NCMB419 LEC & RLE: Exam

Week
BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

0
Bachelor of Science in Nursing 4Y1
Professor: Ma. Diosul Roque, MAN, RN & Evangeline Orata, MAN, RN, RM
Prelim Topics: . Decisional
. Introduction to Nursing Leadership Management - Entrepreneur or Innovator
. Patient Health Care Delivery System - Trouble shooter
. Evidence-Based Practices in Nursing Management Theories of Management
. Ethico-Legal and Moral Considerations in Nursing Four Principles of Scientific Management
Leadership Management
. Organizational Communication 1) Traditional “Rule of Thumb” – means organizing
INTRODUCTION TO NURSING LEADERSHIP AND work must be replaced with scientific methods. Give
MANAGEMENT allotted time to workers in accomplishing their task.
Leadership and Management 2) Workers can be hired, trained and promoted based on
their competence and abilities.
. Leadership 3) Employees are entitled of receiving financial rewards, and
- Viewed by some as one of managements many function incentives for worked accomplished because he viewed
. Management humans as “economic animals’ motivated solely by money.
- It is a universal process 4) Maintain good interpersonal relationship between the
- use in business, practice of one’s profession and even workers and managers they should be cooperative and
day to day personal affairs interdependent, and the work should be shared equally.
- The process of coordinating and supervising personnel Scientific Management
and resources to accomplish organizational goals. 1) Frederick Taylor
. Manager - Father of scientific management
- A person who has responsibility for the activities of - How people work
other people in an organization. - theories of management do not remain static.
- Taylor’s system of work improvement consisting of
the following steps:
Three-Fold Concept to Emphasize, The Broader Scope
of 1) Controlled observation of the worker’s performance
1) Economic source – Is one of the factors of production through time and motion study
together with land, and capital. Industrialization increases, 2) Scientific selection of the best man or woman to
management is substituted by labor and capital. perform each job.
Management of a firm determines to a large extent, 3) Training the selected worker to perform job task.
its productivity and profitability. 4) Paying the worker to a differential rate.
2) System of authority – management first develops with 5) Appointing a few of the most highly skilled workers
top individuals determining the course of action for the to managerial positions and to planning and
rank and file. The constitutional management preparing the task of workers.
emphasizes definite and consistent concern for 6) Appointing a foremen for each aspect of the work.
policies and procedures in dealing with the working 2) Frank Gilbreth and Lillian Gilbreth
group. A line toward a democratic and participative - They emphasized the benefits of job simplification and
approach follows as employee receive higher education. the establishment of work standards, as well as the
3) Class and status system – this is from sociologist’s point effects of the incentive wage plans and fatigue on work
of view that managers have become an elite group of performance.
brains and education. This class is based on education - The Gilbreths were among the first to use motion-
and knowledge. Managers continue to expand their picture films to analyze worker’s motion.
horizons in an effort to attain the ultimate in life or goal. - Lillian Gilbreth is known as the first lady of management.
3) Henry Gantt
Role of Manager - Developed Gantt Chart
. Interpersonal - Advocates for humanitarian management
- Symbol - Concerned with problems of efficiency. He contributed
- Leader to scientific management by refining pervious work
- Liaison rather than introducing a new topic.
. Information Classical Organization Theories
- Monitors 1) Henry Fayol
- Disseminates - Process management – planning, organizing,
- As spokes person coordinating, and controlling known as the “father of
the management process school

J.A.K.E 1 of 34
 NCMB419 LEC & RLE: Exam
Week
BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

0
Bachelor of Science in Nursing 4Y1
Professor: Ma. Diosul Roque, MAN, RN & Evangeline Orata, MAN, RN, RM

J.A.K.E 1 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

- He studied the functions of the managers - This Hawthorne effect shown that people respond that
and concluded that management is universal. they are being studied, they felt that whatever behavior
- Fayol’s14 principle of management: they attempted they still continue to warrant attention.
a) Division of work Employee knows that they are being evaluated by
b) Authority and responsibility management.
c) Discipline 3) Jacob Moreno
d) Unity of command - He developed a system of pairings called Sociometry,
e) Unity of direction believes that people are attracted to, repulsed by or
f) Subordinate of individual interest to general interest just indifferent towards each other.
g) Remuneration of personnel
Behavioral Science
h) Centralization 1) Abraham Maslow
i) Scalar chain (Line of Authority) - Described humans as “wanting” organisms that satisfy
j) Order their basic needs in a specific sequence.
k) Equity - According to Maslow, higher level needs do not
l) Stability of tenure of personnel emerge as motivators until lower level needs satisfied.
m) Initiative 2) Frederick Herzberg
n) Esprit de corps (pride and honor shared by the - Proposed two-factor motivational need theory:>hygiene
members of the group) factors are termed “dissatisfiers”>motivating factors
Management Process are termed “satisfiers”
. Planning it is determining philosophy, goals and objective, 3) Douglas Mcgregor
policies, procedures and rules. - Douglas McGregor (1960) theorizing that managerial
. Organizing it includes establishing the organizational attitude about employees this could be correlated to
structure to carry out plans. Determining the most employee’s satisfaction.
appropriate type of patient care delivery. - He labeled Theory X and theory Y
. Staffing functions consist of recruiting interviewing, hiring 4) William Blake
and orienting staff. - Develop the Managerial Grid
. Directing it includes several staffing functions such as - Types of Managers in Managerial Grid
motivating, managing conflict. Delegating, communicating, - Impoverish Manager
facilitating collaboration. - Country Club Manager
. Controlling functions include performance appraisals. - Organizational Man Manager
Fiscal accountability, quality control, legal and ethical - Authority Obedient Manager
control. - Team Manager
1) Max Webber
- the “Father of Organizational Management” . Country Club Management – Thoughtful attention to
- He developed the organizational chart. needs of people for satisfying relationship.
- According to him there are 3 types of authority: . Impoverished Management – Exertion of minimum effort
. Traditional to get required work done in appropriate to sustain
. Charismatic organization membership.
. Rational Authority. . Team Management – Work accomplishment is from
2) Lynd Allurwick committed people: interdependence
- She combined the theories of Taylor and Fayol to . Authority Obedience – Efficiency in operation results from
develop the classic Organizational Theory”, popularized arranging conditions of work in such away that human
the term “span of control and unity of command.” elements interfere to a minimum degree.
Human Relation Management . Organization Man Management – Adequate organization
1) Mary Follet performance is possible through balancing.
- Mary Parker Follett (1926) one of the first theorist to
suggest basic principles of what today would be called Types of Managers In Managerial Grid
participative decision making or participative . Impoverish Manager – Low Production and Low People
management . Middle-Of-The-Road Leadership – Medium Production
- Managers should have authority with one another, and Medium People
rather than over employees, that solution could be . Produce or Perish Leadership – High Production and
easily be found that could satisfied both employee Low People
without dominating each other. . Country Club Style Leadership – High People and
2) Elton Mayo Low Production
- They found out that if workers give special attention . Team Manager – High Production and High People
productivity increases, regardless of the environmental
conditions.

J.A.K.E 2 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
Contemporary Management
- Direct willing and unwilling subordinates.
Levels of Management

. Top Level Manager – look at the overall operation of the

organization.
. Middle Level Manager – coordinates activities of different
department
. First Level Manager – directly responsible for the actual
production of services.
Skills of a Manager
. Technical – relate to the proficiency in performing
an activity in the correct manner w/ right technique.
. Human – dealing w/ the people and how to get along
w/ them
. Conceptual – ability to see individual matters as they
relate to the total picture & to dev creative ways of
identifying pertinent factors, responding to the big prob,
and discarding irrelevant facts
According to Summer
. Knowledge – factors refer to ideas, concepts, or
principles that can be expressed and are accepted because
they have logical proofs.
. Attitude – factors relate to those beliefs, feelings, and
values that may be used on emotions and may not be
subjected to conscious verbalization.
. Ability – factor skill, art, judgement, and wisdom. They
abstract factors but they direct one’s thinking to factors
that can be developed by the individual manager who
takes time to consider them.
Roles of a Manager
. Interpersonal
. Conceptual
. Decisional

Leadership
- Is the act of influencing group to follow a certain course of
action.
- A process of influence in which the leader influences
others toward goal achievement.
- Is about creating change. It involves establishing
a direction, aligning people through
empowerment, motivating and inspiring them toward
producing useful change and achieving the mission.
- Nursing Leadership – Process where by nurse
influences one or more persons to achieve a specific
goal in the provision of quality nursing car.
Comparison Between Leader and Manager Manager

- Areas signed a position by the organization.

- Have a legitimate source of power due to
delegated authority that accompanies their
position
- Have a specific duties and responsibilities they
are expected to carry out.
- Manipulate people, the environment, money, time, and
other resources to achieve the goals of the organization.
- Have a greater format responsibility and accountability for
rationality and control than leaders.

J.A.K.E 3 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
Leader
- Often do not have delegated authority but obtain power
through other means, such as influence.
- Have a wider variety of roles than managers.
- Focus on group process, information gathering, feedback,
and empowering others.
- Mayor may not be part of the formal hierarchy of the
organization.
- Emphasize interpersonal relationship
- Direct willing followers
- Have goals that may or may not reflect those of the
organization.
Leadership Theories
Great Man theory: (1900-1940)

- Leaders are born.

- Leaders display both instrumental (technical) and
supportive (socially oriented) leadership behavior
- Great leaders arise when situation demands it.
Trait Theory
- Traits are inherent (before). Traits can be learned (now)
- Identified traits: energy, affection, enthusiasm, ambition,
aggressiveness, decisiveness, self-assurance, self-
confidence, friendliness, affection, honesty, fairness,
loyalty, dependability, technical mastery, teaching skill.
Charismatic Theory
- Leaders possess charisma (an inspirational quality that
some leaders possess that makes others feel better in their
presence.)
Situational Theory
- Traits required of a leader differ according to varying
situations (variables)
- Variables:
o Personality of the leader
o Performance requirements of both the leader and
followers
o Attitudes, expectations and needs of the leader and
followers
Contingency Theory: (Fred Fiedler, 1960s)
- According to Fiedler no leadership style is ideal for every
situation.
- The interrelationship between the group’s leader and its
members were most influenced by the manager’s ability to
be a good leader.
- 3 aspects of a situation that structure the leaders
- Leader- member relations – assessed through
- Group Atmosphere Scale

J.A.K.E 3 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Task structure:
. High if it’s easy to define and measure a task
. Low if it’s difficult to define a task and to measure
progress toward its completion
4 criteria to determine the degree of task structure:
. Goal clarity;
. Extent to which a decision can be verified knowing who
is responsible for what;
. Multiplicity of goal paths, number of solutions
. Specificity of solution, number of correct answers
Position power – authority inherent in a position ( use
rewards and punishment)
. Fiedler says that one can predict the most productive
leadership styles
. Task is structured, leader disliked, then diplomatic.
. Task is ambiguous, leader is liked, then seek
cooperation.
. Accepting, considerate leadership style probably will be Transactional Theory
most productive. - Exchange posture that identifies needs of followers and
Path Goal Theory provides rewards to meet those needs in exchange for
- People act as they do because they expect their behavior expected performances
to produce satisfactory results. - Leaders focuses on a day-to-day operation
- Structured activities were more productive and successful. Behavioral Theory
Situational Leadership Theory (Paul Hersey & Kenneth - Is a management philosophy that evaluates leaders
Blanchard) according to the actions they display in the work place.
- Predicts the most appropriate leadership style from the - To be effective leader is to learn a certain set of behaviors.
level of maturity of the followers through the four quadrant - A leadership theory developed, researchers changed from
model, a horizontal continuum registers low emphasis on studying what traits the leader had and placed emphasis
the accomplishment of tasks on the left side to emphasis on what he or she did, the leadership style of leadership.
on task behavior on the right side.
- The vertical continuum depicts low emphasis Leadership Styles
on interpersonal relationships at the bottom to high 1) Authoritarian
emphasis on relationships at the top. - Rigid leader and uses leadership role as an instrument
- The lower left quadrant represents laissez -faire type of of power.
leadership with little concern for production or - Makes all decision
relationships. - Strong control is maintained over the work group
- Leadership Styles by Hersey & Blanchard: - Others are motivated by coercion
1) Directing Style – This a high task, low relationship style - Others are directed with command
and is effective when subordinates are low in 2) Democratic
motivation and ability. - Fair and logical uses the leadership role to stimulate
2) Coaching Style – This is a high-task, high relationship others to achieve collective goal.
style and is effective when subordinates have adequate - Less control is maintained
motivation but low ability. - Economic and ego awards are used to motivate
3) Supporting Style – This is a low-task, high-relationship - Others are directed through suggestion and guidance.
style and is effective when subordinates have adequate 3) Laissez-Fair
ability but low motivation. - Passive and unproductive, usually assumes the role of
4) Delegating Style – This is a low-task, low-relationship participant.
style and is effective when subordinates are very high - Observer and exerts a little control or guidance.
in ability and motivation.
Contemporary Leadership
. Transformational Theory
o Promotes employee development
o Attends to needs and motives of followers
o Inspires through optimism
o Influences changes in perception
o Provides intellectual stimulation
o Encourages followers’ creativity

J.A.K.E 4 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Power – Ability to impose the will of one person or group 4) Take into account all the direct, indirect and unit activities.
to bring certain behaviors in other person or groups. 5) Consider the geographical location of the unit and the
. Reward Power – It is the leader or manager’s assigned duties to save nurse’s time and effort.
power comes from the ability to reward others for 6) Must be balanced among nursing staff.
complying. 7) Never to assign the same task to more than one nurse.
. Coercive Power – based on a fear of punishment if one Characteristics of Effective Assignment
fails to conform., an opposite of reward power 1) Definite and easily understood.
. Legitimate Power – The right of the manager or leader to 2) Simple
influence and the staff member an obligation to accept 3) Clear.
that influence. 4) Signed.
. Referent Power – based on identification with a leader 5) Written.
and what that leader symbolizes. The leader is admired 6) Posted in advance.
and exerts influence because the followers desire to be
like the leader. Process of organizing patient care:
. Expert Power – Gained through knowledge, skills, - The head nurse or the nurse in charge should carry out
information, experience and competence. Their expertise their duties and responsibilities through applying the
gains people respect and compliance. following steps:
. Information Power – Comes from knowledge, access to
information, and the sharing of information. It is especially
powerful when others need the information. 1) Planning – a process of developing a course of action for
. Connection Power – Comes from formal or informal meeting the needs of patients. In planning, the head nurse
coalitions and interpersonal relations and links to decides what should be done, when, how, where, by
prestigious and influential people within and outside of the whom and to whom.
organization. 2) Assigning – Assignment of patient and nursing activities
are written in the assignment sheet by the
PATIENT CARE DELIVERY SYSTEM head nurse/nurse in charge, based on the
- One important function of the professional nurse at the principles of assignment.
first-line management position of nursing service 3) Leading – Includes issuing instructions, motivation, and
department is organizing the activities of the staff into a coordination of activities, by making rounds, checking
workable pattern to meet patient needs. She/he should performance and conducting conferences.
establish effective relationships between the activities to 4) Evaluating – By reviewing nursing performance and
be performed, the workers to perform them. patient progress to be compared by the assignment and
- Assignment – refers to “a written delegation of duties to nursing care plan.
care for a group of patients by trained personnel assigned 5) Reporting – The head nurse prepares a nursing unit report
to the unit. “e.g. shift report” which includes patient’s needs, special
Purposes of Assignment observations, census, bed number, all critically ill and
1) To delegate the work to be done to the nursing personnel. post-operative patients, patients’ needs special
2 ) To gain the cooperation of the nursing personnel by preparation on the on-coming shift, abnormal change in
knowing and accepting the acceptance of the work to be patient’s condition, data concerning, admission, discharge,
done transfer and death.
3) To produce high quality level of nursing care.
4) Improve stability of the environment Nursing Care Delivery Models
5) Minimize uncertainty. - Is the method used to provide care to patients.
6) To improve the communication skills between staff - Each model has advantages and disadvantages, and
members, team spirit and responsibility and leadership no single method is ideal.
abilities. - It is a method to evaluate patient care and save money.
7) To know nursing roles or duties in advance. - Managers must examine the following when selecting
8) To minimize the level of working overload. model
Principles of Personnel Assignment
1) Made by the head nurse or nurse in charge for
each individual nurse.
2) Based on:
. Nursing needs of each patient and approximate time
required to care for him.
. The capabilities, skill level, previous experience and the
interest of the staff members.
. Job description.
3) Planned weekly, and revised daily if necessary, to assure
continuity of care.
J.A.K.E 5 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Traditional Models of Care

1) Total Patient Care (Case Method)
2) Team Nursing
3) Modular Nursing
4) Functional Nursing
5) Primary Nursing
KEY TERMS
• Registered Nurses (RNs)
• Unlicensed Assistive or nursing Personnel (UAPs)
• Licensed Practical Nurses (LPNs)
• Licensed vocational Nurses (LVNs)
Total Patient Care (Case Method)
- Total patient care is the oldest mode of organizing patient
care.
- Provided in the patient’s home, and the nurse was
responsible for cooking, house cleaning, and other
activities specific to the patient and family, in addition to
traditional nursing care.
- Great Depression of the 1930’s people can no longer
afford home care and began using hospitals.
- Nurses and students also became caregivers in hospitals
and in public health agencies.
- 1930’s and 1940’s – hospitals grew and provided total
care continued as the primary means of organizing patient
care.

