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Professional Adjustment, Legal Management, Ethics & Research in Nursing

NURSING RESEARCH
Nursing Research Kerlinger - the systematic, empirical, controlled and critical investigation of a hypothetical proposition in relation to a natural phenomena/ problem Conducted to affirm or deny a hypothesis Phenomenon. everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician) Phenomenon + hypothesis research problem !"(educated guess/scientific/ tentative ans#er) $ithout hypothesis there is no research problem, only a problem Major Characteristics of a Good or Major Research Systematic o conduct research in a step by step process or procedure Em irical o ob%ective data should be observable/measurable or readily collected using your senses Controlled! mani ulated o &ethods/tool of controlling is research design Critical in"estigation!fact finding in"estigation o 'n order to ans#er the data is by using facts. o (oo)ing for human beings #ho can give us facts Pur ose of Research in Nursing Profession #$EE$% $escri ti"e o observe, describe and record o gain richer familiarity regarding the phenomena o *++, )no#n to -. E& loratory o /0plore to those areas that are un)no#n o 1bserve more o 2+,-2+, (2+,)no#n to nurses and 2+, un)no#n to the nurses E& erimental o 3ctive intervention, active manipulation o $ant to find out cause 4 effect o 5one something before observing results $e"elo mental o 6o improve the system of care for the your patient. o 5evelop and improve e0isting system Conducting research is for the benefit the pt or patient care/pt focus +lorence Nightingale 9irthplace 7 'taly 6raining :round 7 :ermany :reatest Contribution 7 environmental 6heory, training -.s in Crimean $ar ;chool 7 ;aint 6homas ;chool of .ursing Ethics of a Researcher S 7 Scientific '(jecti"e 7 conductive research for a good purpose or ob%ect for your pt C 7 Coo eration and Consent. 5o not conduct data/e0periment #/o a consent (legally the patient o#ns the chart. 8o#ever the hospital o#ns the chart) ) 7 )ntegrity 7 #or)ed hard on the research E 7 E*uita(le 7 ac)no#ledging #or)s or contribution of others

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

N 7 No(ility 7 protect the rights of your sub%ects o Right not to (e harmed (physical, mental, moral harm) usually done during e0perimental research Physical ,arm! Negligence - undeliberate physical harm Commission 7 done outside the standard practice of nursing (eg. urinary catheter placed on the nose of the pt) 'mission 7 from the very start, you did not do something about it. Moral ,arm Assault 7 mental fear/threat #ithout physical harm -attery 7 physically you harm the pt -estraint is never an independent nursing order physical restraint 7 eg. <ac)et chemical restraint 7 eg. use of psychotropic drug Moral harm Slander 7 oral defamation Li(el 7 published or placed in the ne#spaper o Right to self.determination o Right to ri"acy Anonymity 7 identity of sub%ect may not be disclosed. Privacy of the 'nformant (pt) eg. conduct a study on 8'= pt. but the pt #ants his name to be #ritten in the ne#spaper as &r. >, &r. ? or &r. $ Confidentiality 7 information ac@uired must be disclosed. Privacy of the information eg. conduct a study on 8'= pt. but the pt #ants the nurse should only )no# / 7 /ruthfulness 7 put only the data you have collected ) 7 )m ortance 7 importance to the nursing profession + 7 +actual 7 facts or data ) 7 )deal (follo# the ** steps of research) C 7 Courage

Ste s in Nursing Research Process )dentification!formulation of research o ro(lem - Aanything that re@uires solution thru scientific investigation. o ;ources of problem B C 7 concepts (Ca, P69, &') L 7 literature, essays, boo)s, %ournals ) 7 'ssues E 7 e0perience N 7 .ursing problems / 7 theories o Characteristics of a research problem G 7 general applicability and use Re 7 -esearchable + 7 Ceasible and measurable + 0 actors of a feasible research B time, money, e0perience of the researcher, instruments, population ) 7 importance to nursing profession N 7 novelty/originality Plagiarism/illegal replication 7 unauthoriDed use of anotherEs literary #or) #ithout any consent or permission S 7 significance to nursing 1 ty es of research according to use (asic! ure research

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

only the research benefits the research 't is only for your personal necessity 3ns#ers your o#n @uestion A lied research problem solving ;olving the problems of the patient. 2aria(le 7 sub%ect to change 3inds of "aria(le )nde endent "aria(le o use this to stimulate a target population $e endent "aria(le!Effectual "aria(le o results of the effects of the study )nter"ening 2aria(le o Comes bet#een dependent and independent o /0ampleB orghanism variable, internal factor, se0, gender, color E&traneous 2aria(le o /0ternal infuences that can be changed o /0ampleB citiDenship, educational status $ichotomous 2aria(le o F choices/ F results o /0ampleB &ale/ Cemale Polychotomous 2aria(le o &ultiple choices o /0ampleB Preferred foods 7 Chinese, <apanese, 3merican. . . . . G3 comparative ;tudy in the 'ncome of Cilipino .urses /mployed in P.:.8. and ..?.:.8.H

