FNP Transes

Nursing as Profession
FNP LEC (Week 2)
HOW TO ACT PROFESSIONAL AS A

NURSE:
PROFESSION ● As a nurse, you have to bring
- An occupation that requires a positive and realistic
extensive education or a callings attitude to your patient and
that requires special knowledge, skill coworkers.
and preparation. ● Take time to listen to your
- Requires a specialized educational patient.
training ● Care about your appearance,
- requires a mastery of complex set of don’t put a lot of makeup, be
knowledge and skills simple
- founded upon specialized ● Be accountable of your
educational training actions
- Paid occupation especially one that ● Follow ethical practices
involves a prolonged training and a especially on making
formal qualification decisions.
REMEMBER: A Profession or a 2. PROFESSIONALIZATION
Professional must satisfy an indispensable ● It is a social process by
social need and must be based upon well which any trade or
established and socially accepted occupation transforms itself
principles. It must requires the exercise of into a true profession of the
discretion judgment as to time and manner highest integrity and
of the performance of your duty. competence.
● Professionalism of the nurse
TWO TERMS RELATED TO PROFESSION influences the quality of care
NEED TO BE DIFFERENTIATE: the nurse provides to the
client.
1. PROFESSIONALISM ● Focuses on how you
● Refers to a professional influence as a nurse, social
characters,spirit, or methods processes.
(develop attitude on how to
handle specific situations)
● For nurses, it always meant CHARACTERISTICS OF NURSING
healing for the sick, nurturing
the wounded, placing ★ Nursing is caring
patients first, providing ★ Nursing involves close personal
holistic care, and educating contact with the recipient of care.
new professionals. ★ Nursing is committed to promoting
● Nursing professionalism individual, family, community, and
owes much to the influence national health goals in its best
of Florence nightingale. manner possible.
★ Nursing is committed to
personalized services for all persons
regardless of color, creed, or nurses but with lesser scope
economic status. than those professional
nurses.
CHARACTERISTICS OF A GOOD PROFESSIONAL
● Baccalaureate Degree
NURSE
- started on University of
Minnesota in 1909
★ Good communication skills
- 5 years program, you need to
★ Has an updated knowledge of
get a three year diploma
general and specific nature
program plus 2 years of
★ Clean, tidy, and well groomed
liberal arts education
★ Mature physically and emotionally
- But in PH its 4 years only
★ Intelligent and have critical thinking
- Have to pass the board exam
skills
- Have more autonomy but
★ Confident
have more responsibilities
★ Punctual
and accountabilities
★ Honest
- Have the chance to
★ Has the ability to teach recipients of
participate in a institutional
nursing
decision making
- Career advancement
● Master’s Degree
Criteria of a Profession - In PH, you need to pass the
licensure board exam
1) Specialized Education - At least have 1 year
- Important aspect of professional experience
status - Focuses on preparing nurses
In the US today, there are 5 means of entry for advance leadership role
into registered nursing: in administration, clinical
● Hospital diploma setting and, in teaching
- 3 years program (1800 to ● Doctoral Degree
1960), pre-existing in US - Have faculty rules in nursing
● Associate degree program or those who want
- 2 year program according to to work in research program
Mildred Montag (they called it - Highest education
“Nursing technician or - You can teach
bedside”(1950s)
- first and the only educational NOTE: This was influenced by nightingale
programs for nursing that to recognize nursing as a profession not just
were systematically vocation.
developed from planned
research and control 2) Body of Knowledge
experimentation
- “Nursing technician or - As a profession, nursing is
bedside” - Nurses are able establishing a well defined body of
to perform nursing functions knowledge and expertise.
broader than those practical
- There are nursing conceptual - A careful study to find solution and
frameworks that contribute to the to report new knowledge about
knowledge base of nursing and give something especially in medical
direction to nursing practice, profession
education, and on-going research. - Can help us in new trends when it
comes to patient care
- Important activity of getting
information about the subject.
Conceptual Research - Considered a careful and diligent
- refers to analytical tool with several search of something
variations and context that helps and - It must developed a scientific
prepare nurses in providing holistic technique which is the result of the
nursing care tested experience
- Through this concept you can
develop standards leading to skills, 5) Code of Ethics
abilities and norms. - Nursing developed its own codes of
- A demand of a body of specialized ethics and in most instances has set
and systematized training up means to monitor the
professional behavior of its
members.
3) Service Orientation - Nurses have traditionally place a
- A service orientation differentiated high value on the worth and dignity
nursing from an occupation pursued of others
primarily for profit. Many consider - Nurses are expected to do what is
altruism as the hallmark of a considered right regardless of its
profession. cost
ALTRUISM - Changes as the needs and values of
- a selfless concern for others from the society change
other profession, wherein you have Purposes:
selfless concern for others, - Standards - of care
especially for you patient - Guidelines - on how to take care of
- You have the feelings and behavior patient
that show a desire to help other - Distinguish - distinguished from
people other courses
- They lack of selfishness - Protect - protect the right of patient
6) Autonomy
4) Ongoing Research - Means having the authority to make
- Is a process in which decisions are decisions and the freedom to act in
made that result in a detailed plan or accordance with one’s professional
proposal for a study, as well as the knowledge base. (Skar R. J Clin
actual implementation of the plan. Nurs. 2010)
- Evidence based nursing. - Once you are a professional, you
- “Nursing is an ongoing research” have the autonomy
- Freedom to act, in accordance with
the knowledge you gain.
- Autonomy in making decisions Nurse
especially in the practice ★ Nurse: Male or Female who has
completed a program of basic
To be Autonomous, A Professional nursing education.
Group Must Be: ( Once you have the ★ Bachelor of Science in Nursing
License ) ★ Authorized by the appropriate
- Granted legal authority to define the authority to practice nursing.
scope of its practice
- Describe its particular function and Professional Nurse
roles ★ A health worker identified by law as
- Determine its goals and a registered nurse whether
responsibilities in delivering its graduated from bachelor or diploma
services. degree, and does not include the
assistant nurse.
7) Professional Organization
- Operation under the umbrella of a Personal Qualities Of A Nurse
professional organization (6C’s)
differentiates a profession from an 1. Care - most unique characteristic of
occupation. a nurse, being connected to your
- Nurse need to work with their patient, creates positive, provides
professional organizations presence
2. Compassion - show kindness,
GOVERNANCE - establishment and willingness to help others, need to
maintenance of social, political and be thoughtful and listen your patient,
economic arrangement by which you nurse need to show that you are ready to
as a practitioners control your practice, help
discipline, work in condition and 3. Competence - ability to deliver care
professional affairs and will also help protect successfully and efficiently in which
you as a nurse you are able to apply and use the
related knowledge, the skills,
abilities or attitudes that you learn,
PERSONAL AND PROFESSIONAL QUALITIES
successfully perform critical work
especially once you are in the area
PHILOSOPHY OF LIFE of critical work or functions in your
➔ Contributes to personal growth that work setting.
relates to the moral values and 4. Communication - the therapeutic
shapes the aspects of the character. communication, act of transferring
infos from one person to another
GOOD PERSONALITY 5. Courage - courage to speak up
➔ Consists of deeper traits which come when you have concerns and to
from the heart. have the personal strength and
➔ Nursing should have a bright mind,
caring heart and healing hands.
vision to innovate and to embrace
new ways of working.
6. Commitment - committed to your 6) Commitment
profession, need to make actions to - A commitment to our patients and
make this vision and strategy a populations is a cornerstone of what
reality and meet the health care and we do.
support challenges ahead, - We need to build on our commitment
dedicating yourself to do something. to improve the care and experience
of our patients.
1) Care
- The care we deliver helps the Professional Qualities Of A Nurse
individual person and improves the
health of the whole community. ★ Caring nature
★ Empathetic
2) Compassion ★ Organized
- Is how care is given through ★ Adaptable
relationships based on empathy, ★ Has physical and mental endurance
respect and dignity. ★ A quick thinker
- It can also be described as ★ Hard working
intelligent, kindness, and is central to
CONTEMPORARY NURSING PRACTICES
how people perceive their care.
3) Competence WHO: NURSING

- The ability to understand an ➔ Nursing encompasses autonomous
individual’s health and social needs and collaborative care of individuals
- The expertise, clinical and technical of all ages, families, groups and
knowledge to deliver effective care communities, sick or well and in all
and treatments based on research settings.
and evidence. ➔ It includes the promotion of health
prevention of illness, and the care of
4) Communication ill, disabled and dying people.
- Central to successful caring ➔ In many countries, nurses make up
relationships and to effective team half of health care professionals and
working. have a vital role in health outcomes.
- Communication is the key to a good ➔ Nursing is client centered, focus is
workplace with benefits for those in on your client
our care and staff alike. ➔ Nursing is holistic, not only the
physical aspect but the whole aspect
5) Courage of the patient that include the mental
- Enables us to do the right thing for or psychological, spiritual aspect,
the people we care for. physical aspect, and social aspect
- Having as strong values and
confident in meeting the challenges
NIGHTINGALE AND HENDERSON: Nursing as an art
NURSING - As a nurse you need to deliver care
artfully with CCR (Compassion,
Florence Nightingale Caring and Respect) for each
● Florence Nightingale: Nursing is an patients dignity and personhood
act of utilizing the environment of the - Need to provide individualized care
patient to assist him in his recovery. for the client
● The first one to build “Nightingale
Training School of Nurses ” at St. Nursing is a science
Thomas Hospital in England (1860). - Nursing practice is based on the
● The founder of modern nursing body of knowledge, continually
● “The Lady with the Lamp” changing with new discoveries and
● Influential in developing nursing innovation
- Education
- Practice Nursing is concerned with health
- Administration promotion
- Involve individual and community
activities to enhance healthy lifestyle
Virginia Henderson such as improving nutrition and
● Virginia Henderson: Nursing is the physical fitness, preventing alcohol
act of assisting the individual, sick or and drug misuse, preventing injuries
well, in the performance of those
activities contributing to health or its Nursing is concerned with prevent
recovery (or to a peaceful death) illnesses
● The person would perform unaided if - Activities such as immunization,
he had the necessary strength, will pranatal, infant care and prevention
or knowledge, and to do this in such sexually transmitted diseases
a way as to help him gain
independence as rapidly as Health restoration/Restoring Health
possible. - Focus on the patient who is actually
ill. Ex. administering medications
CERTAIN THEMES ARE COMMON TO MANY
OF THESE DEFINITIONS: Caring for the dying
🗸 Nursing is caring - Give the client a comfortable life up
🗸 Nursing is an art - CCR to the last minute of his life to make
🗸 Nursing is a science her comfortable and also help family
🗸 Nursing is client centered members or loved ones to cope.
🗸 Nursing is holistic
🗸 Nursing is adaptive > When you integrate ART and SCIENCE of
🗸 Nursing is concerned with health nursing into practice the quality of care you
promotion, health maintenance, and health provide is at the level of EXCELLENCE that
restoration benefits them and their families <
🗸 Nursing is a helping profession
RECIPIENTS OF NURSING ● Help the client in the procedure of
● Consumer treatments
- An individual, a group of people, or a
4. CLIENT ADVOCATE
community that uses a service or
● Protect the right of the client
commodity. ● Represent clients needs
● Patient ● Exercising their rights and help the
- Is a person who is waiting for or speak up for themselves
undergoing medical treatment and
care 5. COUNSELOR
● Client ● Recognize and cope with stressful
- Is a person who engages the advice psychological and social problems
or services of another who is ● Provides emotional, intellectual, and
psychological support
qualified to provide this service
6. CHANGE AGENT
SCOPE OF NURSING
● Make modifications of their behavior
● Promoting health and wellness (Ex. Help Lessen smoking intake of the
● Preventing illness patient )
● Restoring health ● Also, changes in the healthcare system,
● Caring for dying technologic change, age of the client,
population, medications etc
7. LEADER
ROLES AND FUNCTIONS OF THE NURSE
● Influences
● Understanding the needs and goals that
1. CAREGIVER motivate people
● Assists/Care the client physically and ● Knowledge to apply the skills
psychologically ● Interpersonal skills
● Nursing process →framework
● The nursing process provides nurses 8. MANAGER
with a framework for providing care. ● Delegates, supervises, evaluates
● A nurse may provide care directly or ● Requires knowledge, organizational
delegate it to other caregivers. structure among others
2. COMMUNICATOR 9. CASE MANAGER

● Identify client problems ● Works with the multidisciplinary
● Able to work with other professionals healthcare team
and people in the community ● Works with primary or staff nurses to
● Gathering data and then share data to oversee the care of a specific caseload
the one responsible such as the doctor ● Measure the effectiveness of the case
or physician of the client management plan and to monitor
outcomes.
3. TEACHER
● Learn about their health 10. RESEARCH CONSUMER
● Assesses client’s learning needs and ● Use research to improve client care
readiness to learn, sets specific goals, (a) have awareness of the process and
enacts learning strategies and language of research
measures their learning.
(b) be sensitive to issues related to
protecting the rights of human subjects
(c) participate in the identification of
researchable problems
(d) be a discriminating consumer of
research findings
11. EXPANDED CAREER ROLES

● Refers to clinical specialists
● Undergo more trainings
EXTENDED CAREER ROLES
● Nurse Practitioner
● Clinical Nurse Specialist
● Nurse Anesthetist
● Nurse Midwife
● Nurse Researcher
● Nurse Administrator
● Nurse Educator
● Nurse Entrepreneur
● Forensic Nurse
FNP LEC WEEK 2 (PART 2)
1. CONSUMER
- An individual, a group of people, or a
community that uses a service or
DEFINITIONS OF NURSING commodity.

