PROFESSIONAL ADJUSTMENT IN
NURSING
What is Nursing as a Profession?
An occupation or calling requiring advanced training & experience.
Criteria of a Profession
 Must satisfy an indispensable social need
 Must demand adequate pre professional and cultural
training
 Must demand the possession of body of specialized and
systematized training
 Must require exercise & discretion and judgment
 Must have sufficient self-impelling power to retain its
members throughout life
What is a Professional Nurse?
A professional Nurse is a person who has completed a basic
nursing education program and is licensed in his or her country or
state to practice professional nursing.
What is the Scope of Nursing?
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 & supervise students
5. Development of training & research
Qualifications of a Professional Nurse
BSN degree
Physically & mentally fit
License to practice in the country
Personal qualities
 Interest & willingness to work and learn
 Warm personality, assertive, good decision making skills
 Resourceful, creative, active participation in issues
confronting nurses
NURSING REGULATION
What is PRBON?
Professional Regulatory Board of Nursing
What is the primary role of BON?
 It is responsible for the regulation of the admission,
registration and practice of nursing profession in the
Philippines.
What is the composition of the BON?
 1 chairperson & 6 members
TYPES OF APPOINTMENT
 Regular Appointment
 Ad Interim appointment
 Doctrine of Hold over
Qualifications of the Chairperson and Members of the Board
 Natural born citizen & a resident of the Phil
 Member of APO or PNA
 Masters degree holder – nursing, education or allied
medical profession
 CHAIR – man
 10 years of service, last 5 in the Phil
 No conviction of any offense
What are the requirements upon qualification?
 Immediately resign
 NO pecuniary interest in administrative supervision
 Oath
What's the term of office & compensation for BON?
 3 YEARS until successors are appointed
 Reappointment for another term is allowed
Quantum Meruit
Chairman- 2 sg lower than the prc
 Commissioner (30) -2 = sg28
 2 sg higher the members of the
 Board
What agency acts as the record custodian of the Board of
Nursing?
 PRC
 Application for examination
 Examination papers & results
 Minutes of the meeting of the Board
 Administrative investigations and cases
The Board shall be under the administrative supervision of the
Commission
What are the powers & duties of the BON?
Conduct licensure exam for nurses
 if tainted with anomalies, PRC has the power to order a
retake or re conduct NLE, to preserve integrity.
 Issue, suspend or revoke certificates of registration for
the practice of nursing
Grounds
1. Moral turpitude
2. Unprofessional & unethical conduct
3. Gross incompetence or serious ignorance
4. Malpractice or negligence
5. Use of fraud, deceit, false statements
6. Violation of the Code of Ethics
 Monitor & enforce quality standards of nursing to ensure
maintenance of efficient ethical, technical, moral &
professional standards
 Ensure quality nursing education by examining prescribe
colleges & universities to ensure that standards of nursing
education are properly complied.
CHED –opening and closing
BON – gives recommendation after visit
 conduct hearings & investigations to resolve complaints
against a nurse
TERMS FROM R.A 9173
Subpoena
 a writ, a process of mandate issued to a person requiring
him to be present
Contempt of court
 refers to disobedience of a lawful order of a court in a
matter over which has jurisdiction
ad testificandum
 to secure appearance of respondents
Duces tecum
 latin meaning “ you shall bring with you”
 documents Examination & Registration
 kardex, patients chart, medicine card, syringes, vials, and  NLE is given 2x a year
other paraphernalia that could give light to the case  November & May
Does the PRCBON has the power to issue subpeona?  PRC designates venue for applicants
 The PRCBON has a quasi judicial power to issue Qualifications for Admission
subpoenas, without seeking assistance of the court. 1. citizen of the Phil
 It is only the contempt of power of the PRBON that 2. good moral character
requires proper court application. 3. holder of BSN degree
Promulgate a Code of ethics in coordination with APO. Requirements:
2 important Ethical Standards Filipino Nurses should know.  TOR with SO (for Board exam purpose only)
1. Code of Ethics for registered nurses Citizenship – There are widely accepted principles in determining
2. International Council of Nurses Code of Ethics the citizenship of a person
Recognize nursing specialty organizations in coordination with the Jus soli –under which the place of the birth of person determines
APO his/her citizenship
 ADPCN –Association of Diabetes Nurse Educators of the Jus sanguinis –under which the citizenship of the parents
Phil determines the citizenship of the child
 ANSAP ORNAP There are 2 kinds of citizens in the Philippines:
 Catholic Nurses Guild of the Philippines (CNGP) Naturalized Citizens – one who acquires citizenship by
 Critical Care Nurses Association of the Phil (CCNAP) naturalization
 MCNAP  NATURALIZATION – is the process provided by law by
The Board has created a NURSING SPECIALTY CERTIFICATION which a person(alien) acquires citizenship after birth and
COUNCIL (NSCC) pursuant to PRC BON RESOULTIONs No. 24, becomes entitled to the privileges of citizenship
s 1999 & No. 118, s 2002 Natural Born Citizens – are those described in Art IV Sec 2 of the
 To validate and certify nurse processes involving 1987 Philippine Constitution
advance bodies of knowledge necessary for the care of  Birth Cert (NSO)
patients, whether chronic, acute or critically ill.  Marriage Contract
Certification Levels issued with the help of Clinical Nurses  4 pcs passport size picture
Association of the Philippines. (white background with complete name tag)
Nurse Clinician I, II & Clinical Nurse Specialist  Community Tax cert
 The Board shall at the close of its calendar year submit  RLE Summary & cases
an annual report to the President of the Philippines How much is the fee? pHp 900
through the Commission Scope of Exam?
REMOVAL OR SUSPENSION OF BOARD MEMBERS From TFN – Psychia
1. Continued neglect of duty Test I – Promotive
2. Commission or tolerance of irregularities in the licensure Test II – Preventive
exam Test III – Curative A
3. Unprofessional, immoral or dishonorable Test IV – Curative B
“PRESIDENT” Test V – Rehabilitative

