Professional Adjustment

Ma am Llanes April 19, 2011

Professional Adjustment - Growth of the individual and the development of all his capacities- physical, mental, emotional, social and spiritual Profession - An occupation or calling requiring advanced training and experience in some specific or specialized body of knowledge which provides service to society in that special field. Criteria of a Profession (Simms, Price and Ervin, 2000)

Mission/vocation o Reverence for the gift of life o Respect the dignity of each human being Career o Specialized in one area of nursing o Several practice areas Assisting the patient: sick or well, in the performance of the activities of daily living, which he/she could have done unaided, if he/she has the necessary strength, will or knowledge, and if this is not possible, then assisting the patient towards a peaceful death (Virginia Henderson)

Qualities and Abilities of a Professional Nurse Professional Preparation: - License to practice nursing in the country - A degree of Bachelor of Science in Nursing - Be physically and mentally fit
SPECIALAIZED KNOWLEDGE AND SKILLS AUTONOMY

SERVICE TO HUMAN AND SOCIAL WELFARE

CODE OF ETHICS

Attributes of Professional Caring

EDUCATED IN HIGHER EDUCATION INSTITUTION

Commitment
PROFESSIONAL ASSOCIATION LONG TERM COMMITMENT

Confidence

Competence

Compassion

Conscience

Service To Human and Social Welfare Autonomy- we are regulated by the Board of Nursing Code of Ethics- BON 220 Educated in a Higher Education Institution- regulated by higher education institutions- CHED Long Term Commitment Professional Association- PNA

Nursing - Nursing is putting the patient in the best condition for Educational Preparation: The BSN Curriculum (CHED Memo # 14) nature to act upon him (Florence Nightingale) - A four year program with 2 summers - A helping profession and, as such, provides services - Competency- based which contribute to the health and well-being of people - New Subjects: (American Nurses Association) o Theoretical Foundation in Nursing - A profession o Health Assessment o Addresses the responses of individuals and o Research with 2 semesters families to health promotion, health o Competency Appraisal maintenance and health problems

Competence- KSA + Values Compassion- essence of nursing, the way we care and feel for the patient; when we empathize with the patient Commitment-deliver service Confidence Conscience- follow legal ethico-moral standards of the profession; we act in accordance with the law

Electives: Parent Child, Hospice/Palliative Care Core Values of Nursing Nursing, Spiritual Care, Quality Health Care and - Love of God Nursing, Acute/Critical Care, Care of the - Love of the profession- caring, integrity, excellence Chronically-ill and Older Person - Love of country- nationalism

Objectives of the BSN Curriculum

Mission of the Nursing Profession - We, the Filipino nurses, responding to the needs of It aims to produce a fully functioning nurse who: society are engaged in providing humane and globally 1. Practices legal, ethico-moral social responsibilities, competent nursing care Vision accountabilities - The Philippine Professional Nursing Care: the BEST for 2. Practices S-K-A s for the promotion of health, prevention the FILIPINO and the CHOICE OF THE WORLD by 2030 of illness, restoration of health, alleviation of suffering, assisting clients to face death with dignity and in peace Professional Nursing Associations - Alumni Association 3. Prepares a creative and critical thinking nurse who is - First Professional association a nurse joins after abreast with local needs and the demands of global graduation competitiveness - Philippine Nurses Association 4. Demonstrates caring behaviour o The only accredited professional organization 5. Assumes responsibility for personal and professional (APO) of the PRC development o The NNA accredited by the ICN 6. Utilizes research findings in the practice and o Not legally mandated to join but is ethically development of the profession required. It is the area of responsibility of the 7. Contributes effectively to national health development nurse towards her profession 8. Demonstrates love of God, country and profession - Integrated Registered Nurses in the Philippines (IRNUP) - Philippine National League of Government Nurses Key areas of responsibilities (PNLGN) (BON Resolution #112 Series of 2005) - Occupational Health Nurses Association of the - Patterned after Ma am Llanes dissertation! BOOYAH Philippines (OHNAP) - Association of Deans of Philippine Colleges of Nursing Patient Care  Safe and quality Nursing Care Competencies  Communication Inc.(ADPCN)  Collaboration and teamwork - Association of Nursing Service Administration of the  Health education Philippines (ANSAP) Empowering  Legal Responsibility - Operating Room Nurses Association of the Philippines  Ethico-moral responsibility (ORNAP)  Personal and professional development - Mother and Child Nurses Association of the Enabling  Record Management Philippines(MCNAP)  Management of resources and - Critical Care Nurses Association of the Philippines environment Enhancing  Quality Improvement (CCNAPI)  Research - Mental health and Psychiatric Nurses Association of the Philippines (MH and PNAP) Core Competencies in Nursing - Association of Private Duty Nurse Practitioners of the - Unifying framework for the different field in nursing Philippines (APDNPP) - Nursing Regulation- creates course syllabus for Nursing - Military Nurses Association of the Philippines (MNAP) - Used by BON to advance their program in Nursing - Association of Diabetic Nurse Educators of the Specialization Philippines - Used by the Nursing Education for Nursing curriculum - Renal Nurses Association in the Philippines (RENAP) - Used by Nursing Service for screening applicant for work - Philippine Oncologic Nurses Association (PONA) in hospitals - Society of cardiovascular Nurse Practitioner in the - Used as a performance evaluation tool Philippines - Philippine Society of Emergency care Nurses **SEE IPHONE PICTURE 193 and 194

