PROFESSIONAL ADJUSTMENT PGH Library.
The Filipino Nurses Association was established (now PNA)
HISTORY OF NURSING IN THE PHILIPPINES
Early Beliefs, Practices and Care of the Sick
͕ Early Filipinos subscribed to superstitious beliefs and
practices in relation to health and sickness.
͕ Diseases, their causes and treatment were associated with
NURSING ETHICS – JURISPRUDENCE
mysticism and superstitions.
͕ Cause of disease was caused by another person (an enemy
of witch) or evil spirits. Adjustment
͕ Persons suffering from diseases without any identified cause
were believed bewitched by “mangkukulam.”
͕ Difficult childbirth was attributed to “nonos.”
͕ Evil spirits could be driven away by persons with powers to
expel demons. Profession
͕ Belief in special Gods of healing; priest-physician, word
doctors, albularyo/herb doctors.
Early Hospitals During the Spanish Regime
Religious orders exerted efforts to care for the sick by
building hospitals in different parts of the Philippines:
͕ Hospital Real de Manila
Professional Adjustment
͕ San Juan de Dios Hospital
͕ San Lazaro Hospital
͕ Hospital de Aguas Santas
͕ Hospital de Indios
Prominent Personages Involved During the Philippine Revolution
͕ Josephine Bracken – wife of Jose Rizal installed a field
hospital in an estate in Tejeros that provided nursing care to
the wounded night and day.
͕ Rose Sevilla de Alvaro – converted their house into
quarters for Filipino soldiers during the Philippine-American
War in 1899.
͕ Hilaria de Aguinaldo – wife of Emilio Aguinaldo organized
the Filipino Red Cross.
͕ Melchora Aquino (Tandang Sora) – nursed the wounded
Filipino soldiers, gave them shelter and food.
͕ Captain Solomon – a revolutionary leader in Nueva Ecija
provided nursing care to the wounded when not in combat.
͕ Agueda Kahabagan – revolutionary leader in Laguna also
provided nursing services to her troops.
͕ Trinidad Tecson (Ina ng Biak na Bato) – stayed in the
hospital at Biak na Bato to care for the wounded soldiers.
School of Nursing
1900 St. Paul’s Hospital School of Nursing (Intramuros, Manila) Monastic Orders (4th and 5th Century AD)
1906 Iloilo Mission Hospital Training School of Nursing
Distinction of graduating the first trained nurses in the
1909 Philippines with no standard of requirements for admission
of applicants except their “willingness to work.”
Protestant Reformation (16th Century)
A board exam was held outside of Manila. It was held in
April 1946 the Iloilo Mission Hospital thru the request of Ms. Loreto
Tupas, principal of the school.
St. Luke’s Hospital School of Nursing opened after four
1907
years as a dispensary clinic
1907 Mary Johnston Hospital School of Nursing
1910 Philippine General Hospital School of Nursing
School of Nursing
UST College of Nursing – first College of Nursing in Revival of the Deaconess Order
1877
the Philippines
MCU College of Nursing – first college who offered
June 1947
BSN (4 year program)
June 1948 UP College of Nursing
June 1955 FEU Institute of Nursing
October 1958 UE College of Nursing
Three female graduated as “qualified medical-surgical
1909
nurses”
The first Nurses Law (Act No. 2808) was enacted regulating
the practice of the nursing profession in the Philippine
Islands.
1919
It also provided the holding of exams for the practice of
nursing on the 2nd Monday of June and December of each
year.
1920 First board examination for nurses was conducted by the
Board of Examiners, 93 candidates took the exam, 68
passed with the highest rating of 93.75% – Anna Dahlgren.
Theoretical exam was held at the UP Amphitheater of the
College of Medicine and Surgery. Practical exam at the
as the National Organization of Filipino Nurses.
1921
PNA 1st President – Rosario Delgado
Founder – Anastacia Giron-Tupas
Republic Act 877, known as the “Nursing Practice Law” was
1953
approved.
͕ An educational process referring to changes in behavior
towards better life, better relationships, and better
contribution to society.
͕ A calling by which members profess to have acquired
special knowledge by training, by experience, or both so that
they may guide or advise or serve others in that field.
