LM Finals - Management Functions - PDF

Topics {#topics.Header1} ====== - **Management Functions** - **Planning** - **Organizing** - Organizational structure - Staffing (selection, orientation, job description) - Patient classification system - Scheduling - Modalities...

Topics {#topics.Header1} ====== - **Management Functions** - **Planning** - **Organizing** - Organizational structure - Staffing (selection, orientation, job description) - Patient classification system - Scheduling - Modalities of care - Case method - Primary nursing - Team nursing - Modular nursing - Functional nursing - Modified method - **Directing/leading** - Leadership theories - Leadership styles - Leadership skills - Case analysis - Decision making - Bases for power - Principles of delegation - Communication - Motivation theories - Time management - Conflict management - **Controlling** - Budgeting - Types of budgeting - Costing of nursing services - Performance evaluation/appraisal - Feedback - Staff development - Professional Nursing Ethics and Jurisprudence Leadership and Management - **Management:** - The process of designing and maintaining an environment in which individuals working together in groups, efficiently accomplish selected items/tasks. - Management is the process of getting things done, through & with people in organization - **Overview of the Functions of Management** - Management is considered a continuing activity made up of basic management functions which are - **Planning** - **Organizing** - **Staffing** - **Directing and** - **Controlling** - The managers have to perform all of these functions in order to achieve the desired organizational goals Management functions: - **Planning** - Defines the goal & establishing strategy. - **Organizing** - Includes determining what task has to be done, who is to do them. - **Staffing** - Includes recruitment of people and training them towards the project. - **Directing** - Includes the motivating the employees and directing the activities. - **Controlling** - Process of monitoring the performance. Managerial Skills - Three types of skills required by a manager. - **Conceptual Skills** - required by the employee who are in top level management. - **Technical skills** - Required by the employee who are in middle level Management. - **Human Relations Skills** - **R**equired by the employee in the supervisory level. Different Managerial Levels - **Top Management** - **Middle Management** - **Supervisory Level** - **Order of Management** Efficiency & Effectiveness - **Effectiveness**: Adequate to accomplish a purpose; producing the intended or expected result.** ** - **Doing the right thing** - **Efficiency**: Performing or functioning in the best possible manner with the least waste of time and effort. - **Doing things right** - Efficiency is doing something with the least possible expenditure of resources (such as time, energy, etc.) PLANNING - The first and the most important function of management - Involves setting objectives in advance - a goal which is to be achieved within a stipulated time. - Planning is the most basic function of management - It is deciding in advance - what to do - how to do - when to do and - by whom it is to be done Authoritarian Leadership {#authoritarian-leadership.Header2} ======================== - Results in a well-defined group action that are predictable. - Productivity is usually high, but creativity, self -- motivation and autonomy are reduced. Democratic Leadership {#democratic-leadership.Header2} ===================== - Less control - Ask questions and make suggestions rather than issue orders - Get group involved in planning, problem solving and decision making - Participative - Foster independence Laissez -- Faire Leadership {#laissez-faire-leadership.Header2} =========================== - Permissive no control - Non -- directive - Passive and inactive - Members work independently, possible because there is no coordination and cooperation - Uninvolved - Foster chaos Effective Leadership: (Hollander) {#effective-leadership-hollander.Header2} ================================= - Requires the ability to use in the problem-solving process; - Maintain group effectiveness - Communicate well - Demonstrate leader fairness - Competence - Dependability - Creativity - Develop group identification ORGANIZING - Organizing is a crucial management function that **ensures tasks are logically identified, assigned, and grouped**. - **Determines who is responsible** for each task, establishes clear lines of **reporting, and facilitates decision-making**. Process of organizing involves the following: - **Identifying and Defining Tasks**. - Determine the basic tasks that need to be accomplished. - **Delegating Authority and Assigning Responsibility**. - Allocate authority and assign responsibilities to appropriate individuals. - **Establishing Relationships**. - Create a structure that separates activities, arranges them hierarchically, and fosters efficient teamwork. Three forms of Authority {#three-forms-of-authority.Header2} ======================== - **Line authority** - **Direct supervisory authority** that flows from a supervisor to their subordinates - Represents the **clear, direct chain of command** where [decisions](https://nurseslabs.com/nursing-management-guide-to-organizing-staffing-scheduling-directing-delegation/) and instructions are passed down the hierarchy - **Staff authority** - **Based on expertise** and typically involves **providing advice and support to line managers**. - Staff authority **does not entail direct command** over other employees but **focuses on specialized knowledge and guidance**.  - **Team Authority** - Granted to committees or work teams involved in daily operations, team authority empowers groups of employees who share a common [vision](https://nurseslabs.com/special-senses-anatomy-physiology/), goals, and objectives. - These teams are **responsible for collaborative decision-making** and achieving specific outcomes. \*\*Additional Concepts - **Chain of Command** - This is an **unbroken line of reporting relationships** that **extends through the entire organization**, defining the formal decision-making structure and ensuring clarity in the flow of authority. - **Unity of Command** - This principle states that eac**h person in the organization should take orders from and report to only one supervisor, preventing [confusion](https://nurseslabs.com/disturbed-thought-processes/) and overlapping** directives. - **Span of Control** - This refers to the **optimal number of employees that one leader-manager can effectively supervise.** A well-defined span of control ensures efficient management and communication within the organization. Organizational Structure & Organizational Chart An organizational **chart** is based on **people**, while an organizational **structure** is based on **functions** - **Organizational Chart** - A diagram that shows the roles, responsibilities, and relationships between people in a company - Based on **individuals and their titles** - Can become **outdated quickly** because people join and leave companies frequently - **Organizational Structure** - Defines how **roles, responsibilities, and information flow** are assigned and grouped within a company and is based on functions - **Designed** around the co**mpany\'s overall vision and function,** so they b - Made up of **five elements:** - Job design - Departmentation - Delegation - Span of control, and - Chain of command - In an organizational chart, **various lines are used to represent different types of authority and relationships** within the organization: - **Dotted Line.** - Represents **staff positions or staff authority**, indicating **advisory roles to line managers**. - **Solid Horizontal Line** - Represents **positions of equal status but different functions.** - **Solid Vertical Line** - Indicates the **chain of command**, showing **direct authority from supervisors to subordinates** (line authority). - **Centrality** - Refers to the **position on the chart where frequent and diverse communication occurs**. - Positions with **smaller organizational distance, closer to the center, receive more information** compared to those located more peripherally. - In an organization, managerial roles are divided into different levels, each with distinct responsibilities and scope of influence: - **Top-Level Managers** - **Make strategic decisions** with minimal guidelines or structure. - Coordinate both internal and external influences. Examples include: **CEO, President, Vice President, Chief Nursing Officer** - **Middle-Level Managers** - **Oversee day-to-day operations** while also **engaging in long-term planning and policy-making**. Examples include: **Head Nurse, Department Head, Unit Supervisor/Manager** - **First-Level Manager** - **Focus on specific unit workflows** **and address immediate, day-to-day issues**. Examples: **charge Nurse, Team Leader, Primary Nurse, Staff Nurse** Types of Organizational Structure {#types-of-organizational-structure.Header2} ================================= Organizational structures can vary significantly, each designed to meet specific operational needs and management styles. - **Line Organization/Bureaucratic/Pyramidal**. - Has **clearly defined superior-subordinate relationship** - **Authority and power are concentrated** at the **top** - **Flat/Horizontal Organization**. - A **decentralized type** - Applicable in **small organizations** - **Nurses become more productive and directly involved** in decision-making processes, leading to **greater worker satisfaction**. - **Functional Organization**. - **Allows specialists to assist line positions** within a **limited and clearly defined scope of authority** - **Ad Hoc Organization**. - An **ad hoc organization is a modification of the bureaucratic** structure, **often created for specific projects or purposes.