Nursing Ethics SEMI-FINALS PDF

SEMI-FINALS MA. ELENA M. FIGUEROA, RN, MSN NURSING ETHICS The branch of science which treats of the duties of a member of the nursing profession towards her co-professional nurses, to her profession and other professions, to her co-workers and other members of the health team, to her client...

SEMI-FINALS MA. ELENA M. FIGUEROA, RN, MSN NURSING ETHICS The branch of science which treats of the duties of a member of the nursing profession towards her co-professional nurses, to her profession and other professions, to her co-workers and other members of the health team, to her clients and patients, and to the public in general. It refers to the conduct or behavior of nursing practitioners which by reason of public approval or practices of the group has become customary among professional nurses. It is a system of principles governing the conduct of Nurses. It deals with the relationship of the Nurse and patient, the patient’s family, his associates and fellow nurses and the society at large. UNIVERAL PRINCIPLES OF BIOMEDICAL ETHICS AUTONOMY – promotes self-determination and freedom to choose, informed consent. VERACITY – telling the truth BENEFICENCE – “to do good”; refers to actions that benefits others based on the Hippocratic Oath “ to apply measures to benefit the sick”. NON-MALEFISCENCE – this principle imposes the duty to avoid harming the patient based on the Hippocratic Oath of “do no harm”. PATERNALISM – one individual assumes the right to make decisions for another. JUSTICE – right to demand to be treated justly, fairly, and equally. CONFIDENTIALITY – keeping privileged information private. FIDELITY – Keeping one’s word of honor; loyalty to commitments and oaths; reliability PRINCIPLE OF DOUBLE-EFFECT – An action that is good in itself that has two effects – an intended and otherwise not reasonably attainable good effect, and an unintended yet foreseen evil effect – is licit, provided there is a due proportion between the intended good and the permitted evil. CODE OF ETHICS FOR NURSES The Code of Ethics for Filipino Nurses was made after a consultation on October 23, 2013 at Iloilo City after accredited professional organization - the Philippine Nurses Association, Inc. (PNA) decided to adopt a new Code of Ethics under the RA 9173. The Board of Nursing (BON) has the power to promulgate a Code of Ethics for Registered Nurses in coordination and consultation with the accredited professional organization (Sec. 9, (g), Art III of (Republic Act) No. 9173, known as the “Philippine Nursing Act of 2002); Important Provisions: 1. Health is a fundamental right of every individual. 2. The Filipino registered nurse primary responsibility is to preserve health at all cost which encompasses promotion of health, prevention of illness, alleviation of suffering, and restoration of health. (Article 1; Section 1) 3. The desire for the respect and confidence of clientele, colleagues, co- workers, and the members of the community provides the incentive to attain and maintain the highest possible degree of ethical conduct (section 3) 4. Values, customs, and spiritual beliefs held by individuals shall be respected; individual freedom to make rational and unconstrained decisions shall be respected; personal information acquired in the process of giving nursing care shall be held in strict confidence. (Article II, section 4) 5. Registered nurses must know the definition and scope of nursing practice which are in the provisions of R. A. No. 9173, known as the “Philippine Nursing Act of 2002” and Board Res. No. 425, Series of 2003, the “Rules and Regulations Implementing the ; Philippine Nursing Act. of 2002”, (the IRR); be aware of their duties and responsibilities in the practice of their profession. (Article III, section 7) 6. Registered nurses must see to it that quality nursing care and practice meet the optimum standard of safe nursing practice. (Article III, section 7) 7. Registered Nurses must ensure that patients’ records shall be available only if they are to be issued to those who are professionally and directly involved in their care and when they are required by law. (Article III, section 7) 8. Registered Nurses are the advocates of the patients: they shall take appropriate steps to safeguard their rights and privileges. This implies that nurses must respect the “Patients’ Bill of Rights” in the delivery of nursing care. (Article III, section 8). 9. RNs must provide the patients or their families with all pertinent information except those which may be deemed harmful to their well-being (Article III, section 8). 10. RNs must uphold the patients’ rights when conflict arises regarding management of their care Article III, section 8). 11. RNs must perform their professional duties in conformity with existing laws, rules regulations, measures, and generally accepted principles of moral conduct and proper decorum (Article III section 10) 12. RNs must not allow themselves to be used in advertisement that should demean the image of the profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc.) (Article III section 10). 13. RNs must decline any gift, favor or hospitality which might be interpreted as capitalizing on patients (Article III section 10). 14. RNs must not demand and receive any commission, fee or emolument for recommending or referring a patient to a physician, a co-nurse or another health care worker; not to pay any commission, fee or other compensations to the one referring or recommending a patient to them for nursing care. 15. RNs must avoid any abuse of the privilege relationship which exists with patients and of the privilege access allowed to their property, residence or workplace. 16. RNs must maintain their professional role/identity while working with other members of the health team conform with group activities as those of a health team should be based on acceptable, ethico-legal standards; contribute to the professional growth and development of other members of the health team; actively participate in professional organizations; not act in any manner prejudicial to other professions; honor and safeguard the reputation and dignity of the members of nursing and other professions; refrain from making unfair and unwarranted comments or criticisms on their competence, conduct, and procedures; or not do anything that will bring discredit to a colleague and to any member of other professions; respect the rights of their co-workers. (Article IV section 12). 17. RNs must be conscious of their obligations as citizens and, as such, be involved in community concerns; be equipped with knowledge of health resources within the community, and take roles in primary health care; project an image that will uplift the nursing profession at all times (Article V, section 14). 18. Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal; Compliance with the by- laws of the accredited professional organization (PNA), and other professional organizations of which the Registered Nurse is a member is a lofty duty (Article VI Section 15). 19. RNs must be members of the Accredited Professional Organization (PNA); strictly adhere to the nursing standards. PRC-BN– section 16. International Council of Nursing (ICN) Code of Ethics for Nurses An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2012. Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal. Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, color, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race 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 ICN CODE The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. ELEMENTS OF THE CODE: 1. Nurses and people The nurse’s primary professional responsibility is to people requiring nursing care. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. The nurse ensures that the individual receives accurate, sufficient and timely information in a culturally appropriate manner on which to base consent for care and related treatment.  The nurse holds in confidence personal information and uses judgement in sharing this information. The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations. The nurse advocates for equity and social justice in resource allocation, access to health care and other social and economic services. The nurse demonstrates professional values such as respectfulness, responsiveness, compassion, trustworthiness and integrity. 2. Nurses and practice The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. The nurse maintains a standard of personal health such that the ability to provide care is not compromised. The nurse uses judgement regarding individual competence when accepting and delegating responsibility. The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance its image and public confidence. The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people. The nurse strives to foster and maintain a practice culture promoting ethical behavior and open dialogue. 3. Nurses and the profession The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education. The nurse is active in developing a core of research-based professional knowledge that supports evidence-based practice. The nurse is active in developing and sustaining a core of professional values. The nurse, acting through the professional organization, participates in creating a positive practice environment and maintaining safe, equitable social and economic working conditions in nursing. 3 The nurse practices to sustain and protect the natural environment and is aware of its consequences on health. The nurse contributes to an ethical organizational environment and challenges unethical practices and settings. 