SUBMITTED BY:
Woody Vic Engle, R.N.
Maria Reylan Garcia, R.N.
Janelene Galindo, R.N.
A. Critique of 9173
By: Woody Vic Engle, R.N.
The following are the major changes from RA 7164 of 1991 and RA 9173 of 2002:
RA 7164 (November 21, 1991) The Philippine Nursing Act of 1991- introduced by Senator
Heherson Alvarez, codified and revised all the laws regulating the practice of nursing in the
Philippines.
1. Redefinition of the scope of the nursing practice to emphasize:
a.The use of nursing process as a scientific discipline in arriving at an appropriate nursing
action and care
b.The teaching, management, leadership and decision making roles of the nurse
c.The undertaking of and participation in studies and research by nurses
2. Requiring a faculty member who was appointed to the board of nursing to resign from his/her
teaching position at the time of appointment and not one year preceding his/her appointment as
provided in Republic Act 877
3. Updating a facultys educational qualifications by requiring a Masters Degree in Nursing or
related fields or its equivalent in terms of experience and specification as pre-requisite to
teaching
4. Specification of qualifications of administrators of nursing services
5. Inclusion of the phrase unethical conduct as one of the reasons for revocation and
suspension of certificate of registration.
RA 9173 (October 21, 2002) The Philippine Nursing Act of 2002
Subject: Amendments to Article XI- SANCTIONS OF CMO NO. 14, S. 2009 Policies
and Standards for Bachelor of Science in Nursing (BSN) Program
CMO 14
Gradual phase out of the nursing program with an average of below 30% for three- year
period ( SY 2010- 2011, 2011 2012, 2012 2013)
CMO 18
Gradual phase out of the nursing program with an average of below 30% for three
consecutive years ( starting 2008,2009, 2010 and thereafter), and will be monitored
starting 2011.
WEAKNESSES:
1. Deletion of the general entrance requirement of an applicant belonging to the upper
forty 40% of the graduating class in the general secondary course or high school.
2. Lesser number of cases (12: 3 actual deliveries; 3 cord care; 3 major operations scrub
nurse; 3 major cases circulating nurse) needed for scrub requirements for the
intrapartal, post-partal and intra-operative management.
3. The decrease in the number of years required of clinical practice in the field of
specialization for clinical instructors from 3 years to 1 year.
4. The student nurse from the first year up to the fourth year level is exposed to various levels of
health care with various client groups.
First year students are first immersed in self-awareness, so they may identify their roles
to their family, community and the society. Second year students focus on the care and
management of the mother and child. Third year students are trained in the care and
management of patients with physiologic and psychologic alterations. Fourth year
students focus on the disaster and emergency care as well as leadership, management and
research utilization. These opportunities shall be given in graduated experiences to ensure
that the competencies per course, per level and for the whole program are developed.
5. There are available Electives during the third and the fourth year levelElectives 1 and 2.
Elective 1 is taken in the 3rd Year 2nd Semester. Choices for Elective I are Parent-Child
Nursing, Spiritual Care Nursing, and Hospice Palliative Care.Elective 2 is taken in the
4th Year, 1st Semester. Choices for Elective II are Acute/Critical Care Nursing, Quality
Health Care and Nursing, and Care of the Chronically ill and the Older Person.
6. Recommendation of a Virtual Nursing skills laboratory.
Higher education institutions are encouraged to put up Virtual Skills Laboratory. This is
to supplement and complement the related learning experiences prior to actual
experience.
7. There is an existing provision on Research Requirements that all students shall complete a
research project during the course of study.
This will be regarded as a requirement for graduation. This is to encourage and support
research among its students and faculty and promote utilization of research findings to
guide and improve nursing practice, educational management and other aspects of the
nursing program.
8. Implementation of gradual phase-out of Nursing schools an average of below 30% for a threeyear period (SY 2010-2011, 2011-2012, 2012-2013) in the Philippine Nurse Licensure
Examination starting from 2013.
This is to fulfill the regulation function of the Commission of Higher Education among
the BSN programs. This is to maintain the quality and standard of nursing schools in the
country.
9. Deletion of the general entrance requirement of an applicant belonging to the upper forty 40%
of the graduating class in the general secondary course or high school.
This is a response to a constitutional provision that states: the state shall protect and
promote the right of all citizens to provide quality education at all levels and shall take
appropriate steps to make such education possible.
10. Lesser number of cases (12: 3 actual deliveries; 3 cord care; 3 major operations scrub
nurse; 3 major cases circulating nurse) needed for scrub requirements for the intrapartal, postpartal and intra-operative management.
This is as a response to be able to supply adequate number of cases for the completion of
scrub requirements for a considerably large population of nursing students.
11. The decrease in the number of years required of clinical practice in the field of specialization
for clinical instructors from 3 years to 1 year.