- Use healthcare products or service
are consumers of healthcare.
ANA (1973, p.2)
● Direct, goal oriented, and adaptable
2. PATIENT
to the needs of the individual, the - A person who is waiting for or
family, and the community during undergoing medical treatment and
health and illness. care.

- Comes from the Latin word meaning
“to suffer” or “to bear”.
ANA (1980, p.9)
● Nursing is the diagnosis and
3. CLIENT
treatment of human responses to - Individual who engages to advice or
actual or potential health problems services of another who is qualified

to provide this service.
ANA (1995)
● Science of caring
ANA (2010, p.10) ANA (2015b,p.7) SCOPE OF NURSING

● Nursing is the protection, promotion,
and optimization of health and Nurses provide care for 3 types of
abilities, preventions of illness and clients:
injury, alleviation of suffering through 1. Individuals
the diagnosis and treatment of 2. Families
human response, and advocacy in 3. Communities
the care of individuals, families,
communities, and populations Nursing practice involves 4 areas:
1. Promoting health and Wellness

2. Preventing illness
RECIPIENTS OF NURSING 3. Restoring Health

4. Caring for the dying 1. Providing direct care to the ill, such
as administering medications, baths,
PROMOTING HEALTH AND and specific procedures and
WELLNESS treatments.
1. Nurses promote wellness in clients 2. Performing diagnostic and
who are both healthy and ill assessment procedures, such as
2. May involve individual and measuring blood pressure and
community activities to enhance examining feces for occult blood
healthy lifestyles, such as improving 3. Consulting with other health care
nutrition and physical fitness, professionals about client problems.
preventing drug and alcohol misuse, 4. Teaching clients about recovery
restricting smoking, and preventing activities, such as exercises that will
accidents and injury in the home and accelerate recovery after a stroke
workplace. 5. Rehabilitating clients to their optimal

functional level following physical or
PREVENTING ILLNESS mental illness, injury, or chemical
● To maintain optimal health by addiction
preventing disease. Nursing

activities that prevent illness include CARING FOR THE DYING
immunization, prenatal and infant 1. Involves comforting and caring for
car, and prevention of sexually people of all ages who are dying
transmitted infections. 2. Palliative care nurses are part of a

medical team that focuses on
RESTORING HEALTH providing relief from the symptoms
● Focuses on the ill client, and it and stress of a serious illness (e.g
extends from early detection of cancer)
disease through helping the client 3. The goal is to improve the quality of
during the recovery period life for both the client and the family
4. The goal is to help people who are
dying to have peace, comfort and
dignity
RESTORING HEALTH ACTIVITIES

ROLES AND FUNCTION OF NURSE
INCLUDE:
● Caregiver
● Communicator
● Teacher
● Client advocate
● Counselor
● Change agent
● Leader
● Manager
● Case manager
● Research consumer
● Expanded career roles
SETTINGS FOR NURSING

1. In the past, the acute care hospital
was the main practice setting open
to most nurses.
2. Today, many nurses work in
hospitals, but increasingly they work
in clients’ homes, community
agencies, ambulatory clinics, long
term care facilities, health
maintenance organizations, and
nursing practice centers.
NURSE PRACTICE ARTS

1. Nurse practice acts, or legal acts for
professional nursing practice,
regulate the practice of nursing in
the US, with each state having its
own act.
2. Nurses are responsible for knowing
their state’s nurse practice act as it
governs their practice
o Stated that “a self-interpreting being, that
PATRICIA BENNER
is, the person does not come into the world
predefined but gets defined in the course of
FROM NOVICE TO EXPERT: EXCELLENCE AND
living a life. A person also has… an
POWER IN CLINICAL NURSING PRACTICE effortless and non-reflective understanding
of the self in the world. The person is
BIOGRAPHY & CAREER viewed as a participant in common
meanings.”
o Born on August 31, 1942 in Hampton, o Believed that there are significant aspects
Virginia that make up a person
o 1964, earned her Bachelor of Arts in o She had conceptualized the major aspects
nursing from Pasadena College of understanding that the person must deal
o 1960, worked in nursing field with as:
o 1970 – 1975, research associate at the 1. The role of the situation.
University of California at San Francisco 2. The role of the body.
School of Nursing 3. The role of personal concerns.
PUBLISHED BOOKS 4. The role of temporality
Goal: Overcome the Cartesian dualism, the
1. From Novice to Expert: Excellence and view that the mind and body are distinct,
Power in Clinical Nursing Practice separate entities.
2. Nursing Pathways for Patient Safety o Embodiment is the capacity of the body to
3. The Primacy of Caring respond to meaningful situations.
Note: Dr Benner has published nine books, 5 Dimensions of the body (Merle au, Ponty &
including From Novice to Expert, Nursing Dreyfus)
Pathways for Patient Safety, and The Primacy
of Caring. She has also published many 1. The unborn complex
articles. In 1995, she was awarded the 15th 2. The habitual skilled body
Helen Nahm Research Lecture Award from the 3. The projected body
University of California at San Francisco 4. The actual projected body
School of Nursing. 5. The phenomenal body
CO-AUTHORED BOOKS
HEALTH
1. Expertise in Nursing Practice: Caring,
o Focused “on the lived experience of being
Clinical judgment, and Ethics
healthy and ill.”
2. Clinical Wisdom in Critical Care: A
o Defined health as what can be assessed,
Thinking-in-Action Approach
while well-being is the human experience of
health or wholeness.
METAPARADIGM
o Well-being and being ill are recognized as
different ways of being in the world.
NURSING
o Health is described as not just the absence
o Described as an “enabling condition of of disease and illness. Also, a person may
connection and concern” which shows a have a disease and not experience illness
high level of emotional involvement in the because illness is the human experience of
nurse-client relationship. loss or dysfunction, whereas disease is
o Viewed nursing practice as the care and what can be assessed at the physical level.
study of the lived experience of health,
illness, and disease and the relationships ENVIRONMENT
among these three elements. o Used the term “situation” instead, because
it suggests a social environment with social
PERSON definition and meaning.
o Used the phenomenological terms of being o They have difficulty grasping the current
situated and situated meaning, which are patient situation in terms of the larger
defined by the person’s engaged perspective.
interaction, interpretation and o However, clinical situations are viewed by
understanding of the situation. nurses at this level as a stage of their
abilities.
5 LEVELS OF SKILL ACQUISITION & SKILL o They feel highly responsible for managing
DEVELOPMENT patient care, yet they still rely on the help of
those more experienced.
NOVICE o Most newly graduated nurses are placed in
this level.
o the person has no background experience
− 1 year experience
of the situation in which he or she is
involved. − Has some experience
o Context-free rules and objective attributes − Past experience guides actions
must be given to guide performance.
o There is difficulty discerning between
COMPETENT
relevant and irrelevant aspects of a o Through learning from actual practice
situation. situations and by following the actions of
o Generally, this level applies to nursing others, advance beginner moves to this
students, but Benner suggested that a level.
nurse at higher levels of skill in one area of o Typified by considerable conscious and
practice could be classified at the novice deliberate planning that determines which
level if placed in an unfamiliar area or aspects of the current and future situations
situation. are important and which can be ignored.
o A beginner with no experience. They are o Consistency, predictability and time
taught general rules to help perform tasks, management are important, and gaining a
and their rule-governed behavior is limited sense of mastery through planning and
and inflexible. In other words, they are told predictability is the accomplishment.
what to do and simply follow instruction. o Generally, has two- or three-years’
− No experience experience on the job in the same field. For
− Tasks/skills focus example, two or three years in intensive
− Rule follower care. The experience may also be similar
− Inflexible day-to-day situations. These nurses are
more aware of long-term goals, and they
ADVANCED BEGINNER gain perspective from planning their own
actions, which helps them achieve greater
o The person can demonstrate marginally
efficiency and organization.
acceptable performance having coped with
o There is an increased level of efficiency but
enough real situations to note, or to have
the focus is on time management and the
pointed out by a mentor, the recurring
nurse’s organization of the task world.
meaningful components of a situation.
o The competent nurse may display hyper-
o The person has enough experience to
responsibility for the patient, often more
grasp aspects of the situation.
than is realistic, and may exhibit an ever-
o Nurses functioning at this level are guided
present and critical view of the self.
by rules and are oriented by task
o This stage is most pivotal in clinical
completion.
learning because the learner must begin to
o Shows acceptable performance, and has
recognize patterns and determine which
gained prior experience in actual nursing
elements of the situation warrant attention
situations. This helps the nurse recognize
and which can be ignored.
recurring meaningful components so that
o They devise new rules and reasoning
principles, based on those experiences,
procedures for a plan while applying
begin to formulate in order to guide actions.
learned rules for action on the basis of the proficient. Benner’s writings explain that
relevant facts of the situation. nursing skills through experience are a
prerequisite for becoming an expert nurse.
PROFICIENT o Key aspects of the expert nurse’s practice
are:
o The performer recognizes the most salient
1. a clinical grasp and resource-based
aspects and has an intuitive grasp of the
practice
situation based on background
2. embodied know-how
understanding.
3. seeing the big picture
o Nurses at this level demonstrate a new
4. seeing the unexpected
ability to see changing relevance in a
o The expert nurse has the ability of pattern
situation including the recognition and the
recognition on the basis of deep
implementation of skilled responses to the
experiential background.
situation as it evolves.
o Meeting the patient’s actual concerns and
o Perceives and understands situations as
needs is of utmost important, even if it
whole parts. He or she has a more holistic
means planning and negotiating for a
understanding of nursing, which improves
change in the plan of care.
decision-making. These nurses learn from
o There is almost a transparent view of self.
experiences what to expect in certain
situations, as well as how to modify plans − Flexible
as needed. − Intuitive
o They no longer rely on present goals for − Lots experience
organization and they demonstrate an − Just comes naturally
increased confidence in their knowledge These different levels of skills show changes in the
and abilities. three aspects of skilled performance: movement
o There is much more involvement with the from relying on abstract principles to using past
patient and family. experiences to guide actions; change in the
o This stage is a transition into expertise. learner’s perception of situations as whole parts
− More than 3 years of experience rather than separate pieces; and passage from a
− Holistic understanding detached observer to an involved performer,
− Uses experiences to anticipate engaged in the situation rather than simply outside
needs of it.
EXPERT The levels reflect movement from reliance on past

