PROFESSIONAL ADJUSTMENT / JURIS PRUDENCE First Hospitals: I – Iloilo P - PGH L – St Lukes M – Mary Johnson S –St Paul Nsg is a profession. Profession – defined by PNA adapted from Americans NA - a calling which its members profess to have acquired a unique body of knowledge & skills for purpose of guiding & caring others. Calling – service oriented Members – RN Unique – special body of knowledge Others – pt – recipient of care Characteristics of nsg prof: A ccountability – liable for his/her actions C ompetency – having scientific knowledge E thics – S ervice oriented Prof nsg resp: RA 9173 Oct 21,’02 Independent Function: 1. P romotive, Preventive, Curative, Rehabilitative in all health care settings. 2. P reventive – immunization. Provide health education 3. Utilization of nsg process 4. L ink of pts & families to diff community resources - community health nurses – libreng bakuna 5. Collaboration of pts care to other health care team - for continuity of care. 6. R esp for training/ supervision of nsg students 7. A ccurate reporting/ recording. 8. O bservation of S&Sx – provide proper intervention Dependent fx 9. Execution of valid Dr’s order General rule: RN can’t give meds without Drs order otherwise RN will be liable for malpractice. Exception, under code of ethics, RN can give drugs during emergency, calamity, national epidemics, no MD around. Life of patient is in danger. Protected under Good Samaritan Act. Good Samaritan Act – universal law that protects any person who will give an aid to another person whose life is in danger. RA 8344 – “ No deposit policy” during emergency cases. - emergency care 1st before asking for deposit. Mom calls re: 2 yo girl ingested baby aspirin at home. What’s best action for RN to advice mom on phone. 1. Advice mom to bring kid to hosp 2. Advice to call doc 3. Advice to take emetic meds 4. Advice to call h nrse Health teaching – child proofing the home! Aspirin should not be reached by kid. Principal – direct author of crime. Dispensable Accomplice – dispensable, crime will still happen without accomplice. Accessory – entered scene after the crime
LEGAL RESPONSIBILITIES 1. CONTRACTS/ CONSENTS – absence of coercion char: V – voluntary – Free act. Independent act. Rational O – opportunity to ask questions, suggestions & make recommendations T – treatment, surgery, procedure – specifically explained to the patient by MD U – understood by patient M – matured physically – age 18 yo & above Mentally – with sound mind, same & not an imbecile. Substitute or proxy consent – if pt is mentally or physically incapable of giving consent 1. Parent 2. Guardian 3. Adliter – (not a relative!) DSWD, MD 2. ILLEGAL DETENTION – limit freedom of patient to move or travel from one place to another. Hosp – promissory note or guarantee HIV – don’t detain patient High risk HIV transmission – felatio Quarantine regulation – SARS, Meningococcemia, anthrax - public safety is priority. 3. LAST WILL & TESTAMENT - a person in permitted by the law to control/ dispose of his estate. Effect is only upon his death. Decedent – person who died and left no will. The law will handle estate. Testator / Testatoux – died and left a will Testate succession – heirs will inherit under a last will and testament. Illegitimate – entitled to ½ of what legit children will inherit Kabit – will get nothing Intestate Succession – without last will 2 types of last will & testament 1.) Properties a) Ordinary will - RN should check LOC of pt -determine location of signature - end of last word – last page - sign all pages - RN is part of 3 witnesses -
2.) Life/ Body - Advance directives - pt is still alive giving instructions a) Living will – DNR, organ donation, order for cremation
b) Holographic will handwritten by testator dated and signed by testator no need for witness
4. MEDICATONS/ PRESCRIPTIONS Rules 1. MD, DVM, DMD – can prescribe meds 2. Should have : a.) Name MD, PTR, PRC#, location of clinic/ hospital b.) Name of patient, age, sex c.) Information about drug – frequency duration d.) Generic & brand name in prescription -
RA 6675 – Generics Act Should have BOTH generic & brand name on prescription Impossible Prescription – generic & brand name does not correspond with each other.
3.
Know 10 rights in giving meds
What is the right way to ask identity of patient a. call patent by his name b. check chart c. verify name at nurses station d. check name at identification wrist band 4. Telephone orders General rule - no telephone order “Whatever is not written is not an order” Exception – Emergency! After MD says order – repeat instruction on phone Have resident MD sign! Administer meds. When MD arrives – have him counter sign his order 5. Documentation – recording/ charting Purposes: C – communication A –assurance of quality R – research purposes L – legal document S – statistics source SUBPOENA - an order from court Duces Tecum (papers) – documents obj, materials, papers, chart Ad Testificadum (person) – witness Do’s & Don’ts of charting Do’s F – full, factual & accurate L – legible I – immediately after procedure P – personal notes, not delegated
Don’ts L – language – unacceptable I – improper corrections S- spaces, skips A – avoid using too much abbreviations
“addendum” – late entry Negligence – failure to do something which a reasonable & prudent person should have done. 2 types: 1. Commission 2. Omission – total neglect of care – didn’t do anything Elements to prove negligence 1. Duty 2. Failure to do his duty 3. Injury, harm, death= result Malpractice – doing acts or conducts that you are not authorized/ licensed/ competent/ skilled to perform, resulting to injuries/ non injurious consequences - RN exceeding the scope of nursing practice & does an MD’s job. Episioraphy – after proper training, RN can perform this procedure. In absence of fetal & maternal aberration, RN can perform internal examination RES IPSA LOQUITOR – the thing speaks for itself - obvious fault FORCE MAJEURE - God nature – storm, earthquake, flood, - not liable Fortuitous event – created by man – traffic not liable due beyond his control.
