LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA
OUTLINE
I. COMMUNICATION: Continuation…
a. Assertiveness
b. Barriers to Assertiveness
c. Transactional Analysis
d. Ego States
e. Transactions
f. Game Playing
g. Life Positions
Link:
• https://drive.google.com/drive/u/1/folders/17
-W8xBOWaTJc7ogcdPvmvjsHTjU1RJ2b
Book:
Guide to Nursing Management and Leadership by Anne
Marriner Tomey; Ch. 01, page 3 – 26
ASSERTIVENESS
• Nurses should learn how to be assertive, that’s
what were actually lacking. When you talk about
assertiveness, it is different from being
aggressive. Assertive in a manner that you speak
your mind out when it’s needed, you call the
attention of whoever it is may it be the patient,
doctor, or significant other. Pag diri tama you call
out the attention.
• Assertiveness is the best style for nurse
managers and the one they should foster in
their personnel.
• However there maybe barriers that nurse must
overcome to become assertive.
Barriers To Assertiveness
1. Gender Roles
• One of the most pervasive barriers, is the
female role socialization.
• Whereas men are often characterized as
aggressive, competitive, independent,
objective, analytical, task oriented,
confident, self-disciplined, and
emotionally controlled.
• Women are expected to be passive,
dependent, subjective, intuitive,
empathetic, empathetic, interpersonally
oriented, weak, inconsistent, and
emotionally unstable.
• However, it is not just women who
experience discrimination in the work
place. Men also experience
discrimination. Ex: Babye na patient
mayakan “diri ako ha imo na nurse kay
lalaki ka, kuha la hin babaye.”
2. Nursing Socialization Process
• Both nursing schools and health care
agencies usually have organizational
hierarchies with authority and power
concentrated at the top.
• From school nurses are already taught
the value of sacrifice, humble, and
submissive.
• Nurses have been socialized into a
subservient role. They are expected to
follow physician’s orders and to be
professional but not anticipate equal
financial reimbursement for their
education and responsibilities.
• They are expected to be a part of the
health care team but in reality, is not
encouraged to make decisions or
policies.
• They tend to keep so busy that they
ignore their own rights.
• Assertiveness should always begin to be
taught in schools.
• Some of the reasons as to why diri na
uswag iton mga nurse is that one diri kita
cohesive and ika duha some nurses tend
to pull down each other.
3. Male-Female Role Competition
• In addition to these male & female role
competition problems, nurses face
female-female relationship problems.
• Men are more competitive with women
than with other men, and women are
more competitive with women than with
men.
• Consequently, attempts to develop
support systems for nurses are not
usually successful. Instead, the queen
bee and the trashing syndrome emerge.
4. Queen Bees
• The queen bee identifies with men,
enjoys being told that she is different
from most women, and feels superior to
other women. She views the other
female in the organization as lesser than
her.
• Example: In a company, mostly mga
lalaki an CEO. Meada babaye nga
nakakasulod as CEO hin usa na company,
nalingkod hera together. Meeting-
meeting, syempre exchange of ideas,
syempre powerful an pag kita han
babaye. Yana an pag kita na niya han iba
na mga babaye lesser than her, because
she identifies her self as powerful as men
in the organization.
• The queen bee usually has to work very
hard to become a success in a male-
dominated society.
• She is likely to need to be cooperative
and non- threatening to achieve and
maintain her successful position. She
probably feels little animosity toward the
system and the men who allowed her to
become successful.
• Consequently, she is likely to identify
with her male colleagues instead of with
other women.
5. Trashing
• Trashing is a form of character
assassination that divides women against
one another.
• It is self-destructive and leads to
impotent rage. Rather than exposing
disagreements to resolve differences,
trashing is done to destroy.
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 LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA
• It can be done to one's face or behind
one's back, in public or in private. It
questions one's motives, stresses one's
worthlessness, and breaches one's
integrity. The victim may be ignored, or
anything she says or does may be
interpreted in the most negative manner.
Others' unrealistic expectations about
her ensure failure.
• The trasher may give misinformation to
others about what the victim does and
thinks or tell her lies about what others
think of her.
• Whatever method is used, it is
manipulative, dishonest, and destructive.
• Women in general and nurses specifically
need to become aware of what they are
doing to each other, commit themselves
to supportive instead of destructive
behavior, learn to analyze interpersonal
communication, and learn assertive
behavior.
• If we put this into simple terms trashing
is like pulling each other down.
• This is what we need to realize, we need
to create a working environment
conducive to professional and personal
growth for everyone, fostering support
from one another.
TRANSACTIONAL ANALYSIS
• Transactional analysis is a technique that can be
used by nurses for analyzing and understanding
behavior.
• It was developed by Eric Berne (1964, 1996) and
popularized by Thomas Harris (1964, 1969) and
Muriel James and Dorothy Jongeward (1996).
• Transactional analysis is an outgrowth of the
Freudian concepts of id, ego, and superego
elements of the psyche that stimulate, monitor,
and control behavior. Berne calls these ego
states parent, child, and adult.
EGO STATES
• Parent
o The parent ego state controls and is the
source of values, opinions, rules, regulations,
and social conscience.
o The two major types of parent ego states are
nurturing parent and critical parent.
o The nurturing parent guides, teaches,
advises, and supplies "how to" information.
o The critical parent prohibits and supplies
"should" and "should not" information.
o The parent ego state is a result of cultural
traditions, social programming, and
responsibilities. Parental judgments are
drawn heavily from natural parents, older
siblings, teachers and other parent figures.
• Child
o The child ego state is dominated by
emotions and is the feeling state.
o Kung baga, diba ha child you are dominated,
and childish. So, remember if one is childish
one is dominated by his/her emotions.
o It is the id ego state in which strong feelings
are triggered by immediate experiences,
people are in the child state when they are
experiencing childlike natural impulses, such
as joy, delight, and gaiety or anger, hostility,
and rage. The child ego state may be happy
or destructive.
o The natural child is spontaneous, trusting,
joyful, living, creative, and adventurous. The
adapted child is suppressed and may express
anger, rebellion, fear, or conformity.
o This are all your child ego or your feeling
ego.
• Adult
o The adult is the ego state that monitors
one's behavior. It is the unemotional,
thinking, problem-solving state.
o Meaning you use your mind and not your
heart.
o The adult ego state collect information, sets
goals. compares alternatives. makes
decisions and plans and tests reality.
o The adult ego state is an unemotional
state in which rational decision making takes
place.
• Every individual exhibit behavior from the three ego
states at different times. A healthy individual
maintains a balance among them.
• Working with adult-dominated individuals may be
boring because they work so hard.
• A balance among 3 ego states produces the
healthiest worker.
TRANSACTIONS
• A transaction or an observation unit is an
exchange between people that consists of at least
one stimulus and one response.
• Transactional analysis is done to identify the
participant's ego state and consists of
complementary or crossed types.
• The basic principle of the complementary type is
that the response to the stimulus is predictable
and expected.
Transactional Analysis
A. COMPLIMENTARY
a. Adult-to-adult transactions are the
manner in which much business is
conducted. For instance, a supervisor says,
"Would you please give Mr. Jones his prn
medication before you give Mrs. Smith her 8
AM medications?" A staff nurse replies, "Yes,
I understand that Mr. Jones is complaining of
surgical pain."
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MR. ANDRE DE VEYRA
• Waray personalay, waray feelings
feelings.
b. Parent-to-parent interaction is often a
short-term sharing of opinions. One staff
nurse says to another, '"Those new graduate
nurses certainly don't know how to function."
The other nurse replies, "That's for sure."
c. Child-to-child interactions usually involve
an emotional exchange. As long as both
parties are in a child ego state, they are
unable to think rationally and solve problems.
The first staff nurse says, "I just gave Mrs.
Smith her 8 AM medications, and when I
went to chart them, you had signed for giving
them. Why don't you sign right after you give
medications so they won't be repeated!" The
second nurse answers, "Why don't you give
me a chance to sign before you go and give
them again!"
B. CROSSED
a. In parent-to-child interactions one
person takes a psychologically superior
position over the other. A manager says, "I
want to see you in my office." A staff nurse
answers, "Yes, ma'am."
b. Crossed transactions result in closing
communications at least temporarily. The
response may be inappropriate or
unexpected and may confuse or threaten the
sender of the stimulus. A supervisor says,
"Miss Jones, could I see you about this in my
office right away?" Miss Jones replies, "No!
Can't you see I'm busy? You'll have to wait."
C. Pastimes are pleasant ways to pass time with
others to learn if you have enough in common to
warrant further interaction. Common small talk
includes topics such as cooking, fashions, costs,
sports, recreation, and mutual acquaintances.
There is no goal or emotional closeness involved.
