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Go Back to Lesson Outline COMMON LEADERSHIP ROLES LESSON 1: LEADERSHIP AND MANAGEMENT...

Go Back to Lesson Outline COMMON LEADERSHIP ROLES LESSON 1: LEADERSHIP AND MANAGEMENT 1. Decision- maker 12. Teacher 2. Communicator 13. Buffer Leadership 3. Evaluator 14. Critical Thinker Daft (2008) has defined leadership as consisting of six essential elements: influence, intention, personal responsibility, change, 4. Facilitator 15. Visionary shared purpose, and followers. 5. Mentor 16. Forecaster The art or process of influencing people using interpersonal skills that help others achieve their highest potential (Weihrich and 6. Risk-taker 17. Influencer Koontz 2005). A social influence process where leaders use interpersonal 7. Energizer 18. Role Model behaviors to motivate followers to commit and give their best effort to contribute to group goals (Kaiser et al., 2012). 8. Coach 19. Change Agent Whenever one person attempts to influence the behavior of an 9. Advocate 20. Diplomat individual or group—up, down, or sideways in the organization—regardless of the reason. It may be for personal goals 10. Counselor 21. Innovator or for the goals of others, and these goals may or may not be congruent with organizational goals. 11. Creative 22. Problem Solver Maybe Formal or Informal ○ Formal When practiced by a nurse with legitimate authority conferred by the organization and described in a job Management description. Is the coordination and integration of resources through planning, Depends on personal skills, but it may be reinforced organizing, directing, and controlling in order to accomplish specific by organizational authority and position. institutional goals and objectives. ○ Informal Is the coordination and integration of resources through planning, When exercised by a staff member who does not organizing, directing, and controlling in order to accomplish specific have a specified management role. institutional goals and objectives. Thoughtful and convincing ideas substantially influence the efficiency of workflow is exercising Management Roles in the Organization leadership skills Depends primarily on one’s and personal skills. 10 ROLES DIVIDED UP INTO 3 CATEGORIES 3 IMPORTANT COMPETENCIES INTERPERSONAL 1. Ability to Diagnose or Understand the Situation 1. Figurehead 2. Leader 2. Adaptation 3. Liaison 3. Communication dfd  Go Back to Lesson Outline INFORMATIONAL Involves allocating funding, as well as assigning staff and other 4. Monitor organizational resources. 5. Disseminator 10. Negotiator 6. Spokesperson Take part in, and direct, important negotiations within your team, DECISIONAL department, or organization. 7. Entrepreneur 8. Disturbance Handler 9. Resource Allocator Leadership VS Management 10. Negotiator 1. A job title alone does not make a person a leader. INTERPERSONAL 2. A manager is the person who brings things about—the one who 1. Figurehead accomplishes, has the responsibility, and conducts. Social, ceremonial, and legal responsibilities. 3. A leader is the person who influences and guides the direction, opinion, and Expected to be a source of inspiration. course of action. As a person with authority. 4. Leaders often do not have delegated authority but obtain their power through 2. Leader other means, such as influence. Manage the performance and responsibilities of everyone in the 5. Leaders have a wider variety of roles than do managers. group. 6. Leaders may or may not be part of the formal organization. 3. Liaison 7. Leaders focus on group process, information gathering, feedback, and Communicate with internal and external contacts. empowering others. Network effectively on behalf of your organization. 8. Leaders emphasize interpersonal relationships. 9. Leaders direct willing followers. INFORMATIONAL 10. Leaders have goals that may or may not reflect those of the organization. 4. Monitor Seek out information related to your organization and industry, looking for relevant changes in the environment. Monitor your team, in terms of both their productivity, and their Leadership Theories well-being. 5. Disseminator communicate potentially useful information to your colleagues and TRADITIONAL CONTEMPORARY your team. 6. Spokesperson Trait Theories Congruent/Authentic Leadership Represents and speak for their organization. Theory Responsible for transmitting information about your organization Behavioral Theories Scheins’s Model (Interactional and its goals to the people outside it. Leadership Theory) DECISIONAL Contingency Theories Servant Leadership Theory 7. Entrepreneur Create and control change within the organization. Great Man Theory Principal Agent Leadership Theory Solving problems, generating new ideas, and implementing them. 8. Disturbance Handler The Human Capital Theory of Help mediate disputes within. Leadership 9. Resource Allocator The Emotional Intelligence Theory Determine where organizational resources are best applied. dfd  Go Back to Lesson Outline 6. Transactional Theory Traditional Traditional manager, concerned with the day-to-day 1. Great Man Theory operations (Burns). Determined by their genetic and social inheritance. Use rewards and punishments to motivate employees 2. Trait Theories Subordinate are clearly stated with corresponding rewards, “Leaders are born, not made.” fail to satisfy those requirements, they will receive a Leaders possessed multiple characteristics (e.g., they corresponding punishment. tended to be taller, be more articulate, or exude self-confidence). Contemporary SOME COMMONALITIES but No standard list that fit everyone or that could be used to predict or identify who was 1. Congruent/Authentic Leadership Theory or could be an effective LEADER. Suggests that leaders must be true to themselves, know their values, and act accordingly (Marquis and Huston In reality, leadership may come more easily to some than to others, but 2009). everyone can be a leader, given the necessary knowledge and skill. Requires leaders “to be matched (congruence) between the activities, actions, and deeds of the leader and the leader’s values.” 