J.A.K.E 6 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
- The premise of the case method is that one nurse
provides total care for one patient during the entire work
period.
- Is used in critical care setting where one nurse
provides total care to one or two critically ill patients.
- Note: Total patient care nursing is sometimes referred
to as the case method of assignment because patients
were assigned as cases
Nurse Manager’s role
. When using the case method, the manager must
consider the expense of system, weigh the expense of
RN versus (LPNS, UAPS).
. Decide if patient care required RN care or care provided
by (LPNS, UAPS).
Direct care nurse’s role:
. Provide Holistic care (physical, emotional) to a group
of patients during defined work time.
. The nurse must complete the functions of
care (assessment, personal hygiene and
teaching the patient\ and family)
. No delegation of tasks.
Advantages
. Provides nurses with high autonomy and responsibility.
. One nurse gives all care to the same patient(s) for
the entire shift that lead to satisfaction of patients.
. Assigning patients is simple and direct and does
not require the planning.
. Continuous, holistic, expert nursing care.
. Total accountability for the nursing care of the
assigned patient( s ) for that shift.
. Continuity of communication with the patient,
family, physician(s), and staff from other departments.
. The lines of responsibility and accountability are clear.
. The nurse, patient , and family usually trust one
another and work together toward specific goal.
. Changes in the patient’s status can be easily noticed.
. Critical care units or Post anesthesia recovery areas.
Disadvantages
. RNs spend some time doing tasks that could be done
more cost-effectively by less skilled persons.
. To maintain quality care, this method requires
highly skilled personnel.
. There is little opportunity for Supervision or observations.
. The greatest disadvantage of total patient care
delivery occurs when the nurse is inadequately prepared
to provide total care to the patient.
. In the early history of nursing, only RNs provided care;
now a variety of nursing care personnel, many of whom
have no license and limited education, work with
patients.
. During nursing shortages, many hospitals
assign healthcare workers who are not RNs to provide
most of the nursing care.
. Because the co-assigned RN may have a heavy
patient load, little opportunity for supervision
exists. This potentially could result in unsafe care.

J.A.K.E 6 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Functional Nursing (TASK) Advantages

- Evolved primarily as a result of World War II (1940) and the
rapid construction of hospitals. Nursing shortage . The staff become very efficient and effective at
developed and ancillary personnel were needed to assist performing their regular assigned tasks.
in patient care. . Tasks are completed quickly.
- The number of registered nurses (RNs) serving in the . Little confusion regarding responsibilities.
armed forces during World War II depleted the supply of . Unskilled workers can be trained to perform specific
nurses at home. As a result of this loss of RNs, the tasks.
composition of nursing staffs in hospitals changed. . Allow care to be provided with a minimal number
- Staff that had been composed almost entirely of: of registered nurses (cost effective).
. Registered Nurses (RNs) . Functions well in areas such as:
. Unlicensed Assistive Personnel (UAPs) o The Operating Room.
. Licensed Practical Nurses (LPNs) o Long -Term Care Facilities.
- a method by which staff member (licensed and o Ambulatory clinics.
unlicensed) perform specific tasks for a large group of Disadvantages
patients rather than care for specific patients. . Fragmentation of care.
. Lack of holistic understanding of the patient (spiritual
and psychological needs). Problems with follow-up and
patient progress.
. Use of unlicensed assistive personnel (UAPs) to
deliver nursing care.
. Because some workers feel unchallenged and
under stimulated in their roles, (low job satisfaction).
. Employees focus only on their own efforts, with
less interest in overall results.
. Patients become confused with many different
care providers.
. Patient’s response to care is difficult to assess.
. Critical changes in patient status may go unnoticed.
. Can lead to Patient and family dissatisfaction
and frustration.
Economical means of providing care

- Many nurse administrators believe that assigning low-

skill tasks to UAPs frees the professional nurse to
perform more highly skilled duties and is therefore more
economical (This is true if quality care and holistic care
are not regarded as essential)
- Advantages
. Large number of tasks in short period.
. Unskilled person can be trained to one specific task.
. Cost effective to mix staff.
- Disadvantages
Nurse Manager’s Role
. Must be sensitive to the quality of patient care delivered . Fragmented patient care.
and the institution’s budgetary constraints. . Poor communication among staff members.
. Achieving patient outcomes. . Less control of quality.
. By using effective management and leadership skills, can . Professional nurse dissatisfaction.
improve the staff’s perception of their lack of Team Nursing
independence. - Developed in the 1950s in an effort to decrease
. Rotate assignments among staff. the problems associated with the functional
. Staff meetings should be conducted frequently. This organization of patient care.
encourages staff to express concerns and empowers them - Developed that reduced the fragmented care
with the ability to communicate about patient care and that accompanied functional nursing.
functions. - Ancillary personnel collaborate in providing care to a
Direct Care Nurse’s Role group of patients under the direction of a professional
. Nurses are educated to care for the patient holistically
and providing only a fragment of care to the patient.
. Do the tasks that are usually assigned by the charge nurse.

J.A.K.E 7 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

collecting some data) that do not require the expertise of

an RN.
. It allows patient care needs requiring more than one staff
member, such as patient transfers from bed to chair, to be
easily coordinated.
. Is usually associated with democratic leadership.
. Group members are given as much autonomy as possible
when performing assigned tasks.
. Although the team shares responsibility and accountability
collectively.
. High job satisfaction.
Disadvantages
. Assignments may not be equal if they are based on patient
acuity or may be monotonous if nurses continuously care
for patients with similar conditions (e.g., all patients with
hip replacements).
. Problems in delegation and communication are the most
common reasons why team nursing is less effective than it
Nurse Manager’s Role
theoretically could be.
. Teaching, and coordinating patient activities. . Are associated primarily with improper implementation
. Responsible for more than one unit. rather than with the philosophy itself.
. Determine which nurse are competent and interested . A great deal of time is needed for the team leader to
in becoming a charge nurse or a team leader. communicate, supervise, and coordinate team members.
. Provide an adequate staff mix. . Continuity of care may suffer due to changes in
. Orient team members to the team nursing system. team members, leaders, and patient assignments.
. Providing continuing education. . No one person considers the total patient.
Charge Nurse’s Role . There may be role confusion and resentment against the
. Act as a liaison between the team leaders and team leader, who staff may view as more focused on
other healthcare provider. paperwork and less directed at the physical or real needs
. Provide support for the teams on a shift by shift. of the patient.
Team Leader’s Role Modular Nursing
- A mini-team (2-3 members approach).
. Developing or updating nursing care plans. - Members are sometimes called “care pairs” .
. Delegate the work.
- A small team requires less communication, allowing
. Supervise, and coordinate team members. members better use of their time for direct patient care
. Assisting team members. activities.
. Resolving problems encountered by team members.
. Follow up with members to evaluate the quality of care
the patients assigned to their team.
. Facilitates patient care conferences.
Direct Care Nurse’s Role
. Team nursing uses the strengths of each caregiver.
. Some nurses become known for their expertise in
some tasks (IV), will start IV for patients under the
guidance and supervision of the team leader.
. Direct patient care activities under the direction of
the team leader. Primary Nursing
. Nurse acts as a responsible for knowing the condition - A cultural revolution occurred in the united states during
and needs of all the patients assigned to the team the 1960s. The revolution emphasized individual rights,
and for planning individual care. this revolution influenced the nursing profession.
Searching for quality of patient care led to this model
Advantages
as a method to increase RN accountability for.
. Improve patient satisfaction. - An adaptation of the case method, as a method for
. Cost effectiveness for the agency. organizing patient care delivery in which one RN functions
. Organizational decision making occurring at lower levels. autonomously as the patient’s primary nurse throughout
. Allows members to contribute their own special the hospital stay brought the nurses back to direct patient
expertise or skills. care.
. It allows the use of LPNs and UAPs to carry out
some functions (e.g., making beds, transporting
J.A.K.E 8 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

- The primary nurse assumes 2 4 - hour responsibility for . Nurses develop skill in primary nursing care delivery, they
planning the care of one or more patients from admission feel challenged and rewarded.
or the start of treatment to discharge or the treatment’s . 24-hour accountability for nursing care activities by one
end. nurse
- Provide the patient and the family with coordinated, . High job satisfaction.
comprehensive, continuous care.
. Decrease the number of unlicensed nurses.
- Care is organized, using the nursing process.
. All staff are RN (professional staff)
- A nursing Staff comprised totally of RNs.
. Motivation
- Clear communication among the patient, the physician,
. Autonomy
the associate nurses, and other team members.
- Example: Disadvantages
. A patient is admitted to a medical unit with . Nurse may not have the experience or educational
pulmonary edema. background.
. His primary nurse admits him and then provides a . L i e p r i m a r i l y i n i m p r o p er implementation.
written plan of care. When his primary nurse is not . It requires excellent communication between the primary
working, an associate nurse implements the plan. nurses and associate nurses.
Associate Nurses . Primary nurses must be able to hold associate nurses
. Is an RN who has been delegated to provide care to the accountable for implementing the nursing care as
patient according to the primary nurse ’s prescribed.
specification. When the primary nurse is not on duty. . Because of transfers to different units, critically ill patients
. If the patient develops additional complications, the may have several primary care nurses, disrupting the
associate nurse notifies the primary nurse. continuity of care inherent in the model.
. Provides input to the patient ’s plan of care. . This method is difficult to implement because of the
degree of responsibility and autonomy required of the
. Is the only type of patient care delivery that requires a one
primary nurse.
to one relationship between a nurse and a patient with
responsibility for planning and managing care clearly . Many nurses may be uncomfortable in this role or initially
established. lack the experience and skills necessary for the role.
. It sometimes has been difficult to recruit and retain
enough RNs, especially in times of nursing shortages.
. In times of shortage (not be the model of choice).
The Integrated Model of Care
Practice Partnership

- Introduced by Marie Manthey in 1989.

- An RN and assistant (UAP, LPN or less experienced
RN agree to be practice partners.
- Work together with same schedule and the same group of
patients.

Nurse Manager’s Role

. Unit quality manager.
. Delegation.
. Budget controller. - Senior RN direct the work of the junior partner according
. Decision making. to partner’s abilities.
. Ac as role model, consultant, coach. - Two partners work in concern with patients.
Direct care nurse’s role - Seniors perform selected patient care activities and
. Caregiver, Decision maker, Teacher, Care coordinate, delegates less ones to the junior.
manager. - Advantages
. Primary nurse depend on associate nurse. . Improved continuity of care.
. Changing in the plan can be made by the associate . Offered an efficient way of nursing skills of a mix of
. Nurse in coordination with the primary nurse. different levels of experiences.
. Less expensive for the organization.
Advantages
. Satisfying professionally for the partners.
. Improved continuity, quality and coordination of care.
- Disadvantages
. Decentralization of nursing care decisions, authority, and
. Increase number of UAP and decrease ratio
responsibility to the staff nurse.
of professional nurses to non-professional.
. Patient and family are satisfied with the care.

J.A.K.E 9 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Potential for junior team members to assume too preadmission work-ups are completed and that the
much responsibility than appropriate. patient is being admitted at the appropriate time to
Case Management facilitate follow-up through on problems.
- Is a process of coordinating healthcare by planning, 2) Case Managers in Private Practice:
facilitating and evaluating interventions across levels of - focus on a particular group of clients. For example, the
care to achieve measurable cost and quality outcomes geriatric case manager focuses on managing care for
- It may be within the wall of hospitals or beyond the walls. them.
- It became a popular and effective method to manage
shortened lengths of stay for patients while achieving Critical Pathway
- Successful case management relies on critical pathways
desired patient outcomes and to prevent expensive to guide care. The term critical path, also called a care
hospital re-admissions. map, refers to the expected outcomes and care
strategies developed by the collaborative practice team.
- It provides direction for managing the care of a specific
patient during a specified time period.
- Comprehensive pre- printed standard plan reflecting ideal
course of treatment for diagnosis or procedure especially
with relatively predictable outcomes.
- The critical pathway may need to be revised or additional
data may be needed before changes are made.
- Advantages:
. Accommodate unique characters and conditions of
The Case Manager
patients.
- The case manager may help the family to identify all the . Reduce costs and length of stay.
options for care and treatment, ask questions to obtain
. Use appropriate sources.
greater understanding of the overall problem, and work
- Disadvantages:
with the family in the decision- making process. The
. The critical pathway may need to be revised or
private case manager is paid by the client or family
additional data may be needed before changes are
usually based on the hours of service provided.
made.
- The case manager role requires not only advanced nursing
. The critical path must include a means to identify
skills but also managerial and communication skills.
- Professional nurse assigned responsibility for this process. variances easily and to determine whether the outcome
has been met.
- Follow the patient from the diagnostic phase through
hospitalization, rehabilitation and back to home care. Differentiated Practice
- a method that sorting nursing practice roles, function and
Advantages work based on education, experience, and competence or
For the patient: some combination of them.
. Establishing and achieving a set of “expected” or - Nursing competencies are generally measured in three
standardized patient care outcomes for each patient. areas: technical skills, communication and management
. Facilitating early patient discharge or discharge within an of care or leadership skills.
appropriate length of stay. - Advantages:
. Using the fewest possible appropriate health care . Nurses are allowed to work in specialized roles for
resources to meet expected patient care outcomes. which they were educated, leading to greater career
. Facilitating the continuity of patient care through satisfaction.
collaborative practice of diverse health professionals. - Disadvantages:
For the nurse: . Nurses who have experience, knowledge and capability
. Enhancing nurse’s professional development and job to function beyond their original education may not
satisfaction. recognized.
. Facilitating the transfer of knowledge of expert clinical . Organizations that have determined minimal
staff of novice staff. educational requirements for RN positions may have
. Assists with decision-making by ensuring that plans are difficulty in recruiting staff with the requisite credentials.
made in advance for the next needed step. and helps to
ensure that the patient receives care that will achieve
the most positive outcomes in the most efficient
manner. This process helps to eliminate costly delays in
progress.
Case Manager’s Approaches
1) Case Mangers Employed by the Hospitals:
- follow a patient from the time admission is planned
through the time of discharge. This case manager might

J.A.K.E 10 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
plan the admitting process to ensure that all

J.A.K.E 10 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

the nurse: Beginning Nurses’ Role on Client Care, Beginning

Nurses’ Role on Management and Leadership and Beginning
Nurses’ Role in Research as well as four types of clients of
the nurse. With the promulgation of the 2012 NNCCS,
the succeeding stage is its implementation and evaluation in
both nursing education and nursing service in all settings.

