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I.

PERSONAL AND PROFESSIONAL GROWTH AND DEVELOPMENT


a. Historical Perspectives in Nursing

The Philippine Nurses Association (PNA) established in 1922 was


responsible in lobbying our government for the adoption of the
recommendations made by the International Labor Organization in
1977 with regard the status of the economic and social welfare of
our nursing personnel. The Professional Regulation Commission of
the Philippines duly recognizes the PNA as the leading Association of
nurses in the country. In 1924, it published a standardized
curriculum for schools of nursing to adopt.

The following were the first groups interested and registered with
the Philippine Nurses’ Association (PNA), to wit:

 Academy of Nursing of the Philippines, Inc. (ANPHI)


 Association of Deans & Principals of Schools and Colleges of
Nursing of the Philippines (ADPSCNP)
 Association of Nursing Administrators of
the Philippines ( ANSAP)
 Association of Private Duty Nurse Practitioners of
the Philippines (APDNPP)
 Critical Care Nurses’ Association of the Philippines (CCNAP)
 Catholic Nurses Guild of the Philippines (CGNP)
 Golden Age Nurses Association (GANA)
 Ministry of Health National League of Nurses (MHNLN)
 Occupational Health Nurses Association of
the Philippines (OHNAP)
 Operating Room Nurses Association of
the Philippines (ORNAP)
 Philippine Nurse Midwifery Society
 Philippine Nursing Students Association (PNSA)
 Philippine Orthopedic Nurses Society
 Psychiatric Nursing Specialists Foundation of the Philippines,
Inc. (PNSI)
 Philippine School Nurses Association (PSNA)

The following are the later members of the PNA:

 Association of Diabetes Nurse Educators of


the Philippines (ADNEP)
 Graduate Nurses Christian Fellowship (GNCF)
 Integrated Nurses Association of the Philippines (IRNUP)
 National League of Philippine Government Nurses (NLPGN)
 Maternal and Child Nurses Association of
the Philippines (MCNAP)
 Military Nurses Association of the Philippines (MNAP)
 Philippine Oncology Nurses Association (PONA)
Philippine Orthopedic Nurses Society (PONS)
TIMELINE IN THE NURSING HISTORY:

• In the early dawn of human history, diseases or illness were


often related to superstitious beliefs and the treatment also
often involved magical cures.
• The Sumerian Civilization is believed to have recorded in a
clay-tablet 4,000 years ago some healing prescriptions but did
not specify the illnesses.
• The Code of Hammurabi traceable to the Babylonian empire in
1900 BC documented regulations pertaining to sanitation and
public health, the practice of surgery, differentiation in the
practice of human against veterinary medicine, a table of fees
for operations and penalties for violation of the code. During
these early days, nursing practice was vaguely described as
those who render comfort and support to patient. In the Old
Testament, it made mention of women as nurses who provided
care for infants and children, the sick and dying
• The Greek and Roman empires related the care of the sick and
those injured to the mythologies that they have created and
believed that the gods and goddesses possessed special
healing powers. Hygeia, daughter of Greek god Asklepios, the
chief healer, was revered to be the embodiment of the nurse.
• Ancient India – Nursing functions were being carried out by
male nurses provided they meet the four qualifications:
1. knowledge of the manner in which drugs should be
prepared for administration
2. cleverness
3. devotedness to the patient
4. purity of mind and body
• Christian Benevolence- “love thy neighbor as thyself” had a
significant impact on the development of Western Nursing.
• The principle of “Good Samaritan” is the basis of caring for
most Christians that eventually laid down some principles of
nursing.
• During the time of the Roman Empire, rich matrons such as
Fabiola used their wealth to provide houses of care and healing
that served as the early hospitals for the poor, sick and the
homeless.
• The Time of Crusades ( Holy mission or pilgrim to regain the
Holy land by the Christians), knights were trained to provide
care for the wounded soldiers in the battle – this is perhaps the
earliest recognition of men providing nursing care.
• Camillus De Lellis – considered the patron saint of nurses was
the founder of the Nursing Order of the Ministries who provided
care to the sick and the poor.
• Florence Nigthangle born from a wealthy family chose to
dedicate her life in providing care for the sick and injured
especially during the Crimean War. She also started a school to
train nurses in 1860, which eventually sparked the
development of Modern Nursing.

NURSING AS A PROFESSION
Profession - “ 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.”
• It is a calling that requires special knowledge, skill and
preparation.
• “ a calling in which its members profess to have acquired
special knowledge, by training or by experience or by both, so
that they may guide or advice or serve others in that special
field.”
A profession is generally distinguished from other kinds of
occupations/vocations by:
1. Requirement of prolonged, specialized training to acquire a
body of knowledge pertinent to the role to be performed usually
entrusted to higher education.
2. An orientation of the individual toward service, either to a
community or to an organization.
3. The members must be united and identified through their
membership and they must be clearly separated from the laypeople
or the ordinary congregations.
4. The society which it intends to serve has an indispensable need
for such services and which others cannot provide and the society
accepts it.
5. The techniques or skills applied are the product of scientifically
proven and long experience.
6. Requirement to exercise discretion and judgment as to the time
and manner of the performance of the duty.
7. The presence of common values, cultures, and norms uniquely
found among its members which are also being guided by its own
code of ethics.
8. The ability to continue its research to expand constantly its body
of knowledge.
Characteristics of a profession:
1. Autonomy – (independence and self-governance) the ability to
chart or carve its own destiny independent from others.
2. Authority – possession of highly advanced and competent
skills/mastery of such knowledge and skills not available to the
general public.
3. Accountability – responsibility/liability to own up its actions.
Nursing- “is primarily assisting the individual (sick or well) in the
performance of those activities contributing to health, or its
recovery (or to a peaceful death) that he would perform unaided if
he had the necessary strength, will, or knowledge. It is likewise the
unique contribution of nursing to help individual to be independent
of such assistance as soon as possible.” (Virginia Henderson, 1958;
1978)
Nursing is putting “the patient in the best condition for nature to
act.” This description/definition was given by Florence Nightangle,
dubbed as the first nursing theorist. She made use of the
environment (clean and healthy surrounding) in the recovery of an ill
patient.
Nursing- is the diagnosis and treatment of human responses to
actual and potential health problems (ANA).
• The common focus of nursing is the need to provide humanistic
and holistic care that includes the four areas related to health:
1. Health Promotion
2. Health Maintenance
3. Health Restoration
4. Care of the Dying
RA 9173 or the Philippine Nursing Act of 2002 gives the meaning of nursing
practice through the following:
-alone or in collaboration with another, initiates and performs
nursing services to individuals, families and communities in any
health care setting that includes:
1. nursing care during conception, labor, delivery, childhood,
adulthood and old age
2., promotion of health and prevention of illness.
3. collaboration with other health care providers for the
curative, preventive, and rehabilitative aspects of cares, restoration
of health, alleviation of suffering and when recovery is not possible
towards a peaceful death.
Nursing Practice – covers the three areas of nursing, namely:
nursing education, nursing service, and community health nursing
(Rule 1 Sect. 3 (d) IRR RA 9173).
Professional Nurse – a person whose name and
registration/professional license number is entered in the
Commission’s registry book and computerized database as legally
authorized to practice the nursing profession (Rule 1 Sect. 3 (e) IRR
RA 9173).
Practicing Professional Nurse- a person who is engaged in the
practice of nursing profession or is performing acts or activities,
whether regularly or occasionally, including one who is employed in
a government office or in a private firm, company or corporation
whose duties require knowledge and application of the nursing
profession (Rule 1 Sect. 3 (f) IRR RA 9173).
Foreign Professional Nurses – foreign nationals who, being licensed
professional nurses in their own countries, are authorized by
existing laws to practice their profession either as holders of a
certificate of registration and professional identification card or a
special/temporary permit in the Philippines subject to some
provisions of RA 9173 (Rule 1 Sect. 3 (g) IRR RA 9173).
Nursing Specialty Program – a training and development program
intended to develop/enhance the skills, to which a registered nurse
devotes himself /herself whether as a vocation or profession to
enable him/her to provide nursing service in specific areas in
accordance with the ethics of the profession and applicable law.

THEORETICAL FOUNDATION OF NURSING APPLIED IN HEALTH CARE SITUATIONS


Purposes of Nursing Theories and Conceptual Frameworks ( Kozier et al.,45)
• Provide direction and guidance for:
a. structuring professional nursing practice, education and
research
b. Differentiating the focus of nursing from other
professions.
• Assist nurses to describe, explain and predict everyday
experiences.
• Serves to guide assessment, intervention, and evaluation of
nursing care
• Provide a rationale for collecting reliable and valid data about
the health status of clients, which are essential for effective
decision making and implementation.
• Help to establish criteria to measure the quality of nursing care
• Help build a common nursing terminology to use in
communicating with other health professionals. Ideas are
developed and works defined.
• Enhance autonomy (independence and self-governance) of
nursing through defining its own independent functions.
• Provide a general focus for curriculum design
• Guide curricular decision making
• Offer framework for generating knowledge and new ideas
• Assist in discovering knowledge gaps in the specific field of
study
• Offer a systematic approach to identify questions for study,
select variables, interpret findings, and validate nursing
interventions
Concepts – are abstract ideas or mental images of phenomena or
reality. It can be concrete ideas that can be mentally pictured (eg.
Cars, cellphones, house); or it can be abstract ideas (eg.
Powerlessness, adaptation, nursing).
Nursing theories addresses the following four major concepts:
1. Person or client
2. Environment
3. Health/illness
4. Nursing
Conceptual Framework – group of related concepts. It can also be
viewed as an umbrella under which many theories can exist (Cresia
& Parker 1991,p7).
Conceptual Model - is a system of related concepts or a conceptual
diagram.
Model- graphic illustration of relationships.
Theory- is made up of concepts and propositions; however, a theory
accounts for phenomena with much greater specificity.
GENERAL THEORIES IN NURSING
Nightangle’s Environmental theory – Florence Nightangle,“the mother of
modern nursing” espoused her theory focusing on the environment.
She linked health with five environmental factors:
1. pure or fresh air
2. pure water
3. efficient drainage
4. cleanliness
5. light
Henderson’s Definition of Nursing - The definition of nursing given by
Virginia Henderson in 1955 became a milestone in the development
of nursing as discipline apart from medicine. The focus on her
Nursing Concept is to help individuals and families gain
independence in meeting the 14 fundamental needs;
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving and maintaining desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range by adjusting
clothing and modifying the environment
8. Keeping the body clean and well-groomed to protect the
integument
9. Avoiding dangers in the environment and avoiding injuring
others
(10)Communicating with others in expressing emotions, needs,
fears, or opinions
(11)Worshipping according to one’s faith
(12) Working in such a way that one feels a sense of
accomplishment
(13) Playing or participating in various forms of recreation
(14) Learning, discovering, or satisfying the curiosity that leads to
normal development and health, and using available health
facilities.
Rogers’s Science of Unitary Human Beings - Martha Rogers views the
person as an irreducible whole, the whole being greater than the
sum of its parts. Her Key concepts in describing the individual are
energy fields, openness, pattern and organization, and
multidimensionality. She described the Unitary Man as:
1. Irreducible, four-dimensional energy field identified by pattern.
2. Manifesting characteristics different from the sum of the parts
3. Interacts continuously and creatively with the environment
4. Behaving as a totality
5. Participating creatively in change
Orem’s Self Care Deficit Theory – Dorothy Orem developed the self-care
deficit theory that includes self-care, self-care deficit and nursing
system. She believed that the self-care of the individuals and the
self-care of dependents are learned behaviors that individuals
initiate and perform on their own behalf to maintain life, health, and
well-being. According to Rogers, there are three kinds of self-care
requisites:
1. Universal requisites ( common to everybody like maintenance
of air, water etc…)
2. Developmental requisites
3. Health deviation requisites
Roy’s Adaptation Model – Sister Callista Roy focuses on the individual as
a biophysical adaptive system. Both the individual and the
environment are sources of stimuli that require modification to
promote adaptation, an ongoing purposive response. Roy identified
three classes of stimuli:
1. Focal Stimulus: the internal or external stimulus most
immediately confronting the person and confronting the
behavior.
2. Contextual stimuli: all other internal or external stimuli present
3. Residual Stimuli: beliefs, attitudes, or traits having an
intermediate effect on the person’s behavior but whose effects
are not validated.
King’s Goal Attainment Theory – Imogene King based her theory from the
conceptual framework of three dynamic interacting systems:
1. personal system concepts: perception, self, body image,
growth and development, space and time
2. Interpersonal system concepts: interaction, communication,
transaction, role, and stress.
3. Social system concepts: organization, authority, power, status,
and decision making.
Neuman’s Health Care Systems Model – Betty Neuman views the client as
an open system consisting of a basic structure or central core of
energy resources (physiologic, psychologic, sociocultural,
developmental, and spiritual) surrounded by two concentric
boundaries or rings referred to as lines of resistance. She identified
individual’s response to stress and the nursing interventions to be
carried out on three preventive levels:
1. Primary prevention
2. Secondary prevention
3. Tertiary Prevention
Johnson’s Behavioral System Model - Dorothy Johnson defines a system as
a whole that functions as a whole by virtue of the interdependence
of its parts. A behavioral system is patterned, repetitive and
purposeful. Johnson’s key concepts describes the individual as a
behavioral system composed of seven subsystems:
1. attachment-affiliative subsystem provides survival and
security.
2. Dependency subsystem promotes helping behavior that calls
for a nurturing response.
3. Ingestive system satisfies appetite.
4. Eliminative subsystem excretes body wastes.
5. Sexual subsystem functions dually for procreation and
gratification.
6. Achievement subsystem attempts to manipulate the
environment.
7. Aggressive subsystem protects and preserves the self and
society within the limits imposed by the society.
Peplau’s Psychodynamic Nursing Theory- Hildegard Peplau introduced and
defined psychodynamic nursing as understanding one’s own
behavior to help others identify felt difficulties and applying
principles of human relations to problems arising during the
experience. She also described the nurse-patient relationship in four
phases:
1. Orientation – patient seeks help and the nurse assists patient
to understand the problem and the extent of need for help.
2. Identification - patient assumes a posture of dependence,
interdependence, and independence in relation to the nurse
3. Exploitation - patient uses available services on the basis of
self interest and needs
4. Resolution - old needs and goals are put aside and new ones
adopted.
Leininger’s Transcultural Care Theory – Madeleine Leininger established
the transcultural nursing which she defined as a major area of
nursing that focuses on comparative study and analysis of different
cultures and subcultures in the world, with respect to their:
1. Caring behavior
2. Nursing care
3. Health values
4. Beliefs
5. Patterns
– Jean Watson believes the
Watson’s Philosophy and Science of Caring
practice of caring is central to nursing; it is a unifying focus for
practice. According to her, there are two major assumptions that
underlie human care (carative factors):
1. care and love constitute the primal and universal psychic
energy
2. care and love are requisite for our survival and the
nourishment of the society
FIELDS OF NURSING
The Fields of Nursing may be classified in general as follows:
1. Hospital Nursing or the Institutional Nursing
2. Public Health Nursing
3. Community Health Nursing
4. School Nursing or Nursing Education
5. Occupational Health Nursing or Industrial Nursing
6. Military Nursing
7. Clinic Nursing
8. Independent Nursing Practice
9. Private Duty Nursing
Institutional Nurses- those employed as staff nurses or nursing
personnel in a hospital setting or similar institutions.
Public Health Nurse – is one who provides nursing care and counsel to
persons and families, either to individual or groups in clinics, in their
homes, in school, and at their place of work, and cooperates with
others in health promotion.
Community Health Nurse – a nurse whose work combines the element of
nursing and public health practice and takes place outside the
therapeutic institutions.
School Nurse – a registered nurse employed to work in educational
institutions to participate in health programmes for school-aged
children. Responsibilities include monitoring growth and
development, screening health problems and supporting those pupils
with special needs.
Occupational Health Nurse/ Industrial Nurse – one employed in industry
that gives immediate care to ill or injured workers, follows up on the
sick and the injured, and helps develop accident prevention and
health programs for the workers.
Maternal and Child Health Nurse – one who cares for and safeguards the
health of mothers and children.
Nurse Educator – a nurse employed in the teaching or administrative
staff of a school of nursing or other educational institution for
nurses.
Pediatric Care Nurse – a registered nurse qualified in the nursing care
of the sick child.
Private Duty Nurse – is a registered nurse who independently contracts
with a patient; a private duty nurse is responsible for the total
nursing care of the patient during the period she is with him.
Nursing Administrator – is a professional nurse who is a member of the
administrative staff of a hospital, medical center, public health
agency, or a similar institution and who, as a member of the
administrative staff, participates in formulating the policy and
objectives of such.
Clinical Nurse Specialist – A professional nurse, who has had special
training and experience in a particular clinical specialty, often holds
a degree, and is prepared to give expert care to the acutely or
chronically ill and to assist clients to maintain health.
ETHICO-MORAL RESPONSIBILITY
Ethics – part of philosophy that deals with systematic approaches to
questions of morality.
- a term for the study of how we make judgments regarding right and
wrong.
• a system of MORAL PRINCIPLES or moral standards governing
conduct.
Morals- human conduct in the application of ethics. Concerned with
JUDGMENT PRINCIPLES of right and wrong in relation to human
actions and character.
Nursing Ethics – the code governing the NURSE’S BEHAVIOR, especially
towards patients, employing authority and to the profession.
Beneficence - any action that would BENEFIT others. The principle
that imposes upon the practitioner to seek the good for the patients
under all circumstances. Beneficence connotes positive action
toward preventing or removing harm and promoting good such as:
1. One ought to prevent evil or harm
2. One ought to remove evil or harm
3. One ought to do or promote good.
Nonmaleficence – states the idea to REFRAIN from inflicting harm. “one
ought NOT to inflict evil or harm. The admonition of nonmaleficence
is stated in the negative manner while the beneficence is in the
positive.
Justice – The basic principle that deals with FAIRNESS, just deserts,
and entitlements in the distribution of goods and services. In health
care, justice seems to point to distributive justice that deals with the
allocation of scarce resources. ARTICLE XIII of the 1987 Constitution
provides: The State shall adopt an integrated and comprehensive
approach to health development and shall endeavor to make
essential goods; health and social services available to all people at
affordable cost. There shall be priority for the needs of the
underprivileged, the sick, the elderly and the disabled, the women
and the children. The State shall endeavor to provide free medical
care to paupers, establish and maintain an effective food and drug
regulatory system, and undertake appropriate health manpower and
development and research responsive to the country’s health needs
and problems. It shall establish a special agency for disabled
persons for their rehabilitation.
Some methods of distributing goods and services in our society are
as follows:
1. To each, an equal share
2. To each, according to need
3. To each, according to effort
4. To each, according to contribution
5. To each, according to merit
6. To each, according to ability to pay
Autonomy - In health care, it means the form of personal LIBERTY,
where the individual is free to choose and implement ones’ own
decisions, free from deceit, duress, constraint, or coercion. Three
Basic elements involved:
1. ability to decide
2. power to act upon your decisions
3. a respect for the individual autonomy of others.
Stewardship – refers to the actions made for by the health practitioner
IN BEHALF of the patient and for the greater benefit of the patient.
Truth Telling/Veracity – The patient must tell the truth in order that
appropriate care can be provided. The health practitioner needs to
disclose FACTUAL INFORMATION so that the patient can exercise
personal autonomy.
Confidentiality - is also known as PRIVILEGED COMMUNICATION which
refers to any information obtained by the nurse or the health team
during the course of caring for the patient. The information gathered
may only be disclosed under the following:
1. the patient agrees to divulge such information with written
consent
2. the information is material in a criminal case investigation
3. if public safety is jeopardized (communicable disease)
4. such information is relevant to his care to be utilized by other
health team
Priviliged Communication may be divided into two classes:
1. Absolute privileged communication – is one made in the
interest of the public service or the due administration of
justice and is practically limited to legislative and judicial
proceedings and other actions of the state.
2. Qualified privileged communication – is a slanderous statement
uttered in good faith, and made on a proper occasion, from a
proper motive, based upon a probable cause and in honest
belief that such statement is true.
MORAL PRINCIPLES
• GOLDEN RULE – “ Do unto others what you would like others do
unto you”. It is a basic moral principle that if you want others
to respect you, you must also accord respect to them.
• THE TWO FOLD-EFFECT - facing a situation which would have good
and bad effects requires the following basis for arriving a
decision:
a. that the action must be morally good
b. that the good effect must be willed and the bad effect
merely allowed
c. that the good effect must not come from an evil action
but from initial action itself directly; and
d. that the good effect must be greater than the bad effect.
• THE PRINCIPLE OF TOTALITY – states that the whole is always
greater than its parts. To save the patients’ life as a whole, it is
justified under this principle to surgically cut-off a disease body
part of the patient.
• EPIKIA – “exception to the general rule”. It is reasonable
presumption that the authority making the law will not wish to
bind a person in some particular case, even though the case is
covered by the letter of the law.
If a mentally ill patient becomes berserk and the doctor could not be
contacted, the patient may be restrained by virtue of epikia.
Another example of this is allowing a relative to see a seriously ill
patient who expresses the desire the relative although it is not yet
visiting hours
• THE END DOES NOT JUSTIFY THE MEANS – giving a sleeping tablet to
a chronically ill person so he/she can de in peace is morally
wrong.
• THE GREATEST GOOD FOR THE GREATEST NUMBER – during an
epidemic, immunization against communicable diseases is
administered to the people. Although there may be some who
may have slight reactions to the vaccine, the greater majority
of the population shall be considered.
• NO ONE IS HELD TO THE IMPOSSIBLE – the doctors and nurses are
not guarantors of life. They cannot be held liable as long as
they have done everything that modern medicine can afford to
save a patient from dying.
• THE MORALITY OF COOPERATION – formal cooperation in an evil act
is never allowed. A nurse shall not participate upon immoral
operations such as abortion even if the doctor commands it.
• PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION OF LIFE – mercy
killing or euthanasia is not allowed because it will lessen the
incentive to medical research. The state recognizes the
sanctity of life. It shall protect the life of the mother and the
unborn since conception. Any direct attack on the life of a fetus
for whatever cause is immoral. A fetus shall be buried in
consecrated grounds. If it is dead and came from dead mother,
it shall be buried with the mother.
Privacy – the right to be left alone or be apart from others. This right
is guaranteed by most civilized state laws and enshrined also in the
patients’ bill of rights. The patient has the right to every
consideration of his privacy concerning his own medical care
program. Case discussion, consultation, 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. This right also includes privacy of one’s thoughts,
opinions and physical presence and privacy of one’s records.
Informed Consent –The patient UNDERSTANDS the reason for the
proposed intervention, with its benefits and risks, and agrees to the
treatment by affixing his signature in the consent form. It generally
contains the following elements:
1. disclosure
2. understanding
3. voluntariness
4. competence
5. permission giving
• In our present jurisdiction under the 1987 Constitution, the age
of majority is 18 years old. It means that only 18 years old and
above can sign for themselves in legal matters such as the
signing of consent (hospital admission, contracts, will etc..)