3. Contingency or Situational Theories The right thing to do depended on the situation the leader 2. Scheins’s Model (Interactional Leadership Theory) was facing. The leadership behavior is generally determined by the Adaptability relationship between the leader’s personality and the specific Emphasize the importance of understanding all the factors situation. that affect a particular group of people in a particular The leader must diagnose the situation and select environment. appropriate strategies from a large repertoire of skills. Hollander (1978). THREE BASIC LEADERSHIP STYLES (Kurt Lewin) Leaders respond to a complex environment in which many Authoritarian (Autocratic), elements interact. Reactions are not always constant Participative (Democratic), and because: Delegative (Laissez-Faire) ○ People themselves are complex. ○ Motivations change over time. 4. Behavioral Theories ○ Objectives evolve. Based upon the belief that great leaders are made, not born. ○ Nature of task, ability, experience, and emotional Consider it the flip-side of the Great Man theories. intelligence all play their part. 5. Transformational Theory ○ No single leadership strategy is effective in every The true nature of leadership is not the ability to motivate situation. people to work hard for their pay but the ability to transform followers to become more self-directed in all they do. 3. Servant Leadership Theory Emphasizes that people need a sense of mission that goes In order to be a great leader, one needs to be a servant first beyond good interpersonal relationships or the appropriate (Greenleaf, 1977). reward for a job well done (Bass & Avolio, 1993). dfd  Go Back to Lesson Outline Marquis and Huston (2009) suggested that servant leaders 6. The Emotional Intelligence Theory have 10 qualities that define their success. The ability to perceive emotions, facilitate thinking, and to 1. Listening on a deep level, analyze or understand the relationships of others to one’s 2. Truly understanding, own emotions (Mayer et al. 2000). 3. Being open minded, An emotionally intelligent nurse leader is an individual who 4. Being comfortable dealing with complex issues, can work in harmony with his/her thoughts and feelings and ambiguity, and paradoxes, are able to better manage stress in the clinical environment. 5. The ability to involve all parties in challenging situations and requesting their input, 6. Being goal directed, 7. Demonstrating the ability to be servant, helper, and teacher first, then leader, Management Theories 8. Thinking before acting, carefully choosing words, 9. Possessing foresight and intuition, and looking at the “THE KEY TO UNDERSTANDING MANAGEMENT IS TO UNDERSTAND big picture, ITS EVOLUTION” 10. Sensing relationships, and connections. Evolution of Organization and Management Theories 4. Principal Agent Leadership Theory 1900s - Traditional/Classical Theories/Scientific MGT Was derived from an economics model in the 1960s and was 1940s - Human Relations categorized as another interactive theory. 1970s - Contemporary Belief that not all followers (called agents) are naturally motivated to support the best interest of the leader or 1. Classical/Traditional Theories of Organization employer (principal). Emerged in early part of the 20th century. This assumes that in order for the followers to perform, Models were Military and the Catholic Church. adequate incentives must be provided. Unfortunately, in most healthcare models there are little incentives provided 2. Features of Traditional Theories for followers, thus the relationship between the principal Strict control of workers. (RN) and the agent (healthcare personnel) must be one that Absolute chains of command. fosters compliance with the vision, mission, or goals of the Predictability of behavior. principal. Unidirectional downward influence. 5. The Human Capital Theory of Leadership What is the metaphor which characterizes the classical/traditional Recognizes the need for individuals and organizations to approach to organizations? invest in employees with the anticipation of future gains. Human capital is usually viewed as the collective education, THE METAPHOR OF THE MACHINE. knowledge, skills, and abilities of an entire group. Theory assumes that these gains can be increased or improve productivity. Thus, longevity in the workplace becomes a desirable outcome for valued employees. dfd  Go Back to Lesson Outline IF WORKERS COULD BE TAUGHT THE “ONE BEST WAY TO Scientific Management ACCOMPLISH TASK”, PRODUCTIVITY WOULD INCREASE.. Principles of Scientific Management (Taylor’s Principles) 1. The development of a true science “rule of thumb must be replaced with scientific methods using: ○ Time & motion studies ○ Expertise of experienced workers Designed to promote greatest efficiency of time & energy. 2. The scientific selection of the workman. FREDERICK W. TAYLOR March 20, 1856 - March 21, 1915 “Scientific personnel systems must be established. “Father of Scientific Management” Identify employees abilities & limitations to match the most appropriate job. A mechanical engineer at Midvale & Bethlehem Steel in 3. The scientific education and development of the workman Pennsylvania “Hire, train, & promote based on technical competencies Born March 20, 1856 in Germantown, Philadelphia, Pennsylvania, Workers are able to view how they fit into the organization & United States. how they contribute to overall organizational productivity. Provides common goals – motivate thru incentives. LOAFING 4. Intimate and friendly cooperation between the management and the Natural instinct and tendency of men to take it easy. men. SYSTEMATIC SOLDIERING “Relationships between managers & workers should be ‘Why should I work hard when that lazy fellow gets the same pay that I do cooperative & interdependent. and does only half as much work?’ Work should be shared equally but with different roles. Deliberately working slowly to avoid expanding more effort than Managers are to plan, prepare & supervise Workers do the deemed necessary. work. Reasons: ○ The belief that increased output would lead to less workers. Elements of Scientific Management ○ Inefficiencies within the management control system such as 1. Scientific design of every aspect of every task poorly designed incentive schemes and hourly pay rates not Time and Motion Studies linked to productivity. 2. Careful selection and training of every task ○ Poor design of the performance of the work 3. Proper remuneration for fast and high-quality work ○ Easily learned and easily applied procedure or standard, Maximize output - increase pay based on practical experience rather than theory. Equal division of work and responsibility between worker and ○ A principle with broad application that is not intended to be manager strictly accurate or reliable for every situation. WORKERS ACHIEVED MINIMUM STANDARDS DOING THE LEAST AMOUNT OF WORK POSSIBLE DECREASED PRODUCTIVITY dfd  Go Back to Lesson Outline Bureaucratic Management Management Function JULES HENRI FAYOL (HENRI FAYOL) 1841 - 1925 MAXIMILIAN KARL EMIL WEBER (MAX WEBER) “Father of Modern Management 1864 - 1920 Bureaucratic Management Born: July 29, 1841 Born: 21 April 1864, Erfurt, Germany Birthplace : Istanbul, Turkey Died: 14 June 1920, Munich, Germany Died: November 19, 1925 in Paris Sociologist French mining engineer Philosopher General theory of business administration Political economist Father of Modern Management Developed the “14 Principles of Management” Bureaucratic Theory 5 Management Functions (1925) Legalized, formal authority and consistent rules & regulations for 1. Planning personnel in different positions. 2. Organizing Provide more rules, regulations, & structure within organizations to 3. Staffing INCREASE EFFICIENCY. 4. Directing 5. Control Dimensions of Bureaucracy Adopted by many with little changes. 1. Division of labor based on functional specialization. Eventually called the “Management Process” 2. A well-defined hierarchy of authority. 3. A system of rules covering the rights and duties of position. 4. A system of procedures for dealing with work situations. 5. An impersonality in interpersonal relations. 6. A system of promotion and selection for employment based on technical competence. Limitations of Bureaucracy Appropriate for the past where the environment was relatively stable and predictable. Today’s environments are more turbulent and unpredictable. RED TAPE is an idiom that refers to excessive regulation or rigid conformity to formal rules that is considered redundant or bureaucratic and hinders or prevents action or decision-making. dfd  Go Back to Lesson Outline 14 Principles of Management Usage/application: 1. Division/Specialization of labor 1. Change & organization. Specializing encourages continuous improvement in skills 2. Decision-making. and the development of improvements in methods. 3. Understanding that management can be seen as a variety of 2. Authority activities which can be listed and grouped. The right to give orders and the power to exact obedience. 4. Skills. Can be used to improve basic effectiveness of a manager. 3. Discipline No slacking, bending of rules. Activities of Management 4. Unity of command Each employee has one and only one boss. 5. Unity of direction A single mind generates a single plan, and all play their part in that plan. 6. Subordination of individual interest for common good When at work, only work things should be pursued or thought about. 7. Remuneration Employees receive fair payment for services, not what the company can get away with. 8. Centralization Consolidation of management functions. Decisions are made from KULANG!!! LUTHER HALSEY GULICK (LUTHER GULICK) 9. Scalar chain (line of authority) 1892 - 1993 Activities of Management Formal chain of command running from top to bottom of the organization, like the military. Born: January 17, 1892 10. Order Birthplace : Osaka, Japan All materials and personnel have a prescribed place, and Died: January 10, 1993, Vermont, United States they must remain there. Expert on management & public administration 11. Equity Theory: Activities of Management Equality of treatment (but not necessarily identical treatment). “Seven Activities of Management” (1937) 12. Stability and tenure of staff 1. Planning Limited turnover of personnel. Lifetime employment for good 2. Organizing workers. 3. Staffing 13. Initiative 4. Directing Thinking out a plan and doing what it takes to make it 5. Coordinating happen. 6. Reporting 14. Esprit de corps 7. Budgeting Harmony, cohesion among personnel. dfd  Go Back to Lesson Outline Human Relations Management (1930 - 1970) Hawthorne Effect Also called the Behavioral Management Theories. Addresses the human dimension of work where classical theories ignored employee motivation and behavior. Believed that a better understanding of human behavior at work, such as motivation, conflict, expectations, and group dynamics, IMPROVED PRODUCTIVITY. Viewed employees as individuals, resources, and assets to be developed and worked with — not as machines. GEORGE ELTON MAYO (ELTON MAYO) Participative Management 1880 - 1949 Hawthorne Effect Born in Adelaide, Australia (December 26, 1880) Died in: Surrey, England (September 7, 1949) Psychologist An early leader in the field of industrial sociology. 