Nurse’s Prayer

O Lord, my God, I dedicate myself to you

for this great work I undertake for you
Take my eyes, and teach them to see,
the clearest way to nurse the sick for you
My hands guard them, and show them how to prove how
kind and gentle is a nurse’s love
Guide my feet, give swiftness to their thread
in answering every call from the poor sufferer’s bed
Touch my lips, guard my tongue
uttering only words of kindness to each one
Gird me with strength that I may bear my task,
help me play my part in life without fear
And, when I am a night nurse, please guide my action
be near to my patients and watch by my side
O Lord, I ask you, hear me while I pray
be in me through me, and with me all the way. Amen.
 NURSING AS A
PROFESSION
Mr. Alfredo P. Yambao I, RN, MAN©
 The
Nightingale
Pledge
I solemnly pledge myself before God
And in the presence of this assembly
To pass my life in purity
And to practice my profession faithfully.
I will abstain from what ever is deleterious and mischievous,
And will not take nor administer
Any harmful drug
I will do all in my power
To elevate the standards of my profession
And will hold in confidence
All personal matters committed in my keeping
And all family matters coming to my knowledge
In the practice of my profession,
With loyalty will I endeavor to aid
the health team in their work
And devote myself to the welfare of those
committed to my care
IS NURSING A PROFESSION?

• Perhaps you have heard many people

say that nursing is a vocation, while
some say that it is a profession.
 Definition of a
Profession
• Webster’s Dictionary defines a profession
as “an occupation or calling requiring
advanced training and experience in some
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 and which serves society.
 License to Practice
• License- a legal documents given by
the government that permits a
person to offer to the public his
skills and knowledge in a particular
jurisdiction, where such practice
would otherwise unlawful without
license.
 REGISTRATION
• - RECORDING OF NAMES OF
PERSONS WHO HAVE QUALIFIED
UNDER THE LAW TO PRACTICE
THEIR
 CRITERIA OF A
PROFESSION
• A PROFESSIONAL
NURSE- is a person who
has completed a basic
nursing education program
and is licensed in his/her
country or state to
practice professional
nursing.
• The Nursing Act defines professional
nursing as the performance, for a fee,
salary, or other reward or compensation,
of professional nursing services to
individuals, families and communities in
various stages of development toward the
promotion of health, prevention of illness,
restoration of health, and alleviation of
suffering through :
• utilization of the nursing process, including
assessment, planning, implementation and evaluation
of nursing care;
• establishment of connections with community
resources and coordination of the health team;
• motivation of individuals, families and communities
and coordination of services with other members of
the health team;
• participation in teaching, guidance and supervision of
students in nursing education programs, as well as
administering of nursing services in varied settings
such as hospitals, homes, communities and like
settings; undertaking consultation services and
engaging in such other activities that require the
use of knowledge and decision-making skill of
registered nurse; and
• undertaking nursing and health manpower
development training and research and soliciting
finances therefore, in cooperation with the
appropriate government or private agency.
QUALIFICATIONS
AND ABILITIES
OF A
PROFESSIONAL
NURSE
 A professional nurse must possess
specific qualifications and abilities.

• Professional Preparation
• For his/her professional preparation a
nurse must
– have a license to practice nursing in the
country
– have a Bachelor of Science degree in Nursing
– be physically and mentally fit.
 Personal Qualities and Professional Proficiencies
The personal qualities and professional proficiencies
of a nurse include
– interest and willingness to work and learn
with individuals/groups in a variety of
settings;
– a warm personality and concern for people;
– resourcefulness and creativity as well as a
well-balanced emotional condition;
– capacity and ability to work cooperatively
with others;
– initiative to improve self and service;
– competence in performing work through
the use of nursing process;
– skill in decision-making, communicating,
and relating with others and being
research oriented; and
– active participation in issues confronting
nurses and nursing.
ETHICO-MORAL
LEGAL
ASPECTS OF
NURSING
ETHICS- ethos means moral duty a
standard to examine and understand
moral life.
– Studies how people make judgment in
regard to right or wrong.
MORALS- specific way of behavior or
of accomplishing ethical practices.
BIO-ETHICS-focuses on moral issues
in the field of health care
UNIVERSAL PRINCIPLES of
BIOMEDICAL ETHICS
• Beneficence- helping to better the
conditions of other (do what is good)
• Nonmaleficence-avoiding or
preventing injury to others( do no
harm)
• Fidelity- Loyalty
• Veracity- telling the truth
• Justice- equal treatment
• Autonomy- freedom to choose and
implements one’s decision.