principles to the use of past experience and
o The expert performer no longer relies on change in the perception of the situation as a
analytical principle (rule, guide and maxim)
complete whole with certain relevant parts. Each
to connect her or his understanding of the
step builds on the previous step as principles are
situation to an appropriate action.
refined and expanded by experience and clinical
o The expert nurse as having an intuitive
expertise.
grasp of the situation and as being able to
identify the region of the problem without MAJOR CONCEPTS & DEFINITIONS
wasting consideration on a range of
alternative diagnoses and solutions.
ASPECTS OF A SITUATION
o There is a qualitative change as the expert
performer “knows the patient”, meaning
o The recurring meaningful situational
knowing typical patterns of responses and
components recognized and understood in
knowing the patient as a person.
context because the nurse has previous
o No longer rely on principles, rules, or
experience
guidelines to connect situations and
determine actions. They have a deeper
ATTRIBUTE OF A SITUATION
background of experience and an intuitive
grasp of clinical situations. Their
performances are fluid, flexible, and highly-
o Measurable properties of a situation that
can be explained without previous
experience in the situation.
COMPETENCY
o It is “an interpretively defined area of skilled
performance identified and described by its
intent, functions, and meanings.”
DOMAIN
o An area of practice having a number of
competencies with similar intents,
functions, and meanings.
EXEMPLAR
o An example of a clinical situation that
conveys one or more intents, meanings,
functions, or outcomes easily translated to
another clinical situation.
EXPERIENCE
o An active process of refining and changing
preconceived theories, notions, and ideas
when confronted with actual situations;
implies there is a dialogue between what is
found in practice and what is expected.
MAXIM
o cryptic description of skilled performance
that requires a certain level of experience
to recognize the implications of the
instructions.
PARADIGM CASE
o A clinical experience that stands out and
alters the way the nurse perceives and
understands future clinical situations.
o Paradigm cases create new clinical
understanding and open new clinical
perspectives and alternatives.
SALIENCE
o A perceptual stance or embodied
knowledge whereby aspects of a situation
stand out as more or less important.
HISTORY OF NURSING IN THE WORLD o Emphasis on personal hygiene, cleanliness
within & outside the body
ANCIENT CIVILIZATIONS
o Sanitation measures
o Experiments with herbs & plants o Mummification
o Illness attribute to evil spirits o recognized 250 different diseases
o Nurses as a Domestic Servants o developed drugs and procedures
o 480 B.C. (neurosurgery)
HERODOTUS – of Halicarnassus, was a Greek
Historian and regarded as the “Father of History”
HEBREWS (C.A. 1400 BC)
Men uses black & white magic o Founders of public hygiene
PERIOD OF INTUITIVE NURSING (PRIMITIVE ERA) o Moses “Father of Sanitation”
o Mosaic Health Code pertained to every
o Was practiced since prehistoric times aspect of individual, family & community
among primitive tribes. hygiene
o And lasted until the Christian Era a. Principles of personal hygiene (rest, sleep,
o Nursing is untaught and instinctive hours of work, cleanliness)
b. Environmental sanitation
BELIEFS & PRACTICES OF PREHISTORIC MAN 1. Inspection of food
o Nursing was a function that belonged to a 2. Methods of dispose
woman. 3. Detecting and reporting diseases
o He believed that illness was caused by the 4. Practice of isolation, quarantine,
invasion of the victims and evil spirit. fumigation and disinfection
o He believed in “Shaman” or medicine man 5. Detailed instructions on the correct
or witch doctor that uses white magic. way of hand washing
o He also practiced “Trephening” – drilling a
hole on the skull with a rock or stone ANCIENT GREEKS
without the benefit of anesthesia as a last ASCLEPIUS God of medicine and healing in
resort to drive evil spirits from the body of ancient Greek mythology.
the afflicted)
Asclepius represents the healing
THE EGYPTIAN CIVILIZATION (CA 3000 BC) aspect of the medical arts.
HYGIEIA Daughter of Asclepius.
HAMMURABI a first king of Babylonian
Empire Goddess of health, cleanliness
HAMMURABI’S one of the first written and sanitation and afterwards,
CODE codes of law in recorded the moon.
history.
She was associated with the
XENODOCHIUM house for the sick prevention of sickness and the
IMHOTEP God of healing and continuation of good health.
medicine, the second king PANACEA Daughter of Asclepius &
of Egypt’s third dynasty, granddaughter of Apollo
who was later worshipped
as the god of medicine in Said to have potion which she
Egypt and in Greece, where healed sick
he was identified with the
Greek god of medicine, The panacea was supposed to be
Asclepius. remedy that would cure all
disease and prolong life
Architect of the step indefinitely.
pyramid built at the
necropolis of Ṣaqqārah in HIPPOCRATES
the city of Memphis.
o “Father of Medicine” exponent of the
o Practice of prophylaxis by the medicine science of preventive medicine
man and high priest
o Introduced the philosophy of the She erected a fine hospital at Rome
interrelationship between physical and & she gave large sums to the
mental health. churches and religious communities
o “A healthy mind dwells in a healthy body” at Rome, and at other places in Italy.
o Treat patient as a whole All her interests were centered on
o Changed change magic medicine into the needs of the Church and the
science of medicine care of the poor and suffering.
o Taught physicians to use eyes and ears
o The Hippocratic Oath is an oath traditionally HOTEL DIEU OF BEAUNE
taken by physicians pertaining to the
o One of the most charming old hospitals in
ethical practice of medicine.
France, and one quite typical of hospitals
3 KINDS OF REFUGE FOR SICK established in medieval times.
o Reputed to be the oldest existing hospital
o Secular – directed by physicians – spas and which has continuously occupied its
resorts. original building.
o Religious – sanctuaries of gods o This hospital has a history as colorful as its
o Attendants – were basket bearers who steep, gabled roofs.
looked after the sick.
MIDDLE AGES (1100 – 1300)
ROMANS
o Charitable institutions or sanctuaries
o Contributed to the field of sanitation intended for the aged, poor and sick
(building of Aqueducts, purification of water people.
supply) o Nursing during this era was either done by
o Appointing of public health medical officers charitable institutions or poor people who
o Establishment of hospitals which worked for the rich.
emphasized both preventive and curative o Nuns and sisters work as a staff nurse in
aspects of care the hospitals
o Caregiver are not required to have a formal
EARLY CHRISTIAN PERIOD training
o Christian church expressed succor to o Nurses went to the community and
orphans, poor, travelers and the sick. hospitals were built also medical school’s
o Deaconesses (given to women with good increase.
social standing) visited the sick. o Europe men risked their lives to provide
o Order of Deaconesses – organized visiting nursing care
of the sick called visiting nurses o A group of men, the Parabolani, in 300 AD
o forerunner of CHN started a hospital and provided nursing
o endeavored to practice the corporal works care during the Black Plague epidemic.
of mercy (feeding the hungry, caring for the
INFLUENCE OF CRUSADE IN NURSING
sick, burying the dead)
o Crusades – Christian military expeditions to
PHOEBE a friend of St Paul and the first
recapture the Holy Land from Muslims
Deaconess and first visiting nurse.
o In 1244 there are approximately 19,000
FABIOLA A Roman matron of rank. She was hospitals in Western Europe.
one of the companies of noble
Roman women who. o There is a spread of leprosy
o after a thousand years there was no
Influence of St. Jerome attempt to organized nursing.
Gave up all earthly pleasures and 3 TYPES OF ORGANIZATION

devoted themselves to the practice
of Christian asceticism and to MILITARY ORDER
charitable work
KNIGHT men who went to battle o Third order of St. Francis of Assisi. The
HOSPITALLERS and them retired to members of this organization were devoted
nurse the sick. their time and energy on enhancing the
KNIGHT OF ST. JOHN also known as Knights lives of their friends, neighbors in the
Hospitaller, a Christian community where they lived.
organization that o Caring for the sick and poor was one of the
began as an Amalfitan order’s important activities to both men and
hospital founded in women who serve as nurses.
Jerusalem in 1080 to o There were many Catholic orders caring for
provide care for poor, the sick during the Middle Ages. Even the
sick or injured pilgrims secular orders were associated with the
to the Holy Land. Church. Educated by apprenticeship,
ST. JOHN OF GOD & ST. Two patron saints of lacking knowledge of hygienic measures,
CAMILLUS DE LELLIS nurse’s stem from this and practicing under very primitive
period. Both stated as conditions, the care provided was,
soldiers but later nonetheless, humane and caring.
turned to nursing. − Order of Saint Vincent de Paul
ST. CAMILLUS DE Started the sign of red − Sisters of Charity
LELLIS cross and developed
the first ambulance RENAISSANCE PERIOD (A.D 1400 – 1550)
service.
o Interest in arts and science emerged.
The Order of St. o Geographic explorations by Europeans
Lazarus of Jerusalem o Society was filled with thieves due to social
originated in a leper deprivations.
hospital. It was o Care of the sick was entrusted to those who
originally established were proven guilty of a crime or theft
to treat virulent
o caretakers were not given humane facilities
diseases such as
leprosy. like food & quarters, so all the more they
got buried into evil deeds like stealing the
RELIGIOUS ORDER patient’s foods, accepting bribes.
o Need for care of sick and poor escalated
o Institutions managed by clergy. Throughout o Hospitals were for the weak, aged,
the dark Middle Ages, the hospitals and contagious disease, physically and
nursing system were connected by mentally ill.
religious bodies. o A fee was charged for the hospitalization
o Nurses were provided by male and female o Bubonic Plague epidemic, killing 25 to 50%
monastic orders. Europe’s population
o Nurses wore regular clothes.
o Care of the sick- done by volunteers like St. THOMAS SYDENHAM
Catherine of Siena, her lamp represented
o Founder of clinical medicine and
the sick at Sienna
epidemiology.
o Sisters advanced from probations to
o Emphasized the detailed observation of
wearing white robe to wearing hood.
patients & maintained accurate record.
o Name of oldest foundations:
o He has been calling “the English
− Hotel Dieu in Paris
Hippocrates”
− St. Thomas and St. Bartolome’s in
o First person to set an example of clinical
London methodology.
− The order of St. Augustine and St. o Said that a doctor must rely on his own
John of Jerusalem observation and clinical experience and he
SECULAR ORDER appeared to have practiced largely
common-sense medicine.
REFORMATION PERIOD (1550s) Proliferation of factories with
introduction of technology.
o The religious upheaval led by Martin Luther FRANCE Barbers function as
destroyed the unity of Christian faith. surgeons.
o The wrath of Protestantism swept away
Leeching, giving enemas
everything connected with Roman
and tooth extraction
Catholicism.
o Properties of hospital and schools were Women make beds, scrubs
confiscated. floors and bathe the poor in
o Nurses fled for their lives; In England many almshouses.
hospitals were closed.
Factory workers endured
o No one to take care for sick.
long hours of work.
o Nursing became the work of the least
desirable of women, took bribes from Medical schools were
patients, stole the patient’s food and used founded – Royal College of
alcohol as a tranquilizer. Surgeon in London (1800)
o Nurses sank in lowest level, medical
End of 18th Century – no
instruction continued along primitive lines.
standards for nurses working
WOMEN’S MOVEMENT (1848) in the hospitals
o Women are not considered equal to men. 20TH CENTURY – MACHINE AGE
o No right to vote or be educated.
o Increased poverty
o Women’s rights convention in Seneca
o Workers are exploited
Falls, NY signaling the beginning of social
o Development of other nursing services
unrest
aside from hospital service: private duty,
o With suffrage, rights of women were
public health, school, government,
advocated & nursing profession advanced.
maternal)
o 1900’s women were accepted to colleges
A. Age of Specialization
and universities
− College & Post graduate nursing
education programs
INDUSTRIAL REVOLUTION (1700’s – 1800’s)
B. Standards are Set
o This was a time of free thought, − 1913-1937
individualism, and the beginning of − standard curriculum
capitalism and democratic forms of − textbooks
government. C. World War I
o Gradually brought forth a more equitable − Nurse was assisted by the National
living style for the people. Red Cross
o Capitalists were protected by law in his D. The Great Depression
exploitation of workers. There were child − October 29, 1929 (Black Friday)
labor and sweatshops where disease and − Financial crisis – unemployed
accidents were the norm. nurses
o Hospitals remained places where the poor
− Military Nurses
went to die.
o Oppression of women PERIOD OF CONTEMPORARY NURSING
MOTHER MARY founded the sisters of Mercy, o This period includes scientific and
CATHERINE religious order emphasizing technological developments and many of
MCAULEY in nursing the poor and sick. the social changes occurring since 1945.
Emancipation of women-fight o World Health Organization – established
for human rights a step in by the United Nations\to assist in fighting
developing nursing disease by providing health information
profession and improving the nutrition, living standard
and environmental conditions of all people.
o Trends: Cross in LeMans,
− scientific and technological France in 1841.
research FATHER SORIN brought four sisters to
− use atomic energy for medical Notre Dame in South
diagnosis and treatment Bend Indiana in 1841.
− use sophisticated equipment for
diagnosis and therapy. WAR PERIOD
− The advent of space medicine also AMERICAN CIVIL Women played a major
brought about the development of WAR (1861 – role in nursing and
aerospace nursing. 1865) sanitation efforts during
COLONEL developed a comprehensive one- the Civil War, paving the
PEARL E. year course to prepare nurses for way for their entry into the
TUCKER aerospace nursing at Cape nursing profession in
Kennedy greater numbers after the
war, as well as paving the
Nursing involvement in community
way for further
health is greatly emphasized to
support Primary Health Care. professionalization of the
nursing field.
Technologic efficiency has relieved WORLD WAR I The duty of an army
nurses from a numerous tedious (1914 – 1916) nurses much more varied
task. than in civilian nursing
profession.
The nurse of the modern times is
constantly assuming They needed to be
responsibilities of patient care that decisive and quick-
were formerly the sole prerogative thinking when determining
of the physician treatment, cleaning
wounds and attending to
RELIGIOUS INFLUENCES minor surgery.
The strong influence of religions on the Physical strength and