** - **Matrix Structure** - **Focuses on both products and functions, making** it the **most complex type** - It **incorporates both vertical and horizontal chains of command** **and lines of communication**. Staffing {#staffing.Header2} ======== - The **process of assigning competent individuals to fulfill the roles** designated within an organizational structure. - This involves recruitment, selection, development, induction, and orientation of new staff to align with the organization's goals, vision, mission, and philosophy. - **Staffing Process** - Staffing involves a s**ystematic approach to ensuring the organization has the right number and type of personne**l to achieve its goals. Staffing - The following steps outline the key stages in the staffing process: - **Preparing to Recruit** - **Initial step** involves **determining the types and number of personnel required** to meet the organization's needs. - **Attracting Staff** - **Formal advertisements and outreach efforts** are used to attract potential candidates. - **Recruiting and Selecting Staff** - Phase includes conducting interviews, induction, orientation, job orders, pre-employment testing, and signing contracts to onboard new employees. Patient Classification System - **Acuity Systems** - **Measurement systems in nursing that reflect actual patient care needs** for staffing purposes - Used to articulate the nursing workload for specific patients or groups of patients over a defined period. - While **"Acuity"** typically **denotes the unidimensional severity of illness** in a medical context, the nursing community prefers the broader term **"Patient Classification" to encompass the bio-psycho-social-spiritual aspects of patient care**. For this discussion, the term Patient Classification/Acuity System is used. Patient Classification Categories Based on Their Care Needs: - **Self-Care or Minimal Care**. - Patients are **capable of performing [activities of daily living](https://nurseslabs.com/self-care-deficit/) (ADLs) independently**, such as [hygiene](https://nurseslabs.com/bed-bath-and-hygiene-care/) and meals - They require minimal assistance from the nursing staff. - **Intermediate or Moderate Care**. - Patients **require SOME assistance** from the nursing staff for special treatments or specific aspects of personal care. - Ex. include patients with **[IV fluids](https://nurseslabs.com/iv-fluids/), catheters, or on respirators.** - **Total care** - Patients are **[bedridden](https://nurseslabs.com/prolonged-bed-rest-nursing-care-plans/) and lack the strength or [mobility](https://nurseslabs.com/impaired-physical-mobility/) to perform ADLs** - Requires **comprehensive nursing care.** - Ex. Patients on **complete [bed rest](https://nurseslabs.com/prolonged-bed-rest-nursing-care-plans/) (CBR),** those in the immediate **post-operative phase**, or those with **significant [mobility](https://nurseslabs.com/impaired-physical-mobility/) restrictions.** - **Intensive care**: - Intensive care patients are **critically ill and in constant danger of [death](https://nurseslabs.com/end-of-life-care-hospice-care-nursing-care-plans/) or serious [injury](https://nurseslabs.com/risk-for-injury/).** - They require **continuous monitoring and specialized nursing care**. - Ex. **Comatose patients** or those with **life-threatening conditions who are bedridden.** - By classifying patients according to their care needs, the Patient Classification System **ensures that nursing resources are appropriately allocated, enhancing patient care and optimizing the nursing workloa**d. Scheduling {#scheduling.Header2} ========== - Scheduling is the **process of creating a timetable** [ ] that **outlines the planned workdays and shifts** for nursing personnel. - Effective scheduling takes into account several key factors to ensure that staffing meets patient care needs and maintains staff well-being. Considerations in Scheduling - **Patient Type and Acuity** - **Different patients require varying levels of care**, significantly impacting how staff is allocated. - **Number of Patients** - The to**tal patient count directly influences the number of staff needed.** A higher patient load requires more nursing staff to ensure each patient receives adequate attention and care. - **Experience of Staff** - The **skill and experience levels of the staff should match the complexity of patient care required**. - **Support Available to the Staff** - The availability of support personnel, such as **nursing assistants and administrative staff,** affects how nursing duties are distributed. - **Shifting Variations** - **Different shift patterns are utilized to meet both patient care needs and staff preferences.** These variations can help in maintaining a **balanced and effective workforce.** Shifting Patterns To **meet the diverse needs of patients and preferences of nursing staff,** various **traditional shifting patterns are utilized.** - **3 Shift (8-hour shift)**- divides the day into **three 8-hour shifts** *(7 AM to 3 PM, another from 3 PM to 11 PM, and a third from 11 PM to 7 AM)* - **12-hour Shift**. Often preferred by **nurses who enjoy having more consecutive days** off but also requiring **adequate rest between shifts to prevent [burnout](https://nurseslabs.com/nurse-burnout-8-ways-manage-work-stress/).** - **10-hour Shift**. **Less common but offers a balance between 8 and 12-hour shifts.** This pattern might involve a nurse working from **7 AM to 5 PM,** allowing for extended care periods without the intensity of a 12-hour shift. - **Weekend Option**. Staff works primarily on weekends, which can be ideal for nurses who prefer or need **weekdays off.