Salient aspects of the Philippine Nursing act law (RA 9173), Code of ethics and Legal responsibilities of nurses

Objective 1. RA 9173 2. Code of Ethics 3. Legal Responsibilities RA 2808 - very first nursing law RA 7164 - old nursing law - only had 5 members RA 9173 - new nursing law - Philippine Nursing Act of the year 2002 - a Revision of the old nursing law Composition of the Board of Nursing (BON) - 1 chairperson (RN, MAN only) - 6 members of the board (Major has to RN, MAN) - 7 in total Distinction between Amendment vs Revision - Amendment= to beautify/improve a low; teacher corrects paper with only few mistakes - Revision= rewrite the whole law; start all over; RA 9173 is a revision of the old nursing law Powers of BON (Section 9) - Conduct the Licensure Examination - Issue, suspend or revoke Certificates of Registration for the practice of Nursing - Monitor and enforce quality standards of Nursing Practice in the Philippines - Ensure quality Nursing Education - Quasi-Judicial power - Quasi-legislative power - Executive power - Promulgate the Code of Ethics

__________________________________________ Conduct NLE - Sec 12 - Sec 11 - Sec 5 Sec 12 - BON: conduct the licensure exam - PRC: set the date and venue of the exam - RA 8981: PRC Modernization Act Law Section 12 - All are required to pass the written board examination, which shall be given by the BOARD is such places and dates designated by the PRC. Provided, that it shall be in accordance with RA 8981, known as the PRC MODERNIZATION ACT LAW. PRC Modernization Act Law - the computerization of the board exam Section 11: Removal or Suspension of Board Members - Grounds for removal 1. Continued neglect of duty 2. Commission or toleration of irregularities in Licensure examination 3. Unprofessional, immoral or dishonorable conduct Duty of the BON 1. Prepare new set of question for the licensure exam 2. Preserve the integrity and honesty of the board exam Section 5: Qualification before Appointment to BON 1. Any person appointed to the BON shall immediately RESIGN form ANY EMPLOYMENT

2. Any person appointed to the BON shall not have any PECUNIARY INTEREST. Sec 5 summary 1. Resign 2. No pecuniary interest __________________________________________ Section 9: Issue the License - Sec 13 - Sec 15 - Sec 16 - Sec 17 Qualifications for Admission in the NLE: Section 13 1. FILIPINO CITIZEN (Natural Born or Naturalized FIlipino Citizen ) 2. BSN GRADUATE (Transcripts of record plus RLE Requirements 3. GOOD MORAL CHARACTER RA 6809 - Age of Majority: 18 years old Board Rating: Section 15 - An examinee must obtain a GENERAL AVERAGE OF 75% with no grade below 60% in one particular subject * Removal exam: 75% general average within 2 years * Controversial: Take the NLE for the Fourth time; law is still being amended Oath Taking: Section 16 - all qualified candidates are REQUIRED to take the oath before the BON or to any GOVERNMENT OFFICIAL authorized to administer the oath. * within 15 days of passing the board Professional Identification Card: Section 17 - License Number - Date of Registration

- Date of Issuance and Expiration - Signature of the Chairperson of the Commission * Renew on your birth month Certificate of Registration: Section 17 - Stamp given by the government that a person is now in possession of the knowledge, skills, and competence to practice the profession. - it shall show: 1. Name of the Registrant 2. Serial Number 3. Signature of the Chairperson of the Commission and the members of the Board 4. Official Seal of the Commission __________________________________________ Due Process of the Law - It is a law that HEARS first before imposing a punishment - TRIAL or HEARING before punishment Quasi-judicial power * BON monitor, enforce, ensure quality education and nursing practice * BON recommend the closure of a nursing school * CHED official that close of a nursing school Quasi-legislative power * make: policies, rules, regulation, guidelines, resolutions Executive Power - Section 8 - Section 6 - Procedure in the Appointment of BON Administrative Supervision of the Board, Custodian of its Records: Section 8 Office of the President V PRC (Custodian of All Records of BON) V