4. Nurses and co-workers The nurse sustains a collaborative and respectful relationship with co-workers in nursing and other fields. The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co-worker or any other person. The nurse takes appropriate action to support and guide co-workers to advance ethical conduct. LEGAL ASPECTS OF NURSING LAW - “a rule of civil conduct prescribed by the supreme power in a state, commanding what is right and prohibiting what is wrong.” General Classifications of LAW DIVINE LAW – authored by God HUMAN LAW – authored by man I. PUBLIC LAW – branch of law which is concerned with the state in its political or sovereign capacity. 1. Criminal law – branch of jurisprudence which treats of the nature, extent, and degrees of every crime, and adjusts to “it” its adequate and necessary penalty. 2. International Law – the law of nations which regulates the intercourse of nations a. public international law – body of rules which control the conduct of independent states in relations with each other. b. Private international law or conflict of laws – part of the of each state which determines whether, in dealing with a legal situation, the law of some other state will be recognized, be given effect, or be applied. 3. Political Law – branch of jurisprudence which treats of the science of politics (the science of government) or the organization and administration of government. - defines the organization and operation of the governmental organs of the State, and regulates the relation between the state and the individuals that compose it. a. Constitutional Law – department of law which treats of constitutions, their establishment, construction, and interpretation, and of the validity of legal enactments as tested by the criterion of conformity to the fundamental law. b. Administrative Law – part of the law which fixes the organization and determines the competence of the authorities which execute the law, and indicates to the individual the remedies for the violation of his rights. c. Law of Public Administration – branch of political law which deals with the organization and management of the different branches of the government. d. Law of Public Corporations – branch of political law which deals with public corporations - Public corporation – created for public or governmental purposes (ex. Municipal corporations) II. PRIVATE LAW – a term used to indicate a statute which relates to private matters that do not concern the public at large 1. CIVIL Law – branch of the law which has the double purpose of organizing the family and regulating property. 2. COMMERCIAL Law – branch of the law which relates to the rights of property and the relations of persons engaged in commerce. 3. REMEDIAL Law – branch of the law which prescribes methods of enforcing rights or of obtaining redress (remedy or compensation for a wrong or grievance) for their invasion. - In law, remedy is the means employed to enforce a right or redress an injury.  What is a BILL? a draft of Law submitted for the consideration of a legislative body for its adoption. What is an ENROLLED BILL? an already printed bill as finally approved by the Congress, thereafter authenticated with the signatures of the Senate President, the Speaker and the Secretaries of their respective chambers and approved by the President. How Does A Bill Become A Law? 1. A bill is introduced by any member of the House of the Representatives or the Senate except for some measures that must originate only from the former chamber; 2. The First Reading involves a reading of the number and title of the measure and its referral by the Senate President or the Speaker to the proper committee for study; 3. The bill may be “killed” in the committee or it may be recommended for approval, with or without amendments, sometimes after public hearings are first held thereon. If there are other bills of the same nature or purpose, they may all be consolidated into the bill under common authorship or as a committee bill; 4. Once reported out, the bill shall be calendared for Second Reading. It is at this stage that the bill is read in its entirety, scrutinized, debated upon and amended when desired; 5. The bill as approved on the Second Reading is printed its final form and copies thereof are distributed at least three (3) days before the third reading. On the Third Reading, the members merely register their votes and explain them if they are allowed by the rules. Here, no further debate is allowed; 6. Once the bill passes Third Reading, it is sent to the other chamber where it will also undergo the three (3) readings. If there are differences between the versions approved by the two chambers, a conference committee representing both Houses will draft a compromised measure that if ratified by the Senate and the House of Representatives will then be submitted to the President for his consideration; and 7. The bill is enrolled when printed as finally approved by the Congress, thereafter authenticated with the signatures of the Senate President, the Speaker and the Secretaries of their respective chambers and approved by the President. When Does A Bill Become A Law? 1. When the President approves the bill passed by the Congress. 2. When two-thirds votes of all the members of each House repassed the bill over the veto (a constitutional right to reject a decision or proposal made by a law-making body of the President.) 3. If the President does not communicate his veto to any bill to the House where it originated within thirty days after the date of receipt hereof. LEGAL RIGHT Right in civil society, defined to mean that which a man is entitled to have, or to do, or to receive from others within the limits prescribed by law. In a juristic sense, it is a capacity residing in one man of controlling, with the assent (approval) and assistance of the state, the action of others. By legal right is meant that right to which the state gives its sanction (approval); it is a claim which can be enforced by legal means against the persons or the community whose duty is to respect it. COURT OF JUSTICE Court – body in the government to which the public administration of justice is delegated. - it is a place where justice is judicially (legally) administered Court of Law in a wide sense, is any duly constituted tribunal (court of justice) administering the laws of the state or nation. Court of equity is a court which administers justice and decides controversies in accordance with the rules, principles, and precedents of equity. Competent court – court having lawful jurisdiction (the official power to make legal decisions and judgments.)synonym:authority PURPOSE To provide the forum for place where people who have disputes may get them authoritatively settled by an outsider who is not personally concerned in the outcome of the dispute To provide a place where persons accused of offenses against society as a whole may have their guilt or innocence ascertained (find out for certain) JURISDICTION AND VENUE Jurisdiction – the authority to hear and decide a legal controversy, it is the authority by which judicial officers take cognizance (knowledge) of and decide cases. - is the power or authority to hear and determine a cause. Jurisdiction as applied to the faculty of exercising judicial power, mar refer to the authority of the court to entertain a particular kind of action or to administer a particular kind of relief, or it may refer to the power of the court over the parties or over the property which is the subject of litigation. VENUE – is the place where either party to a suit may require the case to be tried, and to the convenience of the parties, it also relates to the proper place where the power to adjudicate may be exercised. - it does not connote jurisdiction but the locality or place where the suit should be heard. The difference between the jurisdiction and venue: Jurisdiction – refers to the inherent power of the court to decide a case Venue – relates to the particular district or city in which a court having such jurisdiction may properly hear and determine the case. LEGAL REMEDIES Remedy – is the means employed to enforce a right or redress an injury Ordinary remedy – an ordinary action or suit in a court of justice, by which one party prosecutes another for the enforcement or protection of a right, or the prevention or redress of a wrong; every other remedy is a special proceeding. Extraordinary remedy – one afforded by law other than the ordinary remedy by action. - An extraordinary remedy is not granted where there is an adequate remedy in the ordinary course of law. Provisional remedy - a remedy which is provided for present need or for the immediate occasion, that is, one adapted to meet a particular exigency (situation demanding prompt action or remedy; it is a temporary process which secures (protects) the plaintiff in a civil action against loss or irreparable injury while the action is pending. SERVICE OF PROCESS Process – in law practice, is generally defined as the means of compelling the defendant in an action to appear in court, it is a means whereby a court compels the appearance of a defendant before it or a compliance with its demands. Service of process - is the giving to a defendant of that notice which makes him a party to the proceeding and makes it incumbent on him to appear and answer to the cause (suit), or run the risk of having a valid judgment rendered against him in consequence of his default. Process more commonly served: Warrant - writing from a competent authority in pursuance of law, directing the doing of an act, and addressed to an officer or person competent to do the act, and affording him protection from damages, if he does it. Search warrant – is an order in writing, in the name of the people or the State, signed by a magistrate (public officer), and directed to a peace officer, commanding him to search for personal property and bring it before the magistrate.  