Download - Laws Governing the Practice of Nursing
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LAWS are the sum of total rules &
regulations by which society is governed.
It is man-made & regulates socialconduct in a formal & binding way
1. The authoritythat the rule
exists
2. Expressed inwriting & source
is identified
Reflects
societys needs,attitudes &morals
3. The right toenforce thesame must be
provided
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The
controllingauthority inour system
TheGovernment
The
fundamentallaw of thegovernment
TheConstitution
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Contains principles on which the governmentis founded
Regulates the division of sovereign powers Directs to what persons each of these powers
are entrusted Specifies manner by which these powers shall
be exercised
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Regulationsissued by the
Executive
Branch of theGovernment
Casedecisions or
judicialopinions
TheConstitution
Letters ofInstruction
PresidentialDecrees
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PresidentialProclamation # 539
Last week of
October of everyyear beginning in1958, as NURSESWEEK
PURPOSE: To
developconsciousness &availability ofnursing resourcesin the Philippines
LOI no. 1000
Members of APO
shall be givenpriority in thehiring ofemployees in thegovernment
service & inengagement ofprofessionalservices
RA 1612
Nurses working in
governmentservice wereexempted frompaying theprivilege tax
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RA 1080
Those who passed the BAR &BOARD exams are declared tobe civil service eligibles
A copy of the board rating &professional license may bepresented to the govtagency that u are applying formay be presented
RA 2644
MIDWIFERY LAW
Only RMs can practicemidwifery
Nurses must pass the BoardExam for Midwives
Requirement:
At least 20 deliveries withthe form signed byMunicipal, Provincial & CityHealth Officer
RA 2382
PHILIPPINE MEDICAL ACT
A person shall be consideredas engaged in the practice ofmedicine who shall forcompensation, fee, salary,reward in any form paid tohim directly or thru another oreven w/o the same maypersonally examine anyperson and diagnose, treat,operate, operate or prescribeany remedy for any human
disease, injury, deformity,physical, mental, physicalcondition or ailment, real orimaginary, regardless ofnature of the remedy ortreatment administered,prescribed or recommended
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PD 541
Formal Filipinoprofessionals/
Balikbayans maypractice theirrespective professionsin the Philippinesduring their stay in thecountry provided thatthey register with the
PRC & pay their incometax on all earningswhile in the country
RA 6425
DANGEROUS DRUGSACT
Sale, administration,delivery, distribution& transportation ofprohibited drugs arePUNISHABLE by law.
Penalty: 12 yrs & 1day to 20 yrsimprisonment or Php12K to 20K: if u sell,admin, give,distribute, disptach intransit/ transport
RA 6425
DANGEROUS DRUGSACT
If victim is a minor:MAXIMUM PENALTY isimposed.
POSSESSION: 6yrs & 1day to 12 years inprison plus a fine 6K to20K
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RA 4073
No person afflictedw/leprosy shall beconfined in aleprosarium exceptwhen diseaserequries institutionaltx. Tx shall betreated in a gov. skinclinic/ RHU
PD 996
CompulsoryImmunization forchildren below 8 y/oagainstcommunicablediseases
Circular # 14 (1965)requires health exam
& immunization ofall prospective Gr 1pupils againstsmallpox, diphteria& tb (pre-requisitefor enrolment)
PD 825
(+) Penalty forimproper disposal ofgarbage
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PD 856
Code ofSanitation: (+)control of allfactors in mansenvironment thataffect health(water, food, milk,
pest control,transmitters ofdisease, sanitary& recreation offacilities
RA 679
Woman & ChildLabor Law
Employable age16 y/o
PD 48
Limits paidmaternity leaveprivileges to 4children only
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RA 4226
Hospital Licensure Act
All hospitals must eb
licensed before theycan offer to serve in acommunity
Licensing agency isOffice for Hospital &Medical Services,
DOH
PD 442
Labor Code of thePhilippines
Workers have a rightto self-organization(UNIONS) & collectivebargaining
Promotes the rights &welfare of co-workers
PD 603
Child and YouthWelfare Code
Promotes the rights &welfare of children &youth
Employment ofchildren below 16 y/ois limited to
performing light workNOT harmful to theirsafety, health, ornormal development& not prejudicial totheir studies
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RA 7600
Rooming in &Breastfeeding Act
Babies born inprivate &governmenthospitals should beroomed in w/ theirmothers to promotebreastfeeding &ensure safe &adequate nutritionto children
RA 9257 SeniorCitizens Act
Elderly=20%discount in all public
establishments suchas restaurants,pharmacies, publicutility vehicles &hospitals; 5% ongrocery items
Entitled to freemedical & dentalcheck-up &hospitalization in allgovt hospitals
RA 9262
Violence againstwomen &children
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PRC Resolution2004-17 s. 2004
Professionals w/
Bachelors degreemust earn 60 CPEcredit units
Excess unitcannot be carried
over to the next 3yr period exceptfor units earnedfor PhD &Masters degree
PRC Resolution2004-200 s. 2004
For PNLE,
ORIGINAL TORwith scannedphoto & a remarkstating FORBOARD
EXAMINATIONPURPOSESONLY
PRC Resolution2004-189 s. 2004
If examinee failedto report & takethe scheduledexam, exam feesare forfeited
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Executive Order 566(Sept 2006)
Review Centers
must be regulatedby CHED
CHED MemorandumOrder 49 s. 2006
Implementing
rules & regulationspromulgated byCHED
CHED Memorandum13
Higher education
institutions areprohibited fromFORCING theirstudents &graduatingstudents to enrol intheir own reviewcenters &/or reviewcenters of theirown preference
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Higher Education Institutions must not:
1. Force their graduates & graduating students to
enrol in their own review centers or in reviewcenters of their preference
2. Charge exorbitant review fees
3. Withhold grades & other school records of
students & graduates who cannot enrol in thesereview centers
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Malpractice & Negligence
Contracts, Wills & Testaments
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If a defendants actions fail to meet thestandard= (+) negligence
at fault the nurses action is contrary towhat should have been done to the patient.