Goals and objectives of the Project

This goal blended well with the goal of the ILO project to
improve Nursing Education and practice through the
dissemination of materials and training of nurses.
Specifically, the project aims to:
1) Establish the team and system for implementing the
project.
2) Develop and implement the training design and materials
aligned with the revised NNCCS competencies.
3) Pilot the training course in Luzon, Visayas and Mindanao.
4) Recommend strategies to address sustainability
concerns.
Significance:
1) Basic Nursing Education Program in the Philippines
through CHED
2) Competency-based test framework development of
course syllabi and test questions for “entry level”
nursing practice in the board licensure examination for
nurses.
3) Standards of professional nursing practice in various
setting in the Philippines.
4) All related evaluation tools in various practice settings in
the Philippines.

EVIDENCE-BASED PRACTICES IN NURSING MANAGEMENT Phase 1 – Work Setting scenario 10 KEY PHASES
National Nursing Care Competency Standards (NNCCS)
Phase 2 – Validation studies of roles and
- Developed for Nursing Practice in 2001, through the responsibilities/Benchmarking
initiative of the Professional Regulation Commission-Board Phase 3 – Integrative review of out puts from the validation
of Nursing (PRC-BON) which created a National Task strategies
Force for Core Competency Standards Development. Phase 4 – Core competency consensual
- The project was completed in 2005 after a series of validation Phase 5 – Conduct of public hearing
workshops, consultations, and discussions among Phase 6 – Promulgation of the revised and modified
representatives of nursing practice, nursing education and core competency standards.
community health nursing. Phase 7 – Printing of the revised and modified
11 Core Competencies Nursing core competency standards.
1) Safe and quality nursing care Phase 8 – Training in the implementation of the revised core
2) Communication competency standards.
3) Collaboration and teamwork Phase 9 – Implementation of the revised core competency
4 ) Health education standards.
5) Legal responsibility Phase 10 – Evaluation of effectiveness of the revised core
6) Ethico-moral responsibility competency standards.
7) Personal and professional development Patient Care Safety Standards
8 ) Quality improvement What is safety?
9) Research
1 0 ) Management of resources and environment - It is one aspects of quality where quality includes not only
11)Record management. avoiding, preventable harm, but also making appropriate
In the foreword of the 2012 NNCCS, care available providing effective services to those who
Professional Regulation Commission Chair T.R. could benefit from them and not providing ineffective or
Manzalastated: harmful services.
“Out of this lengthy process emerged the Revised Nursing - to prevent harm to patients, their families and friends,
Core Competency Standards, emphasizing the three roles of healthcare professionals, contract of service workers,

J.A.K.E 11 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

volunteers, and the many other individuals whose . Patient Centered Care and Empowerment of
activities bring them into an environment. Consumers
Key Elements of Patient Safety - Patients must be at all centers of patient safety
. Leadership initiatives and must be partners in all aspects of the
- Leadership and political commitment are essential at process.
the health facility level where patient safety becomes . Patient centered care and patient safety is a national
an integral component of quality care. priority and core agenda
- The Leadership shall address strategic priorities for - To improve quality care in all health
institutional development. - To protect patients, form faulty system
- Its culture and infrastructure, engage its various
stakeholders, communicate and build awareness.
Importance of Safety in Healthcare
. Institutional Development 1) Improve patient satisfaction and clinical outcomes.
- Approaches to institutionalize patient safety and quality 2) Ensure accuracy of patient’s identification.
in the health facilities will have to consider 3) Enhance the effectiveness of communication among
the following: healthcare personnel.
o Financial and human resource. 4 ) Improve the safety of using medications.
o Facility and equipment management. 5) Reduce the risk of health care associated infections.
o Strengthen management responsibility. 6 ) Reduce the risk of harm resulting from injuries.
o Authority and competency. 7) Increases awareness of occupational health and
o Formulate standards of what is expected from environmental control like ergonomically designed
health providers; communicates; provide training. workplace.
o Enforce the standards that comes with the policies 8) Workers must be trained to. Workers also must be
and give the patients voice through a feedback convinced why it is important to pay attention. To prevent
system or a patient satisfaction survey and be educated about the benefits in terms of reduced
. Reporting System pain and discomfort of adopting good practices and work
- The National Patient Safety Committees shall develop methods.
and institutionalize a pro-active reporting and learning 9) A stronger gonomics integration prevents injuries and
system that requires its leadership to increases productivity. Together, they make the workplace
encourage reporting of events. safer and reduce costs.
. Feedback and Communication
- Performance feedback and benchmarking mechanism:
5 Ways to Improve Staff Safety in Healthcare
o To communicate leadership responses 1) Promote a culture of safety
o To the reports shall be established 2) Measure the performance of safety protocols
o To demonstrate communication 3) Optimize staff scheduling
o To patient safety and ensure continues improvement. 4) Improve patient handling
. Adverse Event Prevention and Risk Management 5) Use safer medical equipment
- Risk and reduction strategies thorough patient
- Risk assessment Nursing Actions to Improve Patient Safely
- Patient feedback survey health technology assessment 1) Knowledge and implementation about healthcare policies
and safety assessment code and procedures.
. Disclosure of Reported Serious Events 2) Open communication and teamwork among all other
- The reporting system ensures confidentiality of health care providers.
individual cases. 3) Review the medication rights before giving
- The events can be made available to the public through the medications.
disclosure of results of investigation, summary reports 4) Engage in creating and updating reporting system to avoid
or annual reports that summarize events and actions a blaming culture,
taken. 5) Involve in research and evidence-based activities for
. Professional Development better decision-making.
- Training and supervision of the healthcare staff to 6) Be updated on all life-saving certification like CPR,
improve their decision and clinical judgments is BLS,ACLS, PALS, NALS and other Nursing
imperative. Specialty Certification Programs.
- It is necessary to instill standard norms of behavior of 7) Engage in hospital committees to make the healthcare
courtesy, promptness and efficiency among the health system safe, effective and patient-centered.
care workers and improve the quality of service given 8) Be responsible in reporting all errors and near misses not
to patients. only for the patient to prevent sentinel and adverse events
to happen again.
9) Ensure better lighting and less clutter in the work areas.

J.A.K.E 12 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
Standards of Professional Nursing Practice (American
Nurses Association, 2015) SECTION 2
Standards of Practice - To assume this responsibility, registered nurses have to
gain knowledge and understanding of man’s cultural,
- The Standards of Practice describe a competent level of social, spiritual, physiological, psychological, and
nursing care as demonstrated by the critical thinking ecological aspects of illness, utilizing the therapeutic
model known as the nursing process. process.
- The nursing process includes the components of - Cultural diversity and political and socio-economic status
assessment, diagnosis, outcomes identification, planning, are inherent factors to effective nursing care.
implementation, and evaluation. Accordingly, the nursing SECTION 3
process encompasses significant actions taken by - The desire for the respect and confidence of clientele,
registered nurses and forms the foundation of the nurse’s colleagues, co-workers, and the members of the
decision-making. community provides the incentive to attain and maintain
. Standard 1. Assessment the highest possible degree of ethical conduct.
. Standard 2. Diagnosis
. Standard 3. Outcome identification ARTICLE II: Registered Nurses and People
. Standard 4. Planning SECTION 4
. Standard 5. Implementation 1) Values, customs, and spiritual beliefs held by individuals
. Standard6. Evaluation shall be respected.
2) Individual freedom to make rational and unconstrained
. Standard7. Ethics
decisions shall be respected.
. Standard8. Education
3) Personal information acquired in the process of giving
. Standard9. Evidence-based practice and research
nursing care shall be held in strict confidence
. Standard10. Quality of practice
SECTION 5
. Standard11. Communication 1) consider the individuality and totality of patients when
. Standard12. Leadership they administer care.
. Standard13. Collaboration 2) respect the spiritual beliefs and practices of patients
. Standard14. Professional practice evaluation regarding diet and treatment.
. Standard15. Resource utilization 3) uphold the rights of individuals.
. Standard16. Environmental health 4) take into consideration the culture and values of patients
ETHICO-LEGAL AND MORAL CONSIDERATIONS IN in providing nursing care. However, in the event of
NURSING LEADERSHIP MANAGEMENT conflicts, their welfare and safety must take precedence.
Code of Ethics for Registered Nurses (Board of Nursing) Code of Ethics for Nurses
ARTICLE III: Registered Nurses and Practice SECTION 6

- WHEREAS, the Board of Nursing (BON) has the power 1) Human life is inviolable.
to promulgate a Code of Ethics for Registered Nurses 2) Quality and excellence in the care of the patients are the
in coordination and consultation with the goals of nursing practice.
accredited professional organization (Sec. 9, (g), Art III 3) Accurate documentation of actions and outcomes of
of (Republic Act) No. 9173, known as the “Philippine delivered care is the hallmark of nursing accountability.
Nursing Act of 2002); SECTION 7
- WHEREAS, in the formulation of the Code of Ethics for 1) Know the definition and scope of nursing practice which
Registered Nurses, the Code of Good Governance for the are in the provisions of R. A. No. 9173, known as
Professions in the Philippines was utilized as the principal the “Philippine Nursing Act of 2002” and Board Res. No.
basis thereof: All the principles under the said Code were 425,
adopted and integrated into the Code of Ethics as they Series of 2003, the “Rules and Regulations Implementing
apply to the nursing profession; the Philippine Nursing Act. of 2002”, (the IRR).
ARTICLE I: PREAMBLE 2) Be aware of their duties and responsibilities in the practice
SECTION 1 of their profession as defined in the “Philippine Nursing
Act of 2002” and the IRR.
- Health is a fundamental right of every individual. The 3) Acquire and develop the necessary competence in
Filipino registered nurse, believing in the worth and dignity knowledge, skills, and attitudes to effectively render
of each human being, recognizes the primary responsibility appropriate nursing services through varied learning
to preserve health at all costs. situations.
- This responsibility encompasses promotion of health, 4) If they are administrators, be responsible in providing
prevention of illness, alleviation of suffering, and favorable environment for the growth and developments of
restoration of health. However, when the foregoing are not Registered Nurses in their charge.
possible, assistance towards a peaceful death shall be 5) Be cognizant that professional programs for specialty
his/her obligation. certification by the BON are accredited through the
Nursing Specialty Certification Council (NSCC).

J.A.K.E 13 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

6) Sees to it that quality nursing care and practice meet the with other members of the health team.
optimum standard of safe nursing practice.
7) Ensure that modification of practice shall consider the
principles of safe nursing practice.
8) If in position of authority in a work environment, be
normally and legally responsible for devising a system of
minimizing occurrences of ineffective and unlawful nursing
practice.
9) Ensure that patients’ records shall be available only if they
are to be issued to those who are professionally and
directly involved in their care and when they are required
by law.
SECTION 8
- Registered Nurses are the advocates of the patients: they
shall take appropriate steps to safeguard their rights and
privileges.
SECTION 9
1) respect the “Patients’ Bill of Rights” in the delivery
of nursing care.
2) provides the patients or their families with all pertinent
information except those which may be deemed harmful
to their well-being.
3) upholds the patients’ rights when conflict arises regarding
management of their care.
SECTION 10
- Registered Nurses are aware that their actions have
professional, ethical, moral, and legal dimensions. They
strive to perform their work in the best interest of all
concerned.
SECTION 11
1) performs their professional duties in conformity with
existing laws, rules regulations measures, and generally
accepted principles of moral conduct and proper decorum.
2) not allow themselves to be used in advertisement that
should demean the image of the profession (i.e. indecent
exposure, violation of dress code, seductive behavior,
etc.).
3) declines any gift, favor or hospitality which might be
interpreted as capitalizing on patients.
4) not demand and receive any commission, fee or
emolument for recommending or referring a patient to a
physician, a co-nurse or another health care worker; not to
pay any commission, fee or other compensations to the
one referring or recommending a patient to them for
nursing care.
5) avoids any abuse of the privilege relationship which exists
with patients and of the privilege access allowed to their
property, residence or workplace
ARTICLE IV: Registered Nurses and Co-Workers SECTION 12

1) The Registered Nurse is in solidarity with other members

of the healthcare team in working for the patient’s
best interest.
2) The Registered Nurse maintains collegial and collaborative
working relationship with colleagues and other health care
providers.
SECTION 13
1) maintains their professional role/identity while working

J.A.K.E 14 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
2) conform with group activities as those of a health team
should be based on acceptable, ethico-legal standards.
3) contributes to the professional growth and development of
other members of the health team.
4) actively participates in professional organizations.
5) not act in any manner prejudicial to other professions.
6) honor and safeguard the reputation and dignity of the
members of nursing and other professions; refrain from
making unfair and unwarranted comments or criticisms on
their competence, conduct, and procedures; or not do
anything that will bring discredit to a colleague and to any
member of other professions.
7) respect the rights of their co-workers.
ARTICLE V: Registered Nurses, Society, And Environment SECTION 14

1) The preservation of life, respect for human rights, and

promotion of healthy environment shall be a commitment
of a Registered Nurse.
2) The establishment of linkages with the public in promoting
local, national, and international efforts to meet health and
social needs of the people as a contributing member of
society is a noble concern of a Registered Nurse.
SECTION 15
1) be conscious of their obligations as citizens and, as such,
be involved in community concerns.
2) be equipped with knowledge of health resources within the
community and take an active role in primary health care.
3) actively participates in programs, projects, and activities
that respond to the problems of society.
4) lead their lives in conformity with the principles of right
conduct and proper decorum.
5) project an image that will uplift the nursing profession at all
times.
ARTICLE VI: Registered Nurses and The Profession SECTION 16

1) Maintenance of loyalty to the nursing profession and

preservation of its integrity are ideal.
2) Compliance with the by-laws of the accredited
professional organization (PNA), and other professional
organizations of which the Registered Nurse is a member is
a lofty duty.
3) Commitment to continual learning and active participation
in the development and growth of the profession is
commendable.
4) Contribution to the improvement of the socio-economic
conditions and general welfare of nurses through
appropriate legislation is a practice and a visionary mission.
SECTION 17
1) be members of the Accredited Professional Organization
(PNA).
2) strictly adheres to the nursing standards.
3) participates actively in the growth and development of the
nursing profession.
4) strives to secure equitable socio-economic and work
conditions in nursing through appropriate legislation and
other means.
5) assert for the implementation of labor and work standards.

