Nursing in the Philippines

Earliest Hospitals
Ethical Principles
A. 1577 - Hospital Real de Manila
B. 1578 – San Lazaro Hospital ETHICAL PRINCIPLES
C. 1586 – Hospital de Indios  Right thing to do is the
D. 1590 - Hospital de Aguas Santas Teleological good thing to do.
E. 1596 – San Juan de Dios  Focus on the outcome
 Duty
Earliest Nursing School Deontological
 Moral worth
 Goodness of a
A. 1903 – Sallie Long Road School of Nursing person/virtues
B. 1906 – Iloilo Mission Hospital SON  How we are brought
C. 1907 – St. Paul SON up or what we have
- Philippine General Hospital SON experienced
- St. Luke’s (Trinity)  Components:
- Mary Johnston SON ( Virtue ethics  Love – treat Px as a
D. 1911 – Mary Chiles hospital SON family
E. 1912 – Frank Dunn Hospital SON  Humility – be
F. 1913 – San Juan de Dios SON humble
G. 1918 – Southern Island SON  Courage – stand up
H. 1921 – Chinese General Hospital SON for what is right
 Honesty -
Earliest College of Nursing
Reciprocating the Love of
Divine command
God
A. 1879 – UST
B. 1947 – MCU
A. Golden Rule – Do unto others as you would
C. 1948 – UP
have them do unto you
D. 1955 – FEU
B. Two-fold effect – conflict between two
E. 1958 – UERM
ethical principles
- Ex. Life and death situation between
Nursing as a Profession
mother and child & organ transplant
C. Totality – The whole is greater than of any
A. Prudence – Proper judgement
parts
B. Retain and attract new members
- Ex. Insulin injection site
C. Obligation to the society
D. Epikia – Exception to the rule (Force
D. Freedom for professional growth
majeure)
E. Educational preparation for health
- Ex. Typhoon Ondoy disrupts flow in the
educational institution – qualifications
hospital which hinders HCP to
F. Service vital to man – extend beyond the
appropriately provide care to the
call of duty
patients
G. Scientific body of knowledge
E. One who acts through an agent is himself
H. Independent and autonomous – working
responsible – command responsibility
side by side by the doctors NOT under
- Ex. Inutusan na nurse nakipag-away sa
I. Obligation to the society
bantay
J. Norms and values
F. No one is obliged to betray himself –
incrimination

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 - Ex. You got caught of doing the wrong Paternalism – interference c kineme the
tasks or procedure liberty/autonomy of the person to decide
G. The end does not justify the mean – the with good intention
good effect should come in your good way A hospital director is about to choose the
- Ex. Refer patient to social worker to get person who should occupy a vacant position
medications of being a nurse-manager in the ICU ward of
H. Defects of nature may be corrected – St. Lukes Hospital. She choose between two
sanctity of the human life staff members, on 7 years general nursing
- Restituto in integrum – Giving a experience and the other who has only 2
chance to all the patient to correct the years experience but with mastery of all ICU
physical deformity – continue the procedures. In the manner of choosing her
quality of life appointee, the ethical principle here is:
I. If one is willing to cooperate, no injustice is A. Beneficience
done (Volenti non Fit injura) – two opposing B. Solidarity
teams comes in to an agreement – C. Justice
J. A little more/less does not change the act – D. Double effect
core value of uprightness
K. Greatest good for the greatest number – Philippine Code of Ethics
- Ex. Bedridden vs Ambulatory
L. No one is held to the impossible - -Ethics is our norm
M. Morality of cooperation – If the act is evil -Health is the fundamental right of everyone
deflects the morality -Health consists of:
N. Origin and destruction of life – home life o Cultural
o Social
Common board Exam Question o Spiritual
In instances wherein beneficence and non- o Physiological
maleficence result in an ethical dilemma. The o Psychological
guiding principle used when choosing a
course of action is: A. Human life
A. Double effect a. Goal of nursing – quality of life of the
B. Totality patient
C. Justice b. Hallmark nursing accountability –
D. Confidentiality documentation should not be fabricated
or changes
A patient was rushed to the hospital after c. RA9173
complaining of severe abdominal pain. The d. Confidentiality and Team work
medical team cannot determine any contact
person for the patients. The surgeon then Nursing Jurisprudence
decided to perform an emergency
appendectomy on the patient, since he -Law is the rule of the civil conduct
suspects that the appendix has already o Social
ruptured. What ethical principle was applied o General – no one is exempted
by the surgeon in this situation? o Enforced sanctions
A. Double effect -Sources:
B. Paternalism o Constitution
C. Non maleficence o Legislation
D. Autonomy o Judicial opinion

