JAVIER, DARRYL O.

BSN 307 NCM 107

AMENDED CODE OF ETHICS FOR NURSES

Section 3 Republic Act No. 877 known as the Philippine Nursing Law and Section 6 of P.D No. 223 the amended Code of Ethics of Nurses Article I Preamble- health is a fundamental right of every individual Article II Values, customs and spiritual beliefs held by individual shall be represented Consider the individuality and totality of patients when they administer care Article III Human life is inviolable Quality and excellence in the care of patients are the goals of the nursing practice Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing accountability Article IV The registered nurse is in solidarity with other members of the healthcare team in working for the patients best interest Article V Preservation of life, respect for human rights and promotion of healthy environment Promotion in local, national, and international efforts to meet health and social needs of the people Article VI Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal Article VII The certification of registration of the registered nurse shall either be revoked or suspended for violation of any provisions of this code. DEFINITION AND MEANING OF LAW The sum total of rules and regulations by which society is governed Man mad regulates social conduct in a formal and binding way Rule of conduct pronounced by controlling authority and which may be enforced Authority or right to declare that the rule exists Rule is pronounced or expressed Source can be defined A right to enforce the same must be provided Controlling authority in our system is the government Laws and Legislation define the scope of acceptable practice and protect individual rights. Fundaments law of the government

 A system of fundamental laws or principles that governs a nation, society, corporation or another aggregate of individuals Its primary purpose is to establish the basis of a governing system for the future and the present The government establishes the general organization of the federal government which grants and limits its specific powers Principal sources of pronouncements Constitution System of fundamental laws or principles Supreme law of a country Creates legal rights and responsibilities and a foundation of a system of justice Statutes or legislations Enacted by any legislative body The regulation of nursing is a function of state law Laws that governs Must be voted on and passed Executive branch/ Administrative agencies Create rules and regulations that enforce statutory laws Ex. Board of nursing Case decision/judicial opinions Laws evolving from court decision Interpreting and applying the constitutional or statutory law Legal issues that are in dispute Presidential decrees Letters of instructions Types of Laws and Courts Most nurses worry primarily about being sued for malpractice, they may be involved in 3 different types of court cases: Public Law Criminal Law o Defines crimes, treats of nature and provides for their punishment o HISTORICAL FOUNDATION OF NURSING/EVOLUTION OF NURSING 1. INTUITIVE NURSING This untaught nursing was instinctive Dated from pre-historic times Practice among primitive tribes and lasted through Christian era. Performed out of feeling of compassion to others Out of wish to do good HELPING 2. APPRENTICE NURSING Extend from the founding of religious orders in the 6 th Century through the crusades which began in the 11th Century to 1836 The Deacons School of Nursing at Kaiserswerth, Germany established by Pastor Fliedner and his wife. Period of on the job training desired of person to be trained

3. EDUCATED NURSING Began in 1860 Florence Nightingale School of Nursing opened at St. Thomas in London. First program of formal education for nurses started 4. C ONTEMPORARY NURSING Began at the end of World War II (1945) Scientific and technological developments of many social changes occurs INTUITIVE NURSING Cause of illness was believed to be the invasion of the victims body by an evil spirit. Uses black magic or voodoo to harm or driven out by using supernatural powers. Believed in medicine man (shaman or witch doctor) that had power to heal by using white magic. They made use of hypnosis, charms, dances, incantations, purgatives, massage, fire, water, herbs or other vegetations and even animals. Performing a trephine Drilling a hole in the skull with a rock or stone without benefit of anesthesia Goal of this therapy is to drive the evil spirit from the victims body. Nurses role was instinctive directive toward comforting, practicing midwifery and being wet nurse to a child. Acts performed without training and Direction. APPRENTICE NURSING Religious orders of Christian Church played a major role in this kind of nursing. Care was done by crusaders, prisoners, religious orders Nursing care was performed without any formal education and by people who were directed by more experienced nurses (on the job training). This kind of nursing was developed by religious orders of the Christian Church. Nursing went down to the lowest level a. Wrath/anger of Protestantism confiscated properties of hospitals and schools connected with Roman Catholicism. b. Nurses fled their lives; soon there was shortage of people to care for the sick c. Hundreds of Hospitals closed, there was no provision for the sick, no one to care for the sick d. -Nursing became the work of the least desirable of women prostitutes, alcoholics, prisoners Pastor Theodore Fliedner and his wife, frederika established the Kaiserswerth Institute for the training of Deaconesses (the 1 st formal training school for nurses) in Germany. a) This was where Florence Nightingale received her 3-month course of stude in nursing. PERIOD OF EDUCATED NURSING

The development of nursing during this period was strongly influenced by: a.) trends resulting from wars Crimean, civil war b.) arousal of social consciousness c.) increased educational opportunities offered to women. Florence Nightingale was asked by Sir Sidney Herbert of the British War Department to recruit female nurses to provide care for the sick and injured in the Crimean War. In 1860, The Nightingale Training School of Nurses opened at St. Thomas Hospital in London. a) The school served as a model for other training schools. Its graduates traveled to other countries to manage hospitals and institute nursetraining programs. b) Nightingale focus vision of nursing Nightingale system was more on developing the profession within hospitals. Nurses should be taught in hospitals associated with medical schools and that the curriculum should include both theory and practice. c) It was the 1st school of nursing that provided both theory-based knowledge and clinical skill building. Nursing evolved as an art and science Formal nursing education and nursing service begun.