͕ An occupation usually involving relatively long and
specialized preparation on the level of higher education and
governed by its own code of ethics.
͕ The growth of the whole individual and development of all
his/her capacities, physical, mental, social, and spiritual
towards efficient and effective performance of his/he
profession.
Dimensions of Adjustment
͕ Health adjustment
͕ Emotional adjustment
͕ Social adjustment
͕ Home adjustment
͕ School adjustment
͕ Professional adjustment
Historical Influences in the Development of Nursing as a
Profession
͕ Knowledge of the past can help us understand how nursing
developed.
Religious Influence
͕ Early Christian Church
͕ Practiced the “Acts of Charity”
͕ Deacons/Deaconesses – servants for the sick, caring for
people is service to God
͕ Augustinian Sisters – first nursing order
͕ Did nursing, housekeeping, cooking, laundering, and at the
same time run the hospital.
͕ Martin Luther promoted medicine by advocating that
physicians should be used whenever possible to treat a
disease.
͕ Luther recommended the use of apothecaries, barbers,
physicians, and nurses to cure physical ailments when he
ministered to the sick.
͕ He recommended fumigation for homes contaminated with
the plague and avoidance of unnecessary travel and
exposure to different places.
͕ Pastor Theodore Fliedner of Kaisenwerth, Germany and his
first wife (1836) – saw deacons in Holland.
͕ Kaiserwerth – place where Nightingale trained.
͕ More nursing schools opened under the secular organization
and churches.
Military Influence
͕ Military nursing orders were established during the crusades.
͕ Florence Nightingale served in the Crimean War in 1854–
1856.
Secular Influence
͕ St. Francis of Assisi believed that men and women can
participate in nursing and social welfare work under religious
control.
͕ Sisters of Charity (1600) – establishment of nurses’
organization, enactment of laws and development of nursing
journals.
Educational Influence
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 ͕ Early nursing – trial and error/apprenticeship
͕ Daughters of St. Vincent de Paul – formal education took
place
͕ Florence Nightingale – at the age of 90 died on August 13,
1910
Nursing in the Philippines
͕ Nursing education was pioneered by Dr. Andrew Hall –
Presbyterian.
͕ Evolved from the apprenticeship system Union Mission
Hospital Training School, Iloilo City became the training
institution for Filipino nursing students.
͕ Iloilo Mission Hospital School of Nursing – set the stage for
nursing as a profession.
͕ First nursing graduates – Felipa dela Pena of Panitan Capiz,
Nicasia Cada of Oton, Iloilo, Dorotea Caldito of Leon, Iloilo.
͕ 1919 – the first Nurse’s Law (RA 2808) was enacted
regulating the practice of the nursing profession in the
Philippine Islands.
͕ It also provided the holding of exams for the practice of
nursing on the 2nd Monday of June and December of each
year.
Traditions in the Nursing Profession
͕ The Nurse’s Cap
͕ The purpose of the cap is to keep the nurse’s har
neatly in place and present a modest appearance.
͕ Florence Nightingale in the 1800s, the caps were
hooded and had a ruffle.
͕ Black band on the nurse’s cap worn at the time of
graduation.
͕ The Nursing Pin
͕ The 8 Pointed Cross (also known as the Maltese
Cross)
͕ The Maltese Cross originated in the Maritime Republic
of Amalfi in Italy.
͕ Amalfi was the birthplace of some pious merchants
who founded the first hospital of the Order of St. John
in Jerusalem in 1048.
͕ Wearing of the pin extended to schools to symbolize
wisdom, strength, courage, and faith.
͕ Pinning ceremony
͕ The Nurse’s Uniform
͕ It has always been significant because it provides a
strong nonverbal message about one’s images.
͕ Communicated an impression of confidence,
competence, professionalism, authority, role, identity,
and accountability.
͕ In the 1900s, the Hemline was raised and uniforms
became more functional.
͕ In the mid 1960s, pant suits became accepted.
͕ In 1970, scrub suits and athletic shoes became
acceptable.
͕ The Nightingale Pledge
͕ Embodies the principles of sacrifice, service, and
obedience written by Lystra E. Gretter of Harper
Hospital School in Detroit.