The Patients Bill of Rights (Filipino)


1. The patient has the right to considerate and respectful care,
irrespective of socioeconomic status
2. The patient has the right to obtain from his physician complete
current information concerning his diagnosis, treatment and
prognosis in terms the patient can reasonably be expected and
understand. When it is not medically advisable to give such
information to the patient, the information should be made
available to an appropriate person in his behalf. He has the
right to know by name and in person, the physician and nurse
responsible in coordinating his care.
3. The patient has the right to receive from his physician
information necessary to give informed consent prior to the
start of any procedure and/or treatment. Except in
emergencies, such information for informed consent should
include but not necessarily limited to the specific procedure
and/or treatment, the medically significant risks involved, and
the probable duration of incapacitation. Where medically
significant alternatives for care or treatment exist, or when the
patient requests information concerning medical alternatives,
the patient has the right to such information. The patient has
also the right to know the name of the person responsible for
the procedures and/or treatment.
4. The patient has the right to refuse treatment/lifegiving
measures, to the extent permitted by law, and to be informed
of the medical consequences of his action.
5. The patient has the right to every consideration of his privacy
concerning his own medical care program. Case discussion,
consultation, 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.
6. The patient has the right to expect that all communication and
records pertaining to his care should be treated confidential.
7. The patient has the right to expect that within its capacity, a
hospital must make reasonable response to the request of
patient for services. The hospital must provide evaluation,
service and/or referral as indicated by the urgency of care.
When medically permissible a patient may be transferred to
another facility only after he has received complete
information concerning the needs and the alternatives to such
transfer. The institution to which the patient is to be
transferred must first have accepted the patient for transfer.
8. The patient has the right to obtain information as to any
relationship of the 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 him.
9. 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 or
participate in such research project.
10. The patient has the right to expect reasonable continuity
of care; he has the right to know in advance what appointment
times the physicians are available and where. The patient has
the right to expect that the hospital will provide a mechanism
whereby his physicians or a delegate of the physician of the
patient’s continuing health care requirements following
discharge informs him.
11. The patient has the right to examine and receive an
explanation of his bill regardless of source of payment.
12. The patient has the right to know what hospital rules and
regulations apply to his conduct as a patient.

The PATIENTS RESPONSIBILITIES towards his care in the hospital:


1. Providing information – It is a responsibility of the patient to
provide the staff with accurate and complete information,
to the best of his knowledge, about the history of his
illness, complaints. If the patient is unable to do so, then
her immediate family member may give such information.
2. Complying with instructions – the patient is responsible for
complying with the treatment recommended by the
attending physician or health team that is primarily
responsible for his care.
3. Informing the physician of refusal to treatment – A patient who
refuses treatment or to be compliant with the treatment
regimen must inform the physician of his decision.
4. Paying the hospital charges – upon admission, the patient
understands that he or she must pay the charges that he
or she may incur in th course of her treatment. The
exception is of course if the patient is admitted on charity
hospitals giving everything for free.
5. Adherence to hospital rules and regulations – the patient is also
governed by the rules and regulation of the hospital which
he or she is seeking medical help for his/her condition.
The patient or the immediate family member must read
the rules or must be informed about the policy of the
hospital and must adhere to them.
6. Consideration and respect for others – the patient must also
show respect for other patients admitted in the hospital.

NURSES’ BILL OF RIGHTS


1. Nurses have the right to practice in a manner that fulfills
their obligation to society and to those who receive
nursing care.
2. Nurses have the right to practice in environments that
allow them to act in accordance with professional
standards and legally authorized scopes of practice.
3. Nurses have the right to a work environment that
supports and facilitates ethical practice, in accordance
with the code of Ethics for nurses and its interpretive
statements.
4. Nurses have the right to freely and openly advocate for
themselves and their patients, without fear or retribution
5. Nurses have the right to a fair compensation for their
work, consistent with their knowledge, experience, and
professional responsibilities.
6. Nurses have the right to a work environment that is safe
for themselves and their patients.
7. Nurses have the right to negotiate the conditions of their
employment, either as individuals or collectively, in all
practice settings.

BASIC HUMAN RIGHTS ON RESEARCH SUBJECTS:


1. Right to informed consent
2. Right to refuse and/or withdrawal from participation
3. Right to privacy
4. Right to confidentiality
5. Right to be protected from harm

CODE OF ETHICS IN NURSING


• The fundamental responsibility of the nurse is fourfold: to
promote health, to prevent illness, to restore health and to
alleviate suffering.
• The need for nursing is universal. Inherent in nursing is respect
for life, dignity and the rights of man. It is unrestricted by
consideration of nationality, race, creed, color, age sex,
politics, or social status.
• Nurses render health services to the individual, the family and
the community and coordinate their services with those of
related groups.
The following Code for Nurses, adopted by the Council of National
Representatives of the International Council of Nurses was also
adopted by the Board of Nursing and became an integral part of the
amended “Code of Nursing Ethics in the Philippines”:
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 beliefs 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 responsibility for nursing practice
and for maintaining competence by continual learning.
The nurse maintains the highest standards of nursing care possible
within the reality of a specific situation
The nurse uses 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
profession.
Nurses and Society
• The nurse shares with other citizens the responsibility for
initiating and supporting action to meet the health and social
needs of the public.
Nurses and the 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
working conditions in nursing.
AMENDED CODE OF ETHICS FOR NURSES
Their conduct should be such that would bring credit to the
profession. Just like any other professional, nurses are looked upon
with respect in the community. They should therefore endeavor to
live a life that would uphold their self-respect.
Especially when nurses are on duty, they should try to look
neat and attractive. Female nurses are advised to use moderate
make-up and have a neat hairstyle. They should wear uniforms that
are not too short or tight fitting that would tend to restrict
movements, nor expose unnecessarily any part of the body while
giving care to the patients. Clean uniforms and clean bodies tend to
enhance the image of nurses. Use of anti-perspirant is advised most
specially during hot summer months.
Male nurses are likewise advised to be clean, shaven, hair
clipped close to the nape of the neck instead of flowing to the
shoulders.
The use of the uniform should be specified in the policy of the
hospital/agency. It should be worn only when on duty. Dining in the
public, shopping or going to the market while in uniform is
discouraged. Nurses’ caps are worn only while on duty. These are
either carried in bags or are left in their places of assignment.
Jewelry, such as earrings, necklaces or bracelets are not allowed
while on duty. However, wedding rings, school rings or school pins
may be worn.
Nurses are looked upon by nursing students as their role
models. Therefore, especially while they are on duty, they should act
in a manner that is worth emulating. Sincere and compassionate
attitudes toward patients are caught by those around them. Soon
their working environment becomes permeated with good working
relationships that are so vital in dealing with patients.

LEGAL RESPONSIBILITY
Legal Aspects in the Practice of Nursing
• The law has always governed the practice of modern nursing.
This what makes the every erroneous nursing action liable to
the law, either answerable to the Civil Law or the Criminal Law
or both. The key word to remember in the legal responsibility
of nurses is ACCOUNTABILITY. The professional nurse is
expected to render reasonably competent nursing care to avoid
getting entangled with the long arm of the law. Anything short
of such standard required that would cause harm or injury to
the patient makes the nurse responsible or liable to the law by
way of negligence or even malpractice suit. The safe way to
avoid such potential legal problems is amplified in the
Philippine Nursing Act of 2002 (RA9173) – that is, for nurses to
utilize the nursing process in the performance of their function
and observe the provision of RA 9173 which governs the
practice of nursing in the Philippines.
The Philippine Nursing Act of 2002 (RA 9173) Article VIII Section 35
enumerates the prohibitions in the practice of nursing: A fine of not
less than 50,000.00 nor more than 100,000.00 or imprisonment of
not less than 1 year nor more than 6 years, or both, upon the
discretion of the court, shall be imposed upon:
a. any person practicing nursing in the Philippines within the
meaning of RA 9173 of 2002:
1. without certificate of registration/professional license and
professional identification card or special temporary permit or
without having been declared exempt from examination in
accordance with the provision of this Act; or
2. who uses as his/her own certificates of registration/
professional license and professional identification card or
special/temporary permit of another; or
3. who uses an invalid certificate of registration/professional
license, a suspended or revoked certificate of
registration/professional license, or an expired or cancelled
special/temporary permit; or
4. who gives any false evidence to the Board in order to obtain a
certificate of registration/professional license, a professional
identification card or special permit; or
5. who falsely poses or advertises as a registered and licensed
nurse or uses any other means that tend to convey the
impression that he/she is registered and licensed nurse; or
6. who appends B.S.N./R.N. or any similar appendage to his/her
name without having been conferred said degree or
registration; or
7. who, as a registered and licensed nurse, abets or assists the
illegal practice of a person who is not lawfully qualified to
practice nursing.
b. any person or the chief executive officer of a juridical entity
who undertakes in-service educational programs or who
conducts review classes for local and foreign examination
without permit/clearance from the board and the Commission;
or
c. any person or employer of nurses who violate the minimum
base pay of nurses and the incentives and benefits that should
be accorded them as specified in Sections 32 and 34; or
d. any person or the chief executive officer of a juridical entity
violating any provision of this Act and its rules and regulations.