J.A.K.E 14 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
ARTICLE VII: Administrative Penalities, Repealing Clause,
And Effectivity
Kinds of Contracts
SECTION 18 . Formal Contract – Refers to an agreement among parties
involved and is required to be in writing by some special
- The Certificate of Registration of Registered Nurse laws.
shall either be revoked or suspended for violation of . Informal Contract – one which is concluded as the result
any provisions of this Code pursuant to Sec. 23 (f), Art. IV of a written document or correspondence where the law
of R. A. No. 9173 and Sec. 23 (f), Rule III of Board Res. does not require the same to be written, or as the result of
No. 425, Series of 2003, the IRR. oral and spoken discussion between the parties or
conduct between the parties, evidence and intention to
The International Council Of Nurses (ICN) Code of Ethics contract.
For Nurses . Voidable Contract – An agreement which is enforceable
- An international code of ethics for nurses was first by law at the option of one or more of the parties thereto,
adopted by the International Council of Nurses (ICN) in but not at the option of the other or others, is a voidable
1953. contract.
- It has been revised and reaffirmed at various times since, . Void Contract – Contract which ceases to be enforceable
most recently with this review and revision completed in by law becomes void, when it ceases to be enforceable.
2012.
. Unenforceable Contract – A contract which cannot be
enforced is a valid contract in law, but is incapable of
The ICN Code of Ethics for Nurses has four principal proof, and therefore cannot be enforced in the Court of
elements that outline the standards of ethical conduct Law.
1) Nurses and people
. Executed Contract – Where both the parties have
- Nurse’s primary professional responsibility is to people performed their obligation, it is an executed contract. Even
requiring nursing care. when one party to the contract has performed his share of
2) Nurses and practice the obligation, the contract is executed through to the
- Nurses carries personal responsibility and other party is still under an outstanding obligation to
accountability for nursing practice perform his part of the promise.
- Maintaining competence by continual learning.
. Executory Contract – Here neither party to the contract
3) Nurses and the profession
has performed his share of the obligation, for example,
- The nurse assumes the major role in: determining and both the parties have yet to perform their promises, the
implementing acceptable standards of clinical nursing contract is executory.
practice, management, research and education.
. Express Contract – When the terms of a contract are
- The nurse is active in: reduced in writing or are agreed upon by spoken words at
a) Developing a core of research-based professional the time of its formation, the contract is express.
knowledge.
. Implied Contract – The terms of a contract are inferred
b) Developing and sustaining a core of
from the conduct or dealing between the parties. When
professional values. the proposal or acceptance of any promise is made
4) Nurses and co-workers
otherwise than in words, the promise is said to be implied.
- The nurse sustains a collaborative and respectful
. Quasi-Contract – Quasi contracts raise out of obligation
relationship with co-workers in nursing and other fields.
enjoyed by one person from the voluntary acts of the other
- The nurse takes appropriate action to safeguard which are not intended to be performed gratuitously.
individuals, families, and communities when their
. Contingent Contract – A contingent is one in which a
health is endangered by a co-worker or any other
promise is conditional, and the contract shall be
person.
performed only on the happening of some future uncertain
- The nurse takes appropriate action to support and
even illustrations.
guide co-workers to advance ethical conduct.
Requisites of a Contract
1) To have a contract, two or more persons must participate.
Contract 2) The parties involved must give consent to the contract.
- a meeting of minds between two persons whereby one
3) The object which is the subject matter of the contract
binds himself, with respect to the other, to give something
must be specified such as:
or to render some service a) all things which are not outside the commerce of man;
- A contract is a promise or a set of promises which the law b) all rights which are not in transmissible;
recognizes as a duty and when that duty is not performed,
c) future inheritance in cases expressly authorized by law;
the law provides a remedy.
and
- When a nurse enters into a contract with and employer, it
d) all services which are not contrary to law, morals, good
is usually an agreement to be paid a certain amount of
customs, public order, and public policy.
money and be provided certain benefits in exchange for
4) The cause of obligation is established. The time, price, and
such services. subject matter are expressed. Generally, the length of time
of a contract for services is at least equal to the period for
which wages or salaries are payable. Thus, if one is
J.A.K.E 15 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

engaged on yearly rates, the length of time of the contract relationship to acquire high salary or other options as
will be atleast one year. property, such contract is invalid as it is illegal.
5) Contracting parties must have the legal capacity to enter 5) Those obtained through material misrepresentation.
into a contract. They must Aside from fraud, material misrepresentation may permit
a) be of legal age; a person to avoid or cancel a contract. Suppose a
b) be of sound mind; midwife applied as nurse in an agency and was soon
c) not be under the influence of intoxicating drugs, or fear found not to be a registered nurse, the contract that she
of bodily harm; and. not be suffering from physical signed becomes illegal because she misled the employer
disability such as those who are mentally incompetent. that she is a nurse.
- Married women have the full capacity to go into a
contract except in some cases when it is specified that Breach of Contract
- Breach of contract is failure to perform an agreement,
the husband should agree to such a contract. whether expressed or implied, without cause.
- Examples are in selling or mortgaging of property. - The following constitute breach of contract for nursing
Married female nurses will need written consent from services:
their husbands if they are going to work abroad.
. Prevention of performance.
Inexistent Contract
. Failure to perform because of inconvenience or
The following contracts are void or inexistent from the difficulty; failure of cooperation in performance;
beginning.
. Abandonment of duty (i.e., leaving unconscious
. Those whose cause, object or purpose are contrary to patients,
law, morals, good customs, public order or public policy.
. Going off-duty without endorsement, loafing While on
. Those whose cause or object did not exist from the time duty);
of transaction. . Substitution of performance; and
. Those whose object is outside the commerce of man.
. Failure to use due care.
. Those which contemplate an impossible service.
Legal Excuses in Refusing, Neglecting or Failure
. Those were the intention of the parties relative to the
to Perform a Contract
principal object cannot be as certain Following are legal excuses in refusing, neglecting or failure to
. Those expressly prohibited or declared void by law. Perform a contract:
. Those which are absolutely simulated or fictitious. . Discovery of material misrepresentation made and relied
Voidable Contracts upon;
The following contracts are voidable or annullable, even . Where performance would be illegal; where performance
though there may have been no damage to the contracting is made impossible by reason of illness;
parties.
. Where performance is made impossible by death of
. Those contracts wherein one of the parties is incapable patient or nurse;
of giving consent to a contract.
. Where performance is made impossible by death of
. Those whose consent is vitiated by mistake, Violence, patient or nurse;
intimidation, undue influence or fraud. . Where performance is made for other reasons; and
Illegal Contracts
. Where contract is insufficient.
- Contracts obtained through use of fraud (deception and
trickery,) undue (unlawful) influence or duress (coercion) in Advantages of Written Contracts
- Many nurses fear written contracts.
securing such, and those that are expressly prohibited by
- The following are the advantages of written contracts over
law are illegal.
oral ones.
- Following are examples of illegal contracts:
. A written contract is certain. It avoids the uncertainty of
1) Those that are made in protection of the law. If a nurse
human memory.
proceeds or administer intravenous injection without
. It can specify a definite time within which it is binding
special training and according to protocol established,
she/ he violates RA 9173, the Philippine Nursing Act of so as to protect both sides against sudden
2002, changes without notice. It also fixes a time limit
after which conditions are no longer binding but may
2) Consent obtained by fraud. If a nurse obtained the
be opened for discussion.
consent of a patient or the family to be given services,
through misrepresentation that she/he is licensed . It sets a standard and relieves an individual
although she/he is not, such a contract is illegal. professional person from haggling overcompensation. It
is more likely to be open and well-known so that the
3) Those obtained under duress. Duress means actual or
use of written contracts tends to establish
threat of violence or imprisonment in order to obtain
minimum standards for professional practitioners and
consent. A nurse may be forced to sign a contract under
to protect them against discrimination in
threat of dismissal.
compensation.
4 ) Those obtained under undue influence. If a nurse who
has been taking care of an elderly patient uses her . It is definite and can be definite on many details which
close may otherwise stimulate favoritism or caprice even
among professionals, such as hours of work, vacation

J.A.K.E 16 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

allowances, holiday privileges, health and insurance .

Every will must be acknowledged before a notary public
provisions. by the testator and witnesses.
. It can provide a definite procedure in case of . Witnesses to the wills shall be of sound mind, 18 years
complaints about substandard work, so that the of age or more, not blind, deaf or dumb, and able to
employer has a clear course and the professional nurse read and write.
has protection against arbitrary action. . A married woman may make a will without the consent of
. It creates a minimum of certainty and security for the her husband and without the authority of the court.
professional employee so that he/she is free to The Nurse’s Obligations in The Execution of a Will
concentrate on his/her work without concern for the - They Should note the soundness of the patient's mind (that
details which the written contract has settled. he/she understood the act of making a will) and that there
. Definite commitments stipulated in a contract are was freedom from fraud or undue influence (he/she was
hours of work and salary, length of time of contract, not induced to make someone the beneficiary of the will)
days of off duty, details of duties and responsibilities and that the patient was above 18 years of age. He/she
including the course to be taken in case of non- should note that the will was signed by the testator, that
fulfilment of the terms of contract. the witnesses were all present at the same time and
signed the will in the presence of the testator.
Will
- Is a legal declaration of person’s intentions upon death? Gifts
- It is called a testamentary document because it takes - Another way of disposing of property, aside from executing
effect after the death of its maker a will is by gifts.
- It is an act whereby a person is permitted with the . The gift must consist of personal property
formalities prescribed by law, to control to a certain . There must be an intention to make the gifts;
degree the deposition of his estate, to take effect after his
. There must be an indication of transfer of control over
death. such property; and
Holographic Will . There must be acceptance by the recipient
- must be entirely written, dated, and signed by the hand of
- Gifts made by a person because of anticipation of death or
the testator himself.
belief in approaching death are called gifts causa mortis or
- In the probate of a holographic will, it is necessary that at
donation causa mortis .
least one witness who knows the handwriting and
signature of the testator explicitly declares that the will
. Legal Procedure and Trial – In a trial, the judicial
and
procedure is to ascertain facts by hearing evidence,
the signature are in the handwriting of the testator.
determine which facts are relevant, apply the appropriate
Oral Wills, Nuncupative Wills, Deathbed Wills
principle of law, and pass judgment.
- An Oral Will is spoken/oral, rather than written. This type
. Commencement of the Action – The first step in the trial
of Will is usually made before witnesses. The Testator will
say out loud to someone else how he/she wants process is to determine what kind of legal action to take.
his/her property and assets to be distributed after death. If the action relates to negligence, the correct action
Nuncupative Will or noncupation would be negligence; and if it related to contract, the
proper action would be for breach of contract.
- An Oral Will that have at least two witnesses and meets
specific statutory guidelines. . Statutes of Limitation – Complaint must be made within
a specific time or the right to complain may be lost
- Restrictions to the oral will are that such will be made
forever. There is a time limit in filing cases because
during the person’s last illness, that it be done in the place
witnesses become less reliable after passage of time.
in which he died, that he asked one more witnesses to the
will, that the will be put in writing within a given number of . Pleading – Each party presents a statement of facts or
days, and that it be offered to: probate within a specified pleading to the court. First pleading is generally known as
time. the complaint or petition. In less serious crimes known as
Testamentary Capacity And Intent misdemeanor, these pleadings are called complaints
Following are the essentials of will to meet legal requirements: while in crimes of more serious nature known as felonies,
the pleadings are called indictments.
. The testator must have the expressed intention of making
a will. He must be of the right age. A person under 18 . Pre- Trial Procedures – This is an informal discussion
years of age cannot make a will. He is required to be of between the judge and attorney to eliminate matters not
in dispute, agree on issues, and settle procedural matters
sound mind and must be free from undue influence.
relating to the trial. Cases are often settled at this point.
. The testator shall name the person who will be in charge
of carrying out the provisions of the will. . Trial – At the trial, facts of the case are determined, the
principles of law relating to those facts are applied and a
. Properties must be disposed of in accordance with legal
requirements. conclusion as to liability is reached. The judge
determines the facts and applies the law.
. The will must be signed by the testator, attested, and
signed by at least three witnesses in his presence and of
one another.
J.A.K.E 17 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Witness – The necessity of testimony by any person in a Proof of consent

legal proceeding is determined by the attorneys for the - A written consent should be signed to show that the
parties. procedure is the one consented to and that the person
. Appeals – An appellate court reviews the case, and when understands the nature of the procedure, the risks
the case is decided by it, the final judgment results and involved and the possible consequences.
the matter is ended. - Who Must Consent? Ordinarily, the patient is the one
Execution of Judgment who gives the consent in his own behalf. However, if he is
- Generally, lawsuits against hospitals or physicians and incompetent (minors or mentally ill) or physically unable
nurses involve recovery of money damages. The defendant and is not an emergency case, consent must be taken
is compelled to execute the judgment. Failure to obey will from another who is authorized to give it in his behalf.
be regarded as contempt of court and will result in fine or - Consent of Minors: Parents or someone standing in their
imprisonment. behalf, Parental consent is not needed, however, if the
- Doctors should limit telephone orders to extreme minor is married or otherwise emancipated.
emergency situations where there is no alternative. The - Consent of Mentally Ill: A mentally incompetent person
use of a telephone in a non-emergency as a substitute cannot legally sign; consent must be taken from the
for the physician himself can lead to serious errors parents or legal guardian.
and may border on malpractice. - Emergency Situation: No consent is necessary because
- Only in an extreme emergency and when no other resident inaction at such time may cause greater injury.
or intern is available should a nurse receive telephone - Refusal to Consent: A patient who is mentally and legally
orders. competent has the right to refuse the touching of his body
- The nurse should read back such an order to the physician or to submit to a medical or surgical procedure no matter
to make certain the order has been correctly received and how necessary, nor the imminent danger to his life or
written on the patients' chart. health if he fails to submit to treatment.
- Such order should be signed by the physician on his/her - Consent for Sterilization: The husband and the wife must
next visit within 24 hours. The nurse should sign the name consent to the procedure if the operation is primarily to
of the physician on her own and note the time the order accomplish sterilization.
was received. Should any problem arise, the order should
be referred back to the ordering physician. It is safer that
Charting DONE BY NURSING STUDENTS
when a telephone order is given, another resident - When a nurse or a clinical instructor countersigns the
physician or intern in the same service receive it since the charting of a nursing student, he/she attests that he/she
latter can discuss with the former the actual condition of has personal knowledge of information and that such is
the patient. accurate and authentic. Anyone who countersigns without
Consent to Medical and Surgical Procedures verification commits herself to possible legal risks.
. Consent – defined as a “free and rational act that
presupposes knowledge of the thing to which consent is Criminal Liabilities and Legal Responsibilities of a Nurse
being given by a person who is legally capable of - As Nurses starts to practice their profession, Nurses
giving consent.” The consent signed by the patient liability has increased. Assuming authority, responsibility,
or his authorized representative/legal guardian upon accountability for their professional practice, professional
admission is for the initial diagnosis and treatment. nurses increasingly are being subjected to scrutiny by
. Nature of Consent – Consent is an authorization, by a Boards of Nursing Representing the law, the scope of
patient or person authorized by law to give the consent on nursing practice to protect the public welfare. Nurses are
the patient’s behalf, that changes touching, for example, also increasingly being subjected to malpractice lawsuits.
from non-consensual to consensual. When nurses become defendants in legal actions, Other
. Informed Consent – Haytand Haytstate that “it is an nurse serve as expert witnesses both for the defense
established principle of law that every human being of (representing the practitioner) and the prosecution
adult years and sound mind has the right to determine (representing the plaintiff). Expert witnesses testify to the
what shall be done with his own body. standard of care required of the health care provider and
. Essential Elements: whether it was met. For these reasons, professional
o The diagnosis and explanation of the condition nurses need basic knowledge of the legal aspects of
o A fair explanation of the procedures to be done and nursing.
used and the consequences of - Responsibility and Accountability for the practice of
o A description of alternative treatments or procedures Professional Nursing Professional nurses undertake to
o A description of the benefits to be expected practice their profession, they are held responsible and
o Material rights if any accountable for the quality of performance of their duties.
o The prognosis, if the recommended care, procedure, is Once they are employed in any institution, or hospital are
refused directly responsible to their immediate supervisors. Private
duty nurses, being independent practitioners, are held to a
standard of conduct that is expected of reasonably
prudent nurses. A standard is the desired and achievable

J.A.K.E 18 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
level of performance against which actual practice is
compared.