** This option helps in ensuring adequate coverage during weekends when patient admissions might fluctuate. - **Rotating Work Shift**. Shifts **rotate between day, evening, and night, allowing all staff to experience different times of day**. This can **help in maintaining a fair distribution of shifts** but requires careful management to **avoid disruption to staff routines and circadian rhythms.** - **Self-Scheduling**. Staff members **create their own schedules, promoting autonomy and job satisfaction**. For example, a nurse might choose to work three consecutive days followed by four days off, allowing flexibility in managing personal commitments. - **Permanent Work Shift**. Staff **work consistent shifts without rotation, providing stability and predictability**. For instance, a nurse might **always work the [night shift](https://nurseslabs.com/12-funny-things-wake-nurses-night/)**, ensuring they can plan their personal life around a steady work schedule. - **Floaters**. Staff who are **"on-call" to fill in as needed**. Floaters provide critical support during unexpected absences or increased patient loads, ensuring that the unit remains adequately staffed at all times. Nursing as a Profession - **Profession -** calling where members profess to have acquired a unique body of knowledge and skills through training education, and experience - **Profession** - **Disciplined group of individuals who adhere to ethical standards** - **ANA --** nursing profession involves protection, promotion, and optimization od health and abilities, prevention of illness and injury, alleviation of suffering through dx and treatment - **Professional Nursing Practice** - Performance for a fee or salary of a professional service - Nursing has all the characteristics of a true profession which are - Accountability - Professional Autonomy - Altruism - Caring Attitude - Competence - Ethical Practice - Service Oriented - Specialized area of practice Characteristics {#characteristics.Header2} =============== Accountability - Being liable of any resulting act or conduct based on professional decisions - Taking responsibility of actions - Always ensure patients that they are competent and always put pt's interest first Administrative Liabilities -- Sec. 23, RA 9173 - Revocation and Suspension of Certificate of Registration/Professional License and cancellation of special permit based on these grounds - For any causes mentioned in Sec 22, RA 9173 - Unprofessional and unethical conduct - Gross incompetence or serious ignorance - Malpractice or negligence in practice - Use of fraud, deceit, or false statements in obtaining license - Practicing during **suspension** - **Suspension can only last for less than 4 years** - **Nurse** shall be required to answer under oath the charges within 15 days from receipt - **Motion of reconsideration can be filed 15 days after decision** Sec. 35, RA 9173 - Prohibitions in the Practice of Nursing - 50 -- 100K or imprisonment for 1 -- 6 years for any person within the meaning of this Act: - Without license of certificate - Uses other's license or permit - Uses invalid license or permit - Gives false evidence to the Board to obtain certificate - Falsely poses or advertise as registered and licensed nurse or uses other means to convey the impression that they are licensed - Appends BSN or RN to their name without getting the said degree or registration - Abets or assists illegal practice to a person who is not lawfully qualified - Any person or CEO of judicial entitiy who undertakes in-service for these programs without permit/clearance from board of commission - Any person or employer who violates minimum base pay of nurses and incentives as specified in **Sec. 32 and 34** - Any person or CEO violating this act and its rules and regulations \*\*Revised Penal Code -- imprisonment/fine, New Civil Code -- Civil Damages Criminal Liabilities -- Art. 365 of RPC amended by RA 1790 - **Imprudence and negligence** - Who by reckless imprudence, with intent, constituting to: - **Grave felony** shall suffer **arresto mayor for maximum period** - w/ but less serious felony -- minimum arresto mayor - **Less grave felony --** minimum or medium period - **Light felony --** max period of arresto menor - With damages to property - Fine ranging amount not less than 25 pesos - Light felony dt simple imprudence or negligence - Not more than 200 pesos - **Reckless imprudence** - Voluntary but without malice, doing or failing to di an act causing material damage - **Simple imprudence** - Lack of precaution which damage impending to be causes is not immediate nor the danger clearly manifest - Penalty next to the higher in degree shall be imposed upon the offender who fails to lend the spot to the injured parties Civil Liabilities -- Art. 2176 and 2177 of NCC - **ART. 2176** - Act or omission causes damage to another dt fault or negligence, **obliged to pay** for the damages - No pre-existing contractual relation bw parties -- **quasi-delict governed by provisions of this chapter** - **ART. 2177** - Responsibility for fault under \[receding article is separate from civil liability arising under penal code - Plaintiff cannot recover damages twice for the same act or omission of defendant - **Civil and Criminal liabilities -- under regular court of justice** - Punishable not exceeding 6 years -- municipal, metropolitan, and municipal