• An Act providing for more responsive nursing profession,


repealing for the purpose Republic Act 7164, otherwise known
as the “Philippine Nursing Act of 1991” and for other purposes.
(Note: The following presentation is the reproduction of RA 9173
with explanation on selected articles appearing in the italics)
ARTICLE I TITLE
SECTION 1. Title – This Act shall be known as the Philippine
Nursing Act of 2002.”

ARTICLE II DECLARATION OF POLICY


SECTION 2. Declaration of Policy . – It is hereby declared the policy of the
State to assume responsibility for the protection and improvement of
the nursing profession by instituting measures that will result in
relevant nursing education, humane working conditions, better
career prospects and a dignified existence for our nurses.
The State hereby guarantees the delivery of quality basic health
services through an adequate nursing personnel system throughout
the country.
ARTICLE III ORGANIZATION OF THE BOARD OF NURSING
SECTION 3. Creation and composition of the Board - There shall be created
a created a Professional Regulatory Board of Nursing, hereinafter
referred to as the Board, to be composed of a Chairperson and six
(6) members. They shall be appointed by the President of the
Republic of the Philippines from among the two (2) recommendees,
per vacancy, of the accredited professional organization of nurses in
the Philippines who possess the qualifications prescribed in Section
4 of this Act.
NOTE: The structure of the members of the Board of Nursing was augmented from
5 members under RA 7164 to 7 members in RA 9173. The chairperson shall have six
members, shall cover the three areas of nursing, namely: nursing education, nursing
service, and community health nursing. The members now are selected from two
recommendees coming from the endorsement of Accredited Professional Organization
(Philippine Nursing Association) which also pre-selected their endorsement not later
than three months prior to expected vacancy from three nominees per vacancy unlike
under RA 7164 where the President appoints the members from 12 nominees. The 7
positions in the Board of Nursing does not ( mandatory) require that all positions be
filled up in order to function ,if the majority positions are occupied then it constitute the
Board to function.


SECTION 4. Qualifications of the Chairperson and the Members of the Board.
The Chairperson and the Members of the Board shall, at the time of
their appointment, possess the following qualifications:
a. Be a natural born citizen and resident of
the Philippines;
NOTE: Natural born Filipino citizen are those Filipino who, since birth did not make any
positive act to perfect their citizenship.
b. Be a member of good standing of the accredited
professional organization of nurses;
NOTE: The Accredited Professional Association (APO) recognizes the Philippine Nurses
Association (PNA) as mentioned in the Implementing Rules and Regulation of RA 9173.
The other existing members of PNA mentioned in the preliminary chapter of this
reviewer are deemed also accredited to satisfy this requirement.
( c ) Be a registered nurse and holder of a master’s degree in
nursing, education or other allied medical profession conferred by a college or
university duly recognized by the government: Provided, That the majority
of the Members of the Board shall be holders of a master’s degree in
nursing: Provided, further, That the Chairperson shall be a holder of
master’s degree in nursing.
NOTE: The new requirement for the members of the Board is a departure from the
previous requirement requiring all members of the Board to be master’s degree holder
in Nursing. RA 9173 provides that only the chairperson and a majority (not all the
members) of the members must be master’s degree holder in nursing and the other
members may be master’s degree holder in education or other allied health profession.
(d) Have at least ten years (10) years of
continuous practice of the profession prior to appointment:
Provided, however, That the last five years (5) of which shall
be in the Philippines; and
NOTE: This new provision which was silent in the previous law allows the member of the
Board to qualify as a nominee even if she practiced nursing abroad, only that, the last
five years before the appointment, that member must have practiced her nursing
profession in the Philippines .
e.
Not have been convicted of any offense involving
moral turpitude;
Provided, That the membership to the Board shall represent the
three areas of nursing, namely: nursing education, nursing service
and community health nursing.
NOTE: Take note of the key word, convicted. An ongoing prosecution in a criminal case
does not constitute a hindrance to being nominated as a member to the Board because
the law speaks of conviction which means that a competent court had rendered already
its final decision on the case. If such member was convicted in the past for crime
involving moral torpidity, even if the penalty was served, is a prohibition to be
nominated in the Board.

SECTION 5. Requirements Upon Qualifications as Member of the Board of


Nursing.– Any person appointed as Chairperson or Member of the
Board shall immediately resign from any teaching position in any
school, college or university or institution offering Bachelor of
Science in Nursing and/or review program for the local nursing board
examinations or in any office or employment in the government or
any of its subdivision, agency or instrumentality thereof, including
government-owned or controlled – corporations or their subsidiaries
as well as those employed in the private sector. He/she shall not
have any pecuniary interest in or administrative supervision over
any institution offering Bachelor of Science in Nursing including
review classes.
NOTE: The qualification required by this Act means that they must be satisfied at the
time of Appointment. The President is the only person who can appoint such member of
the Board and such appointment commences only after the President approves through
her signature in the appointment paper. This further means that even if the nominee is
not yet qualified during the recommendation period, he/she shall have time to perfect or
satisfy all the requirements before the President signs her appointment. A member may
continue to teach in a nursing institution and may only resign during the time that she
is appointed.

The Chairperson and Members of the Board


SECTION 6. Term of Office.
shall hold office for a term of three (3 years) and until their
successors shall have been appointed and qualified: Provided, That
the Chairperson and Members of the Board may be reappointed for
another term.
Any vacancy in the Board occurring within the term of a member
shall be filled for the unexpired portion of the term only. Each
Member of the Board shall take the proper oath of office prior to the
performance of his/her duties.
The incumbent Chairperson and Members of the Board shall continue
to serve for the remainder of their term under RA 7164 until their
replacements have been appointed by the President and shall have
been duly qualified.
NOTE: The maximum number or years that a member can stay as a member of the Board
is six years because from their original appointment of three years, they are still
eligible to be re-appointed for another three years. However, the Hold-over doctrine
applies to this provisions because it specifically provides that a member shall continue
to hold office until their successors shall have been appointed and qualified.

SECTION 7. Compensation of Board Members. – The Chairperson and


Members of the Board shall receive compensation and allowances
received by the Chairperson and Members of other professional
regulatory boards.

SECTION 8. Administrative Supervision of the Board, Custodian of its Records,


Secretariat and Support Services. – The Board shall be under the
administrative supervision of the Commission. All records of the
Board, including applications for examinations, administrative and
other investigative cases conducted by the Board shall be under the
custody of the Commission. The Commission shall designate the
Secretary of the Board and shall provide the secretariat and other
support services to implement the provisions of this Act.
SECTION 9. Powers and Duties of the Board. – The Board shall supervise
and regulate the practice of the nursing profession and shall have
the following powers, duties and functions:
a. Conduct the licensure examination for nurse;
b. Issue, suspend or revoke certificates of registration for the
practice of nursing;
c. Monitor and enforce quality standards of nursing practice in the
Philippines and exercise the powers necessary to ensure the
maintenance of efficient, ethical and technical, moral and
professional standards in the practice of nursing taking into
account the health needs of the nation;
d. Ensure quality nursing education by examining the prescribed
facilities of universities or colleges of nursing or departments
of nursing education and those seeking permission to open
nursing courses to ensure that standards of nursing education
are properly complied with and maintained at all times. The
authority to open and close colleges of nursing and/or nursing
education programs shall be vested on the Commission of
Higher Education upon written recommendation of the Board.
e. Conduct hearings and investigations to resolve conduct and
violations of this Act, or its rules and regulations and in
connection therewith, issue subpoena ad testificandum and
subpoena duces tecum to secure the appearance of
respondents and witnesses and the production of documents
and punish with contempt persons obstructing, impeding
and/or otherwise interfering with the conduct of such
proceedings, upon application with the courts;
f. Promulgate a Code of Ethics in coordination and consultation
with the accredited professional organization of nurses within
one (1) year from the effectivity of this Act;
g. Recognize nursing specialty organizations in coordination with
the accredited professional organization; and
h. Prescribe, adopt, issue and promulgate guidelines, regulations,
measures and decisions as may be necessary for the
improvement of the nursing practice, advancement of the
profession and for the proper and full enforcement of this Act
subject to the review and approval by the Commission.
NOTE: The adoption and regulation of a Code of Ethics and Code of Technical Standards
for the practice of nursing are new addition in the powers of the Board included in this
law. The Board also exercises quasi-judicial powers because they can issue subpoena
duces tecum (court ordering the person to bring documents with himself to appear
before the court) and subpoena ad testificandum (court ordering the person to be
present before the court). The Board can also punish a person by way of contempt. This
power is exercised only by competent courts but the law delegates such powers to the
Board of Nursing through the legislation of RA 9173.Under this Act, the Board of nursing
now recognizes specialty organizations with the accredited professional organizations.

SECTION 10. Annual Report .


– The Board shall at the close of its calendar
year submit an annual report to the President of
thePhilippines through the Commission giving a detailed account of
its proceedings and the adoption of measures that will upgrade and
improve the conditions affecting the practice of the nursing
profession.
SECTION 11. Removal or Suspension of Board Members .
– The President may
remove or suspend any member of the Board after having been
given the opportunity to defend himself/herself in a proper
administrative investigation, on the following grounds:
a. Continued neglect of duty or incompetence;
b. Commission or toleration of irregularities in the licensure
examination; and
c. Unprofessional, immoral or dishonorable conduct.
NOTE: Only the President of the Philippines has the sole power to remove or suspend the
members of the Board of Nursing. The members of the Board being Presidential
appointees are the alter ego of the President, which means that they are under the
whims and caprices of the appointing officer with respect to their stay in the office.

ARTICLE IV EXAMINATION AND REGISTRATION


SECTION 12. Licensure Examination. – All applicants for licensure to
practice nursing shall be required to pass a written examination,
which shall be given by the Board in such places and dates as
maybe designated by the Commission: Provided, that it shall be in
accordance with Republic Act No. 8981, otherwise known as the
“PRC Modernization Act of 2000.”
NOTE: Specific dates as provided for in the previous law are no longer mentioned in the
new law. It used to be not earlier than one month and not later than two months after
the closing of each semestral term.

SECTION 13. Qualifications for Admission to the Licensure Examination.– In


order to be admitted to the examination for nurses, an applicant
must, at the time of filing his/her application, establish to the
satisfaction of the Board that:
a. He/she is a citizen of the Philippines, or a citizen or subject of a
country which permits Filipino nurses to practice within its
territorial limits on the same basis as the subject or citizen of
such country:
Provided: That the requirements for the registration or licensing of
nurses in said country are substantially the same as those
prescribed in this Act;
b. He/she is good moral character; and
c. He/she is a holder of a Bachelor’s Degree in Nursing from a college or university
that complies with the standards of nursing education duly recognized by the
proper government agency .
NOTE: Under the previous law, no examinee shall take the licensure exam below the age
of 18. It is no longer included in the new nursing law.

SECTION 14. Scope of Examination.– The scope of the examination for


the practice of nursing in the Philippines shall be determined by the
Board. The Board shall take into consideration the objectives of the
nursing curriculum, the broad areas of nursing and other related
disciplines and competencies in determining the subject
examinations.
NOTE: The scope of examination for nursing is determined by the Board of Nursing alone
and not in conjunction with the PNA or the PRC.

SECTION 15. Ratings.– In order to pass the examination, an examinee


must obtain a general average of at least seventy-five percent (75%)
with a rating of not below sixty percent (60%) in any subject. An
examinee who obtains an average rating of seventy-five (75%) or
higher but gets a rating below sixty-percent (60%) in any subject
must take the examination again but only in the subject or subjects
where he/she is rated below sixty percent (60%). In order to pass
the succeeding examination, an examinee must obtain a rating of at
least seventy-five percent (75%) in the subject or subjects repeated.
NOTE: specific number of times, which an examinee can take the licensure exam, is now
abolished under the new nursing law. It also deleted the mandatory requirement of
attending a refresher course after failure to pass the nurse licensure examination in
three takes. The removal to take the examination is within two years after the last
failed examination. The examinee who failed may take only the subject which she failed
if his/her average is 75 % but with a grade of below 60% in any subject. The law
however is silent about the prohibition of the examinee in taking the entire set of
examination. In the interpretation of laws – if the law is silent on a matter, then it must
be construed in favor to a side that is not onerous or burdensome to the people. To
retake the examination in a subject matter that the examinee failed the last time and to
target a rating of 75% in that subject area rather than 60% only if the person retakes
the entire set, is onerous on the part of the examinee. This provision must be construed
in favor of the examinee. He/She must have the option to retake the entire examination
with the original passing rate of 75% average with no grade below 60% in any subject
area or he/she may retake only that subject area where he/she failed the last time
provided he/she obtained an average of 75% or above

SECTION 17. Issuance of Certificate of Registration/Professional License and


Professional Identification Card . – A certificate of
registration/professional license as a nurse shall be issued to an
applicant who passes the examination upon payment of the
prescribed fees. Every certificate of registration/professional license
shall show the full name of the Commission and of the Members of
the Board, and the official seal of the Commission.
A professional identification card, duly signed by the Chairperson of
the Commission, bearing the date of registration, license number,
and the date of issuance and expiration thereof shall likewise be
issued to every registrant upon payment of the required fees.

SECTION 18. Fees for Examination and Registration .


– Applicants for
licensure and for registration shall pay the prescribed fees set by
Commission.
SECTION 19. Automatic Registration of Nurses. - All nurses whose names
appear at the roster of nurses shall be automatically or ipso facto
registered as nurses under this Act upon its effectivity.
NOTE: Though the law provides for the automatic enrolment in the roster of nurses after
passing the licensure examination, the Code of Ethics formulated under this Act invites
the nurse to become a member of the PNA.
SECTION 20. Registration by Reciprocity .
– A certificate of
registration/professional license may be issued without examination
to nurses registered under the laws of a foreign state or country:
Provided, That the requirements for registration or licensing of
nurses in said country are substantially the same as those
prescribed under this Act: Provided, further, That the laws of such
state or country grant the same privileges to registered nurse of the
Philippines on the same basis as the subjects or citizens of such
foreign state or country.

SECTION 21. Practice Through Special/Temporary A Permit-


special/temporary permit may be issued by the Board to the
following persons subject to the approval of the commission and
upon payment of the prescribed fees:
a. Licensed nurses from foreign countries/states 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;
b. Licensed nurses from foreign countries/states on medical
mission whose services shall be free in a particular hospital,
center or clinic; and
c. Licensed nurses from foreign countries/states employed by
school/colleges of nursing as exchange professors in a branch
or specialty of nursing;
Provided, however, That the special/temporary permit shall be
effective only or the duration of the project, medical mission or
employment contract.

SECTION 22. Non-registration and Non-issuance of Certificates of


Registration/Professional License or Temporary Permit. – No person
convicted by final judgment of any criminal offense involving moral
turpitude or any person guilty of immoral or dishonorable conduct or
any person declared by the court to be of unsound mind shall be
registered and be issued a certificate of registration/professional
license or a special/temporary permit.
The Board shall furnish the applicant a written statement setting
forth the reasons for its actions, which shall be incorporated in the
records of the Board

SECTION 23. Revocation and Suspension of Certificate of


Registration/Professional License and Cancellation of Special/Temporary
Permit .- The Board shall have the power to revoke or suspend the
certificate of registration/professional license or cancel the
special/temporary permit of a nurse upon any of the following
grounds:
a. For any of the causes mentioned in the preceding section;
b. For unprofessional and unethical conduct;
c. For gross incompetence or serious ignorance;
d. For malpractice or negligence in the practice of nursing;
e. For the use of fraud, deceit, or false statements in obtaining a
certificate of registration/professional license or a
temporary/special permit; or
f. For practicing his/her profession during his/her suspension from
such practice
.
Provided, however, That the suspension of the certificate of
registration/professional license shall be for a period not to exceed
four (4) years.
NOTE: Section 23 (f) is an addition in this new law. The suspended nurse cannot practice
nursing profession while serving his/her suspension orders. Take note of the maximum
period of suspension, it cannot go beyond four years.

