PROFESSIONAL ADJUSTMENT,

NURSING LAW AND ETHICS

PREPARED by: MR. JOSEL D. MONTERO, BSN, RN, HAAD-RN

THE PHILIPPINE
NURSING LAW

Sections 7 and 8 of Act No. 2493

" Law regulating the practice of medicine.
" First Law to influence the practice of Nursing.
" An act providing the need for examination and

registration of nurses in the Philippines.

Section 7 and 8 of Act No. 2493

" REQUIREMENTS:
" 20 years of age
" Of good physical health
" Of good moral character

Act 2808 - MARCH 1, 1919

" FIRST TRUE NURSING LAW
" Creation of Board of Examiners Three Members
" Provided the holding of exam for the practice of nursing on

the 2nd Monday of June and December of each year.

" 1920 First Board Examination
" 93 candidates took the exam
" 68 passed
" Highest rating of 93.5% - Anna Dahlgren

THE PHILIPPINE NURSING LAW - RA 877

" RA 877
" PROVISIONS:
" Organization of BOE.
" Provisions regarding schools and colleges of nursing.

THE PHILIPPINE NURSING LAW - RA 877

" IMPORTANT PROVISIONS:
" Inhibition against practice of nursing
" Misdemeanor
Penalty: Not less than 1 year or more than 5 years

R.A. 4704
" SALIENT CHANGES:
" BOE: from three to five
" Appointment: President with consent of COA
" Board - MAN
" Age qualification not more than 65
" Dean MAN
" Examination - Adjusted to the closing of semester
" Applicant for exam - 18 years of age
" Nursing practice 21 years of age
" PNA and National League of Government Nurses - BON

R.A. 6136 - AUGUST 31, 1970

" Hypodermic and intramuscular injection
" IV with supervision of physician
" Not applicable to SN.

R.A. 7164
" PHILIPPINE NURSING ACT of 1991
" SENATOR HEHERSON ALVAREZ

Proclamation No. 539 OCTOBER 17, 1958

" Nurses Week
" Last week of October

R.A. 9173

THE PHILIPPINE NURSING ACT of 2002

" Repealed the R.A. 7164
" JULY 22, 2002
" Passed:
" SENATE: October 8 Senate Bill No. 2292
" HOUSE of REPRESENTATIVE: October 15 House

Bill No. 1084

" Approved: October 21 - PGMA

THE BOARD OF NURSING

14

THE BOARD OF NURSING

" COMPOSITION

Appointment Of Board Members

" REGULAR

" AD INTERIM

" HOLD-OVER DOCTRINE

APPOINTMENT PHASES
" NOMINATION

" RECOMMENDATION

" APPOINTMENT

Appointment Process
PNA
3 nominees per vacancy not later than 3 months before the
vacancy occurs

PRC
2 nominees per vacancy not later than 2 months before the
vacancy occurs

Office of the President

Appointment be issued not later than 30 days before the
scheduled licensure examination

THE BOARD OF NURSING

" QUALIFICATIONS OF THE BOM
" Natural born Filipino citizen.
" Member of good standing organization.
" RN
" Masters degree holder in Nursing, education or allied medical

profession.

" 10 years experience/continuous practice last 5 years in the Philippines.

" Must not have been convicted of any offense involving moral turpitude.

THE BOARD OF NURSING

" REQUIREMENTS UPON QUALIFICATION
" Immediately resign from any teaching position.

" Immediately resign from any office employment.

" Not have any pecuniary interest in, or administrative

supervision over any institution offering BSN including

review classes.

THE BOARD OF NURSING

" Term of Office

THE BOARD OF NURSING

" Compensation:
" MEMBERS
" CP

POWER, FUNCTIONS, and

RESPONSIBILITIES of the BOARD
" To regulate the practice of the profession.
" To conduct the licensure examination for nurses.
" To issue, suspend or revoke certificates of registration.
" To monitor the conditions affecting the practice of the profession.
" To adopt measures as may deemed proper for the enhancement of the

profession.
" To ensure quality nursing education.
" May conduct ocular inspections in coordination with the CHED.