/0amples

'ndependent variable B P:8 and .?:8 (place of #or)) 6arget population B Cilipino nurses 5ependent variable B income

Research4 *. 'dentify the Problem F. Purpose 7 ob%ective using ;&3-6 (;ystematic, &easurable, 3ttainable, -ealistic, 6ime 9ounded) I. 5efine 6erms a. Conceptual 5efinition 7 dictionary definition b. 1perational 5efinition 7 defined in accordance on ho# the researcher used the #ord J. -evision of 6erms Re"ie5 of related literature o Pur oses 4 to have an update regarding your topic to have a basis of theoretical and conceptual frame#or) o &ain sources of literatures Conceptual Cormulated 3uthors Can be sold 9oo)s 7 general use -esearch -esearcher

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

-esearch #or)s only Cuture research purpose only +ormulation of conce tual and theoretical frame5or6 o 6hery 7 relationship bet#een concepts o Conceptual frame#or) diagrammatic and structural presentation of the problem hypothesis o Paradigm actual structural presentation of your conceptual frame#or) +ormulating hy othesis o 7 ty es of hy othesis Null!statistical hy othesis sho#s no relationship or difference bet#een an independent variable and dependent variable. '5 5= /g. G6here is no difference regarding professional opportunities of Cilipino .urses #or)ing in the Philippines from those #or)ing in K;3.H Sim le!' erational hy othesis!Alternati"e hy othesis this sho#s relationship bet#een a single independent variable from single dependent variable. /g. GCilipinos .urses #or)ing in K;3 has more professional opportunities than those #or)ing in the Philippines. Com le& hy othesis this sho#s a relationship bet#een t#o or more independent variable from t#o or more dependent variable. /g. GCilipino nurses #ho #or)ed for 2yrs and passed the C:C.;, 61-C(, 6;/, .C(/> has greater opportunities in .? as compared to those in &anila $irectional hy othesis specifies the direction of the relationship bet#een variables /g. GCilipino .urses #or)ing in the K;3 has more professional opportunities than those #or)ing in the Phils.H Non.directional only predicts the relationship, but has no specific direction bet#een variables. /g. G6here is a big difference bet#een a Cilipino .urses #or)ing in K;3 than those #or)ing in the Phils.H Selecting research design o ;ystematic controlled plan for finding the ans#er to a problem o -oadmap, blueprint of the study o ;hould have a proper resign design o 'f improper research design, there #ill be improper collection of data o Pur ose B )ey or tool for proper collection of data o /y es According to A lication -asic! Pure o Cor personal )no#ledge, curiosity A lied o 9ased on problem solving approach According to Methods E& erimental o performing active manipulation, observe and record the result. o /y es of E& erimental Reseach control

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

divide grp into F. :roup a 7 control/comparison grp 7 #ill use the same soap everyday :roup b 7 e0perimental grp 7 those #ho #ill use the sample soap randomi8ation using sample by chance. Choose randomly to avoid redundancy of result Mani ulation Performing intervention 2alidation comparison of the effects 9uasi.e& erimental false e0periment. .o control sample. Non.e& erimental o .o manipulation is done. 1nly observation, describe and record do#n the result. o /y es of non.e& erimental research design (ase on time element Retros ecti"e :E& Post +acto; :etting actual e0perience ;tudies a group of people after its occurrence, e0perience or facts. /0perience of people in the past $escri ti"e 1bserve, describe 4 record. ;tudy of current events. Pros ecti"e ;tudy of research about future occurrence or future events. ,istorical Past that is #ritten, documented, published and recorded Primary $ata o 1bserve o *st hand information o person himself Secondary $ata o Fnd 8and 'nformation 3bout the past using records, %ournals, boo)s. ;tudy of the dead people thru his #ritten materials, facts o according to data *uantitati"e data base on numerical interpretation, datas that are measurable, using your senses, data that are observable. *ualitati"e sub%ective data, feelings, perception, beliefs, culture, attitude o Sur"ey Research $esign :roup ;mall

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

Cace to face (arge 7 not good result &ethods &ailed survey Cace to face 6elephone survey o According to /ime 'rientation Cross Sectional 3pplicable to F or more identical group ;hort term Cor comparison Longitudinal * group only #ith initial and follo# up survey long term study for developmental study Selecting your o ulation and sam les o sam le part of population, data is collected. 6he recipient of the e0perimental treatment in e0perimental design or the individuals to be observed in a non-e0perimental design o /y es of sam ling Pro(a(ility - e@ual presentation/ chances in the population. Sim le random techni*ue o Ksed a single/identical group. o Cish bo#l techni@ue Stratified random sam ling o ?ou #ill first going to create a sub population from the #hole population before doing randomiDation. o 1ne population, you divide it. Cluster random sam ling o ?ou #ill first create a sub area in a population before doing the randomiDation. 'n one population, you ma)e it smaller Systematic random sam ling o choosing a sample every nth name in the population. o &ultiple of *++ names o Sam ling frame 7 list of names appearing as your population Non. ro(a(ility sam ling 7 you are not choosing by chance. Accidental! con"enience sam ling o 9ase on the accessibility/availability of your sample. o Kung sino pina)amalapit syo, yun ang )u)unin mo. Pur osi"e!judgmental sam ling o base on the common )no#ledge or popular )no#ledge. Sno5.(all sam ling o get sampling base on last referral 9uota Sam ling o ;etting criteria and getting samples fitting the criteria Conducting ilot studies Collecting data o types B