S ECTION 24. Re-issuance of Revoked Certificates and Replacement of Lost


The Board may, after the expiration of a maximum of
Certificates.-
four (4 ) years from the date of revocation of a certificate, for
reasons of equity and justice and when the cause for revocation has
disappeared or has been cured and corrected, upon proper
application therefore and the payment of the required fees, issue
another copy of the certificate of registration/professional license.
A new certificate of registration/professional license to replace the
certificate that has been lost, destroyed or mutilated may be issued,
subject to the rules of the Board.
ARTICLE V NURSING EDUCATION
SECTION 25. Nursing Education Program. – The nursing education program
shall provide sound general and professional foundation the practice
of nursing.
The Learning experiences shall adhere strictly to specific
requirements embodied in the prescribed curriculum as promulgated
by the Commission on Higher Education’s policies and standards of
nursing education.

– Nurses
SECTION 26. Requirement for Inactive Nurses Returning to Practice.
who have not actively practiced the profession for five (5) years are
required to undergo one month of didactic training and three months
of practicum. The Board shall accredit hospitals to conduct the said
training program.
NOTE: this is a new provision providing for the guidelines of inactive nurses who wish to
return to practice their nursing career. Didactic training means a lecture program.

SECTION 27. Qualifications of the Faculty .


– A member of the faculty in a
college of nursing teaching professional courses must:
a. Be a registered nurse in the Philippines;
b. Have at least one (1) year of clinical practice in a field of
specialization;
c. Be a member of good standing in the accredited professional
organization of nurses; and
d. Be a holder of a master’s degree in nursing, education, or other
allied medical and health sciences conferred by a college or
university duly recognized by the Government of the Republic
of the Philippines.
In addition to the aforementioned qualifications, the dean of a
college must have a master’s degree in nursing. He/she must have
at least five (5) years of experience in nursing.
NOTE: The requirement for the clinical experience of a faculty was reduced from three
years in the previous law to only one year in the new law. The requirement for the dean
was increased from three years to five years in teaching and supervising a nursing
education program.
ARTICLE VI NURSING PRACTICE
SECTION 28. Scope of Nursing. A person shall be deemed to be practicing
nursing within the meaning of this Act when he/she singly or in
collaboration with another , initiates and performs nursing services
to individuals, families and communities in any health care setting.
It includes but not limited to, nursing care during conception, labor,
delivery, infancy, childhood, toddler, pre-school, school age,
adolescence, adulthood and old age. As independent practitioners,
nurses are primarily responsible for the promotion of health and
prevention of illness. As Members of the Health Team, nurses shall
collaborate with other health care providers for the curative,
preventive, and rehabilitative aspects of care, restoration of health,
alleviation of suffering, and when recovery is not possible, towards a
peaceful death. It shall be the duty of the nurse to:
a. Provide nursing care through the utilization of the nursing
process. Nursing care includes, but not limited to, traditional
and innovative approaches, therapeutic use of self, executing
health care techniques and procedures, essential primary
health care, comfort measures, health teachings, and
administration of written prescription for treatment, therapies,
oral, topical and parenteral medications, internal examination
during labor in the absence of bleeding and delivery. In case of
suturing of perineal laceration, special training shall be
provided according to protocol established;
b. Establish linkages with community resources and coordination
with the health team;
c. Provide health education to individuals, families and
communities;
d. Teach, guide and supervise students in nursing education
programs including the including the administration of nursing
services in varied settings such as hospitals and clinics;
undertake consultation services; engage in such activities that
require the utilization of knowledge and decision-making skills
of a registered nurse; and
e. Undertake nursing and health and health human resource
development training and research, which shall include, but not
limited to, the development of advance nursing practice;
Provided: That this section shall not apply to nursing students who
perform nursing functions under the direct supervision of a qualified
faculty: Provided further, That in the practice of nursing in all
settings, the nurse is duty-bound to observe the Code of Ethics for
nurses and uphold the standards of safe nursing practice. The nurse
is required to maintain competence by continual learning through
continuing professional education to be provided by the accredited
professional organization or any recognized professional
organization or any recognized professional nursing organization:
Provided, finally, That the program and activity for the continuing
professional education shall be submitted to and approved by the
Board.
NOTE: The new law deleted already the special requirement of undergoing IV therapy
training before a nurse can administer IV medications. However, the Nursing Service
Administrator still requires formal training in this aspect. The new law also added the
special training for suturing the lacerated perineum being undertaken by the Association
of Nursing Service Administrators with the Maternal and Child Association of the
Philippines ( MCNAP ).

SECTION 29. Qualifications of Nursing Service


Administrators.- A person occupying supervisory or
managerial positions requiring knowledge of nursing must:
a. Be a registered nurse in the Philippines;
b. Have at least two (2) years experience in general nursing
service administration;
c. Possess a degree of Bachelor of Science in Nursing, with at
least nine (9) units in management and administration courses
at the graduate level; and
d. Be a member of good standing of the accredited professional
organization or nurses;
Provided, That a person occupying the position of chief nurse or
director of nursing service shall, in addition to the foregoing
qualifications, possess:
1. At least five (5) years of experience in a supervisory or
managerial position in nursing; and
2. A masters degree major in nursing;
Provided, further, That for primary hospitals, the maximum academic
qualifications and experiences for a chief nurse shall be as specified
in subsections (a),(b), and (c) of this section: Provided, furthermore,
That for chief nurses in the public health agencies, those who have a
master’s degree in public health/community health nursing shall be
given priority. Provided, even further, That for chief nurses in
military hospitals, priority shall be given to those who have finished
a master’s degree in nursing and the completion of the General Staff
Course (GSC): Provided, finally, That those occupying positions
before the effectivity of this Act shall be given a period of five (5)
years within which to qualify.
ARTICLE VII HEALTH HUMAN RESOURCE PRODUCTION,
UTILIZATION AND DEVELOPMENT
SECTION 30. Studies for Nursing Manpower Needs, Production, Utilization and
Development.- The Board, in coordination with the accredited
professional organization and appropriate government or private
agencies shall initiate, undertake and conduct studies on health
human resource production, utilization and development.

Within ninety (90)


SECTION 31. Comprehensive Nursing Specialty Program.-
days from the effectivity of this Act , the Board in coordination with
the accredited professional organization, recognized specialty
organizations and the Department of Health is hereby mandated to
formulate and develop a comprehensive nursing specialty
program that would upgrade the level of skill and competence of
specialty nurse clinicians in the country, such as but not limited to
the areas of the critical care, oncology, renal and such other areas
as may be determined by the Board.
The beneficiaries of this program are obliged to serve in any
Philippine hospital for a period of at least two (2) years of
continuous service.
NOTE: The Board is mandated to formulate and develop a comprehensive nursing
specialty program that would upgrade the levels of skills and competency of specialty
nurse clinicians in the country. This is a new provision of the Nursing law.

SECTION – In order to enhance the general welfare,


32. Salary.
commitment to service and professionalism of nurses, the minimum
base pay of nurses working in the public health institutions shall not
be lower than the salary grade 15 prescribed under Republic Act No.
6758, otherwise known as the “Compensation and Classification Act
of 1989”. Provided , That for nurses working in local government
units, adjustments to their salaries shall be in accordance with
Section 10 of the said law.

SECTION 33. Funding for the Comprehensive Nursing Specialty Program .


– The
annual financial requirement needed to train at least ten percent
(10%) of the nursing staff of the participating government hospital
shall be chargeable against the income of Philipine Charity
Sweepstakes Office and the Philippine Amusement Gaming
Corporation, which shall equally share in the costs and
shall released to the Department of Health subject to the accounting
and auditing procedures: Provided, That the Department of Health
shall set the criteria of this program.
SECTION 34. Incentives and Benefits.- The Board of Nursing, in
coordination with the Department of Health and other concerned
government agencies, association of hospitals and the accredited
professional organization shall establish an incentive and benefit
system in the form of free hospital care for nurses and their
dependents, scholarship grants and other non-cash benefits. The
government and private hospitals are hereby mandated to maintain
the standard nurse-patient ratio set by the Department of Health.

ARTICLE VIII PENAL AND MISCELLANEOUS PROVISIONS


SECTION 35. Prohibitions in the Practice of Nursing .
- A fine of not less than
50,000.00 nor more than 100,000.00 or imprisonment of not less
than 1 year nor more than 6 years, or both, upon the discretion of
the court, shall be imposed upon:
a. any person practicing nursing in the Philippines within the
meaning of RA 9173 of 2002:
1. without certificate of registration/professional license and
professional identification card or special temporary permit
or without having been declared exempt from examination in
accordance with the provision of this Act; or
2. who uses as his/her own certificates of registration/
professional license and professional identification card or
special/temporary permit of another; or
3. who uses an invalid certificate of registration/professional
license, a suspended or revoked certificate of
registration/professional license, or an expired or cancelled
special/temporary permit; or
4. who gives any false evidence to the Board in order to
obtain a certificate of registration/professional license, a
professional identification card or special permit; or
5. who falsely poses or advertises as a registered and
licensed nurse or uses any other means that tend to convey
the impression that he/she is registered and licensed nurse;
or
6. who appends B.S.N./R.N. or any similar appendage to
his/her name without having been conferred said degree or
registration; or
7. who, as a registered and licensed nurse, abets or assists
the illegal practice of a person who is not lawfully qualified
to practice nursing.
(b.) any person or the chief executive officer of a juridical entity who
undertakes in-service educational programs or who conducts review
classes for local and foreign examination without permit/clearance
from the board and the Commission; or
( c ) any person or employer of nurses who violate the minimum
base pay of nurses and the incentives and benefits that should be
accorded them as specified in Sections 32 and 34; or
( d ) any person or the chief executive officer of a juridical entity
violating any provision of this Act and its rules and regulations.
NOTE: The new law also increased the penal provisions regarding violations of the
Nursing law. The fine was raised from the minimum 10,000 and maximum of 40,000 to a
minimum of 50,000 and maximum of 100,000.00.

ARTICLE IX FINAL PROVISIONS


SECTION 36. Enforcement of this Act .
– It shall be the primary duty of the
Commission and the Board to effectively implement this Act. Any
duly law enforcement agencies and officers of national, provincial,
city or municipal governments shall, upon the call or requests of the
Commission or the Board render assistance enforcing the provisions
of this Act and to prosecute persons violating the same.`

SECTION 37. Appointments . – The Chairperson of the Professional


Regulation Commission shall immediately include in its program and
issue such rules and regulations to implement the provisions of this
Act, the funding of which shall be included in the Annual General
Appropriations Act.

SECTION 38. Rules and Regulations .– Within ninety (90) days after the
effectivity of this Act, the Board of Commission, in coordination with
the accredited professional organization, the Department of Health,
the Department of Budget and Management and other concerned
government agencies, shall formulate such rules and regulations
necessary to carry out the provisions of this Act. The implementing
rules and regulations shall be published in the Official Gazette or in
any newspaper of general circulation.
SECTION 39. Separability Clause. – If any of this Act is declared
unconstitutional, the remaining parts not affected thereby shall
continue to be valid and operational.

SECTION 40. Repealing Clause .


– Republic Act No. 7164, otherwise known
as the “Philippine Nursing Act of 1991” is hereby repealed. All other
laws, decrees, orders, circulars, issuances, rules and regulations and
parts thereof which are inconsistent with this Act are hereby
repealed, amended or modified accordingly.
SECTION 41. Effectivity. – This Act shall take effect fifteen (15) days
upon its publication in the official publication in the Official Gazette
or in any two (2) newspapers of general circulation in
the Philippines.

