Professional adjustment and jurisprudence

PROFESSIONAL ADJUSTMENT

First Hospitals:

I – Iloilo

P - PGH
L – St Lukes
M – Mary Johnson
S –St Paul

Nsg is a profession.

• Profession – defined by PNA adapted from Americans NA
• a calling which its members profess to have acquired a unique body of knowledge & skills for purpose of guiding & caring others.
• Calling – service oriented
• Members – RN
• Unique – special body of knowledge
• Others – pt – recipient of care

Characteristics of nsg prof:

• A ccountability – liable for his/her actions
• C ompetency – having scientific knowledge
• E thics –
• S ervice oriented

Prof nsg resp: RA 9173 Oct 21,’02
Independent
Function:
1. Promotive, Preventive, Curative, Rehabilitative in all health care settings.
2. Preventive – immunization. Provide health education
3. Utilization of nsg process
4. Link of pts & families to diff community resources - community health nurses – libreng bakuna
5. Collaboration of pts care to other health care team - for continuity of care.
6. Resp for training/ supervision of nsg students
7. Accurate reporting/ recording.
8. Observation of S&Sx – provide proper intervention
Dependent fx 9. Execution of valid Dr’s order

General rule: RN can’t give meds without Drs order otherwise RN will be liable for malpractice.
Exception, under code of ethics, RN can give drugs during emergency, calamity, national epidemics, no MD around.
Life of patient is in danger. Protected under Good Samaritan Act.
Good Samaritan Act – universal law that protects any person who will give an aid to another person whose life is in danger.

RA 8344 – “ No deposit policy” during emergency cases.
emergency care 1st before asking for deposit.

Mom calls re: 2 yo girl ingested baby aspirin at home. What’s best action for RN to advice mom on phone.
1. Advice mom to bring kid to hosp
2. Advice to call doc
3. Advice to take emetic meds
4. Advice to call h nrse

Health teaching – child proofing the home! Aspirin should not be reached by kid.

• Principal – direct author of crime. Dispensable
• Accomplice – dispensable, crime will still happen without accomplice.
• Accessory – entered scene after the crime

LEGAL RESPONSIBILITIES
1. CONTRACTS/ CONSENTS – absence of coercion
char: V – voluntary – Free act. Independent act. Rational
O – opportunity to ask questions, suggestions & make recommendations
T – treatment, surgery, procedure – specifically explained to the patient by MD
U – understood by patient
M – matured physically – age 18 yo & above
Mentally – with sound mind, same & not an imbecile.

Substitute or proxy consent – if pt is mentally or physically incapable of giving consent
1. Parent
2. Guardian
3. Adliter – (not a relative!) DSWD, MD

2. ILLEGAL DETENTION – limit freedom of patient to move or travel from one place to another.
Hosp – promissory note or guarantee
HIV – don’t detain patient
High risk HIV transmission – felatio
Quarantine regulation – SARS, Meningococcemia, anthrax
- public safety is priority.

3. LAST WILL & TESTAMENT - a person in permitted by the law to control/ dispose of his estate.
Effect is only upon his death.

Decedent – person who died and left no will. The law will handle estate.
Testator / Testatoux – died and left a will
Testate succession – heirs will inherit under a last will and testament.
Illegitimate – entitled to ½ of what legit children will inherit
Kabit – will get nothing
Intestate Succession – without last will

2 types of last will & testament

1.) Properties 2.) Life/ Body
a) Ordinary will - Advance directives
- RN should check LOC of pt - pt is still alive giving instructions
-determine location of signature a) Living will – DNR,
- end of last word – last page organ donation, order for cremation
- sign all pages
- RN is part of 3 witnesses

b) Holographic will
handwritten by testator
dated and signed by testator
no need for witness


4. MEDICATONS/ PRESCRIPTIONS
Rules
1. MD, DVM, DMD – can prescribe meds
2. Should have :
a.) Name MD, PTR, PRC#, location of clinic/ hospital
b.) Name of patient, age, sex
c.) Information about drug – frequency duration
d.) Generic & brand name in prescription

RA 6675 – Generics Act
Should have BOTH generic & brand name on prescription

Impossible Prescription – generic & brand name does not correspond with each other.

3. Know 10 rights in giving meds
What is the right way to ask identity of patient
a. call patent by his name
b. check chart
c. verify name at nurses station
d. check name at identification wrist band
4. Telephone orders -
General rule - no telephone order
“Whatever is not written is not an order”
Exception – Emergency!
After MD says order – repeat instruction on phone
Have resident MD sign! Administer meds.
When MD arrives – have him counter sign his order

5. Documentation – recording/ charting
Purposes:

• C – communication
• A –assurance of quality
• R – research purposes
• L – legal document
• S – statistics source

SUBPOENA - an order from court
Duces Tecum (papers) – documents obj, materials, papers, chart
Ad Testificadum (person) – witness

Do’s & Don’ts of charting

Do’s Don’ts

• F – full, factual & accurate L – language – unacceptable
• L – legible I – improper corrections
• I – immediately after procedure S- spaces, skips
• P – personal notes, not delegated A – avoid using too much abbreviations

“addendum” – late entry

Negligence – failure to do something which a reasonable & prudent person should have done.

