Laws on Critical Care

Nursing
By:
Melinda L. Gonzales, RN, MAN
REPUBLIC ACT NO. 9173
An act providing for a more responsive Nursing
Profession, repealing for the purpose Republic Act
no. 7164, otherwise known as “The Philippine
Nursing Act of 1991” and for other purposes

SECTION 1. Title. — This Act shall be known as

the “Philippine Nursing Act of 2002.”
Declaration of Policy
SEC. 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.
ARTICLE VI - NURSING PRACTICE

SEC. 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 antenatal 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 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 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
nursing organization:

Provided, finally, That the program and activity for the

continuing professional education shall be submitted to
and approved by the Board.
PROMULGATION OF THE CODE OF
ETHICS FOR REGISTERED NURSES

WHEREAS, the Board of Nursing has the power

to promulgate a Code of Ethics for Registered
Nurses in coordination and consultation with the
accredited professional organization (Sec. 9, (g),
Art. III of R.A. No. 9173, known as the “Philippine
Nursing Act of 2002);
ARTICLE I - PREAMBLE
SECTION 1. Health is a fundamental right of every
individual. The Filipino registered nurse, believing in the
worth and dignity of each human being, recognizes the
primary responsibility to preserve health at all cost. This
responsibility encompasses promotion of health,
prevention of illness, alleviation of suffering, and
restoration of health. However, when the foregoing are
not possible, assistance towards a peaceful death shall be
his/her obligation.
SECTION 2. To assume this responsibility, registered
nurses have to gain knowledge and understanding of
man’s cultural, social, spiritual, physiological,
psychological, and ecological aspects of illness, utilizing
the therapeutic process. Cultural diversity and political
and socio-economic status are inherent factors to
effective nursing care.
SECTION 3. The desire for the respect and
confidence of clientele, colleagues, co-workers,
and the members of the community provides the
incentive to attain and maintain the highest
possible degree of ethical conduct.
ARTICLE II - REGISTERED NURSES AND
PEOPLE
SECTION 4. Ethical Principles
1. Values, customs, and spiritual beliefs held by
individuals shall be respected.
2. Individual freedom to make rational and
unconstrained decisions shall be respected.
3. Personal information acquired in the process of
giving nursing care shall be held in strict
confidence.
ARTICLE III - REGISTERED NURSES
AND PRACTICE
SECTION 6. Ethical Principles
1. Human life is inviolable.
2. Quality and excellence in the care of the patients
are the goals of nursing practice.
3. Accurate documentation of actions and
outcomes of delivered care is the hallmark of
nursing accountability.
ARTICLE III - REGISTERED NURSES
AND PRACTICE
SECTION 8. Ethical Principle

4. Registered Nurses are the advocates of the

patients: they shall take appropriate steps to
safeguard their rights and privileges.
Guidelines to be observed:
REGISTERED Nurses must
a. respect the “Patients’ Bill of Rights” in the
delivery of nursing care.

b. provide the patients or their families with all

pertinent information except those which may be
deemed harmful to their well-being.

c. uphold the patients’ rights when conflict arises

regarding management of their care.
ARTICLE IV - REGISTERED NURSES
AND CO-WORKERS
SECTION 12. Ethical Principles
1. The Registered Nurse is in solidarity with other
members of the healthcare team in working for the
patient’s best interest.
2. The Registered Nurse maintains collegial and
collaborative working relationship with colleagues
and other health care providers.
Patients’ Bill of Rights
Obligations as a Patient
1. Know and exercise your right as a patient responsibly and
reasonably

2. Report to your doctor any unexpected changes in your

condition and symptoms.

3. Ask questions when you do not understand what your doctor

or other member of the health care team tell you about diagnosis
and treatment and its cost.
4. Understand and accept consequences of your informed
consent. If you refuse the treatment or advise of the healthcare
provider, you must accept the consequences of such decisions.

5. Provide a complete and accurate information for insurance

claims and work with the hospital’s Billing staff to ensure
payment settlement.

6. Maintain a state of wellness and refrain from indulging

unhealthy lifestyle that has adverse impact on your health.
7. Provide complete and accurate information about your health,
including present condition, past illnesses, hospitalization,
medications, natural products and vitamins

8. Provide complete and accurate information including your full

name, address, telephone number, date of birth, insurance
provider and employer, when necessary.

9. Provide your doctor or the hospital with the copy of your

advance Directive if you have one.
10. Ask your doctor or nurse what to expect regarding pain and
pain management plan.

11. Respect the physician’s decision to treat and his religious

beliefs. Exercise transparency on all communications between
you and your physician.

12. Abide all the hospital’s rules and regulations

- No smoking policy, visiting hours, treat hospital staff and
other patient and their visitors
- Direct complaints to the patient’s relations
- leave valuable at home and bring only necessary items.
The Dying Patient’s Bill of Rights
1. I have the right to be treated as a living human being until I
die
2. I have the right to maintain a sense of hopefulness however
changing its focus may be.

3. I have the right to be cared for by those who can maintain a

sense of hopefulness, however changing this might be.

4. I have the right to express my feelings and emotions about my

approaching death in my own way.
5. I have the right to participate in decisions concerning my care.

6. I have the right to expect continuing medical and nursing

attention even though “cure” goals must be changed to
“comfort” goals.

7. I have the right not to die alone. I have the right to be free
from pain.

8. I have the right to have my questions answered honestly.

9. I have the right not to be deceived.
10. I have the right to have help from and for my family in
accepting my death.

11. I have the right to die in peace and dignity

12. I have the right to retain my individuality and not to be

judged for my decisions which maybe contrary to beliefs of
others.

13. I have the right to discuss and enlarge my religious or

spiritual experiences whatever these may mean to others.
14. I have the right to expect that the sanctity of the human body
will be respected after death.

15. I have the right to be cared for by caring, sensitive

knowledgeable people who will attempt to understand my needs
and will be able to gain some satisfactions in helping me face
death.

The American Journal of Nursing (Lippincott, Williams and Wilkins) “Bill Of Rights For Dying
Patient”. (https://www.support4change.com/)
Senate Bill 586
• An Act Providing Palliative and End-of-life Care,
Appropriating Funds Therefor and for other Purposes

• INTRODUCED BY SEN. JINGGOY EJERCITO ESTRADA

• SECTION 1. Short Title. - This Act shall be known as "The

Palliative and End-of-Life Care Act of 2010".

• The services aim to improve the quality of life of the patients

and their families, and as far as practicable, alleviate their
physical, emotion, psychosocial and spiritual diseases.
Senate Bill 586
Palliative care and end-of-life services include, but not
limited to the following:
1. Pain management;

2. Support to terminally-ill patients to live as best as possible

a comfortable life;

3. Prolong as far as practicable, the life span of critically-ill

patients through therapies, such as chemotherapy, radiation,
and other natural or alternative methods of healing;
4. Provide support and counseling to the families of
terminally-ill patients, especially in times of distress and
bereavement;

5. Integrate physiological, emotional and spiritual

assistance to patients and their families;

6. Enhance the quality of life of the patients and their

families.
SEC 3. Mandatory Palliative Care and End-of-Life Services.
- All government and private hospitals and health centers shall
provide palliative care and end-of-life services to all patients with
life-threatening illness.