Legal Liabilities of BON

Can be sued: Administratively The Competency Based Test Framework
 irregularities in the NLE Nursing Process
Civil Service or Office of the Ombudsman NP I NP II NP III
NP IV NP V
Basic Communi Care of
Care of Care of
 impose penalty for dismissal Foundatio ty Health Clients
Clients Clients
PRC n of Nursing with with with
 impose revoction of license & registration Nursing and Care Physiologic
Physiolog Physiolog
President and of and ic and ic and
Can be sued: Criminally Profession Healthy/A Psychosoci
Psycho- Psycho-
Sandigang Bayan – can impose the penalty for imprisonment al Practice t Risk al social social
Mother Alterations
Alteration Alteration
 dismissal or disqualification and Child [A] s s
Can be sued: Civilly [B] [C]
 Retake exam due to the fault & negligence of BON ACROSS THE LIFESPAN
INDIVIDUALS, FAMILIES, GROUPS, COMMUNITY IN VARIED
SETTINGS
  An earned temporary right;
 An evidence of basic skill, knowledge and attitude to
qualify for nursing practice

Certificate of Registration
 full name of the registrant,
 the serial number,
 the signature of the Chairperson of the Commission and
of the Members of the Board
 The official seal of the Commission.
Professional Identification Card
 Full name with picture
 duly signed by the Chairperson of the Commission,
 date of registration
 license number
 and the date of issuance and expiration
 Renewable every 3 years
Before required 60 hrs continuing professional education, due to
controversies and prfit seeking cpr provides, it has been
discontinued.

Registration by RECIPROCITY
• A certificate of registration/professional license may be
issued without examination to nurses registered under
the laws of a foreign state or country
Professional Ethics & Standards in Nursing
2 Universal Principles in Nursing:
1. The need for nursing is universal
2. The respect for human rights is inherent in nursing.