BON How to get Citizenship - Jus Sangguines: through blood - Jus Soli: place of birth * if born in an airplane, where the plane is registered is it's citizenship Procedure in The APPOINTMENT of BON - Per Vacant Position in the BON PNA Three (3) Nominees V PRC Two (2) Recommendees V President of the Philippines One (1) Appointee When can you be allowed to practice outside the territory of the Phils using your local License? - Under Section 20 by RECIPROCITY AND 21 by SPECIAL PERMIT of the RA 9173 - Reciprocity * "reciprocus"- re (back) and pro (forward) * "du et des"- I give that you may also give - an agreement established by law or treaty between two countries whereby each country grants to the citizens of the other the privilege of being admitted to the practice of professions Special Permit: Section 21 - well know Specialist or outstanding experts. (Internationally Recognized) - Free Medical Mission - Exchange of Professors Revocation and Suspension of License: Section 23 - for unprofessional or unethical conduct - for gross incompetence and serious ignorance - for the use of fraud, deceit, false statement in obtaining a Certificate of Registration - Malpractice - Negligence - Violation to the Code of Ethics __________________________________________ Res Ipsa loquitor (The thing speaks for itself) - the nurse failed to make used of appropriate judgement - the instrument used is within the exclusive control of the nurse - no voluntary participation on the part of the patient * all 3 has to be present Respondeat Superior (Let the master answer for the liability of his employee) - there must be an employer-employee relationship - the liability of the employee must be work-related * all elements must be present __________________________________________ Code of Ethics - Fundamental Responsibilities of a Nurse - Nurse should render services regardless of religious belief, political belief, or creed - Nurse should render services on any ground of medical neutrality - Nurse protects life and should respect the dignity of patient (by respecting pt bill of rights) - Nurse works in collaboration with the members of the health team Freedom of Religion - Two aspects of freedom of religion: a. Freedom to BELIEVE-ABSOLUTE b. Freedom to ACT-RELATIVE (It must be in conformity to the law, morals, customs and traditions) Ruling for Unconscious/Conscious Patient - if the patient is unconscious, all medical practitioners are authorized to perform anything to their patient which they think is best for the patient. (THERAPEUTIC PRIVILEGE) - if the patient is conscious, all medical practitioners are not authorized to perform anything to their patient which they think is best for their patient. Liability is BATTERY. Section 28. Scope of Nursing A person shall be deemed to be practicing nursing wihtin the meanin d o

Term of Office: Section 6 - BON shall serve for a period of 3 years - 3 kinds of Appointment 1. REGULAR APPOINTMENT when one is appointed to serve as a BON for a period of 3 years 2. AD INTERIM- when one is appointed to serve only for the unexpired period of term of a regular appointee 3. HOLD OVER- when the period of term is about to lapse, prescribe, or end, and the appointee is again requested to stay in power until such time that a newly appointed BON will take his/her place __________________________________________ Practice of the Profession - License- permission to practice the profession - considered as a PRIVILEGE/JURISDICTIONAL - not a right but a privilege * Fraudulent Misrepresentation: using another's license

....scope B .Establish Linkage with community resources C. Provide health EDUCATION to INDIVIDUALS, FAMILIES AND COMMUNITIES D. Teach, guide, and supervise the nursing students in nursing Programs - undertake in consultation services - engage yourselves in decision making skills BILL OF RIGHTS OF PATIENTS - Right to Information/Consent - Right to Make Decisions/Autonomy - Right to Privacy and Confidentiality - Right to Abode/Travel - Right to Quality Care Right to Self-Determination Justice Cardozo " A person who is of a sound mind and of legal age shall have the right to determine what is supposed to be done to his body" Rule in Giving Consent - Patient himself/ patient herself - If the patient is married the consent of the spouse is not necessary * void from the very beginning: parents married 16 you that is not sound of mind * Order of Priority: 1. Parents 2. Grandparents 3. Eldest Sibling 4. Uncles/Aunts 5. Godparents 6. Fianc 7. Best friend 8. Teacher * Patient with conflict: nurse side with patient

Privacy of Communication - Privacy of Communication shall be INVIOLABLE except upon: 1. the order of the Court 2. When Public Safety requires it * nurses are the custodian of the records * information is only release only when the pt gives permission Subpoena Ad Testificandum - court order directing a witness to appear at a given date and time Subpoena Duces Tecum - court order directing a witness to bring records, papers or medical charts Testimony of Facts - testifying only on what he knows based on facts Testimony of Opinion - may only be given by expert witness Expert Witness - one who is qualified to test based on based on special knowledge, skills, and training Perjury - false swearing under oath Privilege Against Self Incrimination - right not to answer any question that will incriminate him/her Hearsay Evidence - repetition of what the witness has heard others say Ante Mortem Statement - dying declarations, considered hearsay except when made by a victim of a crime