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

@uestionnaires 7 use of pen and paper method dichotomous 7 divided into t#o. /g. true orfalse. ?es or no rating scale 7 poor *, good F, better I, best J multiple choice 'ntervie# 7 use of oral method of collection of data. Kse of active listening ;tructured 7 #ith chec)list, formal tal), list of @uestion Knstructured 7 informal tal), no pattern, anything goes records 7 pre e0isting data observation 7 use of ocular method using your senses participant observation non-participant observation Problems B o 8a#thorneEs effects 6he data you get from your sample is not accurate. 6he sample has a problem ;olution B double blind research 7 they should not be conscious that they are being studied o 8alo effect 6he researcher has a problem. 8e is manipulating the data collection. 't is affected by special feelings/treatment bet#een the researcher and the sample. Analysis of $ata o part of research #hen the researcher is forming a body of )no#ledge out of data collected for the purpose of affirming or denying your hypothesis o Methods Nominal method get data by means of categories. eg. male, female, income 'rdinal method 7 base on ran) eg. mild, moderate, severe )nter"al base on the distance bet#een F numerical values eg. 9P 7 *2+/*++ 7 *F+/L+, #t, circumference, ht ratio 7 IB*+ children are malnourish )nter retation of $ata o 1 Methods *uantitati"e method 7 base on numerical or graphical standards *ualitati"e method 7 use of narrative #ords Communicating your conclusion o /0plaining the results of your #or) to the public o Conclusion 7 final ans#er to your research o -ecommendation 7 suggestion to others o 5issemination of 'nformation &ethods B thesis/boo) 7 #ritten form symposia/symposium 7 oral presentation publish 7 a lot #ill be able to read your research

LEADERSHIP
Nursing Leadershi

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

style or process #hereby a person is called by a nurse leader #ere influence of group of people called his follo#ers for the purpose of attaining only one goal/ob%ective. le for Effecti"e Leadershi <nity of Command 7 one group given by one leader <nity of $irection 7 one group should al#ays have one ob%ective Su(ordination of your ersonal to your general interest 7 patient first policy o R 7 rescue your patient o A 7 alert the fire alarm o C 7 confine the fire in one area o E 7 e0tinguisher application o Esprit dE corp/team spirit - Cault of one is the fault of all Res ondeat Su erior!Command res onsi(ility o let the master or the superior ans#er for the negligence of his subordinates in half of his patient #ho suffer from in%ury or death. o you can delegate responsibility but not the accountability

Princi

/heories of Nursing Leadershi Great.Man theory 7 born as a leader /rait theory 7 develop characteristics or born #ith the characteristics o = traits of a leader P 7 ersonality (adaptability, independence, creative/assertive, advocate) ability to ad%ust to the need of the pt ) 7 intelligence (proper %udgment, proper decision ma)ing, proper communication) A 7 a(ility 7 (influence others, respect others, participate and cooperate) Proper #ay to influence is thru health teaching Charismatic theory 7 becomes a leader because of the charm Situational theory!case to case (asis o a person can be a leader in one situation but only a follo#er in another situation. (eg. becomes a leader in #here he specialiDes) Leadershi styles 3uthocratic/3uthoritarian/dictatorial/HhardH leader o unilateral style of leadership. 1nly the leader here performs the decision ma)ing #ithout getting the inputs from his members. o 1ne sided style of leadership 9ehavior B 3 7 apathy 7 insensitive to others - 0 -oisterous s eech C 0 consistency $ 0 $ominating E 0 E& loitati"e (eha"ior + 0 ferocious (eha"ior, to coerce or compel the group to follo# him o not a good style of leadership but only best style during emergency or intensive crisis Permissi"e, ultra.li(eral, laisse8 faire, free.rein o (oose style of nursing leadership. o :iving e0cess freedom or liberality to#ards your subordinates if to lenient in your subordinates, there #ill be M control and po#er N negligence $emocratic! artici ati"e o best style of leadership. &utual style of nursing leadership 7 Po5er of a Good Leader Legitimate! +ormal! e&clusi"e Po5er o /0ercise because you are appointed to a higher position E& ert Po5er o ?ou ac@uire e0tra 7 ordinary s)ills, talent or ability

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

Referent Po5er o Charisma and charm Re5ard Po5er o + po#er for the part of the leader o gives re#ards, bonus, promotion, compensation Coerci"e Po5er o 7 po#er on the part of the leader o reprimand, suspend, terminate