 – Created for the ESTABLISHMENT OF NURSING SCHOOLS in


Act # 1931
the country under the Bureau of Education in 1909.
 Act # 1975 – An act that transferred the school of NURSING UNDER
THE BUREAU OF HEALTH.
 – An act that authorized the GRANTING OF THE TITLES of
Act # 2468
graduate in nursing and midwifery from the school of nursing of
Philippine General Hospital in 1915.
 Act # 2808 – This act provided for the earliest and TRUE NURSING
LAW that served as the basis of the practice of nurses in the
Philippines in 1919 and a year after its passage, the first local
licensure or board examination for nurses was held in 1920. The
First Board Examiners were created under act # 2808 composed
of three members then appointed by the Secretary Interior. The
chairman was a doctor of medicine and the other two are
registered nurses who must possess an experience in the nursing
profession for at least five years and with a reputable character.
 RA # 649 – provided for the standardization of nurses’ salaries both in
institutions and in public health.
 RA # 465 – an act which STANDARDIZED THE FEES charged by the
Examining Boards for Examination and Registration .
 RA # 546 – An act that reorganized and placed all the BOARD OF
EXAMINERS under the direct supervision of the President of
thePhilippines.
 RA # 877 – An Act also known as the “ Philippine Nursing Law of 1953 ”
approved on June 19, 1953. This Law was sponsored by Senator
Geromina T. Pecson which enacted “ to regulate the practice of
nursing in the Philippines and to set up provisions for the
registration of nurses, for the establishment and maintenance of
standards of nursing education and nursing practice”.
 RA # 1080 – This act approved on 1954 is also known as, An Act
Declaring the Bar and Board Examinations as “ CIVIL SERVICE
EXAMINATIONS ” which means that when a four year degree course
graduate had passed the board examinations or the Bar
examinations for lawyers they automatically become first grade
civil service eligible.
 RA # 997 – This Republic Act in 1954 ABOLISHED THE DIVISION OF
NURSING and created a decentralized organization with a chief
Public Health Nurse consultant in the office of the Secretary of
Health, and five consultant positions in nursing; namely, in
Maternal and Child Health, in Preventable Diseases, in
Institutional Nursing, in Nursing Education, and in Hospital
Standardization.
 RA # 4704 – This act in 1966 AMENDED THE PHILIPPINE NURSING LAW OF
1953 otherwise known as RA 877 and introduced some minor
revisions of the said act due to some developments of the
practice of nursing in the country.
 RA # 6136 – In 1971, This Republic Act introduced other MINOR
REVISIONS IN THE NURSING LAW of 1966 thus amending RA 4704 of
1966.
 RA 7164 – PHILIPPINE NURSING ACT OF 1991 was sponsored by Senator
Heherson Alvarez and was approved and signed by President
Corazon Aquino on November 21, 1991.
 ILO convention 149 and Recommendations 157 – In 1977, the Philippine
Nurses Association, formerly known as the Filipino Nurses
Association established in 1922 lobbied our government for the
adoption of ILO 149 and Recommendations 157 that were adopted
in Geneva. It set the concerns of employment of nursing
personnel and the CONDITIONS OF THE LIFE AND WORK OF NURSES and in
1978; the PNA passed The Declaration on the Economic and Social
Welfare of Filipino Nurses.
 Proclamation No. 539 – The President of the Philippines declared on
October 17, 1958 that the last week of October (through this
proclamation ) as the “ NURSES WEEK ”
 Presidential Decree No. 223 – This decree formed the PROFESSIONAL
REGULATION COMMISSION on June 23, 1973. Among its power is the
regulation of different profession which used to be under the Civil
Service Commission.
 RA 6511 – This Act Amended RA 465 in 1972,
which STANDARDIZED the examination and REGISTRATION fees
charged by the various Board Examiners.
 Letter of Instruction No. 1000 – this required that the members of
Accredited Professional Organizations (eg. PNA) shall be
given PRIORITY in the HIRING of employees in the government
service and in the engagement of professional services.
 RA 1612 – Refers to the payment of PRIVILEGE TAX before any
business or occupation can be lawfully begun or pursued.
 RA 7392 – This Act provided that only licensed midwives could
practice and that nurses must pass first the MIDWIFERY
EXAMINATION before they can practice midwifery
 RA 2382 – PHILIPPINE MEDICAL ACT ; defines the practice of medicine
in the Philippines. Section 10 of this Act provides: Act constituting
the practice of medicine. A person shall be considered as engaged
in the practice of medicine who shall for compensation, fee,
salary, or reward in any form paid to him directly or through
another or even without the same may physically examine any
person, and diagnose, treat, operate or prescribe any remedy for
any human disease, injury, deformity, physical, mental, physical
condition or ailment nature, real or imaginary, regardless of the
remedy or treatment administered, prescribed or recommended.
 RA 5181 – An act that prescribes PERMANENT RESIDENCE and
reciprocity as qualifications for any examination or registration
for the practice of any profession in the Philippines
 Presidential Decree 541 – a decree allowing former
Filipino (BALIKBAYANS ) professionals to practice their respective
profession in the Philippines.
 RA 6425 – “DANGEROUS DRUG ACT” enacted in 1972 declaring that
sale, administration, delivery, distribution, and transportation of
prohibited drugs are punishable by law.
 Act No. 3573 – This Act in 1929 declared that all COMMUNICABLE
DISEASES shall be REPORTED to the nearest health station, and that
any person may be inoculated, administered or injected with
prophylactic preparations.
 RA 1082 – creation of RURAL HEALTH UNITS in the Philippines.
 RA 4073 – liberalizes the LEPROSY TREATMENT. No person shall be
confined in leprosarium unless such disease requires institutional
treatment.
 Presidential Decree 996 – COMPULSORY IMMUNIZATION for all children
below eight years old.
 RA 8981 – “ PRC MODERNIZATION ACT OF 2000” This Act gave the
Professional Regulatory Commission its regulatory powers and is
now an agency of its own.
 Presidential Decree 825 – provided penalty for improper disposal
of GARBAGE and other forms of unclealiness.
 Presidential Decree 856 – CODE OF SANITATION, provides for control of
all factors in man’s environment that affect health including the
quality of water, food, milk, control of insects, animal carriers,
transmitters of disease, sanitary and recreation facilities, noise,
unpleasant odors and control of nuisance.
 Presidential Decree 148 – “ WOMAN AND CHILD LABOR LAW” The
employable age is 16 years and above and further provides for
the privileges of working women.
 RA 6365 – established a National Policy on Population and created
the Commission on Population ( POPCOM).
 PD 791 – revised population Act. Empowered nurses and midwives
to provide, dispense and administer acceptable METHODS OF
CONTRACEPTION after having undergone training and having been
granted authorization by POPCOM.
 PD 166 – Strengthened FAMILY PLANNING programs through
participation of private organizations and individuals in the
formulation and implementation of the program planning policies.
 General Order No. – enjoins all citizens of the Philippines,
18
universities, colleges, schools, government offices, mass media,
voluntary and religious organizations of all creeds, business and
industrial enterprises to promote the concept of family welfare,
responsible parenthood and family planning.
 Letter of Instruction No. 47 – directs all schools of medicine,
nursing, midwifery and allied medical professions and social work
to prepare, plan, and implement the INTEGRATION OF FAMILY
PLANNING in their curricula and to require from their graduates
sufficient appropriate licensing examination.
 Department of Labor Order No. 7 – requires all industrial
establishments to provide FAMILY PLANNING SERVICES.
 PD 48 – limits paid MATERNITY LEAVE privileges to four children.
 PD 69 – limits the number of children to FOUR for TAX
EXEMPTIONS purposes.
 PD 965 – requires that couples intending to get married must first
undergo a family planning and responsible PARENTHOOD
INSTRUCTION prior to the issuance of marriage license.
 RA 1054 – requires the owner, lessee or operator of any
commercial, industrial or agricultural establishment to furnish
free EMERGENCY , medical, and dental ASSISTANCE to his employees
and laborers.
 RA 4226 – HOSPITAL LICENSURE ACT requires all hospital in the
country to be licensed before it can offer to serve the community.
The licensing agency is the Office For Hospital and Medical
Services, Department of Health.
 RA 5901 – nurses working in agencies with 100-bed capacity
and/or above and are working in area of one million population
are supposed to WORK 40 HOURS A WEEK.
 PD 442 – LABOR CODE OF THE PHILIPPINES provides the right of the
workers to self-organization and collective bargaining agreement.
 PD 603 – CHILD AND YOUTH WELFARE CODE protects and promotes the
rights and welfare of children and youth.
 PD 651 – decrees the REGISTRATION OF BIRTH of a child within 30
days with the Civil Registrar.
 PD 1519 – MEDICARE BENEFITS TO ALL GOVERNMENT
EMPLOYEES regardless of status of appointment.
 PD 626 – EMPLOYEE COMPENSATION AND STATE INSURANCE FUND
 RA 6675 – GENERICS ACT OF 1998
 RA 6758 - standardized the salaries of government employees which
include the nursing personnel.
 RA 7160 – LOCAL GOVERNMENT CODE OF 1991 devolution of powers from
national to local government.
 RA 7305 – MAGNA CARTA FOR PUBLIC HEALTH WORKERS
 RA 7600– ROOMING-IN AND BREASTFEEDING ACT OF 1992 provides that
babies born in private and government hospitals should be
roomed-in with their mothers to promote breastfeeding and
ensure safe and adequate nutrition to children.
 EO 51 – MILK CODE
 RA 7432 – SENIOR does honor and justice to our
CITIZENS ACT
people’s long tradition of giving high regard to elderly. 20%
discount in all public establishments such as restaurants,
pharmacies, public utility vehicles and hospitals.
 PRC Resolution No. 2004-17 Series of 2004 – RE-IMPLEMENTED CONTINUING
PROFESSIONAL EDUCATION requiring sixty (60) credit units for three
years for professionals with bachelor’s degree

Contract – (Article 1305 New Civil Code) defines contract: A contract


is a meeting of minds between two persons whereby one binds
himself, with respect to the other, to give something or to render
some service.
• A contract, from the Latin word “contractus” and from the
French word “contract,” is “ a juridical convention manifested
in legal form, by virtue of which, one or more persons ( or
parties) bind themselves in favor of another or others, or
reciprocally, to the fulfillment of a prestation to give, to do or
not to do.”
• It is the agreement of two or more persons ( or parties ) for the
purpose of creating, modifying, or extinguishing a juridical
relation between them.
Characteristics of Contract
a. Freedom ( or liberty) to stipulate provided not contrary to law,
morals, good customs, public order, or public policy
b. Obligatory force and compliance in good faith
c. Perfection by mere consent as a rule
d. Both parties are mutually bound
e. Relatively ( Generally it is binding only between parties, their
assigns, and heirs)
• The contracting parties may establish such stipulations,
clauses, terms as they may deem convenient, provided they
are not contrary to law, morals, good customs, public order, or
public policy. (1306 NCC)
• The contracts must bind both contracting parties; its validity or
compliance cannot be left to the will of one of them.(1308 NCC)
• stipulates that contract takes effect only between the parties,
their assigns and heirs.(1311 NCC)
• any third person who induces another to violate his contract
shall be liable for damages to the other contracting party.
• Contracts are perfected by mere consent and from that
moment the parties are bound not only to the fulfillment of
what has been expressly stipulated but also to all the
consequences which, according to their nature, may be in
keeping with faith, usage and the law. (1315 NCC)

ESSENTIAL REQUISITES OF A CONTRACT


There is no contract unless the following requisites concur:
1. CONSENT
2. OBJECT certain which is the subject matter of the contract
3. CAUSE o f the obligation which is established
• CONSENT is manifested by the meeting of the offer and the
acceptance upon the thing and the cause which are to
constitute the contract.
• Consent must be given freely and voluntarily
• Consent must be given by a capacitated person
• Consent must not be vitiated
• Under the 1987 Constitution, the age of majority is now fixed
at 18 years old. This is now the legal age where a person can
sign or give consent to contracts or any valid legal acts. Thus,
by this provision of the constitution, there are no more
emancipated minors who can give consent in the Philippines.
• Insane or demented persons, and deaf-mutes who do not know
how to write cannot give consent.
• Contracts entered into during lucid intervals are valid
• Contracts agreed to in a state of drunkenness or during
hypnotic spell are voidable
• A contract where consent is given through mistake, violence,
intimidation, undue influence, or fraud is voidable.
• There is violence when in order to wrest consent, serious or
irresistible force is employed.
• There is intimidation when one of the contracting parties is
compelled by a reasonable and well grounded fear of an
imminent and grave evil upon his person or property, or upon
the person or property of his spouse, descendants or
ascendants, to give his consent.
• There is undue influence when a person takes improper
advantage of his power over the will of another, depriving the
latter of a reasonable freedom of choice.
• There is fraud when, through insidious words or machinations
of one of the contracting parties, the other is induced to enter
into a contract which, without them, he would not have agreed
to.
• OBJECT of contracts are all things which are not outside the
commerce of men, including future things
• All rights which are not intransmissible may also be the object
of contracts
• All services which are not contrary to law, morals, good
customs, public order, or public policy may likewise be the
object of contract.
• Impossible things or services cannot be the object of contracts.
• The object of the contract must be determinate as to its kind
• FORMS OF CONTRACT . (1356 NCC) Contracts shall be obligatory, in
whatever form they may have been entered into, provided all
the essential requisites for their validity are present
• However, there are times when the law requires that a contract
be in some form in order to be valid or enforceable.
• The following are void or inexistent contracts:
1. When the cause, object or purpose of the contract is contrary
to law, morals, good customs, public order, or public policy
2. When the contract is absolutely simulated or fictitious
3. When the cause or object of the contract did not exist at the
time of the making of the contract
4. If the object of the contract is outside the commerce of men
5. If the contract contemplates or intends a performance of an
impossible service
6. If the intention of the contracting parties cannot be ascertained
7. If the contract is expressly prohibited by law or declared by
laws as invalid or ineffective
• Voidable contracts are valid contracts until annulled by a
competent court
• The action to annul voidable contracts shall be brought within
four years. This period begins: In cases of intimidation,
violence or undue influence, from the time the defect of the
consent ceases.

SUCCESSION – is a mode of acquisition by virtue of which property,


rights, and obligations to the extent of the value of the inheritance,
of a person are transmitted through his death to another or others
either by his will or by operation of law. (774 NCC)
DECEDENT – is the general term applied to the person whose property
is transmitted through succession, whether or not he left a will. If he
left a will, he is also called the testator.
TESTATOR – a male decedent
DEVISEE – is a person to whom a gift of real property (eg. Land,
house) is given by virtue of a will
LEGATEE – is a person whom a gift of personal property (eg. Money,
Jewelry) is given by virtue of a will
• The inheritance includes all property, rights and obligations
which are not extinguished by his death
• The rights to succession are transmitted from the moment of
death of the decedent.
• An HEIR is a person called to succession either by the provision
of a will or by operation of the law.
WIILL – is an act whereby a person is permitted, with the formalities
prescribed by law, to control to a certain degree the disposition of
his estate, to take effect after his death.
• The making of a will is strictly personal act; it cannot be left in
whole or in part to the discretion of a third person, or
accomplished through the instrumentality of an agent or
attorney.
• All persons who are not expressly prohibited by law may make
a will
• Persons of either sex under eighteen years of age cannot make
a will
• In order to make a will it is essential that the testator be of
sound mind at the time of its execution.
• To be of sound mind, it is not necessary that the testator be in
full possession of all his reasoning faculties, or that his mind be
wholly unbroken, unimpaired, or unshattered by disease, injury
or other cause.
It shall be sufficient if the testator was able at the time of making
the will to know the nature of the estate to be disposed of, the
proper objects of his bounty, and the character of the testamentary
act.
• The law presumes that every person is of sound mind
• Testamentary Capacity is the capacity to comprehend the
nature of the transaction in which the testator is engaged at
the time to recollect the property disposed of and the persons
who would naturally be supposed to have claims upon the
testator and to comprehend the manner in which the
instrument will distribute his property among the objects of his
bounty.
• a married woman may make a will without the consent of her
husband, and without the authority of the court
• a married woman may dispose by will of all her separate
property as well as her share of the conjugal partnership or
absolute community property.(802 NCC)
• Every Will must be in writing and executed in a language or
dialect known to the testator(803 NCC)
• NOTARIAL WILL is a will that must be signed by the testator or if
written by some other person, it must be done in his presence
and under his express direction
• A notarial will or an ordinary will must be subscribed and
attested by three or more credible witnesses
• A notarial will must be acknowledged before a notary public
• If the testator be deaf, or a deaf-mute – he must personally
read the will if he is able to do so; otherwise, he must
designate two persons to read it and communicate to him in
some practicable manner its contents. If the testator is blind,
the will must be read to him twice; once, by one of the
subscribing witnesses and again, by the notary public before
whom the will is acknowledged.
• The requirement of the will must be in writing but it does not
mean that the testator must himself perform the mechanical
work of writing the will, except in the case of a holographic
will, which must be entirely written, dated and signed by the
hand of the testator himself.
• The requirement that the testator must sign the will is satisfied
by the use of his thumb mark, the sign of the cross, or the
initials or portion of the name of the testator.
• Where the testator directs another person to sign his name, it
is essential that the person so directed write the testator’s
name; it is not sufficient for the other to write his name only.
• HOLOGRAPHIC WILL is a will entirely written dated and signed by
the testator
• Any person of sound mind and of the age of eighteen years or
more, and not blind, deaf or dumb, and able to read and write,
may be a witness to the execution of a will.
The following are disqualified from being witnesses to a will:
1. any person not domiciled in the Philippines
2. Those who have been convicted of falsification of a document,
perjury or false testimony
• A will may be revoked by the testator at any time before his
death. Any waiver or restriction of this right is void
The following Will shall be disallowed in any of the following cases:
1. If the formalities required by law have not been complied with;
2. If the Testator was insane, or otherwise mentally incapable of
making a will, at the time of its execution
3. If it was executed by undue through force or under duress, or
the influence of fear, or threats;
4. If it was procured by undue and improper pressure and
influence, on the part of the beneficiary or of some other
person;
5. If the signature of the testator was procured by fraud;
6. If the testator acted by mistake or did not intend that the
instrument he signed should be his will at the time affixing his
signature thereto.
The law provides for the following kinds of Will:
1. Ordinary or Notarial Will
2. Holographic will
3. Mixed will

Criminal law – is that branch of law which defines crime and treats of
their nature.
• Ignorance of the law excuses no one from compliance therewith
• Laws take effect after 15 days from the publication in the
official gazette or any newspaper of national circulation. It
serves as a constructive notice to all persons so that no one is
exempted from complying with the law or to claim that he or
she is ignorant from the passage of that law.
• The power to define and punish an act is within the powers of
the Legislative Department (House of Congress) where the
legislative power is vested in the fundamental law and has the
power to define and punish an act or omissions as a crime. The
Chief Executive has also the prerogative.
• Limitations in enacting Penal Laws
1. G E NE RA LITY
2. T ER RITORIAL ITY
3. I RR ETROSP ECTIVITY OR PR OS PE CTIV ITY
• Limitations in enacting Penal Laws
1. it cannot enact an ex post facto law nor a bill of attainder
2. it must be of general application
3. it cannot provide for a cruel, degrading or inhuman punishment
nor can it impose excessive fines.
• Theories of Criminal Law
1. Classical Theory –
a. man is essentially a moral creature with an absolutely
free will to choose between good and evil and therefore
more stress is placed upon the result of the felonious act
b. Basic criminal liability is human free will and the purpose
of penalty is retribution.
c. Crime is a juridical entity and penalty is an evil and a
means of juridical tutelage
2. Positivist Theory – Man is subdued occasionally by strange and
morbid phenomenon which conditions him to do wrong in spite
of or contrary to his volition. The basis of criminal
responsibility of the criminal is his dreadfulness or dangerous
state.
• The major source of our criminal law is Act # 3815 otherwise
known as the Revised Penal Code of the Philippines that took
effect on January 1, 1932.
• Crime consists of internal and external acts. Internal acts are
not punished in our jurisdiction.
• Voluntariness is an element of felony because if an act is
committed or performed with deliberate intent then it implies
that the act is voluntary or freely committed.
• Felony is an act or omission punishable by the law
• A felony may be committed by means of DOLO (deceit) or CULPA
(fault)
• The distinction of dolo and culpa: while both are voluntary,
dolo is intentional, whereas culpa is not. Where there is intent
there can be no negligence. In culpable felonies, intent is
replaced by fault.
• Dolo (deceit) involves malice or deliberate intent; culpa
(fault) results from negligence , imprudence, lack of
foresight or lack of skill.
• Imprudence is deficiency in action
• Negligence is deficiency of perception.
• Negligent act must be voluntary- example ( an incidental
dropping of pistol and fired and hit someone, there is no
liability )
Elements of Dolo :
1. Freedom
2. Intelligence
3. Intent
Elements of Culpa:
1. Freedom
2. Intelligence
3. Negligence or imprudence
• Intelligence – is the moral capacity to determine what is right
from what is wrong and to realize the consequences of one’s acts.
• Intent – is a mental state, the existence of which is shown by
the overt acts of a person.
• A crime may be committed without criminal intent by means of
culpa and offenses punishable by special laws.
• Criminal liability shall be incurred by any person committing a
felony although the wrongful act done be different from that
which he intended. By any person performing an act which
would be an offense against persons or property, were it
not the inherent impossibility of its accomplishment or on
account of the employment or inadequate or ineffectual means.