 MORAL PRINCIPLES:
• The Golden Rule
• The Two-fold Effect
• The Principle of Totality
• Epikia
• One who acts through an agent is
himself responsible
• No one is obliged to betray himself
• The end does not justify the means.
• Defects of nature may be corrected
• If one is willing to cooperate in the
act, no injustice is done to him.
• A little more or less does not change
the substance of an act.
• The greatest good for the greatest
number
• No one is held to the impossible
• The morality of cooperation
• Principle relating to the origin and
destruction of life.
Spiritual Commitment on
Nurses
• The Good Samaritan Law
• Nurses and Suffering
• Life in God’s Service
 CODE OF ETHICS FOR
NURSES
• Believe in the worth and dignity of
human being therefore the primary
responsibility is the preservation of
health at all cost.
• Competent and confident nurse.
• Follows the ethical principles.
• Members of APO
 CODE OF NURSING (ICN)
May 1973
• The fundamental responsibility of the
nurse is fourfold:
• 1. promote health
• 2. to prevent illness
• 3. restore health
• 4. alleviation of suffering
• The need for nursing is universal.
Inherent in nursing is respect for life,
dignity and rights of man. It is
unrestricted by consideration of
nationality, race, creed, color, age, sex,
politics or social status.
• Nurses rendering health services to the
individual, the family and the community
and coordinate their services with those
of related groups
 Nurses and People
• The nurse’s primary responsibility is to
those people who require nursing care
• The nurse, in providing care, promotes an
environment in which the values, customs
and spiritual belief of the individual are
respected
• The nurse holds in confidence personal
information and uses judgment in sharing
this information.
 Nurses and Practice
• The nurse carries personal
responsibilities for nursing practice and
for maintaining competence by continual
learning
• The maintain the highest standards of
nursing care possible within the reality
of a specific situation.
• The nurses uses in judgment in relation
to individual competence when accepting
and delegating responsibilities.
• The nurse, when acting in a
professional capacity, should at all
times maintain standards of personal
conduct which reflect credit upon
the professional.
 Nurses and Society
• The nurse shares with other
citizens the responsibilities
for initiating and supporting
action to meet the health and
social needs of the public.
 Nurses and Co-Worker

• The nurse takes appropriate

action to safeguard the individual
when his care is endangered by a
co-worker or any other person.
• The nurse sustain a cooperative
relationship with co-worker in
nursing and other fields.
 Nurses and Profession
• The nurse plays the major role in
determining and implementing desirable
standards of nursing practice and nursing
education.
• The nurse is active in developing a core of
professional knowledge.
• The nurse, acting through the professional
organization participates in establishing
and maintaining equitable social and
economic conditions in nursing.
• Nurses and Labor unions
• Nurses and ILO Convention No. 149
 PATIENT’S BILL OF
RIGHT
• The patient has the right to
considerate and respectful care.
• The patient has the right to obtain
from his doctor complete current
information about his diagnosis,
treatment and prognosis in terms
patient can be reasonably expected
to understand.
• The patients has the right to
received from his doctor information
necessary to give informed consent
prior to the start of any procedure
or treatment.
• The patient has the right to refuse
treatment to the extent permitted
by law and to be informed of the
medical consequences of his action.
• The patient has the right to every
consideration of his privacy
concerning his own medical care
program. Case discussion,
consultations- examination and
treatment are confidential and
should be conducted discreetly.
Those not directly involved in his
care must have the permission of the
patient to be present.
• The patient has the right to expect that
all communications and records
pertaining his care should be treated as
confidential.
• The patient has the right to expect that
within its capacity a hospital must make
reasonable response to the request of a
patient for services.
• The patient has the right to obtain
information as to any relationship of
his hospital to other health care and
educational institutions in so far as
his care is concerned. The patient
has the right to obtain information as
to the existence of any professional
relationship among individuals, by
name, who are treating them.
• The patient has the right to be
advised if the hospital proposes to
engage in or perform human
experimentation affecting his care or
treatment. The patient has the right
to refuse to participate in such
research project.
• The patient has the right to expect
reasonable continuity of care. He has
the right to know in advance what
appointment times and doctors are
available and where.
• The patient has the right to
examine and receive an
explanation of his bill, regardless
of source of payment.
• The patient has the right to
know what hospital rules and
regulation apply to his conduct as
a patient.