Some Situations that have Caused Internal Changes in the
Nursing Profession
1. More men are entering the nursing profession.
2. There has been less acceptance of the passive behaviors
associated with the historical “handmaiden role.”
3. The average age of working registered nurses have
increased.
4. The practice of nursing has shifted from acute care in the
hospital to a more community and primary care focus.
Development of Nursing as Profession
͕ Is nursing a profession? Perhaps you have heard many
people say that nursing is a vocation, while some say that it
is a profession.
͕ According to Webster Dictionary, a profession as an
occupation or calling requires advanced training and
experience in one specific or specialized body of knowledge
which provides service to society in that special field.
͕ Nursing is an occupation requiring a unique body of
knowledge and skills which serves society.
Criteria of a Profession
1. Public service and altruistic activities
2. Autonomy and independence of practice
3. Specialized body of knowledge (ability to do special things,
authority)
4. Evidence-based practice – results of research studies
5. High level of individual responsibility and accountability –
accountable of what you are doing
6. Code of ethics – Code of Nursing Ethics
7. Self-regulation – self-monitored profession
8. Competency and professional license
9. High intellectual level of functioning
10. Well-organized and strong representation
11. Lifetime commitment
12. Public appearance
Profession:
͕ Prestigious occupation with a high degree of identification
among members that requires lengthy and rigorous
education in intellectually demanding and theoretically based
course of study, engages in rigorous self-regulation and
control that holds authority over clients, and that puts service
to society above simple self-interest.
Professional Nursing:
͕ An art and a science in which certain principles are applied
in the skillful care of the sick in appropriate relationships with
the client and the physician and with others who have
related responsibilities.
͕ It is concerned equally with the prevention of illness and
conservation of health.
Professional Nurse:
͕ A person who has completed a basic nursing education
program and is licensed in his/her country to practice
nursing.
Professionalism:
͕ Demonstration of high level personal, ethical, and skill
characteristics of a member of a profession.
Qualifications of a Professional Nurse
A. Professional Preparation
1. Must have a Bachelor of Science degree in Nursing
2. Must have a license to practice nursing in the country
3. Must be physically and mentally fit
B. Personal Qualities and Professional Proficiencies
1. Has interest and willingness to work and learn with
individuals/groups in a variety of settings.
2. Has a warm personality, a well-balanced emotional
condition and concern for people.
3. Is resourceful and creative.
4. Has the capacity and ability to work cooperatively with
others.
5. Has the initiative to improve self and service.
6. Has competence in performing work through the use of the
nursing process.
7. Has the skill in decision-making, communicating, and
relating to others.
8. Must be research-oriented.
9. Does active participation in issues confronting nurses and
the nursing profession.
Professional Adjustment
͕ Growth of the whole person in the development of his
capabilities to make him fit to assume his position.
͕ Preparation of an SN for the responsibilities of professional
and social life (participate in the community), by developing
capabilities in a way that would make her fit for the practice
in nursing.
Educational Preparation for Nursing
Baccalaureate Nursing
͕ 3 year hospital-based program leading to Graduate in
Nursing (phased-out)
͕ 1983 – 4 year college degree program leading to BSN
͕ 1998 – 2 year education and basic nursing procedures
leading to AHSE (Associate in Health Science Education)
͕ Additional 2 years of major nursing component leading to
BSN
͕ Professional adjustment
͕ 2006 – 4 year degree program (CHED 30)
Graduate Education in Nursing
͕ Major purpose is to prepare nurses in improving nursing care
through advancement of nursing theory and science.
͕ Prepare nursing leaders by generating higher levels of
competence and by teaching, administering, and
investigating professional practice.
Master’s Degree Program
͕ Generally takes 1½ to 2 years
2
 ͕ Master in Arts, Master in Nursing, Master in Science in
Nursing, and Master of Science
͕ Pursue an area of clinical specialization and elect an area of
role and development
Doctorate Degree Program
͕ Titles awarded are: Doctor of Philosophy (PhD), Doctor of
Science in Nursing (DNS), Nursing Doctorate (ND)
͕ Preparation for various positions, such as administrators of
nursing colleges, nursing research specialists, consultants of
nursing services, nursing education programs or hospital
services.
