Nursing Leadership and Management

Professional Adjustment
Adjustment- an educational process referring to changes in behavior towards better life,
better relationships and better contribution to society.

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.
 Nursing is an occupation requiring a unique body of knowledge and skills and which serves
society.

Professional Adjustment - the growth of the whole individual and development of all his/her
capacities: physical, mental, social and spiritual towards efficient and effective performance of
his/her profession.
Criteria of a Profession according to William Shepard:
1. Must satisfy an indispensable social need and must be based upon well established and
socially accepted scientific principles
2. Must demand adequate pre-professional and cultural training.
3. Must demand the possession of a body of specialized and systematized training.
4. Must give evidence of needed skills which the public does not possess; that is, skills which
are partly inherent and partly acquired
5. It must have developed a scientific technique which is result of tested experience
6. Must require the exercise of discretion and judgment as to time and manner of the
performance of duty

Definition of Professional Nurse

 Is a person who has completed a basic nursing education program and is licensed in his/her
country or state to practice professional nursing.

Meaning of Professional Nursing

 Phil. Nursing Act 1991( R.A. 7164)-repealed by Phil. Nursing Act 2002(R.A. 9173)
 Art. V1 (Nursing Practice)
 Scope of Nursing)
◦ Singly or collaboration- individual, families or communities in any health care setting
◦ Nursing care during the entire pregnancy, and all developmental stages.
◦ As Independent practitioners-promotion of health and prevention of illness.
◦ As member of the health team- curative, preventive and rehabilitative aspect of care,
restoration of health, alleviation of suffering, and assistance toward a peaceful death.

Scope of Nursing (it shall be the duty of the nurse to):

1. Provide nursing care through the utilization of Nursing Process.
2. Establish linkages with community resources and coordination with the health team
3. Provide health education to individuals, families and communities
4. Teach, guide and supervise students in nursing education programs; undertake consultation
services; engage in such activities that require the utilization of knowledge and decision
making skills of a registered nurse;
5. Undertake nursing and health human resource development training and research, which
shall include, but not limited to, the development of advanced nursing practice.

Qualifications and Abilities of a Professional Nurse

A. Professional Preparation
1. Have a license to practice nursing in the country
2. Have a Bachelor of Science degree in Nursing
3. Be physically and mentally fit
B. Personal Qualities and Professional Proficiencies:
1. Interest and willingness to work and learn with individuals/groups in a variety of setting;
2. A warm personality and concern for people;
3. Resourcefulness and creativity as well as a well balanced emotional condition;
4. Capacity and ability to work cooperatively with others;
5. Initiative to improve self and service;
6. Competence in performing work through the use of nursing process;
7. Skills in decision-making, communicating, and relating with others and being research
oriented;
8. Active participation in issues confronting nurses and nursing.

BSN CURRICULUM
  The four year BSN Program offers a competency-based community oriented curriculum to
educate future nurse practitioners to assume their roles and responsibilities in the Phil Health
Care System
 It aims to prepare nurses for entry level positions in any healthcare setting in the country

Terminal competencies
1. Utilize the nursing process in the care of individuals, families and community
2. Communicate effectively at all levels of healthcare in various setting
3. Utilize the elements of management process in the delivery of healthcare setting
4. Utilize research findings in the care of client
5. Assume responsibility for personal and professional growth and development

BSN Program intends to produce Professional nurse who demonstrates:

1. Caring behavior
2. Ability to practice legal, ethico-moral, social responsibilities/accountabilities.
3. Critical and creative thinking
4. Skills in practicing S-K-A and values for the promotion of health, prevention of illness,
restoration of health, alleviation of suffering; assisting clients for face death with dignity and
in peace.

LICENSE TO PRACTICE NURSING

License
 Is a legal document given by the government that permits a person to offer to the public his
or her skills and knowledge in a particular jurisdiction
 Appropriate authority- PRC
 To protect the health of the people by establishing a minimum standards which qualified
practitioners must meet.
 Most important tool for legal control and enforcement of nursing practice.
 Use to gather statistical data about nurses and nursing in the country.