IV. P ERIOD OF CONTEMPORARY NURSING/20 TH C ENTURY Licensure of nurses started Specialization of Hospital and diagnosis Training of Nurses in diploma program Development of baccalaureate and advance degree programs Scientific and technological development as well as social changes mark this period. a. Health is perceived as a fundamental human right b. Nursing involvement in community health c. Techological advances disposable supplies and equipments d. Expanded roles of nurses was developed e. WHO was established by the United Nations f. Aerospace Nursing was developed g. Use of atomic energies for medical diagnosis, treatment h. Computers were utilized-data collection, teaching, diagnosis, inventory, payrolls, record keeping, billing. i. Use of sophisticated equipment for diagnosis and therapy. REPUBLIC ACT NO. 7305 THE MAGNA CARTA OF PUBLIC HEALTH WORKERS. SECTION 1. Title. - This Act shall be known as the "Magna Carta of Public Health Workers."chan robles virtual law library SEC. 2. Declaration of the Policy. - The State shall instill health consciousness among our people to effectively carry out the health programs and projects to the government essential for the growth and health of the nation. Towards this end, this Act aims: to promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment;

to develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and to encourage those with proper qualifications and excellent abilities to join and remain in government service. SEC. 3. Definition. - For purposes of this Act, "health workers" shall mean all persons who are engaged in health and health-related work, and all persons employed in all hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics and other health-related establishments owned and operated by the Government or its political subdivisions with original charters and shall include medical, allied health professional, administrative and support personnel employed regardless of their employment status. SEC. 4. Recruitment and Qualification. - Recruitment policy and minimum requirements with respect to the selection and appointment of a public worker shall be developed and implemented by the appropriate government agencies concerned in accordance with policies and standards of the Civil Service Commission: Provided, That in the absence of appropriate eligibles and it becomes necessary in the public interest to fill a vacancy, a temporary appointment shall be issued to the person who meets all the requirements for the position to which he/she is being appointed except the appropriate civil service eligibility: Provided, further, That such temporary appointment shall not exceed twelve (12) months nor be less than three (3) months renewal thereafter but that the appointee may be replaced sooner if (a) qualified civil service eligible becomes available, or (b) the appointee is found wanting in performance or conduct befitting a government [Link] robles virtual law library SEC. 5. Performance Evaluation an Merit Promotion. - The Secretary of Health, upon consultation with the proper government agency concerned and the Management-Health Workers Consultative Councils, as established under Section 33 of this Act, shall prepare a uniform career and personnel development plan applicable to all public health personnel. Such career and personnel development plan shall include provisions on merit promotion, performance evaluation, inservice training grants, job rotation, suggestions and incentive award system. The performance evaluation plan shall consider foremost the improvement of individual employee efficiency and organizational effectiveness: Provided, That each employee shall be informed regularly by his/her supervisor of his/her performance evaluation. The merit promotion plan shall be in consonance with the rules of the Civil Service Commission. SEC. 6. Transfer or Geographical Reassignment of Public health Workers. a transfer is a movement from one position to another which is of equivalent rank, level or salary without break in service; a geographical reassignment, hereinafter referred to as "reassignment," is a movement from one geographical location to another; and a public health worker shall not be transferred and or reassigned, except when made in the interest of public service, in which case, the employee concerned shall be informed of the reasons therefore in writing. If the public health worker believes that there is no justification for the transfer and/or reassignment, he/she may appeal his/her case to the Civil Service Commission, which shall cause his/her reassignment to be held in abeyance; Provided, That no transfer and/or reassignment whatsoever shall be made three (3) months before any local or national elections: Provided,

further, That the necessary expenses of the transfer and/or reassignment of the public health worker and his/her immediate family shall be paid for the [Link] robles virtual law library. SEC. 7. Married Public Health Workers. - Whenever possible, the proper authorities shall take steps to enable married couples, both of whom are public health workers, to be employed or assigned in the same municipality, but not in the same office. SEC. 8. Security of Tenure. - In case of regular employment of public health workers, their services shall not be terminated except for cause provided by law and after due process: Provided, That if a public health workers is found by the Civil Service Commission to be unjustly dismissed from work, he/she shall be entitled to reinstatement without loss of seniority rights and to his/her back wages with twelve percent (12%) interest computed from the time his/her compensation was withheld from his/her up to time of reinstatement. SEC. 9. Discrimination Prohibited. - A public worker shall not be discriminated against with regard to gender, civil status, civil status, creed, religious or political beliefs and ethnic groupings in the exercise of his/her profession. SEC. 10. No Understaffing/Overloading of Health Staff. - There shall be no understaffing or overloading of public health workers. The ratio of health staff to patient load shall be such as to reasonably effect a sustained delivery of quality health care at all times without overworking the public health worker and over extending his/her duty and service. Health students and apprentices shall be allowed only for purposes of training and education. In line with the above policy, substitute officers or employees shall be provided in place of officers or employees who are on leave for over three (3) months. Likewise, the Secretary of Health or the proper government official shall assign a medico-legal officer in every province. In places where there is no such medico-legal officer, rural physicians who are required to render medico-legal services shall be entitled to additional honorarium and allowances. SEC. 11. Administration Charges. - Administrative charges against a public health worker shall be heard by a committee composed of the provincial health officer of the province where the public health worker belongs, as chairperson, a representative of any existing national or provincial public health workers organization or in its absence its local counterfeit and a supervisor of the district, the last two (2) to be designated by the provincial health officer mentioned above. The committee shall submit its findings and recommendations to the Secretary of Health within thirty (30) days from the termination of the hearings. Where the provincial health officer is an interested party, all the members of the committee shall be appointed by the Secretary of Health. SEC. 12. Safeguards in Disciplinary Procedures - In every disciplinary proceeding, the public health worker shall have; the right to be informed, in writing, of the charges; the right to full access to the evidence in the case; the right to defend himself/herself and to be defended by a representative of his/her choice and/or by his/her organization, adequate time being given to the public health worker for the preparation of his/her defense; the right to confront witnesses presented against him/her and summon witnesses in his/her behalf;chan robles virtual law library the right to appeal to designated authorities;