POWER, FUNCTIONS, and

RESPONSIBILITIES of the BOARD
" To hear and investigate cases arising from the respected

laws, the rules and regulations promulgated thereunder

and the Code of Ethics.
" May issue subpoena and subpoena duces tecum.
" To delegate a hearing or investigation of administrative

cases.
" Submit an annual report to the Commission.

Different Powers of the Board

" DISCRETIONARY POWER:

" MINISTERIAL POWER:

Different Powers of the Board

" QUASI-LEGISLATIVE:

" QUASI-JUDICIAL:

Removal/Suspension of Board Members

" Continued neglect of duty

" Incompetence
" Toleration of irregularities in the NLE
" Unprofessional, immoral or dishonorable conduct

LICENSE TO PRACTICE NURSING

LICENSE

CONTINUING PROFESSIONAL
EDUCATION

CPE
" Refers to the inculcation, assimilation and

acquisition of knowledge, skills and proficiency.

Legal Basis of CPE

EO No. 266

CPE Council
" COMPOSITION:
" Each CPE Council shall be composed of one (1) chairman

and two (2)members.

" CHAIRMAN chosen by members of the Board.

" FIRST MEMBER President of Accredited Professional

Org.

" SECOND MEMBER President of any officer of the org. of

deans or department heads of schools, colleges or

universities offering courses requiring licensure
examination.

Need for LICENSURE

" PRIMARY PURPOSE of registration:

REVOCATION or SUSPENSION of
CERTIFICATION of REGISTRATION or LICENSE
" Unprofessional or unethical conduct.
" Gross incompetence and serious ignorance.
" Malpractice and negligence.
" Fraud, deceit, or false statement in obtaining a certificate of

registration/professional license or a temporary/special permit.

" Practice of profession during suspension.
" NOTE: SUSPENSION shall be a period of 4 years.

RE-ISSUNACE of REVOKED CERTIFICATE

" SUSPENSION: The LICENSE is NOT

CONFISCATED.
" REVOCATION: LICENSE is CONFISCATED.

RE-ISSUNACE of REVOKED and LOST

CERTIFICATE
" After the expiration period of four (4) years from

the date of revocation of a certificate.

" When the cause for revocation has disappeared or

has been cured and corrected.

" When the request is to replace lost, destroyed, or

mutilated certificate/license.

REGISTRATION

38

REGISTRATION

REGISTRATION by RECIPROCITY

REGISTRATION by RECIPROCITY

REGISTRATION by RECIPROCITY
" The requirements or licensing of nurses in said

country are substantially the same as those

prescribed under RA 9173.
" The law of such state or country grants the same

privileges to registered nurses of the

Philippines on the same basis as the subjects or
citizens of such foreign state or country.

REGISTRATION by RECIPROCITY
" PROOF of RECIPROCITY:

" RESIDENTIAL REQUIREMENT:

" PROOF:

REGISTRATION by RECIPROCITY
" Copy of the law or petition showing reciprocal

practice with the Phils.

" BSN Curriculum.

PRACTICE through SPECIAL/TEMPORARY

PERMIT
" Licensed foreign nurses whose service are either for a fee or

free if they are internationally well-known specialists or

outstanding experts in any branch or specialty of nursing.

" Licensed foreign nurses on free medical mission.

" Licensed foreign nurses employed by colleges of nursing as

exchange professor.

" EFFECTIVITY: Only during the duration of project, medical

mission, or employment contract.

REGISTRATION by EXAMINATION
" LICENSURE EXAMINATION

QUALIFICATIONS for ADMISSION to the

LICENSURE
" Filipino Citizen or Citizen of a country which permits

Filipino Nurses to practice in the said country.