3 Major Approaches in the study of Nursing Ethics

1. Deontological Approach/Duty Oriented Theory
 Greek work deon which means duty
 a person is morally good if his or her actions are
done from a sense of duty or reason
A person is morally good and admirable if his actions are done
Examination & Registration from a sense of duty and reason – deontological
 Passing Rate: 75% with NO GRADE below 60% in any  Ethical Relativism
subject. 2. Ethical skepticism
 Refresher course REQUIRED under RA 8981  follows the principle of relativity morality is relative
 UNDER RA 9173: no longer needed to the norms of one’s culture
 Special Law shall prevail of General Law 3. Utilitarianism/ Teleological Approach
 Greek word telos which means goal or end the right
Automatic Registration of Nurses thing to do is the good thingto do.
All nurses whose names appear at the roster of nurses shall be  What is best for most people?
automatically or ipso facto registered as nurses under this Act 4. Divine Command Ethics
OATH TAKING follows
When are exams reconsidered? Ethics Committee in Hospitals
4 Possible Cases (ME)  If the problem is an ethical one, then, remember that
1. Malfeasance in rating responsible ethical reasoning is rational and systematic. 
2. Mechanical error A good decision is one that is in the client’s best interest
3. Clerical Errors and at the same time preserves the integrity of all
4. Clear Errors involved.
File within 90 days What is the primary responsibility of nurses to the
Certificate of Registration or Professional License PATIENTS?
 A privilege
  giving quality nursing care regardless of their race, color,  Thus, the ethical nurse is able to explain the rationale
nationality or status behind every action and recognizes the standards to
which she will be held.

3 Legal Principles in Nursing Professional Ethics

1. Autonomy – self governance Bill of Rights of Nurses
2. Veracity – telling the truth
1. To practice that fulfills their obligations to the society
3. Beneficence – acts of kindness and mercy
2. To practice based on professional, ethical and legal
4. Nonmaleficence – to do no harm
standards
5. Justice – right to fair treatment
3. To freely and openly advocate for themselves and their
6. Fidelity – being faithful
patients
7. The moral development theorists are:
4. Having fair compensation
Kolberg – emphasizes rights and formal reasoning   5. Having a safe environment
6. To negotiate the conditions of their employment in all practice
Gilligan – emphasizes care and responsibility settings

Autonomy   right to make one’s own decisions because each Code of Governance
person is unique.  People have “inward autonomy” if they have the Under EO 220 OF June 23, 2003 by GMA
ability to make choices; they have “outward autonomy” if their 1. Service to others
choices are not limited or imposed by others. 2. Integrity and objectivity
 Do not disregard a client’s statement about subjective 3. Professional competence
symptoms they may be having 4. Solidarity and teamwork
 Be sure the client gives “informed” consent 5. Social and civil responsibility
Nonmaleficence   the duty to do no harm 6. Global competitiveness
 Their is sometimes unintentional harm, such as; an 7. Equality to all Professions
adverse reaction to a medication, bruising a client that
you held to tightly in order to keep him from falling, Code of Ethics (July 14, 2004)
breaking a rib doing CPR Brief History:
Beneficence   the moral obligation to do good or to implement 1922 – FNA or Filipino Nurses Association
actions that benefit clients and their support persons 1982 – PNA or Philippine Nurses Association approved its 1ST PNA
 Doing good can also cause harm, such as; advising a CODE OF ETHICS FOR NURSES headed by Dean Julita V.
client to do strenuous exercise, but he should for risk of a Sotejo
heart attack 1983 – October, published during the PNA Convention
Justice   fairness.  This is not always easy considering time March 21, 1984 – PRCBON adopted the ICN as approved
constraints 1989 – amendments
 A home healthcare nurse must decide to stay with the
current client, who is depressed, 30 more minutes, and The Philippine Nurses Association Code for Nurses was produced
have to reduce her time with the next client by a Special Committee on the Code of Ethics headed by Dean
Fidelity   a moral principle that obligates the individual to be faithful Julita V. Sotejo adopted by the PNA House of Delegates on
to agreements and responsibilities one has undertaken October 27, 1982 and the PNA members during the annual
 If a nurse says “I’ll be right back with pain medication”, meeting on October 22, 1982.
she should do so or find an alternative for relief of the
client’s pain Summary of Articles
Veracity   a moral principle that holds that one should tell the truth
 Registered Nurses and People
and not lie
 Registered Nurses and Practice
 Does a nurse tell a lie when it is known that the lie will
 Registered Nurses and Co-workers
relieve anxiety and fear?  The loss of trust in the nurse
rarely justifies any benefits gained from lying.  Registered Nurses and Society and
 Nurses should also have the following according to the  Environment
Code of Ethics for Nurses by the ANA  Registered Nurses and the Profession
Accountability   being responsible for one’s actions and accepting
the consequences of one’s behavior 12 Patients’ Bill of Rights
Responsibility   the specific accountability or liability associated 1. The patient has the right to considerate and respectful
with the performance of duties of a particular role or an obligation care
to complete a task. 2. The patient has the right to obtain information
concenrcing his dx from physicians, treatment and
prognosis
 3. The patient has the right to make decisions about plan of 5. Parenteral medications
care prior to and during the course of tx (whether to 6. Internal examination during labor in the absence of
refuse or accept) antenatal bleeding
4. The patient has the right to have an advance directive
7. Suturing of perineal lacerations – Special Training
concerning tx or designating a surrogate decision maker
maintain COMPETENCE & PROFESSIONALISM
5. 5. The patient has the right to every consideration of his
privacy What about Inactive Nurses?
 5 years inactive
6. The patient has the right to expect all communications
 1 month didactic training
and records and review such pertaining to his medical
care and to have the information explained or 3 months practicum in the hospital accredited
interpreted. Nursing Specialty Certifications
NC 1, NC 2, NC 3 Valid for 5 years, renewable
7. The patient has the right to expect that a hospital must PRC BON Resolution. No 14, s 1999 & 118, s 1992
provide service or referral as indicated by the urgency of Expanded Nursing Practice:
the case
 Internal examination during labor & delivery
8. That patient has the right to decline or consent research  Suturing of perineal laceration
studies affecting his care  Intravenous theraphy