Registration
 Recording of names of persons who qualified under the law to practice their respective
professions.
 It contains:
◦ Full name of registrant
◦ Number and date of registration
◦ Age, sex and place of birth
◦ Place of business
◦ Post office address
◦ Name of school, college or university from which he or she graduated or in which he or
she has studied.
◦ Date of such graduation or term of study, together with the time spent in the study of
the profession elsewhere, if any
◦ All other degrees granted to him or her from other institutions of learning.
Registration required
 Under the Philippine Nursing Act of 2002, RA 9173, Sec 12 and 30, state that license to
practice nursing shall be issued to those who pass the licensure examination or by reciprocity

Registration by Reciprocity(RA 9173, sec 20)

 Reciprocity means mutuality in the grant and enjoyment of privileges between persons or
nations.
 Based on the principle of “do ut des” which means that for a country to expect a favor from
another, it should be willing to give a corresponding favor.
 A certificate of registration/professional license may be issued without examination to
nurses registered under the laws of a foreign state or country.
Specifically, these provisions are explained thus:
1. Nurses registered in the Philippines desiring to practice in said foreign state or country are
granted under its laws the same privileges as those accorded to its subjects or citizens and as
are enforced by them.
2. The applicant is a registered under the law of her/his state or country.
3. The requirements for registration is substantially the same as those prescribed under this act
4. The applicant has resided in the Philippines for at least three years as provided by R.A. 5181

Additional Requirements:
1. A certification from the Commission on Immigration and Deportation stating that they have
been residents of the Philippines for at least (3) three years prior to the registration
2. A copy of the law or petition thereof showing reciprocal practice with the Philippines
3. A copy of their officially approved Bachelor of Science in Nursing curriculum
Sec 21. Practice Through Special/Temporary Permit
 Maybe issued by the board subject to the approval of the commission and upon payment of
the prescribe fees:
 a. Licensed nurses from foreign countries/states whose service are either for a fee or free if
they are internationally well-known specialist 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
c. Licensed nurses from foreign countries/states employed by schools/colleges of nursing as
exchange professors in a branch or specialty of nursing

Registration by Examination
Licensure Examination- required to pass a written examination which shall be given by the Board
in such places and dates as maybe designated by the commission

Qualifications for Admission to the Licensure Examination

1. 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
2. Is of good moral character
3. Is a holder of a Bachelor’s Degree in Nursing for a college of university that complies with the
standards of nursing education duly recognized by the proper government agency

Requirements for Examination

1. Original TOR with Special Order from the Department of Education, Culture and Sports
unless she is a graduate of a Level II accredited nursing program
2. For state colleges and universities, original transcript of records with date of graduation.
3. Record of actual RLE for the entire BSN program duly signed by the Chief Nurse of the
hospital or her duly authorized representative in addition to that of the Dean of the nursing
school and the clinical Instructor
4. Actual number of operating room scrubs and deliveries assisted, signed by the chief nurse
and dean of the nursing school and the clinical instructor
5. Where applicable:
a. Birth Certificate
b. Marriage Certificate
c. Alien Certificate of Naturalization
d. Clearance showing dismissal of case from the Court or Prosecutor’s Office, if any

The application form, together with the requirements, should be filed at the PRC ten (10) days
prior to the first day of the examination

Fees for the Examination and Registration

 Shall be prescribed by the Commission

Scope of Examination
 Shall be determined by the Board taking into consideration the objectives of the nursing
curriculum, the broad areas of nursing and other related disciplines and competencies in
determining the subjects of examinations.
 It draws knowledge from the five broad areas of nursing-Fundamentals of Nursing, MCN,
CHN, Nursing of Adolescent, Adults and Aged and Mental Health and Psychiatric Nursing
including Physiology and Anatomy, Pharma and Therapeutics, Microbiology and Diet Therapy.
 Shall be divided into 4 parts: Promotive, preventive, curative and rehabilitative

Rating of the NLE

 Must obtain a general average of at least 75 % with a rating of not below sixty percent (60%)
in any subject
 Renewal examination shall be taken within 2 years after the last failed examination.
 Reconsideration of Rating:
◦ maybe entertained only grounds of mechanical, clerical, or clear errors; or if it is
conclusively shown that there had been malfeasance in the rating papers
◦ Should be filed with the Commission within 90 days from the date of the official
release of the examination results.