J.A.K.E 18 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Standards serve as benchmark against which to plan, to Example:

implement and assess quality of services and to show that o A patient came in walking to the out-patient clinic for
nursing is accountable to society, to consumers of nursing injection. Upon administering the injection to his
services and to governments as well as to the profession buttocks, the patient experienced extreme pain. His leg
of nursing and individual members, Venson, (2016). felt weak and he was subsequently paralyzed. His
sciatic nerve was injured.
Professional Negligence and Malpractice o The presence of sponges in the patient’s abdomen after
. Standard an operation.
- Desired and achievable level of performance against o Fracture on a newly delivered baby born by breech
which actual practice is compared. presentation.
- Serves as benchmark against which to plan, Malpractice
to implement and assess quality of services - Improper or unskillful care of the patient by a nurse; also
. Intentional Wrongs denotes stepping beyond one’s authority with serious
- Tortious acts that a nurse may be held liable which consequences
arise in performance of her duties - Term of negligence of professional personnel (Professional
. Negligence Negligence)
- Refers to the commission or omission of an act, - Used properly only when it refers to a negligent act
pursuant to a duty, that a reasonably prudent person in committed in the course of professional performance
the same or similar circumstances would or would not - Example: Giving of Anesthesia by a nurse or
do, and acting or the non-acting of which is the prescribing medicines.
proximate cause of injury to another person or his
property. Doctrine of Res Ipsa Loquitur
- If a person charged with negligence shows that she “the thing speaks for itself”
meets or even surpasses this standard, then there is no - the injury could not have happened if someone was not
negligence or carelessness. But if the defendant’s negligent that no further proof is required.
action fails to meet the standard, then there has been - Example: forceps left inside the abdominal cavity after a
negligence. TAHBSO procedure
. Elements of professional Negligence
o Existence of a duty Doctrine of Force Majeure
o Failure to meet the standard of due care - An Irresistible force, one that is unforeseen or inevitable.
o Foreseeability of harm - Under the Civil Code of the Philippines, no person shall be
o Injury to the plaintiff responsible for those events which cannot be foreseen, or
. Examples of Negligence which, though foreseen, are inevitable, except in cases
o Failure to report observations to attending physicians expressly specified by law.
o Failure to exercise the degree of diligence which - Ex. floods, fire, earthquakes and accidents fall under this
the circumstances of the particular case demands doctrine and nurses fail to render service during this
o Mistaken identity circumstance are not held negligent.
o Wrong medicine, wrong concentration, wrong route,
wrong dose Doctrine of Respondent Superior
o Defects in the equipment such as stretchers and - “Let the master answer for the acts of the subordinate.”
wheelchairs may lead to falls thus injuring the patients - The liability is expanded to include the master as well as
o Administration of medicine w/o a doctor’s prescription the employee and not a shift of liability from the
o Errors due to family assistance subordinate to the master.
. Civil Code, Article 1 9 – One shall act with justice, - Example:
give every man his due, observe honesty and good faith. . The hospital will be held liable, if, in an effort to cut
. Civil Code, Article 20 – Those who, in the performance down on expenses if decides to hire under board
of their obligations through negligence cause any injury nurses or midwives in place of professional nurses,
to another, are liable for damages. and these persons prove to be incompetent.
3 conditions required to establish a defendant’s . The surgeon will be held responsible in case a
negligence laparotomy pack is left in a patient’s abdomen.
. Injury was of such nature that it would not normally occur Note: Private duty nurses, however, are considered
unless there was a negligent act on the part of someone independent contractors. They are liable for their own
. Injury was caused by an agency w/in control of the negligent actions.
defendant . Incompetence
. Plaintiff himself did not engage in any manner that would - Lack of ability, or legal qualifications and being unfit to
tend to bring about the injury discharge the required duty. It is a ground for the
revocation and suspension of her certificate of
registration.

J.A.K.E 19 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

- Ex. A nursing assistant giving IV medication to Medical Orders, Drugs, and Medications RA 6675
the patient. - Only validly registered medical, dental and veterinary
practitioners, whether in private institutions, corporations
Liability for Work of Nurse Trainees and Nurse Volunteers or in the government, are authorized to prescribe drugs.
- Nurses are responsible and accountable for their practice, - Requires that the drug be written in their generic names.
nurse volunteers should exercise utmost caution, critical - Only when these orders are legal writing and bear the
thinking and independent judgment to prevent incurring doctor’s signature thus the nurse has the legal right to
liabilities which may be hard to get out of. follow them.
- The nurse must not execute an order if she is reasonably
Liability of Nurses for the Work of Nursing Aides certain it will result in harm to the patient.
- Nurses should not delegate their functions to nursing
aides since the Philippine nursing act specifies the
scope of nursing practice of professional nurses. PHARMACY ACTRA 5921
All prescriptions must contain the following information:
- Nurses are enjoined to supervise their subordinates and . Name of the prescriber
see to it that they perform only those which they have
. Office address
been taught to do and those which they are capable of
. Professional registration number
doing.
- Nursing aids are responsible for their actions . Professional tax receipt number
- Nurses should not delegate their functions to nursing aides. . Patient’s/client’s name, age, sex
- Nursing aides perform selected nursing activities under . Date of prescription
the direct supervision of nurses.
Intravenous Therapy and Legal Implications
- Philippine nursing act of 1991 section 28 “
Liability for the Work of Nursing Students - In the administration of intravenous injections, special
- RA 9173 – nursing students do not perform
professional nursing duties. training shall be required according to protocol
established” .
- Nursing students should be under supervision of their
- Basis of nurse’s legal right to give IV injection.
clinical instructors.
- Board of nursing resolution no. 8 states that any registered
- In order that the errors committed by nursing students will
nurse without such training and who administers IV
be avoided or minimized, the following measures should
injections to patients should be held liable, either
be taken:
criminally or administratively or both.
. Nursing students should always be under supervision of
Scope of Duties and Responsibilities in Intravenous
their clinical instructors.
Therapy
. They should be given assignments that are their level of
1) Interpretation of the doctor’s orders for intravenous
training experience and competency.
therapy
. They should be advised to seek guidance if they are 2) Performance of venipuncture, insertion of needles,
performing a procedure for the first time. cannulas except TPN and cut down
. They should be oriented to the policies where they are 3) Preparation, administration, monitoring and termination of
assigned. intravenous solution such as additives, intravenous
. Their performance should be assessed frequently to medications, and intravenous push
determine their strengths and weaknesses. 4) Administration of blood/blood products as ordered by
physicians
. Legal Defense in Negligence 5) Recognition of solution and medicine incompatibilities
- When Nurses know and attain the standard of care 6) Maintenance and replacement of sites, tubing’s, dressings
giving service and that they have documented the care in accordance with established procedures
they give. 7) Establishment of flow rate of solutions, medicines, blood
- If the patient’s careless conduct contributes to his own and blood components
injury. 8) Utilization of thorough knowledge and proficient technical
. Advocacy ability in the use/care, maintenance, and evaluation of
- Helping others grow and self-actualize by informing intravenous equipment
them of their rights and ascertaining that they have the 9) Nursing management of TPN, outpatient intravenous care
right information on which to base their decisions. 10)Maintenance of established infection control and aseptic
- The Code of Ethics for Registered Nurses, Sec. 8 nursing interventions
and Sec. 9 11)Maintenance of appropriate documentation associated
- Guidelines to be Observed: with the preparation, administration and termination of all
1 ) Registered nurses are the advocates of the patients. forms of intravenous the therapy.
2) Nurses should be able to advocate for themselves and
the profession.

J.A.K.E 20 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Telephone Orders 4) Invasion of Right to Privacy and Breach

- Only in an extreme emergency and when no other resident of Confidentiality
or intern is available should a nurse receive telephone - The right to be left alone, right to be free of
orders. unwanted publicity and exposure to public view.
- The nurse should read back such an order to the physician - Privacy relates to a person or identity.
to make certain the order has been correctly written. - Example: curtains are used during bed bath
- Such an order should be signed by the physician on his procedure to provide privacy of the patient
next visit within 24 hours. - Confidentiality relates to data or information about
Medical Records an individual.
- Supplies rich material for medical and nursing research - Example: patient’s charts are not shared with
- Serves as a legal protection for the hospital, doctor, and nurses who have not have direct involvement in the
nurse by reflecting the disease or condition of the patient care of the patient.
and his management. 5) Defamation
- “if it was not charted, it was not observed or done” . - Character assassination, be it written or spoken
- Nurses are expected to record fully, accurately, legibly and - Slander –oral or spoken defamation
promptly their observations from admission to the time of - Libel –written defamation (cartoon characters,
the patient’s discharge. words written or essay). There must be a third
- Nurses are legally and ethically bound to protect the person who hears or reads the comment.
patient’s chart from unauthorized persons - There must be a third person who hears or reads the
comment.
Charting Done by Student Nurses
- When a nurse or clinical instructor counter signs the Crimes, Misdemeanors, and Felonies
charting of the nursing student, he/she has personal . Crime
knowledge of information and that such is accurate and - Defined as an act committed or omitted in violation of
authentic. the law
- Anyone who countersigns without verification commits - It has 2 elements: (1) criminal act and (2) evil or criminal
herself to possible legal risks. intent
. Conspiracy to commit a crime
Tort - Conspiracy to commit a crime exists when 2 or more
- A tort is a legal wrong, committed against a person persons agree to commit a crime or felony and decide
or property independent of a contract which renders to do it. They can be classified as:
the . Principal
person who commits it liable for damages in a civil action. - Has committed a direct part in the execution of the act.
1) Assault - He/she directly force or induce others to commit the
- Imminent threat of a harmful or offensive act.
bodily contact. - Considered as the mastermind of the crime: principal
- Verbal threat by inducement
- Ex: A nurse threatens a geriatric patient when he . Accomplices
will take his medications - Cooperates in the execution of the offense by previous
2) Battery or simultaneous act and has knowledge of the criminal
- Intentional, unconsented touching of another intention of the principal
person . Accessory
- Ex. When the patient refuses the IM injection of - Have knowledge of the commission of the crime
medication, but the nurses give it anyway, he can be - Take part subsequent to its commission by profiting
charged with battery themselves or assisting the offender to profit from the
3) False Imprisonment or Illegal Detention effects of the crime
- Unjustifiable detention of a person without legal - Provides exit strategy
warrant within boundaries fixed by the defendant by . Criminal Actions
an act or violation of duty intended to result in such - Deals with acts or offenses against public welfare.
confinement These vary from minor offenses and misdemeanors to
- Ex. Patient insists on leaving the hospital, probable felonies.
consequences of their action explained by the
. Misdemeanor
doctor or medical staff, he is still allowed to go
- Is a general name for a criminal offense which does
home against medical advice in order not to be
not in law amount to felony?
charged with false imprisonment
- Punishment is usually fine or imprisonment in term of
- However, if patient has a communicable disease, less than one year
hospital cannot be charged with false imprisonment
in order to protect the public.

J.A.K.E 21 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Felony 2) Less Grave felonies

- Public offense for which a convicted person is liable to - Law punishes with penalties which in their maximum
be sentenced to death or to be imprisoned in a period are correctional. Imprisonment from one month
penitentiary or prison? A felony Is committed with and one day to six years Fine not
deceit and fault. exceeding php6,000.00
- Deceit exists when the act is performed with deliberate 3) Light felonies
intent and there is fault when the wrongful acts result - Those infractions of law for the commission of which
from imprudence, negligence, or lack of skill or the penalty of arrestment or Imprisonment for one day
foresight. to 3o days or a Fine not exceeding php200.00. Light
. Criminal Negligence may be classified into: felonies are punishable only when they have been
- Reckless Imprudence when a person does an act or consummated, with the exception of those committed
fails to do it voluntarily but without malice, from which against a person or property.
material damage results immediately.
- Simple Imprudence the person or nurse did not use
Criminal Liability
precaution and the damage was not immediate or the - Nurse may incur criminal liability or subject herself to
impending danger was not evident or manifested criminal prosecution either by committing a felony or by
immediately. performing an act which would be an offense against
. Criminal Intent person or property. Ignorance of the law is not an excuse
- State of mind of a person at the time of the criminal for failure to comply therewith.
act is committed. The person is aware that the - Violators of the criminal law cannot escape punishment on
act is unlawful but commits it anyway. Deliberate the ground of ignorance of the law.
intent includes two elements without which can be no Circumstances affecting Criminal Liability
crime. These are freedom and intelligence. 1) Justifying circumstances
- However, when the person offers evidence of insanity, - a person may not incur criminal liability under the
necessity, compulsion or accident or infancy, the court following circumstances:
will decide if he is not guilty of the criminal offense. - When he/she acts in defense of his/her person or rights
provided that:
Classified according to the degree of the acts of execution a) There is an unlawful aggression on the part of the
1) Consummated offended or injured party;
- When all the elements necessary for its execution and b) There is reasonable necessity for the means
accomplishment are present. employed by the person defending himself/herself
- Ex. The nurse wanted to commit euthanasia and had to prevent such aggression
given an overdose of morphine that leads to patient’s c) There is lack of sufficient provocation on the part of
death the person defending himself.
2) Frustrated - When he/she acts in defense of the person or the rights
- When the offender performs all the acts or execution of his/her spouse, ascendants, descendants, or
which will produce the felony as a consequence but legitimate or natural or adopted brothers or sisters, or
which nevertheless, do not produce it by reason relatives
of causes independent of the will of the perpetrator. - When he/she acts in defense of the person or rights of
- Ex. Nurse was hired to give poison to a geriatric patient a stranger provided that the first circumstances
by a relative for inheritance. However, the patient was and second requisites mentioned in the first
revived after the poison was given. circumstance and that the person defending is not
3) Attempted included by revenge, resentment or other evil motives
- When the offender commences the commission of the - When any person who, in order to avoid an evil or injury,
same directly by overt (open or manifest) acts due to does not an act which causes damage to another
unforeseen circumstances there was no complete provided that the evil sought to be avoided actually
execution to produce the desired felony. exists, the injury feared is greater that done to avoid it
- Ex. Respiratory Physiotherapist planned to poison a and there is no other practical and less harmful means
geriatric patient with an overdose of inhaled anesthetic to prevent it.
but due to lack of available supply, the patient was - Fulfillment of a duty or lawful exercise of right or office,
only kept drowsy and not comatose or dead. - Ex: police officers shooting a drug addict to defend
oneself from getting shot back.
Felonies classified according to the degree of punishment 2) Exempting circumstances
1) Grave felonies - The following persons may be exempted from the crime
- those to which the law attaches the capital punishment they have committed:
(death) or penalties which in any of their periods are . Imbecile or insane person, unless the latter has
afflictive imprisonment ranging from 6 years and 1 day acted during a lucid interval.
to life imprisonment or fine not exceeding php6,000.00. . Person less than 9 years’ old