A-C>s s6ills, *ualities and a(ilities A 0 Authority o basis of the leader to delegate tas)s, responsibilities, %obs to be performed by his subordinates o 1 ty es of authority Centrali8ed 7 top to bottom for proper management $ecentrali8ed 7 9ottom, to manage directly - 0 -eha"ioral o S 7 specialiDed body of )no#ledge and s)ills to do safe care o P 7 patient centered o A 7 accountability 7 liable for the results of your actions o C 7 confidentiality 7 nurse-patient relationship /0ceptions to confidentiality of the contract B P 7 patient consent, if there is ) 7 inform/report to healthcare team for purpose of precautionary measures C 7 Communicable disease o RA =7?= (a# on .otifiable 5isease o FJ 7 Polio/ &easle o * $ee) 7 ;35/ 8'=/6etanus .eonaturom C 0 Crimes o Child 3buse JL hours, 9aranggay, .:1 E 7 ethics '= 68/-3P';6B 1ld -., 6raining, 2+ 'nsertion, 3.;3P .e# -., 6raining C 0 Communication s6ill o transfer of information #ith understanding o Communication barriers/communication bac)log 7 eg. 5ialect differences, noise, deaf, high level of an0iety, hallucinating $ 0 $ecision ma6ing s6ills o ;teps identify the problem identify person affected gather options/alternative brainstorming delphitechni@ue 7 gathering solutions outside the group (eg. specialiDed nurse) choose and implement /valuation E 0 Ethics o Princi les o Princi le of Autonomy independent %udgment or decision ma)ing in all situation the pt himself is the one #ho should decide for his o#n care Consent

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

respect the decision of the pt e0plain the ris) to the patient/;1 #aiver - a legal doc #hen the pt refuse for treatment. o Princi le of 2eracity telling the truth to the patient O* the patient has the right to )no# from the P8?;'C'3. (not the nurse) o Princi le of $ou(le Effects if the pt is made to choose bet#een F e@ual danger and he only needs to choose one, choose the one that #ill produce one good effect and less evil effect. o Princi le of -eneficence doing good to the patient (eg. providing therapeutic communication, providing privacy) o Princi le of Non.Maleficence do no harm I types of 8arm Physical 7 negligence by commission &ental 7 assault and battery &oral 7 slander and libel o Princi le of @ustice PrioritiDe the needs of the patient. 6o be able to provide nursing care to the patient, provide the nursing process. .ursing Process characteristics B 3 7 acceptable universally 9 - based patients assessment needs C 7 client focused 5 7 dynamics 7 base on the ever changing needs of the pt / 7 e@uitable care C 7 familiarity/rapport to the patient : 7 goal directed to#ards solving the assess needs of the patient (;&3-6) o Princi le of Res ect!)n"iola(ility of life ;uicide and abortion is violation of this principle + 0 +ace!sol"e Conflicts o any clash of ideas resulting to crisis o Methods of resol"ing conflict a"oidance 7 by paying attention smoothing 7 appealing to ones conscience and )indness unilateral action 7 use of forced fear or threat negotiation 7 best method in resolving conflict. 6he head nurse should offer negotiation bet#een conflicting parties.

NURSING MANAGEMENT
N<RS)NG MANAGEMEN/ choosing the right person and giving them the appropriate tas) for the purpose of achieving their goal/ob%ective in achieving total care +rederic6 /aylor>s Scientific Management /heory /lements o choosing the appropriate person (631) o choosing the appropriate team o choosing the appropriate training

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

choosing the appropriate tools

,uman Relations theory the be a good manager, there should be a good interpersonal relationship bet#een the leader and follo#er $ouglas Mc Gregor>s Moti"ational theory /heory A o .egative #or)ers o negligence, inefficient, ineffective #or)ers /heory B o Positive #or)ers o diligent, effective, efficient #or)er theory > should be given focus because they are prone to negligence and malpractice. Ma& Ce(er>s -ureaucratic! authoritarian /heory #hoever is on the top #ould perform the management function centraliDed Elton Mayto>s -eha"ioral /heory overtime pay, rest day, day off provide physical needs of the #or)ers 8a#thorneEs /ffect o 'f #or)ers )no#s they are observed they become more efficient ,enry +ayol>s Princi le of Management <nity of Command 7 one leader, one command <nity of $irection 7 one group should al#ays have one goal Remuneration of Personnel 7 patient first policy Es rit de cor s 7 team spirit Command res onsi(ility!Res ondeat Su erior 7 let the superior ans#er the fault of his subordinates even harm or death 9alance bet#een centraliDation and decentraliDation ;ecurity tenure 5elegation of responsibility Pro er Com ensation of 5or6ers o RA ?=D7 :Magna Carta La5; 7 salary grade 2+ P*I,+++/month o '"ertime ay 7 additional of F2,/hr o Night $ifferential 7 additional of *+,/hr o Legal holiday 7 0 F o Philhealth - 9enefit of #or)er both related and non-related #or) (aesthetic, dental and cosmetics are not included) o Maternity lea"e 7 P+days leave is .;5, QLdays if C; only to first J pregnancy only to legitimate spouse o Paternity lea"e 7 Qday/*#ee) leave o Senior Citi8en>s Act 7 F+, discount 7 ste s in Management Process Planning stage o loo)ing ahead of time. o Cormulating future goals/ob%ective o /y es of lan Standard!' erational Plan :NCP; plans for everyday or ordinary activities Strategic!Contingency Plan plan used during sudden or acute crisis Long.range!future Plan plans #hich you canEt evaluated immediately.