developments of nursing started in India (800-600 high level of efficiency I
B.C.) and flourished in Greece and Ireland in 3 required
B.C. with male-nurse priests.
Endured excessive
THEODOR FLIEDNER revived the churched workload and a lack of
order of Deaconesses staff to meet the
demands.
to care for those in a
hospital he had The conditions made life
founded. He had more difficult to a nurse.
profound influence in
nursing because Also, at risk of contracting
Florence Nightingale contagious disease.
had her training at the
Experienced same
Kaisers Werth hardships as the soldiers.
Institute.
Deaconesses of The harsh, foreign
Kaisers Werth became climate, inadequate basic
famous because they necessities and
consequent dysentery
were the only ones
were all endured by the
formally trained in female nurses as well.
nursing. WORLD WAR II Casualties created an
FATHER BASIL Founded the Nursing (1939 – 1945) acute shortage of
MOREAU Sisters of the Holy caregiver.
The Cadet Nurse Corps CLARISSA A pioneer of America teacher
was established in HARLOWE nurse, & Humanitarian.
response to a marked BARTON
shortage of nurses. She has been described as
(December 25,
having a "strong and
1821-April 12,
Auxiliary health care independent spirit “and is
workers became 1912) best remembered for
prominent. organizing the American Red
Cross
Practical nurses, aides, LILLIAN D. WALD Was a nurse, social worker,
and technicians provided (1867 – 1940) public health official, teacher,
much of actual nursing author, editor, publisher,
care under the instruction women's rights activist, and
and supervision of better the founder of American
prepared nurses. community nursing.
Medical specialties also Founder of visiting nursing in

arose at that time to meet the United States and
the needs of hospitalized Canada.
clients.
Provide nursing care to
NURSING PIONEERS indigent
HARRIET Born Araminta Ross, c. 1820 First community health nurse

TUBMAN – 10 March 1913
Established Henry Street
Was an African-American Settlement Service in New
abolitionist, humanitarian, York
and Union spy during the
U.S. Civil War. Supported education for the
mentally challenged
Thirteen missions to rescue
over seventy slaves using Advocate more lenient
the network of antislavery immigration laws
activists and safe houses ISABEL ADAMS Was one of the founders of
known as the Underground modern American nursing
HAMPTON ROBB
Railroad. Known as “The theory and one of the most
Moses of Her People” (1860 – 1910)
important leaders in the
SOJOURNER The self-given name, from history of nursing.
TRUTH (1797– 1843, of Isabella Baumfree.
November 26, She implemented an array of
1883) An American abolitionist and reforms that set standards for
women's rights activist. nursing education.
Truth was born into slavery in One of her most notable
Swartekill, New York. contributions to the system of
nursing education was the
Her best-known speech, Ain't implementation of a grading
I a Woman? was delivered in policy for nursing students.
1851 at the Ohio Women's
Rights Convention in Akron, President of American
Ohio. Society of Superintendents
DOROTHEA Was an American activist on of Training Schools for
LYNDE DIX behalf of the indigent insane. Nurses (now known as
(April 4, 1802 – National League for
Created the first generation Nursing), and of the
July 17, 1887)
of American mental asylums. organization that became the
American Nurses
During the Civil War, she Association.
served as Superintendent of
Army Nurses.
She was also one of the to substantially below the
founders of the American national average.
Journal of Nursing.
JANE ARMINDA She started work in 1887 at a Thanks to FNS, nurse-
DELANO (March Jacksonville, Florida hospital midwives were no more than
13, 1862 treating victims of a yellow six miles away from any
fever epidemic. patients. Providing both
Montour Falls,
preventive and curative
New York, United She demonstrated her nursing, FNS continues to
States – died superior executive and serve this region.
April 15, 1919 in administrative skills and MARY ELIZA Was the first African-
Savenay, Loire- developed innovative MAHONEY (May American to study and work
Atlantique, nursing procedures. 7, 1845 – as a professionally trained
France.) January 4, 1926) nurse in the United States,
A leading pioneer of the graduating in 1879.
modern nursing profession,
Delano almost single- In 1908, she co-founded the
handedly created American National Association of
Red Cross Nursing when she Colored Graduate Nurses
united the work of the (NACGN).
American Nurses
Association, the Army Nurse The NACGN eventually
Corps, and the American merged with the American
Red Cross. Through her Nurses Association (ANA) in
efforts, emergency response 1951.
teams were organized for
disaster relief and over 8,000 She is commemorated by the
registered nurses were biennial Mary Mahoney
trained and ready for duty by Award of the ANA for
the time the United States significant contributions in
entered World War I. advancing equal
opportunities in nursing for
During the course of the War, members of minority groups.
more than 20,000 of her She encouraged respect for
nurses played vital roles with cultural diversity.
the United States military. ADAH BELLE African American nurse who
MARY She also was known as Mary SAMUELS co-founded the National
BRECKINRIDGE Carson Breckinridge. THOMS Association of Colored
(February 17, (January 12, Graduate Nurses.
1881-May 19, Was an American nurse-
1870 – February
midwife and the founder of Acting director of the Lincoln
1965) 21, 1943) School for Nurses (New
the Frontier Nursing Service.
York), and fought for African
Introduced a model rural Americans to serve as army
health care system, to nurses during World War I.
provide professionals She was among the first
services. nurses inducted into the
American Nurses
She created a decentralized Association Hall of Fame
system of nurse-midwives, when it was established in
district nursing centers, and 1976.
hospital facilities.
Originally called the President of the NACGN
Kentucky Committee for from 1916-1923, and played
Mothers and Babies, later the a critical role in lobbying for
Frontier Nursing Service the rights of African American
(FNS), the system lowered women to serve in the United
the rate of death in childbirth States military during World
in Leslie County, Kentucky, War I.
from the highest in the nation
Campaigned the American control, Sanger was ahead of
Red Cross permit black her time.
nurses to enroll. SHIRLEY TITUS Nurse, Educator,
LINDA (1892 – 1967) Administrator- advocated
First professionally trained
improved economic security
RICHARDS American nurse.
of nurses.
(July 27, 1841-
April 16,1930) She established nursing
Championed nursing's
training programs in the
responsibility to improve the
United States and Japan.
economic security
First system for keeping
Her 1943 article, Economic
individual medical records for
Security Is Not Too Much to
hospitalized patients.
Ask, asserted that as
In 1885 she helped to employed professionals,
establish Japan’s first nurses need the protection
nurses-training program. of, and the legal right to,
collective bargaining.
She was elected as the first
president of the American
FLORENCE "The Lady with the Lamp",
Society of Superintendents
NIGHTINGALE was a pioneer of modern
of Training Schools, and
(12 May 1820 – 13 nursing, a writer and a
served as head of the
August 1910) noted statistician.
Philadelphia Visiting Nurses
Society. She retired from
Florence's older sister
nursing in 1911, at the age of
was named Parthenope.
seventy
Her parents were William
LAVINIA LLOYD Compiled the first, and long Edward Nightingale
DOCK most important, manual of (1794–1875) and Frances
(1858 – 1956) drugs for nurses, Materia Nightingale née Smith
Medica for Nurses (1890). (1789–1880).
She strove not only to Inspired by what she took
improve the health of the as a Christian divine
poor but also to improve the calling, experienced first
profession of nursing through in 1837 at Embley Park
her teaching, lecturing, and and later throughout
writing. Florence's life, she
committed herself to
She played a major role as a
nursing (though
contributing editor to the
discouraged by her
American Journal of Nursing.
parents).
She also did most of the work
Florence Nightingale's
for A History of Nursing (4
most famous contribution
vols, 1907–12, later revised
came during the Crimean
and abridged).
War, which became her
MARGARET An American birth control central focus when
HIGGINS activist, an advocate of reports began to filter
SANGER negative eugenics, and the
back to Britain about the
(September 14, founder of the American Birth horrific conditions for the
Control League (which wounded.
1879 –
eventually became Planned
September 6, Parenthood).
1966) By 1859, she set up the
Nightingale Training
Woman's choice to decide
School at St. Thomas'
how and when, if ever, she Hospital on 9 July 1860.
will bear children.
In her drive to open the way The first trained
to universal access to birth Nightingale nurses began
work on 16 May 1865 at or diminished health
the Liverpool Workhouse status.
Infirmary.
HISTORY OF NURSING IN THE PHILIPPINES
She also campaigned and
raised funds for the Royal EARLY BELIEFS & PRACTICES
Buckinghamshire Hospital
in Aylesbury, near her o Treatment for Disease and what cause
family home. them are formed by mysticism and
BELIEFS - Holistic framework superstition
inclusive of illness and 1. Causation of disease:
health a. Beliefs that it could be from another
- Need for theoretical person or a witch
basis
b. Evil spirits
- Liberal Education as
foundation for nursing 2. Persons with powers to expel
practice demons are believed that could
- Importance of creating drive away evil spirits.
an environment that 3. People believed in special gods of
promotes healing healing, with the priest-physician
- Need for the body of (called “word doctors”) as
nursing knowledge
distinct from medical intermediary. If they used leaves or
knowledge. roots, they were called herb doctors
CONCEPT - Having systematic (Herbolarios).
method of assessing
patient EARLIEST HOSPITALS ESTABLISHED DURING THE SPANISH
- Individualized care on REGIME:
the basis of patients’
needs and preferences Hospital Real de Care for the Spanish
- Maintaining Manila (1577) king’s soldiers, founded
confidentiality by Gov. Francisco de
- Nurses should be Sande.
formally educated and San Lazaro Hospital Founded by Bro. Juan
function as client
(1578) Clemente,administered
advocate
ENVIRONMENTAL Adequate ventilation has by Hospitalliers of San
FACTORS also been regarded as a Juan De Dios, exclusively
AFFECTING HEALTH factor contributing to for patient with Leprosy.
changes of the patient's Hospital de Indio By Franciscan order,
process of illness (1586) supported by alms &
recovery. Defined in her
contributions for
environmental theory are
the following factors charitable persons.
present in the patient's Hospital de Aguas Established in Laguna
environment: Santas (1590) near medicinal spring,
founded by BRO. J.
- Pure or fresh air Bautista of the Franciscan
- Pure water Order.
- Sufficient food supplies
- Efficient drainage San Juan de Dios Founded by brotherhood
- Cleanliness Hospital (1596) of Mesiricordia and run by
- Light (especially direct Hospitalliers of San Juan
sunlight) de Dios, support from
alms & rents, general
Any deficiency in one or services for people.
more of these factors
could lead to impaired
functioning of life NURSING DURING THE PHILIPPINE REVOLUTION
processes
The prominent persons involved in nursing works Massachusetts. (1st
were: Superintendent)
JOSEPHINE Wife of Jose Rizal Miss Flora Ernst, an