People who spend too much time participating in
pastimes may sense that their lives are happy but
empty, whereas the person who spends too little
time making small talk may not have much fun
and may feel harassed. Pastimes become a
problem for the organization when they are an
alternative to work.
• Amo ini an times na you are just talking
casually in the workplace.
• May gamit ini hiya interms of extablishing
rapport.
GAME PLAYING
• A game is an ongoing series of complementary
ulterior transactions progressing to a well-
defined, predictable outcome."
• Games have hidden agendas that prevent both
people and organizations from becoming
winners.
Examples
1. BLAME OTHERS
• Games that blame others includes
o "If it weren't for you"
o "See what you made me do”
o "If it weren't for you"
• "If it weren't for you"
o is a blaming game in which people
who feel inadequate blame others for
their inability to achieve.
• "See what you made me do”
o "See what you made me do" and
"You got me into this" are closely
related blaming games.
o The player avoids responsibility by
being vindictive.
o It is common for workers to blame
managers for problems and for
democratic managers to blame
workers for mistakes or poor
decisions.
2. ATTACK
• Blemish
o Player looks for inconsequential,
unimportant flaws.
o Instead of looking at purposes, the
player concentrates on minutiae and
zeroes in on trivial mistakes.
• Now I've got you
o In this game the persecutor waits for
the victim to make a mistake or sets
the victim up for failure.
o The manager may be indulging in
this game by setting standards too
high to achieve, assigning people to
work for which they are not qualified,
• Bear trapper
o Often baits someone with false
promises and then lets the trap fall.
o Organizations play this game in
hiring practices when glamorous job
descriptions are presented. This
tends to result in high turnover.
o This tends to result in high turnover.
• Corner
o The "Corner" player's victim is in a
lose-lose situation. No matter what
the victim does, it is wrong.
o A woman manager is damned if she
is aggressive because that is not
considered feminine and damned if
she is not because aggressiveness is
a desired managerial quality.
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MR. ANDRE DE VEYRA
o To put it into simple terms, whatever
you do, sayop permi. Himuon mo ini
hiya, yayaknan ka nga sipsip ka. Diri
mo liwat himuon, hubya.
o "Corner" can lead to "Uproar”.
• Rapo
o A woman may wear revealing
clothing and move in provocative
ways. When a man responds, she
rejects him.
o This game is problematic when men
and women work together.
o Organizations require concentrating
on equality and using human
resources regardless of gender.
• Uproar
o Uproar often starts with a critical
remark and results in an attack-
defense dialogue that is often loud.
o To put it into simple term, nagbuto
ka, sumabog ka na.
• Let's you and him fight
o One person gets a second and a third
person into a fight.
o In simple terms mahilig mag bulang-
bulang.
3. SELF-PITY
• Poor me
o Managers play "Poor me" games
also.
o Example: “Kay waray na kamo
respeto ha akon, waray na kamo
kaluoy ha akon.”
• Kick me
o Players provoke putdowns and make
o comments such as "I could kick
myself for that."
• Stupid
o Players collect putdowns about their
intelligence.
o Managers need to give immediate
feedback and take corrective actions
to prevent the Stupid game.
• Wooden leg
o Player uses a physical or social
handicap to avoid work. .
• Harried
o Executives work hard to maintain the
sense of being ok.
o They are likely to work nights and
weekends to appear competent and
confident.
o "I'm not ok" feelings are hidden by
appearing super ok.
• Lunch bag
o The Harried executive may also
participate in the "Lunch bag game."
o Managers carry leftovers in a used
paper bag and eat at their desk
instead of going out to lunch with
peers.
o This technique can be used to make
other people feel guilty.
LIFE POSITIONS
1. I'm OK, you're OK
• In the I'm OK, you're OK position, individuals
feel interdependent with others and the
environment.
• They are happy, active people with a positive
outlook on life who like reinforcement for
being 0K but are not dependent on it.
2. I'm OK, you're not OK
• People in the I'm OK, you're not OK position
do not believe they can rely on anyone but
themselves.
• They think people are worthless and are likely
to be enemies and consequently tend to
blame others.
3. I'm not OK, you're OK
• People in the I'm not OK, your OK position is
burdened with self-defeating attitudes and a
lack of confidence.
• They take a psychologically inferior stand to
others and assume that they are less
competent and less influential than others.
4. I'm not OK, you're not OK
• Individuals in the I'm not OK, you're not OK
position are maladjusted.
• They think they are worthless and so are
others. Lacking confidence
ASSERTIVENESS TECHNIQUES
1. BROKEN RECORD
• To achieve assertiveness, one must
substitute persistence for silent passivity
and verbal abuse.
• Broken record is a technique managers
can use to reach a compromise by
indicating what they want and by keeping
other people from talking them into what
the others want to do.
• With the broken-record technique
managers keep repeating what they wan
2. FOGGING
• Fogging, negative assertion, and
negative inquiry are techniques for
dealing with criticism. whether it is self-
directed or from another source, real or
imagined.
• They help minimize the negative
emotional response of anxiety to criticism
that manipulates one into defending
what one wants to do instead of doing it.
• It is a way of responding to criticism
without being too emotional.
• Fogging is agreeing with the truth,
agreeing in principle, or agreeing with
the odds rather than denying the
criticism, getting defensive, or
counterattacking with criticism.
• It also encourages a person to listen to
what the critic says, to respond only to
what the critic says rather than to what
is implied, and to consider probabilities.
3. NEGATIVE ASSERTIONS
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 LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA
• Negative assertion is not appropriate for
physical or legal conflicts or for relating
to people on a close interpersonal basis.
• The persistence of the critic will
determine if one needs to use other
assertive techniques.
4. NEGATIVE INQUIRY
• Negative inquiry fosters assertiveness in
the critic. In an unemotional manner, the
criticized person asks for more
information that may be negative.
• This provides a basis for problem solving
and consequently reduces repetitive
criticism.
• Assertive behavior is more than demanding your
rights from others and keeping others from
manipulating.
• In a social sense assertiveness is the ability to
communicate with others about who you are,
how you live, what you do, and what you want
and the ability to make them feel comfortable
talking about themselves.
• Free information—information offered without
being asked for—gives you something to talk
about and reduces awkward silences.
MEMO WRITING
MEMO
Description
• A written communication used most by managers
in their daily work life
• A short, to the point communication conveying
thoughts, reactions or opinion on something
• Can call people to action or broadcast a bit of
timely news
• Shorter is better
Purpose
• Bring attention to problems or to a specific
agenda
• They solve problems
Continuation
• Should be sent to only a small to moderate
number of people.
• Memos should not be used for highly sensitive
messages, which are better communicated face-
to-face or by telephone
Composition
Business memos should be composed of:
• Header - includes the to, from, date, and subject
lines.
• Opening, context, and task - includes the
purpose of the memo, the context and problem,
and the specific assignment or task.
• Summary, discussion segment - the details
that support your ideas or plan.
• Closing segment, necessary attachments -
the action that you want your reader to take and
a notation about what attachments are included.
GUIDELINES IN WRITING MEMO (DO’S AND
DON’TS)
DO’S
• Keep your message short and concise.
• Use the first paragraph to express the context or
purpose of the memo and to introduce the
problem.
• Add a conclusion to summarize the memo.
• Focus on the recipient's needs.
• Use simple language so that the message is clear.
• Pay attention to tone.
• Use spelling and grammar checks to be sure that
the communication looks professional.
• Do use bullet points
• Do be succinct
• Review the message and revise as needed.
DON’TS
• Don't use informal/emotional language.
• Don't berate or use sharp words.
• Avoid spelling errors.
• Avoid long sentences and wordy phrasing.
• Do not use a salutation.
SAMPLE OF MEMO
MEMORANDUM
To: Mary McGee, Alistair Warwranka, George Lipton
CC: Dorothy Barrie
From: The Boss
Date: June 1, 2006
Re: Need for New Memo Format
I’ve noticed that we don’t seem to be able to
communicate important changes, requirements and
progress reports throughout the company as effectively
as we should. I propose developing one consistent memo
format, recognizable by all staff as the official means of
communicating company directives.
While I know this seems like a simple solution, I believe
it will cut down on needless e-mail, improve universal
communication and allow the staff to save necessary
information for later referral.
Please talk among yourselves to determine the proper
points of memo writing and return the input to me by 12
noon. I will then send out a notice to the entire staff
regarding the new memo format.
Thank you for your prompt attention to this.
=TITLE = HEADER = BODY
Sir Andre:
• Usually for memo in an organization, the type of
communication used is the downward
communication. Coming from the admin going
down to the personnel’s/employees.
MINUTES OF THE MEETING
MEETING OF MINUTES
Description
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 LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA

• Meeting minutes are an official record of actions DON’TS

the board or committee took at a meeting, not a • Word contractions should be avoided.
record of everything that was said. • Don't write a transcript.
• They serve as a legal purpose, documenting the • Don't include personal comments.
group’s adherence to the proper procedures and • Don't wait to type up the minutes.
the associations by laws. • Don't handwrite the meeting minutes.
• Minutes and recordings made during a meeting
are discoverable in litigation, so it is imperative to SAMPLE OF MINUTES OF THE MEETING (SIR
be prudent about what to include. ANDRE’S SAMPLE)
• It highlights the key issues that are discussed,
Hello! For a more clearer view of the given sample by sir
motions proposed or voted on, and activities to
andre you may visit the recorded lecture “COMM – ANDRE
be undertaken.
2” starting from 30:45 – 35:40 . Link is give at the
• The minutes of a meeting are usually taken by a
beginning of the reviewer. Thank you!
designated member of the group, and the task is
to provide an accurate record of what transpired
during the meeting.

GUIDELINES IN WRITING MINUTES OF THE

MEETING
1. Pre-planning
• In this stage we simply clarify the goals
and expectation of the meeting.
2. Taking notes during the meeting
• Or record of the meeting
• We write here the location, date and
attendees of the meeting, action stat,
voting outcomes, motions, etc.
3. Transcribing your notes
• We should ensure that we transcribe out
notes legibly, neat and organized for
future reference.
4. Distributing or sharing to the right people
• Nowadays we do this electronically.
5. Filing and storing for future reference
• Categorizing the topic for easy
identification later on.

DO’S AND DON’TS

DO’S
• Use the agenda.
• Start with a heading such as "Meeting minutes of
the XYZ committee."
• Sit close to the Officiating officer so you can easily
ask questions and get clarifications.
• Circulate an attendance list.
• If participants' names are unfamiliar to you, take
advantage of a seating chart, name tags, or
placards.
• Take minutes with a laptop or tablet in addition
to any recording device
• Ensure that your electronic devices are
connected, working well, and have a battery life
twice the expected length of the meeting.
• Ask for clarification and information whenever
you're unsure about something.
• Listen carefully during discussions and synthesize
key points, focusing on concerns that were
discussed.
• Keep your writing clear, objective, and succinct.
• Before distributing the minutes, spell check and
proofread the document carefully, then send it to
the chair for approval.
• Include your name at the end as the recorder of
the minutes.
Sir Andre:
• So, in writing minutes of thee meeting, you just
write the salient points.
• Others really records the whole meeting in order
for them transcribe it later on.
• What is the use of the numbers at the sides
and the page number at the bottom
(example: 1/4)?
- After it has been prepared it will be signed by
the one who has prepared the meeting and
approved by the presiding officer. After that,
towards the next meeting it will then be
distributed towards the all members wherein
they will first read and review the minutes of
the previous meeting before starting a new
meeting.
• Why does it need to be reviewed?
- For it to be subjected to corrections. Through
the help of the numbers at the sides and the
page number at the bottom, it will be much
easier to locate and correct that particular
area with a mistake. (Example: page 2 line
21)

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 LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA

• After the minutes of the previous meeting has • First is to define the meeting purpose if it
been read and corrected, the body will now move is to do brainstorming, is it to have a
to approve it and someone will second to approve discussion, or plan the next step.
the minutes of the previous meeting. • Having clear objective it will be much
easier to decide on an agenda for the
Another sample: meeting.
• It is similar to the one given earlier, but the body 2. Specify the main goal
is now in a tabulated form consisting of 3 • What should come out of the meeting.
columns. 3. Create & share an agenda
• A meeting agenda in an outline of all
Example activities and discussion points to come
AGENDA DISCUSSION ACTIONS TAKEN up during the meeting in order to identify
a. Acquaintance Dean Gasco - Discussed – the main goal.
Party asked for the • In short it is a structure that the meeting
indulgence of Another will follow.
everyone for the examples: • The main discussion points should also
change of • The body be written that you would want to touch
schedule for the agreed that down during the meeting.
Acquaintance the
party which was acquaintance 4. Send out meeting invites
moved from party will be • To those who are only involved in the
august 29 to held online meeting for at least 2 weeks in advance
august 27 since via zoom so that workmates have the enough time
she has an platform, to work it in their schedules.
important etc.. 5. Collect questions and ideas from your team
matter to attend • What were • Gather inputs from the team members
to. the decisions prior to the meeting works great with
and some meeting formats.
agreement 6. Distribute supporting materials
made. • For instance, attaching meeting invites so
that all team mates will be aligned and
At the last part you may close it by writing: familiar to the forthcoming discussion.
There, having no matters to discussed, Dean Gasco
moved to adjourned the meeting at exactly 1:26 pm. 7. Prepare your slides
• It should be in a minimalistic approach to
Certified true and correct, make the presentation simple.
Andre Carlo C. de Veyra MAN, RN • We can also use 3 bullet points or 3
Faculty Secretary columns for a easier processing of the
members.
Approved by: Socorro Salvacion Gasco • We can also cut our slides, to have a
Dean, RTRMF, CN meaningful discussion and avoid lengthy
presentation.
PREPARATION AND CONDUCT OF MEETING • We can also add visuals, such as images,
graphs, tables, etc. for the members to
MEETING visualize the main ideal of the
Description
presentation.
• A meeting is a group communication in action • In there will be multiple presenters, one
around a defined agenda, at a set time, for an presenter should have the master depth
established duration. Meetings can be effective, to avoid switching the presentation as
ineffective, or a complete waste of time (Mosvick, well as prolonging the duration of the
1996). meeting.
• Meetings can occur face-to-face, but increasingly • As you prepare your slides of the meeting
business and industry are turning to think of all point of interaction with your
teleconferencing and videoconferencing options team mates of meeting participants.
as the technology improves; the cost to 8. Create opportunities for interaction
participate is reduced, and the cost of travel • Members should contribute ideas for
including time is considered. them to have a contribution and
• Regardless how you come together as a team, meaningful engagement throughout the
group, or committee, you will need to define your meeting.
purpose in advance with an agenda (Deal & 9. Prepare the Opening
Kennedy, 1982). • How you kick off the meeting may lay the
foundations for the rest of the meeting.
PREPARATION OF MEETING • If your meeting includes remote
DO’S participants give them a special greeting
1. Set purpose and goals