Fields of Nursing - Nursing Practice - Nursing Education - Nursing Research - Nursing Administration - Military Nursing - Occupational Health Nursing Roles of a Nurse: - Direct care provider - Clinical decision maker - Client and family advocate o Promote/protect/safeguard their rights - Researcher - Educator - Counsellor - Administration - Forensic Analyst - IT consultants Common Areas of Nursing Practice 1. Acute Care/Hospital Nursing o Staff Nursing o Staff Education and training o Risk Management  legalities o Performance Improvement  Quality control  Standards, policies and procedures 2. Extended care opportunities o Elderly long-term care o Rehabilitation Nursing 3. Outpatient Nursing Opportunities o Outpatient clinics and physician s office o Outpatient surgery centres o Community education  Mother s class 4. Business Opportunities o Insurance and managed care companies o Consultancies o Sales o Occupational Health and Worker s compensation

Criteria in Choosing Employment Area

STRUCTURE Nursing Prominence Open Communication Benefits Diversification

NURSING PRACTICE

Professional Growth Currencies Excellent Skills

ORGANIZATIONAL CLIMATE Respect Pride Teamwork Ownership

Republic Act 9173 An act providing for a more responsive nursing profession repealing for the purpose R.A. 7164 otherwise known as the Philippine Nursing Act of 1991 and for other purposes - Repeal- whole is revised - Amend- part is revised Concept of Law - The sum total of rules, and regulations by which society is governed - Rule of conduct pronounced by controlling authority Three Essential Characteristics of a Law - Authority or the right to declare that the rule exists - Pronounced or expressed and the source can be identified (must be declared in writing) - Right to enforce the same Principal Sources of the Law - Constitution - Statutes of legislations (republic Acts) - Regulations issued by the Executive branch of the government (Executive orders) o When the nature of the issue is urgent - Case decisions or judicial opinions - Presidential decrees - Letters of instructions Nursing Legislation - The making of laws or the body of laws already enacted affected the science---Historical Perspectives of Philippine Nursing Law - 1915 Act No. 2493- regulated the practice of medicine and provided for the examination and registration of nurses in the Philippine islands -