BRACKEN American nurse took
Installed a field of hospital charge of the school in
in an estate house in 1942.
Tejeros Provided nursing St. Paul’s Hospital The hospital was
care to the wounded night School of Nursing established by the
and day (Manila, 1907) Archbishop of Manila.
ROSA SEVILLA DE Converted their house The Most Reverend
ALVERO into quarters for the Jeremiah Harty, under
Filipino soldiers during the the supervision of the
Philippine-American war sisters of St. Paul de
(1899) Charters
DONA HILARIA DE Wife of Emilio Aguinaldo Philippine General Mainly for “Civil
AGUINALDO Hospital School of officers & Employees”
Organized the Filipino Nursing (1907) in the city of Manila &
Red Cross under the became Civil Hospital
inspiration of Apolinario
Mabini St. Luke’s Hospital Hospital in
DONA MARIA Second wife of Emilio School of Nursing Episcopalian
Aguinaldo (Quezon City, 1907) Institution, began as a
AGONCILLO DE
small dispensary.
AGUINALDO Opened with 3 fil girls
Provided nursing care for
the Filipino soldiers during admitted.
the revolution Philippine Christian a. Sallie Long Read
Mission Institute Memorial Hospital
President of the Filipino Schools of Nursing School of Nursing
Red Cross branch in (Laoag, Ilocos Norte,
Batangas 1903)
MELCHORA AQUINO Nurse the wounded b. Mary Chiles Hospital
(TANDANG SORA) Filipino soldiers and gave School of Nursing
them shelter and food (Manila, 1911)
CAPITAN SALOME Revolutionary leader in Mary Johnston Hospital “Bethany Dispensary”
Nueva Ecija and School of Nursing founded by Methodist
(Manila, 1907) Mission for the relief of
Provided nursing care to suffering among
the wounded when not in women & children.
combat Emmanuel Hospital San Juan de Dios
AGUEDA Revolutionary leader in School of Nursing Hospital School of
KAHABAGAN Laguna who provided (Capiz, 1913) Nursing
nursing services to her (Manila, 1913)
troop Southern Islands Other schools of
TRINIDAD TECSON Stayed in the hospital in
Hospital School of Nursing established
Biak na Bato to care for
the wounded soldiers Nursing were the ff:
(Cebu, 1918) a. Zamboanga
HOSPITALS AND SCHOOLS OF NURSING General Hospital
School of Nursing
Iloilo Mission Hospital It was run by the (1921)
School of Nursing Baptist Foreign
b. Chinese General
(Iloilo City,1906) Mission Society of
America. Hospital School of
Nursing (1921)
Miss Rose Nicolet, a c. Baguio General
graduate of New Hospital School of
England Hospital for Nursing (1923)
women and children in
Boston,
d. Manila Sanitarium school having been impressed with their
and Hospital School of work.
Nursing (1930) o The 1st batch of five sisters arrived in
e. St. Paul’s School of August, 1921.
Nursing in Iloilo City o Mrs. Praxedes Co Tui, RN from PGH was
(1946) appointed as Chief Nurse and Principal of
f. Northern General the School of Nursing.
Hospital and School of
Nursing (1946)
g. Silliman University
School of Nursing
(1947)
1ST COLLEGES OF NURSING IN THE PHILIPPINES
o University of Santo Tomas College of

Nursing (1946)
o Manila Central University College of
Nursing
o University of the Philippines College of
Nursing
NURSING LEADERS IN THE PHILIPPINES
ANASTACIA GIRON- 1st fil. Nurse as chief

TUPAS nurse superintendent,
founder of PNA.
CESARIA TAN 1st fil. To receive a
Master’s degree in
nursing abroad.
SOCORRO SIRILAN Pioneered chief nurse
in San Lazaro Hosp.
ROSA MILITAR A pioneer in school
health education.
SOR RICARDA A pioneer in nursing
MENDOZA education
CONCHITA RUIZ 1st full-time editor of
the newly named PNA
magazine “The Filipino
Nurse”
LORE TUPAZ “Dean of the Philippine
Nursing”; Florence
Nightingale of Iloilo.
HISTORY OF NURSING IN CGHCNLA
o CGHCNLA was founded in 1921 as CGHSN

o Idea was conceived by Dr. Jose Tee Han
Kee, Director of CGH.
o With him were three physicians who
organized the training school.
o The Sisters of the Immaculate Conception
based in HK and Canton were requested
by Dr. Tee Han Kee to help in starting the
N-103 FNP LEC: LEGAL ASPECTS OF NURSING
2nd Semester | S.Y. 2023 – 2024 | BACHELOR OF SCIENCE IN NURSING
LAW LEGISLATIVE LAW
“The sum total of rules and regulations by • Laws enacted by any legislative
which society is governed. As such, law is body.
created by people and exists to regulate all • When federal and state laws
persons.” (Guido, 2014) conflict, federal law supersedes,
LITIGATION – action of lawsuit and state law supersede local laws
• It regulates the function of nursing
LITIGATORS – lawyers who participate in
practice acts
lawsuit
• Law which has been promulgated
LAWSUIT – a case in a court of law involving (or "enacted") by a legislature or
a claim, complaint, etc., by one party other governing body or the
against another; suit at law
process of making it. Whether a
given bill will be proposed and is
generally a matter of
the legislative priorities of
government.
• Legislation is defined as laws and
rules made by the government.
An example of legislation is a new
state rule that changes textbook
requirements.
SOURCES OF LAW
ADMINISTRATIVE LAW
CONSTITUTIONAL LAW
• Rules and regulation created by the
• Foundation of the justice system administrative agency when the
and created legal rights and state legislature passes a statute.
responsibilities. • The body of law that regulates the
• It establishes the general operation and procedures of
organization of the federal government agencies.
government grants certain powers Administrative law is a branch of
to the government and places limits public law that is concerned with
on what federal and state the procedures, rules, and
government may do. regulations of a number of
• The body of rules, doctrines, and governmental agencies.
practices that govern the operation An example of administrative law is
of political the regulation and operation of the
communities. Constitutional law is Social Security Administration, and
the channel, or vehicle, for the administration of benefits to the
our constitutional rights. That people.
means there are over
10,000 republic acts. Add a few COMMON LAW
more for other documents such • Law evolving from court decisions
as the constitution, • In deciding specific controversies,
the court generally adhere to the
VIERNES, JINGER KIM M.
doctrine of the stare decisis – to harm to others, such automobile

stand by things decided accidents.
• System of law which is based on o Breach of contract actions, based
judges' decisions and on custom upon the failure of a party to live up
rather than on written laws. to the terms of a contract.
• A common law relationship is
regarded as a marriage because it EXAMPLES OF VIOLENT CRIMES
has lasted a long time, although no o Murder.
official marriage contract has been o Manslaughter.
signed. o Rape.
• An example of common law is a o Arson.
rule that a judge made that says o Terrorism.
that people have a duty to read o Domestic violence.
o Gang violence.
contracts
o Kidnapping.
THE HIERARCHY OF LAW: MANSLAUGHTER – the crime of killing a

human being without malice aforethought,
or otherwise in circumstances not
amounting to murder. Manslaughter is an
unlawful killing that doesn't involve malice
aforethought—intent to seriously harm or
kill, or extreme, reckless disregard for life.
The absence of malice aforethought means
that manslaughter involves less moral
blame than either first- or second-degree
murder.
TYPES OF LAW
PUBLIC LAW
KINDS OF LEGAL ACTIONS • Refers to the body of the law that
deals with relationships between
individuals and the government and
governmental agencies
• Law comprises of constitutional law,
administrative law, tax law, criminal
law, and procedural law.
CRIMINAL LAW
• Deals with actions against the
safety and welfare of the public.
Examples of civil actions include, among (homicide, theft, arson, active
others: euthanasia, sexual assault)
o Personal injury claims based on the
negligent acts of others that cause

PRIVATE LAW • assists in maintaining a standard

of nursing practice by making
• The body of law that deals with nurses accountable to the law
relationships among private
individuals. BRIEF HISTORY OF PHILIPPINE NURSING
- Contract Law
1915 - Act No.2493 – which regulated the
- Tort Law
practice of medicine. This act provided for
• Found in an organizations and
the examination and registration of nurses
employment (no smoking at
in the Philippine Islands
headquarters)
1919 - Act 2808 was passed, this is known
CONTRACT LAW as the First True Nursing Law. It created
among others a board of examiners for
• Involves the enforcement of
nurses. However, it was in 1920 that the
agreements among private
first board examination in the Philippines
individuals or payment of
was given.
compensation for failure to fulfil
agreements. June 19, 1953 - Philippine Nursing Law or
R.A. 877 was passed. This act regulated
THE CIVIL JUDICIAL PROCESS the practice of nursing in the Philippines.
One of the landmarks in the history of the
nursing profession in the Philippines is the
Presidential Proclamation of a Nurses'
Week.
October 17, 1958 - Proclamation No. 539,

the President of the Philippines designated
the last week of October every year
beginning in 1958 as Nurses' Week
June 18, 1966 - Republic Act 4704

amended certain portions of R.A. 877
COMPLAINT – a document filed by a person.
1991 - Republic Act 7164, introduced by
PLAINTIFF – a person who filed a complaint
Senator Heherson Alvarez, codified and
DEFENDANTS – accused
revised all the laws regulating the practice
= complaint-answer-discovery-trial-
of nursing in the Philippines. It was known
decision/verdict (by a judge or jury)
as the Philippine Nursing Act of 1991
FUNCTIONS OF LAW IN NURSING October 21, 2002, Republic Act No. 9173
otherwise known as “The Philippine
• provides a framework for
Nursing Act of 2002” replaced R.A. 7164
establishing what nursing actions in
the care of patients are legal
R.A 9173 “THE PHILIPPINE NURSING ACT OF
• delineates the nurse’s
2002
responsibilities from those of other
professionals
TITLE AND DECLARATION OF POLICY
• helps to establish the boundaries of
independent nursing actions
This Act shall be known as the “Philippine time of their appointment, possess
Nursing Act of 2002.” the following qualifications:
(a) Be a natural born citizen and
• Declaration of Policy. — It is hereby
resident of the Philippines;
declared the policy of the State to
(b) Be a member of good standing
assume responsibility for the
of the accredited professional
protection and improvement of the
organization of nurses;
nursing profession by instituting
(c) Be a registered nurse and
measures that will result in relevant
holder of a master’s degree in
nursing education, humane working
nursing, education or other
conditions, better career prospects
allied medical profession
and a dignified existence for our
conferred by a college or
nurses.
university duly recognized by
• The State hereby guarantees the the Government: Provided,
delivery of quality basic health That the majority of the
services through an adequate Members of the Board shall be
nursing personnel system holders of a master’s degree in
throughout the country. nursing: Provided, further, That
the Chairperson shall be a
ORGANIZATION OF THE BOARD OF NURSING holder of a master’s degree in
• SEC. 3. Creation and Composition nursing;
of the Board. — There shall be (d) Have at least ten (10) years of
created a Professional Regulatory continuous practice of the
Board of Nursing, hereinafter profession prior to
referred to as the Board, to be appointment: Provided,
composed of a Chairperson and six however, That the last five (5)
(6) members. years of which shall be in the
• They shall be appointed by the Philippines; and
President of the Republic of the (e) Not have been convicted of any
Philippines from among two (2) offense involving moral
recommenders, per vacancy, of the turpitude;
Professional Regulation • Provided, That the membership to
Commission, hereinafter referred to the Board shall represent the three
as the Commission, chosen and (3) areas of nursing, namely:
ranked from a list of three (3) nursing education, nursing service
nominees, per vacancy, of the and community health nursing.
accredited professional • SEC. 5. Requirements Upon
organization of nurses in the Qualification as Member of the
Philippines who possess the Board of Nursing. — Any person
qualifications prescribed in Section appointed as Chairperson or
4 of this Act. Member of the Board shall
• SEC. 4. Qualifications of the immediately resign from any
Chairperson and Members of the teaching position in any school,
Board. — The Chairperson and college, university or institution
Members of the Board shall, at the offering Bachelor of Science in
Nursing and/or review program for