1927-1932. Pioneered industrial research project at the Western Electric Company’s Hawthorne Works, Chicago Hawthorne Experiment MARY PARKER FOLLET Original purpose of the experiments was to study the effects of 1868 - 1933 physical conditions on productivity. “Mother of Conflict Management” Two groups of workers in the Hawthorne factory were used. (control & experimental group) Born in Massachusetts, in 1892 ○ Lighting “Mother of conflict management” ○ working hours, rest breaks and so on Social worker, consultant & author The Results: Management and political theorist Workers being observed. Introduced such phrases as: ○ Recognition and attention. conflict resolution, Good working relationship with co-workers and supervisors. authority and power, ○ Positive social atmosphere. task of leadership Meeting individuals’ need and desire to belong to a group and be Defined management as: included in decision making and work. “The art of getting things done through people.” Participative Decision Making/Participative Management INCREASED PRODUCTIVITY Workers felt: Supports that managers should have “authority with, rather than Valuable & special over”, employees. Being part of the team There’s a sense of loyalty & cooperation dfd  Go Back to Lesson Outline Theory Y required a change in management, not a change in the Contributions worker or the workplace. Improved classical approach by stressing social needs. Formalized ideas many good managers already practiced but could Focus on workers – not on techniques. not define. Emphasized management skill rather than technical skill. Focus on group dynamics rather than individual. Employee Participation Theories X & Y CHRIS ARGYRIS 1923 - 2013 Born in New Jersey in July 16, 1923 DOUGLAS MURRAY MCGREGOR Behavioral Scientist 1906 - 1964 Management Professor at Harvard Born in Detroit 1906 Advocated the development and practice of management style Psychologist parallel to McGregor's Theory Y. Management Professor at MIT Managerial domination causes workers to become discouraged and passive. Contributions Promote Self Esteem & Independence. 1960. Introduced Theory X and Theory Y. ○ Employees become discouraged & troublesome. Theory X (classical) The need for employee flexibility and employee participation in Workers are lazy and want to be told what to do and have decisions decision making. made for them. Theory X Average employee is lazy, dislikes work, and will try to do as little as possible. Manager’s task is to supervise closely and control employees through reward and punishment. Theory Y (based on developments in social sciences) Employees want autonomy, job satisfaction, responsibility, and will work hard when they are appreciated. Employees will do what is good for the organization when committed. Manager’s task is to create a work setting that encourages commitment to organizational goals and provides opportunities for employees to exercise initiative. dfd  Go Back to Lesson Outline LESSON 2: Primary Prevention: Health Promotion and Illness Prevention Healthcare Delivery Systems Aim: Focuses on improved health outcomes for an entire population The “True prevention” Applied to physically and emotionally healthy clients Health Care Delivery System Requires collaboration among health professionals, health care leaders, and community members Used to describe how a national, regional, or local health care Includes: system is organized, administered, provided, and paid for, ○ Primary care and health education sometimes to a circumscribed system such as that under the ○ Proper nutrition guidance of a specific medical and hospital insurance carrier or ○ Maternal-child care health maintenance organization. ○ Family planning Is a complex and constantly changing system ○ Immunizations Broad variety of services are available from different disciplines of ○ Control of diseases (illness prevention programs) health professionals Settings: ○ Schools DIFFICULTIES IN ACCESSING HEALTH CARE DELIVERY SYSTEM ○ Physician’s Offices/Clinics High Healthcare Cost ○ Occupational Health Clinics Limited Financial Resources ○ Community Health Centers Limited/No Health Insurance Health Promotion Programs Health Care System Lower the overall costs of healthcare by reducing the incidence of disease, minimizing complications, and thus reducing the need to Is the totality of services offered by all health disciplines use more expensive health care resources. Originally created to cater the ill and the sick but later on shifted towards promotion and prevention Secondary Prevention: Diagnosis and Treatment of Illness Types of Health Care Services Aim: Focuses on clients who are experiencing health problems and illnesses and are at risk for developing complications The most common and expensive services in the HealthCare Primary Prevention Health Promotion and Illness Prevention Delivery System Settings: Secondary Prevention Diagnosis and Treatment of Illness ○ Hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units Tertiary Prevention Rehabilitation, Health Restoration, and provide secondary and tertiary levels of care Palliative Care The FOCUS in hospitals is to provide the highest quality of care possible so patients are discharged early but safely to home or another health care facility that will adequately manage remaining health care needs. dfd  Go Back to Lesson Outline Discharge planning begins the moment a patient is admitted to a Frameworks for Care/Nursing Modalities health care facility. For continuity of care ○ Critical Thinking Configurations for delivery of nursing care ○ Using NPS Help nurses achieve desirable outcomes for their patients, either in the way work is organized or in the way a nurse’s responsibilities are defined. Tertiary Prevention: Rehabilitation, Health Restoration, and Palliative Care NURSING MODALITIES Occurs when defect or disability is permanent or irreversible 1. Managed Care Minimizing effects of long-term disease or disability 2. Case Management 3. Differentiated Practice Restorative Care 4. Functional Method Patients recovering from an acute or chronic illness or disability often 5. Team Nursing require additional services to return to their previous level of function 6. Primary Nursing or reach a new level of function limited by their illness or disability. 