STAGES OF FELONY
1. Consummated – all elements necessary for execution and
accomplishment are pesent.
2. Frustrated – the offender has performed all the acts of execution
to produce the felony as a consequence but the crime does not
result due to some cause independent of the will of the
offender.
3. Attempted – the offender begins the commission of the felony by
direct overt acts but does not perform all the acts of execution
which should produce the felony as a consequence by reason of
some cause or accident other than his own spontaneous
desistance

SUBJECTIVE & OBJECTIVE PHASE OF FELONY : The subjective phase is that


portion of execution of the crime starting from the point where he
still has the control of his acts. If it reaches the point where he has
no more control over his acts, the subjective phase has passed. If
the subjective phase is not yet passed, the felony would be mere
attempt. If it has already passed but the felony is not yet produced,
as a rule it is frustrated.
Objective phase is the result of the acts of execution that is the
accomplishment of crime. Consummated.

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY


1. Justifying Circumstance – the acts of the actor are in accordance
with the law , hence he incurs no criminal and civil liability ( no
crime, no criminal).
2. Exempting Circumstance – those wherein there is an absence in
the agent of the crime any of all the conditions that would
make an act voluntary and hence, although there is no criminal
liability, there is civil liability ( no criminal but there is crime ).
3. Mitigating Circumstances – those that have the effect of reducing
the penalty due to the lesser perversity of the offender.
4. Aggravating Circumstance – those which increases the penalty.
5. Alternative Circumstance – either aggravating or mitigating
depending on the facts of the situation.
JUSTIFYING CIRCUMSTANCES:
1. Self- defense
2. Defense of Relative
3. Defense of stranger
4. State of necessity
5. Fulfillment of duty
6. Obedience to superior order
EXEMPTING CIRCUMSTANCE
1. Imbecility and Insanity
2. Minority
3. Accident
4. Compulsion of Irresistible force
5. Lawful causes
6. Instigation and entrapment
MITIGATING CIRCUMSTANCES
1. Passion or obfuscation
2. Voluntary Surrender
3. Voluntary plea of guilty
4. Deaf, and dumb, blind
5. Illness that diminishes the exercise of will power
6. Lack of instruction
7. Incomplete self-defense
8. Offender is below 18 or over 70 years old
9. When the act is committed in the immediate vindication of a
grave offense
AGGRAVATING CIRCUMSTANCES
1. Taking advantage of official position
2. Crime is committed in contempt of or with insult to public
authorities
3. Crime committed with insult or disregard due to offended by
age, sex or rank
4. Crime is committed in the dwelling of the offended
5. Abuse of confidence or obvious ungratefulness
6. Nighttime
7. Band
8. Uninhabited place
9. Crime committed during calamity
10. Recedivism
11. Habituality
12. Crime committed in consideration of price, promise or
reward.
13. By means of fire,explosion,poison and stranding of a
vessel
14. Evident premeditation
15. Craft, fraud or disguise is employed
16. Advantage taken of superior strength
17. Means employed to weaken defense
18. Treachery
19. Adds ignominy to the natural effects of the crime
20. Unlawful entry
ALTERNATIVE CIRCUMSTANCE
1. degree of relationship
2. intoxication
3. illiteracy or lack of education
* CLASSIFICATION OF FELONIES
1. GRA VE
2. L ES S GRA VE
3. L IGHT FE LONIES
PERSONS CRIMINALLY LIABLE FOR FELONIES
• When several persons take part in the commission of a crime it
does not necessarily follow that their participation in it is
equal. Some may have a greater or more important in it than
others. Consequently, their liability also varies according to the
position they occupy in the commission of the felony, that is,
whether they are principals, accomplices, or accessories
• This classification of offenders does not apply when there is
conspiracy to commit a crime because of the rule that the act
of one is the act of all.
• A Juridical person cannot be punished like a natural person
because they are only acting through their officers, generally,
an officer of a corporation who commits a violation is the one
criminally liable.
1. (Art. 16) The following are criminally liable for grave and less
grave felonies:
A. PRINCIPAL
B. ACCOMPLICE
C. ACCESSORIES

for light felonies:


a. principals
b. accomplices
2. The following are considered Principals (Art. 17) :
a. those who take a direct part in the execution of the act;
*to be considered as a principal by direct participation , it is
essential
that the offender (a) participated in the criminal resolution as shown
by his prior or simultaneous acts (b) carried out the plan and
personally took part in its execution, and (c) performed acts tending
directly to the same end. Accordingly, if he was not present at the
scene of the crime, he cannot be deemed to be a principal by direct
participation.
b. those who directly force or induce others to commit it;
*Principal by inducement presupposes that the offender himself is
determined to commit the felony; he must have persistently clung to
his determination; he offers the strongest of temptations sufficient
to induce the commission or exercises ascendancy to compel
obedience and the inducement must be the determining cause for
the commission of the crime.
Where the inducer only made remarks or gave an order after the
fatal blow had been struck, he cannot be punished as a principal by
inducement.
c. those who cooperate in the commission of the offense by another
act without which it would not have been accomplished;
*principal by indispensable cooperation must have concurred in the
criminal resolution and cooperated by performing another act
indispensable for the commission of the felony agreed upon. His
cooperation is similar to that of an accomplice but is of greater
degree because of its indispensability to the accomplishment of the
offender’s objective, while that of an accomplice is of a lesser and
minor importance.
3. Accomplices (Art. 18) - are those persons who, not being included in
article 17, cooperate in the execution of the offense by previous or
simultaneous acts
* Under American law, accomplices are accessories before the fact
* to be considered an accomplice, the offender must have known of
the criminal design of the principal by direct participation and
concurs therein. The acts of the accomplice should not produce the
most serious effect on the victim, otherwise he will be a principal.
The acts of an accomplice is similar to those of a principal by
cooperation, but may be distinguished from the latter in that,
although the acts of the accomplice are necessary for the
commission of the crime, they are not indispensable. An example
would be if a nurse agrees to prepare a 20 cc lethal drug to be used
by the nurse’s friend on victim A and did inject a 10 cc killing victim
A but the other 10 cc was injected on another victim B to which the
nurse does not know about, the nurse cannot be held criminally
liable to the second victim B but an accomplice to victim A only.
3. Accessories (Art. 19) – are those who, having knowledge of the
commission of the crime, and having participated therein,
either as principals or accomplices, take part subsequent to its
commission in any of the following manners:
a. by profiting themselves or assisting the offender to profit by the
effects of the crme.
* the acts of an accessory are always performed after the
commission of the crime by the principal and that the accessory had
no participation therein in any form (accessory after the fact). An
example is a daughter who stole an earrings and the mother pawned
them, the mother is guilty as an accessory.
b. by concealing or destroying the body of the crime, or the
effects or instruments thereof, in order to prevent its
discovery.
* The prescribed acts of the accessory must have been intended to
prevent discovery of the crime , hence mere silence does not make
one an accessory. The body of the crime is equivalent to the corpus
delicti.
c. by harboring , concealing, or assisting in the escape of the
principal of the crime, provided the accessory acts with abuse of
his public functions.
* this provision distinguishes a person either as a public officer or a
private individual. They may have different penalties.

NURSES AND CRIMES


• The professional practice of a nurse entails with it the legal
responsibilities that he or she must know and understand in
order to avoid liabilities in the discharge of her functions.
The following are crimes that a nurse must be familiar with:
 ASSAULT – An unlawful attempt or offer to beat or to do bodily
injury to another.
 BATTERY – The unlawful beating or touching of another
person. The unlawful beating or use of force upon a person
without his consent.
 MURDER – is the unlawful killing of a human being by another with
intent to kill (DOLO is an element).
 HOMICIDE – is the killing of a human being by another without
deliberate intent to kill.
 ABORTION – Termination or expulsion of the product of conception
even before the age of viability. Abortion is a crime penalized in
our jurisdiction. A nurse who advises a woman on what drugs to
take is criminally liable.
 INFANTICIDE - killing of a child less than three days of age.
 PARRICIDE – is committed by one who kills his/her father, mother
or child whether legitimate or illegitimate, or any of his/her
ascendants or his/her espouse.
 SEXUAL HARASSMENT – is committed by a person who, having
authority, influence or moral ascendancy over another in a work,
training or education environment, demands, requests or
otherwise requires any sexual favor from the other regardless of
whether such demand, request or requirement for submission is
accepted.
 ILLEGAL DETENTION – any private individual who shall detain
another or, in any other manner, deprive him of his liberty.
 ARBITRARY DETENTION – any person in authority (public officer) who
shall detain another or, in any other manner, deprive him of his
liberty.
 SIMULATION OF BIRTH – any person who shall substitute one child
for another or who shall conceal or abandon any legitimate child
with intent to cause such child to lose its civil status.
• CRIMINAL NEGLIGENCE – is negligence of such character or
occurring under such circumstances, as to be punishable as a
crime by statute.
• PROFESSIONAL NEGLIGENCE – breach of professional duty.
Negligence committed in the practice of a profession.
• NEGLIGENCE - is often referred to as that “doing of a thing which
a reasonably prudent man would not have done and not doing a
thing which a reasonably prudent man would have done”. It
also 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 do or would not do, and acting or the non-
acting of which is the proximate cause of injury to another
person or his property
• The elements of professional negligence are:
1. existence of a duty on the part of the person charged to use
due care under circumstances
2. failure to observe such duty
3. such failure resulted to injury or harm
• The test for negligence: “ would a prudent man, in the position
of the person to whom negligence is attributed, foresee harm
to the person to whom negligence is attributed, foresee harm
to the person injured as a reasonable consequence of the
course about to be pursued; if so, the law imposes a duty on
the actor to refrain from that course or to take precaution
against its mischievous results, and the failure to do so
constitutes negligence.
• Reasonable foresight of the harm and ignoring such foresight is
constitutive fact in negligence.
• If such negligence is the proximate cause of the injury or harm,
then the person causing such negligence is liable for damages
under the law
• A failure of the nurse to apprise or report to the physician
his/her observation like sudden increase in BP or sudden drop
of vitals signs and such failure to report resulted to the death
or injury to the patient, then the nurse is liable for negligence.
• Observance of the standard of care as prescribed by RA 9173 is
the only for nurses to avoid negligence/malpractice suits in the
practice of their profession in the Philippines.
• Wrong medication or wrong drug given to another patient
constitute negligence on the part of the nurse
• MALPRACTICE - refers to a negligent act committed in the course
of professional performance. Any professional misconduct,
unreasonable lack of skill or fidelity in professional or fiduciary
duties ; evil practice; or illegal or immoral conduct; improper
discharge of professional duties, or failure to meet the
standard of care of a professional which results in harm to
another.
• to go beyond the practice of nursing as prescribed by RA
9173, like for example, the nurse suturing in a surgical
procedure without special training or the nurse
prescribing medicine or drugs, is malpractice. It means
encroaching on the practice of other profession where the
nurse is not supposed to perform as prescribe by the law.
• Negligence is malpractice
• Malpractice is determined if the nurse owed a duty to the client
and did not carry out the duty, and the client was injured
because the nurse failed to perform the duty.
• If a nurse gives care that does meet appropriate standards, he
or she may be held liable for negligence.
• Negligence encompasses (includes) the concepts of
foreseeability of harm to the person injured and of a duty of
care toward that person.
• Article 20 of the New Civil Code of the Philippines provides that
every person who, contrary to law, willfully or negligently
causes damage to another shall indemnify the latter for the
same. This means that negligent acts resulting to injuries must
be indemnified in monetary terms.
• INCOMPETENCE - is the lack of ability, legal qualifications or
fitness to discharge the required duty. Incompetence is now
included as a ground for revocation/suspension of the
certificate of registration as a nurse.

DOCTRINE OF RES IPSA LOQUITOR – it literally means, “ let the thing


speak for itself”. This is a legal doctrine usually used in litigations
involving negligence or malpractice suits. If the plaintiff (the one
bringing an action in court) offers such evidence under this doctrine,
then no other evidence is necessary. An example would be sponges
left inside the abdomen of the patient after surgery – the fact that
there is the sponge left is evidence by itself that can speak that
negligence was indeed committed and the court may no longer ask
for other evidence to prove the occurrence of such
negligence. There are three conditions for the application of this
doctrine:
1. the accident must be of a kind which ordinarily does not occur
in the absence of someone’s negligence
2. the accident must be caused by an agency or instrumentality
within the exclusive control of the defendant ( one being sued
in a civil case)
3. the accident must not have been due to any voluntary action or
contribution on the part of the plaintiff ( injured party )

DOCTRINE OF RESPONDEAT SUPERIOR – it means “let the master answer;


let the principal answer for the acts of his agent”. Respondent
superior simply provides that where one acts through the agency of
another , then , in the contemplation of the law , he is himself
acting so as to make him responsible for the acts of his servant. This
doctrine is founded on the principle that he who expects to derive
advantage from an act which is done by another must answer for
any injury which a third person may sustain from it. Master-servant
or employer-employee relationship must exist for this doctrine to
apply.

DOCTRINE OF FORCE MAJEURE – vis major, an act of God, irresistible


force, one that is unforeseen, inevitable. Natural calamities like
strong typhoons or floods that would deter the nurse to report for
duty in the hospital for her shift is an example of this doctrine. Even
if the hospital needs her to report or some untoward incidents
happened in the hospital, which would not happen if the nurse were
there does not constitute any liability on the part of the nurse
because of this doctrine.

NURSE AS A WITNESS – Any information obtained in the course of caring


for the patient by the health team ( doctor, nurses, medtechs) or
any matters communicated by the patient to the nurse is considered
privilege. The nurse cannot testify in a civil case for any privilege
communication except when the patient allows such testimony or
the patient himself offered such information first in a court hearing
or when the health of the many will be jeopardized. This seal of
secrecy will remain forever until removed by the patient. However,
any privileged communication may be divulged in a criminal
proceeding even without the consent of the patient where such
information was obtained.