the local nursing board Chairperson and members of other

examinations or in any office or professional regulatory boards.
employment in the government or • SEC. 8. Administrative Supervision
any subdivision, agency or of the Board, Custodian of its
instrumentality thereof, including Records, Secretariat and Support
government-owned or controlled Services. — The Board shall be
corporations or their subsidiaries as under the administrative
well as those employed in the supervision of the Commission.
private sector. • All records of the Board, including
• He/she shall not have any applications for examinations,
pecuniary interest in or administrative and other
administrative supervision over any investigative cases conducted by
institution offering Bachelor of the Board shall be under the
Science in Nursing including review custody of the Commission.
classes. • The Commission shall designate
• SEC. 6. Term of Office. — The the Secretary of the Board and shall
Chairperson and Members of the provide the secretariat and other
Board shall hold office for a term of support services to implement the
three (3) years and until their provisions of this Act.
successors shall have been • SEC. 9. Powers and Duties of the
appointed and Board. — The Board shall
qualified: Provided, That the supervise and regulate the practice
Chairperson and Members of the of the nursing profession and shall
Board may be reappointed for have the following powers, duties
another term. and functions:
• Any vacancy in the Board occurring (a) Conduct the licensure
within the term of a Member shall examination for nurses;
be filled for the unexpired portion of (b) Issue, suspend or revoke
the term only. certificates of registration for the
• Each Member of the Board shall practice of nursing;
take the proper oath of office prior (c) Monitor and enforce quality
to the performance of his/her standards of nursing practice in the
duties. Philippines and exercise the
• The incumbent Chairperson and powers necessary to ensure the
Members of the Board shall maintenance of efficient, ethical
continue to serve for the remainder and technical, moral and
of their term under Republic Act No. professional standards in the
7164 until their replacements have practice of nursing taking into
been appointed by the President account the health needs of the
and shall have been duly qualified. nation;
• SEC. 7. Compensation of Board (d) Ensure quality nursing
Members. — The Chairperson and education by examining the
Members of the Board shall receive prescribed facilities of universities
compensation and allowances or colleges of nursing or
comparable to the compensation departments of nursing education
and allowances received by the and those seeking permission to

open nursing courses to ensure that • SEC. 10. Annual Report. — The
standards of nursing education are Board shall at the close of its
properly complied with and calendar year submit an annual
maintained at all times. The report to the President of the
authority to open and close colleges Philippines through the
of nursing and/or nursing education Commission giving a detailed
programs shall be vested on the account of its proceedings and the
Commission on Higher Education accomplishments during the year
upon the written recommendation and making recommendations for
of the Board; the adoption of measures that will
(e) Conduct hearings and upgrade and improve the conditions
investigations to resolve complaints affecting the practice of the nursing
against nurse practitioners for profession.
unethical and unprofessional • SEC. 11. Removal or Suspension
conduct and violations of this Act, or of Board Members. — The
its rules and regulations and in President may remove or suspend
connection therewith, any member of the Board after
issue subpoena ad having been given the opportunity
testificandum and subpoena duces to defend himself/herself in a proper
tecum to secure the appearance of administrative investigation, on the
respondents, and witnesses and following grounds:
the production of documents and (a) Continued neglect of duty or
punish with contempt persons incompetence;
obstructing, impeding and/or (b) Commission or toleration of
otherwise interfering with the irregularities in the licensure
conduct of such proceedings, upon examination; and
application with the court; (c) Unprofessional, immoral or
(f) Promulgate a Code of Ethics in dishonorable conduct.
coordination and consultation with • Scope of Nursing. — A person shall
the accredited professional be deemed to be practicing nursing
organization of nurses within one within the meaning of this Act when
(1) year from the effectivity of this he/she singly or in collaboration
Act; with another, initiates and performs
(g) Recognize nursing specialty nursing services to individuals,
organizations in coordination with families and communities in any
the accredited professional health care setting.
organization; and • It includes, but not limited to,
(h) Prescribe, adopt, issue and nursing care during conception,
promulgate guidelines, regulations, labor, delivery, infancy, childhood,
measures and decisions as may be toddler, pre-school, school age,
necessary for the improvement of adolescence, adulthood and old
the nursing practice, advancement age.
of the profession and for the proper • As independent practitioners,
and full enforcement of this Act nurses are primarily responsible for
subject to the review and approval the promotion of health and
by the Commission. prevention of illness.

• As members of the health team, • Provide health education to

nurses shall collaborate with other individuals, families and
health care providers for the communities
curative, preventive, and • Teach, guide and supervise
rehabilitative aspects of care, students in nursing education
restoration of health, alleviation of programs including the
suffering, and when recovery is not administration of nursing services in
possible, towards a peaceful death. varied settings such as hospitals
and clinics; undertake consultation
IT SHALL BE THE DUTY OF THE NURSE services; engage in such activities
TO: that require the utilization of
knowledge and decision-making
skills of a registered nurse; and
• Undertake nursing and health
human resource development
training and research, which shall
include, but not limited to, the
development of advance nursing
practice;
THE ICN CODE OF ETHICS FOR NURSES

• An international code of ethics for
nurses was first adopted by the
Provide nursing care through the utilization International Council of Nurses
of the nursing process. (ICN) in 1953.
• It has been revised and reaffirmed
• Nursing care includes, but not
at various times since, most
limited to, traditional and innovative
recently with this review and
approaches, therapeutic use of self,
revision completed in 2021.
executing health care techniques
and procedures, essential primary
PURPOSE OF THE CODE
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;
• Establish linkages with community
resources and coordination with the • It guides everyday ethical nursing
health team; practice and can serve as a

regulatory tool to guide and define interests of patients in the lawful

ethical nursing practice. collection, use, access,
• Provides ethical guidance in transmission, storage and
relation to nurses’ roles, disclosure of this information.
responsibilities, behaviors, • 1.5 Nurses respect the privacy and
decision-making and relationships confidentiality of colleagues and
with patients and people who are people
receiving nursing care. • 1.6 Nurses share with society the
• It is to be used in combination with responsibility for initiating and
the laws, regulations and supporting action to meet the health
professional standards of countries and social needs of all people.
that govern nurses’ practice. • 1.7 Nurses advocate for equity and
• The values and obligations social justice in resource allocation,
expressed in this Code apply to access to health care and other
nurses in all settings, roles and social and economic services.
domains of practice, and should be • 1.8 Nurses demonstrate
aspired to by all nursing students. professional values such as
respect, justice, responsiveness,
4 FUNDAMENTAL NURSING RESPONSIBILITIES compassion, empathy,
o PROMOTE HEALTH trustworthiness and integrity.
o PREVENT ILLNESS • 1.9 Nurses provide evidence-
o TO RESTORE HELATH informed, person-centered care,
o TO ALLEVIATE SUFFERING recognizing and using the values
and principles of primary health
ELEMENTS OF THE CODES care and health promotion.
• 1.10 Nurses encourage a culture of
NURSES & PATIENTS OR PEOPLE safe health care and raise any
REQUIRING HEALTH concerns regarding the safety of
• 1.1 Nurses’ primary professional people and health services.
responsibility is to people requiring • 1.11 Nurses support and protect the
nursing care whether individuals, right to self-determination of all
families, communities or patients and other health care
populations (hereinafter referred to professionals.
as either ‘patients’ or ‘people • 1.12 Nurses ensure that use of
requiring care’). technology and scientific advances
• 1.2 Human rights, values, customs, are compatible with the safety,
religious and spiritual beliefs dignity and rights of people. In the
• 1.3 Nurses ensure that the case of devices, such as robots,
individual receives accurate, nurses ensure that care remains
sufficient and timely information in a person-centered and that such
culturally appropriate manner on devices support and do not replace
which to base consent for care and human relationships.
related treatment.
• 1.4 Nurses hold in confidence NURSES AND PRACTICE
personal information and respect
the privacy, confidentiality and
• 2.1. Nurses carry personal consent to access their genetic

responsibility and accountability for information, including activities
nursing practice, and for linked to genetic and genomic-
maintaining competence by based research. They protect the
continual learning. They engage in use, privacy and confidentiality of
continuous professional genetic information and human
development and lifelong learning. genome materials. They also foster
• 2.2 Nurses maintain fitness to the equitable access to genomic
practice so as not to compromise technologies.
the ability to provide care. • 2.10 Nurses develop and sustain
• 2.3 Nurses practice within the limits collaborative and respectful
of their individual competence and relationships with colleagues and
use judgement when accepting and other members of the health care
delegating responsibility. team. They recognize and respect
• 2.4 Nurses value their own dignity, their knowledge, skills and
well-being and health. They know perspectives.
that positive practice environments, • 2.11 Nurses take appropriate
characterized by professional actions to safeguard individuals,
recognition, education, support families and communities when
structures, adequate resourcing, their health is endangered by a co-
management practices and worker, any other person, policy,
occupational health and safety, are practice or misuse of technology.
pivotal to achieve them. • 2.12 Nurses are active participants
• 2.5 Nurses, at all times maintain in the promotion of patient safety.
standards of personal conduct They promote ethical conduct when
which reflect well on the profession errors or near misses occur, speak
and enhance its image and public up when patient safety is
confidence. In their professional threatened, and work with others to
role, nurses recognize and maintain reduce the potential of errors.
personal relationship boundaries.
• 2.6 Nurses share their knowledge NURSES AND THE PROFESSION
and provide feedback, mentorship • 3.1 Nurses assume the major role
and guidance for the professional in determining and implementing
development of nursing students, acceptable standards of clinical
novice nurses, other nurses and nursing practice, management,
other health care providers. research and education.
• 2.7 Nurses foster and maintain a • 3.2 Nurses are active in developing
practice culture that promotes a core of research-based, updated
ethical behavior and open dialogue. professional knowledge that
• 2.8 Nurses may conscientiously supports evidence-informed
object to participating in a particular practice.
medical procedure or research • 3.3 Nurses are active in developing
study but must ensure that people and sustaining a core of
receive care. professional values.
• 2.9 Nurses maintain a person’s
right to give and withdraw informed
• 3.4 Nurses, through their reduce environmentally harmful

professional organizations, practices in order to promote health
participate in creating a positive and well-being.
practice environment that supports • 4.7 Nurses collaborate with other
individual practice and ensures safe health professions and the public to
quality care, and maintains safe, uphold principles of justice by
equitable social and economic promoting responsibility in human
working conditions for nurses. rights, equity and fairness and by
• 3.5 Nurses contribute to positive promoting the public good and a
and ethical organizational healthy planet.
environments and challenge
unethical practices and settings.
• 3.6 Nurses engage in the creation,
dissemination and use of research.
• 3.7 Nurses prepare for and respond
to emergencies, disasters, conflicts,
epidemics and conditions of scarce
resources.
NURSES AND GLOBAL HEALTH

• 4.1 Nurses value access to health
care as a human right, affirming the
need for universal health coverage.
• 4.2 Nurses uphold the dignity, PATIENT’S RIGHTS
freedom and worth of all human
beings and oppose all forms of Are policies and rules that must be
exploitation, such as human preserved and protected by Health
trafficking and child labor. Facilities toward patients and their families.
• 4.3 Nurses lead or contribute to
health policy development. RIGHT TO APPROPRIATE MEDICAL CARE &
• 4.4 Nurses support and work HUMAN TREATMENT
towards the achievement of the
• Right to health and medical care
United Nations Sustainable
and good quality.
Development Goals.
• If the patient has to wait for care, he
• 4.5 Nurses recognize the
shall be informed of the reason for
significance of the social
the delay.
determinants of health. They
contribute to, and advocate for, • Patients in emergency shall be
policies and programs that address extended immediate medical care
them. and treatment without any deposit,
pledge, mortgage or any form of
• 4.6 Nurses collaborate and practice
to preserve, sustain and protect the advance payment for treatment.
natural environment and are aware
RIGHT TO INFORMED CONSENT
of its consequences on health.
They advocate for initiatives that