LAWS GOVERNING THE
PRACTICE OF NURSING
 CONCEPT OF LAW
• The sum total of rules and
regulations by which society is
governed
• Rule of conduct pronounced by
controlling authority
 Types Law
•DIVINE LAW- are those
which have God for their
author.
•HUMAN LAW- are those
authored by man.
 HUMAN LAW
– Private Law
• Criminal Law
• International Law
– Public International Law
– Public International Law
• Political Law
– Constitutional Law
– Administrative Law
– Law of Public Administration
– Law of Public Corporations
– Public Law
• Civil Law
• Commercial Law
• Remedial Law
 Three Essential
Characteristics of Law
• Authority or the right to declare
that the rule exist.
• Pronounced or express and the
source can be identified (must be
declared in writing)
• Right to enforce the same
Principle Sources of Law
• Constitution
• Statutes or legislations (RA’s)
• Regulations issued by the Executive
Branch of the Government (EO’s)
• Case decisions or judicial opinions
• Presidential Decrees
• Letter of Instructions
 History of Nursing Law
• Act No. 2493 of 1915 regulate the practice
of medicines.
– Every person desiring to practice as a
registered nurse in the Philippines Island
shall apply to the Director of Health for a
certificate of registration as a registered
nurse
• At least 21 years old
• Good physical and moral character
• Graduates of recognized school of
nursing
• Act 2808 of 1919 The First
True Nursing Law The act
created a Board of Examiners
for Nurses, consisting of three
members appointed by the
Secretary of Interior composed
of one
• 2nd Monday June and December
• Act 3025- provided registration for
Red Cross aids and welfare workers
• Registration without examination for
US nurse
• Changing of the date of examination
to 2nd Monday of April and October
• Act No. 3488 changing the date of
examination to 2nd Monday of April
and 4th Monday of October
• Republic Act 877 of 1953
• RA 4704 of 1966 amended RA 877
increased the Board from 3 to 5.
• RA 7164 Phil. Nursing Act of 1991.
– IV Therapy
– Upper 40 %
– Qualifications of CI, Dean etc.
 Salient Points of
RA 9173
• “ An Act Providing for a More
Responsive Nursing
Profession, repealing for the
Proposed RA 7164, otherwise
known as Philippine Nursing
Act of 19991”
• Title: The Philippine Nursing
Act of 2002
• “State guarantees the delivery
of quality basic health services
through an adequate nursing
personnel system throughout
the country.”
• Nursing includes nursing care across the
life span. Independent
practice-promotion of health and
prevention of illness. Member of health
team-collaborates for curative,
preventive and rehabilitative aspect of
health, alleviation of suffering, or
peaceful death. Covers direct nursing
care; linkaging for community health;
teaching in nursing, nursing and health
human resources.
• Board of Nursing composed of chairperson
and six members
• BON appointed by President
• BON should be:
Natural born and registered resident of the
Philippines
– Member of good standing APO
– RN with MA degree
– 10 years of continuous practice prior to
appointment (5 years should be in the Phil.)
– Not convicted with any offense involving moral
turpitude
• Proc. No 539- 1958 Nurses’ Week
• PD 223 creation of PRC
• RA 1080 Civil Service Act
• RA 2382- Phil. Medical Act
• RA 5181- Permanent Reciprocity
• RA 6136- Application of Legal Orders
• RA 7170- Organ Donation
• RA 7719- Blood Donation
• RA 7846- EPI- Hepatitis B
•
• LI 1000- prioritizing members of
APO’s.
• RA 7392 Midwifery Law
• RA 6425- Dangerous Drugs Act
• Act 3573 reporting of all
Communicable Diseases
• RA 1082- creation of RHU
• RA 4073- liberalize the treatment of
leprosy
• PD 996- compulsory Immunization
•PD 825- improper waste disposal
•PD 856- Code of Sanitation
•PD 148- Woman and Child labor
•RA 6365- POPCOM
•Gen Order No. 18- Family Planning
•LI No, 47 inclusion of Family Planning
in the curricula
PD 48 limits maternity leave to 4
PD 69 limits tax exemption to 4
• PD 965- Family Planning seminar
before marriage.
• RA 1054- Medical facilities in work
place
• RA 4226- Hosp. Licensure Act
• RA 5901- 40 hours work
• PD 442- Labor Code of the Phil.