Citizenship Requirements
The ff are citizens of Philippines as per Art. IV Sec. 1-5 of the 1987 Phil. Constitution:
1. Those who are citizens of the Phil at the time of the adoption of this Constitution.
2. Those who elect Phil citizenship pursuant to the provisions of the Constitution of 1935.
3. A female citizen of the Phil who marries an alien shall retain her Phil citizenship, unless by
her act or omission she is deemed, under the law, to have renounced her citizenship.
4. The Phil. Citizenship may be lost or re-acquired in the manner provided by law.
5. A natural born citizen

 In “jus sanguinis” doctrine, the nationality of a person is determined by the law of his
descent or parentage; the child follows the citizenship of his father.
  In “jus soli doctrine, the nationality of a person is determined by the law of the place of his
birth; the child born in a foreign country whatever may be the citizenship of the father, is a
citizen of the country.
 Naturalization is the act of adopting a foreigner and giving him the privileges of a native
citizen.

Oath-Taking of Nurses
 Shall be required to take an oath of profession before the Board or any government official
authorized to administer oaths prior to entering the nursing practice.
 Schedule is within 15 days upon the release of the result, which is included in a press
release issued by the PRC
 The professional oath includes a pledge to support and defend the Constitution, bear true
faith and allegiance to the same, obey the laws, legal orders and decrees promulgated by the
duly constituted authorities of the Philippines and adherence to the ethical and professional
standards of nursing.
 The commission is assisted by the accredited professional organization.
 Nurses are inducted as new members of their professional organization.

Issuance of Certificate of Registration/Professional License and Professional Identification Card

 Shall issue upon payment of the prescribed fees.
 Every certificate of Registration/Professional license shall show the full name of the
registrant, the serial number, the signature of the Chairperson of the Commission and of the
Members of the Board, and the official seal of the Commission
 Professional identification card, signed by the chairperson, bearing the date of registration,
license number, and the date of issuance and expiration thereof, shall be issued upon
payments.

Annual Registration
 Shall pay a fee for three(3) years, on the birth month.
 Surcharge of 20% for each calendar year for failure to pay.
 After 5 years of non payment- be suspended and be dropped from the annual roster for not
having been in good standing.
 Maybe reinstated only upon application and payment of the required fee without examination

Automatic Registration of Nurses

 All nurses whose names appear at the roster of nurses shall b automatically or ipso facto
registered as nurses under this Act upon its effectivity.

Sec. 22: Non-registration and Non-issuance of Certificates of Registration/Professional License or

Temporary Permit
 Convicted by final judgment of any criminal offense
 With unsound mind

Renewal of the Nurses’ License

 Every three years with the PRC on the form prescribed, not later than the due date indicated
in the license and pay the prescribed fee.
 CPE credits for registered professionals with Baccalaureate Degree- sixty (60) credits for
three years.
◦ PRC Resolution No. 2004-179 series of 2004 entitled “Standardized Guidelines and
Procedures for the Implementation of the Continuing Professional Education for
Professionals”.
◦ Any excess credits earned shall not be carried over to the next 3 years except for
doctoral and master degrees.

Sec. 23: Revocation/suspension of certificate of registration/professional license or cancel the

special/temporary permit:
a. For any of the causes mentioned in Sec 22 of RA 9173
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, of false statements in obtaining a certificate of
registration/professional license or temporary/special permit
f. For violation of this Act, the implementing rules and regulation, code of ethics
g. For practicing his/her profession during his/her suspension from such practice

Re-issuance of Revoked Certificates

Sec.24
 After the expiration of a minimum of four (4) years from the date of revocation of certificate
 A new certificate of registration/license to replace a certificate that has been lost, destroyed
or mutilated may be issued, subject to the rules of the board.
 Suspension
  Revocation

Prohibitions in the Practice of Nursing

Fine- not less than fifty thousand pesos (P50,000) nor more than one hundred thousand pesos
(P100,000.) or imprisonment of not less than one (1)year nor more than six (6) years, or both.

a) Any person practicing nursing in the Phil within the meaning of this Act:
1. Without certificate of registration/prof.license and prof. I.D or special/Temporary
permit.
2. Who uses as her/his own certificate ……as her own.
3. Who uses an invalid certificate/ I.D., suspended or revoked certificate of…….or an
expired or cancelled special/temporary permit
4. Who gives any false evidence to the Board in order to obtain a certificate
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 a registered and license nurse.