the right to reimbursement of reasonable expenses incurred in his/her defense in case of exoneration or dismissal of the charges; and such other rights as will ensure fairness and impartiality during proceedings. SEC. 13. Duties and Obligations. - The public health workers shall: discharge his/her duty humanely wit conscience and dignity; perform his/her duty with utmost respect for life; and race, gender, religion, nationality, party policies, social standing or capacity to pay. SEC. 14. Code of Conduct. - Within six (6) months from the approval of this Act, the Secretary of Health, upon consultation with other appropriate agencies, professional and health workers organization, shall formulate and prepare a Code of Conduct for Public Health Workers, which shall be disseminated as widely as possible. SEC. 15. Normal Hours of Work. - The normal of wok of any public health worker shall not exceed eight (8) hours a day or forty (40) hours a week. Hours worked shall include: all the time during which a public health worker is required to be on active duty or to be at a prescribed workplace; and all the time during which a public health worker is suffered or permitted to work. Provided, That the time when the public health worker is place on "On Call" status shall not be considered as hours worked but shall entitled the public health worker to an "On Call" pay equivalent to fifty percent (50%) of his/her regular wage. "On Call" status refers to a condition when public health workers are called upon to respond to urgent or immediate need for health/medical assistance or relief work during emergencies such that he/she cannot devote the time for his/her own use. SEC. 16. Overtime Work. - Where the exigencies of the service so require, any public health worker may be required t render, service beyond the normal eight (8) hours a day. In such a case, the workers shall be paid an additional compensation in accordance with existing laws and prevailing practices. SEC. 17. Work During Rest Day. Where a public health worker is made to work on his/her schedule rest day, he/she shall be paid an additional compensation in accordance with existing laws; and Where a public health worker is made to worm on any special holiday he/she shall be paid an additional compensation in accordance with existing laws. Where such holiday work falls on the workers scheduled rest day, he/she shall be entitled to an additional compensation as may be provided by existing laws. SEC. 18. Night-Shift Differential. Every public health worker shall be paid night-shift differential of ten percent (10%) of his/her regular wage for each hour of work performed during the night-shifts customarily adopted by hospitals. Every health worker required to work on the period covered after his/her regular schedule shall be entitled to his/her regular wage plus the regular overtime rate and an additional amount of ten percent (10%) of such overtime rate for each hour of work performed between ten (10) oclock in the evening to six (6) oclock in the morning.

SEC. 19. Salaries. - In the determination of the salary scale of public health workers, the provisions of Republic Act No. 6758 shall govern, except that the benchmark for Rural Health Physicians shall be upgraded to Grade 24. Salary Scale - Salary Scales of public health workers shall be provided progression: Provided, That the progression from the minimum to maximum of the salary scale shall not extend over a period of ten (10) years: Provided, further, That the efficiency rating of the public health worker concerned is at least satisfactory. Equality in Salary Scale - The salary scales of public health workers whose salaries are appropriated by a city, municipality, district, or provincial government shall not be less than those provided for public health workers of the National Government: Provided, That the National Government shall subsidize the amount necessary to pay the difference between that received by nationally-paid and locally-paid health workers of equivalent positions. Salaries to be Paid in Legal Tender. - Salaries of public health workers shall be paid in legal tender of the Philippines or the equivalent in checks or treasury warrants: Provided, however, That such checks or treasury warrants shall be convertible to cash in any national, provincial, city or municipal treasurers office or any banking institution operating under the laws of the Republic of the [Link] robles virtual law library Deductions Prohibited - No person shall make any deduction whatsoever from the salaries or public health workers except under specific provision of law authorizing such deductions: Provided, however, That upon written authority executed by the public health worker concerned, (a) lawful dues or fees owing to any organization/association where such public health worker is an officer or member, and (b) premium properly due all insurance policies, retirement and medicare shall be considered deductible. SEC. 20. Additional Compensation. - Notwithstanding Section 12 of Republic Act No. 6758, public workers shall received the following allowances: hazard allowance, subsistence allowance, longevity pay, laundry allowance and remote assignment allowance. SEC. 21. Hazard Allowance. - Public health worker in hospitals, sanitaria, rural health units, main centers, health infirmaries, barangay health stations, clinics and other health-related establishments located in difficult areas, strife-torn or embattled areas, distresses or isolated stations, prisons camps, mental hospitals, radiation-exposed clinics, laboratories or disease-infested areas or in areas declared under state of calamity or emergency for the duration thereof which expose them to great danger, contagion, radiation, volcanic activity/eruption occupational risks or perils to life as determined by the Secretary of Health or the Head of the unit with the approval of the Secretary of Health, shall be compensated hazard allowance equivalent to at least twenty-five percent (25%) of the monthly basic salary of health workers receiving salary grade 19 and below, and five percent (5%) for health workers with salary grade 20 and above. SEC. 22. Subsistence Allowance. - Public health workers who are required to render service within the premises of hospitals, sanitaria, health infirmaries, main health centers, rural health units and barangay health stations, or clinics, and other health-related establishments in order to make their services available at any and all times, shall be entitled to full subsistence allowance of three (3) meals which may be computed in accordance with prevailing circumstances as determined by the Secretary of Health in consultation with the Management Health Workers