• PD 603- child and Youth Welfare
Code
• PD 651 Birth Registration
• ILO Convention No. 149-
improvement of the work condition
for nursing personnel.
• PD 1519- Medicare
• RA 6675- Generic Act of 1988
• RA 7305- Magna Carta for Health
Care Workers.
• RA 7600- Rooming –In and
Breastfeeding Act
• RA 7432- Senior Citizen’s Act
• RA 9003- Solid Waste Management
Act
• RA 8423-Phil Institution of
Traditional and Alternative Medicine
• RA 8749- Clean Air Act
PROFESSIONAL NEGLIGENCE
• Negligence- refers to the commission
and omission of an act, pursuant to a
duty, that a reasonably prudent person
in the same manner would or would not
do of which is the proximate cause of
injury to another person or his
property.
 Sample:
• Failure to report observations to
attending physicians.
• Mistaken identity.
• Wrong medicine, wrong concentration,
wrong route.
• Administration of medicine without
prescriptions.
 Doctrine of Res Ipsa
Loquitur;
• That the injury was such nature that it
would not normally occur unless there was
a negligent act on the part of someone
• Injury was caused by an agency within
control of the defendant, and
• That the plaintiff himself did not engage
in manner that would tend to bring about
the injury
 Sample:
• The presence of sponges in
the patient’s abdomen
after operation
• Fracture on a
newly-delivered baby born
by breech presentation.
 MALPRACTICE
• The improper or unskillful care of a
patient by a nurse. Stepping beyond
one’s authority with serious
consequence.
INCOMPETENCE
Lack of skill or ability, legal
qualifications or fitness to discharge
the required duty.
 Doctrine of Force Majeure
• Irresistible force, one that is unforseen
or inevitable
Doctrine of Respondeat
Superior
let the master answer for the acts of
the subordinate
CRIMES, MISDEMEANORS
and FELONIES
• CRIME- an act committed or omitted
in violation of the law
• ELEMENTS OF CRIME
– Criminal act
– Evil, criminal intent
 Persons Responsible to
Commit Crime:
• Principals- direct part in the
execution
• Accomplices- cooperate in the
execution
• Accessories- having knowledge of the
commission of the crime.
Three Stages of Execution
of a Crime
• Attempted
• Frustrated
• Consummated
Circumstances Affecting
Criminal Liability
• Justifying Circumstances
• Exempting Circumstances
• Mitigating Circumstances
• Aggravating Circumstances
• Alternative Circumstances
• Murder- unlawful killing of human being
with intent to kill.
• Homicide- killing of human being by
another
• Abortion- expulsion of the product of
conception before the age of viability.
• Infanticide- killing of a child less than 3
days of age.
• Parricide- killing of a family members.
TORTS
• Is a legal wrong, committed against a
person or property independent of a
contract which renders the person
who commits it liable for damages in
civil action
• Assaults –imminent threat of harmful
or offensive bodily contact
• Battery- is an intentional,
unconsented touching of another.
• False imprisonment or illegal
detention
• Invasion of Right to Privacy and
Breach of confidentiality.
• Defamation- Character
assassination
– Slander- oral defamation
– Libel- defamation in written
word.
 CONSENT
• Free and rational act that
presupposes knowledge of the thing
to which consent is being given by a
person who is legally capable to give
consent
CONTRACTS
• A contract is a meting of minds
between two persons whereby one
binds himself, with respect to the
other, to give something or to render
some service.
• A contract is a promise or a set of
promises which the law recognizes as
a duty and when that duty is not
performed, the law provides a
remedy.
KINDS OF CONTRACTS
– A formal contract refers to an agreement among parties
involved and is required to be in writing by some special laws.
Examples are marriage contracts, mortgages, deeds of sale
or work contracts.
– An informal contract is one which is concluded as the result
of a written document or correspondence where the law does
not require the same to be in writing, or as the result of oral
and spoken discussion between the parties or conduct
between the parties, evidence and intention to contract.
– An express contract is one in which the conditions and
terms of the contract are given orally or in writing by the
parties concerned. An example of this is usually found in
formal contracts wherein the kind of services offered,
salary, date and time of affectivity including fringe benefits,
if any, are specified.
 KINDS OF CONTRACTS
• If a private duty nurse is asked by a physician to go on
special duty for his patient and the patient himself and
his relatives do not object to the service, it is implied
that the private duty nurse will be paid under the
doctrine of facio ut des which means “ I do that you
may give.”