2 types:
1. Commission
2. Omission – total neglect of care – didn’t do anything

Elements to prove negligence
1. Duty
2. Failure to do his duty
3. Injury, harm, death= result

Malpractice – doing acts or conducts that you are not authorized/ licensed/ competent/ skilled to perform, resulting to injuries/ non injurious consequences
RN exceeding the scope of nursing practice & does an MD’s job.

Episioraphy – after proper training, RN can perform this procedure.

In absence of fetal & maternal aberration, RN can perform internal examination

RES IPSA LOQUITOR – the thing speaks for itself
obvious fault

FORCE MAJEURE - God nature – storm, earthquake, flood, - not liable

Fortuitous event – created by man – traffic not liable due beyond his control.


CRIMES AFFECTING RNs
Classification:
1.) Manner of its commission – dolo (deceit) – with criminal content
- culpa – (fault) – without criminal intention, negligence
2.)Stages of execution –
Consumated – all elements to commit crime were all present.
Frustrated – offender performs everything to consummate but it did not happen for reasons beyond his control
Attempted – overt acts – mere intensions to commit crime.

3.) Degree of participation
Principal – indispensable. Without the principal = no crime- author of crime
Accomplice – with or without accomplice = crime will happen
- dispensable, look out.
- enters scene before or during crime
Accessory – enters scene after crime is committed
conceals/ destroys evidence.

RA 7877 – anti sexual Harassment act
1. Any person who exercises authority (Prof & student, Dr & RN)
2. Asking sexual favors in exchange of another favor
Rape:
a.) Ordinary rape – forcible penetration of sex organ to a sex organ
b.) Sexual assault – anything forcibly inserted to any orifice.

Illegal abortion – termination of product of conception before the age of viability.

Infanticide – crime committed of person killed is age < 72h or <3days old
Parricide – killing of a person with relationship, ex. Bro in-law, sis, - relative
Homicide – killed a person to whom you have no relationship- product of negligence.
Murder – killing of a person with intension.

Simulation of birth – any person who shall substitute 1 child or identity of a child for the purpose of losing his civil status.

PD651 – Birth registration act
- requires any person (RN,OB, midwife, pilot) who shall assist in giving birth to report within 30 days without penalty any live birth at Local Civil Registrars Office.

RA 2808 – (y1919) – BON 1 chairman, 2 members = all RNs
1920 – 1st board exam

RA 9173 (Oct21,02)
BON qualifications

• M – masters in NSG
• A- accredited nsg org (PNA)
• S – seven (1 chairman, 6 members)
• I – immediately resign upon appointment
• N – not convicted of any crime

• P – pecuniary interest, absence of
• T – ten yrs experience (last 5 years hr in RP)
• C – citizen & resident of RP

DEAN qualification- RN + MAN + 5 yrs experience in nsg

Nurse Licensure Exam
1. Cert of Good Moral Char (Optional)
2. Proof – holder of Fil citizenship – Birth cert.
3. Proof – BSN degree – Transcript with scanned picture – done by reg.

NSG SERVICE ADMINISTRATOR

• S – supervisor head nurse/ ward/ shift/ day
• M – manager
• 
  
• C – chief nurse manage whole hosp
• D – director

Supervisor B – BSN holder – RN
Manager A – accredited nsg org PNA
N – Nine units nsg mgt
T – two years practice

Chief nurse RN+ MAN
Director 5 years supervisory experience

PD 223 - PRC – regulatory body to all profession in Phil

RA 1080 – Civil Svc Act
Automatic civil service eligible once you pass PRC nsg exam

RA 6425 (9165) – Dangerous Drugs Act

Prohibited – totally absolutely, can’t be used by human being.
Ex. Methaphetamine Hcl (Shabu) cocaine, cannabis

Regulated – can use this drug
with appropriate prescription
MD with appropriated license (BFAD, PDEA licence)
Valium, dormicum

Penalty for licensed health care provider
1. Fines
2. Imprisonment
3. Automatic revocation of license

RA 7600 – Mother Baby Friendly Hosp Act
early bonding of mom to child through breast feeding & rooming in technique
Sen. Flavier

December 1 – World AIDS day

RA 8981 – PRC modernization / Computerization Act
after 5 days – result of board exam will come out
June 11 – result
www.prc.gov.ph
results of board exam – Nurse
or txt 233 globe/ 136 smart
txt PRC (space) Rating (space) TABUENA,ABIGAILC

Registration. Sign in both of registry of BON
Special – can get license by reciprocity
RN in a foreign country & that country where you are registering has employment for Fil RN in their country


PROHIBITED / ILLEGAL PRACTICE OF NURSING
Imprisonment / jail 1-6 yrs / P50 – 100k fines

• L – license , without
• O – own (using as your own license of another)
• I – invalidated license + revoked , suspended
• S – sign name & attach title BSN, RN (not true)
• 
  
• F – falsification of documents (diploma, experiences)
• A – assist another person in illegal practice of nsg
• U – underwaging
• R – review/ training centers for RN not accredited by government
• A- any person violating this act