Summons – is the name of a writ commanding the sheriff or other authorized officer to notify a party to appear in court to answer a complaint made against him, and in said writ specified, on a day therein mentioned. Subpoena – is the process by which the attendance of a witness, it is a writ or order directed to a person requiring his attendance at a particular time and place to testify as a witness. Subpoena duces tecum – is a subpoena which does not only compel the personal attendance of a witness in court but also requires such witness to bring with him and produce to the court, books, papers, and the like, which may be in his hands or possession and which tend to elucidate the matter in issue. DAMAGE AND DAMAGES Damage – a loss, injury or harm caused to one’s person, property, or rights by the negligence, design (plan), accident or wrongful act or omission of another. Damages – refers to a sum of money which the law awards to a person to compensate him for his loss, injury, or harm cause by the negligence, design (plan), accident, or wrongful act or omission of another. In short, damage is a loss, injury or harm; damages is the monetary compensation for such loss, injury or harm RA 9173 or The Nursing Act of 2002 October 21, 2002 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 Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assemble Important provisions: ARTICLE III Organization of the Board of Nursing Section 3. Creation and Composition of the Board. - There shall be 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 two (2) recommendees, per vacancy, of the Professional Regulation Commission, hereinafter referred to as the Commission, chosen and ranked from a list of three (3) nominees, per vacancy, of the accredited professional organization of nurses in the Philippines who possess the qualifications prescribed in Section 4 of this Act. Section 4. Qualifications of the Chairperson and Members of the Board. - The Chairperson and 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; (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 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 a master's degree in nursing; (d) Have at least ten (10) years of continuous practice of the profession prior to appointment: Provided, however, That the last five (5) years of which shall be in the Philippines; and (e) Not have been convicted of any offense involving moral turpitude; Provided, That the membership to the Board shall represent the three (3) areas of nursing, namely: nursing education, nursing service and community health nursing.  Section 5. Requirements Upon Qualification 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, 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 subdivision, agency or instrumentality thereof, including government-owned or controlled corporations or their subsidiaries as well as these 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. Section 6. Term of Office.. - The Chairperson and Members of the Board 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 re-appointed 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 Republic Act No. 7164 until their replacements have been appointed by the President and shall have been duly qualified. Section 7. Compensation of the Board 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. 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 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 the written recommendation of the Board; (e) Conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional 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 interfeming with the conduct of such proceedings, upon application with the court; (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 improvements 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. Section 10. Annual Report. - The Board shall at the close of its calendar year submit an annual report to the President of the Philippines through the Commission giving a 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. 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 dis honorable conduct.  ARTICLE IV Examination and Registration Section 12. Licensure Examination. - All applicants for license to practice nursing shall be required to pass a written examination, which shall be given by the Board in such places and dates as may be 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." 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 of 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. 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 subjects of examinations. 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 percent (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. Section 16. Oath. - All successful candidates in the examination shall be required to take an oath of profession before the Board or any government official authorized to administer oaths prior to entering upon the nursing practice. 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 registrant, the serial number, the signature of the Chairperson 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. 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 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. - A 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 schools/colleges of nursing as exchange professors in a branch or specialty of nursing; d. Provided, however, That the special/temporary permit shall be effective only for the duration of the project, medical mission or employment contract. Section 22. Non-registration and Non-issuance of Certificates of Registration/Professional License or Special/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; (f) For violation of this Act, the rules and regulations, Code of Ethics for nurses and technical standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the temporarily/special permit; or (g) 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. Section 24. Re-issuance of Revoked Certificates and Replacement of Lost Certificates. - The Board may, after the expiration of a maximum of 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 therefor 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 for 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. Section 26. Requirement for Inactive Nurses Returning to Practice. - Nurses who have not actively practiced the profession for five (5) consecutive years are required to undergo one (1) month of didactic training and three (3) months of practicum. The Board shall accredit hospitals to conduct the said training 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.  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, preschool, school age, adolescence, adulthood, and old age. As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. A 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 antenatal 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 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 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 nursing organization: Provided, finally, That 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. - 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 Bachelors 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 of 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 master's 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 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 such positions before the effectivity of this Act shall be given a period of five (5) years within which to qualify.  ARTICLE VII Health Human Resources 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 resources production, utilization and development. Section 31. Comprehensive Nursing Specialty Program. - Within ninety (90) 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 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 and continuous service. Section 32. Salary. - In order to enhance the general welfare, commitment to service and professionalism of nurses the minimum base pay of nurses working in the public health institutions shall not be lower than salary grade 15 prescribes 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 the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation, which shall equally share in the costs and shall be released to the Department of Health subject to accounting and auditing procedures: Provided, That the department of Health shall set the criteria for the availment 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 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: (a) any person practicing nursing in the Philippines within the meaning of this Act: (1) 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 provision of this Act; or (2) who uses as his/her own certificate 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 permits; 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 a registered and licensed nurse; or (6) 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 (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 judicial 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 (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 LEGAL RESPONSIBILITIES OF NURSES Nursing Jurisprudence defined.. As that department of law which comprises all the legal rules and principles affecting the practice of nursing. As a science of law, it includes not only the study but also the interpretation of all these rules and principles and their application in the regulation of the practice of nursing. Nursing legislation Legislation means “the act or process of making a law or laws”, and also “the law or laws made.” Therefore, nursing legislation may be defined as the making of laws, or the body of laws already enacted, affecting the science or the art and practice of nursing. NURSES AND CRIMINAL LIABILITY FELONIES Are acts or omissions punishable by law and they may be committed not only by means of deceit (dolo) but also by means of fault (culpa) - revised penal code, article 3 Deceit – when the act is performed with deliberate intent. Fault – when the wrongful act results from imprudence, negligence, lack of foresight, or lack of skill. CRIMINAL LIABILITY Incurred by any person committing a felony although the wrongful act done be different from that which he intended. In other words, the author of a crime shall be held liable for all the natural consequences of his illegal acts even if such results have not been intended by him.  