1919 Act 2808- the first true nursing law was passed,  Provides for incentives and benefits creating a board of exainers for nurses system for nurses and dependents 1920- first board examination for nurses was give  Upgraded the salary of government June 19, 1953- R.A. 877, The Philippine Nursing Law was nurses to SGTS(salary grade 15) passed. - Philippine Nursing Act of 202 o Provisions: - Oct 2002  Organization of the board of examiners  Provisions regarding nursing schools Declaration of Policy and colleges - It is herby declared the policy of the state to assume  Examination and registration of nurses responsibility for the protection and improvement of the  Sundry provisions nursing profession by instituting measures that will June 18, 1966- R.A> 4707 amended certain portions of result in relevant nursing education, humane working A.A. 877 which include among others the following conditions, better career prospects, and a dignified o Members of the Board were to be appointed by existence for our nurses the president Creation of the Board - Chairperson: 1 August 31, 1970 R.A. 6163 amended sub-paragraph 7 of - Members: 6 section 17of R.A. 877 which provided for the application - Appointed by the President of the Republic of the and execution of legal orders in writing of physicians Philippines including the application of hypodermic and - From: Two (2) recommendees for every vacancy by the intramuscular injections, provided that professional regulation commission (PRC) - Chosen and ranked from 3 nominated by APO R.A. 7164 known as the Philippine Nursing Act of 1991 codified and revised all the laws regulating the practice Chairman of the Board:CarmencitaAbaquin- CA of nursing in the Philippines Betty Merritt- Psych o Salient Features: Perla Po- Psych  Redefinition of the score of nursing Leonila Faire- OR practice Marco Antonio Santo Tomas- OB  Educational qualification of master s Amelia Rosales- Management, TQM, degree for faculty and deans of Yolanda Arugay- research colleges of nursing  Educational qualification of Qualifications of the Chairperson and members administrators of nursing services - Be a natural born citizen (see book)  Inclusion of the phrase unethical - Have at least ten (10) years of continuous practice of the conduct as one of the reasons for profession prior to the appointment: Provided, however revocation and suspension od that the last five (5) years of which shall be in the certificated of registration Philippines  IV therapy training is required - Not have been convicted(not charged but CONVICETEDR.A. 9173- otherwise known as Philippine Nursing Act of final verdict) of any offense involving moral turpitude 2002 repealed R.A. 7164 (estafa etc.) o Salient Features - Provided that the membership to the Board shall  Increases the composition of board to represent the three areas of nursing namely nursing 7 service, education and community health nursing.  Recognizes the specialty certification Requirements Upon qualifications as Members of the Board of program Nursing  Required those inactive in practice to - Immediately resign from undergo 1 month didactic and 3 month o Any teaching from position in any school, practicum college, university or institution offering  Suturing of perineal lacerations is Bachelor of Science in Nursing and/or review allowed after undergoing training program for the local nursing board according to protocol established examinations

Any office or employment in the government or Grounds for removal any subdivision, agency or instrumentality thereof, including government-owned or - The president may remove or suspend any member of controlled corporations or their subsidiaries the Board after having been given the opportunity to o Those employed in the private sector defend himself/herself in a proper administrative o He shall not have any pecuniary interest in or - Continued neglect of duty or incompetence administrative offering Bachelor of Science in - Commission or toleration of irregularities in the licensure Nursing including review classes examination Term of Office - Unprofessional, immoral or dishonourable conduct - Shall hold office for a term of three (3) years until their successors have been appointed and qualified Licensure Examination - May be appointed for another term - All applicants for license to practice nursing shall be Any vacancy in the Board occurring within the term of a required to pass a written examination, which shall be member shall be filled for the unexpired portion of the given by the Board of Nursing in such places and dates as term only may be designated by the Commission: Provided, that it - Each member of the board shall take the proper oath shall be in accordance with R.A. 8981, (PRC - Shall receive compensation and allowances comparable Modernization Act of 2000) to the compensation and allowances received by the Chairperson and members of other professional Qualification for Admission to the Licensure Examination regulatory boards. - He/she is a citizen of the citizen of the Philippines, or a - Salary grade 29 citizen or subject of a country that permits Filipino Administrative Supervision of theBoard nurses to practice within its territorials limits on the - Custodian of its records- including applications for same basis as the subject or citizen of such country: applications for examinations, administrative and other Provided that the requirements for registration or investigative cases conducted by the board licensing of nurses in said country are substantially the - Secretariat and support services- the commission shall: same as those prescribed in this Act. o Designate the Secretary of the Board- Carlos Mutual Recognition Arrangement- during the ASEAN summit in Almelor Cebu. Can practice by reciprocity in asean countries life Singapore o Provide secretariat Powers and Duties of the Board - He/she is of good moral character - Conduct licensure examination for nurses; - He/she is a holder of a Bachelor s degree in Nursing from - Issue suspend and revoke certificates of registration for a college or university that complies with the standards the practice of nursing of nursing education duly recognized by the government - Monitor and enforce quality standards of nursing agency practice in the Philippine and exercise the power Scope of examination necessary to ensure the maintenance of efficient, ethical - The scope of the examination for the practice of nursing and technical, moral and professional standards in the in the Philippines shall be determined by the Board. IN practice of nursing taking into account the health needs determining the subjects of the examinations the board of the nation shall take I to consideration: o The objectives of the nursing curriculum 3 Categories of functions and duties o The broad areas of nursing and other related - Executive- regular disciplines - Quasi-legislative- law making o Competencies - Quasi-judicial- hearing Ratings: - General Average of at least 75% with a rating of not Annual Report below 60% in any subject - The board of nursing shall at the close of its calendar - Average rating of 75% or higher but gets a rating below year submit an annual report of the President of the 60% in any subject must take the examination again but Philippine through the Commission only in the subject or subjects where he/she rated below 60% - A score below 60%- retake the exam within 2 years o