7. Total Patient Care Rehabilitation Managed Care Restores a person to the fullest physical, mental, social, vocational, and economic potential possible. Patients require rehabilitation after a physical or mental illness, injury A health care system whose goals are to provide cost-effective, or chemical addiction. quality care that focuses on decreased costs and improved Rehabilitation services include physical, occupational, and speech outcomes for groups of clients - KOZIER therapy and social services. Health care providers and agencies (outsourcing) collaborate to render the most appropriate, fiscally responsible care possible. Hospice Can be used with primary, team, functional, and alternative nursing A system of family-centered care that allows patients to live and care delivery systems remain at home with comfort, independence, and dignity while easing the pains of terminal illness. Manage Care Nurse Focus of hospice care is palliative care, not curative treatment. Paperwork Act as Liaison between patient, doctor, hospital, community clinics, Palliative Care social service programs Level of care that is designed to relieve or reduce intensity of Keeping healthcare cost down uncomfortable symptoms but not to produce a cure. Educate patient Relies on comfort measures and use of alternative therapies to help individuals become more at peace during end of life. dfd  Go Back to Lesson Outline Case Management Involves multidisciplinary teams that assume collaborative responsibility for planning, assessing needs, and coordinating, implementing, and evaluating care for groups of clients from pre admission to discharge or transfer and recuperation. Case Manager May be a nurse, social worker, or other appropriate professional. Based on a production and efficiency model that gives authority and Tracks patient’s progress responsibility to the person assigning the work, for example, the head nurse. Team Nursing LPN (Licensed Practical Nurse) - the most basic kind of nurse aka Licensed Vocational Nurse (LVN) Unlicensed Assistive Personnel (UAP) Consist of RNs, LPNs, and UAPs Team is responsible for providing coordinated nursing care to a set of clients for a specific period of time, for example, one shift. Delegates appropriate tasks to team members Differentiated Practice A system in which the best possible use of nursing personnel is based on their educational preparation and skill sets. Consist of specific job descriptions for nurses according to their education or training. Functional Method Primary Nursing Focuses on the jobs to be completed (e.g., bed making, temperature A system in which one nurse is responsible for overseeing the total measurement) care of a number of hospitalized clients 24 hours a day, 7 days a Task-oriented approach, personnel with less preparation than the week, even if he or she does not deliver all of the care personally. professional nurse perform less complex care requirements A method of providing comprehensive, individualized, and consistent care. dfd  Go Back to Lesson Outline Total Patient Care The nurse plans, organizes and performs all care. dfd  Go Back to Lesson Outline LESSON 3: ARTICLE III, Section 9 OF THE R.A. 9173 National Nursing Core "Professional Regulatory BON is empowered to "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 BON Resolution no.12 S.2005 and professional standards in the practice of nursing taking into account the health needs of the nations". adaptation and promulgation of Core Competency Standards of Nursing Practice in the Philippines Revisit (2012 NNCS) -CORE COMPETENCY STANDARDS under the 11 key areas of REVISITING THE CORE COMPETENCY STANDARDS OF NURSING PRACTICE responsibility IN THE PHILIPPINES 1. safe and quality nursing care, PHASES: 2. communication, Phase I - Work setting scenario analysis 3. collaboration and teamwork, Phase II - Validation studies of roles and responsibilities/ 4. health education, Benchmarking of core competencies with other countries 5. legal responsibility, Phase III- Integrative review of outputs from the validation strategies. 6. ethico-moral responsibility, Phase IV- Consensual Validation of Core Competency Standards 7. personal and professional development, Phase V - Conduct of Public hearing 8. quality improvement, Phase VI - Promulgation of the Revised and Modified Core 9. research, Competency Standards 10. management of resources and environment, Phase VII- Printing of the Revised and Modified core competency 11. Record management Standards (2012 NNCCS) Phase VIII- Training in the implementation of the 2012 National DUE TO: Nursing Core Competency Standards - global and local developments in health Phase IX - Implementation of the 2012 National Nursing Core - professional nursing developments Competency Standards Phase X - Evaluation of the effectiveness of the 2012 National Nursing Core Competency Standards BON Resolution no.14 S.2009 Will serve as a guide for the development of the following: BON REVISIT (CHED MEMORANDUM ORDER (CMO) No. 14 S. 2009) SIGNIFICANCE OF THE 2012 NNCCS included a collaboration with CHED Technical Committee on Nursing 01 Basic Nursing Education Program in the Philippines X Education to determine the relevance of the current nursing core 02 Competency-based Test Framework competencies to the expected roles of the nurse and to its current 03 Standards of Professional Nursing Practice 05 Related evaluation tools and future work setting. 04 National Career Progression Program (NCPP) 05 Related evaluation tools dfd  Go Back to Lesson Outline CONCEPTUAL FRAMEWORK OF 2012 NNCCS: I. Beginning Nurse’s Role on Client Care Responsibility 1: Practices in accordance with legal principles and the code of ethics in making personal and professional judgment. Responsibility 2: Utilizes the nursing process in the interdisciplinary care of clients that empowers the clients and promotes safe quality care. Responsibility 3: Maintains complete and up to date recording and reporting system. Responsibility 4: Establishes collaborative relationship with colleagues and other members of the team to enhance nursing and other health care services. Responsibility 5: Promotes professional and personal growth and development II. Beginning Nurse’s Role on Management & Leadership Responsibility 1: Demonstrates management and leadership skills to provide safe and quality care. Responsibility 2: Demonstrates accountability for safe nursing practice. 