Liberty of Abode/Travel - Liberty of abode/travel shall not be impaired except; 1. Upon the order of the Court 2. When public safety requires it Tort - Legal wrong, committed against a person or property independent of a contract which renders the person who commits it liable for damages in a civil action. - Ex: Assault- imminent threat Battery- unconsented touching another of person False Imprisonment or Illegal Detention - unjustifiable detention of a person without a legal warrant. (Doctrine is liberty of abode) Invasion of Right to Privacy/Breach of Confidentiality - (Privacy of Communication) Defamation - character assassination, be it written or spoke Slander - oral defamation of a person by speaking unprivileged or false words by which his reputation is damage Libel - defamation by written words Malpractice Negligence Confidentiality - anything that is related to the health care of the pt

Privacy - anything that is not related to the health care of the pt Ethical Principles Beneficence: do good to your patient; during, after the act Non-maleficence: do no harm to your patient; before the act Veracity: tell the truth Justice: give what is due to the patient: management of resources, prioritize of pts, n-p ratio Fidelity: loyalty to one's patient; do what is promised Autonomy: right of patient to make the decision/right to self determination __________________________________________ Reapplication for a Revoked License: Section 24 - One has the right to reapply for a revoked license after the expiration of a MAXIMUM PERIOD of FOUR (4) years in the interest of Justice and Equity - Provided that the reasons for the revoked license had already been cured and corrected Inactive Nurses - Failure of one to practice the nursing profession for FIVE CONSECUTIVE YEARS will make on to be inactive - Requirements to be back in nursing profession: a. One (1) Month Diactic Training b. Three (3) Month Practicum In a Hospital Accredited by BON

__________________________________________ Qualifications of BON: Section 4 - Natural born Filipino Citizens and resident of the Philippines - Be a member f good standing of the Accredited Professional Organization of Nurses: - Be a registered Nurse and a holder of Master's degree in Nursing, Education or other Allied Medical Profession * old law RA 7164 stated only RN, MAN * new law RA 9173 included RN, MA Ed & RN, MA. Allied Medical Profession Qualifications of BON - Have at least 10 years of continuous practice of the profession prior to the appointment. * That the last 5 years of which shall be in the Philippines - Not have been convicted of any crime involving moral turpitude. BON - BON shall represent the following areas of nursing a. Nursing Education b. Nursing Service c. Community Health Nursing Qualification of the Dean: Section 27 - 5 years of Clinical Experience - RN, MAN Qualification of the Clinical Instructor: Section 27 - 1 year of Clinical Experience - RN, MAN or RN, MA.ED or RN, with ALLIED MEDICAL PROFESSION Qualification of the Chief Nurse - at least 5 years experience in Supervisory or Managerial Position - RN, MAN

Qualification of the Chief Nurse in the Military - at least 5 years of Supervisory or Managerial Position - RN, MAN and MASTERS DEGREE in the MILITARY STAFF COURSE Supervisor or Managerial Position: Section 29 - RN - 2 years of experience of General Service Administration - 9 units in Management and Administration Courses __________________________________________ Legal Responsibilities Will - is an act whereby a person disposes of his property to take effect after his death Testator/Testatrix: is a person who makes the will Probate: to prove the validity of the will in Court is know as a probate Escheat: when his property is transferred in the name of the Republic of the Philippines Two kinds of Will: 1. Holographic Will - when the testator entirely writes down the will. Date and signature of the testator should be indicated in the will 2. Notarial/Nuncupative/Authenticated Will - when the testator orally makes the will and will ask someone to write it down or him Two kinds of Succession: 1. Testate - when there is a will executed by the testator 2. Intestate - when there is no will executed by the testator by the testator - 1/4 Spouse, 1/4 Free Portion, 1/2 Distributed equal to Children

Living WIll Advanced Directives: - when a patient makes the directions as to what will be done to him just in case he/she can no longer make the decision Durable Power of Attorney: - when one patient appoints someone to make the directions as to what will be done to him Last WIll and Testament: - pertains to properties PD 651: registration of birth certificate after 50 days Contract - it is an agreement between two persons which creates an obligation recognized by the law - Elements of a valid Contract: a. Consent must be freely given b. Competent parties c. Legal Objects d. Valid Considerations Two Kinds of Contract 1. According to Format 2. According to Statement According to Format 1. Formal Contract - it is written down and it follows at all times the legal documents 2. Informal Contract - it is orally done or written down but it does not follow the legal documents According to Statement 1. Expressed Contract - the terms and conditions are written down and the beginning and ending of the contract are also expressed. e.g. Job Description 2. Implied Contract