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 LECTURE 8: COMMUNICATION PART 2
MR. ANDRE DE VEYRA
to make them feel included from the
start.
10. Set up the meeting
• Make sure you have the meeting room
arrangements figured out whether you
are in an actual room or virtual one.
11. Start on time
• This values the time of the attendees and
it builds the reputation of the presenter’s
respect, professionalism and respect.
12. Do foster positive framework
• Where your team members will disagree
with you and at each other.
• As a leader or the facilitator, it is your job
to facilitate when this occurs.
13. Do wrap it on time
• All good meetings must come to an end
and remember to stick to your agenda
and don’t run overtime.
• Don’t forget to outline any action points
and next steps to be take.
DON’TS
1. DON'T wait until the day of your meeting to
prepare for it.
• Work with a ventured person to prepare
the meeting agenda at least a few days
in advance to know what to discuss and
just in case to request for materials and
supplies that will be needed for the
meeting.
2. DON'T forget to assign a meeting
facilitator.
• To run the meeting successfully,
someone needs to facilitate. The
facilitator’s role is to ensure that meeting
starts and ends on time, covers and
sticks to the agenda follows all
established meeting roles.
3. DON'T forget to have a detailed agenda.
• The agenda could be shared prior to the
meeting to help the attendees in case
that there are necessary information’s
they needed to gather to have a
productive meeting.
4. DON'T forget the "Ground Rules"
• Ground rules are basic meeting request
made by the presenters to the attendees.
• It includes basic things that help the
meeting run more smoothly for everyone
involved
• Be sure to post ground rules at each
meeting. It may include turning off on
cellphones, refraining from texting during
meeting, and sharing ideas as well as
asking questions.
5. DON’T forget the visual aids
• Meetings are always better with visuals.
Present visuals, videos, and handouts to
make the topics more presentable.
• Much possible use whiteboard to outline
agenda and summarize points.
6. DON’T forget to thank your teams
WHAT IS A MEETING ETIQUETTE?
Description
• Meeting etiquette refers to the standard of
behavior expected in the workplace during
meetings. Meeting etiquette, like regular business
etiquette, encourages attendees to behave
professionally and respectfully. It includes
behavior like being on time, listening without
interrupting, not having your phone out and
being prepared. Business meeting etiquette can
change somewhat depending on the situation.
DO’S
1. Be punctual
- Being on time for meetings shows maturity,
professionalism and courtesy to the rest of
the meeting attendees. Leaders want their
meetings to run efficiently, so eliminating
distractions associated with lateness is an
important step in this process.
2. Come prepared
- Many meeting organizers send out emails
with a rundown of the agenda, especially if
it's a meeting with a lot of people and several
topics that the organizer wants to discuss. An
agenda will ensure the meeting runs
smoothly and efficiently.
3. Dress professionally
- Depending on the nature of your office, the
appropriate attire may vary. Follow the dress
code rules your office enforces for in-office
meetings. If you are meeting a client outside
of the office the same rules usually apply, but
you may want to ask your manager what the
appropriate attire is if you have uncertainties.
4. Speak loud enough
- When you speak during the meeting make
sure to speak loudly and clearly so everyone
can hear you. This portrays confidence and
makes you look more professional. It also
ensures everyone hears your thoughts and
can respond accordingly. Soft speaking can
affect the meeting's efficiency if you need to
repeat yourself or someone mishears you.
5. Take turns speaking
- Business meetings sometimes create exciting
and passionate conversations where
everyone wants to give their input. The best
thing to do is wait for your turn to speak and
allow others to finish their thoughts before
jumping into the conversation.
6. Follow the agenda
- Staying on topic is good business etiquette
because it reduces time wasted on tangents.
Business meetings sometimes go off agenda,
but it's helpful to the facilitator if you stay on
task and try to keep the meeting productive.
If you can, lead the conversation back to the
original topic if you notice it drifted to an
unrelated subject.
7. Ask questions at the appropriate time
- The best time to ask questions is during the
presentation at opportune moments when
your question is relevant to the presenter's
information. Try to avoid asking all of your
questions at the very end when the meeting
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needs to wrap up. If you have unanswered
questions at the end you could stay to ask
them privately or send an email to the
meeting leader.
8. Be attentive your body language
- Try to avoid the following habits:
➢ Tapping pens
➢ Fidgeting
➢ Swiveling your chair side to side
➢ Tapping your feet
➢ Rustling papers
➢ Making quiet noises like humming or
clicks
- Though harmless at your own desk, these
behaviors can distract presenters and
listeners and may give them the impression
that you aren't interested.
9. Put away technology
- Many people tend to keep their phones on
the table during meetings, but this may turn
into a distraction if it accidentally rings,
buzzes or lights up. Turn off or silence your
device, then put it away where it is no longer
visible, such as in a purse, briefcase or jacket
pocket.
10. Be polite and courteous
- Being polite means being aware and
respecting the feelings of other people. This
may demonstrate good social etiquette and
improve your relationship with others. This
can also reduce arguments,
misunderstandings, and miscommunications.
11. Listen attentively
- Meeting productivity relies on participants
listening well to others and actively
participating in discussions. You could
practice active listening by nodding or
paraphrasing what the other person is saying
to show understanding, expressing your
concern or asking specific, probing questions.
12. Eat on the designated breaks
- Normally water and coffee are acceptable to
drink during meetings, but check if food is
fine to bring. Often the smell of food and
chewing sounds can distract others, so it's
likely best to leave the food for after the
meeting. Also, always clean up after yourself
and leave your seat the way you found it.
DONT’S
1. Don’t invite everyone to your meeting
- People get distracted easily due to the
unnecessary population in the room. People
will get distracted. Only the necessary people
should be invited.
2. Don’t allow phones in your meetings
- It will cause distractions. Use pen and paper
to take down notes.
3. Don’t zone out
- Make sure you are always listening and
taking down notes so that you don’t zone out
because it is an insult to the one who is
discussing if one of the members is zoning
out.
4. Don’t get too emotional
- Meetings can be heated so always keep a
cool mind and give others a chance to discuss
their point of view.
5. Don’t let the meeting wander
- You should know the goals and the content
of your meeting and don’t make it a chika
time.
6. Don’t be controlling
- As a leader, never dominate a meeting. Allow
other people in leading discussions and listen
to their opinions.
7. Don’t be negative
- Avoid badmouthing everyone. Give back in a
constructive manner rather than defensive or
judgement when giving feedback. Also give
positive reinforcements.
8. Don’t be ambush productive employees
- Never have a surprise meeting because this
decrease or lower the productivity of the
employees.
CUSTOMER ENGAGEMENT MANAGEMENT
Description
A. Nurse Manager - nurse managers work with
their staff to coordinate all aspects of daily patient
care on the unit. By ensuring that staff, patients,
and patients' families are communicating, nurse
managers help unit staff members deliver the
safest possible care.
• Nurse managers embody nurse and
executive roles
• Typically report to a superior in nursing:
director, chief nursing officer, or vice
president of nursing
• Responsible for functions of the unit:
o Staffing, employee satisfaction
o Safety and quality
o Customer satisfaction
o Budgeting
B. Customer Engagement Manager - is
responsible for creating and maintaining
important relationships with customers, both
potential and existing customers of the business.
Their role is to act as an essential connection
point between the company and the customer.
C. Consumer Engagement/Customer
Engagement Management - It is defined
generally as the actions individuals take to
become better informed and more directly and
proactively involved in decisions and behaviors
that affect their health, insurance coverage, and
health care.
These actions may include:
• Taking deliberate steps to monitor and
improve their health.
• Looking for information to learn more
about health concerns and compare
treatment options.
• Taking cost and quality into consideration
when choosing treatments, providers,
and plans.
• Partnering with doctors to make
treatment decisions as well as
communicating and sharing information
with doctors.
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• Adhering to recommended treatment Philippines, or those who maintain an office,