2012 NNCCS Responsibility 3: Demonstrates management and leadership skills to deliver health programs and services effectively to specific client groups in the I. BEGINNING NURSE'S ROLE ON CLIENT CARE community settings. Responsibilities (5) Responsibility 4: II. BEGINNING NURSE'S ROLE ON MANAGEMENT & LEADERSHIP Manages a community/village-based health facility /component of a Responsibilities (6) health program or a nursing service. III. BEGINNING NURSE'S ROLE ON RESEARCH Responsibility 5: Responsibilities (3) Demonstrates ability to lead and supervise nursing support staff Responsibility 6: Utilizes appropriate mechanisms for networking, linkage building, and referrals. dfd  Go Back to Lesson Outline III. Beginning Nurse’s Role on Research 1.2. Applies ethical 1. Executes the ethical reasoning and decision reasoning process used in making process to address arriving at decisions to Responsibility 1: situations of ethical distress address situations of ethical and moral dilemma. distress and moral dilemma. Engages in nursing or health-related research with or under the 2. Decides on cases based supervision of an experienced researcher. on ethical reasoning. Responsibility 2: Evaluate the research study/report utilizing guidelines in the conduct 1.3. Adheres to established 1. Articulates clearly the norms of conduct based on scope and standards of of a written research critique. the Philippine Nursing Law nursing practice. Responsibility 3: and other legal, regulatory 2. Shows evidence of legal Applies the research process in improving client care in partnership and institutional requirements in the practice requirements relevant to of nursing, (i.e. current with a quality improvement /quality assurance/nursing audit team. safe nursing practice. professional license) 3. Acts in accordance with the terms of contract of IV. Beginning Nurse’s Role on Client Care employment and other rules and regulations. 4. Articulates the vision, Responsibility 1: PRACTICES IN ACCORDANCE WITH LEGAL PRINCIPLES AND THE mission and values of the CODE OF ETHICS IN MAKING PERSONAL AND PROFESSIONAL JUDGMENT. institution where one belongs. COMPETENCY PERFORMANCE KEY AREAS OF INDICATORS RESPONSIBILITY 1. Advocates for client's 1.4. Protects clients rights rights. 1.1. Adheres to ethico-legal 1. Specifies the ethico-legal Ethico-moral Responsibility based on "Patient's Bill of 2. Evaluates client's considerations when bases for providing safe, Legal Responsibility Rights and Obligations". understanding of health care providing safe, quality and quality and professional Communication rights. professional nursing care. nursing care 3. Implements 2. Makes professional strategies/interventions to decisions within ethical and protect client's rights guided legal parameters. by the "Patient's Bill of 3. Uses institutional, Rights and Obligations". community and scholarly 4. Ensures that the client resources to address ethical acknowledges that he/she is and legal concerns in accountable for his/her nursing practice. obligations. 4. Applies legal and ethical principles to advocate for 1.5. Implements 1. Demonstrates an human and societal well strategies/policies related to understanding of informed being and preferences. Informed consent as it consent as it applies in 5. Clarifies unclear or applies in multiple contexts. multiple contexts. questionable orders, 2. Validates with client if decisions or actions made by informed consent is clear, other inter-professional complete, taken wholly health care team members. voluntarily, and signed by dfd  Go Back to Lesson Outline legally competent 2. The employers: representative. To be able to develop systems that support nurses & meet 3. Obtains the client's prescribed standards of practice focusing on: signature on the informed consent taking into -Developing job descriptions consideration ethico-legal -Developing orientation and in-service programs principles. -Creating performance appraisal tool 4. Acts as a witness to the signing of the informed consent. CHED MEMORANDUM ORDER (CMO) No. 15 S. 2017 5. Questions the informed consent process when the 3. The nursing Education Leaders: requirements are not met. To serve as guide in the development of standards that shall serve as the basis for curriculum development. Philippine Professional Nursing Practice Standard 4. The public: can be assured of competent, safe, quality nursing care and ethical PRBON RESOLUTION No. 22 S. 2017 practice. 2012 NNCCS Implementation 5. The PRBON: refining the set of competencies and performance indicators under to be able to use the same as basis in regulating the nursing four domains of nursing standard. 1. Value-based nursing practice practice by: 2. Knowledge driven nursing practice -using it as framework for the Nurse Licensure Examination 3. Outcome oriented professional relationships - recognizing the entry level education program; 4. Leadership and governance -providing guidance to nurses of their professional July 16, 2016, Public consultation at St. Luke's Medical Center obligations; March 23, 2017, Public orientation of the nursing practice standards - providing a foundation for the assessment of their Oct. 18, 2017, promulgated PRBON Res. No. 22. professional performance; - clarifying to the public and other health care professional TO PROMOTE, GUIDE AND DIRECT PROFESSIONAL NURSING PRACTICE what the profession expects of its members; and Specifically, it will be useful to the following: - serving as a basis in addressing incompetent and unethical nursing practice. 