Consultative Councils, as established under Section 33 of this Act: Provided, That representation and travel allowance shall be given to rural health physicians as enjoyed by municipal agriculturists, municipal planning and development officers and budget officers. SEC. 23 Longevity Pay. - A monthly longevity pay equivalent to five percent (5%) of the monthly basic pay shall be paid to a health worker for every five (5) years of continuous, efficient and meritorious services rendered as certified by the chief of office concerned commencing with the service after the approval of this Act. SEC. 24. Laundry Allowance. - All public health workers who are required to wear uniforms regularly shall be entitled to laundry allowance equivalent to one hundred twenty-five pesos (P125.00) per month: Provided, That this rate shall be reviewed periodically and increased accordingly by the Secretary of Health in consultation with the appropriate government agencies concerned taking into account existing laws and prevailing practices. SEC. 25. Remote Assignment Allowance. - Doctors, dentists, nurses, and midwives who accept assignments as such in remote areas or isolated stations, which for reasons of far distance or hard accessibility such positions had not been filed for the last two (2) years prior to the approval of this Act, shall be entitled to an incentive bonus in the form of remote assignment allowance equivalent to fifty percent (50%) of their basic pay, and shall be entitled to reimbursement of the cost of reasonable transportation to and from and during official trips. In addition to the above, such doctors, dentists, nurses, and midwives mentioned in the preceding paragraph shall be given priority in promotion or assignment to better areas. Their tour of duties in the remote areas shall not exceed two (2) years, except when there are no positions for their transfer or they prefer to start in such posts in excess of two (2) years. SEC. 26. Housing. - All public health workers who are in tour of duty and those who, because of unavoidable circumstances are forces to stay in the hospital, sanitaria or health infirmary premises, shall entitles to free living quarters within the hospital, sanitarium or health infirmary or if such wuarters are not available, shall receive quarters allowance as may be determined by the Secretary of Health and other appropriate government agencies concerned: Provided, That this rate shall be reviewed periodically and increased accordingly by the Secretary of Health in consultation with the appropriate government agencies [Link] robles virtual law library For purposes of this Section, the Department of Health is authorized to develop housing projects in its own lands, not otherwise devoted for other uses, for public health workers, in coordination with appropriate government agencies. SEC. 27. Medical Examination. - Compulsory medical examination shall be provided free of charge to all public health workers before entering the service in the Government or its subdivisions and shall be repeated once a year during the tenure of employment of all public health workers:Provided, That where medical examination shows that medical treatment and/or hospitalization is necessary for those already in government service, the treatment and/or hospitalization including medicines shall be provided free either in a government or a private hospital by the government entity paying the salary of the health worker: Provided, further, That the cost of such medical examination and treatment shall be included as automatic appropriation in said entitys annual budget.

SEC. 28. Compensation of Injuries. - Public health workers shall be protected against the consequences of employment injuries in accordance with existing laws. Injuries incurred while doing overtime work shall be presumed work-connected. SEC. 29. Leave Benefits for Public Health Workers. - Public health workers are entitled to such vacation and sick leaves as provided by existing laws and prevailing practices: Provided, That in addition to the leave privilege now enjoyed by public health, women health workers are entitled to such maternity leaves provided by existing laws and prevailing practices: Provided, further, That upon separation of the public health workers from services, they shall be entitled to all accumulated leave credits with pay. SEC. 30. Highest Basic Salary Upon Retirement - Three (3) prior to the compulsory retirement, the public health worker shall automatically be granted one (1) salary range or grade higher than his/her basic salary and his/her retirement benefits thereafter, computed on the basis of his/her highest salary: Provided, That he/she has reached the age and fulfilled service requirements under existing laws. SEC. 31. Right to Self-Organization. - Public health workers shall have the right to freely from, join or assist organizations or unions for purposes not contrary to law in order to defend and protect their mutual interests and to obtain redness of their grievances through peaceful concerned activities. However, meanwhile the State recognizes the right of public health workers to organize or join organization, public health workers on-duty cannot declare, stage or join any strike or cessation of their service to patients in the interest of public health, safety or survival of patients. SEC. 32. Freedom from Interference or Coercion. - It shall be unlawful for any person to commit any of the following acts of interference or coercion: to require as a condition of employment that a public health worker shall not join a health workers organization or union or shall relinquish membership therein; to discriminate in regard to hiring or tenure of employment or any item or condition of employment in order to encourage or discourage membership in any health workers organization or union; to prevent a health worker from carrying out duties laid upon him/her by his/her position in the organization or union, or to penalize him/her for the action undertaken in such capacity; to harness or interfere with the discharge of the functions of the health worker when these are calculated to intimidate or to prevent the performance of his/her duties and responsibilities; and to otherwise interfere in the establishment, functioning, or administration of health workers organization or unions through acts designed to place such organization or union under the control of government authority. SEC. 33. Consultation With Health Workers Organization. - In the formulation of national policies governing the social security of public health workers, professional and health workers, organizations or unions as well as other appropriate government agencies concerned shall be consulted by the Secretary of Health. For this purpose, Management Health Workers Consultative Councils for national, regional and other appropriate levels shall be established and operationalized. SEC. 34. Health Human Resource Development/Management Study. - The Department of Health shall conduct a periodic health human resource