" JUS SANGUINIS
" JUSE SOLI
" Of good moral character.
" BSN Degree Holder.

REQUIREMENTS for EXAMINATION

" TOR with date of graduation.
" RLE record.
" Actual number of OR cases and DR cases.
" NSO Birth Certificate.

RATING OF THE NLE

RATING OF NLE
" RENEWAL EXAMINATION:

" RECONSIDERATION OF RATINGS:

OATH TAKING

NURSING ETHICS

ETHICS
" ETHICS studies how people make judgment in

regard to right and wrong.

ETHICAL PRINCIPLES and APPROACHES

" TELELOGICAL APPROACH

ETHICAL PRINCIPLES and APPROACHES

" DEONTOLOGICAL APPROACH-DUTY

ORIENTED THEORY

VIRTUE ETHICS APPROACH

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" AUTONOMY

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" BENEFICENCE

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" NON-MALEFICENCE

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" VERACITY

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" FIDELITY

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" JUSTICE

UNIVERSAL PRINCIPLES OF BIO-ETHICS

" SOLIDARITY

THE CODE OF ETHICS FOR FILIPINO

NURSES

The Code of Ethics for Filipino Nurses

" ETHICAL CODES: systematic guides for

developing ethical behavior.

The Code of Ethics for Filipino Nurses

" DEAN EMERITUS JULITA V. SOTEJO
" CODE of GOOD GOVERNANCE
" Promulgated by the PRC on July 23, 2003.
" HALLMARK of a PROFESSION:
Willingness to accept a set of professional and ethical

principles.

ETHICAL PRINCIPLES
" REGISTERED NURSES AND PEOPLE
" Values, customs, and spiritual beliefs held by individuals shall

be respected. (RESPECT)
" Individual freedom to make rational and unconstrained

decisions shall be respected. (AUTONOMY)

" Personal information acquired in the process of giving nursing

care shall be held in strict confidence. (CONFIDENTIALITY)

ETHICAL PRINCIPLES
" REGISTERED NURSES AND PRACTICE
" Human life is inviolable.
" Quality and excellence in the care of the patients are the

goals of nursing practice.

" Accurate documentation of actions and outcomes of

delivered care is the hallmark of nursing accountability.

ETHICAL PRINCIPLES
" Registered Nurses are the advocates of the patients:

they shall take appropriate steps to safeguard their

rights and privileges.
" Registered Nurses are aware that their actions have

professional, ethical, moral, and legal dimensions.

They strive to perform their work in the best interest
of all concerned.

ETHICAL PRINCIPLES
" REGISTERED NURSES AND CO-WORKERS
" The Registered Nurse is in solidarity with other

members of the healthcare team

patients best interest.

in working for the

" The Registered Nurse maintains collegial and

collaborative working relationship

with
colleagues and other health care providers.

ETHICAL PRINCIPLES
" REGISTERED NURSES, SOCIETY, AND

ENVIRONMENT
" The preservation of life, respect for human rights, and

promotion of healthy environment shall be a commitment of

a Registered Nurse. (HEALTH PROMOTION)
" The establishment of linkages with the public in promoting

local, national, and international efforts to meet health and

social needs of the people as a contributing member of
society is a noble concern of a Registered Nurse. (NURSES
ARE LINKS IN THE PROMOTION OF HEALTH)

ETHICAL PRINCIPLES
" REGISTERED NURSES AND THE

PROFESSION
" Maintenance of loyalty to the nursing profession and

preservation of its integrity are ideal.

" Compliance with the by-laws of the accredited

professional organization (PNA), and other

professional organizations of which the Registered
Nurse is a member is a lofty duty.

ETHICAL PRINCIPLES
" Commitment to continual learning and active

participation in the development and growth of the

profession are commendable obligations. (CPE)
" Contribution to the improvement of the socio-

economic conditions and general welfare of nurses

through appropriate legislation is a practice and a
visionary mission.