plans. branch, or agency in the Philippines.
Actions such as these potentially can lead to
healthier behaviors; more effective, efficient, and CHAPTER I – GENERAL PROVISIONS
satisfying care experiences; better health • SECTION 1. Short Title.
outcomes; and lower overall spending. • SECTION 2. Declaration of Policy.
• SECTION 3. Definition of Terms.
Roles and Responsibilities
• SECTION 4. Scope.
• Nurse managers ensure the care delivered on • SECTION 5. Protection Afforded to Journalists
their unit is customer focused. The hospital unit and Their Sources.
has numerous customers, and each has its • SECTION 6. Extraterritorial Application.
unique needs and care delivery requirements.
Nurse managers are responsible for ensuring the CHAPTER II – THE NATIONAL PRIVACY COMMISSION
needs of customers are met.
• SECTION 7. Functions of the National Privacy
a. Patient- and family-centered care
Commission.
➢ Nurse managers work with patients,
• SECTION 8. Confidentiality.
families, and unit staff to develop
• SECTION 9. Organizational Structure of the
patient- and family-focused care plans.
Commission.
Involving patients and their families in
• SECTION 10. The Secretariat.
their care ensures the best possible care
for the patient and creates a supportive CHAPTER III – THE NATIONAL PRIVACY COMMISSION
and caring environment in which staff
• SECTION 11. General Data Privacy Principles.
members are able to work closely with
• SECTION 12. Criteria for Lawful Processing of
patients and their families.
Personal Information.
b. Regulators
• SECTION 13. Sensitive Personal Information and
➢ Nurse managers must also adhere to the
Privileged Information.
requirements of regulatory agencies and
• SECTION 14. Subcontract of Personal
organizations, such as the Joint
Information.
Commission and the Centers for
• SECTION 15. Extension of Privileged
Medicare & Medicaid Services. The
Communication.
regulations of these organizations will
determine almost all components of care
CHAPTER IV – RIGHTS OF THE DATA SUBJECT
delivery and staffing needs on the unit.
• SECTION 16. Rights of the Data Subject.
c. Local governments
• SECTION 17. Transmissibility of Rights of the
➢ Local governments take an active
Data Subjects.
interest in the quality of care their local
• SECTION 18. Right to Data Portability.
hospital delivers to the community. Nurse
• SECTION 19. Non-Applicability.
managers ensure the goals of the local
government are embodied in the unit and
CHAPTER V – SECURITY OF PERSONAL INFORMATION
community members receive the highest
quality of care possible. • SECTION 20. Security of Personal Information.

CHAPTER VI – ACCOUNTABILITY FOR TRANSFER OF

• By engaging these customers, nurse managers
PERSONAL INFORMATION
ensure the unit is able to deliver the highest
• SECTION 21. Principle of Accountability.
quality of care for their patients while adhering to
regulations.
CHAPTER VII – SECURITY OF SENSITIVE PERSONAL
INFORMATION IN GOVERNMENT
DATA PRIVACY: PROTOCOLS AND LAWS
• SECTION 22. Responsibility of Heads of Agencies.
WHAT IS THE DATA PRIVACY ACT? • SECTION 23. Requirements Relating to Access by
Description
Agency Personnel to Sensitive Personal
• Republic Act No. 10173, otherwise known as the Information.
Data Privacy Act is a law that seeks to protect all • SECTION 24. Applicability to Government
forms of information, be it private, personal, or Contractors.
sensitive. It is meant to cover both natural and
juridical persons involved in the processing of CHAPTER VIII – PENALTIES
personal information. • SECTION 25. Unauthorized Processing of
Personal Information and Sensitive Personal
WHAT IS THE SCOPE OF THE DATA PRIVACY Information.
ACT? • SECTION 26. Accessing Personal Information and
• As mentioned earlier, the Data Privacy Act applies Sensitive Personal Information Due to
to any natural or juridical persons involved in the Negligence.
processing of personal information. It also covers • SECTION 27. Improper Disposal of Personal
those who, although not found or established in Information and Sensitive Personal Information.
the Philippines, use equipment located in the