circuit trial courts - Over 6 years imprisonment -- Regional Trial Court - **Civil liabilities or monetary claims less than 2M** - **Metro, municipal or municipal circuit** - **Over 2M -- RTC** Professional Autonomy - Nurses having independent authority to perform duties within the limits of law and profession - **SEC. 28, RA 9173 -- Scope of Nursing** - Nurses can provide health services independently or in collaboration - Not only within hospitals - Independent practitioner -- promotion of health and prevention of illness - It shall be the duty of the nurse to: - Provide care through nursing process - Establish linkages with community resources and coordination - Provide health education - Teach, guide, and supervise students in nursing program - Undertake nursing and health human resource development Altruism - Caring for others and demands sense of selflessness - Truly caring despite of financial gains or compensation - Feeling that people should help one another without regard for compensation Caring Attitude - Nurses require diligent efforts in caring for the sick and well - Only profession where monetary consideration is not the primary reason in providing care - **Jean Watson (1997) -- Theory of Human Caring** - **Caring as science** -- encompasses humanitarian, human science orientation, phenomena, and experiences - Holistic health care is central to nursing practice - Nursing: human science of persons and human health-illness experiences mediated by professional, personal, scientific, esthetic, and ethical human transactions" - **Seven Assumptions in Nursing** - Caring can be effectively demonstrated and practiced interpersonally - Consist of carative factors that result in human satisfaction - Effective caring promotes individual or family health - Caring environment is one that offers the development of potential while allowing patient to choose best action - Science of caring is complementary to science of curing - Practice of caring is central to nursing Competence - Possession of required skills and trainings through theoretical and related learning experience - **SEC. 25. Nursing Education Program** - Shall provide sound general and professional foundation for all practice of nursing - Shall adhere to specific requirements promulgated by CHED and standard of nursing education - **SEC. 30. Studies for Nursing Manpower Needs, Production, Utilization, and Development** - Board and other organizations shall conduct studies on health human resources production, utilization, and development - **SEC. 31. Comprehensive Nursing Specialty Program** - Program that would upgrade the level of skill and competence of specialty - Beneficiaries are obliged to serve in the Philippines for 2 years consecutively - **SEC. 9. ART. III, RA 9173** - Members of the board shall monitor and enforce quality standard in nursing practice in PH - **Board Resolution No. 112, S. 2005** - **Core Competency Standards of Nursing Practice (11)** - Safe and quality nursing care - Management of resources and environment - Health education - Legal responsibility - Ethic/moral responsibility - Personal and professional development - Quality Improvement - Research - Record Management - Communication - Collaboration and teamwork RA 10912 - CPD Act of 2016 - Requires CPD units as mandatory requirement for renewal of license - **SEC. 4. Strengthening CPD Program** - Enhance and upgrade competencies and qualifications of professionals - Ensure international alignment of competencies and qualifications through career progression mechanisms leading to specialization - Ensure development of quality assured mechanisms for validation, accreditation, and recognition of formal or non-formal outcomes - Ensure maintenance of core competencies and develop advanced and new competencies - Recognize and ensure that contributions of professionals in uplifting general welfare - **SEC. 5. Nature of CPD Programs** - Consist of activities that range from structured to non-structured with learning processes and outcomes - Formal learning - Non-formal learning - Informal - Self-directed - Online learning - Professional work experience - **SEC. 10. CPD as Mandatory Requirement in Renewal of License** - **SEC. 11. Recognition of Credit Units** - **Accumulated and transferred in accordance with pathways and equivalencies of PQF** - Not more than 15 units (previously 60 for nursing) effective March 1, 2019 - **SEC. 12. Career Progression and Specialization** - Parts: Career progression and Specialization Part - **SEC. 13. Role of concerned Government Agencies and Private Sector** - Shall include CPD in their human resource development plan and program - **Ethical Practice** - Requires nurses to observe morality of human conduct, values, and standards. - Involved rightness and wrongfulness of human actions - **Code of Ethics** - Principles or ideas that guide behavior and decision-making practices of an individual or group with similar goals and objectives - **SEC. 9, (g), ART. III RA 9173** -- PH nurses act of 2002 - Became an accredited organization on October 23, 2003 at Iloilo City - **Preamble states that:** - Health is a fundamental right of every individual. The Filipino registered nurse, believing in the worth