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 Types of Law A. Lawsuit – civil legal (personal) action
1. Divine law – law of the transcendent or law - Litigation – process of settling the lawsuit
of the supreme being - Parties in a lawsuit:
- Ex. Good Samaritan law 1. Defendants – the one being sued
2. Litigants – the one who sued
2. Human Law – devised by human reason 3. Witness – Person/s possessing
A. Public law – relationship between relevant information about the case
individual and society o Ordinary – directly knows the
1. Criminal law event
 malpractice o Experts – well knowledgeable
 negligence about the event
2. International law
 Public international B. Due Process
 Private international - Legal processing is accomplished
3. Political law according to the law
 Constitutional - Requirements (VICKS):
 Administrative o Violence
 Law of Public administration o Informed
 Law of Public corporation o Competent counsel - Attorney
B. Private law – governs relationship o Know the witness
between individuals o Silent (right)
1. Civil law - Phases:
2. Commercial law o
3. Remedial law
C. Written orders of court
 Personal - Writ – written
 Individual o Subpoena – to witness
Accountability
 Result focused o Ad testificandum – to witness
 Ex. Needle pricking o Duces tecum - evidence
 Shared o Summon – given to the accused
Responsibility
 Task focused o Writ of habeas corpus – reason
 Part of the litigation for detaining
process o Writ of prohibito – temporary
 Ex. Failure to comply to restraining order or stop the
Liability
the standard continuance of the proceeding
 Define the causation - Warrant – generally an order that
(facts) serves as a specific type of authorization
 Part of the litigation o Arrest - detention of the
 Actual compensation individual
 Special damages o Search – search for evidence
Damages (banga) & General o Alias – fails to appear in court
damages (not (different name)
quantifiable such as o Bench – fails to appear in court
pain) (testified in the court)

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 TORTS - an act or omission that gives rise to
Failure to perform in injury or harm to another and amounts to a
a competent manner civil wrong for which courts impose liability.
(BCDI) Assault Intentional threat
- Breach in the Physical force which
Battery
duty resulted to inury
- Causation Restraining another
Negligence
- What is the Duty False imprisonment person against their
- Injury will
Gross neg. – serious Derogatory
Comparative neg. – statement leading to
small amount neg. false information
result to harm Defamation towards an individual
Harm done due to
Malpractice
wrong practice Slander - spoken
Lack of legal and Liable - written
Incompetence requisite ability to Intentional deception
perform something Fraud
for personal gain
Intrusion of
Common board question someone’s private or
When examining the case for a nurse who is Invasion of privacy
personal affairs
being sued for negligent acts in the Operating without consent
Room what principle extends the liability to Unconsented
the surgeon in the same case? Breach of disclosure of
A. Respondent superior confidentiality information of the
B. Res ipsa loquitor – let the think speck for person
itself
C. Captain of the ship Common board question
D. Force majeure – natural act When teaching the staff about legal
The client responds when the nurse calls the terminology used in child abuse, nurse narsan
client by name. After giving the emphasizes that the term battery means:
digstcanecheatine, the the nurse aed the nits a. A legal wrong committed against the
the iverse clietoTisto the medication. What property of another -
should the nurse understand about the b. Damaging the character and reputation of
possibility of being sued for malpractice? a person by spreading false statements -
а.There is no validity to a lawsuit for defamation
malpractice because the client did not sustain C. The application of force to another person
harm or injury from the action. without lawful justification
b. If the nurse notifies the physician, the d. Doing something that a reasonable person
nurse is no longer liable for the action. with the same education or preparation
C. The nurse can be sued because the action would not do. - malpractice
was below the standard of practice
d. There would be no lawsuit because the
client identified himself by answering when
the nurse called the name