– An implied contract is one that is concluded as a result of acts
conduct of the parties to which the law ascribes an objective
intention to enter into a contract.
• To avoid subsequent problems, nurses are advised to
clarify the terms and conditions of employment before
assumption of work with the prospective employer.
– A void contract is one that is inexistent from the very
beginning and therefore may not be enforced.
– An illegal contract is one that is expressly prohibited by law.
Examples of void and illegal contracts are found towards the
end of this chapter.
BREACH OF CONTRACT
• Breach of contract is failure to perform an
agreement, whether expressed or implied, without
cause.
• The following constitute breach of contract for
nursing services:
• prevention of performance;
• failure to perform because of inconvenience or
difficulty;
• failure of cooperation in performance;
• abandonment of duty (i.e., leaving unconscious
patients, going off-duty without endorsement,
loafing while on duty);
• substitution of performance; and
• failure to use due care.
 ADVANTAGES OF WRITTEN
CONTRACTS
• Many nurses fear written contracts. The following are the
advantages of written contracts over oral ones.
• A written contract is certain. It avoids the uncertainty of
human memory.
• It can specify a definite time within which it is binding so as
to protect both sides against sudden changes without
notice. It also fixes a time limit after which conditions are
no longer binding but may be opened for rediscussion.
• It sets a standard and relieves an individual professional
person from haggling over compensation.
• It is more likely to be open and well-known so that the use
of written contracts tends to establish minimum standards
for professional practitioners and to protect them against
discrimination in compensation.
• It is definite and can be definite on many details which
may otherwise stimulate favoritism or caprice even
among professionals, such as hours of work, vacation
allowances, holiday privileges, health and insurance
provisions.
• It can provide a definite procedure in case of
complaints about substandard work, so that the
employer has a clear course and the professional nurse
has protection against arbitrary action.
• It creates at least a minimum of certainty and security
fro the professional employee so that he is free to
concentrate on his work without concern for the
details which the written contract has settled.
• Definite commitments stipulated of certainty are
hours of work and salary, length of time of contract,
days of off duty, details of duties and responsibilities
including the course to be taken in case of
non-fulfillment of the terms of contract.
THE DIFFERENT
FIELDS OF
NURSING
 INSTITUTIONAL
NURSING
• Nursing in hospitals and related health
facilities such as extended care facilities,
nursing homes, and neighborhood clinics,
comprises all of the basic components of
comprehensive patient care and family
health. The concept of the modern
hospital as a community health center
where in-patient and out-patient care are
continuous describes the goal of medical
care in most general hospitals.
ADVANTAGES OF STAFF IN
HOSPITALS
• There is always a supervisor whom one can consult if
problems exist.
• Nurses are updated with new trends in medicine and in
the nursing care of patients.
• They undergo rotation to different units and have a
chance to determine their special area of choice before
they are assigned permanently in one area such as
Medicine, Pediatrics, Surgery, ICU-CCU, Obstetrics,
Operating Room, Delivery Room, etc.
• They have an eight-hour day and forty-hour week duty.
They provisions for sick leaves, holidays, and vacations
with pay according to personnel policies of the
institution.
ADVANTAGES OF STAFF
IN HOSPITALS
• They have the chance to get promoted to
higher position if they are qualified.
• Salary increases are given periodically
according to merit system thereby
increasing their initiative and best efforts.
• They are considered an important member
of the health team in providing care to the
patients.
• More staff development programs are
available in the hospital.
 DISADVANTAGE OF
NURSING IN HOSPITALS
• There is a great possibility of
understaffing which may require nurses
to sacrifice some of their plans or put in
overtime work. This is specially true in
hospital where budget for personnel is
limited.
• Because of the bulk of work, some staff
nurses do not find time to improve their
skills through continuing education
program are provided.
• Administrative problems and overwork
may tend to dissatisfy the staff nurse.
PUBLIC HEALTH NURSING
OR COMMUNITY HEALTH
NURSING
Public health nursing is also called
community health nursing. The National
Health Program of the Philippines gives as
much emphasis on the promotion of health
and prevention of diseases rather than care
of the sick. It needs a deeper involvement
and close cooperation with all the members
of the health team such as physicians,
nurses, epidemiologists, dentists, sanitary
inspectors, sanitary engineers, nutritionists,
health educators, social workers, the
community, and the barangay leaders.
ADVANTAGE OF PUBLIC
HEALTH NURSING
• The focus of the nursing care is only family
and community health rather than on an
individual basis. Here the nurse will be able
to see the total picture of family and
community health.