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MR. ANDRE DE VEYRA
• SECTION 28. Processing of Personal Information
and Sensitive Personal Information for
Unauthorized Purposes.
• SECTION 29. Unauthorized Access or Intentional
Breach.
• SECTION 30. Concealment of Security Breaches
Involving Sensitive Personal Information.
• SECTION 31. Malicious Disclosure.
• SECTION 32. Unauthorized Disclosure.
• SECTION 33. Combination or Series of Acts.
• SECTION 34. Extent of Liability.
• SECTION 35. Large-Scale.
• SECTION 36. Offense Committed by Public
Officer.
• SECTION 37. Restitution.
CHAPTER IX – MISCELLANEOUS PROVISIONS
• SECTION 38. Interpretation.
• SECTION 39. Implementing Rules and
Regulations (IRR).
• SECTION 40. Reports and Information.
• SECTION 41. Appropriations Clause.
• SECTION 42. Transitory Provision.
• SECTION 43. Separability Clause.
• SECTION 44. Repealing Clause.
• SECTION 45. Effectivity Clause.
WHAT IS PROCESSING OF PERSONAL
INFORMATION?
• Under Sec. 3 of the Data Privacy Act, “processing
refers to any operation or any set of operations
performed upon personal information including,
but not limited to, the collection, recording,
organization, storage, updating or modification,
retrieval, consultation, use, consolidation,
blocking, erasure or destruction of data.”
• In other words, processing of personal
information is any operation where personal
information is involved. Whenever your
information is, among other things, collected,
modified, or used for some purpose, processing
already takes place.
WHAT IS PERSONAL INFORMATION?
• Under Sec. 3 of the Data Privacy Act, “personal
information refers to any information whether
recorded in a material form or not, from which
the identity of an individual is apparent or can be
reasonably and directly ascertained by the entity
holding the information, or when put together
with other information would directly and
certainly identify an individual.”
• In other words, personal information is any
information which can be linked to your identity,
thus making you readily identifiable.
WHAT IS PRIVILEGED INFORMATION?
• Under Sec. 3(k) of the Data Privacy Act,
“[p]rivileged information refers to any and all
forms of data which under the Rules of Court and
other pertinent laws constitute privileged
communication.” One such example would be any
information given by a client to his lawyer. Such
information would fall under attorney-client
privilege and would, therefore, be considered
privileged information.
DOES THE DIFFERENCE BETWEEN PERSONAL
INFORMATION AND SENSITIVE PERSONAL
INFORMATION MATTER?
• Yes. The law treats both kinds of personal
information differently. Personal information may
be processed, provided that the requirements of
the Data Privacy Act are complied with. On the
other hand, the processing of sensitive personal
information is, in general, prohibited. The Data
Privacy Act provides the specific cases where
processing of sensitive personal information is
allowed.
IS THERE A DIFFERENCE BETWEEN
PERSONAL INFORMATION AND SENSITIVE
PERSONAL INFORMATION?
• Yes. While personal information refers to
information that makes you readily identifiable,
sensitive personal information, as defined in Sec.
3(l) of the Data Privacy Act, refers to personal
information:
1) About an individual’s race, ethnic origin,
marital status, age, color, and religious,
philosophical or political affiliations;
2) About an individual’s health, education,
genetic or sexual life of a person, or to any
proceeding for any offense committed or
alleged to have been committed by such
person, the disposal of such proceedings, or
the sentence of any court in such
proceedings;
3) Issued by government agencies peculiar to
an individual which includes, but not limited
to, social security numbers, previous or
current health records, licenses or its denials,
suspension or revocation, and tax returns;
and
4) Specifically established by an executive order
or an act of Congress to be kept classified.
• Therefore, any information that can be
categorized under any of the enumerated items
are considered sensitive personal information.
ARE THERE ANY EXCEPTIONS TO THE
APPLICATION OF THE DATA PRIVACY ACT?
• The Data Privacy Act explicitly states that its
provisions are not applicable in the following
cases:
a. Information about any individual who is or
was an officer or employee of a government
institution that relates to the position or
functions of the individual, including:
1. The fact that the individual is or was an
officer or employee of the government
institution;
2. The title, business address and office
telephone number of the individual;
3. The classification, salary range and
responsibilities of the position held by the
individual; and
4. The name of the individual on a
document prepared by the individual in
the course of employment with the
government;
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b. Information about an individual who is or was
performing service under contract for a
government institution that relates to the
services performed, including the terms of
the contract, and the name of the individual
given in the course of the performance of
those services;
c. Information relating to any discretionary
benefit of a financial nature such as the
granting of a license or permit given by the
government to an individual, including the
name of the individual and the exact nature
of the benefit;
d. Personal information processed for
journalistic, artistic, literary or research
purposes;
e. Information necessary in order to carry out
the functions of public authority which
includes the processing of personal data for
the performance by the independent, central
monetary authority and law enforcement and
regulatory agencies of their constitutionally
and statutorily mandated functions. Nothing
in this Act shall be construed as to have
amended or repealed Republic Act No. 1405,
otherwise known as the Secrecy of Bank
Deposits Act; Republic Act No. 6426,
otherwise known as the Foreign Currency
Deposit Act; and Republic Act No. 9510,
otherwise known as the Credit Information
System Act (CISA);
f. Information necessary for banks and other
financial institutions under the jurisdiction of
the independent, central monetary authority
or Bangko Sentral ng Pilipinas to comply with
Republic Act No. 9510, and Republic Act No.
9160, as amended, otherwise known as the
Anti-Money Laundering Act and other
applicable laws; and
g. Personal information originally collected from
residents of foreign jurisdictions in
accordance with the laws of those foreign
jurisdictions, including any applicable data
privacy laws, which is being processed in the
Philippines.
ARE COMPANIES REQUIRED TO APPOINT
SOMEONE WHO SHOULD BE RESPONSIBLE
FOR ENSURING COMPLIANCE WITH THE
DATA PRIVACY ACT?
• Yes. Under the Implementing Rules and
Regulations of the Data Privacy Act, all
organizations are required to appoint a Data
Protection Officer (“DPO”). The Data Protection
Officer shall be accountable for ensuring
compliance with the appropriate data protection
laws and regulations.
CAN THERE BE MORE THAN ONE PERSON
WHO SHALL PERFORM THE FUNCTIONS OF A
DATA PROTECTION OFFICER IN AN
ORGANIZATION?
• Yes. The Implementing Rules and Regulations of
the Data Privacy Act speaks of an individual or
individuals who shall perform the functions of a
Data Protection Officer or a Compliance Officer.
HOW IS PRIVILEGED INFORMATION
TREATED BY THE DATA PRIVACY ACT?
• Much like sensitive personal information, the
processing of privileged information is prohibited
by the law.
WHAT ARE THE CASES WHERE THE
PROCESSING OF SENSITIVE PERSONAL
INFORMATION AND PRIVILEGED
INFORMATION IS ALLOWED?
• Section 13 of the Data Privacy Act enumerates
the cases where sensitive personal information
and privileged information may be processed.
These are the following:
a. The data subject has given his or her
consent, specific to the purpose prior to the
processing, or in the case of privileged
information, all parties to the exchange
have given their consent prior to
processing;
b. The processing of the same is provided for
by existing laws and regulations: Provided,
that such regulatory enactments guarantee
the protection of the sensitive personal
information and the privileged information:
Provided, further, That the consent of the
data subjects are not required by law or
regulation permitting the processing of the
sensitive personal information or the
privileged information;
c. The processing is necessary to protect the
life and health of the data subject or
another person, and the data subject is not
legally or physically able to express his or
her consent prior to the processing;
d. The processing is necessary to achieve the
lawful and noncommercial objectives of
public organizations and their associations:
Provided, that such processing is only
confined and related to the bona fide
members of these organizations or their
associations: Provided, further, That the
sensitive personal information are not
transferred to third parties: Provided,
finally, that consent of the data subject was
obtained prior to processing; As a health
care practitioners, it is lawful to process the
data, to receive the information of personal
data of our patients if we are directly taking
care of the patient or directly involve with
the care of the patient. An mga dire na
pwede kay an mga dire na directly involve.
e. The processing is necessary for purposes of
medical treatment, is carried out by a
medical practitioner or a medical treatment
institution, and an adequate level of
protection of personal information is
ensured; or
f. The processing concerns such personal
information as is necessary for the
protection of lawful rights and interests of
natural or legal persons in court
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proceedings, or the establishment, exercise
or defense of legal claims, or when
provided to government or public authority.
Who is the owner of the chart?
• The patient but the hospital serves as the
keeper of the chart
Can people access data for ethico-legal purposes?
• Yes, it is lawful. Authorities can obtain data
provided that it is down in proper channels like
consent, etc.
Can they scrutinize the chart? Bring the chart to
the court?
• Yes, for legal evidence. Provided again that there
is a proper channel. And what is that proper
channel? There should be an equal corresponding
subpoena. That’s what we call, subpoena duces
tecum. Meaning, we bring the documents to the
court in order to cross-examined it or scrutinize
it. An usa liwat kay subpoena ad
testificandum, it is when a person is invited to
court to give his or her testimony.
WHAT IS CONFIDENTIALITY OF
INFORMATION?
• Confidential information is also termed as
privileged communication because it is given
based on trust. Patients and/or their relatives are
expected to give the necessary information so
that the proper diagnosis and treatment could be
made.
• Patients and their families are entitled to know
information or facts within the limits determined
by the physician. If the patient insists on knowing
their diagnosis, nurses may only repeat what
doctors wish to disclose.
ANY INFORMATION GATHERED BY THE NURSES
DURING THE COURSE OF CARING FOR THEIR
PATIENTS SHOULD ALWAYS BE TREATED
CONFIDENTIAL. This duty extends even after the
patient’s death.
Confidential Information may only be revealed when:
1. Patients themselves permit such revelation as in
the case of claim for hospitalization, insurance
benefits, among others;
2. The case is medico-legal such as attempted
suicide, gunshot wounds which have to be
reported to the local police or NBI or
constabulary;
3. The patients are ill of communicable disease and
public safety may be jeopardized; and
4. Given to members of the health team if
information is relevant to this care.
ARTICLE IV, SECTION 4 (1) OF THE NEW
CONSTITUTION
• “The privacy of communication and
correspondence shall be inviolable except upon
lawful order of the court or when public safety
and order require otherwise.”
• When you say about privilege
communication, it is a communication that two
people get into and one is willing to divulge or to
open everything to the person. But the one who
receives the information should not divulge it to
anyone.
KNOW YOUR DATA PRIVACY RIGHTS
1. The right to be informed
2. The right to access
3. The right to object
4. The right to erasure or blocking
5. The right to damages
6. The right to file a complaint
7. The right to rectify
8. The right to data portability
SCENARIO
• A medical doctor in a private hospital in Manila
recorded a conversation with his lady patient
without the patient’s knowledge and prior
consent. Upon realizing what was happening, the
patient immediately confronted the doctor and
expressed her strong dismay, pointing out the
physician’s lack of professionalism in recognizing
his personal right to privacy. She said she could
have given her consent anyway if only she was
asked politely. The doctor apologized and
explained that his action was just meant to aid
his recall, especially when he later examined the
case, saying he just wanted to provide the best
possible service, which the patient deserves. The
patient, however, demanded the doctor to delete
the recorded conversation and canceled on the
medical consultation. She said if the doctor does
not even know the basic courtesy of asking for
consent, then how can he expect to win the
patients’ confidence in his competence as a
medical practitioner.
o Under R.A. 10173, your personal data is
treated almost literally in the same way as
your own personal property. Thus, it should
never be collected, processed and stored by
any organization without your explicit
consent, unless otherwise provided by law.
o Information controllers usually solicit your
consent through a consent form. Aside from
protecting you against unfair means of
personal data collection, this right also
requires personal information controllers
(PICs) to notify you if your data have been
compromised, in a timely manner.
o As a data subject, you have the right to be
informed that your personal data will be, are
being, or were, collected and processed.
o The Right to be Informed is a most basic right
as it empowers you as a data subject to
consider other actions to protect your data
privacy and assert your other privacy rights.
ANECDOTAL, INCIDENT, AND VARIANCE
REPORTS
ANECDOTAL REPORT
Definition
• Anecdotal records are a record of some
significant item of conduct, a record of an episode
in the life of students, a word picture of the
student in action, a word snapshot at the moment