In order to pass the examination, an examinee must obtain a rating of at least 75% in the subject or subjects repeated Issuance of Certificates of Registration/Professional License and Professional identification Card - A certificate of registration/professional license as a nurse shall be issued Certificate of Registration/Professional License - Shall show the following: o Full name of the registrant o Serial number o Signature of the chairperson of the commission and the members of the board o Official seal of the commission Professional Identification Card - Duly signed by the Chairperson of the Commission - Date of registration - License number - Date of issuance - Date of expiration **The ID is the renewed every 3 year NOT the LICENSE Oath: - All successful candidates shall be required to take an oath of profession before the board or any government official authorized to administer oaths prior to entering upon the nursing practice. Fees for Examination and Registration - Applicants for licensure and Automatic Registration of Nurses - All nurses whose names appear at the roster of nurses shall be automatically or ipso facto registered as nurses under this Act upon its effectivity Registration by reciprocity - A certificate of registration/professional license may be issued without examination to nurses registered under the laws of a foreign state or country; provided, that the requirement for registration or licensing of nurses in said country are substantially the same as those prescribed under this act - Provided further, that the laws of such state or country grant the same privileges to registered nurses of the Philippines on the same basis as the subjects or citizens of such foreign state or country. Practice through temporary permit - Granted to licensed nurses from foreign countries/ states: - Whose services are either for a fee or free if they are internationally well-known specialists or outstanding experts in any branch or specialty of nursing

On medical mission whose services shall be free on a particular hospital, centre or clinic - Employed by schools /colleges of nursing as exchange professors in a branch or specialty of nursing - Provided that the special permtis shall be effective only for the duration of theproject, medical mission, employment contract Ground for non-registration and non-issuance of certificates of registration/professional license or special/temporary permit - Convicted by final judgement =of any criminal offense involving moral turpitude - Guilty of immoral or dishonourable conduct - Declared by the court to be of unsound mind Grounds for revocations and suspension of certificate of registration/professional license and cancellation of special/temporary permit - Any of the causes under no-registration - Unprofessional and unethical conduct - Gross incompetence or serious ignorance - Malpractice or negligence in the practice of nursing - Use of fraud, deceit, or false statements in obtaining certificate of registration/professional license or a temporary/special permits - Violation of this act, the rules and regulations, code of ethics for nurses, and technical standards for nursing practice, policies of the Board and the commission or the conditions and limitations for the issuance of temporary/special permit - For practicing his/her profession during his/her suspension from such practice Re-issuance of Revoked Certificates and Replacement of Lost Certificated - After the expiration of a maximum of four years from the date of revocation of a certificate - For reasons of equity and justice and - When the cause for revocation has disappeared or has been cured and corrected - Upon application thereof and the payment of the required fees. - A new certificate of registration/professional license to replace the certificate that has been lost, destroyed or mutilated may be issued subject to the rules of the Board. Nursing Education Program - Shall provide sound general and professional foundation for the practice of nursing - The learning experiences shall adhere strictly to specific requirement embodied in the prescribed curriculum as promulgated by the CHED s policies and standards for nursing education

