPRACTICE - refers to a negligent act committed in the course of professional

performance. Any professional misconduct, unreasonable lack of skill or fidelity in
professional or fiduciary duties; evil practice; or illegal or immoral conduct; improper
discharge of professional duties, or failure to meet the standard of care of a professional
which results in harm to another.
- to go beyond the practice of nursing as prescribed by RA 9173, like for example,
the nurse suturing in a surgical procedure without special training or the nurse
prescribing medicine or drugs, is malpractice. It means encroaching on the
practice of other profession where the nurse is not supposed to perform as
prescribe by the law.

 Negligence is malpractice
 Malpractice is determined if the nurse owed a duty to the client and did not carry out the
duty, and the client was injured because the nurse failed to perform the duty.
 If a nurse gives care that does meet appropriate standards, he or she may be held liable
for negligence.
 Negligence encompasses (includes) the concepts of foreseeability of harm to the person
injured and of a duty of care toward that person.
 Article 20 of the New Civil Code of the Philippines provides that every person who,
contrary to law, willfully or negligently causes damage to another shall indemnify the
latter for the same. This means that negligent acts resulting to injuries must be
indemnified in monetary terms.
 INCOMPETENCE- is the lack of ability, legal qualifications or fitness to discharge the
required duty. Incompetence is now included as a ground for revocation/suspension of the
certificate of registration as a nurse.

DOCTRINE OF RES IPSA LOQUITOR – it literally means, “ let the thing speak for
itself”. This is a legal doctrine usually used in litigations involving negligence or malpractice
suits. If the plaintiff (the one bringing an action in court) offers such evidence under this
doctrine, then no other evidence is necessary. An example would be sponges left inside the
abdomen of the patient after surgery – the fact that there is the sponge left is evidence by
itself that can speak that negligence was indeed committed and the court may no longer ask
for other evidence to prove the occurrence of such negligence. There are three conditions for
the application of this doctrine:
(1) the accident must be of a kind which ordinarily does not occur in the absence of
someone’s negligence
(2) the accident must be caused by an agency or instrumentality within the exclusive control
of the defendant ( one being sued in a civil case)
(3) the accident must not have been due to any voluntary action or contribution on the part of
the plaintiff ( injured party )

DOCTRINE OF RESPONDEAT SUPERIOR – it means “let the master answer; let the
principal answer for the acts of his agent”. Respondent superior simply provides that where
one acts through the agency of another , then , in the contemplation of the law , he is
himself acting so as to make him responsible for the acts of his servant. This doctrine is
founded on the principle that he who expects to derive advantage from an act which is done
by another must answer for any injury which a third person may sustain from it. Master-
servant or employer-employee relationship must exist for this doctrine to apply.

DOCTRINE OF FORCE MAJEURE – vis major, an act of God, irresistible force, one
that is unforeseen, inevitable. Natural calamities like strong typhoons or floods that would
deter the nurse to report for duty in the hospital for her shift is an example of this doctrine.
Even if the hospital needs her to report or some untoward incidents happened in the hospital,
which would not happen if the nurse were there does not constitute any liability on the part of
the nurse because of this doctrine.
NURSE AS A WITNESS – Any information obtained in the course of caring for the patient
by the health team ( doctor, nurses, medtechs) or any matters communicated by the patient to
the nurse is considered privilege. The nurse cannot testify in a civil case for any privilege
communication except when the patient allows such testimony or the patient himself offered
such information first in a court hearing or when the health of the many will be jeopardized.
This seal of secrecy will remain forever until removed by the patient. However, any
privileged communication may be divulged in a criminal proceeding even without the
consent of the patient where such information was obtained.

LIABILITY FOR FALSE TESTIMONY – any person who shall give false testimony in
any criminal case, either against or in favor of the defendant, shall be liable to punishment as
provided by the law. The punishment, depending on the case, ranges from imprisonment to
paying fines and/or both. The nurse can commit this violation if he/she is negligent on
charting or erroneously altering her entry in the charts.

