laws governing the practice of nursing

7/31/2019 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


For PNLE,

ORIGINAL TORwith scannedphoto & a remarkstating FORBOARD

EXAMINATIONPURPOSESONLY


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

laws governing the practice of nursing

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