development/management study into, among others, the following areas;chan robles virtual law library. adequacy of facilities and supplies to render quality health care to patients and other client population; opportunity for health workers to grow and develop their potentials and experience a sense of worth and dignity in their work. Public health workers who undertake postgraduate studies in a degree course shall be entitled to an upgrading in their position or raise in pay: Provided, That it shall not be more than every two (2) years; mechanisms for democratic consultation in government health institutions; staffing patterns and standard or health care to ensure that the people receive-quality care. Existing recommendations on staffing and standards of health care shall be immediately and strictly enforced; ways and means of enabling the rank-and-file workers to avail of education opportunities for personal growth and development; upgrading of working conditions, reclassification positions and salaries of public health workers to correct disparity vis-a-vis other professions such that positions requiring longer study to upgrade and given corresponding pay scale; and assessment of the national policy on exportation of skilled health human resource to focus on how these resources could instead be utilized productivity for the countrys needs. There is hereby created a Congressional Commission on Health (HEALTHCOM) to review and assess health human resource development, particularly on continuing professional education and training and the other areas described above. The Commission shall be composed of five (5) members of the House of Representatives and five (5) members of the Senate. It shall be co-chaired by the chairperson of the Committee on health of both houses. It shall render a report and recommendation to Congress which shall be the basis for policy legislation in the field of health. Such a congressional review shall be undertaken once every five (5) [Link] robles virtual law library SEC. 35. Rules and Regulations. - The Secretary of Health after consultation with appropriate agencies of the Government as well as professional and health workers organizations or unions, shall formulate and prepare the necessary rules and regulations to implement the provisions of this Act. Rules and regulations issued pursuant to this section shall take effect thirty (30) days after publication in a newspaper of general circulation. SEC. 36. Prohibition Against Double Recovery of Benefits. - Whenever other laws provide for the same benefits covered by this Act, the public health worker shall have the option to choose which benefits will be paid to him/her. However, in the event that the benefits chosen are less than that provided under this Act, the worker shall be paid only the difference. SEC. 37. Prohibition Against Elimination and/or Diminution. - Nothing in this law shall be construed to eliminate or in any way diminish benefits being enjoyed by public health workers at the time of the effectivity of this Act. SEC. 38. Budgetary Estimates. - The Secretary of health shall submit annually the necessary budgetary estimates to implement the provisions of this Act in staggered basis of implementation of the proposes benefits until the total of Nine hundred forty-six million six hundred sixty-four thousand pesos (P964,664,000.00)

is estimated within five (5) years. Budgetary estimates for the succeeding years should be reviewed and increased accordingly by the Secretary of Health in consultation with the Department of Budget and Management and the Congressional Commission on Health (HEALTHCOM). SEC. 39. Penal Provision. - Any person shall willfully interfere with, restrain or coerce any public health worker in the exercise of his/her rights or shall in any manner any act in violation of any of the provisions of this Act, upon conviction, shall be punished by a fine of not less than Twenty thousand pesos (P20,000.00) but not more than one (1) year or both at the discretion of the court. If the offender is a public official, the court, in addition to the penalties provided in the preceding paragraph, may impose the additional penalty of disqualification from office. SEC. 40. Separability Clause. - If any provision of this Act is declared invalid, the remainder of this Act or any provision not affected thereby shall remain in force and effect. chan robles virtual law library SEC. 41. Repealing Clause. - All laws, presidential decrees, executive orders and their implementing rules, inconsistent with the provisions of this act are hereby repealed, amended or modified accordingly. SEC. 42. Effectivity. - This Act shall take effect fifteen (15) days after its publication in at least two (2) national newspapers of general circulation. APPROVED : MARCH 26, 1992. REPUBLIC ACT NO. 9173 - PHILIPPINE NURSING ACT OF 2002 OCTOBER 21, 2002 ARTICLE I Title Section 1. Title. - This Act shall be known as the "Philippine Nursing Act of 2002." ARTICLE II Declaration of Policy Section 2. Declaration of Policy. It is hereby declared the policy of the State to assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, humane working conditions, better career prospects and a dignified existence for our nurses. The State hereby guarantees the delivery of quality basic health services through an adequate nursing personnel system throughout the country. ARTICLE III Organization of the Board of Nursing Section 3. Creation and Composition of the Board. - There shall be created a Professional Regulatory Board of Nursing, hereinafter referred to as the Board, to be composed of a Chairperson and six (6) members. They shall be appointed by the president of the Republic of the Philippines from among two (2) recommendees, per vacancy, of the Professional Regulation Commission, hereinafter referred to as the Commission, chosen and ranked from a list of three (3) nominees, per vacancy, of the accredited professional organization of nurses in the Philippines who possess the qualifications prescribed in Section 4 of this Act.