6. Who appends B.S.N./R.N or similar appendage to his/her name without having been
conferred said degree or registration
7. Who, as 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 CEO of a juridical entity who undertakes in-service educational programs or
who conducts review classes for both local and foreign examination without
permit/clearance form the Board and the Commission
c) Any person or employer of nurses who violate the minimum base pay of nurses and the
incentives and benefits that should be accorded then as specified in Sec. 32 and 34
d) Any person or chief executive officers of juridical entity violating any provision of this Act
and its rules and regulation.

The Licensing Board

Sec. 4: Composition of the Board
 Chairperson
 Six (6) members
 Representing the three (3) areas of nursing:
◦ Nursing Education
◦ Nursing Service
◦ Community Health Nursing

Appointment of Members of the Board

 Appointed by the President of the Philippines
 Confirmed by the Commission of Appointment.

Types of Appointment:
1. Regular appointment
◦ PNA submits 12 qualified candidates
◦ Rank accordingly
◦ Forwarded to the Commissioner of PRC for further screening
◦ Commission will submit the first 6 from the list to the President of the Philippines
◦ The pres. appoints the board member.
◦ Confirmed by the Commission on Appointments.

2. Ad Interim appointment-
 A board member is appointed in the meantime to fill the vacancy or perform the
duties of an office during the absence of the regular incumbent
 There is no definite term of appointment.
 Doctrine Of Hold-Over
Member of Board is permitted to continue to exercise the functions of the office
after the end of his/her lawful term until replaced.

Qualifications of the Chairperson and Members:

1. A natural born citizen and resident of the Philippines
2. A member of good standing of the accredited professional organization of nurses
3. A registered nurse and holder of master’s degree in nursing, education or other allied medical
profession
4. Must have at least ten (10) years of continuous practice of the profession prior to
appointment, the last 5 years of which must be in the Philippines
5. Must not have been convicted of any offense involving moral turpitude

Requirements Upon Qualification as Chairperson and Member of the board:

a. Immediately resign from any teaching position
b. Immediately resign from the office or employment in private sector and/in the government or
any subdivision, agency or instrumentality thereof, including government-owned and or
controlled corporations or their subsidiaries
c. Not have any pecuniary interest in, or administrative supervision over any activity offering BSN
including review classes.

Term of Office
 3 years and until their successors shall have been appointed and qualified, provided that:
 No Chairperson and Member shall be appointed and reappointed for more than
two (2) terms or a period of six (6) years.
 Appointment to a vacancy that occurs before the expiration of the term of office
of the Chairperson/Member shall cover only the unexpired portion of the term of the
immediate predecessor
 Chairperson and Member shall take the proper oath of office prior to the
performance of his/her duties.

Compensation of the Board Members

 Chairperson shall receive compensation and allowances comparable to the compensation and
allowances received by the Chairperson and Members of other professional regulatory
boards.
 They are paid based on the principle of quantum meruit which means “as much as they
deserve”.

Removal or Suspension of Board Members

 The President may remove or suspend BON after having been given the opportunity to defend
himself in proper administrative investigation, on the ff ground:
a. Continued neglect of duty or incompetence
b. Commission or toleration or irregularities in the licensure examination
c. Unprofessional, immoral or dishonorable conduct.

Powers and Duties of the Boards

a. Conduct the licensure examination for nurses
b. Issue, suspend or revoke certificates of registration for the practice of nursing
c. Monitor and enforce quality standards on nursing practice in the Philippines
d. Ensure quality nursing education
e. Conducts hearings and investigations to resolve complaints against nurse practitioners:
◦ issue subpoena and testificandum and subpoena duces tecum
◦ Punish with contempt persons obstructing, impeding and/or otherwise interfering
with the conduct of such proceedings.