CRIMES AFFECTING RNs Classification: 1.) Manner of its commission – dolo (deceit) – with criminal content - culpa – (fault) – without criminal intention, negligence 2.)Stages of execution – Consumated – all elements to commit crime were all present. Frustrated – offender performs everything to consummate but it did not happen for reasons beyond his control Attempted – overt acts – mere intensions to commit crime. 3.) Degree of participation Principal – indispensable. Without the principal = no crime- author of crime Accomplice – with or without accomplice = crime will happen - dispensable, look out. - enters scene before or during crime Accessory – enters scene after crime is committed - conceals/ destroys evidence. RA 7877 – anti sexual Harassment act 1. Any person who exercises authority (Prof & student, Dr & RN) 2. Asking sexual favors in exchange of another favor Rape: a.) Ordinary rape – forcible penetration of sex organ to a sex organ b.) Sexual assault – anything forcibly inserted to any orifice. Illegal abortion – termination of product of conception before the age of viability. Infanticide – crime committed of person killed is age < 72h or <3days old Parricide – killing of a person with relationship, ex. Bro in-law, sis, - relative Homicide – killed a person to whom you have no relationship- product of negligence. Murder – killing of a person with intension. Simulation of birth – any person who shall substitute 1 child or identity of a child for the purpose of losing his civil status. PD651 – Birth registration act - requires any person (RN,OB, midwife, pilot) who shall assist in giving birth to report within 30 days without penalty any live birth at Local Civil Registrars Office. RA 2808 – (y1919) – BON 1 chairman, 2 members = all RNs 1920 – 1st board exam RA 9173 (Oct21,02) BON qualifications M – masters in NSG A- accredited nsg org (PNA) S – seven (1 chairman, 6 members) I – immediately resign upon appointment N – not convicted of any crime P – pecuniary interest, absence of T – ten yrs experience (last 5 years hr in RP) C – citizen & resident of RP DEAN qualification- RN + MAN + 5 yrs experience in nsg Nurse Licensure Exam 1. Cert of Good Moral Char (Optional) 2. Proof – holder of Fil citizenship – Birth cert. 3. Proof – BSN degree – Transcript with scanned picture – done by reg.
NSG SERVICE ADMINISTRATOR S – supervisor M – manager
head nurse/ ward/ shift/ day
C – chief nurse D – director
manage whole hosp
Supervisor Manager
Chief nurse Director 5
B – BSN holder – RN A – accredited nsg org PNA N – Nine units nsg mgt T – two years practice RN+ MAN years supervisory experience
PD 223 - PRC – regulatory body to all profession in Phil RA 1080 – Civil Svc Act - Automatic civil service eligible once you pass PRC nsg exam RA 6425 (9165) – Dangerous Drugs Act Prohibited – totally absolutely, can’t be used by human being. Ex. Methaphetamine Hcl (Shabu) cocaine, cannabis Regulated – can use this drug - with appropriate prescription - MD with appropriated license (BFAD, PDEA licence) - Valium, dormicum Penalty for licensed health care provider 1. Fines 2. Imprisonment 3. Automatic revocation of license RA 7600 – Mother Baby Friendly Hosp Act - early bonding of mom to child through breast feeding & rooming in technique - Sen. Flavier December 1 – World AIDS day RA 8981 – PRC modernization / Computerization Act - after 5 days – result of board exam will come out - June 11 – result - www.prc.gov.ph - results of board exam – Nurse - or txt 233 globe/ 136 smart txt PRC (space) Rating (space) TABUENA,ABIGAILC Registration. Sign in both of registry of BON Special – can get license by reciprocity RN in a foreign country & that country where you are registering has employment for Fil RN in their country
PROHIBITED / ILLEGAL PRACTICE OF NURSING Imprisonment / jail 1-6 yrs / P50 – 100k fines L – license , without O – own (using as your own license of another) I – invalidated license + revoked , suspended S – sign name & attach title BSN, RN (not true) F – falsification of documents (diploma, experiences) A – assist another person in illegal practice of nsg U – underwaging R – review/ training centers for RN not accredited by government A- any person violating this act
