MY PRELIM NOTES FOR PROFESSIONA ADJUSTMENT o Preventive

PROFESSION o Rehabilitative aspects of care

 An occupation or calling requiring advance o Restoration of health

training
o Alleviation of suffering
 Experience in some specific or specialized
body of knowledge o Towards a peaceful death

 Provides service to society in that special  Provide nursing care through the utilization of the
field nursing process

 The term profession is honoric and should o Therapeutic use of self

be carried with pride and honor
o Executing health care techniques and
NURSING procedures

 An occupation requiring a unique body of o Essential primary health care

knowledge and skills and which serves
o Comfort measures
society

PROFESSIONAL NURSE o Health teachings

 Completed a basic nursing education o Administration of written prescription for

program treatment

o Therapies
 Licensed in his/her country or state to
practice professional nursing o Oral
NURSING PRACTICE o Topical
 Primary responsibility promotion of health and o Parenteral medications
prevention of illness
o Internal examination during labour in the
 Collaborate with other health care providers absence of antenatal bleeding and delivery
o Curative o Suturing of perineal laceration
  Establish linkages with community resources
 Coordination with the health team
 Provide health education to individuals, families
and communities
 Teach, guide and supervise students in nursing
education programs
 The nurse is required to maintain competence by
continual learning through continuing professional
education
QUALIFICATIONS AND ABILITIES OF A
PROFESSIONAL NURSE
 Professional Preparation
o Have a license to practice
o Bachelor of science degree in nursing
o Be physically and mentally fit
 Personal Qualities and Professional
Proficiencies
o Interest and willingness to work and learn
o Warm personality and concern for people
o Resourcefulness and creativity, well
balanced emotional condition
o Capacity and ability to work cooperatively
with others
o Skill in decision making
DEFINITION OF LICENSE
 A legal document given by the government that
permits a person to offer to the public his or her
skills and knowledge in a particular jurisdiction
CONTRACT
 Meeting of minds between two persons whereby
one binds himself, with respect to other, to give
something or to render some service
 A promise or a set of promise which the law
recognizes as a duty and when that duty is not
performed the law provides a remedy
NURSING ETHICS
 Ethics came from the Greek word ETHOS moral
duty
 Standard to examine and understand moral life
 Guides of human conduct provided by ethical
systems
 How people make judgement in regard to right or
wrong
 Critical reflection about morality and rational
analysis about it
  JOHNSTON- examination of all ethical and bio-
ethical issues from the prospective of nursing
theory and nursing ethics
 VERCOE- the fields of nursing ethics be focused on
the needs and experiences of practicing nurses,
the exploration of its meaning and that of ethical
practice in terms of the perception of these nurses
Morals
 Specific ways of behaviour or of accomplishing
ethical principles
 Greek work MORALIS
 Social consensus about moral conduct for human
beings and society
 Morality is what you believe is right and good
Health Care ethics
 Division of ethics that relates to human health
 Realm of human values, morals, customs,
personal beliefs and faith
Bioethics
 Specific domain of ethics that focuses on moral
issues in the field of health care
 Result of life and death dilemmas faced by health
care practitioners
 Systematic study of human behaviour in the field
of life science and health care in the light of moral
values and principles
TELEOLOGICAL APPROACH
 Greek word TELOS or goal or end
 The right thing to do is the good thing to do
 Act utilitarianism- good resides in the promotion of
happiness or the greatest net increase of pleasure
over pain
 If the act helps people, then it is a good act
 If the act hurts people then it is a bad act
FLETCHER’S GUIDELINES FOR MAKING ETHICAL
DECISIONS
1. Consideration for people as human beings
2. Consideration of consequences
3. Proportionate good to come from the choices
4. Propriety of actual needs over ideal or potential
needs
5. A desire to enlarge choices and reduce chance
6. A courageous acceptance of the consequence of
the decision
DEONTOLOGICAL APPROACH OR DUTY ORIENTED  Duties of nonmaleficence- avoiding or preventing
THEORY injury to others