CLASSIFICATION OF FELONIES According to the degrees of the acts of execution: Consummated – when all elements necessary for its execution and accomplishment are present. Frustrated – when the offender performs all the acts of execution which would produce the felony as a consequence but which, nevertheless, do not produce it by reason of causes independent of the will of the perpetrator (a person who commits an evil deed.  There is an attempt to commit a felony when the offender commences the commission of the same directly by overt (open or manifest) acts, and does not perform all the acts of execution which should produce the felony, by reason of some cause or accident other than his own spontaneous desistance (stopping to act by a natural feeling or impulse) Consummated felonies, as well as those which are frustrated and attempted, are punishable According to the degree of punishment: Grave felonies are those to which the law attaches the capital punishment (death) or penalties which in any of their periods are afflictive (imprinsonment ranging from 6 years and 1 day to life imprisonment, or a fine exceeding 6,000.00 ) Light felonies – are those infractions of law for the commission of which the penalty of arresto menor (imprisonment ranging from 1 day to 30 days) or a fine not exceeding 200.00, or both is imposed. It is punishable only when they have been consummated, with the exception of those committed against persons or property. Conspiracy to commit a crime Conspiracy exists when 2 or more persons come to an agreement concerning the commission of a felony and decide to commit it. Each is criminally responsible for the acts of his associates, provided such acts are the result of the common plan or purpose. Classification of persons criminally liable Principals of a crime are those who take a direct part in the execution of the act, or those who directly force or induce others to commit it, or those who cooperate in the commission of the offense by another act without which the crime would not have been accomplished. Accomplices are those persons who, not being principals by direct participation, inducement, or cooperation through another act essential to the consummation of the crime, cooperate in the execution of the offense by previous or simultaneous acts. In criminal law, accomplices are also known as “accessories before the act” Ex: A nurse who advises a pregnant woman as to where she may go to submit to criminal abortion, may be guilty of said crime as a accomplice, that is, “accessory before the act,” although she may not be present when the abortion is performed. Accessories are those who, having knowledge of the commission of the crime and without having participated therein either as principals or accomplices, take part subsequently to its commission in any of the following manners: a. By profiting themselves or assisting the offenders to profit by the effects of the crime. b. By concealing or destroying the body of the crime, or the effects or instruments thereof, in order to prevent its discovery; c. By harboring, concealing, or assisting in the escape of the principal of the crime Circumstances affecting criminal liability Justifying circumstances – one who acts in defense of his person or rights, does not incur any criminal liability, provided that the following circumstances concur: A. Unlawful aggression (hostile or violent behavior) on the part of the offended or injured party; B. Reasonable necessity of the means employed by the offender (person defending himself) to prevent or repel such aggression; and C. Lack of sufficient provocation on the part of the offender. D. Anyone who acts in defense of the person or rights of his spouse or relative does not incur any criminal liability, provided that there is unlawful aggression on the part of the offended or injured party. E. Anyone who acts in defense of the person or rights of a stranger does not also incur any criminal liability, provided…and that the defender is not induced by revenge, resentment, or other evil motive. F. Any person who, in order to avoid an evil or injury, does an act, which causes damage to another, shall not likewise incur any criminal liability, provided that the evil sought to be avoided actually exists; that the injury feared be greater than that done to avoid it. G. Any person who acts in the fulfillment of a duty or in the lawful exercise of a right or office shall not also incur any criminal liability where such acts result in the commission of a crime. H. Any person who acts in obedience to an order issued by a superior for some lawful purpose shall not likewise incur any criminal liability. Two requisites are necessary: 1. The order of the superior must be lawful. The superior giving the order must be acting within the scope of his official authority. 2. The order must be for some lawful purpose Exempting Circumstances: a. An imbecile or an insane person, unless the latter has acted during a lucid interval. b. A person under 9 years of age. c. A person over nine years of age and under fifteen unless he has acted with discernment. d. Any person who, while performing a lawful act with due care, causes an injury by mere accident, without fault or intention of causing it. e. Any person who acts under the compulsion of an irresistible force. f. Any person who acts under the impulse of an uncontrollable fear of an equal or greater injury. g. Any person who fails to perform an act required by law, when prevented by some lawful or insuperable cause. In order that an act or omission may be considered a crime, it must have been done with criminal intent or willfulness. Mitigating circumstances – circumstances that lessen the criminal liability of the offender. a. The offender is under 18 years of age or over 70 years. b. The offender had no intention to commit so grave a wrong as that committed. c. Sufficient provocation or threat on the part of the offended party immediately preceded the act. d. The offender is deaf and dumb, blind or otherwise suffering from physical defect which thus restricts his means of action, defense, or communication with his fellow beings. e. The offender had voluntarily surrendered himself to a person in authority or his agents, or that he had voluntarily confessed his guilt before the court prior to the presentation of the evidence for the prosecution. Aggravating circumstances – are those attending the commission of a crime which increase the criminal liability of the offender or make his guilt more severe. a. The advantage be taken by the offender of his public position. b. The crime be committed with abuse of confidence or obvious ungratefulness c. The crime be committed in consideration of a price, reward, or promise. d. the craft, fraud, or disguise be employed. e. The crime be committed by means of inundation, fire, poison, explosion, stranding of a vessel or intentional damage thereto, derailment of a locomotive, or by the use of any other artifice involving a great waste or ruin. f. The act be committed with evident premeditation. g. The wrong done in the commission of the crime be deliberately augmented by causing other wrong not necessary for its commission. h. The crime be committed in contempt of or with insult to the public authorities. i. The crime be committed on the occasion of a conflagration, shipwreck, earthquake, epidemic or other calamity or misfortune. Alternative circumstances – are those which must be taken into consideration either as aggravating or mitigating, depending on the nature and effects of the crime. a. Relationship – when the offended party is the spouse, ascendant, descendant, brother or sister or relative by affinity in the same degrees of the offender. b. Intoxication – taken into consideration as a mitigating circumstance when the offended has committed a felony in a state of intoxication, provided that the same is not habitual or subsequent to the plan to commit said felony. Habitual or intentional – aggravating circumstance  NURSES AND CRIMES Parricide – the crime committed by one who kills his father, mother, or child, whether legitimate or illegitimate, or any of his ascendants or descendants, or his spouse; Punishment: penalty of reclusion perpetua (life imprisonment) to death. Murder – the crime committed by a person who kills another, other than his father, mother, or child or any of his ascendants or descendants, or his spouse. Reclusion temporal in its maximum period (imprisonment from 17 years, 4 months and 1 day to 20 years) to death if the crime is committed with any of the following circumstances: 1. With treachery, taking advantage of superior strength, with the aid of armed men or means to weaken the defense. 2. In consideration of a price, reward, or promise. 