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 LEGAL DOCTRINES – circumstantial evidence
- Let the things *Note: Nursing assistants cannot do charting.
speaks for itself (If you forgot something to chart and you want
- Usually seen in to insert it – put ADENDUM)
litigation with OR
Res Ipsa Loquitor
cases wherein Common board question
materials were Which of the following points should a team
left inside the leader consider when delegating work to
patient team members in order to conserve time?
- Master must A. Assign unfinished work to other team
answer members.
Respondeat Superior - Superior is B. Explain to each team member what needs
responsible for its to be done
employee C. Relinquish responsibility for the outcome
- Good family of the work
Bonus Pater Familias
father D. Assign each team member the
- He who acts on responsibility to obtain dietary trays
Qui Facit Per Alium
another acts on
Facit Per Se
himself NURSING STUDENTS
Force Majeure - Act of nature
S - Supervised by CI
DELEGATION N - Not performing professional duties.
- Transfer responsibility E.g. Charting
U - Understand the Policy of assigned area
A. 5 Rights of Delegation: R - Receive guidance for procedures
o Person S - Skill must be appropriate to assigned
o Task tasks
o Direction E - Evaluated and assessed frequently
o Circumstance
o Supervision - Physicians,
Dentists,
RA 6675 – GENERIC
B. Issues with Delegation: Veterenarians
ACT OF 1988
o Under Delegation - Generic Name ->
o Over Delegation Choose
o Wrongful Delegation RA 5921 – - Components of
PHARMACY LAW Rx:
DO NOT DELEGATE: Name of prescriber
o Teaching Address of
prescriber
o Evaluation
PRC lic #
o Assessment
Professional tax
o Unstable Patient
Receipt #
o Planning
Name, Age, Sex,
o Medication (Endorse! Not Delegate!) and medication of
the patient
CAN DELEGATE (to nursing assistants):
o NGT Feeding
Eg. Paracetamol
o Range of Motion

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 (Biogesic) - Principles:
500 mg. tablet o Just the facts (who, what when,
where, how)
o Objective - No emotions
IV ADMINISTRATION o File within 24 hours
o Chronological order timeline
RA 7164 – PH Special Training is o Full names those of involved
NURSING ACT OF Required o Direct quotation – significant
1991 information
RNS without IV o Do not conclude
BON RESOLUTION training is not o IR is not part of the patient
NO 8 Series of 1994 allowed to give IV chart
meds - Types:
Completion of IV o Adverse Errors – harm present
BON RESOLUTION
therapy training is o Near miss (muntik na) – harm
NO 38 Series of 2016
not required should have been present
o Errors –
TELEPHONE ORDERS

Principles: CONSENT – legal document consenting a

1. Emergencies procedure/admission
2. Read back order to physician.  Parents will sign
3. Order should be written within 24  Emancipated
hours. Minors minors : epikia
4. RNS document order and time received.  Married
5. Have another RN validate.  *independent
 Not capable of
MEDICAL ORDERS
Mentally Ill deciding
- Anything not charted or documented
 Guardian will sign
was not done.
 No consent
- Accurate documentations
Emergency required at time
o No erasures
of incident
 Consent required
Superimpositions:
for both partners
- Abbreviations are not allowed but
(married)
depends on the hospital. Sterilization
- List of acceptable abbreviations:  In emergency –
one partner is
Charting by students – Counter signed by CI sufficient
 Must have a
INCIDENT REPORT HIV testing special consent
- Must be detailed: (interview)
o Time Research  Ongoing consent
o Place
o Person Contract – basis for limitation and
o Circumstance responsibilities
- Non punitive - Mutual agreement between 2 or more
parties