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of the incident, any narration of events in which • They should be compiled and filed.
may be significant about his personality. • They should be emphasized as an educational
• As the name implies, an anecdotal record involves resource.
setting down an anecdote concerning some
aspects of students' behaviors which seem
significant to the observer.
• It is one of the methods for assessing clinical Don’ts
performance of the student’s behavior observed • Words and phrases are avoided which express
by the teacher. This allows the instructor to chart the opinion. Terms that should be avoided are the
student progress in various areas by making following: Well-behaved, Delinquent, Aggressive,
comparisons over time in a variety of situations. Didn't cry, Industrious, Nervous & Happy
• Words and phrases that have strong emotional
Purposes connotations are avoided. i.e., love, hate,
• To furnish the multiplicity of evidence needed for insolent, courteous, loyal, dishonest etc.
a good cumulative record.
• To substitute for vague generalizations about a Sample
student's specific exact description of behaviour.
• To stimulate teachers to look for information, i.e.
pertinent in helping each student realize good
self- adjustment.
• To understand an individual's basic personality
pattern and his reactions in different situations.
• The teacher is able to understand her pupil in a
realistic manner.
• It provides an opportunity for healthy pupil-
teacher relationship.
• It can be maintained in the areas of behaviour
that cannot be evaluated by other systematic
method.
• Helps the students to improve their behaviour, as
it is a direct feedback of an entire observed
incident, the student can analyse his behaviour
better.
• Can be used by students for self-appraisal and
peer assessment.

GUIDELINES THAT SHOULD BE FOLLOWED WHEN

WRITING AN ANECDOTAL REPORT (INCLUDING DOS
AND DON’TS)
Contents of an Anecdotal Record:
• Name of student, class and school, date of
observation
• Setting of the observation
• Record of student actions with an objective
• A detailed description of the observed
performance
• Recommendation concerning the behavior
• Signature of the observer
Do’s
• Keep a notebook handy to make brief notes to
remind you of incidents you wish to include in the
record. Also include the name, time, and setting
in your notes.
• Write the record as soon as possible after the
event. The longer you leave it to write your
anecdotal record, the more subjective and vaguer
the observation will become.
• Identify time, child, date, and setting.
• Describe the actions and what was said.
• Include the responses of other people if they
relate to the action.
• Describe the event in the sequence that it
occurred.
• Record should be complete.
INCIDENT REPORT
Definition
• In general, an incident is any event that affects
patient or employee safety. In most healthcare
facilities, injuries, patient complaints, medication
errors, equipment failure, adverse reactions to
drugs or treatments, or errors in patient care
must be reported.
• An incident report is a formal document that
details the facts related to an incident at the
workplace such as in a healthcare facility. The
report usually relates to an accident or injury that
has occurred on the worksite, but it can also
pertain to any unusual worksite occurrences such
as near misses, security lapses, property and
equipment damage, and health and safety issues.
Purposes
• To document the exact detail of an accident or
unusual incident that occurred in a health-care
institution.
• To be used in the future when dealing with
liability issues stemming from the incident.
• To protect the nursing staff against unjust
accusations.
• To protect and safeguard the client in case of
negligence on the part of the nurse.

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• Helps in the evaluation of nursing care to ensure
safe care to all patients.
GUIDELINES THAT SHOULD BE FOLLOWED WHEN
WRITING AN ANECDOTAL REPORT (INCLUDING DOS
AND DON’TS)
An even becomes a reportable incident when it meets one
or both prerequisites:
• A person sustains an injury.
• Property sustains damage.
Do’s
• Written at the first opportunity after the incident
so that the details are not blurry or forgotten.
• Record data to the best of your ability quickly and
efficiently while maintaining descriptive
information gathering. Only report facts, not
feelings or impressions.
• Use a pen when writing the report.
• Events should be written in sequence that they
occurred.
• Details should be complete and accurate:
o the exact time and date
o the names of persons involved and any
witnesses
o factual information about what happened
o other relevant facts, including the corrective
actions taken
• Proper technical terms should be used.
• Signed legibly with the correct designation.
Don’ts
• Do not offer a prognosis.
• Do not speculate about who or what may have
caused the incident. Never place a judgment or
blame in the report.
• Do not draw conclusions or make assumptions
about how the event unfolded.
• Do not suggest ways that similar occurrences
could be prevented.
Sample
VARIANCE REPORT
Definition
• A variance is a deviation from what was planned
on the critical pathway - unexpected occurrences
that affect the planned care or the client’s
responses to care. When a variance occurs, the
nurse writes a note documenting the unexpected
event, the cause, and actions taken to correct the
situation or justify the actions.
Purposes
• To provide a systematic, standardized hospital-
wide mechanism to identify and to develop
prevention/improvement programs which have
direct or indirect adverse effect on patient care;
and which represent a potential hazard to
patients, visitors, volunteers, trainees,
employees, or the facility as quality improvement
approach.
• OVR shall be used as a mechanism for
monitoring, Quality Improvement in a Non-
Punitive Approach.
DOs and DON’Ts IN WRITING A VARIANCE REPORT
Do’s
• If paper form, write in a legible handwriting, can
use blue or black ink.
• Write an objective view and comments.
• It is the responsibility of all employees to
immediately report the details of any occurrence
that may negatively affect patient care outcome
• All sections of the OVR form must be completed
and submitted online or to the immediate
supervisor within the current work shift.
• The person who has the best knowledge of the
occurrence must complete the OVR form/online.
• All OVR shall be handled and maintained
confidentiality; access to such documentation
shall be restricted to authorized individuals only.
Don’ts
• In writing an OVR form, avoid using pencils.
• Avoid personal opinions.
• The OVR form shall not be photocopied or placed
in the medical record. The terms "incident" and
"error" shall not be used in the medical record
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when making an entry regarding an occurrence
or the results of an occurrence.
• The information contained in the OVR form
cannot and shall not be used against any
individual as the sole basis for disciplinary action.
• Hospital staff are not at liberty to discuss the
contents of an OVR or the events and
circumstances relative to the occurrence either
with the patient, visitor, or other members of the
staff unless clarifying facts is necessary under
investigation with the proper authorities.
• Names of involved/concerned persons should not
be used. Use ID# instead.
Sample
an in-patient stay is necessary for his or her
safety.
• A person seeking treatment under Section 201
may arrive at an emergency room for an
evaluation to determine the level of treatment
needed.
• If the patient later requests discharge, the
hospital can hold the patient on the unit for up to
72 hours until a mental health professional can
evaluate the patient for safety concerns. The
patient will be discharged if the evaluating mental
health professional determines that the patient is
safe for discharge.
• There is no time limit on a voluntary in-patient
stay. The individual may stay as long as he or she
and the medical staff believes there is a continued
need for in-patient treatment.
• If the mental health professional evaluates the
patient and feels that he/she is at risk of harm to
self/others or unable to care for self, the mental
health professional can convert the admission to
an involuntary admission (“302”).