and dignity of each human being, recognizes the primary responsibility to preserve health at all cost. This responsibility encompasses promotion of health, prevention of illness, alleviation of suffering, and restoration of health. However, when the foregoing are not possible, assistance towards a peaceful death shall be their obligation. Service-Oriented - Goal of professional nursing practice: - Deliver optimum level of health for all, both sick and well regardless of they are capable of fees -- "nurse is service" Specialized Area of Practice - Requires well-defined skills continuously and exclusively performed - **No license and registration and practices exclusive nursing procedures -- Malpractice** - **ART. VII RA 9173** - **SEC. 31. Comprehensive Nursing Specialty Program** - Program that would upgrade the level of skill and competence of specialty - Beneficiaries are obliged to serve in the Philippines for 2 years consecutively - **SEC. 32. Salary** - Shall not be lower than SG 15 (36,619 pesos) under **RA 6758 Compensation and Classification Act of 1989** - Adjustments must be in accordance with Section 10 of said law - **SEC. 32. Funding for the Comprehensive Nursing Specialty Program** - **PCSO and PAGCOR** - **SEC. 34. Incentives and Benefits** - Free hospital care for nurses and their dependents, scholarship grants and other non-cash benefits - Mandates standard nurse-patient ratio for both public and private hospitals Basic Requirements to Practice Nursing in the Philippines Degree in BSN {#degree-in-bsn.Header2} ============= - CHED Memo No. 15 S. 2017 - Core competencies - Nature of Field of Study - 4-year program - Goal: - Aims to develop a professional nurse who would assume entry-level positions in health facilities or community setting - Capable of providing safe, humane, quality, and holistic care to individuals singly or in collab with other HCP to promote health, prevent illness, restore health, alleviate suffering, and provide end of life crisis - Outcomes specific to BSN - Applies knowledge of physical, social, natural, and health sciences and humanities - Perform safe, appropriate, and holistic care to individuals, families, population, groups - Applies guidelines and principles of evidence-based practice in delivery of care - Practice nursing in accordance with existing laws, legal, ethical, and moral principles - Communicate effectively in speaking, writing, and presenting using culturally appropriate language - BSN Level Outcomes - **First year:** At the end of the first year given simulated situations in selected settings, the learners demonstrate basic nursing skills in rendering safe and appropriate care utilizing the nursing process. - **Second year:** At the end of the second year, given a normal and high risk mother and newborn, child, family, communities and population groups in any health care setting, the learners demonstrate safe, appropriate and holistic care utilizing the nursing process. - **Third year:** At the end of the third year, given individuals, families, population groups and communities with physiologic and psychosocial health problems and maladaptive patterns of behavior in varied health care settings, the learners demonstrate safe, appropriate and holistic care utilizing the nursing process and applying research and evidence- based practice. - **Fourth year:** At the end of the fourth year, given groups of clients (individuals, families, population group and communities) with health problems and special needs, the learners demonstrate safe, appropriate and holistic care utilizing the nursing process and can assume first level entry positions in any field of nursing. - After BSN degree, student must now take the licensure examination mandated in **Section 12, RA 9173 (Licensure Examination** - All applicants shall pass a written exam given by the Board designated by the commission in accordance with RA 8981 (PRC Modernization Act of 2000) RA 8981 (PRC Modernization Act of 2000 - Qualifications to take NLE {#ra-8981-prc-modernization-act-of-2000---qualifications-to-take-nle.Header2} =================================================================== - Must be a citizen or must have the same requirement from their country - Foreign nationals are allowed to take the PRC exam given that the requirements are substantially the same in their country - Filipinos can practice nursing in other countries provided that they are competent and has documentary evidence and the said country permit Filipinos to practice under RA 2382 and PD 223 - Has good moral character - BSN degree holder - **Basic Requirements to take the Licensure Exam** - **PSA birth certificate** - **TOR with scanned picture and remarks "For Board Examination Purposes" (First timer and retakers"** - **Payment** - **900 complete** - **450 conditioned/removal** - **Summary of RLE** - **OR/DR** - 3 minor scrubs - 3 DR handle - 3 Assist - 3 Cord Dressing - If under CMO 30 -- Certificate of Undertaking - Notarized Certificate of Undertaking (CMO No. 14, S. of 2009) - **SEC. 14. RA 9173. Scope of Examination** - NP I -- Foundation of Nursing and Professional Nursing Practice **(CHN)** - NP II -- Community Health Nursing and Care of the Mother and Child **(Care of