3. By means of inundation, fire, poison, explosion, shipwreck, stranding of a vessel, derailment or assault upon a street car or locomotive, fall of an airship, by means of motor vehicles, or with the use of any other means involving great waste and ruin. 4. With evident premeditation Homicide – killing of any human creature; not necessarily a crime; it may be committed without criminal intent and without criminal consequences, as where it is done in self-defense. Under the law, homicide is the crime committed by any person who kills another other than his father, mother, or child, or any of his ascendants or descendants, or his spouse. Penalty: imprisonment for 12 years and 1 day to 20 years. Infanticide – is the killing of the child less than 3 days of age. Penalty: same with parricide and murder If this crime be committed by the mother of the child for the purpose of concealing her dishonor, she shall suffer the penalty of imprisonment ranging from 2 years, 4 months and 1 day to 6 years. Abortion – In medical science, abortion means the termination of pregnancy before the fetus is viable Miscarriage – expulsion of the fetus occurs during the period after the fetus has reached viability. Legal jurisprudence defines abortion as “the expulsion of the fetus at a period of uterogestation (pregnancy within the womb) so early that is has not acquired the power of sustaining an independent life”. In the Philippines, the practice of abortion is a crime punishable with heavy penalties. Abortion is usually understood to mean “criminal abortion” whenever it is performed deliberately or on purpose. 3 Categories of Criminal Abortion (Revised Penal Code) Intentional – liable to criminal penalty of imprisonment ranging from 12 years and 1 day to 20 years,if he uses violence upon the pregnant woman, and 6 yrs and 1 day to 12 yrs if, using no violence, he causes the abortion without the consent of the pregnant woman. Or imprisonment for 2 yrs, 4 months and 1 day to 6 years, if he causes the abortion with the consent of the pregnant woman. Unintentional – if he causes an abortion but unintentional, he is liable to a criminal penalty of imprisonment ranging from 6 months and 1 day to 4 years and 2 months. Abortion practiced by the woman herself or by her parents – or gives her consent to another to do it, she will be subject to the penalty of imprisonment lasting from 2 years, 4 months and 1 day to 6 years A pregnant woman who performs an abortion on herself, or gives her consent to another to do it, for the purpose of concealing her dishonor is likewise criminally liable and can suffer the penalty of imprisonment lasting from 6 months and 1 day to 4 yrs and 4 months; if the abortion is performed by the parents, or by either of them, with the consent of the pregnant woman, for the purpose of concealing her dishonor, the offenders can also be criminally liable and can be penalized with imprisonment from 2 yrs, 4 months and 1 day to 6 years. Abortion practiced by a physician or midwife A physician or midwife who takes advantage of his or her scientific knowledge or skill and it causes an abortion or assists in bringing about an abortion, with the use of violence upon the person of the pregnant woman, is liable to the penalty of imprisonment from 17 yrs, 4 months and 1 day to 20 yrs. If the physician or midwife causes an abortion or assists in causing an abortion without using violence but without the consent of the pregnant woman, he or she can be punished with imprisonment from 10 years and 1 day to 12 yrs If the pregnant woman consented to her abortion the physician or midwife is liable to imprisonment ranging from 4 yrs, 2 months and 1 day to 6 yrs. Child Abuse – any form of cruelty to a child’s physical, moral or mental well-being. - Also a term used to describe form of sexual attack which may or may not amount to rape. - Abused and neglected children – are those who are suffering serious physical or emotional injury inflicted on them, including malnutrition. - In the Philippines, under the law, child abuse refers to the maltreatment, whether habitual or not, of the child, and such maltreatment includes any of the following: 1. Psychological and physical abuse, neglect, cruelty, sexual abuse and emotional maltreatment; 2. Any act, by deeds or words, which debases, degrades or demeans the intrinsic worth and dignity of a child as a human being. 3. Unreasonable deprivation of the child’s basic needs for survival, such as food and shelter; or 4. Failure to immediately give medical treatment to an injured child, resulting in serious impairment of his growth and development or in his permanent incapacity or death. 5. An offender convicted by the court of child abuse is subject to imprisonment or fine under the law. Sexual Harassment – is meant words, gestures and actions which tend to annoy and verbally abuse another person. A person commits a petty misdemeanor if, with purpose to harass another, he: Makes a telephone call without purpose of legitimate communication; or Insults, taunts (mocks), or challenges another in a manner likely to provoke violent or disorderly response; or Makes repeated communications anonymously or at extremely inconvenient hours, or in offensively course language; or Subjects another to an offensive touching; or Engages on any other course of alarming conduct serving no legitimate purpose of the action. Sexual harassment, as defined by law, is committed by an: Employer teacher Employee instructor Manager professor Supervisor coach Agent of the employer or any other 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. Any person who violates the provisions of RA 7877, declaring an unlawful sexual harassment in the employment, education or training environment, shall, upon conviction be penalized by imprisonment of not less than one month nor more than 6 months or a fine of not less than 10,000.00 nor more than 20,000.00 or both such fine and imprisonment at the discretion of the court. Giving assistance to suicide- he shall imprisonment from 6 years and 1 day to 12 yrs., if such person lends his assistance to another to the extent of doing the killing himself, he shall suffer the penalty of imprisonment from 12 yrs and 1 day to 20 yrs; However, if the suicide is not consummated, the penalty of imprisonment from 2 months and 1 day to 6 months shall be impose. Illegal detention – crime of illegal detention may arise in connection with the enforcement of quarantine regulations or in the isolation of patients. Any private individual who shall detain another, or in any other manner, deprive him of his liberty, shall suffer the penalty of reclusion perpetua (life imprisonment) or death, if he committed the crime under the following circumstances: 1. The detention had lasted for more than 5 days 2. The offender was simulating public authority (pretending to be a government authority when he committed the crime; 3. Serious physical injuries had been inflicted on the detained or kidnapped victim, or threats to kill him had been made. 4. The detained or kidnapped victim is a minor, female or a public officer.  The penalty of death shall be imposed on the offender even if none of the aforementioned circumstances was present, if he detained a person for the purpose of extorting ransom from the detained or kidnapped victim or from any other person. Simulation of births – is a crime against the civil status of persons for which the law imposes the penalty of imprisonment from 6 years and 1 day to 12 years and a fine not exceeding 1,000.00 The same penalties shall be imposed upon any person who shall substitute one child for another or who shall conceal or abandon any legitimate child with intent to cause such child lose its civil status. Any physician, surgeon or public officer who, in violation of the duties of his profession or office, shall cooperate in the commission of the crime aforementioned, shall suffer the same penalties as stated above and also the penalty of temporary special disqualification. Criminal negligence – is negligence of such a character, or occurring under circumstances, as to be punishable as a crime by statute, or such a flagrant and reckless disregard of the safety of others, or willful indifference to the injury liable to follow, as to convert an act otherwise lawful into a crime when it results in personal injury or death. classes: 1. Reckless imprudence or negligence -a person is guilty of this if he does an act or fails to do an act, voluntarily but without malice, from which act or omission a material damage results because of his inexcusable lack of precaution, taking into consideration his employment or occupation, degree of intelligence, physical condition, and other circumstances regarding persons, time and place. 