Continuing Education for Nurses
͕ It refers to formalized experiences designed to enlarge the
knowledge and skills of professional nurses.
͕ Forms of continuing education:
͕ Graduate School
͕ Seminar-Workshops/Lectures
͕ Conventions – gathering of professionals
͕ Distance learning/self-directed learning package –
school of correspondence
͕ On the job training for specializations (4 weeks)
͕ Authorship-ownership of intellectual property
͕ In-service education – planned program for staff nurses
by the employer
͕ CPE (Continuing Professional Education) credit units –
requires 60 CPE credit units every 3 years (15 credit units
now)
͕ BON Resolution No. 01 Series of 2008 – created the CPE
Council for nursing
͕ Objective of Continuing Education:
1. To provide and ensure the continuous education of a
registered profession with the latest trends in the
profession.
2. To raise and maintain the highest standard and quality
of the practice for the profession.
3. To make the nurse globally competitive.
4. To promote the general welfare of the public.
͕ Factors in society that promote need of nurses to
continue education:
1. An aging population results in older clients with more
complex health problems.
2. Skilled nursing care is needed with the advent of home
care nursing.
3. Nurses need to be knowledgeable about the cultural
and social influences on health.
4. Newer technology and scientific discoveries.
5. New diseases related to social and environmental
problems.
Significance:
1. Guide in developing the curriculum in nursing.
2. Framework for developing test syllabus for entrants
(newcomer) into the nursing profession.
3. Tool performance evaluation among nurses.
4. Basis for advanced practice and specialization.
5. Framework for developing a training curriculum for nurses.
6. Yardstick for unethical and unprofessional practice of
nursing.
Key Areas of Responsibilities:
͕ Patient Care Competencies (70%)
͕ Safe and quality nursing care
͕ Communication
͕ Collaboration and teamwork
͕ Health education
͕ Empowering Competencies (10%)
͕ Legal responsibilities
͕ Ethico-moral responsibilities
͕ Personal and professional responsibilities
͕ Enhancing Competencies
͕ Records management
͕ Management of resources and environment
Personal Values
͕ Values that a person may internalize by how he/she
perceives them from the society in which he/she lives.
Professional Values
͕ Values that are acquired from the code of ethics, nursing
experiences, teachers, and peers.
͕ Nurses hold values that relate to both competence and
compassion.
Nurses are expected to value:
͕ Virtues learned
͕ The ability to provide safe, competent and ethical care
͕ Health promotion and well-being of clients
͕ Respect and promotion of autonomy of clients
͕ Dignity and worth of each person
͕ Justice and fairness in the care of clients
͕ Confidentiality of information gathered
Morals or Morality:
͕ Fundamental standards of what is right or wrong that the
individual learns and internalizes, usually in the early stages
of childhood development.
͕

Core Competency Standards for Nursing Practice

Committee Members: BON, CHED Technical Committee on
Nursing Education, PNA
͕ Project was conceptualized – April 2001
͕ Initial draft presented – June 2003
͕ Refinement done – January 18, 2005
͕ Date of Effectivity – August 2005
͕ Revised CCS – May 2009

Legal basis – RA 9173, Article 3 Section 19

͕ The Board shall monitor and enforce quality standards of
nursing practice in the Philippines and exercise the powers
necessary to ensure the maintenance of efficient, ethical,
technical, moral, and professional standards in practice of
nursing taking into account the health needs of the nation.

Rationale:
1. Effects of globalization.
͕ Globalization – free enterprise and no monopoly of
business; new technology comes into our country.
2. New expectations for contemporary nursing practice.
͕ Nurse anesthetist
͕ First assistant to the surgeon
͕ Nurse entrepreneur
3. Changes in dynamics of health science and information
technology.
4. Demographic changes.
͕ Study of the population of a certain place.
͕ Increased demand for food.
͕
5. ??
6. Increasing and more exacting (strict) demands from the
consumers of healthcare.
7. Surge of overseas employment opportunities for Filipino
nurses.
͕ Nursing Relief Act – only Filipinos can be employed;
abolished in 1995.
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