J.A.K.E 22 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Person over 9 years of age and under fifteen . Act committed with abuse or confidence or obvious
unless he/she acted with discernment ungratefulness
. Any person while performing a lawful act with due . When the crime committed in consideration of a
care he/she causes merely an accident without price, reward, or promise
fault or intention or causing it. . Crime is committed on occasion of a conflagration,
. Any person under compulsion of an irresistible force shipwreck, earthquake, epidemic or other calamity
. Any person who acts under the impulse of an or misfortune
uncontrollable fear of an equal or greater injury . When craft, fraud or disguise was employed
. Any person who fails to perform an act required by . When the wrong done in the commission of the
law when prevented by some lawful or insuperable crime is deliberate augmented by causing other
cause. wrongs not necessary for its commission.
3) Mitigating circumstances 5) Alternative circumstances
- Those which do not constitute justification or excuse of - Taken into consideration as aggravating or mitigating
the offense in question, but which in fairness and according to the nature and effects of the crime and
mercy, may be considered as extenuating degree of other conditions attending to its commission
moral culpability. The following are some of - Relationship is aggravating in physical injuries inflicted
the circumstances considered by law to be mitigating by a descendant upon as ascendant.
and Lessen the criminal liability of the offenders. - It is mitigating when an accused aided his/her brother
- When the offender has no intention to commit so grave in the fight against the offended party.
a wrong as the one committed. - Intoxication of the offender as mitigating when the
- When the offender is under eighteen years of age or offender committed the felony in a state of intoxication.
over seventy years old. - When intoxication is habitual or intentional, it can be an
- When sufficient provocation or threat on the part of the aggravating circumstance.
offended party immediately precedes the act. - Illiteracy is mitigating if there is lack of sufficient
- Act is committed in the immediate vindication of grave intelligence and knowledge of the full significance of
offense to the one committing the felony, his/her one’s act.
spouse, ascendants, legitimate, natural or adopted - Lack of education is not mitigating in: rape, force
brothers or sisters, or relative by affinity within the abduction, arson, treason, crimes against chastity like
same degree. seduction and acts of lasciviousness and acts
- Offender voluntarily surrenders himself to a person in committed in merciless or heinous manner.
authority or authority
- Defender is deaf and dumb, blind or otherwise suffering . Murder unlawful killing of a human being with intent to
from some physical defects which does restricts kill. Ex. Euthanasia and abortion
his/her means of actions, defense or . Homicide killing of a human being by another. It may be
communication with fellow beings. committed without criminal intent by any person who kills
- Suffering from such illness as would diminish the another other than his father, mother, child or ascendants
exercise of his/her will power without, depriving or descents, spouse without any of the circumstances
him/her consciousness of his/her acts attendant the crime of murder being present.
- Note: Lack of education is not mitigating in: . Abortion expulsion of a product of conception before the
a) Rape age of viability. In law, any person with the intention of
b ) Forcible abduction prematurely ending a pregnancy willfully or unlawfully does
c) Arson. any act to cause the same is guilty of procuring abortion.
d) Treason.
. Infanticide killing of child less than 3 days of age. The
e) In crimes against chastity like seduction and acts of mother who commits this crime shall suffer penalty of
lasciviousness imprisonment ranging from 2 years, four months and one
f) Those acts committed in a merciless or day to 6 years.
heinous manner
. Parricide crime committed when one kills his/her father,
4) Aggravating circumstances
mother or child whether legitimate or illegitimate, his/her
- Attending the commission of crime and which increase ascendants or descendants or his spouse. A person
the criminal liability of the offender or make his guilt or convicted shall be imposed of penalty for life
more severe. imprisonment (reclusion perpetua) to death.
- The following are Some of the circumstances
. Robbery crime against person or property of taking
that consider the law as aggravating:
personal property of another person. Ex. Nurse takes
. When the offender takes advantage of his public patient’s cash or jewelry while patient is sleeping.
position.
. Crime is committed in place of worship
. Act is committed with evident premeditation or after
an unlawful entry

J.A.K.E 23 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Controlled Substances RA 6425 (Dangerous Drugs Act

of
- covers administration and regulation of
manufacture, distribution and dispensing of controlled
drugs. Authorized persons to prescribe or dispense
these drugs require to register and have special
license for this purpose. Controlled drugs are kept
in locked cabinets and are documented and counted
every shift

Simulation of Birth, Substitution of One Child for Another

or Abandonment of Legitimate Child
- Simulation of birth –one who enters in a birth certificate a
birth that did not occur. It is a crime against the civil Persistent Inequities in Health Outcomes
status of a person. . Every year, around 2000 mothers die due to pregnancy-
- Substitution of one child for another or concealing related complications.
or abandoning any legitimate child with intent to cause . A Filipino child born to the poorest family is 3 times more
such a child his/her civil status shall be punishable for likely to not reach his 5th birthday, compared to one born
simulation by birth, prison mayor and a fine not to the richest family.
exceeding one thousand pesos. . Three out of 1 0 children are stunted.

Things to remember in order to avoid criminal liability Restrictive and Impoverishing Healthcare Costs
1 ) Be very familiar with the Philippine nursing law. . Every year, 1.5 million families are pushed to poverty due
2) Beware of laws that affecting nursing practice to health care expenditures.
3) At the start of employment, get a copy of your job . Filipinos forego or delay care due to prohibitive and
description, the agency’s rules, regulations and policies. unpredictable user fees or co-payments.
4) Upgrade your skills and competence . Php 4 , 0 0 0 / month healthcare expenses considered
5) Accept only such responsibility that is within the scope of catastrophic for single income families.
your employment and your job description. Poor quality and undignified care synonymous with
6) Do not delegate your responsibilities to others. public clinics and hospitals
7) Determine whether your subordinates are competent in . Long wait times
the work you are assigning them. . Limited autonomy to choose provider
8) Develop good interpersonal relationships with your co- . Less than hygienic restrooms, lacking amenities
workers, whether they be your supervisors, peers or . Privacy and confidentiality taken lightly
subordinates. . Poor record-keeping
9) Consult your superior for problems that may be too big for . Overcrowding & under-provision of care
you to handle.
All for Health Towards Health for All
10)Verify orders that are not clear to you or those that seem
. Investing in People
to be erroneous.
. Protection Against Instability
1 1 ) The doctors should be informed about the patient' s
. Universal Health Coverage
conditions.
1 2 ) Keep in mind the values and necessity of keeping accurate . Strengthen Implementation of RPRH Law
and adequate records . War Against Drugs
13)Patients are entitled to an informed consent. . Additional Funds From PAGCOR

PHILIPPINE HEALTH AGENDA

The Health System We Aspire For

. Financial Protection – Filipinos, especially the poor,

marginalized, and vulnerable are protected from high cost
of health care
. Better Health Outcomes – Filipinos attain the best
possible health outcomes with no disparity
. Responsiveness – Filipinos feel respected, valued, and
empowered in all of their interaction with the health
system
. Equitable & Inclusive To All Uses Resources Efficiently
. Transparent & Accountable
. Provides High Quality Services

J.A.K.E 24 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

Guarantee 1: All Life Stages & Triple Burden of Disease

Our Strategy

. Communicable Diseases
- HIV/AIDS, TB, Malaria
- Diseases for Elimination
- Dengue, Lepto, Ebola, Zika Advance quality, health promotion and primary care
. Noncommunicable Diseases & Malnutrition 1) Conduct annual health visits for all poor families
- Cancer, Diabetes, Heart and special populations (NHTS, IP, PWD, Senior
- Disease and their Risk Citizens)
- Factors – obesity, smoking, diet, sedentary lifestyle 2) Develop an explicit list of primary care entitlements that
- Malnutrition will become the basis for licensing and contracting
. Diseases of Rapid Urbanization & Industrialization arrangements
- Injuries 3) Transform select DOH hospitals into mega-hospitals with
- Substance abuse capabilities for multi-specialty training and teaching and
- Mental Illness reference laboratory
- Pandemics, Travel Medicine 4 ) Support LGUs in advancing pro- health resolutions or
- Health consequences of climate change / disaster ordinances (e.g. city-wide smoke-free or speed limit
ordinances)
Guarantee 2: Service Delivery Network 5) Establish expert bodies for health promotion and
Services are delivered by networks that are: surveillance and response
. Fully Functional Cover all Filipinos against health-related financial risk
- Complete Equipment, Medicines, Health Professional 1) Raise more revenues for health, e.g. impose
. Compliant with Clinical Practice Guidelines health promoting taxes, increase NHIP premium rates,
. Available 24/7 & Even During Disasters improve premium collection efficiency.
. Practicing Gatekeeping 2) Align GSIS, MAP, PCSO, PAGCOR and minimize
. Located Close to the People overlaps with PhilHealth
- Mobile Clinic or Subsidize Transportation Cost 3) Expand PhilHealth benefits to cover outpatient
. Enhanced by Telemedicine diagnostics, medicines, blood and blood products
aided by health technology assessment
4) Update costing of current PhilHealth case rates to ensure
Guarantee 3: Universal Health Insurance
Services are financed predominantly by PhilHealth that it covers full cost of care and link payment to service
. Philhealth as the Gateway to Free Affordable Care quality
- 100% of Filipinos are members 5) Enhance and enforce PhilHealth contracting policies for
- Formal sector premium paid through payroll better viability and sustainability
- Non-formal sector premium paid through tax subsidy Harness the power of strategic HRH development
. Simplify Philhealth Rules 1) Revise health professions curriculum to be more primary
- No balance billing for the poor/basic accommodation & care-oriented and responsive to local and global needs
Fixed co-payment for non-basic accommodation 2) Streamline HRH compensation package to incentivize
service in high-risk or GIDA areas
. Philhealth as Main Revenue Source for Public Health Care
Providers 3) Update frontline staffing complement standards from
profession-based to competency-based
- Expand benefits to cover comprehensive range of
4) Make available fully funded scholarships for HRH hailing
services
from GIDA areas or IP groups
- Contracting networks of providers within SDNs
5) Formulate mechanisms for mandatory return of service
schemes for all heath graduates
Invest in eHealth and data for decision-making
1) Mandate the use of electronic medical records in all health
facilities
2) Make online submission of clinical, drug dispensing,
administrative and financial records a prerequisite for
registration, licensing and contracting

J.A.K.E 25 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

3) Commission nationwide surveys, streamline information recognized by the

systems, and support efforts to improve local civil
registration and vital statistics
4) Automate major business processes and invest in
warehousing and business intelligence tools
5) Facilitate ease of access of researchers to available data
Enforce standards, accountability and transparency
1) Publish health information that can trigger better
performance and accountability.
2) Set up dedicated performance monitoring unit to track
performance or progress of reforms.
Value all clients and patients, especially the poor,
marginalized, and vulnerable
1 ) Prioritize the poorest 2 0 million Filipinos in all health
programs and support them in non-direct health
expenditures
2) Make all health entitlements simple, explicit and widely
published to facilitate understanding, & generate demand
3) Set up participation and redress mechanisms
4) Reduce turnaround time and improve transparency of
processes at all DOH health facilities
5) Eliminate queuing, guarantee decent accommodation and
clean restrooms in all government hospitals
Elicit multi-sectoral and multi-stakeholder support for
health
1 ) Harness and align the private sector in planning supply
side investments
2) Work with other national government agencies to address
social determinants of health
3) Make health impact assessment and public health
management plan a prerequisite for initiating large-scale,
high-risk infrastructure projects
4) Collaborate with CSOs and other stakeholders on budget
development, monitoring and evaluation

RA 9173 PHILIPPINE NURSING ACT OF 2002

- Composed of 9 articles and 4 1 sections
. Article I – S1. Title “Philippine Nursing Act of 2002”
. AII – S2. Declaration of the Policy
. AIII– S3. Organization of the Board of Nursing
- Composed of a chairperson and 6 members
S4. Qualifications of the chairperson & members of the
board
a ) Be a natural born citizen and resident of the Philippines;
b ) Be a member of good standing of the
accredited professional organization of nurses;
c) Be a registered nurse and holder of a master's degree
in nursing, education or other allied medical
profession conferred by a college or university duly

J.A.K.E 26 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
Government: Provided, That the majority of the members of
the Board shall be holders of a master's degree in nursing:
Provided, further, That the Chairperson shall be a holder of
a master's degree in nursing;
d) Have at least ten (10) years of continuous practice of the
profession prior to appointment: Provided, however, That
the last five (5) years of which shall be in the Philippines;
and
e ) Not have been convicted of any offense involving moral
turpitude; Provided, That the membership to the Board
shall represent the three (3) areas of nursing, namely:
nursing education, nursing service and community health
nursing.
S5. Requirements Upon Qualification as Member of the
Board of Nursing
- Any person appointed as Chairperson or Member of the
Board shall immediately resign from his/her work.
S6. Term of Office
- The Chairperson and Members of the Board shall hold
office for a term of three (3) years and until their
successors shall have been appointed and qualified:
Provided, That the Chairperson and members of the Board
may be re-appointed for another term.
S7. Compensation of the Board Members
- They shall receive compensation and allowances
comparable to the compensation and allowances received
by the Chairperson and members of other professional
regulatory boards.
S8. Administrative Supervision of the Board, Custodian of
its Records, Secretariat and Support Services
- Commission (PRC)
S9. Powers and Duties of the Board
The Board shall supervise and regulate the practice of the
nursing profession and shall have the following powers, duties
and functions:
a) Conduct the licensure examination
b) Issue, suspend or revoke certificates of registration for
the practice of nursing;
c) Monitor and enforce quality standards of nursing practice
in the Philippines and exercise the powers necessary to
ensure the maintenance of efficient, ethical and
technical, moral and professional standards in the
practice of nursing taking into account the health needs
of the nation;
d) Ensure quality nursing education by examining the
prescribed facilities of universities or colleges of nursing
or departments of nursing education and those seeking
permission to open nursing courses to ensure that
standards of nursing education are properly complied
with and maintained at all times. The authority to open
and close colleges of nursing and/or nursing education
programs shall be vested on the Commission on Higher
Education upon the written recommendation of the
Board;
e) Conduct hearings and investigations to resolve
complaints against nurse practitioners for unethical and
unprofessional conduct and violations of this Act
f) Promulgate a Code of Ethics
g) Recognize nursing specialty organizations