• It gives the nurse a better perspective of
the health conditions of the community and
the health programs conceived and
implemented by the government; and to
appreciate the nurse’s role in nation building.
• It maximize efforts to improve where there
are no sufficient facilities, supplies, and
equipment.
ADVANTAGE OF PUBLIC
HEALTH NURSING
• It enables the nurse to utilize various
community resources and maximize
coordination with other members of the
health team.
• Focus of care is more on educational and
preventive aspects. Thus, nurses have
the privilege of contributing to the
program for healthy citizenry especially
among the rural poor.
• Individuals, families and communities are
motivated to assume responsibility for
their own health care.
 DISADVANTAGES OF
PUBLIC HEALTH NURSING
• Cases found in public health nursing are
limited mostly to chronic and/or
communicable diseases.
• There are most hazards in public health
than in hospital nursing; such exposure to
elements (inclement weather, heat of the
sun, rain), dog or snake bites, accidents, etc.
• There are no fixed hours of work. The
nurse may be called upon any time of the day
or night.
• Some claim that public health nursing is not
as exciting nor as glamorous as hospital
work.
 DISADVANTAGES OF
PUBLIC HEALTH NURSING
• Facilities for care of the sick are limited
so that practice or skills may also be
limited.
• The public health nurse may not be
immediately aware of changes nor trends
in fields of medicine or nursing.
• Public health nursing is not a place for
introverts. A nurse has to be outgoing to
meet people.
• There is no immediate supervisor to
consult in case of emergency.
NURSES IN IN-SERVIVE
EDUCATION PROGRAM
• In-service education programs have
been existence for many years both
in hospitals and public health
agencies. This is one way of
improving service in these agencies.
• Many tertiary hospitals and public
health agencies have nursery staff in
charge of staff development training
and research.
• Nurses in this field need:
• skills in nursing practice, therefore they must have
experience of at least two years in basic nursing;
• understanding of skills in teaching, supervision, and
consultation;
• understanding of the relationship of these persons to
the process of administration and research;
• understanding of the broad problem-solving approach
to resolve everyday problems in the practice of
nursing and in-service education in the areas of
concern;
• understanding of the role and the functions of the
revising personnel in this area of in-service education;
• understanding of self and others invo0lved in
in-service education within the various agencies in
nursing; and
• ability to plan and implement programs for different
kinds of nursing personnel.
 PRIVATE DUTY
NURSING
• Nurses in private practice are expected to
be expert clinicians as well as expert
generalist in nursing. They use the title
Private Duty Nurse, Private Nurse
Practitioner, Special Duty nurse or Private
Duty Nurse Specialists
• A private duty nurse is a registered nurse
who undertakes to give comprehensive
nursing care to a client on a one-to-one
ratio. She/he is an independent
contractor. The patient may be provided
care in the hospital or in the home.
Private duty nurse practitioners
are grouped into two categories.
• General Private Duty Nurse – Has the
capabilities for providing basic nursing care to
any type of patient, among which are:
– assessment of the physical conditions and
interpretation of the significance of her findings as
basis for planning her nursing care;
– identification of emotional and social factors and
relating these to signs and symptoms observed;
– application of scientific principles in the performance
in the nursing techniques;
– working with patient’s family so that the gain
understanding of his illness and cooperate towards
promoting early recovery of the patients;
– utilization of laboratory and diagnostic
tests in promoting progress of care and
enhancing her own usefulness as a health
teacher or counselor;
– knowledge and recognition of
pharmacological effects of drugs and
medications, their implications for nursing
action as needed; and
– interpretation’s of doctor’s orders
concerning medicines and treatments and
communicating the same effectively to
the patient and carrying them out
promptly, and accurately with
understanding of cause and effect.
• Private Duty of Nurse Specialist – In the
addition to the foregoing abilities expected of
the general nurse practitioner and as a result of
his/her specialized preparation he/she
demonstrates the following competencies:
• skills in handling and operating, and monitoring
other complicated devices.
• skills in interpretation of data gathered from
ECG, EEG, laboratory diagnostic results and
vital signs;
• skills in observation of signs and symptoms and
their favorable or untoward significance to
progress of patient care; and\
• promptness and adeptness in instating
appropriate nursing measures.