Section 4. Qualifications of the Chairperson and Members of the Board. The Chairperson and Members of the Board shall, at the time of their appointment, possess the following qualifications: Be a natural born citizen and resident of the Philippines; Be a member of good standing of the accredited professional organization of nurses; 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 recognized by the 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; 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 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. Section 5. Requirements Upon Qualification as Member of the Board of Nursing. - Any person appointed as Chairperson or Member of the Board shall immediately resign from any teaching position in any school, college, university or institution offering Bachelor of Science in Nursing and/or review program for the local nursing board examinations or in any office or employment in the government or any subdivision, agency or instrumentality thereof, including government-owned or controlled corporations or their subsidiaries as well as these employed in the private sector. He/she shall not have any pecuniary interest in or administrative supervision over any institution offering Bachelor of Science in Nursing including review classes. Section 6. 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. Any vacancy in the Board occurring within the term of a Member shall be filled for the unexpired portion of the term only. Each Member of the Board shall take the proper oath of office prior to the performance of his/her duties. The incumbent Chairperson and Members of the Board shall continue to serve for the remainder of their term under Republic Act No. 7164 until their replacements have been appointed by the President and shall have been duly qualified. Section 7. Compensation of the Board Members. - The Chairperson and Members of the Board shall receive compensation and allowances comparable to the compensation and allowances received by the Chairperson and members of other professional regulatory boards. Section 8. Administrative Supervision of the Board, Custodian of its Records, Secretariat and Support Services. - The Board shall be under the administrative supervision of the Commission. All records of the Board, including applications for examinations, administrative and other investigative cases conducted by the Board shall be under the custody of the Commission. The Commission shall designate the Secretary of the Board and shall provide the secretariat and other support services to implement the provisions of this Act.

Section 9. 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: Conduct the licensure examination for nurses; Issue, suspend or revoke certificates of registration for the practice of nursing; 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; 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; Conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations of this Act, or its rules and regulations and in connection therewith, issue subpoena ad testificandum and subpoena duces tecum to secure the appearance of respondents and witnesses and the production of documents and punish with contempt persons obstructing, impeding and/or otherwise interfeming with the conduct of such proceedings, upon application with the court; Promulgate a Code of Ethics in coordination and consultation with the accredited professional organization of nurses within one (1) year from the effectivity of this Act; Recognize nursing specialty organizations in coordination with the accredited professional organization; and Prescribe, adopt issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the improvements of the nursing practice, advancement of the profession and for the proper and full enforcement of this Act subject to the review and approval by the Commission. Section 10. Annual Report. - The Board shall at the close of its calendar year submit an annual report to the President of the Philippines through the Commission giving a detailed account of its proceedings and the accomplishments during the year and making recommendations for the adoption of measures that will upgrade and improve the conditions affecting the practice of the nursing profession. Section 11. Removal or Suspension of Board Members. - The president may remove or suspend any member of the Board after having been given the opportunity to defend himself/herself in a proper administrative investigation, on the following grounds; Continued neglect of duty or incompetence; Commission or toleration of irregularities in the licensure examination; and Unprofessional immoral or dishonorable conduct. ARTICLE IV Examination and Registration Section 12. Licensure Examination. - All applicants for license to practice nursing shall be required to pass a written examination, which shall be given by the

Board in such places and dates as may be designated by the Commission: Provided, That it shall be in accordance with Republic Act No. 8981, otherwise known as the "PRC Modernization Act of 2000." Section 13. Qualifications for Admission to the Licensure Examination. - In order to be admitted to the examination for nurses, an applicant must, at the time of filing his/her application, establish to the satisfaction of the Board that: He/she is a citizen of the Philippines, or a citizen or subject of a country which permits Filipino nurses to practice within its territorial limits on the same basis as the subject or citizen of such country: Provided, That the requirements for the registration or licensing of nurses in said country are substantially the same as those prescribed in this Act; He/she is of good moral character; and He/she is a holder of a Bachelor's Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency. Section 14. Scope of Examination. - The scope of the examination for the practice of nursing in the Philippines shall be determined by the Board. The Board shall take into consideration the objectives of the nursing curriculum, the broad areas of nursing, and other related disciplines and competencies in determining the subjects of examinations. Section 15. Ratings. - In order to pass the examination, an examinee must obtain a general average of at least seventy-five percent (785%) with a rating of not below sixty percent (60%) in any subject. An examinee who obtains an average rating of seventy-five percent (75%) or higher but gets a rating below sixty percent (60%) in any subject must take the examination again but only in the subject or subjects where he/she is rated below sixty percent (60%). In order to pass the succeeding examination, an examinee must obtain a rating of at least seventy-five percent (75%) in the subject or subjects repeated. Section 16. Oath. - All successful candidates in the examination shall be required to take an oath of profession before the Board or any government official authorized to administer oaths prior to entering upon the nursing practice. Section 17. Issuance of Certificate of Registration/Professional License and Professional Identification Card. - A certificate of registration/professional license as a nurse shall be issued to an applicant who passes the examination upon payment of the prescribed fees. Every certificate of registration/professional license shall show the full name of the registrant, the serial number, the signature of the Chairperson of the Commission and of the Members of the Board, and the official seal of the Commission. A professional identification card, duly signed by the Chairperson of the Commission, bearing the date of registration, license number, and the date of issuance and expiration thereof shall likewise be issued to every registrant upon payment of the required fees. Section 18. Fees for Examination and Registration. - Applicants for licensure and for registration shall pay the prescribed fees set by Commission. Section 19. Automatic Registration of Nurses. - All nurses whose names appear at the roster of nurses shall be automatically or ipso facto registered as nurses under this Act upon its effectivity. Section 20. Registration by Reciprocity. - A certificate of registration/professional license may be issued without examination to nurses registered under the laws of a foreign state or country: Provided, That the