J.A.K.E 26 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

h) Prescribe, adopt issue and promulgate guidelines,

S18. Fees for Examination and
regulations, measures and decisions as may be
Registration S19. Registration by
necessary for the improvements of the nursing practice, - A certificate of registration/professional license may be
advancement of the profession and for the proper and issued without examination to nurses registered under the
full enforcement of this Act subject to the review laws of a foreign state or country:
and - Provided, That the requirements for registration or
approval by the Commission. licensing of nurses in said country are substantially the
S10. Annual Report same as those prescribed under this Act: Provided,
- The Board shall at the close of its calendar year submit an further, That the laws of such state or country grant the
annual report to the President of the Philippines through same privileges to registered nurses of the Philippines on
the Commission. the same basis as
S11. Removal or Suspension of Board Members the subjects or citizens of such foreign state or country.
- The president may remove or suspend any member of the S21. Practice Through Special/Temporary Permit
Board on the following grounds; (a) Licensed nurses from foreign countries/states whose
a) Continued neglect of duty or incompetence. service are either for a fee or free if they are internationally
b) Commission or toleration of irregularities in the well-known specialists or outstanding experts in any
licensure examination; and branch or specialty of nursing;
c) Unprofessional immoral or dishonorable conduct. (b) Licensed nurses from foreign countries/states on medical
mission whose services shall be free in a particular
Article IV. Examination & Registration hospital, center or clinic; and
S12. Licensure Examination (c) Licensed nurses from foreign countries/states employed
- Written examination by schools/colleges of nursing as exchange professors in a
S13. Qualifications for Admission to the Licensure branch or specialty of nursing;
Examination - Provided, however, That the special/temporary permit
a) a citizen of the Philippines, or a citizen or subject of a shall be effective only for the duration of the project,
country which permits Filipino nurses to practice within its medical mission or employment contract
territorial limits on the same basis as the subject or citizen S22. Non-registration and Non-issuance of Certificates of
of such country: Provided, That the requirements for the Registration/Professional License or Special/Temporary
registration or licensing of nurses in said country are Permit.
substantially the same as those prescribed in this Act; - No person convicted by final judgment of any criminal
b) good moral character offense involving moral turpitude or any person guilty of
c) a holder of a Bachelor's Degree in Nursing from a college immoral or dishonorable conduct or any person declared
or university that complies with the standards of by the court to be of unsound mind shall be registered and
nursing education duly recognized by the proper be issued a certificate of registration/professional license
government or a special/temporary permit.
agency. S23. Revocation and suspension of Certificate of
S14. Scope of Examination Registration/Professional License and Cancellation of
- The Board shall take into consideration the objectives of Special/Temporary Permit
the nursing curriculum, the broad areas of nursing, and (a) For any of the causes mentioned in the preceding section;
other related disciplines and competencies in determining (b) For unprofessional and unethical conduct;
the subjects of examinations (c) For gross incompetence or serious ignorance;
S15. Ratings (d) For malpractice or negligence in the practice of nursing;
- an examinee must obtain a general average of atleast 75% (e) For the use of fraud, deceit, or false statements in
with a rating of not below 60% in any subject. An examinee obtaining a certificate of registration/professional license
who obtains an average rating (75%) or higher but gets a or a temporary/special permit
rating below sixty percent (60%) in any subject must take (f) For violation of this Act, the rules and regulations, Code of
the examination again but only in the subject or subjects Ethics for nurses and technical standards for nursing
where he/she is rated below sixty percent (60%). In order practice, policies of the Board and the Commission, or the
to pass the succeeding examination, an examinee conditions and limitations for the issuance of the
must obtain a rating of at least (75%) in the subject or temporarily/special permit; or
subjects repeated. (g) For practicing his/her profession during his/her suspension
S16. Oath from such practice;
S17. Issuance of Certificate of Registration / - Provided,however, That the suspension of the certificate
Professional of registration/professional license shall be for a period
- A certificate of registration/professional license as a nurse not to exceed four (4) years.
shall be issued to an applicant who passes S24. Re-issuance of Revoked Certificates and
the Replacement of Lost Certificates
examination upon payment of the prescribed fees - Board may, after the expiration of a maximum of four (4)
years from the date of revocation of a certificate, for

J.A.K.E 27 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
reasons of equity and justice and when the cause for

J.A.K.E 27 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

revocation has disappeared or has been cured and organization or any recognized professional nursing
corrected, upon proper application therefore and the organization:
payment of the required fees, issue another copy of the - Provided, finally, That the program and activity for the
certificate of registration/professional license. continuing professional education shall be submitted to
Article V. Nursing Education and approved by the Board.
S25. Nursing Education Program S29. Qualification of Nursing Service Administrators.
- A person occupying supervisory or managerial positions
- The nursing education program shall provide sound general requiring knowledge of nursing must:
and professional foundation for the practice of nursing. (a) Be a registered nurse in the Philippines;
S26. Requirement for Inactive Nurses Returning to (b) Have at least two (2) years experience in
Practice general nursing service administration;
- Nurses who have not actively practiced the profession for (c) Possess a degree of Bachelors of Science in
five (5) consecutive years are required to undergo one (1) Nursing, with at least nine (9) units in
month of didactic training and three (3) months of management and administration courses at the
practicum. graduate level; and
S27. Qualifications of the Faculty (d) (Be a member of good standing of the accredited
(a) Be a registered nurse in the Philippines; professional organization of nurses;
(b) (b) Have atleast one (1) year of clinical practice in a field - Provided, That a person occupying the position of chief
of specialization; nurse or director of nursing service shall, in addition to the
(c) (c) Be a member of good standing in the accredited foregoing qualifications, possess:
professional organization of nurses; and (1) At least five (5) years of experience in a supervisory
(d) Be a holder of a master's degree in nursing, education, or or managerial position in nursing; and
other allied medical and health sciences (2) A master's degree major in nursing;
- In addition to the aforementioned qualifications, the dean - Provided, further, That for primary hospitals, the maximum
of a college must have a master's degree in nursing. academic qualifications and experiences for a chief nurse
He/she must have at least five (5) years of experience in shall be as specified in subsections (a), (b), and (c) of this
nursing. section: Provided, furthermore, That for chief nurses in the
public health nursing shall be given priority.
Article VI. Practice - Provided, even further, That for chief nurses in military
S28. Scope of Nursing hospitals, priority shall be given to those who have
- It shall be the duty of the nurse to: finished a master's degree in nursing and the
- Provide nursing care through the utilization of the nursing completion of the General Staff Course (GSC):
process. Nursing care includes: - Provided, finally, That those occupying such positions
- In case of suturing of perineal laceration, special training before the effectivity of this Act shall be given a period of
shall be provided according to protocol established; five (5) years within which to qualify
a) establish linkages with community resources and
coordination with the health team; ARTICLE VII. Health Human Resources Production,
b) Provide health education to individuals, families Utilization and Development
and communities; S30. Studies for Nursing Manpower Needs, Production,
c) Teach, guide and supervise students in Utilization and Development
nursing education programs including the S31. Comprehensive Nursing Specialty Program
administration of nursing services in varied settings S32. Salary
such as hospitals and clinics; undertake consultation - the minimum base pay of nurses working in the public
services; engage in such activities that require the health institutions shall not be lower than salary grade 15
utilization of knowledge and decision-making skills of a prescribes under Republic Act No. 6758, "Compensation
registered nurse; and and Classification Act of 1989“
d) Undertake nursing and health human resource - Provided, That for nurses working in local government
development training and research, which shall include, units, adjustments to their salaries shall be in
but not limited to, the development of advance nursing accordance with Section 10 of the said law.
practice;
S33. Funding for the Comprehensive Nursing Specialty
- Provided, That this section shall not apply to nursing
Program.
students who perform nursing functions under the direct
supervision of a qualified faculty: S34. Incentives and Benefits
- Provided, further, That in the practice of nursing in all Article VIII Penal and Miscellaneous Provisions S35. Prohibitions
settings, the nurse is duty-bound to observe the Code of
Ethics for nurses and uphold the standards of safe nursing - A fine of not less than (P50,000.00) nor more than
practice. The nurse is required to maintain competence by (P100,000.00) or imprisonment of not less than one (1)
continual learning through continuing professional year nor more than six (6) years, or both, upon the
education to be provided by the accredited professional discretion of the court, shall be imposed upon:
J.A.K.E 28 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

(a) any person practicing nursing in the Philippines within . Importation of prohibited drugs
the meaning of this Act: . Den or drive
1) without a certificate of registration/professional . Employees or visitors of dens
license and professional identification card or . Manufacture
special temporary permit .
. Use and possession
2) who uses as his/her own certificate of
. Culture of plants
registration/professional license and professional
4) RA 6425 – Dangerous Drug Act – Provision of S2- code
identification card or special temporary permit of for selected doctors who can prescribe narcotic drugs
another; or
5) RA 7877 – Anti-Sexual Harassment Law – Authority,
3) who uses an invalid certificate of
influence or moral ascendancy over another demands,
registration/professional license, a suspended or
requests or requires any sexual favors.
revoked certificate of registration/professional
. Work related
license, or an expired or cancelled
special/temporary permits; or . Education related
4 ) who gives any false evidence to the Board in order . Training related
6) RA 7610 – Anti Child Abuse
to obtain a certificate of
registration/professional license, a professional 7) RA 7658 – An Act Prohibiting the Employment of Children
identification card or special permit; or below 15 years of age
8) RA 9262 – Anti Violence Against Women and Their
5) who falsely poses or advertises as a registered and
Children
licensed nurse or uses any other means that tend to
9) RA 8172 – Salt Iodization Law
convey the impression that;
10) RA 3573 – An Act Providing for the Prevention
6) who appends B.S.N./R.N. (Bachelor of Science in
and Suppression of Dangerous Communicable Diseases
Nursing/Registered Nurse) or any similar appendage
11) RA 7432 – Senior Citizen Act
to his/her name without having been coferred said
degree or registration; or 12) RA 8423 – Established the traditional and alternative
health care
7) who, as a registered and licensed nurse, abets or
13) RA 8344 – An act penalizing the refusal of Hospitals and
assists the illegal practice of a person who is not
medical Clinics to administer appropriate initial
lawfully qualified to practice nursing.
treatment and support in emergency cases
(b) any person or the chief executive officer of a judicial
14) RA 7305 – Magna Carta of Public Health Workers
entity who undertakes in-service educational
programs or who conducts review classes for both . Has provisions on the benefits, rights and
local and foreign examination without responsibilities of public health workers
permit/clearance from the Board and the . Entitlement and protection:
Commission; or o Discrimination is prohibited
( c ) any person or employer of nurses who violate o Understaffing and overstaffing not allowed
the minimum base pay of nurses and the incentives o Due process observed
and benefits that should be accorded them as o Normal hours of work, overtime pay, night shift
specified in Sections 32 and 34; or different, salary scale
(d) any person or the chief executive officer of a juridical o Payment of salaries in legal tender
entity violating any provision of this Act and its rules o Hazard allowance
and regulations. o Right to self-organization
Article IX. Final Provisions 15) RA 8749 – Philippines Clean Air Act Of 1999
16) RA 6173 – Code of Conduct and Ethical Standards for
Other Laws Affecting Nursing Profession and the Nurse Public Officials and Employees
1) Republic Act – an act passed by the Congress of 17) RA 7160 – Local Government Code
the Philippines. 18) RA 2644 – Philippines Midwifery Act
2) RA 6675 – GENERIC DRUG ACT OF 1988 19) RA 2382 – Practice of Medicine by A Nurse
20) RA 7600 – Rooming in And Breastfeeding Act Of 2002
. Generic name – identification of drugs with
21) RA 7164 - Philippine Nursing Act of 1991
scientifically and internationally recognized active
ingredient. 22) RA 9173- Philippine Nursing Act of 2002
. Brand name – propriety name given by manufacturer 23) RA 1080 - Civil Service Eligibility for those who passed
board and bar exams
. Essential drug list – list of drugs prepared by DOH on
24) RA 2328 - Philippine Medical Act
the basis of health conditions in the Philippines as well
25) RA 1612 - Privilege Tax Law - professional tax payment
as internationally accepted criteria.
26) RA 5181 - Permanent residence and Reciprocity
3) RA 9165 – Comprehensive Dangerous Drug Act Of
27) RA 1082 - Rural Health Units all over the Philippines
2002 (repealing RA 6425)
28) RA 4073 - Liberalizes leprosy treatment
Prohibited acts:
29) RA 1054 - Free emergency medical treatments
. Sell, administer, deliver or distribution and transport of
to employees and laborers
prohibited drugs

J.A.K.E 29 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
30) RA 4226 - Hospital Licensure Act

J.A.K.E 29 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

31) RA 5901 - 40 hours/week for nurses in with 100-bed . Creation of Board of Nursing
capacity... . Professional Regulation Commission has the power to
32) RA 3573 - Reporting of Communicable Diseases recommend nominee members of the board to the
33) RA6111 - Medicare Act President of the Republic, June 22, 1973.
34) RA 6713 - Code of Conduct and Ethical Standards for 11) PD 143 - Woman and Child Labor Law (no child below
Public Officials/Employees 14 shall be employed)
35) RA 6758 - Salary Standardization Law 12) PD 69 - Four children for tax exemption
36) RA 7277 - Magna Carta of Disabled Persons 13) PD 541 - Practice of profession in the Philippines by
37) RA 7624 - Drug Education Law former professionals
38) RA 6972 - Day Care Center for every barangay 14) PD 48 - Four children for maternity privilege
39) RA 7170 - Organ Donation 15) PD 965 - Family Planning and Responsible Parenthood
40) RA 349 - Legalized use of human organs for scientific 16) PD 1 519 - Medicare Benefits for all
purposes government employees
41) RA 9505- Cheaper medicines Act 17) PD 1636 - Compulsory membership to SSS of self-
42) RA 877 (1953) – Philippine Nursing Law employed persons
43) RA 8991- PRC modernization Act of 2000
44) RA 9439 – Hospital Detention Law Executive Order – An order issued by the
45) RA 8187- granting 7 days paternity leave executive department in order to implement a
46) RA 8171- Prevention & Control of Diabetes Mellitus Act constitutional or a statutory provision.
47) Public Act 2808- The first True Nursing Law 1) EO 51 – Milk Code
2) EO 209 – Family Code
Presidential Decree – an order of the president in his 3) EO 203 – List of Regular Holidays and Special days
capacity to act as legislator. 4) EO 180 – Guidelines on the right to organize of
1) PD 603 – Child and Youth Welfare Code Government Employees
. Highlights the role of the nurse which include: 5) EO 857 - Compulsory Dollar Remittance Law
o Registration of births 6) EO - 174 - National Drug Policy (availability, affordability or
o Child’s health safe, effective, quality drugs)
o Freedom of expression
o Child’s inherent right to life
Board Resolutions
o Basic health service . No. 633 series of 1984 - ICN Code of Ethics
. It includes the rights and duties of parents over their . No. 1955 s. 1989 - PNA Code of Ethics
children. . No. 1930s. 1985-CPE for Nurses
o Parental authority . No. 187 s. 1991 - Renewal of Professional license
o Joint . No. 217s. 1992 - Delisting of delinquent professionals
o Grandparents Letters of Instructions
o Eldest brother or sister
. LOI 949 - Legal Basis of Primary Health Care
o Nearest next of kin
. LOI 100 - Preference given to members of
o Guardian appointed by the court
accredited professional organization for employment and
2) PD 651 – Requires immediate registration of birth within
seminars
30 days
3) PD 996 – Provided for compulsory basic immunization ORGANIZATIONAL COMMUNICATION
for infants and children below 8 years old
Models and Theories of Communication
4) PD 856 – Code of Sanitation
Transmission Model of Communication
5) PD 825 – Garbage Disposal Act - Describes communication as a linear, one-way process in
6) PD 418 – FAMILY CODE – Promote the concept of which a sender intentionally transmits a message to a
family responsible parenthood and family planning. receiver (Ellis & McClintock, 1990).
7) PD 626 – Employee Compensation and State Insurance - The communication encounter us viewed more as a target
Fund – Injury/ death that are work related are or end point rather than a part of an ongoing process.
compensable.
- In this model, the receiver either successfully receives and
8) PD 807 – CIVIL SERVICE LAW – Provides for understands the message or not. The sender is expected
recruitment and selection of employees in government to ensure the message is successfully conveyed.
service.
Interaction Model of Communication
9) PD 442 – Labor Code of The Philippines – Provides
- Describes communication as a process in which
for the rights, benefits and privileges of employees in
participants alternate positions as sender and receiver and
the private sector.
generate meaning by sending messages and receiving
. Vacation leave, sick leave, nsd- 10%, overtime pay, feedback within physical and psychological contexts
. Right of women workers (Schramm, 1997).
. Right to self- organization
10) PD 223 - Professional Regulation Commission (PRC)
J.A.K.E 30 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