healthy/at risk mother and child)** - NP III -- Care of Clients with Physiologic and Psychosocial Alterations (A) - NP IV - Care of Clients with Physiologic and Psychosocial Alterations (B) - NP V - Care of Clients with Physiologic and Psychosocial Alterations (V) - **SEC. 15. RA 9173. Ratings** - General Ave: 75% w/ no below 60% - Those with 75 or higher but with 60% shall take the exam on the specific subject - Must get 75% on repeated subject Registration Before the PRC {#registration-before-the-prc.Header2} =========================== - **Oath taking -- Sec. 16, Art. IV, RA 9173** - All successful candidates shall be required to take the oath before any board or govt official authorized to administer oath - States Oath of Professionals and Nightingale's Pledge - **SEC. 20. Registration by Reciprocity** - **Certificate or license without examination to nurses registered under laws of foreign state or country** provided that requirements are substantially the same as in this Act - **SEC. 21. Practice Through Special/Temporary Permit** - Licensed nurses from foreign country whose service are for fee or free, internationally well-known specialists or outstanding experts - Licensed nurses from foreign country on medical mission - Licensed nurses from foreign country employed by schools/colleges of nursing as exchange professors - **Effective only for the duration of project, medical mission, or employment contract** Disqualification, Suspension and Revocation of a Nurse's License - **SEC. 22, ART. IV, RA 9173** - **Non-registration and Non-issuance of Certificate/Permit or Special/Temp Permit** - No person convicted of any criminal offense involving moral turpitude or guilty of immoral or dishonorable conduct shall be issue a certificate or permit - **SEC. 23. Revocation and suspension of certificate of registration/cancellation of special permit** - **SEC. 24. Re-issuance of Revoked Certificates and Replacement of Lost Certificate** - After 4 years of revocation, reasons for equity and justice and cause of revocation have disappeared, proper application and payment is done Professional Expectations Among Nurses - Proper physical appearance - Well-groomed - Properly wear uniform - Proper hygiene - Conservative appearance - Mindful of proper social skills - Wear minimal accessories and make up - **Interpersonal Skills** - Excellent and well-communicators - Ability to explain complex information in a simple way - Patients understand all risks, benefits, and complications to make well-informed decisions - Should strive to make patients comfortable - Requires practitioners to develop leadership skills - Patience is a key quality - Good Health - Average classroom schedule must no exceed **10-15 hours/week** - Average clinical/hospital exposure: 20-24 hours/week Accredited Professional Organization in PH - **PH Nurses Association (PNA)** - Founded September 2, 1922 as Filipino Nurses Association by Anastacia Giron Tupas, incorporated in 1924 - Member of ICN in July 8-13, 1926 - Became PNA in 1966 - **Mission** - Championing the global competence, welfare, and positive and professional image of Filipino Nurse - **Vison** - By 2030, PNA is the primary professional association advancing welfare and development of globally competitive Filipino Nurses - **Core Values** - Love of God and Country - Caring - Quality and Excellence - Integrity - Collaboration - **Program Thrust** - Promote holistic welfare of nurses - Generate programs and activities that would prepare nurses to be globally competitive - Intensify membership campaign - Engage nurses to actively participate in programs - Establish national and intl networking/linkages - Promote professional image of nurses and nursing - Guarantee transparent, policy-based, and responsible utilization of resources - Promote positive practice environment - Anastacia Giron Tupas Award Nursing Specialty Organizations - Association of Diabetes Nurse Educators Of the PH (ADNEP) - Formally organized and registered at SEC on Feb 15, 1993 - Critical Care Nurses Association of the PH Inc. (CCNAPI) - Focused on critical care nursing - Founded 1977 - Enterostomal Therapy Nursing Association of the PH (ETNAP) - Gerontology Nurses Association of the Philippines - Officially launched on August 28, 2008 at PGH - Mother and Child Nurses Association - To promote standards of mother and child nursing practice in the PH - Empowers maternal and childcare nurses to deliver save quality care through specialty education and training - Military Nurses Association of the PH Inc - Occupational Health Nurses Association of the PH - Industrial, agricultural, commercial, educational, service, whether govt or non-govt - Operating Room Nurses Association of the Philippines - Promotes competent and dynamic peri-operative nurses committed to innovation and provision of optimum perioperative - Philippine Hospital Infection Control Nurses Association - Develops competent, empowered and dedicated infection control nurses through practice, education, training, and research - Philippine Oncology Nurses Association (PONA) - Psychiatric-Mental Health Nurses Association of the PH - Philippine Society of Emergency Care Nurses Inc. - Renal Nurses Association of the PH - Society