LIABILITY FOR FALSE – any person who shall give false


TESTIMONY
testimony in any criminal case, either against or in favor of the
defendant, shall be liable to punishment as provided by the law. The
punishment, depending on the case, ranges from imprisonment to
paying fines and/or both. The nurse can commit this violation if
he/she is negligent on charting or erroneously altering her entry in
the charts.
• The hospital records, even if the patient was already
discharged are part of public documents, which can be
summoned in any court hearing should the need arises. Most of
the time, it is the record custodian of the institutions who is
given the subpoena duces tecum or subpoena ad testificandum
by the court. However, the nurses who made the entries in the
chart, if clarification is needed may also be summoned to
appear in a court hearing through the service of subpoena.
• A patient’s chart that is correctly and accurately accomplished
is not only valuable as evidence in legal proceedings but also
useful as guide in the proper treatment of the patient.
• Doctor’s Orders – as mandated by law, nurses must execute such
orders for the treatment of the patient, deviation or failure to
perform this lawful duty can make the nurse criminally and
civilly liable and her license may be revoked or suspended. The
nurse must exercise certain degree of judgment in carrying out
the doctor’s order. If in the assessment of the nurse that such
order may cause some injury to the patient, then she is morally
obligated to verify such orders before carrying them out. The
verification must be made to the person giving such order. The
nurse must be assertive enough to protect the welfare of the
patient (stewardship) and also to protect his/her professional
career from lawsuits arising from erroneous carrying out of
doctor’s orders. Should the doctor insist in carrying out a
questionable order, the nurse must refer the matter to her
immediate superior and must properly document the actions
taken.
• Telephone Orders – the following guidelines may be observed in
carrying out orders of the physician given through telephone:
a. the nurse must chart the date and exact time when the
order was given
b. the nurse must repeat and record the telephone order
c. the nurse must sign the order; begin with t.o. (telephone
order) write the doctor’s name, and then signature the
order
d. if another nurse witnessed the order, then her signature
must also follow
e. if another physician or intern or resident is present in the
station where such order was given, then it is prudent
that the phone call is given to that doctor so they can
discuss the order properly and that doctor can sign the
orders given in a telephone.
f. The physician must sign the telephone order as soon as
he is around or within 24 hours depending on the policy of
the hospitals.
• Reporting Responsibilities – the nurse are required to report
certain communicable diseases or criminal activities such as
abuse, gunshot wounds, assaults, homicides, and suicides to
the appropriate authorities.
• Incidental Report – the nurse must write incidental report to
protect themselves from sanctions. The matters that must be
reported are those that deviate from the norms or standard in
the performance of their duties. This is also done so that
proper remedy can be reached in a given crisis or situation.
The report must always be addressed to the immediate
superior or proper authorities ( eg. DSWD,PNP,RITM etc…).
• Charting Done by students – the clinical instructor or the nurse on
duty must sign the charting done by the student as required by
RA 9173. Those persons signing such charting attests that the
charting made by the student are accurate and authentic and
consequently takes or assumes the responsibility from that
charting.
* PROFESSIONAL ADJUSTMENT - means “ the preparation of a student
nurse for the responsibilities of professional and social life, by
the development of her capacities in a way that would make her fit
to enter upon the practice of nursing.” “Being a nurse means more
than just doing a good job; it means involving one’s self in the
pressing health problems of the community; it means listening,
understanding, communicating, and working with others whose life
styles, beliefs, morals, values and culture may differ from those of
the nurse.” ( robles,183)

* HOLD-OVER DOCTRINE – simply requires those who have been


appointed to continue serving or holding their position even if their
terms has already lapsed, until such time that their successor or
replacement shall have qualified and appointed. Under RA 9173,
members of the Board of Nursing are appointed by the President of
the Philippines and confirmed by the Commission on Appointments.
Members of the Board of Nursing may be appointed by:
1. Regular appointment . – The Philippine Nurses Association certifies
for the Appointment to the Board of Nursing from the three (3)
nominees per vacancy and the Board shall endorse two (2)
nominees per vacancy to the President.
2. Ad interim Appointment – A board member is appointed in the
meantime to fill in a vacancy or perform the duties of an office
during the absence of the regular incumbent. There is no
definite term of appointment.

Republic of the Philippines


Professional Regulation Commission
Manila
BOARD OF NURSING
Board Resolution No. 425
Series of 2003

IMPLEMENTING RULES AND REGULATIONS OF THE “PHILIPPINE NURSING ACT OF


2002 ”
(Republic Act No. 9173)
BACKGROUND
This Implementing Rules and Regulations (IRR) is being issued
pursuant to Section 38, Article IX of Republic Act (RA) No. 9173,
entitled “An Act Providing for a More Responsive Nursing profession,
Repealing for the Purpose Republic Act No. 7164, Otherwise Known
as the Philippine Nursing Act of 1991 and for Other Purposes”,
mandating the Professional Regulatory Board of Nursing, hereinafter
referred to as the Board, and the Professional Regulation
Commission, hereinafter referred to as Commission, in coordination
with the Accredited Professional Organization (APO), the Department
of Health (DOH), the Department of Budget and Management (DBM)
and other concerned government agencies to formulate the
necessary rule and regulations that will effectively implement the
provisions of the law.

RULE I
COVERAGE, POLICY STATEMENT, AND DEFINITION OF TERMS
SECTION 1 . Title.– This Resolution shall be known as the “Rules
and Regulations Implementing the Philippine Nursing Act of 2002”,
referred to in short as IRR.
SECTION 2. Declaration of Policy . – It is hereby declared the policy of
the State to assume responsibility for the protection and
improvement of nursing profession by instituting measure that will
result in relevant nursing education, humane working conditions,
better career prospects and a dignified existence for our nurses.
SECTION 3. Definition of Terms . – As used in this IRR, the following
terms are construed as follows:
a. New Nursing Act – RA No. 9173, otherwise known as the
“Philippine Nursing Act of 2002”
b. Commission – the Professional Regulation Commission (PRC)
created under Section 3 of RA No. 8981.
c. Board – the Professional Regulatory Board of Nursing created
under Section 3. Article II of RA No. 9173.
d. Nursing Practice – covers the three (3) areas of nursing namely
nursing education, nursing service and community health
nursing.
e. Professional Nurse – a person whose name and
registration/professional license number id entered in the
Commission’s registry book and computerized database as
legally authorized to practice the nursing profession.
f. Practicing Professional Nurse – a person who is engaged in the
practice of nursing profession or is performing acts or
activities, whether regularly or occasionally, including one who
is employed in a government office or in a private firm,
company or corporation whose duties require knowledge and
application of the nursing profession.
g. Foreign Professional Nurses – foreign nationals who, being
licensed professional nurses in their own countries, are
authorized by existing laws to practice their profession either
as holders of a certificate of registration and a professional
identification card or a special/temporary permit in the
Philippines, subject to the provisions of subsections (j) and (l)
of Section 7 of RA No. 8981 and other pertinent provisions of
said RA No. 8981 and RA No. 9173.
h. Nursing Specialty Program – a training and development
program intended to develop/enhance the skills, to which a
registered nurse devotes himself/herself whether as a vocation
or profession, to enable him/her to provide nursing service in
specific areas in accordance with the ethics of the profession
and applicable law.
i. Public health Institution – any organization that pursues the
aims of public health through the provision of services (e.g.
Local Government Units through its Rural Health Units)
research (e.g. Research Institute for Tropical Medicine) training
9e.g. College of Public Health) management of
programs/projects (e.g. Department of Health) or advocacy
9e.g. health Alliance for Democracy) to include schools.
j. Accredited Professional Organization (APO) – The Philippine
Nurses Association (PNA), Inc. or any professional organization
of Nurses which now or may hereinafter, is accredited by the
Commission.
RULE II
COMPOSITION OF THE BOARD, APPOINTMENT, QUALIFICATIONS, TERM OF OFFICE
AND COMPENSATION OF CHAIRPERSON AND MEMBERS, THEIR REMOVAL AND
SUSPENSION, REQUIREMENTS UPON QUALIFICATION AS MEMBERS OF THE BOARD
OF NURSING, SUBMISSION OF REPORTS, AND THEIR POWERS AND DUTIES.
SECTION 4 . Composition of the Board. – The Board created under
Section 3. Article III of the said Nursing Act shall be composed of a
Chairperson and six (6) members, representing the three (3) areas
of nursing. The Board shall be under the administrative supervision
and control of the Commission, and as such:
a. All records of the Board, including applications for
examinations, administrative and other investigative cases
conducted by the Board shall be under the custody of the
Commission: and
b. The Commission shall designate the Secretary of the Board and
shall provide the secretariat and other support services needed
by the Board to implement the provisions of the said Nursing
Act.
SECTION 5 . Appointment . – The Chairperson and six members shall
be appointed by the President of the Republic of the Philippines
upon the recommendation of the Commission: Provided, That all
those who will be recommended by the Commission to the President
for the appointment shall be duly licensed/registered nurses chosen
only from among the nominees submitted by the accredited
professional organization of nurses in the Philippines to the
Commission to fill up vacancies. For this purpose, the following shall
strictly be observed/complied with:
a. The commission shall, before the last year of the term of office
of any member, notify and request the accredited professional
organization of nurses in the Philippines to submit to the
Commission at least three (3) qualified nominees per vacancy.
b. The accredited professional organization of nurses shall upon
receipt of the Commission’s request screen and rank qualified
nurses only for the purpose and submit three (3) nominees, per
vacancy, to the Commission not later than three months before
the vacancy occurs.
c. The Commission upon receipt of the list of nominees of the
accredited professional organization of nurses in the
Philippines shall rank said nominees and submit to the
President of the Philippines two (2) nominees per vacancy, not
later than two (2) months before the vacancy occurs, with the
request that the appointment be issued not later than thirty
(30) days before the scheduled licensure examinations.
d. Reappointment shall be subject to the provisions of E.O. No.
496.
e. The necessary operating procedures to ensue strict compliance
therewith shall be embodied in a Memorandum of Agreement
(MOA) by the Commission and the accredited professional
organization of nurses.
SECTION 6. Qualification of the Chairperson and Members. – The Chairperson
and members of the Board shall, at the time of the appointment
possess the following qualifications:
a. Be a natural born citizen and resident of the Philippines.
b. Be a member of good standing of the accredited professional
organization of nurses:
c. Be a registered nurse and holder of a master’s degree in
nursing, education or other allied medical profession conferred
by a college or university duly recognized by the Government,
provided that the Chairperson and majority of the Members
must be holders of a master’s degree in nursing.
d. Must have at least ten (10) years of continuous practice of the
profession prior to appointment, the last five (5) years of which
must be in the Philippines; and
e. Must not have been convicted of any offense involving moral
turpitude.
SECTION 7 . Term of Office. – The Chairperson and Members shall hold
office for a period of three (3) years and until their succession shall
have been appointed and qualified, provided that
a. No Chairperson and Member shall be appointed and/or
reappointed for more than two (2) terms or a period of six (6)
years.
b. Appointments to a vacancy that occurs before the expiration of
the term of office of the Chairperson/member shall cover only
the unexpired portion of the term of the immediate
predecessor.
c. The Chairperson and Members shall take the proper oath of
office prior to the performance of his/her duties.
The incumbent Chairperson and Members of the Board shall continue
to serve for the remainder of their term under R.A. No. 7164 until
their replacements shall have been appointed by the President and
shall have been duly qualified.
SECTION 8 . Removal or Suspension of the Board Members . – The President may
remove or suspend any member of the Board after having been
given the opportunity to defend himself/herself in a proper
administrative investigation to be conducted by the commission on
the following grounds:
a. Continued neglect of duty or incompetence;
b. Commission or toleration of irregularities in the licensure
examination; and
c. Unprofessional, immoral or dishonorable conduct.
SECTION 9 . Compensation of Board of Members . – The Chairperson and
Members of the Board shall receive compensation and allowances
comparable to the compensation and allowances received by the
Chairperson and members of other professional regulatory boards
from the Commission.
SECTION 10 . Requirements upon Qualifications as Chairperson and Member of the
Board . – Any person appointed as Chairperson or Member of the Board
shall:
a. Immediately resign from any teaching position in any school,
college, university or institution offering Bachelor of Science in
Nursing and/or review program for the local nursing board
examinations.
b. Immediately resign from any office or employment in the
private sector and/in the government and any subdivision,
agency or instrumentality thereof, including government-owned
and/or-controlled corporations or their subsidiaries.
c. Not have any pecuniary interest in or administrative
supervision over any institution offering Bachelor of Science in
Nursing including review classes.
Pecuniary interest refers to involvement of husband/wife,
children, brothers/sisters, mother/father in any activity that will
conflict with her position in the Board, particularly money matters.
SECTION 11 . Powers, Duties, Functions and Responsibility of the Board. – The
Board shall supervise and regulate the practice of the nursing
profession in the Philippines. As such, pursuant to the provisions of
R.A. No. 9173 and R.A. No. 8981, otherwise known as the “PRC
Modernization Act of 2000”, the Board shall have the following
specific powers, functions, duties and responsibilities:
a. Conduct the licensure examination for nurses;
b. Issue, suspend or revoke certificates of registration for the
practice of nursing;
c. Monitor and enforce quality standards of nursing practice in the
Philippines and exercise the powers necessary to ensure the
maintenance of efficient, ethical and technical, moral and
professional standards in the practice of nursing taking into
account the health needs of the nation;
d. Ensure quality nursing education by examining the prescribed
facilities of universities or colleges of nursing or departments
of nursing education and those seeking permission to open
nursing courses to ensure that standards of nursing education
are properly complied with and maintained at all times. The
authority to open and close colleges of nursing and/or nursing
education programs shall be vested on the commission on
Higher Education upon written recommendation of the Board.
e. Conduct hearings and investigations to resolve complaints
against nurse practitioners for unethical and unprofessional
conduct and violation of this Act. Or its rules and regulations.
In connection therewith, the Board, upon application with the
court, is empowered to:
1. Issue subpoena ad testificandum and subpoena duces tecum to
secure the appearance of respondents and witnesses and the
production of documents: and
2. Punish with contempt person obstructing, impeding and/or
otherwise interfering with the conduct of such proceedings.
f. Adopt and promulgate a Code of Ethics and a Code of Technical
Standards for the practice of nursing in coordination and
consultation with the accredited professional organization of
nurses within one (1) year from the affectivity of the subject
Nursing Act.
g. Recognize nursing specialty organizations in coordination with
the accredited professional organization: the recognition of
nursing specialty organizations shall be based on the criteria
jointly developed by the Board of Nursing and the Accredited
Professional Organization.
h. Subject to the review and approval of the Commission,
prescribe, adopt, issue and promulgate guidelines, regulations,
measures, and decisions as may be necessary for the
improvement of nursing practice, advancement of the
profession, and for the proper and full enforcement of the
provisions of the “Philippine Nursing Act of 2002”; and
i. Submit an annual report to the Commission at the close of its
calendar year giving detailed account of its proceedings and
the accomplishments during the year and making
recommendations for the adoption of measures that will
upgrade and improve the conditions affecting the practice of
the nursing profession.
RULE III
EXAMINATION AND REGISTRATIONS
SEC TION 12 .Licensure Examination. – All applicants
for registration as
a nurse and issuance of a certificate of registration and professional
identification card to practice nursing shall be required to pass a
written examination which shall be given by the Board in such places
and dates as maybe designated by the Commission. Such
examination must be in accordance with and fully compliant with R.
A. No. 8981.
SECTION 13 . Qualifications for Admission to the Licensure Examination . – In
order to be admitted to the examination for nurses, an applicant
must, at the time of filing his/her application, establish to the
satisfaction of the Board of the following:
a. He is a citizen of the Philippines, or if a citizen or subject of a
country which permits Filipino nurses to practice within its
territorial limits on the same basis as the subject or citizen of
such country, that is, the requirements for the registration or
licensing of nurses is said country are substantially the same
as those prescribed in this Act.
b. He/she is good moral character; and
c. He/she is a holder of Bachelor’s Degree in Nursing from a
college or university that complies with the standards of
nursing education duly recognized by the proper government
agency.
SECTION 14 . Scope of Examination . – The Board shall determine the
scope of the examination for the practice of nursing in the
Philippines taking into consideration the objectives of nursing
curriculum, the board areas of nursing, and other related disciplines
and competencies in determining the subjects of examinations.
SECTION 15 . Ratings. – In order to pass the examinations, the
following shall be fully complied with:
a. An examinee must obtain a general average of at least
seventy-five percent (75%) or higher with a rating of not below
sixty percent (60%) in any subject:
b. Any examinee who obtained an average rating of 75% or higher
but with a rating of below 60% in any subject shall be required
to take the examination again but only on subjects where
he/she is rated below 30%. However, in order to pass the
succeeding examination, he/she must obtain a rating of at least
75% in the subject or subjects repeated.
c. Removal examination shall be taken within two years after the
last failed examination.
SECTION 16 . Oath. – All successful candidates in the examination
must first take an oath of profession before the Board, a Commission
official duly designated by it, or any government official authorized
to administer oaths before entering upon the practice of nursing.
SECTION 17 . Issuance of Certificate of Registration/Professional License and
Professional Identification Card. – All successful candidates shall, upon
payment of prescribed fees, be issued the following:
a. Certificate of Registration/professional License bearing the (i)
full name of the registrant, (ii) serial number, (iii) the signature
of the Chairperson of the Commission, (iv) signature of the
Members of the Board, and (v) official seal of the Commission
and of the Board; and
b. Professional Identification card, duly signed by the Chairperson
of the Commission, bearing the (i) date of registration, (ii)
license number, and (iii) date of issuance and expiration date.
SECTION 18 . Fees for Examination and Registration. – Applicants for
licensure and for registration shall pay the prescribed fees set by
the Commission.
SECTION 19 . Automatic Registration of Nurses. – All nurses whose names
appear at the Roster or Registry Book of Nurses shall be
automatically or ipso facto registered as nurses under this Act upon its
affectivity.
SECTION 20 . Registration by Reciprocity . – A foreign nurse shall be
registered without examination and issued with a certificate of
registration/professional license and a professional identification
card provided that he/she is a nurse registered under the laws of a
foreign state or country, subject to the following conditions:
a. That the requirements for registration or licensing of nurses in
said country are substantially the same as those prescribed
under this Act; and
b. That the laws of such state or country grant the same
privileges to registered nurses of the Philippines on the same
basis as the subjects or citizens of such foreign state or
country.
SECTION 21 . Practice Through Special/Temporary Permit . – Subject to the
prior approval of the Commission and upon payment of the
prescribed fees, the Board may issue a Special/Temporary permit
which shall be effective only for the duration of the project, medical
mission or employment of contract, to the following:
a. Licensed nurses from foreign countries/states whose service
are either for a fee or free if they are intentionally well-known
specialists or outstanding experts in any branch of specialty of
nursing;
b. Licensed nurses from foreign countries/states on medical
mission whose service shall be free in a particular hospital,
center or clinic; and
c. Licensed nurses from foreign countries/states employed by
schools/colleges ad exchange professors in any branch of
specialty nursing.
SECTION 22 . Non-Registration and Non-Issuance of certificates of
Registration/Professional License or Special/Temporary Permit – The following shall
not be registered and issued Certificate of Registration/Professional
Licensed and Professional Identification Card or granted
Special/Temporary Permit:
a. Any person convicted by the final judgment of any criminal
offense involving moral turpitude;
b. Any person guilty of immoral or dishonorable conduct; and
c. Any person declared by the court to be of unsound mind.
The board shall furnish the applicant a written statement setting
forth the reasons for its actions, which shall be incorporated in the
records of the Board.
SECTION 23 . Revocation and Suspension of Certificate of Registration/Professional
License and Cancellation of Special/Temporary Permit – The following shall be
grounds for the Board to exercise its power to revoke and suspend
Certificate of Registration/Professional License and to cancel
Special/Temporary Permit of a nurse:
a. For any of the causes mentioned in Section 22 of RA No. 9173;
b. For unprofessional and unethical conduct;
c. For gross incompetence or serious ignorance;
d. For malpractice or negligence in the practice of nursing;
e. For the use of fraud, deceit, or false statements in obtaining a
certificate of registration/professional license or a
special/temporary permit;
f. For violation of RA No. 9173 and this IRR, Code of Ethics for
nurses and Code of Technical Standards for nursing practice,
policies of the Board and the Commission, or the conditions
and limitations for the issuance of the special/temporary
permit; or
g. For practicing his/her profession during his/her suspension from
such practice.
For this purpose, the suspension of the Certificate of
Registration/Professional License shall be for a period not to exceed
four (4) years.
SECTION 24 . Re-issuance of Revoked Certificate and Replacement of Lost
Certificates. – Upon proper application and payment of the required
fees, the Board may, for reasons of equity and justice and subject to
the rules of the Board, issue another copy of the Certificate of
Registration/professional License under the following instances only:
a. After the expiration of a maximum period of four (4) years from
the date of revocation of a certificate;
b. When the cause for revocation has disappeared or has been
cured and corrected; and
c. When the request is to replace lost, destroyed or mutilated
certificate/license.
RULE IV
NURSING EDUCATION
SECTION 25 . Nursing Education Program . –
The nursing education
program shall provide sound general and professional foundation for
the practice of nursing taking into consideration the learning
outcomes based on national and universal nursing care
competencies.
The learning experiences shall adhere strictly to specific
requirements embodied in the prescribed curriculum as promulgated
by the Commission on Higher Education’s policies and standards of
nursing education.
SECTION 26 . Requirement for Inactive Nurses Returning to Practice . – Nurses
who have not actively practiced the profession for five 95)
consecutive years are returning to the practice of the nursing
profession undergo one (1) month of didactic training and three (3)
months of practicum. For this purpose, the Board shall accredit
hospitals to conduct the said training.
The accredited hospitals shall develop training programs based
on guidelines formulated by the Board of Nursing.
SECTION 27 . Qualifications of the Faculty . – A member of the faculty in a
college of nursing teaching professional courses must:
a. Be a registered nurse in the Philippines;
b. Have at least one (1) year of clinical practice in a field of
specialization of nurses; and
c. Be a member of good standing in the accredited professional
organization of nurses; and
d. Be a holder of master’s degree in nursing, education, or other
allied medical and health sciences conferred by a college or
university duly recognized by the Government of the republic
of the Philippines.
RULE V
NURSING PRACTICE
SECTION 28 . Scope of Nursing. – A person
shall be deemed to be
practicing nursing within the meaning of RA No. 9173 when he/she
singly or in collaboration with another, initiates and performs
nursing services to individuals, families and communities in any
health care setting. It includes, but not limited to, nursing care
during conception, labor, delivery, childhood, adulthood and old age.
As member independent practitioners, nurses are primarily
responsible for the promotion of health and prevention of illness. As
members of the health team, nurses shall collaborate with other
health care providers for the curative, preventive, and rehabilitative
aspects of cares, restoration of health, alleviation of suffering, and
when recovery is not possible, towards a peaceful death.
Duties and responsibilities of a nurse:
a. Provide nursing care through the utilization of the nursing
process. Nursing care includes, but not limited to, traditional
and innovative approaches, therapeutic use of self, executing
health care techniques and procedures, essential primary
health care, comfort measures, health teaching and
administration of written prescription for treatment, therapies,
oral, topical and parenteral medications, internal examination
during labor in the absence of antenatal bleeding and delivery.
In case of suturing of perineal laceration, special training shall
be provided according to protocol established.
b. Establish linkage with community resources and coordination
with the health team;
c. Provide health education to individuals, families and
communities;
d. Teach, guide and supervise students in nursing education
programs including the administration of nursing services in
varied settings such as hospital and clinics:
e. Undertake consultation services:
f. Engage in such activities that require the utilization of
knowledge and decision-making skills of a registered nurse:
and
g. Undertake, nursing and health human resource development
training and research, which shall include, but not limited to,
the development of advance nursing practice.
The above enumerated provisions shall not apply to nursing
students who perform nursing functions under the direct supervision
of a qualified faculty. However, a nurse, while in the practice of
nursing in all settings, is duly-bound/required to:
a. Observe the Code of Ethics and the Code of Technical
Standards for nurses;
b. Uphold the standards for safe nursing practice; and
c. Maintain competence by continual learning through continuing
professional education to be provided by the accredited
professional organization or any recognized nursing
organization. For this purpose, the program and activity for the
continuing professional education shall be submitted to and
approved by the Board.
SECTION 29 . Qualification of Nursing service Administrators . – The following
are the mandatory requirements for Nursing Service Administrators
occupying positions as follows.
1. Supervisory or Managerial Positions
a. Be a registered nurse in the Philippines
b. Have at least two (2) years experience in general nursing
service administration.
c. Possess a degree of Bachelor of Science in Nursing with at
least nine (9) units in management and administration course
at the graduate level; and
d. Be a member of good standing of the accredited professional
organization of nurses.
2. Chief Nurse or Director of Nursing
In addition to the above requirements must also have:
a. At least five (5) years of experience in a supervisory or
managerial position in nursing; and
b. A master’s degree in nursing
3. Chief Nurse for primary Hospitals
a. Be a registered nurse in the Philippines
b. Have at least two (2) years experience in general nursing
service administration; and
c. Possess a degree of Bachelor of Science in Nursing, with at
least nine (9) units in management and administration course
at the graduate level.
SECTION 30 . Priority in Appointments . – The following shall strictly be
observed/complied with:
1. Appointment for a Chief Nurse in the public health agencies. –
Priority shall be given to those who have master’s degree in
public health/community health nursing.
2. Appointment for a Chief Nurse in Military Hospitals – Priority
shall be given to those who have finished a master’s degree in
nursing and the completion of the General Staff Course (GSC).
Those occupying such positions before the affectivity of this Act
shall have a period of five (5) years within which to comply with the
above requirements to qualify thereof.