HELSINSKI DECLARATION 2 Major Types of Research

DOH LAUNCHES NURSES’ SPECIALTY CERTIFICATION
OF 1964
PROGRAM Press Release/24 September 2013
issued guidelines on medical • Essentially eleven specialty areas such as cardiovascular, renal, pulmonary,
research therapeutic mental health, maternal and child, infectious diseases, orthopaedic
-emphasized that research • Directed towards and rehabilitation, trauma and emergency, operating room and
subjects must be informed scientific knowledge anesthesia care
 cardiovascular nursing at the Philippine Heart Center
(PHC)
9. The patient has the right to expect reasonable continuity
 renal nursing at the National Kidney and Transplant
of care or options when the hospital is no longer
appropriate to give realistic care Institute (NKTI)
10. The patient has the right to be informed of hospital  pediatric nursing at the Philippine Children’s Medical
policies and practices that relate to patient care, Center, and the National Children’s Hospital
treatment, charges, services and other payment records.  pulmonary nursing at the Lung Center of the Philippines
 mental health nursing at the National Center for Mental
Health
Confidentiality of information  maternal and child nursing at the Dr. Jose Fabella
Confidential information may be revealed ONLY when: Memorial Hospital
 1. Patients themselves permit such revelation  infectious disease nursing at the San Lazaro Hospital;
 2. the case is medico-legal  orthopedic and rehabilitation nursing at the Philippine
 3. ill of communicable disease and public safety may be Orthopedic Center
jeopardized  trauma and emergency nursing at the East Avenue
 4. if information is relevant to his care Medical Center (EAMC)
 operating room nursing at the NKTI, EAMC, the Quirino
Patient’s responsibilities Memorial Medical Center,and the Jose R. Reyes
1. Providing Information Memorial Medical Center.
2. Complying with instructions In RA 9173, Sec,28:
3. Informing the physician of refusal to treatment
4. Paying hospital charges  A registered nurse is authorized to administer a written
5. Following hospital rules and regulations prescription for parenteral medications, on top of internal
6. Showing respect and consideration examinations during labor and delivery and suturing of
perineal lacerations
NURSING PRACTICE
In RA 9173, Article VI: What are the standard criteria of nursing personnel in public and in
1. Utilization of nursing process private?
2. Establish linkages with community resources
 Nurse service Administrators
3. Provide health education to individuals, fam and
 Chief Nurse & Director of
communities
4. Teach guide and supervise to students bound duty to  Nursing
observe the Code of Ethics  Public Health Nurse