Professional Adjustment PROFESSIONAL ADJUSTMENT / JURIS PRUDENCE

First Hospitals:

I – IloiloP - PGHL – St LukesM – Mary JohnsonS –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 orientedMembers – RNUnique – special body of knowledgeOthers – pt – recipient of care

Characteristics of nsg prof:A ccountability – liable for his/her actionsC ompetency – having scientific knowledgeE thics –S ervice oriented

Prof nsg resp: RA 9173 Oct 21,’02

Independent Function:1. Promotive, Preventive, Curative, Rehabilitative in all health care settings.2. Preventive – immunization. Provide health education3.Utilization of nsg process4. Link of pts & families to diff community resources - community health nurses – libreng bakuna5. Collaboration of pts care to other health care team - for continuity of care.6. Resp for training/ supervision of nsg students7. Accurate reporting/ recording.8. Observation of S&Sx – provide proper interventionDependent 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 hosp2. Advice to call doc3. Advice to take emetic meds4. 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 RESPONSIBILITIES1. CONTRACTS/ CONSENTS – absence of coercionchar: V – voluntary – Free act. Independent act. RationalO – opportunity to ask questions, suggestions & make recommendationsT – treatment, surgery, procedure – specifically explained to the patient by MDU – understood by patientM – 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 consent1. Parent2. Guardian3. 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 guaranteeHIV – don’t detain patientHigh risk HIV transmission – felatioQuarantine 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 inheritKabit – will get nothingIntestate Succession – without last will

2 types of last will & testament

1.) Properties 2.) Life/ Bodya) Ordinary will - Advance directives- RN should check LOC of pt - pt is still alive giving instructions-determine location of signature a) Living will – DNR,- end of last word – last page organ donation, order for cremation - sign all pages - RN is part of 3 witnesses

b) Holographic will- handwritten by testator- dated and signed by testator- no need for witness

4. MEDICATONS/ PRESCRIPTIONSRules1. MD, DVM, DMD – can prescribe meds2. Should have :a.) Name MD, PTR, PRC#, location of clinic/ hospitalb.) Name of patient, age, sexc.) Information about drug – frequency durationd.) 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 medsWhat is the right way to ask identity of patienta. call patent by his name

b. check chartc. verify name at nurses stationd. check name at identification wrist band4. Telephone orders -General rule - no telephone order“Whatever is not written is not an order”Exception – Emergency!After MD says order – repeat instruction on phoneHave resident MD sign! Administer meds. When MD arrives – have him counter sign his order5. Documentation – recording/ charting

Purposes:

C – communicationA –assurance of qualityR – research purposesL – legal documentS – statistics source

SUBPOENA - an order from courtDuces Tecum (papers) – documents obj, materials, papers, chartAd Testificadum (person) – witness

Do’s & Don’ts of charting

Do’s Don’tsF – full, factual & accurate L – language – unacceptableL – legible I – improper corrections I – immediately after procedure S- spaces, skipsP – personal notes, not delegated 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. Commission2. Omission – total neglect of care – didn’t do anything

Elements to prove negligence1. Duty2. Failure to do his duty3. 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 RNsClassification:1.) Manner of its commission – dolo (deceit) – with criminal content- culpa – (fault) – without criminal intention, negligence2.)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 controlAttempted – overt acts – mere intensions to commit crime. 3.) Degree of participationPrincipal – indispensable. Without the principal = no crime- author of crimeAccomplice – with or without accomplice = crime will happen - dispensable, look out.- enters scene before or during crimeAccessory – enters scene after crime is committed- conceals/ destroys evidence.

RA 7877 – anti sexual Harassment act1. Any person who exercises authority (Prof & student, Dr & RN)2. Asking sexual favors in exchange of another favorRape:a.) Ordinary rape – forcible penetration of sex organ to a sex organb.) 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 oldParricide – killing of a person with relationship, ex. Bro in-law, sis, - relativeHomicide – 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 RNs1920 – 1st board exam

RA 9173 (Oct21,02)BON qualificationsM – masters in NSGA- accredited nsg org (PNA)S – seven (1 chairman, 6 members)I – immediately resign upon appointmentN – 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 Exam1. 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 head nurse/ ward/ shift/ dayM – managerC – chief nurse manage whole hospD – director

Supervisor B – BSN holder – RNManager A – accredited nsg org PNAN – Nine units nsg mgtT – two years practice

Chief nurse RN+ MANDirector 5 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 provider1. Fines2. Imprisonment3. 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 smarttxt PRC (space) Rating (space) TABUENA,ABIGAILC

Registration. Sign in both of registry of BONSpecial – 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 NURSINGImprisonment / jail 1-6 yrs / P50 – 100k finesL – license , withoutO – own (using as your own license of another)I – invalidated license + revoked , suspendedS – sign name & attach title BSN, RN (not true)

F – falsification of documents (diploma, experiences)A – assist another person in illegal practice of nsgU – underwagingR – review/ training centers for RN not accredited by governmentA- any person violating this act