 ADVANTAGES OF PRIVATE
DUTY PRACTICE
• The chance to see life as it really is, to study human nature and
to know at close range interesting people of different
nationalities, cultures, religion, and status;
• The opportunity to make real friends through a close association
with the patient and his family;
• The chance to travel and to see the world;
• ability to own time, adjusting work and private life satisfactorily,
and directing off-duty time into enjoyable leisure;
• Keeping abreast with new knowledge and procedures which
provide an exciting, stimulating experience, with infinite variety
of problems to solve and personal satisfaction to be gleaned; and
• The challenge of giving his/her best in providing care and having
the satisfaction of seeing its results.
 DISADVANTAGES OF
PRIVATE DUTY PRACTICE
• Some private duty nurses create a situation in which
the patients become totally dependent on them.
• Many private duty nurses have graduated so long ago
and may not have upgraded their knowledge and
skills.
• There are not enough nurses for evening and night
shifts, for holiday, week-ends and vacation periods.
• Being a lone practitioner minimizes opportunity for
developing good relationships with other hospital
personnel.
• Some private duty nurse nurses supervision by
hospital staff.
 DISADVANTAGES OF
PRIVATE DUTY PRACTICE
• Little assistance is given by the Head Nurse when
the patient is critically ill and needs help in giving
treatment or in changing the position of the
patient. Sometimes the private duty nurse goes
without meals because the Head Nurse does not
arrange for relief when the patient cannot be
left alone.
• There is very little or no participation in
professional activities. If they ever do, they do
so on their own time and expense.
• Nurses who are very experienced and
well-qualified receive the same fees as the new
graduates.
 DISADVANTAGES OF
PRIVATE DUTY PRACTICE
Problems in private practice as an independent
contractor and need for liability insurance have
become bigger.
There are no retirement, insurance and medicare
benefits unless the private duty nurses provide
these for themselves.
The Private Duty Nurses Association of the
Philippines defined categories of the private
nursing practitioners in 1975. In February 1976, it
submitted to the Philippine Nurses Association the
proposal to revise the rates from a twelve-hour
basis to an eight-hour basis. This was approved.
 OCCUPATIONAL HEALTH
NURSING OR
INDUSTRIAL NURSING
• Occupational Health Nursing was once called industrial
nursing. In 1958, industrial nurses in the United States
elected to call themselves occupational health nurses to
reflect the broader and changing scope of practice within
the specialty.
• Occupational health nursing is the specialty practice that
provides for and delivers health care services to workers.
The practice focuses on promotion, protection, and
supervision of workers’ health within the context of a
safe and healthy work environment. Occupational health
nursing is autonomous and occupational health nurses make
independent nursing judgment in providing occupational
health services.
NURSING EDUCATION
• Career opportunities in teaching are
better today than ever before.
There is a chronic teacher shortage
in all education programs. Nurses
who like to consider teaching as their
field of choice shall have to consider
the following qualifications as per
R.A. 9173 (Appendix O). They
NURSING EDUCATION
• must be a Filipino citizen;
• must be a registered nurse in the Philippines;
• must have at least ONE (1) year of clinical
practice in a chosen field of specialization;
• must be a member of good standing in the
accredited national organization of nurses; and
• must be a holder of master’s degree in nursing
or other related fields.
• The practice of some schools to hire
under board nurses or those without
any experience as faculty members
contributes to the poor quality of
nursing students who later will become
incompetent nurses themselves. This
practice also subjects said nurses and
their employers to legal problems that
may arise later.
 PERSONAL QUALITIES AND
SPECIAL ABILITIES OF
FACULTY MEMBERS include:
– capability to promote interest in the subject they
teach; stimulate the minds of the students, arouse
enthusiasm, quicken imagination, and awaken
ambition;
– competence in the particular field they teach;
– resourcefulness with infinite patience,
understanding, confidence and perseverance. They
must be able to inspire students to develop to their
fullest potential; and
– expertise in providing care in the chosen field and
are good role models.
 Military Nursing
• The functions of the AFP Nurse Corps may be
grouped into
• Three (3) broad areas:
– to meet the nursing needs of today’s patients in AFP
medical facilities;
– to prepare each Nurse Corps Officer (regular and
reserve) for future assignments at a higher level of
responsibility in the different stations and general
hospitals in times of peace and war; and
– to teach and train enlisted personnel who perform
nursing function in settings where there are no
nurses.
•
 Flight Nursing in the Philippines
• One field of nursing that is considered peculiar only to the military
and to the Air Force is flight nursing or aero-space nursing. A
flight nurse is responsible for patients, military or other wise, who
have been evacuated from battle areas to the nearest installation
fro treatment.