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 - Requirements: clear or immediate
o Consent
o Cause of obligation
o Breach of contract – failure to
comply with the requirements Common board questions
inside the contract What is the best defense of a nurse to avoid
cases of negligence in the workplace?
Wills – distribution of assets after death a. Carrying out nursing duties according to
- Testate – person who died and made standards of safe nursing practice
the will b. Extensive knowledge about criminal and
- Intestate – alive who made the will civil liabilities of nurses
- Executor – person who will manage the c. Thorough knowledge of RA 9173 and the
estate Magna Carta for Health Care Workers
- Estate – property D. Continuing professional education after
- Holographic will – written in paper and getting an RN license
it is not formal
- Mystic – seal; between attorney and CIRCUMSTANCES OF A CRIME – reasons of
can be open once death occur the weight of crime
- Solemn – testate + witness  Reasonable
- Unsolemn – will not share inheritance Justifying
necessity
- Living will – advance directives Exempting  Insane minor
 Lessens the crime
Testament – proof evidence  Good conduct
Mitigating
 Voluntarily
Crimes – criminal offense surrendered
- Law violation  Worsening of the
- Elements: Aggravating crime
o Mental state
 Piled up crimes
o Intent – guilty
 There is an
o Motive
alternate
o Causation Alternative
punishment
- Conspiracy to crime  Detained or fined
o Principal – the who acted or
planned Common board questions
o Accomplice – directly involved
Nurse Kian was transporting a patient to the
o Accessory – indirectly provincial hospital via ambulance. The patient
participant has had massive blood loss and was rapidly
progressing to shock. On the way to the
Misdemeanor – lesser criminal act hospital, a landslide occurred, blocking off
the entire road. Nurse Kian's patient died as a
CRIMINAL NEGLIGENCE – inexcusable lack of result of delay in medical attention. Which of
precaution the following statements is true about Kian's
The danger is highly situation?
Reckless imprudence
visible A. Nurse kian is liable for negligence since he
Simple imprudence Danger that would should have ordered the driver to take an
result from the alternative route
imprudence is not B. Nurse kian is not liable for negligence by

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virtue of force majeure – exempting force condition
majeure c. Better career
C. Only the ambulance driver is liable for prospects
choosing the route of transport d. Dignified existence
D. The hospital is also liable for sending out
an incompetent ambulance driver to the Article III – Organization of
scene the BON
- 1 chair
PHILIPPINES NURSING LAWS - 6 members
- First nursing law - Assigned by the
- Applicant should be 20 president (DDS)
years old; good physical - Term: 3 years
Act of 2493 of health; good moral - 10 years in service (5 in
1915 character PH)
- Within 2 ½ years of - Master’s Degree
completion you are now - Member of APOC (PNA)
considered as a nurse - Function:
- First true nursing law a. Quasi executive –
Act of 2808 of - BON (3 members) is conduct NLE,
1919 formed for examination b. recognize nursing
- 1920 – first board exam specialty organization
- Registration before c. Ensures quality
practice education
- If violated d. Monitor quality
RA 877 of 1953 (misdemeanor) = e. Quasi legislative
imprisonment for more f. Quasi judiciary –
than 1 year BUT not less investigation, revoke
than 5 years or suspend
- BON (5 members)
- Appointed by the Article IV – Examination &
president Registration
RA 4704 of - Must have Master’s - Examination
1953 degree and less than 65 requirement:
years old - BSN graduate
- Salary: 16,000 – 18,000 - PH citizen
per year - Good moral
- Redefined nursing -> character
RA 7164 of nursing process - Passing score is
1991 - Teaching and gwa of 75% with
management no grade lower
Philippine Article II – Declaration of than 60% (if failed,
nursing act of policy have to retake the
2002 RA 9173 -Protection of client and specific subject)
improvement of care -Registration:
a. Relevant nursing - Board certificate
education - PRC ID (renewal
b. Humane working after 3 years – birth

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 month) examination. Mike is a newly graduate
- Must have 15 units nursing student of JP Sioson, asked you about
the requirements in taking the nursing
Article V – Nursing licensure examination.
education Which of the following would qualify him in
-CMO 155 2019 OBE taking the examination?
-Faculty: i- Citizen of the Philippines i - good moral
- APO (PNA) character iii - at least 17 years old iv - holder
- MAN/MSN of BS degree
- One year experience A. iii, iv
- RN B. it,ili,iv
- Must have 3 years of C. ii, iii
experience D. L,i,iv
-Dean: Nurse Maria is applying for a faculty position
- Five years in in Arellano University. In order to be
teaching/supervisory qualified, she must possess which of the
- APO/PNA following?
- RN A. BSN,RN
- Master’s degree B. BSN, RN, MAN, 1 yr clinical experience
C. BSN, RN, with at least 9 academic units in
Article VI – Nursing the master's degree program
Practice D. BS, RN, with one year nursing practice in
- Nurse Manager: the clinical field of specialization
- APO (PNA)
- Nine unites masters
- Two years general
practice
- Chief Nurse:
- Five years
supervisory
- MAN/MSN
- APO (PNA)
- Nine units in
management and
admin course (HA
admin)
- Government:
- MA in PHN/CHN
- Military chief:
- General staff
course

Common board questions

One way to practice nursing in the Philippines
is to take and passed the written

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