2. Simple imprudence – if a person shows lack of precaution in those cases in which the damage about to be caused is not immediate or in which the impending danger is not evident or manifest. Any person who, by reckless imprudence shall commit an act which, had been intentional, would constitute a grave felony can be liable to a penalty of imprisonment ranging from 4 months and 1 day to 2 years and 4 months; if the negligent act constitutes a less grave felony, the offender can be punished by imprisonment from 1 month to 4 months. Any person who by simple imprudence, shall commit an act which would constitute a grave felony can be liable to a penalty of imprisonment ranging from 2 months and 1 day to 6 months; if the negligent act constitutes a less serious felony, the offender can be punished by imprisonment from 1 month to 2 months. NURSES and MISDEMEANOR Misdemeanor – is a term used to express every offense inferior to felony; punishable by indictment, or by particular prescribed proceedings; misdemeanors comprehend all indictable offenses which do not amount to felony. Misdemeanor – is applied to all those crimes and offenses for which the law has not provided a particular name. - doing an act falling within the domain of practice of an established profession by a person not licensed to practice the same. Ex of these laws: Nursing law, Midwifery law, Dental law, Pharmacy law  Under the nursing law, for instance, any person who practices nursing in the Philippines without a certificate of registration as nurse issued by the board of nursing, or without having been exempted from examination and registration, or any person assuming or using the title of, or advertising as Registered Nurse, or appending to her name the letters, “R.N.” or “BSN” without being conferred such title or degree, or any person advertising any title or description tending to convey the impression that she is a nurse (ex. Using the nurse’s uniform and cap)without holding a valid registration certificate as nurse issued by the Board, shall be guilty of misdemeanor and shall, upon conviction, be sentenced to a fine of not less than 1,000.00 nor more than 5,000.00 or to suffer imprisonment for a period of not less than one year nor more than 5 years, or both. PROFESSIONAL NEGLIGENCE Negligence – 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 or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property. Example: Failure to report observations to attending physician. ELEMENTS 1. Existence of a duty on the part of the person charged to use due care under circumstances 2. Failure to meet standard of due care. 3. The foreseeability of harm resulting from failure to meet the standard. 4. The fact that the breach of this standard resulted in an injury to the plaintiff. 3 Conditions occur to establish a defendant’s negligence without proving specific conduct 1. That the injury was of such nature that it would not normally occur unless there was a negligent act on the part of someone. 2. That the injury was caused by an agency within control of the defendant. 3. That the plaintiff himself did not engage in any manner that would tend to bring about the injury. DOCTRINE OF RES IPSA LOQUITOR “The thing speaks for itself” Rule: When a thing which has caused an injury is shown to be under the management of the party charged with negligence and the accident is such as in the ordinary course of things will not happen if those who have such management use proper care, the accident itself affords reasonable evidence in the absence of explanation by the parties charge, that is rose from the want of proper care. MALPRACTICE Implies the idea of improper or unskillful care of a patient by a nurse. Also denotes stepping beyond one’s authority with serious consequences. DOCTRINE OF FORCE MAJEURE Means an irresistible force, one that is unforeseen or inevitable. Rule: When a debtor is unable to comply with his obligation because of force majeure, he cannot be liable for such performance. In the absence of stipulations to the contrary, impossibility of performance, without the negligence of the parties, prevents the enforcement of bond or contract. Circumstances such as floods, fire earthquakes and accidents falls under this doctrine and nurses who fail to render circumstances are not held negligent. DOCTRINE OF RESPONDEAT SUPERIOR -Let the master answer for the acts of the subordinate. Ex. If the hospital will decide to hire under board nurses or midwives in place of professional nurse in an effort to cut down on expenses and these persons prove to be incompetent then the hospital will be held liable. INCOMPETENCE – lack of ability, legal qualifications of fitness to discharge the required duty.  OTHER LAWS AFFECTING NURSING PROFESSION AND THE NURSE The Magna Carta of Public Health Workers (Republic Act 7305) Approved: March 26, 1992. This act aims to promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment; to develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and to encourage those with proper qualifications and excellent abilities to join and remain in government service. For purposes of this Act, "health workers" shall mean all persons who are engaged in health and health-related work. Recruitment and Qualification: shall be developed and implemented by the appropriate government agencies concerned in accordance with policies and standards of the Civil Service Commission: Provided, That in the absence of appropriate eligibles and it becomes necessary in the public interest to fill a vacancy, a temporary appointment shall be issued to the person who meets all the requirements for the position to which he/she is being appointed except the appropriate civil service eligibility: Provided, further, That such temporary appointment shall not exceed twelve (12) months nor be less than three (3) months renewal thereafter but that the appointee may be replaced sooner if (a) qualified civil service eligible becomes available, or (b) the appointee is found wanting in performance or conduct befitting a government employee. Performance Evaluation and Merit Promotion. - The Secretary of Health, upon consultation with the proper government agency concerned and the Management-Health Workers’ Consultative Councils, as established under Section 33 of this Act, shall prepare a uniform career and personnel development plan applicable to all public health personnel. Such career and personnel development plan shall include provisions on merit promotion, performance evaluation, inservice training grants, job rotation, suggestions and incentive award system. The performance evaluation plan shall consider foremost the improvement of individual employee efficiency and organizational effectiveness: Provided, That each employee shall be informed regularly by his/her supervisor of his/her performance evaluation. The merit promotion plan shall be in consonance with the rules of the Civil Service Commission. Transfer or Geographical Reassignment of Public health Workers: Transfer is a movement from one position to another which is of equivalent rank, level or salary without break in service; a public health worker shall not be transferred and or reassigned, except when made in the interest of public service, in which case, the employee concerned shall be informed of the reasons therefore in writing. If the public health worker believes that there is no justification for the transfer and/or reassignment, he/she may appeal his/her case to the Civil Service Commission, which shall cause his/her reassignment to be held in abeyance; Provided, That no transfer and/or reassignment whatsoever shall be made three (3) months before any local or national elections: Provided, further, That the necessary expenses of the transfer and/or reassignment of the public health worker and his/her immediate family shall be paid for the Government.  Married Public Health Workers. - Whenever possible, the proper authorities shall take steps to enable married couples, both of whom are public health workers, to be employed or assigned in the same municipality, but not in the same office. Security of Tenure. - In case of regular employment of public health workers, their services shall not be terminated except for cause provided by law and after due process: Provided, That if a public health workers is found by the Civil Service Commission to be unjustly dismissed from work, he/she shall be entitled to reinstatement without loss of seniority rights and to his/her back wages with twelve percent (12%) interest computed from the time his/her compensation was withheld from his/her up to time of reinstatement. Discrimination Prohibited. - A public worker shall not be discriminated against with regard to gender, civil status, civil status, creed, religious or political beliefs and ethnic groupings in the exercise of his/her profession. No Understaffing/Overloading of Health Staff. - There shall be no understaffing or overloading of public health workers. The ratio of health staff to patient load shall be such as to reasonably effect a sustained delivery of quality health care at all times without overworking the public health worker and over extending his/her duty and service. Health students and apprentices shall be allowed only for purposes of training and education. Administration Charges. - Administrative charges against a public health worker shall be heard by a committee composed of the provincial health officer of the province where the public health worker belongs, as chairperson, a representative of any existing national or provincial public health workers’ organization or in its absence its local counterfeit and a supervisor of the district, the last two (2) to be designated by the provincial health officer mentioned above. The committee shall submit its findings and recommendations to the Secretary of Health within thirty (30) days from the termination of the hearings. Where the provincial health officer is an interested party, all the members of the committee shall be appointed by the Secretary of Health. Safeguards in Disciplinary Procedures - In every disciplinary proceeding, the public health worker shall have; (a) the right to be informed, in writing, of the charges; (b) the right to full access to the evidence in the case; (c) the right to defend himself/herself and to be defended by a representative of his/her choice and/or by his/her organization, adequate time being given to the public health worker for the preparation of his/her defense; (d) the right to confront witnesses presented against him/her and summon witnesses in his/her behalf; (e) the right to appeal to designated authorities; (f) the right to reimbursement of reasonable expenses incurred in his/her defense in case of exoneration or dismissal of the charges; and (g) such other rights as will ensure fairness and impartiality during proceedings. Duties and