• The aero-medical section of the different air bases of the
Philippine Air Force is tasked with carrying out this mission in line
with the overall objective of the AFP Medical Service which is to
conserve the fighting strength of the troops.
• A flight nurse is commissioned officer of the Nurse Corps in the
active service, usually assigned in AFP, and who has undergone
special training and instruction about flight nursing in the
Philippines or abroad. To be considered competent, he/she must
be:
• genuinely interested in flying and attending to patients even under
the
• most trying conditions around the clock; yet still able to perform
regular hospital nursing duties when not on flight alert.
 School Health Nursing
• School health nursing is very different from hospital
nursing. School health nurses must like children a
lot. They often work alone, out of touch from other
nurses, the hospital and all professional supports
they have known. They are responsible for activities
in the areas of health service, health education and
environmental health and safety.
• The primary function of the school is education.
Each school health program is geared toward making
the students and faculty understand those health
programs which emphasize health promotion,
prevention of disease, and follow-through of any
findings that may indicate and treatment. They
perform a wide variety of services including basic
screening for vision, hearing, and risk factors that
would interfere with the development of a healthy
lifestyle.
 ADVANTAGES OF SCHOOL
NURSING

• School nursing affords one the

opportunity to watch children advance
from grade to grade in school health.
Hours are usually good and there is no
shift duty.
 DISADVANTAGES OF
SCHOOL NURSING
• Many school nurses do not update
themselves on the current issues in nursing
making them unaware of changes in nursing
and nursing practice.
• School nurses should enjoy working with
children and should be able to work
through, and with, others to achieve their
objectives. They should accept the
educational functions of the school and be
committed to the promotion of health
through education.
 Clinic Nursing
Clinic nursing requires a nurse with general skills.
• The nurse acts as a receptionist, answers phone, does
the billing, takes x-rays and ECGs, changes dressings,
gives injections (such as BCD, DPT, or measles
vaccine), and assists in physical examination.
• The nurse may even do autoclaving of instruments,
keep records, order and stores supplies, make follow
calls and referrals for patients.
• Teaching patients and families has become an
important function of the clinic nurse.
•Nurses in this field must have
excellent teaching and
communication skills, exhibit
organizational and leadership
ability, possess good assessment
skills, and have good insight in
order to anticipate and interpret
the needs of their patients
ADVANTAGES OF
CLINIC NURSE
• favorable working hours
• satisfaction of working with people
they know and like and who know and
like them in return
• efficient clinic nurses are trusted in
their judgment and share in planning
the care of the patient.
 Advanced Practice
Nursing
• This field of nursing is synonymous with specialization.
even specialization is a hallmark of a mature discipline.
• Is the umbrella term for nurses who have specialized
education and experience beyond the basic nursing
program.
• It requires the knowledge skills obtained through
graduate study in nursing (either masteral or
doctoral). This field covers the roles of the clinical
nurse specialist.
 • The clinical nurse specialist is also known as
a nurse specialist, nurse clinician or clinical
specialist. The clinical specialist is an expert
practitioner within a specialized field of
nursing. Some may concentrate on:
• cancer
• rehabilitation
• care of patients with astomies, neurological
conditions, psychiatry, and many other
subspecialties
• these nurses participate in a range of sub-roles
including direct patient care, research, teaching,
consultation, and management.
 Independent Nursing
Practice
• As the term implies “ independent ” means the nurse is
self-employed and provides professional nursing
services to clients/patients and their families.
• While some independent nursing practitioners set up
their clinics near a hospital (as in the case of the
Psychiatric Nursing Specialists, Inc.) most of them are
community based
• These nurses reach out and offer their services rather
than expects clients to seek their help. They perform
both independent and collaborative roles.
• Health care assessment, formulating plans for health
maintenance, prevention strategies, continuation of
supportive activities in critical and complex health
problems are all within the scope of nursing practice.
• They make referrals and collaborate with physicians
and other disciplines as needed by the client or family.
• Independent nurse practitioners are accountable for
their decisions.
• Whether their role is independent or collaborative, it is
based on the fact that each health care discipline
offers an area of knowledge and expertise.
• Collaborative blending is needed for
effective, efficient, and economical
care. It is essential therefore that
independent nurse practitioners
acquire working knowledge of the
skills and expertise of other health
workers
Thank you
very much!