- it is actually based on the reaction and behavior of the contracting parties Lawsuits - are proceeding in court - Purpose: * to enforce a right * to redress a wrong Parties: a. Criminal Action - Complainant - Respondent b. Civil Action - Plaintiff - Defendant Moral Turpitude - an act of baseness, vileness or depravity in social order - (Any act that is AGAINST THE LAW) - Kinds of Moral Turpitude 1. Murder - unlawful killing of human being with intent to kill. It is committed with Premeditated Intention ("Dolo"-Deceit) 2. Homicide - killing of a human being by another, It is committed Without Criminal Intent ("Culpa"-Fault) 3. Abortion - the expulsion of the product of conception before the age of viability 4. Infanticide - killing of the child less than 3 DAYS of age 5. Parricide - crime by reason of blood relationship on a direct line. It is committed by one who kills his/her father, mother, or child whether legitimate or illegitimate, and of his/her ascendants or descendants, his/her spouse or any of his legally adopted children

* not including siblings because they are at a collateral line 6. Robbery/Theft - crime against a property - Robbery is committed with FORCE upon persons or things 7. Controlled Substances - RA 9165 know as "The Comprehensive Dangerous Drug Act" covers the administration and manufacture, distribution, and dispensing of drugs 8. Simulation of Birth - getting a birth certificate without an actual birth 9. Substitution of Birth - switching Liabilities Principal 1. Direct Participation: - Doer, Executor, Performer 2. Inducement: -Order, Command, Influence, Convince, Persuade Accomplice - Before the Act - Essential, Material, Necessary Accessory - After the Act [Table Criminal Case: - for imprisonment - filed in Court - use of moral turpitude - Judge will: * Conviction- Guilty * Acquitted- Innocent - Complainant/Respondent - To attend: Subpoena testeficandum - Subpoena ducec tecum -Accused of: Homicide, Murder ect...

__________________________________________ Civil Case (Administrative Case) - for revocation/suspension of license - filed in PRC - conducted by the BON - Grounds for filling: Section 23 RA 9173 - To attend Summon - Subpoena ducec tecum - Accused of: Malpractice, Negligence ect...]

Circumstances that Affect Criminal Liabilities Exempting Circumstance 1. Imbecile or Insane person, unless he acted with lucid interval 2. the person is Under 9 years of age 3. Over 9 years but Under 15 unless he/she acted with Discernment (if they already know the consequences of their own action) 4. when it is a mere Accident 5. when the person acted under the Impulse of an Uncontrollable Fear 6. when the person acted under the Compulsion of an Irresistible Force * there will be no case Mitigating Circumstances 1. When the offender is Under 18 years or Over 70 years of age 2. When there is Voluntary Surrender 3. When there is Passion/Obfuscation (darken;confuse) 4. When there is Sufficient Provocation 5. When the person is Deaf-Mute, Dumb, or BLind 6. When there is No Intention to commit so grave a wrong as the one committed 7. Any kind of Mental Illness that will Diminish Will Power * lower the penalty by 1 degree * stacks for each circumstance * still liable

Aggravating Circumstances 1. When one takes Advantage of Public Position 2. When there is an Abused of Confidence 3. When the crime is committed Inside the Church 4. Wen the crime committed on the Occasion of FIre, Shipwreck, Earthquake, Epidemic or other Calamity 5. When it is committed because of a Price, Reward 6. When it is committed in times of Natural Calamities 7. When it is committed with Evident Premeditation 8. When it is committed with Craft, Fraud, and Disguise * raise the penalty by 1 degree Justifying Circumstance 1. When there is an Unlawful Aggression 2. When the person is Under Imminent Danger 3. When the means employed in order to Prevent or to Stop the aggression must be Reasonable * the law of self defense * all 3 elements MUST be present Definition Subpoena Ad Testificandum - court order directing a witness to appear at a given date and time Subpoena Duces Tecum - court order directing a witness to bring records, papers or medical charts Testimony of Facts - testifying only on what he knows based on facts Testimony of Opinion - may only be given by expert witness Expert Witness - one who is qualified to test based on based on special knowledge, skills, and training

Perjury - false swearing under oath Privilege Against Self Incrimination - right not to answer any question that will incriminate him/her * you cannot be be your own witness * Incriminating: use of imagination/mind * not incriminating: mechanical act; actions ex taking finger prints, pregnancy test Hearsay Evidence - repetition of what the witness has heard others say Ante Mortem Statement - dying declarations, considered hearsay except when made by a victim of a crime