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

Ksually last months or yrs. Ksed for chronic pt #hich re@uires longer period of care. o Stages of Planning Process Mission 7 present reason #hen established your organiDation 2ision - statement of your future purpose of your future organiDation Philoso hy 7 set of values and beliefs of your organiDation Goal 7 general statement of your purpose '(jecti"es 7 more specific statement of your purpose Policies 0 set of rules and regulations in your organiDation Procedures -udgeting 7 proper allocation of your resources o = ty es Personnel Compensation for salaries of #or)ers ' erational everyday use of e@uipment and facilities (gloves, #ater, electricity) Ca ital long term use e@uipment (&-', C6 ;can, hospital beds, hospital buildings) 'rganiDing o E stages 'rgani8e your team RN Su(ordinates 5uties of the -. 1nly assessment can perform the nurse 1nly the nurse can perform 86 1nly the nurse should e0plain the procedure to the patient Preparation, administration, treatment of drugs to the patient 6he nurse can only perform evaluation 6he nurse can only do %udgment $elegate /as6 6hey can only delegate to subordinates the -outinary tas) (standard, unchanging procedure) eg. monitoring of '41, bathing, ambulating, toileting, shampooing, transporting, feeding, clothing, #iping ;table patient - predictable outcome (eg. postmortem care #ith direct supervision of the nurse only) ;upervision 7 need guidance Staff Schedule! Staffing ;chedules (8o# many hours) o 6raditional 7 Lhrs a day/J+hrs/#) o 6en hour shift/J days a #ee) o 9aylor plan 7 it consist of t#o shifting nurses traditional 7 mon-fri Lhrs Fnd shift 7 *Fhr shift during #ee)ends o Part-time #or) 7 fe#er #or)ing hours per day and may choose the day or #or). (ess than Lhrs %ob o 1n 7 call 7 during shortage of nurses/staff but increase in the number of patients. Methods of Nursing care $eli"ery $ifferent Methods o Primary 0 1Ehrs a day Primary nurse is the only nurse #ho is responsible to ma)e a care plan of the

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

patient from the moment of admission till the moment of discharge. (eg. private duty nurse or special nurse) +unctional Method 518 format/government hospitals 3ssign nurse B $uty/tas) 'ne nurse, one tas) ,ighly recommended during a period of shortage of nurses and budget poorest method of delivery because communication is hindered Case &ethod/Case .ursing provide total care #ithin your shift. Ksed in 'CK department C 7 Case &ethod 6 7 total care to the patient 1 7 one is to one ratio

$irecting/5elegation stage o a %ob or a tas) is done or performed by another perform for you o $hat you cannot delegateB you cannot delegate total control of the procedure you canEt delegate discipline of subordinates or staff members. Confidential tas) 6echnical tas) &edical tas) performing surgical procedure is done by the doc not the nurse Coordination/Collaboration o the nurse needs to collaborate to other members of the health care team. o &ulti-interdisciplinary approach 7 to be able to provide holistic approach to the patient. o /y es of Colla(oration )nter ersonal!)ntrade artmental 1ne patient, one unit. Collaboration bet#een one nurse to another healthcare team in one unit/department /g. &' patient - nurse, dietary, specialiDed in cardio )nterde artmental J units in one hospital. Coordination of the patients care bet#een F-more units/departments but still under one same hospital or institution /g. patient due for appendectomy is transferred to the 1 )nter Agency!)nstitutional Coordination of patientEs care bet#een F or more hospitals/health care institution for the benefit of the patient /g. lying 7 in due for C/; and #as transferred to a hospital Evaluation/Controlling o stage #herein you determine #hether or not your plans for your patient is met or achieved o Methods of e"aluating staff erformance Chec6list it is being evaluated higher than you. (eg. nurse manager/supervisor or head nurse) Nursing rounds it is being evaluated higher than you. (eg. .urse manager/supervisor or head nurse)

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

Psychiatric #ard is not done by nursing rounds Peer re"ie5 same ran) or level is being evaluated you poor method Performance a raisal the patient evaluates you best method in evaluation

PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE

Professional 3 calling in #hich its members profess to have ac@uired special values, )no#ledge, training or by e0perience so that they may guide others in that special field. Nursing is a rofession Calling 7 service oriented 1thers 7 patients Characteristics (y rofession A 7 accountability/liability for the result C 7 caring profession Central Cocus C 7 competent E 7 ethics S 7 service oriented S 7 specialiDed scientific body of )no#ledge and s)ills PR'+ESS)'NAL $</)ES '+ A N<RSE <N$ER RA FG?= All are inde endent nursing actions Promotive, preventive, curative and rehab care in all health care service health education utiliDes nursing process lin) of patients in different health care services collaboration of patientEs care for continuity of patient care train nursing students supervision of subordinates accurate recording and reporting e0ecution of valid doctorEs order (the only one that is dependent nursing action) Perennial ;uturing after training Perform '/ if antenatal bleeding is absent and before full delivery A doctors order is valid when giving medication is when it is put into writing and signed by the physician. Whatever is not put into writing is considered not ordered by the physician. Good Samaritan Act 5uring emergency, national calamity, national epidemic there is no doctor around the life or the patient is in possible danger, then you can give drugs alone provided you )no# the drugs for the patient. RA H=EE 7 .o deposit policy during emergency cases only Areas of Nursing Practice GI )nstitutional Nursing 8ospital 9ased =enue

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

5 7 5uties are routinary and supervised 3 7 3c@uired different learning and technical s)ills C- Coordination #ith 8C6 ; 7 ;pecialiDed areas o .urse :eneralist 7 community nurse o .urse specialist 7 staff nurse

1I Pu(lic ,ealth Nursing 1nce a Public nurse in the community, you are focus on the preventive and promotive of health because this is the mandate of Primary 8ealth Care (a#. Gst P,C o 5ate B *RQL o Place B 3lma 3ta o Country B -ussia o (ocal version of C. &arcos after *yr of 3lma 3ta o ConferenceB (etter of 'nstruction RJR that mandates that all public #or)ers to have a duty of promotive and preventive care for the patient. Promotion of Pu(lic ,ealth o P5 LRQP 7 &icronutrient ;upplement 3ct =it. 3, iron supplements, iodine o P$ H17 :En"ironmental sanitation la5 of the PhilsI; 't is cleanliness of the environment. 1utside the institution (eg. proper disposal of e0creta, proper drainage system) o P$ H7J :sanitation code of the PhilsI; 'nvolves proper sanitation of an institution that engage in food and #ater supply. 'nside the institution. (eg. canteen, mineral #ater store, public mar)et, ;e0 shop B 351.';, P/:3;K;, C8'C1;) not applicable to private se0 practitioners. Pre"ention of $isease o P$ FFJ :EP) la5; Compulsory 'mmuniDation of children belo# R y/o Psychological and social adjustments (ecause you 5ill (e ta6ing care of numerous clients o RA ?GJD :local go"ernment code; decentraliDation or devolution of care. 6he 518 together #ith 5'(: and local government units (brgy, provincial) together #ith community participation they made a local health board #hich is the &3?1-. Purpose of local health board B it ma)es @uality health care available, accessible and pro0imal for all Partici ation is maintained 5ith all mem(ers of the community, health care team and family =I 'ccu ation ,ealth Nursing industrial or company health nurse $uties 4 o Curati"e!reha(ilitati"e C 7 care for sic)/in%ured laborers - 7 -eferral = 7 =isit and ff. ups (home visits) o Promoti"e!Pre"enti"e . 7 nutritional ; 7 safety and sanitation C 7 Counseling EI Clinical )nstructor o 9ualifications 4 A 7 accredited nursing 1rg

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

M 7 &3. in nursing or other health courses ' 7 1ne yr clinical e0perience R 7 -...

P,)L)PP)NE N<RSES ASS'C)A/)'N o Chen 5as PNA founded B 1ct. FF, *RFF (*+-FF- FF) o Cho is the founder PNA B 3nastacia :. :uiron 6upas o Pur oses B P 7 professional #ell-being < - unity P 7 promotes reciprocity even outside the Phils. A 7 advancement of the )no#ledge and s)ills of the nurse E 7 ethics promulgation Proclamation 'rder 7=F 5eclared by Pres. :arcia la# declaring the last #ee) 1ct as the official nurses #ee). School of Nursing in the Phili ines KPC. 7 *st ;chools originated in the Phil. o 'loilo &ission hospital o P:8 o ;t. (u)eEs o &ary <ohnston 8ospital o ;t. Paul 8ospital o ;an <uan de 5ios Contracts and Consents Characteristics of a 2alid Consent 2 7 voluntariness ' 7 1pportunities to as) @uestionAbe e0plained to ptA / 7 treatment e0plained to the patient < 7 understood by pt M 7 matured both physically and mentally Criteria of a good consent 4 *L y/o 7 above &entally capacitated (absence of insanity and imbecility) 'f belo# *L y/o and mentally incapacitated a pro0y consent B in chronological order o Parents o :uardian o physician (if parents and guardian are dead) :uardian 3d (item 7 social #or)er or ;urgeon Nurses and )llegal $etention it happens if someone #ill limit the freedom of the patient to move or travel from one place to another. 8'= Patient 7 should be )ept in one room o Celacio 7 oral se0 7 most fastest mode of transfer o Cannalingus 7 tongue on clitoris o 3nalingus 7 tongue on anus 7 least mode of transfer Last Cill and /estament 3ct #hereby a person is permitted by the la# to have control in the manner of disposing/ giving his estate but #ill ta)e effect at the time of his death