 Basic rightness or wrongness of an act depends VIRTUE ETHICS APPROACH

on the intrinsic nature rather than upon the
situation or its consequences  ARETIC, Greek word ARETE, heart of the person
performing the act
 Greek word DEON meaning DUTY
 Traits and virtues of a good person, courage,
 Immanuel Kant- rational human being with temperance, wisdom, and justice
freedom and social worth
DIVINE COMMAND ETHICS
 A person is morally good and admirable if his
 Supreme or divine that sets down rules to provide
actions are done from a sense of duty and reason
guidance to moral decisions
W.D ROSS- PRIMA FACIE DUTIES- WHAT ONE
UNIVERSAL PRINCIPLES OF BIOMEDICAL ETHICS
SHOULD DO WHEN OTHER RELEVANT FACTORS IN
A SITUATION ARE NOT CONSIDERED  To determine right or wrong in regard to value
issues
 Duties of fidelity- telling the truth, keeping
promises  Autonomy-
 Duties of reparation- righting the wrong we have o Greek word AUTOS meaning self and nomos
done to others meaning governance
 Duties of gratitude- recognizing the service others o Self determination
have done for us
o Freedom to choose and implement one’s
 Duties of justice- preventing distribution of decision
pleasure or happiness that is not in keeping with
the merit of people involved o Informed consent

 Duties of beneficence-helping to better the o Allowing the patient to refuse treatment if

condition of other beings he decides so

 Duties of self improvement- bearing ourselves

with respect to virtue or intelligence
 o The person making the decision must be o Reasonable continuity of care when
deemed competent, intellectual capacity, appropriate and be informed of other care
legal age options

 Veracity o Be informed of hospital polices and

practices
o Health care providers are bound to tell the
truth  NONMALEFICENCE-

 Beneficence o To do no harm

o Promotes the doing acts of kindness and o Not assisting in or performing abortion
mercy that directly benefit the patient
o Not to assist people to commit suicide
 PATIENT’s BILL OF RIGHTS
o Be involved in mercy killing
o Considerate and respectful care
 JUSTICE
o Relevant, current and understandable
o The right to demand to be treated justly,
information
fairly and equally
o Make decisions regarding his care plan
 NURSES’ BILL OF RIGHTS
o Have advance directive (living will)
o Registered nurses promote and restore
o Every consideration of his privacy health

o Confidentiality of communications and o Prevent illness

records
o Protect the people entrusted to their care
o Review his records concerning his medical
o Alleviate suffering
care

o Be informed of business relationship among o Provide services that maintain respect for
the hospital educational institution human dignity

o Consent or decline to participate  LVING WILLS OR ADVANCE DIRECTIVE

experimental research affecting his care
 o Accept or refuse any treatment, service or
procedure used to diagnose or treat physical
or mental condition
o Decision to provide or withhold life-
sustaining measures
o This living will is signed by the patient
o Witnessed by two other persons who is not
designated as the person’s health care
representative
o Directive has force of law
 MORAL PRINCIPLES
o The golden rule
 Do unto others what you would like
others do unto you
o The two fold effect
 May have bad and good effect
 Must be morally good
 Good effect must be willed and the
bad effect merely allowed
 Good effect must not come from an
evil action
 Good effect must be greater than the
bad effect
o The Principle of Totality
 The whole is greater than any of its
parts
o Epikia
 Exception to the general rule
o One who acts through an agent is
himself responsible
 Ex. Nurse recommends patient to
another clinic for abortion but does
not want to perform
o No one is obliged to betray
himself/herself
 No one can force any person to
answer a question if such will
incriminate him/her
o The end does not justify the means
 Giving sleeping tablets to someone
who has chronic illness
o Defects of nature may be corrected
 Corrected by plastic surgery
o If one is willing to cooperate in the act,
no injustice is done to him/her
 With patient’s consent
o A little more or less does not change
the substance of an act
  Stealing o Perform their responsibilities with the
highest sense of integrity
o The greatest good for the greatest
number • Professional Competence