requirements for registration or licensing of nurses in said country are substantially the same as those prescribed under this Act:Provided, further, That the laws of such state or country grant the same privileges to registered nurses of the Philippines on the same basis as the subjects or citizens of such foreign state or country. Section 21. Practice Through Special/Temporary Permit. - A special/temporary permit may be issued by the Board to the following persons subject to the approval of the Commission and upon payment of the prescribed fees: Licensed nurses from foreign countries/states whose service are either for a fee or free if they are internationally well-known specialists or outstanding experts in any branch or specialty of nursing; Licensed nurses from foreign countries/states on medical mission whose services shall be free in a particular hospital, center or clinic; and Licensed nurses from foreign countries/states employed by schools/colleges of nursing as exchange professors in a branch or specialty of nursing; Provided, however, That the special/temporary permit shall be effective only for the duration of the project, medical mission or employment contract. Section 22. Non-registration and Non-issuance of Certificates of Registration/Professional License or Special/Temporary Permit. - No person convicted by final judgment of any criminal offense involving moral turpitude or any person guilty of immoral or dishonorable conduct or any person declared by the court to be of unsound mind shall be registered and be issued a certificate of registration/professional license or a special/temporary permit. The Board shall furnish the applicant a written statement setting forth the reasons for its actions, which shall be incorporated in the records of the Board. Section 23. Revocation and suspension of Certificate of Registration/Professional License and Cancellation of Special/Temporary Permit. - The Board shall have the power to revoke or suspend the certificate of registration/professional license or cancel the special/temporary permit of a nurse upon any of the following grounds: For any of the causes mentioned in the preceding section; For unprofessional and unethical conduct; For gross incompetence or serious ignorance; For malpractice or negligence in the practice of nursing; For the use of fraud, deceit, or false statements in obtaining a certificate of registration/professional license or a temporary/special permit; For violation of this Act, the rules and regulations, Code of Ethics for nurses and technical standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the temporarily/special permit; or For practicing his/her profession during his/her suspension from such practice; Provided, however, That the suspension of the certificate of registration/professional license shall be for a period not to exceed four (4) years. Section 24. Re-issuance of Revoked Certificates and Replacement of Lost Certificates. - The Board may, after the expiration of a maximum of four (4) years from the date of revocation of a certificate, for reasons of equity and justice and when the cause for revocation has disappeared or has been cured and corrected,

upon proper application therefor and the payment of the required fees, issue another copy of the certificate of registration/professional license. A new certificate of registration/professional license to replace the certificate that has been lost, destroyed or mutilated may be issued, subject to the rules of the Board. ARTICLE V Nursing Education Section 25. Nursing Education Program. - The nursing education program shall provide sound general and professional foundation for the practice of nursing. The learning experiences shall adhere strictly to specific requirements embodied in the prescribed curriculum as promulgated by the Commission on Higher Education's policies and standards of nursing education. Section 26. Requirement for Inactive Nurses Returning to Practice. - Nurses who have not actively practiced the profession for five (5) consecutive years are required to undergo one (1) month of didactic training and three (3) months of practicum. The Board shall accredit hospitals to conduct the said training program. Section 27. Qualifications of the Faculty. - A member of the faculty in a college of nursing teaching professional courses must: Be a registered nurse in the Philippines; Have at least one (1) year of clinical practice in a field of specialization; Be a member of good standing in the accredited professional organization of nurses; and Be a holder of a master's degree in nursing, education, or other allied medical and health sciences conferred by a college or university duly recognized by the Government of the Republic of the Philippines. In addition to the aforementioned qualifications, the dean of a college must have a master's degree in nursing. He/she must have at least five (5) years of experience in nursing. ARTICLE VI Nursing Practice Section 28. Scope of Nursing. - A person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in any health care setting. It includes, but not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood, and old age. As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. A members of the health team, nurses shall collaborate with other health care providers for the curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death. It shall be the duty of the nurse to: Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral topical and parenteral medications, internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be provided according to protocol established;

Establish linkages with community resources and coordination with the health team; Provide health education to individuals, families and communities; Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse; and Undertake nursing and health human resource development training and research, which shall include, but not limited to, the development of advance nursing practice; Provided, That this section shall not apply to nursing students who perform nursing functions under the direct supervision of a qualified faculty: Provided, further, That in the practice of nursing in all settings, the nurse is duty-bound to observe the Code of Ethics for nurses and uphold the standards of safe nursing practice. The nurse is required to maintain competence by continual learning through continuing professional education to be provided by the accredited professional organization or any recognized professional nursing organization: Provided, finally, That the program and activity for the continuing professional education shall be submitted to and approved by the Board. Section 29. Qualification of Nursing Service Administrators. - A person occupying supervisory or managerial positions requiring knowledge of nursing must: Be a registered nurse in the Philippines; Have at least two (2) years experience in general nursing service administration; Possess a degree of Bachelors of Science in Nursing, with at least nine (9) units in management and administration courses at the graduate level; and Be a member of good standing of the accredited professional organization of nurses; Provided, That a person occupying the position of chief nurse or director of nursing service shall, in addition to the foregoing qualifications, possess: At least five (5) years of experience in a supervisory or managerial position in nursing; and A master's degree major in nursing; Provided, further, That for primary hospitals, the maximum academic qualifications and experiences for a chief nurse shall be as specified in subsections (a), (b), and (c) of this section: Provided, furthermore, That for chief nurses in the public health nursing shall be given priority. Provided, even further, That for chief nurses in military hospitals, priority shall be given to those who have finished a master's degree in nursing and the completion of the General Staff Course (GSC): Provided, finally, That those occupying such positions before the effectivity of this Act shall be given a period of five (5) years within which to qualify. ARTICLE VII Health Human Resources Production, Utilization and Development Section 30. Studies for Nursing Manpower Needs, Production, Utilization and Development. - The Board, in coordination with the accredited professional organization and appropriate government or private agencies shall initiate