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

6estate ;uccession 7 son or daughter #ill inherit the last #ill of the parents 'ntestate ;uccession 7 #ithout last #ill and testament 1 ty es of Last Cill and /estament o Pro erty Notarial! 'rdinary Cill Chec) (1C Chec) proper location of the signature 7 end part of all the pages at the side .urses can be a #itness ,ologra hic Cill 5uring emergency cases .o #itness involved call a persdon #ho )no#s and familiar #ith the hand#ritten of the testator /ntire last #ill and testament is hand #ritten dated and signed by the testator o Life -ody Ad"ance $irecti"es -espectful death 5irection/ instruction of the patient in advance 5.-, donate organ, cremation

Medications and rescri tion only registered medical, dental and veterinary practitioners are authoriDed to prescribe drugs I information o name of the 3&5, address of his clinic/hosp and P6-C license O o name of the pt, age, se0 o drug name, fre@uency, duration of the drug RA JJ?7 Generic Act o all prescribe drug must be #ritten in generic and brand name or generic name but never the brand name alone) o Purpose B for the pt to choose #hat brand name they #ant -emember the *+ -Es of medication -ight patient name by chec)ing the pt #rist tag =erbal or telephone 7 only done during emergency doubts or error 7 in case there is doubt in medication, refer to the physician '= drugs 7 in proper training $ocumentation, recording and charting Patient Chart 7 absolutely legal Pur ose of a atient Chart o Communication and conitinuity of care o Assurance of @uality of care o Research o Legal document o Statistics of disease Su( oena 7 order coming from the court o ;ubpoena 5uces 6ecum 7 any documents, ob%ects, papers, materials o ;ubpoena 3d 6estificandum 7 person #ho #ill testify (#itness) $o>s in Charting o + 7 full, factual and ob%ectively accurate o L 7 legible o ) 7 immediate o P 7 Personal Adendum 7 late entry/late documentation $on>ts in charting o L 7 language, %argons or #ords #hich are unacceptable

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

o o o

) 7 improper corrections S 7 ;paces and s)ips Abbreviation

LEGAL $'C/R)NES )N N<RS)NG Professional Negligence Negligence failure to do something #hich are reasonable and prudent nurse should have done something under a particular situation. (eg. failure to raise side rales #hen the pt is unconscious) = elements of negligence o duty on part of the nurse o failure to do said duty o in%ury, harm, death 7 most important negligence Mal ractice in%ury, harm or death is not important in malpractice 6he nurse is allo#ed to perform episiorrhapy #ith proper training but not episiotomy 6he nurse is allo#ed to perform '/ but #ith F conditions B o fetal aberration/ abnormal delivery o prior to complete delivery Crimes affecting nurses 6ypes of crime B Manner of Commission o $'L' 7 crimes committed #ith deceit. Crime #ith real criminal intention o C<LPA 7 crimes committed under negligence. Crimes that are intentional stages of e&ecution o consummated #hen the crime intended is totally committed or perfected o frustrated the offended performs everything to consummate the crime but it did not happen o attem ted crime has not happened (overt acts 7 acts merely sho#ing the intention to commit the crime) degree of artici ation o rinci al degree of participation is very important/indispensable because he is the primary author of the crime.. 'f no principle, there is no crime. o accom lice participation is merely dispensable. Ksually performs before (eg. referral by the nurse of a abortionist to a pregnant #omen) or during the crime eg. 19 nurse is to perform abortion. 6he nurse is loo) out for police. 6he nurse is the accomplice. o accessory usually performs after the crime (eg. stole a nebuliDer in the hospital. ;old the nebuliDer to an asthmatic pt) 6his is an accessory because he benefited from the crime RA ?H?? 0 Anti se&ual harassment la5 committed by any person #ho e0ercises authority. (eg. teacher to student, head nurse to staff nurse). 6hat person #ho is in authority is as)ing for a se0ual favor in an e0change of another favor.

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

/y es of Ra e 'rdinary ra e o a forcible penetration of an organ for copulation to another organ for copulation. (eg. #omen are only the victim) se&ual assault o anything that is forcible inserted to a body orifice #ith se0ual malice. o 3lso form of rape (eg. hand or an ob%ect is being inserted in the anal. Committed in both female or male) o 'ntervention B S 7 safety (emotional or physical safety) R 7 report (M *L 7 report to brgy.) R 7 referral (if father is the rapist, refer to 5;$5) A(ortion is the e0pulsion or termination of a product of conception before the stage of viability. (I-Pmonth/*F-FJ#ee)s) )nfanticide )ill the person in less than Idays or QFhrs of life. Parricide )illing another person to #hom you have a relationship (mother, father, husband) ,omicide unintentionally )illing another person #ithout any relationship (eg. negligence in giving meds) Murder intentionally )illing another person #ithout any relationship Simulation of (irth committed by any person #ho shall substitute one child to another child or alter his identities for the purpose of losing his civil status. (eg. the mid#ife failed to report the birth of the baby, giving #rong information of the gender of the baby) P$ J7G :-irth registration act; la# any person #ho assist in giving birth to report #ithin I+ days to the (ocal Civil -egistration 1ffice La5 Affecting Nurses Act 1HDH :yrI GFGF; 7 first true nursing la# o 't removed from the doctor the control of nurses #ith I man team (* chairman and F members all nurses) GF1D 7 *st official board e0am Gst nursing school :Jmonths; o 'loilo &ission 8ospital (*R+P) o P:8 ;chool of .ursing (*R+Q) o ;t. (u)eEs school of nursing (*R+Q) o &ary <ohnsonEs school of .ursing (*R+Q) o ;t. Paul 'loilo *R+Q) o ;an <uan de 5ios (*R+Q) Gst college of nursing :Eyears; 0 <P RA ?GJE :GFFG; RA FG?= :'ct 1G, 1DD1; o -oard of Nursing 'ld o & 7 &3. o 3 7 3ccredited .ursing 1rg (P.3) o C 7 five &3. team (* chairman, J members) o ; 7 P2 y/o 7 * year interim period