Requirement for Inactive Nurses Returning to practice - Undertake nursing and health human resource - Nurses who have not actively practiced the profession development training and research, which shall include, for five (5) consecutive years are required to undergo: but not limited to the development of advance nursing o One month of didactic training practice o 3 months of practicum - The enumerated provisions shall not apply to nursing - The board shall accredit hospitals to conduct said students who perform nursing function under the direct training program supervision of a qualified faculty Qualifications of the Faculty - Be a registered nurse in the Philippines Nursing care includes but not limited to: - Have at least 1 year of clinical practice in a field of - Tradition and innovative approaches specialization - Therapeutic use of self - Be a member of good standing in the accredited - Executing health care techniques and procedures professional organization of nurses - Essential primary health care - Be a holder of master s degree in nursing education, or - Comfort measures other allied medical and health sciences conferred by a - Health teachings college or university duly recognized by the government - Administration of written prescription for treatment, of the republic of the Philippines. therapies, oral, topical and parenteral medications Qualification of the Dean - Internal examination during labour in the absence of - All the qualification of the faculty plus: antenatal bleeding; and o Master s degree in nursing - Delivery o At least 5 years of experience in teaching and - In the case of suturing perineal lacerations, special supervision of nursing education programs training shall be provided according to protocol Scope of Nursing established. - A person shall be deemed ro be practicing nursing within the meaning of the act when he/she: singly or in However, a nurse while in the practice of nursing in all settings collaboration with another, initiates and performs is duty-bound required to: nursing services to individuals, families, and communities - Observe the code of ethics and the code of technical in any health care setting standards for nurses - Includes but not limited to nursing care during - Maintaining competence by continual learning through conception, labour, delivery, infancy, childhood, toddler, CPE to be provided by the APO or any recognized pre-school, school age, adolescence adulthood and old professional nursing organization, which shall be age submitted to and approved by the board As a member of the health team, nurses shall - Collaborate with other health care providers for the Qualifications of Nursing Service Administrators: curative, preventive and rehabilitative aspects of care, - Be a registered nurse in the Philippines restoration of health, alleviation of suffering and when - Have at least 2 tear experience in general nursing recovery is not possible, to a peaceful death administration Duties of the Nurse: - Possess a degree of Bachelor of Science in nursing. With - Provide nursing care through the utilization of the at least 9 units in management and administration nursing process courses at the graduate level - Establish linkages with community resources and - Be a member of a good standing of the APO coordination with the health team - In addition to the requirements for supervisory or - Provide health education to individuals, families and managerial position, at least 5 years of experience in communities supervisory or managerial position in nursing and - Teach, guide and supervise students in nursing education - A master s degree in nursing programs including the administration of nursing services in varied settings such as hospitals, and clinics - Undertake consultation services - Engage in such activities that required the utilization of knowledge and decision making skills of registered nurse

Qualifi cation s RN Educa tional Attain ment

BON Chair X MAN Member X Nursing Educatio ns Allied Medical Course

Nursing Educaiton Dean X MAN Faculty X Nursing EducatiAlli ed Medical Course

Nursing Practice DON X MA N Manager X

4 major groups of nursing specialty Promotive, preventive, curative, rehabilitative Group 1 - Community health nursing specialty - Focus: family/community/hig h rish Group 2 - Medical Surgical nursing specialty - Foucure:cvs, nsg, pulmo nursing, neauro, gerontology, critical care, nephrolofy Group 3 DreyfussModel(read on this) Expert Proficient Competent Advanced Beginner Novice Level of specialization Level 1: Nurse Clinician 1 Level 2: urseClinicain 2 Level 3: Nurse Clinical 3 June 20, 2002 formal launching of NSCC Certified Nurses- 53 Accredited Specialty Organizations MCNAP ORNAP RNAP CCNAPI NCAP OHNAP

Years of Experi ence APO

10 yearsm 5 years in te Philippines

Qualifications for Chief Nurse for Primary Hospitals - Be a registered nurse in the Philippines - Have at least 2 year s experience in general nursing administration - Possess a degree of Bachelor of science in nursing, with at least nine units in management and Priority in Appointments: - Chief nurse in public health agencies: o Master s degree in Public Health/CHN - Chief nurse in Military Hospitals o Master s degree in Nursing and the completion of the General Staff Course (GSC) o Those occupying such positions before the effectivity of this act shall have 5 years Health human resource Studies nursing manpower needs, production, utilization development - The board in coordination with the Apo and appropriate government in private agencies shall initiate, undertake, and conduct studies on human resource, production, utilization and development.