Obligations. - The public health workers shall: (a) discharge his/her duty humanely wit conscience and dignity; (b) perform his/her duty with utmost respect for life; and race, gender, religion, nationality, party policies, social standing or capacity to pay. Code of Conduct. - Within six (6) months from the approval of this Act, the Secretary of Health, upon consultation with other appropriate agencies, professional and health workers’ organization, shall formulate and prepare a Code of Conduct for Public Health Workers, which shall be disseminated as widely as possible. Normal Hours of Work. - The normal of wok of any public health worker shall not exceed eight (8) hours a day or forty (40) hours a week. Hours worked shall include: (a) all the time during which a public health worker is required to be on active duty or to be at a prescribed workplace; and (b) all the time during which a public health worker is suffered or permitted to work. Provided, That the time when the public health worker is place on "On Call" status shall not be considered as hours worked but shall entitled the public health worker to an "On Call" pay equivalent to fifty percent (50%) of his/her regular wage. "On Call" status refers to a condition when public health workers are called upon to respond to urgent or immediate need for health/medical assistance or relief work during emergencies such that he/she cannot devote the time for his/her own use. Overtime Work. - Where the exigencies of the service so require, any public health worker may be required t render, service beyond the normal eight (8) hours a day. In such a case, the workers shall be paid an additional compensation in accordance with existing laws and prevailing practices. Work During Rest Day. Where a public health worker is made to work on his/her schedule rest day, he/she shall be paid an additional compensation in accordance with existing laws; and where a public health worker is made to worm on any special holiday he/she shall be paid an additional compensation in accordance with existing laws. Where such holiday work falls on the workers’ scheduled rest day, he/she shall be entitled to an additional compensation as may be provided by existing laws. Night-Shift Differential. - ten percent (10%) of his/her regular wage for each hour of work performed during the night-shifts customarily adopted by hospitals; every health worker required to work on the period covered after his/her regular schedule shall be entitled to his/her regular wage plus the regular overtime rate and an additional amount of ten percent (10%) of such overtime rate for each hour of work performed between ten (10) o’clock in the evening to six (6) o’clock in the morning. Salaries. - In the determination of the salary scale of public health workers, the provisions of Republic Act No. 6758 shall govern, except that the benchmark for Rural Health Physicians shall be upgraded to Grade 24. Deductions Prohibited - No person shall make any deduction whatsoever from the salaries or public health workers except under specific provision of law authorizing such deductions Additional Compensation. - Notwithstanding Section 12 of Republic Act No. 6758, public workers shall received the following allowances: hazard allowance, subsistence allowance, longevity pay, laundry allowance and remote assignment allowance. Hazard Allowance. - at least twenty-five percent (25%) of the monthly basic salary of health workers receiving salary grade 19 and below, and five percent (5%) for health workers with salary grade 20 and above. Subsistence Allowance. - Public health workers who are required to render service within the premises of hospitals, sanitaria, health infirmaries, main health centers, rural health units and barangay health stations, or clinics, and other health- related establishments in order to make their services available at any and all times, shall be entitled to full subsistence allowance of three (3) meals which may be computed in accordance with prevailing circumstances as determined by the Secretary of Health in consultation with the Management Health Workers’ Consultative Councils, as established under Section 33 of this Act: Provided, That representation and travel allowance shall be given to rural health physicians as enjoyed by municipal agriculturists, municipal planning and development officers and budget officers. Longevity Pay. - A monthly longevity pay equivalent to five percent (5%) of the monthly basic pay shall be paid to a health worker for every five (5) years of continuous, efficient and meritorious services rendered as certified by the chief of office concerned commencing with the service after the approval of this Act. Laundry Allowance. - All public health workers who are required to wear uniforms regularly shall be entitled to laundry allowance equivalent to one hundred twenty-five pesos (P125.00) per month: Provided, That this rate shall be reviewed periodically and increased accordingly by the Secretary of Health in consultation with the appropriate government agencies concerned taking into account existing laws and prevailing practices. Remote Assignment Allowance. - Doctors, dentists, nurses, and midwives who accept assignments as such in remote areas or isolated stations, which for reasons of far distance or hard accessibility such positions had not been filed for the last two (2) years prior to the approval of this Act, shall be entitled to an incentive bonus in the form of remote assignment allowance equivalent to fifty percent (50%) of their basic pay, and shall be entitled to reimbursement of the cost of reasonable transportation to and from and during official trips. Housing. - All public health workers who are in tour of duty and those who, because of unavoidable circumstances are forces to stay in the hospital, sanitaria or health infirmary premises, shall entitles to free living quarters within the hospital, sanitarium or health infirmary or if such quarters are not available, shall receive quarters allowance as may be determined by the Secretary of Health and other appropriate government agencies concerned: Provided, That this rate shall be reviewed periodically and increased accordingly by the Secretary of Health in consultation with the appropriate government agencies concerned. Medical Examination. - Compulsory medical examination shall be provided free of charge to all public health workers before entering the service in the Government or its subdivisions and shall be repeated once a year during the tenure of employment of all public health workers. Compensation of Injuries. - Public health workers shall be protected against the consequences of employment injuries in accordance with existing laws. Injuries incurred while doing overtime work shall be presumed work-connected. Leave Benefits for Public Health Workers. - Public health workers are entitled to such vacation and sick leaves as provided by existing laws and prevailing practices: Provided, That in addition to the leave privilege now enjoyed by public health, women health workers are entitled to such maternity leaves provided by existing laws and prevailing practices: Provided, further, That upon separation of the public health workers from services, they shall be entitled to all accumulated leave credits with pay.  Highest Basic Salary Upon Retirement - Three (3) prior to the compulsory retirement, the public health worker shall automatically be granted one (1) salary range or grade higher than his/her basic salary and his/her retirement benefits thereafter, computed on the basis of his/her highest salary: Provided, That he/she has reached the age and fulfilled service requirements under existing laws. Right to Self-Organization. - Public health workers shall have the right to freely from, join or assist organizations or unions for purposes not contrary to law in order to defend and protect their mutual interests and to obtain redness of their grievances through peaceful concerned activities. Freedom from Interference or Coercion. - It shall be unlawful for any person to commit any of the following acts of interference or coercion: (a) to require as a condition of employment that a public health worker shall not join a health workers’ organization or union or shall relinquish membership therein; (b) to discriminate in regard to hiring or tenure of employment or any item or condition of employment in order to encourage or discourage membership in any health workers’ organization or union; (c) to prevent a health worker from carrying out duties laid upon him/her by his/her position in the organization or union, or to penalize him/her for the action undertaken in such capacity; (d) to harness or interfere with the discharge of the functions of the health worker when these are calculated to intimidate or to prevent the performance of his/her duties and responsibilities; and (e) to otherwise interfere in the establishment, functioning, or administration of health workers organization or unions through acts designed to place such organization or union under the control of government authority. Labor Code: PD 442 of 1974 Frequently Asked Questions (FAQs) Is there any law prohibiting discrimination or harassment in employment? If so, what categories are regulated under the law? The Labor Code prohibits discrimination against women on account of their gender, and against children on account of their age. The Magna Carta of Women (Republic Act No. 9710, as amended) prohibits discrimination against women and expressly imposes liability for damages on the person directly responsible for such discrimination. The Anti-Age Discrimination in Employment Act (Republic Act No. 10911) prohibits discrimination on account of age, and imposes penalties for violation of the Act. The Magna Carta for Persons with Disability (Republic Act No. 7277, as amended) provides that a qualified employee with disability shall be subject to the same terms and conditions of employment as a qualified able-bodied person.  