 Have more good effects for more o Knowledge, technical skills, attitudes and
people than a smaller group experience

o No one is held to the impossible • Solidarity and teamwork

 Do not promise impossible things o Maintain and support one professional

organization
o The morality of cooperation
• Social and Civic Responsibility
 Formal cooperation is an evil act and
never allowed o Shall always carry out their professional
duties with due consideration of the broader
o Principle relating to the origin and
interest of the public
destruction of life
• Global Competitiveness
 Thou shall not kill
o Shall remain open to challenges of a more
GOOD SAMARITAN LAW
dynamic and interconnected world
• A nurse who renders first aid or treatment at the
• Equality of All professions
scene of an emergency and who does so within
the standard of care, acting in good faith, is o Shall treat their colleagues with respect and
relieved of the consequences strive to be fair in their dealings with one
another
CODE OF GOOD GOVERNANCE
AMENDED CODE OF ETHICS FOR NURSES
• Service to others
• Section 3 Republic Act No. 877 known as the
o Commitment to a life of sacrifice and
Philippine Nursing Law and Section 6 of P.D No.
genuine selflessness in carrying out their
223 the amended Code of Ethics of Nurses
professional duties
• Article I
• Integrity and Objectivity
 o Preamble- health is a fundamental right of
every individual
• Article II
o Values, customs and spiritual beliefs held by
individual shall be represented
o Consider the individuality and totality of
patients when they administer care
• Article III
o Human life is inviolable
o Quality and excellence in the care of
patients are the goals of the nursing
practice
o Accurate documentation of actions and
outcomes of delivered care is the hallmark
of nursing accountability
• Article IV
o The registered nurse is in solidarity with
other members of the healthcare team in
working for the patient’s best interest
• Article V
o Preservation of life, respect for human rights
and promotion of healthy environment
o Promotion in local, national, and
international efforts to meet health and
social needs of the people
• Article VI
o Maintenance of loyalty to the nursing
profession and preservation of its integrity
are ideal
• Article VII
o The certification of registration of the
registered nurse shall either be revoked or
suspended for violation of any provisions of
this code.
DEFINITION AND MEANING OF LAW
• The sum total of rules and regulations by which
society is governed
• Man mad regulates social conduct in a formal and
binding way
• Rule of conduct pronounced by controlling
authority and which may be enforced
o Authority or right to declare that the rule
exists
o Rule is pronounced or expressed
o Source can be defined
o A right to enforce the same must be
provided
• Controlling authority in our system is the
government
 • Fundaments law of the government is the
constitution
• Principal sources of pronouncements
o Constitution
o Statutes or legislations
o Executive branch
o Case decision/judicial opinions
o Presidential decrees
o Letters of instructions
RESONSIBILITY AND ACCOUNTABILITY FOR THE
PRACTICE OF PROFESSIONAL NURSING
• Professional Negligence
o Commission or omission of an act, pursuant
to a duty
 Existence of a duty on the part of the
person charged to use due care under
circumstances
 Failure to meet the standard of due
care
 The foresee ability of harm resulting
from failure to meet the standard
 The fact that the breach of this
standard resulted in an injury to the
plaintiff
• Article 19 of the civil code
o One shall act with justice, give every man
his due, observe honest and good faith
• Article 20
o Those who in the performance of their
obligations through negligence causes any
injury to another, are liable for damages
• Common acts of negligence
o Burns resulting from hot water bags, heat
lamps, vaporizers, sitz bath
o Objects left inside the patient’s body;
sponges suction tips, loose dentures lodged
in the patient’s trachea
o Falls of the elderly; confused, unconscious,
sedated patients
o Falls of children whose bed rails were not
pulled up and locked
o Failure to observe and take appropriate
action
o Failure to report observations to attending
physicians
o Failure to exercise the degree of diligence
which the circumstances of the particular
case demands
 o Mistaken identity- drug given to the wrong
patient
o Wrong medicine, wrong concentration,
wrong route, wrong dose
o Defects in the equipment
o Errors due to family assistance
o Administration of medicine without a
doctors prescritption
THE DOCTRINE OF RES IPSA LOQUITUR
• Injury was of such nature that it would not