September 23, 2005- First National Conference on Advanced nursing practice - Certification of new applicants o Individuals o Specialty organizations Comprehensive Nursing Specialty Program - Presentation of draft of core competencies in advanced - Within ninety (90) days from the effectivity of this act, nursing practice the boards in coordination with the APO, recognized specialty organizations and the DOH is hereby mandated Salary of CNSP - In order to enhance the general welfare commitment to formulate and professionalism of nurses, the minimum base pay of nurses working in public health institutions shall not be Legal bases of nursing specialty certification program (see book) lower than salary grade 15 prescribed under R.A. 6758, compensation and classification act of 1989, Composition of the NSCC - Proovided that for nu - Chair must be from the BON Incentives and benefits - Vice chair is elected at large - The BON, in coordination with the DOH and other concerned government agencies, association of hospitals

and the APO shall esrablish an incentive and benefit system in the form of free hospital care for nurses and trheir dependents PENAL and miscellaneous

Effectivity- ths act shall take affect 15 days upon its publicatiuon in the official gazette or in any two newspapers of general circulation in the Philippines Passed in the house og representative ovtober 15, 2002

Prohibitions in the practice of nursing Drugs Administration - Fine of not less than 50,000 Any perons practicing in nursing in the Philippines within the R.A. 6425- Dangerous Drugs Act of 1972 Art. II Sec. 4 states that meaning of this act: the sale, administration, delivery, distribution and transportation - Without a certificate of prohibited drugs are punishable by law - Uses a certificate/ professional license, professional Id or special temporary permit of another R.A. 9165 known as comprehensive Dangerous Drug Act of Who uses an invalid certificate of registration 2002, repealed the Dangerous Drug Act, R.A. 6435 professional license, a suspended or revoked certificate of registration/professional Nursing Jurisprudence - Who give any false evidence to the board in order to - The department of law which cinpises all the legal rules obtain a certificate of registration/professional license, a and principles affecting the practice of nursing professional ID and or special permit Professional Negligence - Who falsely poses - Refers to the commission or omission of an act pursuant - Who appends BSN/RN or any similar appendages tob to a duty that a reasonably prudent person in the name his/her name without having been conferred said defree or similar circumstance would or would not do, and or registration or acting or non-action of which is the proximate cause of - Who as registered and licensed nurse abets or assist he injury to another person or property illegal practice of a person who is Elements of Professional Negligence - Any perons or the cief executive ifficeofdjuridicailentitiy - Existence of a duty on the part of the person charged to who undertakes in servcei education program ot who use due care under circumstances; condutcrs review classes foorbotht local and - Failure to meet the standards of due care; foereginexinaition whiteout permit/clearance from the - Foreseeability of harm resulting from failure to meet the borasd and the commission standard; and - Any employer of nurses who violate the minimum base - The fact that the breach of this standard resulted in an pay of nurses and the incentives and benefits that injury to the plaintiff shoiuls be accorded them as specified in sec. 32 and 32 o 4Ds - Any person or the chiegf executive officaer od judicial  Duty entity cviolating  Dereliction of Duty FINAL Provisions  Direct causation - Enfromcement of the Act  Damage - Appropriation Civil Code - Implementaing Rules and Reguklations - Art 19. States that one shall act with justice, gives every o BON resolution No. 425 was issued pursuant to man his due, observes honesty and good faith Sec. 38m Article IX of this act - Art 20. States that those who, in the performance oof o Promulgated in October 22, 2003 their obligations through negligence cause injury to o Published in the officaila gazetteer: December another are liable for damages 15, 2003 Specific Examples of Negligence: o Effectivity: December 31, 2003 - Failure to report observations to attending physician Separability clause - Failure to exercise the degree of diligence which the - If any of this act is declared unconstitutional the circumstances of the particular case demands remaining part not affected thereby shall continue to be - Mistaken Identity vaclid and operational - Errors in Medication Repealing Clause - Defects in Equipment o Record last date of maintenance - Errors due to family assistance