The Solo Parents’ Welfare Act (Republic Act No. 8972) prohibits an employer from discriminating against any solo parent employee with respect to the terms and conditions of employment on account of the employee being a solo parent. The Indigenous Peoples’ Rights Act (Republic Act No. 8371) prohibits discrimination against Indigenous Cultural Communities or Indigenous Peoples with respect to recruitment and conditions of employment on account of their descent. The Anti-Sexual Harassment Act (Republic Act No. 7877) prohibits sexual harassment in the workplace. The Mental Health Act (Republic Act No. 11036) requires employers to develop appropriate policies and programmes on mental health in the workplace designed to, among others, raise awareness on mental health issues, correct the stigma and discrimination associated with mental health conditions, identify and provide support for individuals at risk and facilitate access of individuals with mental health conditions to treatment and psychosocial support. The Philippine HIV and AIDS Policy Act (Republic Act No. 11166) also prohibits the rejection of job application, termination of employment, or other discriminatory policies in hiring, provision of employment and other related benefits, promotion or assignment of an individual solely or partially on the basis of actual, perceived or suspected HIV status. This law also states that policies and practices that discriminate on the basis of perceived or actual HIV status, sex, gender, sexual orientation, gender identity and expression, age, economic status, disability and ethnicity are deemed inimical to national interest. Enforcement agencies What are the primary government agencies or other entities responsible for the enforcement of employment statutes and regulations? The Department of Labor and Employment (DOLE) is the primary policy-making, programming, coordinating and administrative entity in the field of labor and employment. It has primary responsibility for the promotion of gainful employment opportunities, the advancement of workers’ welfare and promoting harmonious, equitable and stable employment relations. Worker representation Legal basis Is there any legislation mandating or allowing the establishment of employees’ representatives in the workplace? The Labor Code provides for and regulates the creation of legitimate labor organizations, or unions or associations of employees in the private sector that exist in whole or in part for the purpose of collective bargaining, mutual aid, interest, cooperation, protection or other lawful purposes. In particular, unions are organized for collective bargaining as well as other legitimate purposes, while workers’ associations are organized for mutual aid and protection or any legitimate purpose other than collective bargaining. The Labor Code also provides that employees may form labor- management councils to allow employees to participate in policy and decision-making processes of the establishment where they are employed, insofar as said processes will directly affect their rights, benefits and welfare, except those that are covered by collective bargaining agreements (CBAs) or are traditional areas of bargaining. Medical examinations Are there any restrictions or prohibitions against requiring a medical examination as a condition of employment? the Philippine HIV and AIDS Policy Act prohibits the rejection of a job application solely or partially on the basis of actual, perceived, or suspected HIV status. Access to personal data relating to an employee’s hepatitis B status is bound by the rules of confidentiality and is strictly limited to medical personnel or if legally required (DOLE Department Advisory No. 05-10). In addition to the foregoing, medical examination results should not be used to deny employment when the denial of employment would constitute discrimination under the laws mentioned in question 2. For example, discrimination under the Magna Carta for Persons with Disability includes using qualification standards, employment tests or other selection criteria that screen out or tend to screen out a disabled person unless such standards, tests or other selection criteria are shown to be job-related for the position in question and are consistent with business necessity. Drug and alcohol testing Are there any restrictions or prohibitions against drug and alcohol testing of applicants? There are no restrictions against drug and alcohol testing, and there is no law prohibiting an employer from refusing to hire an applicant who refuses to submit to a test. However, the DOLE has issued the Guidelines for the Implementation of a Drug-Free Workplace Policies and Programs for the Private Sector (DOLE Department Order No. 053-03), which states that only drug-testing centres accredited by the Department of Health shall be utilized for drug testing. Hiring of employees Must there be a written employment contract? If yes, what essential terms are required to be evidenced in writing? Generally, the law does not require an employment contract to be reduced into writing, but specific laws may require the same. For example, the Domestic Workers Act (Republic Act No. 10361) requires an employment contract to be executed between the domestic worker and the employer in a language or dialect understood by both the domestic worker and the employer. The contract must include the duties and responsibilities of the domestic worker, the period of employment, the agreed compensation and authorized deductions, among others.  The Rules and Regulations Implementing the Act Providing for the Elimination of the Worst Forms of Child Labour (DOLE Department Order No. 065-04) also provides that, when the employer is in public entertainment or information, they shall submit to the DOLE regional office a written employment contract concluded between the employer and the child’s parents or guardian, and approved by the Department. Under DOLE Department Order No. 174-17, the employment contracts of employees of a contractor or subcontractor involved in job contracting are required to include the following stipulations: Probationary period What is the maximum probationary period permitted by law? The Labor Code provides that probationary employment shall not exceed six months from the date the employee started working unless it is covered by an apprenticeship agreement stipulating a longer period. However, the Philippine Supreme Court has held that the probationary employee may voluntarily agree to an extension if it would afford the employee another chance to pass the standards for regularisation after having initially failed the probationary period. Terms of employment Working hours Are there any restrictions or limitations on working hours and may an employee opt out of such restrictions or limitations? The Labor Code and its implementing rules prescribe eight hours a day, as normal hours of work, for rank-and-file employees. Work performed beyond the normal hours entitles the employee to receive overtime pay. Employees who render services between 10pm and 6am are also entitled to a night shift differential. Employees are entitled to a rest day of not less than 24 consecutive hours after every six consecutive work days. In emergency cases, employees may be required to render work on a rest day. Special restrictions are imposed on minors who are allowed to work. Minors below 15 years of age may be allowed to work for not more than four hours a day, and not more than 20 hours a week. They are not allowed to work between 8pm and 6am the following morning. Minors aged 15 or over but below 18 may work for not more than eight hours a day, and not more than 40 hours a week. They cannot work between 10pm and 6am the following morning. Overtime pay What categories of workers are entitled to overtime pay and how is it calculated? All rank-and-file employees in the private sector, except domestic workers, workers paid by results and non-agricultural field personnel, are entitled to overtime pay. Overtime work performed on an ordinary working day entitles employees to an additional 25 per cent of the hourly rate for that day, which shall increase to 30 per cent if the work is performed on a holiday, special day or rest day.  Can employees contractually waive the right to overtime pay? Generally, overtime pay cannot be waived, and overtime work cannot be offset by undertime work. However, both the DOLE and the Philippine Supreme Court have allowed companies to employ a ‘compressed workweek scheme’, where the normal working week is reduced to less than six days but the total number of work hours remains at 48 hours per week (or 40 hours per week for firms whose normal working week is five days). Under a compressed workweek scheme, work beyond eight hours will not be compensable by the overtime premium provided the total number of hours worked per day shall not exceed 12 hours (in a 48-hour working week) or 10 hours (in a 40-hour working week). Employers may implement a compressed workweek scheme only with the express and voluntary agreement of a majority of the covered employees and prior notice to the DOLE of the adoption of the scheme. Vacation and holidays Is there any legislation establishing the right to annual vacation and holidays? Under the Labor Code, rank-and-file employees who have rendered at least 12 months of service, whether continuous or broken, are entitled to a yearly service incentive leave of at least five