- In this model, feedback which includes messages sent in the individuals with whom they interfere.
response to other messages, is included and makes
communication a more interactive, two-way process.
Transactional Model of Communication
- Describes communication as not an exchange of
messages, but also as a way to create relationships, form
intercultural alliances, shape our self-concepts, and
engage with others in dialogue to create communities.
- In this model, participants are not just senders and
receivers, but termed communicators and are
simultaneously senders and receivers.
Peplau’s Theory of Interpersonal Relations
- Hildegard Peplau defined nursing as an “interpersonal,
therapeutic process that takes place when professionals,
specifically educated to be nurses, engage in therapeutic
relationships with people who are in need of health
services.”
- She posited that nurse-patient relationships must pass
through three phases in order to be successful:
a) Orientation Phase – Starts with the definitions of
the problem. The nurse’s assessment of the
patient’s health and situation is vital in this phase.
The patient seeks assistance, tells the burse what he
or she needs, asks questions, and shares
preconceptions and expectations based on past
experiences.
b) Identification phase – Includes the selection of the
appropriate assistance by a professional. The patient
begins to feel as if he or she belongs, and feels capable
with dealing with the problem which decreases the
feeling of helplessness and hopelessness. The
development of a nursing care plan is performed in this
phase.
c) Exploitation Phase – Utilizes professional assistance
for problem-solving alternatives. When communicating
with the patient, the nurse should use the interview
techniques to explore, understand, and adequately deal
with the underlying problem. This phase is the
implementation of the nursing care plan.
d) Resolution Phase – This is the termination of the
professional relationship after the patient’s needs have
been met through the collaboration of patient and
nurse. This is the evaluation of the nursing process.

Barriers to Communication Among Health-Care

Providers and Health-Care Recipients
1 ) Low Health Literacy – individuals who lack the
skills necessary to acquire and use healthcare
information are less likely to manage their chronic
conditions and/or medication regimens effectively. For
this reason, they utilize healthcare facilities more
frequently and have higher mortality rates.
2) Cultural Diversity – Culture affects communication in
how the content is conveyed, emphasized, and understood
3) Cultural Competence – This affects the way\y healthcare
providers interact with each other and with the
populations they service. To practice, cultural
competence, healthcare professionals need to recognize
and relate how culture is reflected in each other and in

J.A.K.E 31 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
4 ) Interprofessional Communication Education of
Healthcare Providers – Challenges may also occur when
communicating with professionals in other disciplines and
may include use of concepts and terminology common to
once specific discipline but not well understood by
members of other professions. These may affect another
professional’s understanding of the meaning or value of
the situation.

Written Communication within the Organization

- Although many forms of communication take place in
organizations, written communication is the most used in
large organizations.
- The written communication issued by the manager reflects
greatly on both the manager and the organization.
Therefore, the manager must be able to write clearly and
professionally and to use understandable language. Many
types of written communication are used in organizations.
- Organizational policy, procedures, events and change may
be announced in writing. Job descriptions, performance
appraisal, and letters of reference are also forms of written
communication.
Memo Writing
- The written communication used most by managers in
their daily work life is the memo.
- Perkins and Brizee (2013) suggest that business memos
have a twofold purpose: They bring attention to problems
and they solve problems.
- Hence, it is essential to choose the recipient of a memo
prudently and to ensure that everyone intended to receive
it actually reads it. Typically, memos should be sent to only
a small to moderate number of people and must not be
used for highly sensitive messages.
- Business memos, according to Perkins and Brizee -(2013)
suggest that business memos should be composed of the
following components:
. Header (includes the to, from, date, and subject lines):
one eighth of the memo
. Opening, context, and task (includes the purpose of
the memo, the context and problem, and the specific
assignment or task): one fourth of the memo.
. Summary, discussion segment (the details that
support your ideas or plan): one half of the memo.
. Closing segment, necessary attachments (the action
that you want your reader to take and a notation about
what attachments are included): one eighth of the
memo.
- In addition, because writing is a learned skill that improves
with practice, Writing Help Central, suggests the following
in writing professional correspondence:
. Keep your message short and concise. Less than once
page is always preferred. Use bullets to highlight key
points.
. Use the first paragraph to express the context or
purpose of the memo and to introduce the problem. In
the next paragraphs, address what has been done or
needs to be done to address the problem at hand.

J.A.K.E 31 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

. Add a conclusion to summarize the memo, to clarify . Approval of the agenda – Should indicate if the
what the reader is expected to do, and to address any agenda was approved and distributed
attachments that are a part of the memo. . Approval of the previous minutes – Should indicate
. Focus on the recipient’s needs. Make sure that your of the previous minutes were approves and
communication addresses the recipient’s expectations distributed
and what he or she needs to know. . Business from previous meeting – Summary of the
. Use simple language so that the message is clear. business that was discussed in the previous
Keep paragraphs to less than three or four sentences. meeting
. Review the message and revise as needed. Always . New business – Summary of each agenda item
reread the written communication before sending it. discussed at the current meeting. This should
Look for areas that might be misunderstood. Pay include a description of the action, rational behind
attention to tone. the decision, and major arguments for or against the
. Use spelling and grammar checks to be sure that the action
communication looks professional. Remember that . Additions to the agenda – Any additional motions
your document is a direct reflection of you, and even that were not listed on the next meeting agenda
the most important message will likely be ignored if the . Agenda for the next meeting – Topics to be
communication is perceived as unprofessional. discussed at the next meeting
Meeting Minutes . Adjournment – Time the meeting ended and date
- Meeting minutes are notes or records, usually taken by the and time of the next meeting
secretary that contains the details of what transpired in a 4) Submission and approval. The meeting minutes must
meeting, the issues that were discussed, motions include the name of the person who made the minutes
proposed, and any votes taken. If a member did not attend and the name of the person who approved it. The
a corporate meeting, they can refer to the meeting notes chairperson usually reviews and approves the minutes
to find out any important information they have for circulation.
missed (contractscounsel.com). 5) Distribution of meeting minutes. It is usually the
- Purpose of Meeting Minutes: responsibility of the secretary to distribute the meeting
. Meeting minutes are used to capture important details minutes to the members.
in a meeting.
. Boards will often refer to meeting minutes to make Reports in Nursing
future decisions about how to move forward with - According to Venzon, reports are oral, taped or written
decisions or new projects. exchanges of information between nurses and/pr members
- Steps on How to Record Meeting Minutes: of the health team.
1) Plan and outline. The secretary or whoever will Change-of-Shift Reports
be recording the minutes should meet will the - This is a system of communication aimed at transferring
chairperson before the meeting begins to decide on essential information and holistic care for patients.
an agenda for the meeting to keep meeting minutes - Its purpose is to provide continuity of patient care for 24
organized and easy to record. hours. It may be given orally, by audio tape recording, or at
2) Record taking at the meeting. Take detailed notes for the bedside during nursing rounds.
each agenda item which include: - Oral reports are initially given at the nurses’ station or
o Decision made conference room with nurses from both shifts attending.
o Actions taken or agreed to be taken a) Oral Report – Prior to the nursing rounds, a
o Next steps moving forward pre- conference is made at the nurses’ station or
o Voting outcomes including who made the conference room. Essential information includes
motion and how each member voted the patient’s name, their medical diagnosis, nursing
o Any motions that were rejected diagnosis and related causes, diagnostic measures
o Items to be held over completed and those that still have to be done,
o New business observations about the patient’s family as these
o The date and time of the next meeting relate to his/her problems, effects of nursing and
- Ask for clarification if necessary to ensure that the medical measures, priorities which the incoming
notes are accurate. shift nurses must attend to, and instructions for
3) Writing the minutes. Using the detailed notes, the procedures that must be done. Any information that
recorder will then write the final draft of the meeting may alarm the patient and/or his/her family is
minutes. The recorder should do this as soon as reported out of hearing. The report is given in a low
possible. Many corporations use a standard template voice to prevent others from hearing. Change-of-
that includes the following information: shift reports should be done quickly and efficiently.
. Opening – Meeting title, location, time, and date b) Audio-tape Report – This is made by the
. Present members – Include full names and titles outgoing nurse and is relayed by the incoming
. Absent members – Include full names and titles nurse. The disadvantage of this report is that
immediate answers cannot be provided if any
J.A.K.E 32 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
problems arise unlike in oral

J.A.K.E 32 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

reports or those made during nursing rounds which can together with the transfer report.
permit immediate feedback when needed.
c) Nursing rounds – These are made at the
patient’s bedside. The patient’s care plan is
discussed. This enables the patient and his family to
participate in the discussion, pose questions or seek
clarifications. At the same time, the nurse can
perform an additional and needed assessment,
evaluate the patient’s progress and determine the
interventions that best meet his/her needs.
Telephone Reports
- There are occasions when nurses give telephone reports
update physicians about changes in the patient’s
conditions or to another nurse in another unit about a
transferred patient. Information given through telephone
should be accurately transcribed by the receiving nurse in
written form especially if this pertains to medications, or if
significant events or changes in a client’s condition have
occurred.
- There are legal risks in telephone orders. These may
be misunderstood or misinterpreted by the receiving
nurse. They may sound unclear because of some
trouble in the telephone line. Most importantly, the
signature of the ordering physician is not affixed in the
order and may be denied in case errors exist or when
court litigations arise.
- Nurses should only receive telephone orders only in
extreme emergency and when there is no other resident or
medical intern is available. The nurse should read back the
order to the physicians to make sure that the order
received is correct. The order must be signed by the
ordering physician once he/she returns to the hospital.
- The nurse should note the date and time when the order
was made , when he/she wrote the order, the name of the
physician making the order, then sign his/her own name,
including designation.
Transfer Reports
- Patients may be transferred from one unit to another as
their condition or case warrants it, in such case of a
patient from the medical ward diagnosed to have
bleeding peptic ulcer. The patient may be transferred
to the surgical department for further management
after proper referral and assessment of a surgeon. A
patient may also be transferred to another agency
after proper referral and coordination. The receiving
unit is usually advised beforehand about the
transfer so that the unit or bed including special
equipment if needed will be arranged.
- The transfer report accompanies the patient and contains
information that the receiving nurse needs to know for
continuity of care. This includes a summary of the medical
progress up to the time of transfer and is usually made by
a physician, current health status, current nursing
diagnosis or health problems and care plan, or critical
assessments or interventions to be completed after
transfer and the special equipment necessary. An oral
report is usually made by the accompanying nurse
so that additional information can be made or clarified.
The patient’s chart also accompanies the patient

J.A.K.E 33 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023
- A post-operative patient transferred back to his original
unit after surgery will need a transfer report from the
Recovery Room if he stayed there. The transfer report will
show a progression of reports from the Operating Room to
the Recovery Room until the time of transfer. It will include
the kind of surgery the patient underwent, the kind of
anesthesia used, the medications received by the patient
both in the Operating and Recovery Rooms, his or her
general condition while in these units, condition on transfer,
continuing medications, and treatment, and assessments
to be done.
- When a patient is to be transferred to another agency,
proper coordination must first be made to ensure that the
agency has the proper services and facilities needed by the
patient. A transfer report accompanies the patient. The
patient’s medical record or chart is left at the original
agency.
Preparation and Conduct of Meetings Pre-meeting Work

1) Determine the specific purpose(s) for the meeting (What do

you want to accomplish in the meeting?).
2) Create a list of meeting topics, such as “revisions to
nursing handbook” or “new admission policy.” Create a
fact sheet related to each topic to distribute with the
agenda.
3) Determine the meeting attendees. They are individuals,
groups, or department representatives with valuable
insight or who are affected by decisions made during the
meeting.
4) Determine the date, time, and location for the meeting, and
invite attendees. To maximize meeting attendance, ask
attendees what date and time would work with their
schedules.
5) Create the meeting agenda. It should contain the following
components:
6) Title of the group meeting
7) Date, time, and location of the meeting
8) Purpose(s) for the meeting in sentence form
9) Agenda items, time allotted for each item, and person
responsible for reporting on each item.
10)Send the meeting agenda out at least 1 week before the
meeting so that attendees come prepared. Send a meeting
reminder 2 days before the meeting.
During the Meeting
1) Ensure that the participants’ comfort needs are met by
arranging the seating in an oval or circular shape and
preferably around a table.
2) Ask for volunteers to fulfill the following roles.
- Leader
- Timekeeper
- Recorder
3) The leader guides the meeting by:
- Processing one agenda at a time.
- Allowing the timekeeper to do his or her job to keep the
meeting on track.
- Debriefing the end of the meeting by asking these
questions: “What went well with the meeting?” and
“What can we improve upon for the next meeting?”

J.A.K.E 33 of 34
 NURSING LDSHP AND MGMT LEC & RLE: BSN 4TH YEAR 1ST SEMESTER PRELIM 2023

These questions should be used at the end of each

meeting to improve subsequent meetings.

Patient Satisfaction and Customer Service Provider

- Recently, patient satisfaction has moved to be on the list
of the nurse’s primary agenda. Nurses are confronted to
meet a comprehensive range of patient needs, from how
quickly call lights are answered to the extent of family
support provided. At this time, home health agencies,
hospitals, ambulatory clinics, and even hospice
agencies compete for patients. To be in this competitive
environment, nurses are expected to keep patient
satisfaction and customer service, which includes
safety and quality care, as the leading motivator of all
plans and activities (Cherry & Jacobs, 2014).
- Customers can be categorized as external and internal,
depending on their relationship to the organization.
. External customers are not employed by the
organization and include patients and families, in
addition to physicians and others who serve as referral
sources for new patients. Payers (insurance companies,
managed care plans) are also being considered as
primary external customers.
. Internal customers are employed by the organization
and may include patient care staff members, staff
members of other departments (laboratory, dietary),
administrators, social workers, dietitians, and
therapists. For example, nurses should view staff
members as “customers” and determine how to meet
their needs to facilitate effective and efficient work
performance. The needs of internal customers who
help manage an effective nursing unit such as
housekeeping, maintenance, laboratory, and social
services should be considered.

GOOD LUCK FUTURE RNs! LETZGOOO RAWR

J.A.K.E 34 of 34