CONFIDENTIALITY TO INFORMATION

CONFIDENTIALITY TO INFORMATION

CONFIDENTIALITY TO INFORMATION
" WHEN TO REVEAL:
" The patient himself/herself permits such revelation as in the case

of claim for hospitalization, insurance benefits, and among others.

" The case is medico-legal, such as attempted suicide, gunshot

wounds which have to be reported to the local police or NBI or

constabulary.
" The patient is ill of communicable disease and public safety may

be jeopardized.
" Given to the members of healthcare team if information is relevant

to his care.

Moral and Spiritual Responsibilities of RN

" MORAL PRINCIPLES
" Golden Rule
" Two-Fold Effect
" Totality
" Epikia

LEGAL ASPECTS AND THE RN

Professional Negligence
" Refers to the commission or omission of an act,

pursuant to a duty, that a reasonably prudent

person in the same or similar circumstance would
not do.

Elements of Professional Negligence

" Existence of duty
" Failure to meet standard
" Foreseeability of harm
" Injury

The Doctrine of RES IPSA LOUITOR

" Three conditions:
" There is a negligent act.
" The injury was caused by an agency within control of

the defendant.
" The plaintiff himself did not engage in any manner

that would tend to bring about the injury.

LEGAL DEFENSE in NEGLIGENCE

Malpractice

The Doctrine of FORCE MAJEURE

Incompetence

Fraud and Deceit

CONSENT TO MEDICAL AND

SURGICAL PROCEDURES

Essential Elements of Informed Consent

" The diagnosis and explanation of the condition.
" Fair explanation of the procedures to be done and the

consequences.
" Description of alternative treatments or procedures.
" Description of the benefits to be expected.
" The prognosis, if recommended care, procedure , is refused.

Proof of Consent

Who Must Consent

Consent for Minors

Consent of Mentally Ill

Emergency Situation

Refusal to Consent

Consent for Sterilization

INTENTIONAL WRONGS

TORTS

Assault and Battery

"ASSAULT:

"BATTERY:

False Imprisonment or Illegal Detention

Invasion of Right to Privacy and Breach of

Confidentiality

DEFAMATION

CRIMES

CRIME
" Defined as an act committed or omitted in

violation of the law.

Conspiracy to Commit A Crime

PRINCIPALS

ACCOMPLICES

ACCESSORIES

Criminal Actions
" MISDEMEANOR: general name for a criminal

offense which does not in law amount to felony.

" FELONY: public offense for which a convicted

person is liable to be sentenced to death or to be

imprisoned in a penitentiary or prison.

Criminal Negligence
" 2 Classifications:
" RECKLESS IMPRUDENCE
" When a person does not act or fails to do it voluntarily.

" SIMPLE IMPRUDENCE

" The person or nurse did not use precaution.

Criminal Intent
" Is the state of mind of a person at the time the

criminal act is committed, that is, he/she knows

that an act is not lawful and still decided to do it
anyway.

CLASSES OF FELONIES
" CONSUMMATED

" FRUSTRATED

" ATTEMPTED

DEGREES OF PUNISHMENTS
" GRAVE: Capital Punishment (Death); Imprisonment

ranging from six(6) years and one(1) day to life

imprisonment or a fine not exceeding Php6,000.00

" LESS GRAVE: Correctional (Imprisonment ranging

from one(1) month and one(1) day to six(6) years, or a

fine not exceeding Php6,000.00 but not less than
Php200.00

" LIGHT: Arresto Menor (Imprisonment for one(1) day to

thirty(30) days or a fine not exceeding Php200.00 or

both.