negligent when there is failure in observing
the necessary protection of interests &wellness of the patient the degree of care,precaution & vigilance which circumstancesdemand, whereby such patient suffers an injuryor even death.
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1. Existence of a duty on the part of the personcharged to use due care under circumstances
2. Failure to meet the standard of due care3. Foreseeability of harm resulting from failure
to meet the standard4. The fact that the breach of this standard
resulted in an injury to the plaintiff
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Burns resulting from hot water bags, heatlamps, vaporizers, sitz bath
Objects left inside the patients body such assponges, suction tips, loose dentures lodgedin patients trachea
Falls of elderly, confused, unconsciouspatients or children
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Improper or unskillful care of a patient by anurse; negligent act committed in the course
of professional performance Carelessness of professional personnel
IF INVOLVED IN A MALPRACTICE SUIT, EITHER AS A
DEFENDANT OR WITNESS, CONSULT A LAWYER.
DO NOT ACCEPT AN INVITATION BY AN ADVERSE PARTY TO
INFORMALLY DISCUSS A CASE
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Clarify cause & preventive actionsUsed for medico-legal purposes
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Failure to report observations to attending physicians
Failure to exercise the degree of diligence w/c the circumstances of the particular casedemands
Mistaken identity
Wrong =medicine, concentration, route, dose
Defects in equipment such as stretchers & wheelchairs leading to falls & injuries
Errors due to family assistance
Administration of medicine w/o MD Rx
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the thing speaks for itselfThe injury could not have happened ifsomeone was not negligent that no
further proof is required.
3 CONDITIONS ARE REQUIRED TOESTABLISH DEFENDANTs
NEGLIGENCE W/O PROVING SPECIFICCONDUCT:
1. Injury was of such nature that it
would not normally occur unlessthere was negligence on the part ofsomeone
2. Injury was caused by an agency w/incontrol of the defendant
3. Plaintiff himself did not engage in
any manner that would tend to bringabout the injury
Ex. A patient came in walking to theOPD for injection. Upon injection tohis buttocks,, pt experience extremepain, leg felt weak& wa subsequently
paralyzed. Sciatic nerve was injured.
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Examples of circumstances: Floods
Fire
Earthquakes
Accidents
unforeseen or irresistibleforce
No person shall beresponsible for events which
cannot be foreseen orwhich, though foreseen, are
inevitable.
Nurses who fail to renderservice during these
circumstances are not heldnegligent.
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NOTE: PrivateDuty Nurses are
consideredindependentcontractors.They are liablefor their ownnegligentactions.
Let the master answer foracts of the subordinate
This doctrine applies only tothose actions performed by
the employee within thescope of his employment.
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LIABILITY FOR THE WORK OF
NURSING STUDENTS
Although nursing studentsare not employees of the
hospital , they are entrustedwith the responsibility of
providing supervised nursingcare to patients.
Both CI & staff nurse in the
clinical area where SN are
assigned should coordinatein assessing competence of
nursing students
Nursing Aids areresponsible for their ownactions HOWEVER, if a
nurse delegates her
functions to a nursing aide& the latter commits amistake, then she is
responsible & accountable
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When nurses know & attain that standard ofcare in giving service
Care provided is documented in a concise &
accurate manner Assumption of risk: If nurse has expressly
given advanced consent in performing a duty(e.g. caring for a psych pt or pt w/
communicable disease), nurse cannot bring suitagainst the patient if she gets hurt or contractsthe disease
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RA 6675 states that only validly registeredmedical, dental & veterinary practitioners,
whether in private institution/ corporation or ingovernment, are authorized to prescribe drugs.