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

o o o o Ne5 o o o o o o o

. 7 .ot convicted of any crime P 7 Pecuniary interest (3bsence) 6 7 *+ years nursing practice C- CitiDen of -.P.

& 7 &3. 3 7 3ccredited .ursing 1rg (P.3) ; 7 Q &3. team (* chairman, Pmembers) ' 7 immediately resigned upon appt. . 7 .ot convicted of any crime P 7 Pecuniary interest (3bsence) 6 7 *+ years nursing practice but 2 yrs must be in the Phils. o C- CitiDen 4 resident of -.P. Cho formulates the *uestion of the -oard E&amK 7 9oard of .ursing 'n having a license it is a Privilege not a -ight 9oard of .ursing issues the license P-C issues the certificate of registration C8/5 are the ones #ho has the po#er to open and close a nursing school 91. %ust inspects 2 consecutive years of belo# L+, passing rate, the school #ill be closed Po5ers and +unctions of -'N o L 7 (icensure e0am o ) 7 'ssue C1o M 7 &onitor standards of nursing practice o E 7 /ducation o C 7 Code of ethics o , 7 8ear and decides cases of negligence and malpractice o A 7 3ccredits different organiDations o G 7 :uides .ursing Practice in the phils

$ean -...,A&3. 2 years nursing e0perience Clinical )nstructor 3 7 allied in nursing or any allied health courses & 7 member of P.3 1 7 * yr e0perience - 7 -... Nursing Administrator Community Military ,os

Su er"isor!Manager , 9 7 9;. -. 3 7 3ccredited 1rg . 7 R units 6 7 F yrs

Chief/5irector -. + &3. + 2 yrs supervisor e0perience (..9. if primary hosp) o E&aminees

3dd only masterEs in P8. or C8.

&3. + :;C (:en. ;taffing Course)

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Professional Adjustment, Legal Management, Ethics & Research in Nursing

C:& (:ood &oral Character) Proofs of =alid 8older of Cilipino CitiDenship Proofs of valid holder of a 9;. 5egree only from schools #hose curriculum is approved by the C8/5 I docs sub to P-C -(/ certificate 61- #ith ;canned picture (ist of cases /0amination fee is PR++ (ast day 's B

1ther related la#s P$ 11= 0 PRC Act RA GDHD 7 Civil ;ervice e0am Cum (aude, 9oard passer 7 eligible in ta)ing C;/ RA JE17 0 $angerous drugs Act o unisha(le 5ith 1 chemical su(stances Prohi(ited drugs chemical substance totally, abosultely canEt be consumed by human being (eg. ;habu, &ariana, Cocaine, 1pium) Regulated drugs you can use this drug provided the pt has the prescription and the 3&5 has appropriate license coming from the 9C35 or 5angerous 5rugs RA ?JDD 0 -a(y +riendly ,os italI o /arly bonding for mother is /arly -ooming in and early baby breast techni@ue for early bonding /arly bonding for father is thru cuddling EI'I 7G 0 Mil6 Code :-reast Mil6; o 3void manufactured or formula mil) ,o5 to (e an RINI under FG?= o 8ave all @ualifications o ta)e the e0am o ac@uire the re@uired ratings o 'n order to pass the e0amination, an e0aminee must obtain a general average of at least Q2 , #ith a rating of not belo# si0ty percent (P+,) in any sub%ect o 3n e0aminee #ho obtains an average rating of Q2, or higher but gets a rating belo# P+, in any sub%ect must ta)e the e0amination again but only in the sub%ect or sub%ects #here he/she us treated belo# P+ , (P+,). 'n order to pass the succeeding e0amination, an e0aminee must obtain a rating of at least Q2, in the sub%ect or sub%ects repeated.H RA HFHG 0Moderni8ation ActI Cor every 2,+++, results #ill be released after 2days P-C rating .3&/ 6e0t to FPI (smart) FII (globe) Chat are the grounds for nurse not to (e registeredK o $ 7 5ishonorable conduct o < 7 Knsound mind o M 7 moral turpitude o ) 7 'ndecent immortal conduct