• The patient has a right to a clear, • Right to be informed of the result of

truthful and substantial explanation the evaluation of the nature and
and will not be subjected to any extent of his/her disease.
procedure without his written • Right to examine and be given an
informed consent, except in the itemized bill of the hospital and
following cases: medical services
a) in emergency cases • Right to be informed by the
b) when the health of the physician or his/her delegate of
population is dependent on the his/her continuing health care
adoption of a mass health requirements following discharge.
program to control epidemic;
c) when the law makes it RIGHT TO CHOOSE HEALTH CARE
compulsory for everyone to PROVIDER & FACILITY
submit a procedure;
d) When the patient is either a • The patient is free to choose the
minor, or legally incompetent, in health care provider to serve him as
which case. a third-party well as the facility
consent Is required; • The patient has the right to discuss
e) when disclosure of material his condition with a consultant
information to patient will specialist, at the patient’s request
jeopardize the success of and expense.
treatment, in which case, third
party disclosure and consent RIGHT TO SELF-DETERMINATION
shall be in order;
• Right to avail himself/herself of any
f) When the patient waives his
recommended diagnostic and
right in writing.
treatment procedures provided that
a) he is informed of the medical
RIGHT TO PRIVACY & CONFIDENTIALITY
consequences of his choice;
• The patient has the right to be free b) he releases those involved in
from unwarranted public exposure, his care from any obligation
except in the following cases: relative to the consequences of
a) when his mental or physical his decision;
condition is in controversy and c) his decision will not prejudice
the appropriate court, in its public health and safety.
discretion, order him to submit
to a physical or mental RIGHT TO RELIGIOUS BELIEF
examination by a physician;
• The patient has the right to refuse
b) when the public health and
medical treatment or procedures
safety so demand; and
which may be contrary to his
c) when the patient waives this
religious beliefs, subject to the
right in writing.
limitations described in the
preceding subsection:
RIGHT TO INFORMATION
• Provided, that such a right shall not
be imposed by parents upon their
children who have not reached the

legal age in a life-threatening • The patient has the right to

situation as determined by the communicate with relatives and
attending physician or the medical other persons and to receive
director of the facility. visitors subject to reasonable limits
prescribed by the rules and
RIGHT TO MEDICAL RECORDS regulations of the health care
institution
• He has the right to view the
contents of his medical records,
RIGHT TO EXPERIENCE GRIEVANCES
except psychiatric notes and other
incriminatory information obtained • The patient has the right to express
about third parties, with the complaints and grievances about
attending physician explaining the care and services received
contents thereof. without fear of discrimination or
reprisal and to know about the
RIGHT TO LEAVE disposition of such complaints.
• Such a system shall afford all
• The patient has the right to leave parties concerned with the
hospital or any other health care opportunity to settle amicably all
institution regardless of his physical grievances.
condition: Provided that
a) he/she is informed of the RIGHT TO BE INFORMED OF HIS RIGHTS &
medical consequences of
OBLIGATIONS AS A PATIENT
his/her decision
b) he/she releases those involved • It shall be the duty of health care
in his/her care from any institutions to inform of their rights
obligation relative to the as well as of the institution's rules
consequences of his decision; and regulations that apply to the
c) his/her decision will not conduct of the patient while in the
prejudice public health and care of such institution.
safety.
NURSING JURISPRUDENCE
RIGHT TO REFUSE PARTICIPATION IN
MEDICAL RESEARCH • department of law which comprises
all legal rules and principles
• Right to be advised if the health effecting the practice of nursing
care provider plans to involve him in • includes the study and interpretation
medical research, including but not of rules and principles and their
limited to human experimentation application in the regulation of the
which may be performed only with practice of nursing
the written informed consent of the
patient. LEGAL LIABILITIES IN NURSING
• As nurses begin their professional
RIGHT TO CORRESPONDENCE AND TO
obligations, their legal
RECEIVE VISITORS responsibilities begin as well.

• Their license to practice attests that o rules of behavior based on ideas

they are qualified under the law to about what is morally good and
practice their profession. bad. A branch of Philosophy dealing
• The Philippine Nursing Act of 1992 with what is morally right or
is the best guide the nurse can wrong/moral judgement
utilize as it defines the scope of
nursing practice. MORAL
• There are also standards of care o personal standards of right and
that may be used as criteria in wrong
evaluating their work. o based on what you think is right and
• The nurses are enjoined to be good/ agreeing with a standard of
familiar with the Philippine Nursing right behavior. (honest, just, decent)
Law, and the standards of nursing
care, other laws which affect CRIMES
nursing practice and their code of
ethics o an act committed in violation of
public (criminal) law & punishable
RESPONSIBILITY & ACCOUNTABILITY FOR by fine or imprisonment. Punished
THE PRACTICE OF PROFESSIONAL through criminal action by the state
against the individual.
NURSING
o an illegal act for which someone
Responsibility – refers to the execution of can be punished by the
duties associated with a nurse’s particular government; activity that is against
role. That is, the nurse is responsible the law, an illegal act in general, an
for providing care within established act that is foolish or wrong.
standards of the profession.
• FELONIES – ex: Murder or
Accountability – refers to the ability to rape (a serious crime)
answer for one’s own actions. The nurse is
accountable to herself most of all. He/she • MISDEMEANOR – a crime
also balances accountability to the patient, that is not very serious
the profession, the employing institution, (misdeed) – ex: Defacing
and society. (ruin the surface with writing
or pictures) school property
Liability – an obligation one has incurred or
might incur through any act or failure to act. TORT
-When the nurse fails to meet the legal
expectations of care, the client can initiate o a civil wrong committed against a
action if harm or injury is incurred by the person or a person’s property.
client. Usually litigated in court by civil
action between individuals.
DEFINITION OF TERMS • Unintentional
• Intentional
ETHICS
o a wrongful act that causes harm to
o expected standards of behavior of a
someone but that is not a crime and
particular group
dealt with a civil court

False Unlawful restraint or

NEGLIGENCE
Imprisonment detention of another
o Omission or failure to do that which person against his or
a reasonable and prudent man her wishes
Right of Privacy Right of an individual to
would do
withhold himself and
his property from
MALPRACTICE public scrutiny
o Any professional misconduct, Defamation Communication that is
false or made with a
unreasonable lack of skill or fidelity
careless disregard
in professional duties, evil practice from the truth and
or illegal or immoral conduct results in injury to
person’s reputation
PROFESSIONAL NEGLIGENCE
Libel – printed, written
o Refers to the commission or or pictures
omission of an act, pursuant to a
duty, that a reasonably prudent Slander – spoken
person in the same or similar words
circumstances would or would not
do and acting or the non-acting is NEGLIGENCE
the proximate cause of injury to
Negligence Is misconduct or practice
another person or his property.
that is below the standard
o The elements of professional expected of an ordinary,
negligence are reasonable, and prudent
(1) existence of a duty on the part of person.
the person charged to use due care Gross Involves extreme lack of
under circumstances, Negligence knowledge, skill, or
(2) failure to meet the standard of decision making that the
due care, person clearly should
(3) the foreseeability of harm have known would put
resulting from failure to meet the others to harm
standard, and
(4) the fact that the breach of this AREAS OF POTENTIAL LIABILITY
standard resulted in an injury to the
plaintiff. Categories of Negligence that result in
Professional Negligence Lawsuits
TORTS (INTENTIONAL) o Failure to follow standards of care
Assault Attempt or threat to o Failure to use equipment in
touch another person responsible manner
unjustifiably; it o Failure to communicate
precedes battery; it is o Failure to document
the act that causes the o Failure to assess and monitor
person to believe a o Failure to act as a client advocate
battery is about to
occur. MALPRACTICE
Battery Is the willful touching of
a person that may or o In the usual sense implies the idea
may not cause harm of improper or unskillful care of a
patient by a nurse. It would also
see that malpractice also denotes THE 4 Cs OF MALPRACTICE PREVENTION

stepping beyond one's authority
with serious consequences Caring Sincere caring
decreases the like
6 Elements hood that a patient
Duty Nurse must have a will sue of
relationship with the outcomes are
client that involves unsatisfactory or
providing care & adverse events
following an acceptable occur
standard of care. Communication Develop trust and
Breach of Nurse must have a respect with
Duty relationship with the patients by
client that involves communicating
providing care & professionally and
following an acceptable confirming that you
standard of care. have been
Foreseeability A link must exist understood.
between the nurse’s act Competence Maintain
& the injury suffered. competence and
Causation It must be proved that update knowledge
the harm occurred as a and skills
direct result of the frequently
nurse’s failure to follow Charting Document is proof
the standard of competence.
Harm or Plaintiff must Chart every
injury demonstrate some type conversation and
of harm or injury as a interaction you
result of breach of duty have with a patient.
owed the client.
Damages If malpractice caused the KINDS OF LEGAL ACTIONS
injury, the nurse is held
liable for damages that CIVIL ACTIONS Deals with the
may be compensated. relationships
among individuals
TYPES OF NURSING MALPRACTICE in the society. (man
file a suit against a
o Medication error person who
o Failure to follow a Physician’s believes he
orders cheated him,
o Delaying patient care and/or failure negligence,
to monitor a patient malpractice)
o Incorrectly performing a procedure, CRIMINAL ACTIONS Deals with
or trying to perform a procedure disputes between
without training individual and the
o Documentation error society as a whole
o Failure to get informed patient (a man shoots a
consent person; society
brings him to trial)
LITIGATION Action of lawsuit.

THE DOCTRINE OF “RES IPSA LOQUITOR” • patient’s/client’s name, age

and sex, and date of
o “The thing speaks for itself.” prescription.
o Conditions: o R.A. 6675 requires that the drugs
• Injury was of such nature be written in their generic names.
that it would not normally
occur unless there was a INTRAVENOUS THERAPHY & LEGAL
negligent act. IMPLICATIONS
• Injury caused by an agency
within control of the o "In the administration of
defendant. intravenous injections, special
• Plaintiff did not engage in training shall be required according
any manner that would bring to protocol established."
about injury. o Therefore, nurses have to
undertake a certified training course
MEDICAL ORDERS, DRUGS, & MEDICATIONS on intravenous therapy.
o R.A. 6675 states that only validly TELEPHONE ORDERS

registered medical, dental and
veterinary practitioners, whether in o There are legal risks by telephone
private institution/ corporation or in orders. These may be
the government, are authorized to misunderstood or misinterpreted by
prescribe drugs. the receiving nurse.
o Prescriptions made by o Sometimes too, messages from
unauthorized persons constitute telephones may sound unclear or
illegal practice of medicine, garbled because of some trouble in
dentistry or veterinary medicine and the telephone lines.
is punishable under R.A. 2832 of o Most importantly, the signature of
the Medical Act of 1959, R.A. 4419 the ordering physician is not
of the Dental Act, and R.A. 382 or present and this order may later be
the Veterinary Act denied incase errors exist or court
litigations arise.
R.A 5921, THE PHARMACY ACT AS
AMENDED CONSENT TO MEDICAL & SURGICAL
PROCEDURE
o An act regulating the practice of
pharmacy and settings standards o Consent is defined as a “free and
pharmaceutical education in the rational act that presupposes
Philippines and of the other knowledge of the thing to which
purposes. consent is being given by a person
o All prescriptions must contain the who is legally capable to give
following information: consent.”
• name of the prescriber, o The consent signed by the patient
• office address, or his authorized
• professional registration representative/legal guardian
number, upon admission is for the initial
• professional tax receipt diagnosis and treatment.
number, o Subsequent treatments/operations
require individual, informed
consent.
o Before any medical or surgical

INFORMED CONSENT
procedure can be performed on a
patient, consent must be obtained o The essential elements of informed
from the patient or his authorized consent include
representative who may be his (1) the diagnosis and explanation
parent or guardian. of the condition;
o It is only in case of emergency (2) a fair explanation of the
where the consent requirement procedures to be done and
does not apply. used and the consequences;
o The physician should give as much (3) a description of alternative
information about a contemplated treatments or procedures;
procedure and the patient should (4) a description of the benefits to
receive enough information to allow be expected;
him to give an informed consent for (5) material rights if any;
such procedure or treatment. (6) the prognosis, if the
o The intentional touching or unlawful recommended care, procedure,
beating of another person without is refused.
authorization to do so is a legal
wrong called battery. PROOF OF CONSENT
NATURE OF CONSENT o A written consent should be signed

to show that the procedure was the
o Consent is an authorization, by a one consented to and that the
patient or a person authorized by person understood the nature of the
law to give the consent on the procedure, the risks involved and
patient's behalf that changes a the possible consequences.
touching from non-consensual to o A signed special consent is
consensual. necessary before any medical or
o It is the nurse who actually secures surgical treatment is done such as
the consent of the patient upon x-rays, special laboratory tests,
admission. blood transfusions, operations,
o This consent is usually for cobalt therapy, or chemotherapy
diagnostic procedures and initial and the like.
treatment deemed necessary by
the medical staff. WHO MUST CONSENT
o To substantiate the patient’s
consent, a written authorization is o Ordinarily, the patient is the one
needed as proof against any liability who gives the consent in his own
that may arise due to an alleged behalf.
unlawful touching of a patient. o However, if he is incompetent (such
as in the case of minors or the
mentally ill) or physically unable
and is not an emergency case,
consent must be taken from
another who is authorized to give it
in his behalf.
CONSENT OF MINORS