normally occur unless there was negligent act
• Injury was caused by an agency within control of
the defendant
• Plaintiff himself did not engage in any manner
that would tend to bring about the injury
MALPRACTICE
• The idea of improper or unskilful care of a patient
by a nurse
• Stepping beyond one’s authority with serious
consequences
• Carelessness of professional personnel
• LESNIK- negligent act committed in the course of
professional performance
DOCTRINE OF FORCE MAJEURE
• Irresistible force; unforeseen or inevitable
• No person shall be responsible for those events
which cannot be foreseen
• Floods fire, earthquakes
DOCTRINE OF RESPONDEAT SUPERIOR
• Let the master answer for the acts of the
subordinate
• The liability is expanded to include the master as
well as the employee
INCOMPETENCE
• Lack of ability, legal qualifications or fitness to
discharge the required duty
CONSENT TO MEDICAL AND SURGICAL PROCEDURES
• Consent
o Free and rational act that presupposes
knowledge of teh thing to which consent is
being given by a person who is legally
capable to give consent
o Signed by the patient or authorized
representative/legal guardian
o An authorization by a patient or a person
authorized by law to give the consent on the
patient’s behalf
 o Nurse secures the consent of the patient
upon admission
• Informed Consent
o Established principle law that every human
being of adult years and sound mind has the
right to determine what shall be done with
his own body
o May choose whether to be treated or not
• Proof of Consent
o A written consent should be signed to show
that the procedure is the one consented to
and that the person understands the nature
of the procedure
TORTS
• A legal wrong, committed against a person or
property
• Assault and Battery
o Imminent threat of harmful or offensive
bodily contact
o Unjustifiable to tough another person or to
threaten to do so
• Battery
o An intentional, unconsented touching of
another person
• False Imprisonment of Illegal Detention
o Unjustifiable detention of a person without a
legal warrant within boundaries
• Invasion of Right to Privacy and breach of
confidentiality
o Right to privacy is the right to be left alone
o Right to be free from unwarranted publicity
o Exposure to public view
o Divulge information from patient’s chart to
improper sources or unauthorized person
• Defamation
o Character assassination
o Slander-oral defamation
o Libel-written words
o There must be a third person who hears or
read the comment before it can be
considered defamation
CRIMES, MISDEMEANORS, AND FELONIES
CRIME
• An act committed or omitted in violation of
the law
• Two elements
o Criminal act
o Evil/criminal intent
• Conspiracy to commit a crime
o Two or more persons agree to commit
a felony
 Principals- who take a direct
plan/part
 Accomplices- cooperate in the
execution
 Accessories- having knowledge
of the commission of the crime
• Criminal Actions
o Acts or offenses against public welfare
• Criminal negligence
o Reckless imprudence- person does an
act or fails to do it voluntarily but
without malice
o Simple imprudence- did not use
precaution and the damage was not
immediate or the impending danger
was not evident or manifest
• Criminal Intent
o States of mind of a person at the time
the criminal act is committed that
he/she knows that an act is not lawful
and still decide to do it anyway
WILLS
• A legal declaration of a person’s intentions upon
death
• Testamentary document takes effect after the
death of its maker
• Decedent- person whose property is transmitted
through the succession whether or not he left a
will
• If he left a will he is called a testator
• Woman is testatrix
• Heir- called to succession either by the provision
of a will or by operation of law
• A person who dies leaving a will is said t have died
testate
• One who dies without will is said to have died
intestate
• Validation of the will in a court is known as
probate
 • A will which is written, dated and signed by the
testator is called holographic will

• An oral will is called nuncupative will or

nuncupation- made during the person’s last
illness, that it be done in the place in which he
died, one or more witnesses to the will

• Testator must have the expressed intention of

making a will

• Must be right of age

• Under 18 cannot make a will

• Required to have sound mind

• Think clearly ability at the time of its execution

NURSES OBLIGATIONS IN THE EXECUTION OF A WILL

• The nurse should note the soundness of the

patient’s mind

• There was freedom from fraud or undue influence

• Make a notation on the patient’s chart of the

apparent mental and physical condition of the
patient at the time of making the will