1. The professional nurses: LEGAL BASES To have better understanding of their professional obligations Article III, Section 4 of RA 7164 (Philippine Nursing Act of 1991) As basis for their continuing competence and professional "Promulgate decisions or adopt measures as may be development necessary for the improvement of the nursing practice, for Advocate for enhancing changes in policies and practice the advancement of the profession Define and resolve professional practice issues and concerns Article III, Section 9 of RA 9173 (Philippine Nursing Act of 2002) dfd  Go Back to Lesson Outline 4 Domains A. VALUE-BASED NURSING PRACTICE STANDARD A1. CARE OF CLIENTS -8 COMPETENCIES STANDARD A2. ETHICAL, MORAL, AND LEGAL PRACTICE -5 COMPETENCIES STANDARD A3. PERSONAL & PROFESSIONAL VALUES -4 COMPETENCIES B. KNOWLEDGE-DRIVEN NURSING PRACTICE STANDARD B1. RESEARCH - 3 COMPETENCIES STANDARD B2. EVIDENCE-BASED NURSING PRACTICE -3 COMPETENCIES STANDARD B3. CONTINUAL QUALITY IMPROVEMENT -3 COMPETENCIES C. OUTCOME-ORIENTED PROFESSIONAL RELATIONSHIPS STANDARD C1. COMMUNICATION - 4 COMPETENCIES STANDARD C2. COLLABORATION & TEAMWORK -6 COMPETENCIES STANDARD C3. TRANSCULTURAL NURSING CARE -1 COMPETENCY D. LEADERSHIP AND GOVERNANCE STANDARD D1. PERSONAL AND PROFESSIONAL DEVELOPMENT -7 COMPETENCIES STANDARD D2. PERSONAL RESPONSIBILITY AND ACCOUNTABILITY -3 COMPETENCIES STANDARD D3. POSITIVE PRACTICE ENVIRONMENT -2 COMPETENCIES STANDARD D4. SOCIAL RESPONSIBILITY -2 COMPETENCIES STANDARD D5. RESOURCE MANAGEMENT -5 COMPETENCIES Please read the competencies of each standards from these... FOUR DOMAINS dfd  Go Back to Lesson Outline Known as the "Philippine Nursing Act of 2002'' which was approved LESSON 4: on October 21,2002 Nursing Jurisprudence. LAW RELATED TO RA 9173 LAW Act 2808 (First True Nursing Law) Set of rules established by a governing power to: ○ Was approved on March 1, 1919 ○ Guide actions ○ It was entitled " An act regulating the practice of the nursing ○ Regulate conduct of the people profession in the Philippine Islands" ○ Impose sanctions for violation or non-compliance ○ 1920, first board examination was given Sources of Law: Republic Act No 465 ○ Divine Law: Found in the Bible ○ It was approved in June 1950 ○ Human Law: Made by legislative body or any law-making ○ It standardized the examination and registration fees body charged by the Examining Board General/Public Law: Republic Act 877 - Constitutional law: Principles that governs a ○ It took effect on June 19, 1953 nation, society, or corporation. Highest law that ○ It was otherwise known as "The Philippine Nursing Law" gives authority to: ○ It repealed all the provisions of the above-mentioned laws - Statutory law or legislative law: that are inconsistent with its provisions on nursing education Passed by a legislative body and approved by the President and practice - E.g. Nursing Law ○ It includes the provision for the organization of Board of - Administrative law: Established by Examiners for nurses, nursing schools and colleges, appointed agencies of executive branch examination and registration of nurses - E,g. PRC license Republic Act No 4704 Individual/Private Law: ○ It was approved on June 18, 1966 - Civil Law/Court Laws: Torts and Criminal ○ It amended RA 877 Law ○ Members of the BON increase from 3 to 5 ○ Members of the Board were to be appointed by the President with consent from the Commission on NURSING JURISPRUDENCE Appointments upon recommendation of the Civil Service Study of nursing laws, lawsuits, liabilities, legal principles, rules and Commission regulations and doctrines affecting nursing practice ○ Board Members must be Master’s Degree Holder Republic Act 6136 ○ It was approved on August 31, 1970 REPUBLIC ACT 9173 ○ It amended RA 877 and RA 4704 An act providing for a more responsive nursing profession ○ It expressly authorized RN to administer intravenous and RA 7164, "The Philippine Nursing Act of 1991" other injections as long as the administration is under the Aims: direction of and in the presence of a physician ○ To provide a sound general and professional foundation for the practice of nursing through quality nursing education. dfd  Go Back to Lesson Outline Republic Act No 7164 Section 18 - Fees for Examination and Registration ○ Introduced by Senator Heherson Alvarez, it codified and Section 19 - Automatic Registration of Nurses revised all the laws regulating the practice of nursing Section 20 - Registration by Reciprocity ○ It was approved on November 21, 1991 Section 21 - Practice through Special/ Temporary ○ It was entitled "The Philippine Nursing Act of 1991" Permit ○ It repealed, amended or modified existing laws that are Section 22 - Non-Registration and Non-Issuance of inconsistent with it COR or Professional License or Special/Temporary Permit ○ Redefinition in the scope of nursing practice Section 23 - Revocation and Suspension of COR or ○ Requiring a faculty member who is appointed as BON to Professional License or Special/ Temporary Permit resign from his/her position Section 24 - Re Issuance of Revoked Certificates and Replacement of Lost Certificates RA 9173 Article V Nursing Education (Section 25-27) Section 25 - Nursing Education Program Article I Title (Section 1) Section 26 - Requirement for Inactive Nurses Returning to Practice Article II Declaration of Policy (Section 2) Section 27 - Qualifications of the Faculty Article III Organization of the BON (Section 3-11) Article VI Nursing Practice (Section 28-29) Section 3: Creation and Composition on of the Section 28 - Scope of Nursing Board Section 29 - Qualifications of Nursing Service Section 4: Qualifications of the Chairperson and Administrators Members of the Board Section 5: Requirements upon Qualification as Article VII Health Human Resources Production, Utilization and Member of the Board of Nursing Development (Section 30-34) Section 6: Term of Office Section 30 - Studies for Nursing Manpower Needs, Section 