of Cardiovascular Nurse Practitioner of the PH - Association of the Dermatology and Aesthetic Nurses of the PH (ADANP) - Philippine Society of SRH Nurses Inc - Association of Nursing Service Administrators of the PH - Association of Deans of PH Colleges in Nursing **Specialty Areas In Nursing Practice** - **Institutional Nursing** - Most familiar of all forms or nursing practice - Involves provision of comprehensive health services both for in-patient and outpatient status - Entry level - routine tasks - Staff positions - direct supervision - Various skills and competencies - Functions: - Decision-making and delegation - Carry out the most technical procedures - Coordinate client care to other department - Health education - Properly report and record care - Supervise delegated task - Advocate for client and enforce rights of patients - Community Health Nursing - Synthesis of nursing and public health applied to promote and protect health - Involves family in the care of the sick or dependent individual - Health monitor - Researcher - Statistician - Change Agent - Communicator - **Adopts the principles of primary health care** - Whole-of-society approach to health and well-being - Centered on the needs and preference - Addresses broader determinants of health focuses on the comprehensive and interrelated aspects of physical, mental and social health and well-being - Rooted in commitment to social justice and equity in recognition of the fundamental right to highest attainable standard health - Art. 25. Universal Declaration on Human Rights - **Occupational Health Nursing (OHNAP)** - AKA industrial nursing - Factories, offices, educational, agricultural, and industrial zones where labor happens - **Certified Occupational Health Nurse** - Must be a graduate of BSN - Post graduate course for basic occupational health safety for nurses - Must have attended at least 3 conventions within 5 years of active membership - Multifaceted and diverse. Safety inspectors, educators, and controllers of new health and safety measures and programs - Duties: - Developing and implementing health and safety programs - Developing disease prevention programs (smoking cessation, exercise, and healthy eating program) - Documenting all employee injuries and illness within workplace - Observing and assessing the work environment for potential dangers and hazards - **Private Duty Nursing** - Private nurse practitioners, specialty duty nurses, or private nurse specialist - Freelancers, hospital, agencies - Provide primary and focused nursing care and implement care plans. **1:1 ratio** - **Basic qualification:** - 2 years bedside experience in hospital setting - With knowledge in critical care practitioner - IV therapy certification - One is to one ration - Adequate medical assessment and history - Day to day pt interaction - Vital signs checking - Meds administration - Dressing, bandage, and contraption changing - Diet supervision - Assist self-care - Clinic Nursing - School Health Nursing - Provide care to students and educational employees - Injuries and acute illness - **Nurse Educator** - Clinical instructor - Educate theories and skills - Supervises all activities - **SEC. 27. Art. V. RA 9173 - Qualifications of Faculty** - Registered Nurse - At least 1 year clinical practice - Member of good standing in accredited org - Master\'s degree in nursing, education, or other allied med health sciences - Dean: 5 years of clinical experience - Military Nursing **Professional Roles and Responsibilities of Nurses and Healthcare** - **Advocate** - Defend patient\'s rights and interests and assure safety - Extends to family and support system - Become facilitators when patients - To fulfill the nurses obligation providing care vis-a-vis respect of their right - **Communicator** - Vital element in nursing in all areas of activity and in all its intervention such as prevention, treatment, therapy, rehab, education, and health promotion - Reflection of knowledge of participants the way they think and feel - **Caregiver** - Helps to manage physical needs, prevent illness, and treat health outcomes - Observe and monitor patient recording any relevant information to aid in decision making - Holistic care of pt encompassing psychosocial, developmental, cultural, and spiritual needs of individuals - **Collaborator** - Healthcare professionals assuming complementary roles and cooperatively working together, sharing responsibility - Characterized by trust, respect, and dignity - Inimical to a system in which all health care team are working - Interdisciplinary approach - **Educator** - Empowers patients to improve their health status - More likely to inc participation - Build rapport - Effective pt education - start from time patient is admitted and continues until discharged - Teach patient how to inject, change dressing - **Change Agent** - A nurse who directly or indirectly promote change process through intentional interventions into life of patients - Utilizes \"change\" concepts - Problem formulation and problem resolution in order to promote social change - Employed primarily to provide health services to clients but uses behavioral science concepts and methods in order to facilitate change in system -