The decrease in the number of years of required clinical practice in the field of
specialization among clinical instructors as well as their Masters degree major expansion
was implemented to meet the increasing demands of clinical instructors to facilitate also
the mushroom growth of nursing schools following the rapid influx of nursing enrollees.
E. .Ethico-moral and legal cases and court decisions of actions
By: Janelene Galindo, R.N.
The types of ethics that are of particular concern to the nurse are:
1. BIOETHICS-branch of ethics that studies moral values in the biomedical sciences
2. CLINICAL ETHICS concerned with ethical problems at the bedside that arise
within the context of caring for actual patients
Ex.: Informed consent & how one ought to respond to requests for assisted
suicide
3. NURSING ETHICS study of ethical issues that arise in the daily practice of nursing
& of the analysis used by nurses to make ethical judgment
Ex.: cost-containment, breaches of patients confidentiality, illegal practices
of colleagues
MAJOR BIOETHICAL PRINCIPLES
1.Respect for person
a. The recognition of the equality possessed by every human being as unique, worthy,
rational, self determining creature having the capacity & the right to decide what is best
for himself
b. Responsibility of all to treat persons as an end never as a means
c.. The respect for persons autonomy(self governance). The person should be allowed to
determine his own destiny, to choose according to his own values to act accordingly
Doctrines of Negligence:
1. Res ipsa loquitor the thing speaks for itself
the injury is enough proof of negligence
2. Respondeat Superior let the master answer command responsibility
3. Force majuere unforeseen event, irresistible force
b. Malpractice stepping beyond ones authority
failure to act as a professional to demonstrate careful and thoughtful action.
(6) Elements of nursing malpractice:
1.Duty the nurse must have a relationship with the client that involves providing care and
following an acceptable standard of care.
2.Breach of duty the standard of care expected in a situation was not observed by the nurse-is
the failure to act as a reasonable, prudent nurse under the circumstances
-something was done that should not have been done or nothing was done
when it should have been done.
3. Foreseeability a link must exist between the nurses act and the injury suffered.
4.Causation it must be proved that the harm occurred as a direct result of the nurses failure to
follow the standard of care and the nurse should or could have known that the failure to follow
the standard of care could result in such harm.
5. Harm/injury physical, financial, emotional as a result of the breach of duty to the client
Example: physical injury, medical cost/expenses, loss of wages, pain and suffering.
6. Damages amount of money in payment of damage/harm/injury
3. False Imprisonment unjustifiable detention of a person without legal warrant to confine the
person Occurs when clients are made to wrongful believe that they cannot leave the place
Example: (1) Telling a client no to leave the hospital until bill is paid
(2) Use of physical or chemical restraints
(3) False Imprisonment Forceful Restraint - Battery
4. Invasion Of Privacy intrusion into the clients private domain; right to be left alone
Types of Invasion the client must be protected from:
a. Use of clients name for profit without consent using ones name, photograph for
advertisements of HC agency or provider without clients permission
b. Unreasonable intrusion observation or taking of photograph of the client for
whatever purpose without clients consent.
c. Public disclosure of private facts private information is given to others who have no
legitimate need for that.
d. Putting a person in a false/bad light publishing information that is normally
considered offensive but which is not true.
5. Defamation communication that is false or made with a careless disregard for the truth and
results in injury to the reputation of a person
(2) Types:
Libel - defamation by means of print, writing or picture
Example: writing in the chart/nurses notes that doctor A is incompetent because he
didnt respond immediately to a call
Slander - defamation by the spoken word stating unprivileged (not legally protected) or
false word by which a reputation is damaged
Example: 1. Nurse a telling a client that nurse B is incompetent
2. Person defamed may bring the lawsuit
3. The material (nurses notes) must be communicated to a 3rd party in order
that the persons reputation maybe harmed
Criminal Law deals with actions or offences against the safety and welfare of the public.
Classification:
1. Misdemeanor- less infarction of the law
-punishable by fine or imprisonment less than 1 year
2. Felony- more serious violation of the law
-punishable by longer imprisonment
INTENTIONAL FELONIES
1.
2.
3.
4.
5.
Parricide
Child abuse
Homicide
Infanticide
Abortion
6.
7.
8.
9.
10.
11.
Mutilation
Sexual harassment
Rape
Giving assistance in suicide
Physical injuries
Simulation of births
3.
4.
CPR-prolong suffering
Further deterioration caused by CPR
7. EMERGENCY CARE
8. FRAUD
9. ASSULT AND BATTERY
10. INVASION OF PRIVACY
11. MEDICATION ERRORS
NURSES OBLIGATIONS IN THE EXECUTION OF AWILL
The nurse should note the soundness of the patients mind
There was freedom from fraud or undue influence
Make a notation on the patients chart of the apparent mental and physical condition of
the patient at the time of making the will