CRIMINAL LIABILITIES OF RN

MORAL TURPITUDE

MURDER

HOMICIDE

ABORTION

INFANTICIDE

PARRICIDE

ROBBERY and THEFT

Crimes Against Chastity

Crimes Against Civil Status

Crimes Against Public Interest

Circumstances Affecting Criminal Liability

" JUSTIFYING CIRCUMSTANCES
Self-defense.
Lack of provocation on the part of the person defending

himself.
Defense of the person or rights of another person.
Avoidance of an evil or injury to occur.
Fulfillment of duty

Circumstances Affecting Criminal Liability

" EXEMPTING CIRCUMSTANCES
An imbecile or an insane person, unless acted during lucid

interval.
Under nine.
A person over nine, and under fifteen unless he/she acted with

discernment.
A person under the compulsion of an irresistible force.
Any person who acts under the impulse of an uncontrollable

fear.

Circumstances Affecting Criminal Liability

" MITIGATING CIRCUMSTANCES
The offender has no intention to commit so grave a

wrong as the one committed.

The offender is under 18.
The offender is over 70.
There is sufficient provocation on the part of the

offended party immediately precedes the act.

Circumstances Affecting Criminal Liability

When the offender voluntarily surrenders himself to a

person in authority.
When the defender has some physical defect.
When the offender is suffering from an illness.

Circumstances Affecting Criminal Liability

" AGGRAVATING CIRCUMSTANCES
When an offender takes advantage of his public position.
When the act is committed with insult or in disregard of the

respect of the offended party.

When the crime is committed in a place of worship.
When the crime is committed on the occasion of a

conflagration, shipwreck, earthquake, epidemic, or other

calamity or misfortune.

Circumstances Affecting Criminal Liability

When the crime is committed in consideration of a price,

reward, or promise.
When the crime is committed by means of inundation,

fire, poison, explosion, standings of a vessel or

intentional damage thereto.
When craft , fraud or disguise is employed.

ADVANCED DIRECTIVE, LIVING WILL,

DURABLE POWER OF ATTORNEY, DNR ORDER

130

ADVANCED DIRECTIVE
" Advance directives are legal documents that

allow A person to spell out his decisions about

end-of-life care ahead of time. They give way to
tell client's wishes to family, friends, and health
care professionals and to avoid confusion later
on.

131

ADVANCED DIRECTIVE
" LIVING WILL: indicates what kind of medical

care, especially life-sustaining care, would or

would not like to receive if patients become
unable to speak for themselves.
" DURABLE POWER OF ATTORNEY: document

that names your health care proxy.

132

NURSING ASSOCIATIONS

Alumni Association

Professional Associations

Philippine Nursing Association

" Organized: OCTOBER 22, 1922
" FOUNDER: ANASTACIA GIRON TUPAS
" PRESIDENT: ROSARIO DELGADO

National League of Government Nurses

" FOUNDER: ANNIE SAND
" JANUARY 16, 1961

COMPREHENSIVE NURSING
SPECIALTY PROGRAM

PURPOSE
" To upgrade the level of skill and competence of

specialty nurse clinicians in the country

AREAS of the Nursing Specialty Program

" CRITICAL CARE
" ONCOLOGY
" RENAL
" OTHER AREAS to be DETERMINED by the

BOARD

OTHER INVOLVED AGENCIES

" The PNA
" Recognized specialty organizations
" The DOH

BENEFICIARIES
" At least 10% of the nursing staff of the

participating government hospitals.

" The beneficiaries of CNSP are obliged to serve in

any Philippine hospital for a period of at least 2

years of continuous service

FUNDING
" PCSO
" PAGCOR

ROLE of the DOH

" The annual fund shall be released to the DOH for

accounting and auditing procedures.

" Set criteria for the availment of the program.

FIELDS OF NURSING

INSTITUTIONAL NURSING
" Hospitals
" Nursing homes
" Clinics

QUALIFICATIONS
" BSN Degree Holder
" RN

MILITARY NURSE
" Natural born Filipino citizen
" Good moral character, pleasing personality
" Registered Nurse with 80%+ Board rating
" Must be single
" No older than 32 years of age at time of commission
" Female at least 5'2", male at least 5'4"
" Must be mentally and physically fit

148

" Pass the entrance exam and training.