RULE VI
HEALTH RESOURCE PRODUCTION,
UTILIZATION AND DEVELOPMENT
SECTION 31. Studies for Nursing Manpower Needs, Production, Utilization and
Development.– The board, in coordination with the accredited
professional organization and appropriate government or private
agencies, shall initiate, undertake, and conduct studies on health
human resource production, utilization and development.
SECTION 32. Comprehensive Nursing Specialty Program . – The Board, in
coordination with the accredited professional organization,
recognized specialty organizations, and the DOH, is hereby
mandated to upgrade the level of skill and competence of specialty
nurse clinicians in the country, such as but not limited to the areas
of critical care, oncology, renal and thereon shall be subject to
approval by the Commission and shall be effective after its complete
or full publication in the Official gazette or newspaper of general
circulation, which ever is earlier.
The beneficiaries of the said program are issued a certificate of
the completion and obliged to serve in any PhilippinesHospital for at
least two (2) years of continuous service.
SECTION 33 . Salary – The minimum base pay of nurses working in
the public health institutions shall not be lower than the 1 s t step or
hiring rate prescribe for salary Grade 15 pursuant to RA No. 6758,
otherwise known as the “Compensation and Classification of Act of
1989”. However, for nurses working in local government units,
adjustment to their salaries shall be in accordance with Section 10
of the same Act.
The implementation of this Section shall strictly be in
accordance with the rules and regulations that will prescribe in a
circular that will be issued by the DBM.
SECTION 34 . Funding for the Comprehensive Nursing Specialty Program .
– The
annual financial requirements to train at least ten percent (10%) of
the nursing staff of the participating government hospital shall be
chargeable against the income of the Philippine Charity Sweepstake
Office and the Philippine Amusement and gaming Corporation, which
shall equally share in the cost and shall release said funds to the
DOH subject to the usual accounting and auditing procedures. For
this purpose, the DOH shall set the criteria for the availment of this
program.
SECTION 35. Incentives and Benefits . – The incentives and benefits
referred to in subject Nursing Act shall be limited to non-cash
benefits, such as free hospital care for nurses and their dependents,
scholarship grants and other similar non-cash benefits. For this
purpose, (i) The Board, DOH, DBM, in coordination with other
concerned government agencies, association of hospitals and the
accredited professional organization shall formulate and establish
the necessary incentives and benefit system and the corresponding
rules and regulations for its implementation, and (ii) as part of the
improved working condition of nurses, the government and private
hospitals are mandated to maintain the standard nurse-patient ratio
set by the DOH.

RULE VII
PENAL AND MISCELLANEOUS PROVISIONS
SECTION 36 .Prohibition in the practice of Nursing . – A fine
of not less than
Fifty thousand pesos (P50, 000.00) nor more than One hundred
thousand pesos (P100, 000
00) or imprisonment of not less than one (1) year nor more than six
(6) years, or both, upon the discretion of the court, shall be imposed
upon:
1. Any person practicing nursing in the Philippines within the
meaning of this Act:
a. without a certificate of registration/professional
license and professional identification card or special
temporary permit or without having been declared
exempt from examination in accordance with the
provisions of RA No. 9173; or
b. who uses as his/her own certificates of
registration/professional license and professional
identification card or special temporary permit of another;
or
c. who uses as invalid certificate of registration/professional
license, a suspended or revoked certificates of
registration/professional license, or an expired or
cancelled special/temporary permit; or
d. who gives any false evidence to the Board in order to
obtain a certificate of registration/professional license, a
professional identification card or special permit; or
e. who falsely poses or advertises as registered and licensed
nurse or uses any other means that tend to convey the
impression that he/she is a registered and licensed nurse;
or
f. who appends B.S.N., R.N. (bachelor of Science in Nursing
Registered Nurse) or any similar appendage to his/her
name without having been conferred said degree or
registration; or
g. who as a registered and licensed nurse, abets or assists
the illegal practice of a person who is not lawfully
qualified to practice nursing.
2. any person or the chief executive officer of a juridical
entity who undertakes in-service educational programs or
who conducts review classes for both local and foreign
examination without permit/clearance from the Board and
the Commission; or
3. any person or employer of nurses who violate the
minimum base pay of nurses and the incentives and
benefits that should be accorded them as specified in
Sections 32 and 34, Article VII of RA No. 9173, as
implemented by Sections 33 and 35 of this IRR; or
4. any person of the chief executive officer of a judicial
entity violating any provisions of RA No. 9173, as
implemented by this IRR.

RULE VIII
FINAL PROVISIONS
SECTION 37 . Enforcement of the Provisions of RA No. 9173, as Implemented by
– It shall be the primary duty of the Commission and the
this IRR.
Board to effectively implement the provisions of RA No. 9173 and
this IRR.
SECTION 38 . Assistance of Law Enforcement Agency . – any duly authorized
law enforcement agencies and officers of national, provincial, city or
municipal governments shall upon the call or request of the
Commission or the Board, render assistance in enforcing the
provisions of RA No. 9173 and this IRR and to prosecute any person
violating the same.
For orderly implementation of this provision, the Commission
and the Board may enter into a Memorandum of Agreement with
each law enforcement agency and subject a government offices
providing for the procedures to be followed for the call or request for
assistance.
SECTION 39 . Appropriations. – The amount necessary to carry out the
initial implementation of RA No. 9173 shall be charged against the
current year’s appropriation of the Commission for the purpose as
provided in the General Appropriations Act (GAA). Thereafter, such
amount as may be necessary for the continued implementation of
the said Act shall be included in the program of the Commission in
the succeeding GAA. For this purpose, the Board and the
Commission shall issue the necessary rules and regulations, in
coordination with the professional organization, DOH, DBM and other
concerned agencies.
SECTION 40 . Separability Clause. – If any provision of this IRR or the
application of such provision to any person or circumstances is
declared invalid or unconstitutional, the remainder of this IRR or
application of such provisions to other persons or circumstance shall
not be affected by such declaration.
SECTION 41 . Repealing Provisions . – Any issuance of the Board or
Commission or of their respective chairpersons,
including resolutions, memorandum, office orders/circulars, etc., or
any part thereof which is/are in conflict with the provisions of this
herein IRR are deemed superseded or modified accordingly.
SECTION 42. Effectivity . – This IRR shall take effect after fifteen (15)
days following its complete or full publication in the Official gazette
or any two 920 newspapers of national circulation in the Philippines,
whichever comes first.
PROMULGATED in the City of Manila, Philippines on this 22 n d day of
October, 2003 .