RA 2832 states that prescriptions made byunauthorized persons constitute illegal practice
of medicine, dentistry & vet medicine.
Only when the treatment & medication order ofthe MD have been written and signed does the
nurse have the legal right to follow them.
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Nurse Lorenza Somera was condemned in
May 1929 in Manila to 1 year imprisonment inconnection with death of a young girl in theOR. She was accused of HOMICIDE thrureckless imprudence.
The case was published in the InternationalNursing Review in 1930
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Days before May 26, 1929, Pedro Clemente took his daughter, Anastacia
to Dr. Favis in Manila. Dr. Favis decided to perform a tonsillectomy &
instructed the father & daughter to go to St. Pauls Hospital where he
would perform the operation at 7am, May 26, 1929
Assisting Lorenza Somera, a head nurse, were student nurses ValentinaAndaya & Consolacion Montinola. Assistant Surgeon Dr. Bartolome.
During the operation, Dr. Favis asked Dr. Bartolome for novocaine
solution.Ms. Montinola handed Dr. Bartolomea syringe solution which
was handed to Dr. Favis who injected the same to the patient. After a
few minutes, Dr. Bartolome noticed that pt was becoming pale & actingas if dying. He called Dr. Favis, 3rd syringe of solution was injected & few
minutes later, pt convulsed. Adrenalin was injected twice but the
patient died in a few minutes.
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Dr. Favis asked if novocaine was fresh. MISS SOMERAREPLIED THAT SOLUTION WAS NOT NOVOCAINE BUT 10%COCAINE.
In court, Ms. Montinola testified that she heard Dr. Favisorder cocaine with adrenalin for injection & heard Ms.Somera verify the order.
Autopsy report showed that pt was suffering from statuslymphaticus & such patients were known to die even with a
slight injury like a needle prick.
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Facts not brought to the trial:
1. Ms. Somera finished her training only on May 29,
1929
2. She has NOT received her registration certificate& was not an experienced graduate as stated inthe prosecution
3. Dr. Favis had performed tonsillectomy once
previously in St. Pauls Hospital. During that time,
Ms. Somera was not on duty at the OR & no order
was given by Dr. Favis before his arrival
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The 2 accused MDs were ABSOLVED of crimeBUT Ms. Somera was condemned to suffer 1
year & 1 day imprisonment & to indemnifyheirs of Anastacia Clemente the sum ofP1,ooo
2 Justices of the Supreme Court reviewed thecase ; PNA petitioned for executive clemencywhich Board of Pardons unanimouslyrecommended
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Had Ms. Somera asked Dr, did u ask for cocaine or
novocaine?
Since cocaine was administered topically & locally
NOT via injection A nurse must see to it that she understands the
action of the drug, its minimum & maximum
dosages, route, untoward effects.
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Consent: a free & rational act thatpresupposes knowledge of the thing to w/c
consent is being given by a person who islegally capable to grant such. Before any medical/surgical procedure is to
be given; consent must be obtained from
patient Only in cases of emergency = consent
requirement does not apply
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Every human being ofadult years & sound
mind has the right todetermine what shall
be done with his ownbody.
Essential Elements of
INFORMED CONSENT
Diagnosis & explanation of condition
Fair explanation of procedures to bedone & used, consequences
Description of alternative treatments
Description of benefits to be expected
Material rights, if any Prognosis, if recommended
care/procedure is refused
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Written consent should be SIGNED to showthat procedure is the one consented to & that
person understands :1. Possible consequences2. Risks involved3. Nature of procedure Signed special consent is necessary before
any medical or surgical treatment e.g. X-rays, BT, chemotx, CT scan, MRI
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Patient Proxy consent is given if pt is incompetent:
MINOR Unconscious MENTALLY ill
PHYSICALLY unable and not anemergency case
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Parents; legal guardian IF minor is married, parental consent is not
needed
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Consent must be taken from parent or legalguardian
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Because inaction may cause greater injury,consent is not necessary
GET CONSENT: If time is available &informed consent is possible Ex. A mother who is in advanced stage of
labor who goes to the emergency room gives
an implied consent to an immediatetreatment or attendance
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If pt is mentally & legally competent (of sanemind & legal age)
If after explanation, pt still refuses to sign, he
should fill out release form to protect hospital &its personnel from any liability that may resultfrom refusal
If pt refuses to sign release form, this must be
noted in the chart REMEMBER: THE COMPETENT PERSON HAS
THE & ETHICAL RIGHT TO REFUSE TREATMENT