NURSING SERVICE ADMINISTRATORS

" BSN
" RN
" 2 years experience in general nursing service

administration
" At least 9 units in management and

administration courses
" Member of PNA

CHIEF NURSE
" At least 5 years of experience in a supervisory or managerial

position in nursing

" Masters Degree in Nursing

" For PUBLIC HEALTH AGENCIES
" PRIORITY: Masters Degree in PUBLIC
" HEALTH/COMMUNITY HEALTH NURSING

" For MILITARY HOSPITALS

" Masters Degree in Nursing
" General Staff Course

PUBLIC HEALTH NURSING

" BSN
" RN

NURSING EDUCATION
" FACULTY
" BSN
" RN
" Member of PNA
" Masters Degree in Nursing, Education or other

allied medical and health sciences

" FOR DEAN: Masters Degree in Nursing + 5 years

experience (teaching and supervisory)

WILLS

Will
" Legal declaration of a persons intention upon

death.
" A.K.A. Testamentary Document

Types of Will
" TESTAMENTARY

" INTESTATE

" MIXED

155

Forms of Will
" HOLOGRAPHIC

" NOTARIAL or ORDINARY

156

Decedent
" A person whose property is transmitted through succession

whether or not he left a will.

" INTESTATE
" TESTATE
" TESTATOR
" TESTATRIX

Successor
" A person called to succession.
" HEIR
" HEIRESS

Administrator

Devisees and/or Legatees

160

Probate

Codicil

162

Escheat

163

ELEMENTS and CHARACTERISTICS of a

WILL
" It is a STATUTORY RIGHT

" It is a UNILATERAL ACT

" It is a SOLEMN and FORMAL ACT

" There must be ANEMUS TESTANDI

" The testator must have TESTAMENTARY CAPACITY

164

" The will is strictly a personal act

" It is effective MORTIS CAUSA
" It is essentially revocable
" It is free from vitiated consent
" It disposes of the testators state

165

COMMON LAWS AFFECTING

NURSING PRACTICE

Law
" The sum total of rules and regulation by which

society is governed.
" Man-made and regulate social conduct.
" 3 Essential Characteristics of A Law
" Authority
" Pronounced or Expressed
" Right to enforce must be provided

EXECUTIVE ORDER No. 51

" The MILK CODE

EXECUTIVE ORDER No. 209

" The FAMILY CODE.

LETTER OF INSTRUCTION No. 47

" INCLUSION OF FAMILY PLANNING IN ALL

ALLIED HEALTH COURSES

LETTER OF INSTRUCTION No. 949

" Legal BASIS OF PRIMARY HEALTH CARE.

PRESIDENTIAL DECREE No. 825

" IMPROPER GARBAGE DISPOSAL.

PRESIDENTIAL DECREE No. 996

" Legal BASIS of EPI.

PRESIDENTIAL DECREE No. 965

" FAMILY PLANNING and RESPONSIBLE

PARENTHOOD.

PRESIDENTIAL DECREE No. 651

" The BIRTH and DEATH REGISTRATION.

PRESIDENTIAL DECREE No. 856

" CODE of SANITATION.

PRESIDENTIAL DECREE No. 223

" Creation of PRC.

PRESIDENTIAL DECREE No. 603

" The CHILD and YOUTH WELFARE CODE.

REPUBLIC ACT No. 1082

" The RURAL HEALTH ACT.

REPUBLIC ACT No. 5181

" RECIPROCITY.

REPUBLIC ACT No. 6675

" GENERICS ACT.

REPUBLIC ACT No. 7305

" MAGNA CARTA of PHW.

REPUBLIC ACT No. 7600

" ROOMING-IN and BREASTFEEDING ACT.

REPUBLIC ACT No. 7610

" ANTI-CHILD ABUSE, EXPLOITATON and

DISCRIMINATION LAW.

END OF LECTURE
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