7:Compensation on of Board Members Production, Utilization and Development Section 8: Administrative Supervision of the Board, Section 31 - Comprehensive Nursing Specialty Custodian of its Records, Secretariat and Support Program Services Section 32 - Salary Section 9: Powers and Duties of the Board Section 33 - Funding for the Comprehensive Section 10: Annual Report Nursing Specialty Program Section 11: Removal and Suspension on of Board Section 34 - Incentives and Benefits Members Article VIII Penal and Miscellaneous Provisions (Section 35) Article IV Examination and Registration (Section 12-24) Section 12 - Licensure Examination Article IX Final Provisions (Section 36-41) Section 13 - Qualifications for Admission to the Section 36 - Enforcement of this Act Licensure Examination Section 37 - Appropriations Section 14 - Scope of Examination Section 38 - Rules and Regulations Section 15 - Ratings Section 39 - Separability Clause Section 16 - Oath Section 40 - Repealing Clause Section 17 - Issuance of Certificate of Registration Section 41 - Effectivity or Professional License and Professional Identification Card dfd  Go Back to Lesson Outline LEGAL RESPONSIBILITIES AND LAW AFFECTING NURSING ADMINISTRATIVE OFFENSES DUE TO NEGLIGENCE PRACTICE Failure to report observations to AP Failure to exercise the degree of diligence which the circumstances Negligence of the particular case demands Mistaken identity Commission or omission of an act, pursuant to a duty, that a prudent Wrong meds, conc., route, dose (Careful and sensitive marked by sound judgment) person in the Defects of equipment same or similar circumstance would or would not do, and acting or Errors due to family assistance the non-acting of which is the proximate cause of injury to another Admin meds w/o MDs RX person or his property Examples: ETHICAL PRINCIPLES ○ Medication Errors ○ Documentation mistakes Respect for Autonomy ○ Birth injuries ○ human beings are free to decide how they live their lives as ○ Failure to diagnose correctly long as their decisions do not negatively impact the lives of ○ Misusing medical equipment others. ○ Failure to monitor the client - like VS ○ also have the right to exercise freedom of thought or choice. ○ Pressure ulcers Nonmaleficence ○ Do no harm ○ Should not engage in any activities that run the risk of Malpractice harming others. Implies the idea of improper or unskilful care by the nurse or any Beneficence professional ○ Benefiting others Careless, wrong, or illegal actions by someone (such as a ○ Our actions should actively promote the health and doctor) who is performing a professional duty well-being of others The term for negligence or carelessness of professional personnel Justice ○ Being just / fair ELEMENTS OF PROFESSIONAL NEGLIGENCE: ○ rights of one individual or group are balanced against 1. Existence of a duty on the part of the person charged to use another due care under circumstances ○ Assumes three standards: 2. Failure to meet the standard of due care impartiality, 3. The foreseeability of harm resulting from failure to meet the equality, and standard reciprocity 4. The fact that the breach of this standard resulted in an injury Fidelity to the plaintiff (A person who sues another person accuses ○ Being faithful another person of a crime in a court of law) ○ involves loyalty, truthfulness, promise keeping, advocacy and respect Veracity ○ Principle of truth telling dfd  Go Back to Lesson Outline ○ Violation includes: A ground for revocation or suspension If the performance of a RN Act of lying manifests incompetency Deliberate exchange of erroneous information Liability of work for Nursing Students Deliberate withholding of all or portions of the truth ○ Measures to be taken: Deliberate cloaking of information in jargons or Always be under Cl's supervision language that fails to convey the information Given tasks at their level of training, experience & competency DOCTRINE Must seek guidance in performing procedure Should be oriented to the policy of area of RES IPSA LOQUITUR assignment ○ "The thing speaks for itself" Performance should be assessed frequently ○ Injury could not have happened if someone was not Frequent conferences- discussion of doubts, negligent that no further proof is required problems ○ 3 Conditions required to Establish Negligence 1. Injury of such nature that it would not normally occur unless there was a negligent act INTENTIONAL WRONG 2. Injury was caused by an agency within control of the defendant TORT 3. Plaintiff did not engage in any manner that would Is a legal wrong, committed against a person or property bring about the injury independent of a contract which renders the person who commits it FORCE MAJEURE liable for damages in civil action ○ "IRRESISTIBLE FORCE" one that is unforeseen or ○ Is an wrongdoing that results in injury to another person or inevitable ○ No person shall be responsible for those events w/c cannot damage to property. be foreseen, or are inevitable, except in cases expressly How does tort differ from crimes? specified by law ○ CRIMES are punishable in criminal court, whereas TORTS Response Superior generally allow individuals to seek compensation for their ○ "LET THE MASTER ANSWER FOR THE ACTS OF THE injuries in civil court SUBORDINATE" Examples: ○ Liability is expanded to include the master as well as the ○ Assault and Battery employee & not a shift of liability from the subordinate to the ○ False Imprisonment or Illegal Detention master ○ Invasion of Rights to Privacy & Breach of Confidentiality ○ Examples: Hospital liable for crosscutting & hire underboard ○ Defamation nurses, student IR - expanded to CI Assault INCOMPETENCE Is the imminent threat of harmful or offensive bodily contact. Lack of ability, or legal qualifications & being unfit to discharge the Any reasonable threat to a person can cause fear of impending required duty violence in a person even though there is no actual violence inflicted