 The hospital records, even if the patient was already discharged are part of public
documents, which can be summoned in any court hearing should the need arises. Most of
the time, it is the record custodian of the institutions who is given the subpoena duces
tecum or subpoena ad testificandum by the court. However, the nurses who made the
entries in the chart, if clarification is needed may also be summoned to appear in a court
hearing through the service of subpoena.
 A patient’s chart that is correctly and accurately accomplished is not only valuable as
evidence in legal proceedings but also useful as guide in the proper treatment of the
patient.

 Doctor’s Orders – as mandated by law, nurses must execute such orders for the
treatment of the patient, deviation or failure to perform this lawful duty can make the
nurse criminally and civilly liable and her license may be revoked or suspended. The
nurse must exercise certain degree of judgment in carrying out the doctor’s order. If in the
assessment of the nurse that such order may cause some injury to the patient, then she is
morally obligated to verify such orders before carrying them out. The verification must
be made to the person giving such order. The nurse must be assertive enough to protect
the welfare of the patient (stewardship) and also to protect his/her professional career
from lawsuits arising from erroneous carrying out of doctor’s orders. Should the doctor
insist in carrying out a questionable order, the nurse must refer the matter to her
immediate superior and must properly document the actions taken.

 Telephone Orders – the following guidelines may be observed in carrying out orders of
the physician given through telephone:

a. the nurse must chart the date and exact time when the order was given
b. the nurse must repeat and record the telephone order
c. the nurse must sign the order; begin with t.o. (telephone order) write the doctor’s
name, and then signature the order
d. if another nurse witnessed the order, then her signature must also follow
 e. if another physician or intern or resident is present in the station where such order
was given, then it is prudent that the phone call is given to that doctor so they can
discuss the order properly and that doctor can sign the orders given in a telephone.
f. The physician must sign the telephone order as soon as he is around or within 24
hours depending on the policy of the hospitals.

 Reporting Responsibilities – the nurse are required to report certain communicable

diseases or criminal activities such as abuse, gunshot wounds, assaults, homicides, and
suicides to the appropriate authorities.
 Incidental Report – the nurse must write incidental report to protect themselves from
sanctions. The matters that must be reported are those that deviate from the norms or
standard in the performance of their duties. This is also done so that proper remedy can
be reached in a given crisis or situation. The report must always be addressed to the
immediate superior or proper authorities ( eg. DSWD,PNP,RITM etc…).

 Charting Done by students – the clinical instructor or the nurse on duty must sign the
charting done by the student as required by RA 9173. Those persons signing such
charting attests that the charting made by the student are accurate and authentic and
consequently takes or assumes the responsibility from that charting.

PROFESSIONAL ADJUSTMENTS

( the concepts of professional adjustment are discussed in this reviewer according

to the format prepared by the Professional Regulation Commission as given by the
Board of Nursing.)

* PROFESSIONAL ADJUSTMENT - means “ the preparation of a student nurse for the

responsibilities of professional and social life, by the development of her capacities in a way that
would make her fit to enter upon the practice of nursing.” “Being a nurse means more than
just doing a good job; it means involving one’s self in the pressing health problems of the
community; it means listening, understanding, communicating, and working with others whose
life styles, beliefs, morals, values and culture may differ from those of the nurse.” ( robles,183)

* HOLD-OVER DOCTRINE – simply requires those who have been appointed to continue
serving or holding their position even if their terms has already lapsed, until such time that their
successor or replacement shall have qualified and appointed. Under RA 9173, members of the
Board of Nursing are appointed by the President of the Philippines and confirmed by the
Commission on Appointments. Members of the Board of Nursing may be appointed by:

(1) Regular appointment. – The Philippine Nurses Association certifies for the
Appointment to the Board of Nursing from the three (3) nominees per vacancy and the
Board shall endorse two (2) nominees per vacancy to the President.

(2) Ad interim Appointment – A board member is appointed in the meantime to fill in a

vacancy or perform the duties of an office during the absence of the regular incumbent.
There is no definite term of appointment.