o Parents, or someone standing in sign the consent form, he should be

their behalf, give the consent to made to fill out the release form to
medical or surgical treatment of a protect the hospital and/or agency
minor. and its personnel from any liability
o Parental consent is not needed that may result from his refusal.
however, if the minor is married or o If he refuses to sign the release
otherwise emancipated. form, this should be noted in his
chart. The competent person has a
CONSENT OF MENTALLY ILL legal and ethical right to refuse
treatment, and this right is formally
o A mentally incompetent person
established.
cannot legally consent to medical or
surgical treatment.
o The consent must be taken from the MEDICAL RECORDS
parents or legal guardian. o value = scientific and legal.
o "If it was not charted, it was not
EMERGENCY SITUATION observed or done.”
o In the performance of their duties,
o When an emergency exists, no
nurses are expected to record fully,
consent is necessary because
accurately, legibly, and promptly
inaction at such time may cause
their observations from admission
greater injury.
to the time of the patient’s
o A mother who is on the advanced
discharge.
stage of labor or a patient who goes
o Daily notes should include not only
to the emergency room gives an
medications and treatments given
implied consent to an immediate
or rendered but also the physical
treatment or attendance.
and emotional symptoms exhibited
o However, if time is available and an
by the patient.
informed consent is possible, it is
o Data Privacy is essential
best that this be taken for the
o Permission has to be taken from the
protection of all parties concerned.
hospital authorities for authorization
to secure any information from the
REFUSAL TO CONSENT patient’s chart.
o A patient who is mentally and o Nurses are responsible for
legally competent (sane mind and safeguarding the patient’s record
of legal age) has the right to refuse from loss or destruction or from
to permit touching of his body or to access by persons who are not
submit to a medical or surgical legally authorized to read such.
procedure no matter how
necessary, nor how imminent the LEGAL RESPONSIBILITIES OF STUDENTS
danger to his life or health if he fails
o Nursing students are responsible
to submit to treatment.
for acquiring the knowledge and
o Examples are patients who,
skills necessary to become a
because of their religious beliefs,
safe practitioner.
may refuse blood transfusion.
o Included in this knowledge and
o A patient may refuse to consent due
skill development is the awareness
to inadequate information regarding
of ethical principles and the process
the procedure to be done. If after
of ethical decision making.
the explanation, he still refuses to

o Nursing students must act as o The primary purpose of an incident

reasonably prudent persons, report is to document and prevent
equivalently with education and possible consequent injuries.
experience, when performing o Classifying an event, as an incident
nursing duties. does not imply that someone made
o They must perform only those tasks a mistake, it only means that
that they are competent to perform something unusual happened.
ETHICO-LEGAL-MORAL FUNCTION &

LIABILITY FOR THE WORK OF NURUSNG RESPONSIBILITIES OF A NURSE
STUDENTS
1. Nursing students should always be LEGAL PROTECTIONS IN NURSING
under the supervision of their PRACTICE
Clinical Instructors.
2. They should be given assignments o Laws and strategies are in place to
that are in level of their training, protect the nurse against litigation.
experience and competency. o Providing safe and, competent
3. They should be advised to seek practice is a major safeguard for
guidance specially if they are nurses.
performing a procedure for the first o Accurate and complete
time. documentation is also a critical
4. They should be oriented to the component of legal protection for
policies of the nursing unit where the nurse
they are assigned.
5. Their performance should be GOOD SAMARITAN ACTS
assessed frequently to determine
their strengths and their o are laws that protects the health
weaknesses. care provider who provide
6. Frequent conferences with the assistance at the scene of an
students will reveal their problems, emergency against claims of
which they may want to bring to the professional negligence.
attention of their instructors or vice-
versa. Discussions of these Guidelines for nurses who choose to
problems will iron out doubts and render emergency care are as follows:
possible solutions may be provided
o Limit actions to those normally
CHARTING DONE BY NURUSNG STUDENTS considered first aid, if possible
o Do not perform actions that you do
o When a nurse or a clinical instructor
not know how to do
countersigns the charting of a
o Offer assistance, but do not insist
nursing student, she attests that
o Have someone call for additional
she has personal knowledge of
help
information and that such is
o Do not leave scene until the injured
accurate and authentic.
person leaves or another qualified
o Anyone who countersigns without
person takes over
verification commits herself to
o Do not accept any compensation
possible legal risk
INCIDENT REPORTS PROFESSIONAL LIABILITY INSURANCE

o It covers all costs incurred by the

nurse up to the face value of policy. WHAT ARE THE LEGAL ASPECTS OF
However, the insurance company NURSING FOR?
may have the right to make the
decisions about the claim and o The legal aspects of nursing have
settlement. an impact on the manner in which
o Common claims that professional care is delivered to patients by
liability insurance covers are nurses.
negligence, misrepresentation o Legal concerns shape the
o A Primary care provider or a hospital environment in which nursing is
can be sued because of the practiced and determine how
negligence conduct of a nurse and documents are kept or shared.
the nurse can also be held liable for Ultimately, nurses and the nursing
professional negligence care they provide are judged based
o Hospitals are known to countersue on a legal definition for the standard
nurses when they find negligence of care for nurses.
and the hospital is required to pay o Written "standards of care and
that’s why nurses are advised to "guidelines" are available as
provide their own insurance resources for determining how
coverage and not rely on hospital nursing care is to be delivered and
provided insurance. the quality of care. However, the
legal definition of the standard of
NURSE AS WITNESSES care for nurses is not a "guideline"
or a "policy" set by any one
o A nurse who is asked to testify in a individual or institution. Rather, it is
situation regarding legal action the embodiment of collective
must seek the advice of an attorney knowledge for what is required of
before providing testimony and that the average nurse and sets the
the lawyer can also provide support minimum criteria for proficiency.
and counsel during the legal case. o The reason for having such a
o A nurse may also provide testimony general definition is to allow for
as an expert witness. An expert changes in the manner in
witness has a special training, which nursing is practiced.
experience, or skill in a relevant
area and is allowed by the court to NURSE PRACTICE ACTS
offer an opinion on some issue
o State Nurse practices acts also
within his/her area of expertise.
legally control nursing practice;
many states require.
REGULATIONS OF NURSING PRACTICE o The practice of nursing is a right
The standards of professional nursing granted by a state to protect those
practice are authoritative statements of the who need nursing care. and safe,
duties that all registered nurses, regardless competent nursing practice is
of role, population or specialty are grounded in the guidelines of the
expected to perform competently” (2010, p. state nurse practice act (NPA) and
2) – AMERICAN NURSES ASSOCIATION its rules.
(ANA) o All nurses have a duty to
understand their NPA and to keep
up with ongoing changes as this

dynamic document evolves and the o Nursing License is mandatory in all

scope of practice expands. states. For an occupation to obtain
o Republic Act (RA) No. 9173, the right to license to its members,
otherwise known as the "Philippine three criteria must generally be met:
Nursing Act of 2002. “As with the 1. Need to protect the public safety
new driver, education and or welfare
standards provided 2. The occupation is clearly
by laws designed to protect the delineated as a separate,
public provide guidance in nursing distinct area of work.
practice 3. A proper authority has been
established to assume the
CREDENTIALING obligations of the licensing
process.
1. Is the process of determining and
maintaining competence in nursing IMPORTANCE OF LICENSURE
practice.
2. Is one way of in which the nursing o According to Nurse Attorney. Brous,
profession maintains standards of (2012). He stated that “Nurses don't
practice and accountability for have the right to practice nursing or
educational preparation of its to hold themselves out as nurses
members and is recognized as unless their nursing licenses are in
qualified to carry out a tasks good standing."
3. Includes the following: o A professional license in nursing is
1. Licensure important because it sets minimum
2. Certification and pervades assuranete to ese
3. Accreditation public that predetermined
o The process of establishing the standards have been met.
qualifications of licensed medical
professionals and assessing their CERTIFICATION
background and legitimacy.
o The process of obtaining, verifying, o The voluntary practice of validating
and assessing the qualifications of that an individual nurse has met
a practitioner to provide care or minimum standards of nursing
services in or for a health care competence in specialty areas.
organization. Credentials are o National certification may be
documented evidence of licensure, required to become licensed as an
education, training, experience, or advanced practice nurse.
other qualifications. o Certification programs are
conducted by the American Nurses
FACTORS INCLUDED IN CREDENTIALING Association (ANA) and by specialty
nursing organization.
o The action or process of providing
LICENSURE someone or something with an
official document attesting to a
o A license is a legal permit that a
status or level of achievement.
government agency grants to
individuals to engage in the practice
of a profession and to use a
particular title.

ACCREDITATION/APPROVAL OF BASIC
NURSING EDUCATION PROGRAMS
o Depending on the state, a state

board of nursing must either
approve or accredit a nursing
program.
o Nursing programs can also choose
to seek voluntary accreditation from
a private organization such as the
Accreditation Commission for
Education in Nursing (ACEN) and
the Commission on Collegiate
Nursing Education (CCNE)
o The action or process of officially
recognizing someone as having a
particular status or being qualified
to perform a particular activity.
o Accreditation is important because
it: Helps determine if an institution
meets or exceeds
minimum standards of quality.
Helps students determine
acceptable institutions for
enrollment. Assist institutions in
determining acceptability of transfer
credits.
STANDARDS OF CARE
o The skills and learning commonly
possessed by members of a
profession (Guido, 2014).
o Nursing standards of care can be
classified into two categories:
internal and external standards.
o Internal standards of care include
“the nurses job description,
education. and expertise as well as
individual institutional policies and
procedures” (Guido. 2014, p.55)
o External standards consist of the
following:
a. Nurse practice acts
b. Professional organization
c. Nursing specialty – practice
organizations
d. Federal organizations and
federal guidelines.

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Nursing as Profession

FNP LEC (Week 2)

HOW TO ACT PROFESSIONAL AS A

3) Competence WHO: NURSING

2. COMMUNICATOR 9. CASE MANAGER

11. EXPANDED CAREER ROLES

EXTENDED CAREER ROLES

DEFINITIONS OF NURSING commodity.

to the needs of the individual, the - A person who is waiting for or

family, and the community during undergoing medical treatment and

health and illness. care.

treatment of human responses to - Individual who engages to advice or

actual or potential health problems services of another who is qualified

ANA (2010, p.10) ANA (2015b,p.7) SCOPE OF NURSING

1. Promoting health and Wellness

RECIPIENTS OF NURSING 3. Restoring Health

1. Nurses promote wellness in clients 2. Performing diagnostic and

who are both healthy and ill assessment procedures, such as

2. May involve individual and measuring blood pressure and

community activities to enhance examining feces for occult blood

healthy lifestyles, such as improving 3. Consulting with other health care

nutrition and physical fitness, professionals about client problems.

preventing drug and alcohol misuse, 4. Teaching clients about recovery

restricting smoking, and preventing activities, such as exercises that will

workplace. 5. Rehabilitating clients to their optimal

PREVENTING ILLNESS mental illness, injury, or chemical

● To maintain optimal health by addiction

preventing disease. Nursing

transmitted infections. 2. Palliative care nurses are part of a

RESTORING HEALTH providing relief from the symptoms

extends from early detection of cancer)

RESTORING HEALTH ACTIVITIES

SETTINGS FOR NURSING

NURSE PRACTICE ARTS

EXPERT The levels reflect movement from reliance on past

Gave up all earthly pleasures and 3 TYPES OF ORGANIZATION

The strong influence of religions on the Physical strength and

Medical specialties also Founder of visiting nursing in

HARRIET Born Araminta Ross, c. 1820 First community health nurse

JOSEPHINE Wife of Jose Rizal Miss Flora Ernst, an

1ST COLLEGES OF NURSING IN THE PHILIPPINES

o University of Santo Tomas College of

NURSING LEADERS IN THE PHILIPPINES

ANASTACIA GIRON- 1st fil. Nurse as chief

HISTORY OF NURSING IN CGHCNLA

o CGHCNLA was founded in 1921 as CGHSN

LAW LEGISLATIVE LAW

doctrine of the stare decisis – to harm to others, such automobile

THE HIERARCHY OF LAW: MANSLAUGHTER – the crime of killing a

VIERNES, JINGER KIM M.

PRIVATE LAW • assists in maintaining a standard

October 17, 1958 - Proclamation No. 539,

June 18, 1966 - Republic Act 4704

VIERNES, JINGER KIM M.

the local nursing board Chairperson and members of other

VIERNES, JINGER KIM M.

VIERNES, JINGER KIM M.

• As members of the health team, • Provide health education to

THE ICN CODE OF ETHICS FOR NURSES