undertake and conduct studies on health human resources production, utilization and development. Section 31. Comprehensive Nursing Specialty Program. - Within ninety (90) days from the effectivity of this Act, the Board in coordination with the accredited professional organization recognized specialty organizations and the Department of Health is hereby mandated to formulate and develop a comprehensive nursing specialty program that would upgrade the level of skill and competence of specialty nurse clinicians in the country, such as but not limited to the areas of critical care, oncology, renal and such other areas as may be determined by the Board. The beneficiaries of this program are obliged to serve in any Philippine hospital for a period of at least two (2) years and continuous service. Section 32. Salary. - In order to enhance the general welfare, commitment to service and professionalism of nurses the minimum base pay of nurses working in the public health institutions shall not be lower than salary grade 15 prescribes under Republic Act No. 6758, otherwise known as the "Compensation and Classification Act of 1989": Provided, That for nurses working in local government units, adjustments to their salaries shall be in accordance with Section 10 of the said law. Section 33. Funding for the Comprehensive Nursing Specialty Program. - The annual financial requirement needed to train at least ten percent (10%) of the nursing staff of the participating government hospital shall be chargeable against the income of the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation, which shall equally share in the costs and shall be released to the Department of Health subject to accounting and auditing procedures: Provided, That the department of Health shall set the criteria for the availment of this program. Section 34. Incentives and Benefits. - The Board of Nursing, in coordination with the Department of Health and other concerned government agencies, association of hospitals and the accredited professional organization shall establish an incentive and benefit system in the form of free hospital care for nurses and their dependents, scholarship grants and other non-cash benefits. The government and private hospitals are hereby mandated to maintain the standard nurse-patient ratio set by the Department of Health. ARTICLE VIII Penal and Miscellaneous Provisions Section 35. Prohibitions in the Practice of Nursing. - A fine of not less than Fifty thousand pesos (P50,000.00) nor more than One hundred thousand pesos (P100,000.00) or imprisonment of not less than one (1) year nor more than six (6) years, or both, upon the discretion of the court, shall be imposed upon: any person practicing nursing in the Philippines within the meaning of this Act: (1) without a certificate of registration/professional license and professional identification card or special temporary permit or without having been declared exempt from examination in accordance with the provision of this Act; or (2) who uses as his/her own certificate of registration/professional license and professional identification card or special temporary permit of another; or

(3) who uses an invalid certificate of registration/professional license, a suspended or revoked certificate of registration/professional license, or an expired or cancelled special/temporary permits; or (4) who gives any false evidence to the Board in order to obtain a certificate of registration/professional license, a professional identification card or special permit; or (5) who falsely poses or advertises as a registered and licensed nurse or uses any other means that tend to convey the impression that he/she is a registered and licensed nurse; or (6) who appends B.S.N./R.N. (Bachelor of Science in Nursing/Registered Nurse) or any similar appendage to his/her name without having been coferred said degree or registration; or (7) who, as a registered and licensed nurse, abets or assists the illegal practice of a person who is not lawfully qualified to practice nursing. any person or the chief executive officer of a judicial entity who undertakes in-service educational programs or who conducts review classes for both local and foreign examination without permit/clearance from the Board and the Commission; or any person or employer of nurses who violate the minimum base pay of nurses and the incentives and benefits that should be accorded them as specified in Sections 32 and 34; or any person or the chief executive officer of a juridical entity violating any provision of this Act and its rules and regulations. ARTICLE IX Final Provisions Section 36. Enforcement of this Act. - It shall be the primary duty of the Commission and the Board to effectively implement this Act. Any duly law enforcement agencies and officers of national, provincial, city or municipal governments shall, upon the call or request of the Commission or the Board, render assistance in enforcing the provisions of this Act and to prosecute any persons violating the same. Section 37. Appropriations. - The Chairperson of the Professional Regulation Commission shall immediately include in its program and issue such rules and regulations to implement the provisions of this Act, the funding of which shall be included in the Annual General Appropriations Act. Section 38. Rules and Regulations. - Within ninety (90) days after the effectivity of this Act, the Board and the Commission, in coordination with the accredited professional organization, the Department of Health, the Department of Budget and Management and other concerned government agencies, shall formulate such rules and regulations necessary to carry out the provisions of this Act. The implementing rules and regulations shall be published in the Official Gazette or in any newspaper of general circulation. Section 39. Reparability Clause. - If any part of this Act is declared unconstitutional, the remaining parts not affected thereby shall continue to be valid and operational. Section 40. Repealing Clause. - Republic Act No. 7164, otherwise known as the "Philippine Nursing Act of 1991" is hereby repealed. All other laws, decrees, orders, circulars, issuances, rules and regulations and parts thereof which are inconsistent with this Act are hereby repealed, amended or modified accordingly.

Section 41. Effectivity. - This act shall take effect fifteen (15) days upon its publication in the Official Gazette or in any two (2) newspapers of general circulation in the Philippines.
APPROVED , FRANKLIN DRILON P RESIDENT OF THE SENATE JOSE DE VENECIA JR. S PEAKER OF THE H OUSE OF REPRESENTATIVES

THIS ACT , WHICH ORIGINATED IN THE H OUSE OF REPRESENTATIVE WAS FINALLY PASSED BY THE H OUSE OF REPRESENTATIVES AND THE S ENATE ON O CTOBER 15, 2002 AND O CTOBER 8, 2003 RESPECTIVELY . OSCAR G. YABES ROBERTO P. NAZARENO Secretary of Senate Secretary General House of Represenatives Approved: October 21, 2002 GLORIA MACAPAGAL-ARROYO President of the Philippines