Sample

FORM 201, PATIENT’S CHARTS, AND

NURSING KARDEX

FORM 201
Definition
• Voluntary admission (also known as a“201”) to an
acute inpatient psychiatric hospital occurs when
a person goes for psychiatric evaluation and the
evaluating mental health provider and patient
agree that the patient would benefit from
hospitalization and meets criteria for
hospitalization.
• The 201 form documents the patient’s rights and
describes the inpatient hospital experience. By
signing the form, the patient agrees to being
hospitalized on a locked unit.

Purposes
• A voluntary admission may be appropriate for
anyone 14 years of age or older who is
experiencing a mental health crisis and feels that

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➢ Dosage
➢ Route
➢ Time
➢ Date of regularly administered
medications
➢ Name or initials of nurse administering
the medication
• Nurse’s Notes
➢ Pertinent assessment of client
➢ Specific nursing care including teaching
and client's responses
➢ Client's complaints and how client is
coping
• Medical History and Physical Examination
➢ Past and family medical history, present
medical problems, differential or current
diagnoses, findings of physical
PATIENT’S CHART examination by the primary care provider
Definition • Physician’s Order Form
• It is a formal, legal document that provides ➢ Medical orders for medications,
evidence of a client’s care and can be written or treatments
computer based. Although health care • Physician’s Progress Notes
organizations use different systems and forms for ➢ Medical observations
documentation, all client records have similar ➢ Treatments,
information. ➢ Client progress
• Consultation Records
Purposes ➢ Reports by medical and clinical specialists
• Communication • Diagnostic Reports
• Planning Client Care ➢ Includes:
• Auditing Health Agencies o Laboratory reports
• Research o X-ray reports
• Education o MRI and CT scan reports
• Reimbursement o Electrocardiogram (ECG) results
• Legal Documentation o Electroencephalogram (EEG)
• Health Care Analysis results
o Biopsy
Components of a Patient’s Chart o Ultrasound
• Admission (Face) Sheet o Hearing and eye tests
➢ Legal name, birth date, age, gender • Client Discharge Plan & Referral Summary
➢ Social Security number ➢ Started on admission and completed on
➢ Address discharge
➢ Marital status: closest relatives or person ➢ Includes nursing problems, general
to notify in case of emergency information, and referral data
➢ Date, time, and admitting diagnosis • Record of Informed Consent
• Initial Nursing Assessment ➢ Guidelines include:
➢ Findings from the initial nursing history o Diagnosis or condition that
and physical health assessment requires treatment
• Graphic Record (TPR sheet) o Purposes of the treatment
➢ Body temperature, o What the client can expect to feel
➢ pulse rate, or experience
➢ respiratory rate, o Intended benefits of the
➢ blood pressure, treatment
➢ daily weight, and o Possible risks or negative
➢ special measurements (e.g. fluid intake outcomes of treatment
and output, and oxygen saturation) o Advantages and disadvantages
• Daily Care Record of possible alternatives
➢ Activity (including no treatment)
➢ Diet • Insurance
➢ Bathing ➢ Protects patients from unexpected, high
➢ Elimination records medical costs
• Special Flow Sheet ➢ Get free preventive care, such as
➢ Fluid Balance record vaccines, screenings, and check-ups
➢ Skin assessment
• Medication Record GUIDELINES IN CHARTING: DOs and DON’Ts
➢ Name of drug Do’s

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• Chart a change in client’s condition and show that 3) List of medications

follow up actions are taken
• Read the nurse’s notes prior to care to determine
if there has been a change in the client’s
condition.
• Be timely
• Use objective, specific, and factual descriptions
• Correct charting errors
• Chart all teachings
• Record the client’s actual words by putting quotes
around the words.
• Chart the client’s response to interventions
• Review your notes/charting
Don’ts
• Leave a blank space for a colleague to chart later.
• Chart for someone else.
• Record "patient" or "client" because it is their
chart.
• Chart in advance of the event (e.g., procedure,
medication). Use vague terms (e.g., "appears to
be comfortable," "had a good night").
• Alter a record even if requested by a superior or
a primary care provider
• Record assumptions or words reflecting bias
(e.g., "complainer," "disagreeable").
NURSING KARDEX
Definition
• A desktop file system or a form that gives a brief
overview of each patient and is updated every
shift.
• A reference sheet for nurses that is separate from
the patient chart.
• It is kept in the nursing station, for quick access.
Uses
• Used to organize and record data about a client
• Used to make the information quickly accessible
to all health professionals
• Used in nursing as a quick reference guide to the
particular needs of individual clients or to get a
quick summary of the client's needs
• Used to streamline the workflow of caring for
clients
➢ Date of Order
➢ Times of administration for each
4) List of intravenous fluids
➢ Dates of infusion
5) List of daily treatments and procedures
➢ Irrigations
➢ Dressing changes
➢ Postural drainage
➢ VS monitoring
6) List of diagnostic procedures ordered
➢ X-ray
➢ Laboratory tests
7) Specific data on how the client’s physical needs
are to be met
➢ Type of diet
➢ Assistance needed with feeding
➢ Elimination devices
➢ Activity, hygienic needs, and safety
8) Problem list, stated goals, and a list of nursing
approaches to meet the goals and relieve the
problems
DOs and DON’Ts of Nursing Kardex
Do’s
• Always return the Kardex to its designated file
after use.
• Keep the data current and updated.
• Whether it is written or computerized, It is
important to have a place on it to record dates
and initials of the person reviewing or revising it.
Don’ts
• Forget to put initials and date after revising
• Fail to return Kardex to its indexed file
• Fail to update and review Kardex
• Lose the patients’ Kardex
Sample

Purposes
• A quick reference for nurses
• Provides a concise method of organizing and
recording data about a client
• A way to ensure continuity of care from one shift
to another and from one day to the next
• Keep endorsement of patients organized
• Save time and effort in keeping track of patient
management

Parts of a Nursing Kardex

1) Patient information about the client
➢ Name
➢ Room Number
➢ Age
➢ Admission date
➢ Primary care provider’s name
➢ Diagnosis
2) Allergies

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