Nursing Leadership and Management

BS NURSING / FOURTH YEAR

STUDENT ACTIVITY SHEET
Session # 4

LESSON TITLE: DIFFERENT FIELDS OF NURSING Materials:

LEARNING OUTCOMES: Book, pen and notebook, and index card/class list
Upon completion of this lesson, the nursing student can: References:
1. Enumerate the different fields of Nursing; Lydia M. Venzon RN, MAN, FPCHA Ronald M.
2. Discuss the advantages and disadvantages of the different Venzon RN, MAN (2010), Professional Nursing In
fields of Nursing; and, The Phillippines 11th Edition: C & E Publishing, Inc.
3. Enumerate the qualifications of each fields of Nursing. 839 EDSA, South Triangle, Quezon City

LESSON PREVIEW/REVIEW
Give 3 laws mentioned in the previous lesson and briefly explain:
1.
2.
3.

MAIN LESSON

CLASSIFICATION OF FIELDS OF NURSING IN GENERAL

The fields of nursing may be classified according to the following:
1. Hospital or Institutional Nursing
2. Public Health Nursing or Community Health Nursing
3. Private Duty or Special Duty Nursing
4. Industrial or Occupational Health Nursing
5. Nursing Education
6. Military Nursing
7. School Nursing
8. Clinic Nursing
9. Independent Nursing Practice

INSTITUTIONAL NURSING
Nursing in hospitals and related health facilities such as extended care facilities, nursing homes, and neighborhood
clinics, comprises all of the basic components of comprehensive patient care and family health. The concept of the modem
hospital as a community health center where in-patient and out-patient care are continuous describes the goal of medical
care in most general hospitals.
The educational qualification for beginning practitioners is a Bachelor of Science degree in Nursing. The nurse, as a
member of the healthcare team, participates in all phases of patient care of the acutely ill, the convalescing and the
ambulatory patient. The nurse cares for the patient in the hospital or in the out-patient department and plans for the nursing
care needs of the patient about to be discharged. The nurse performs nursing measures that and will meet the patient's
physical, emotional, social and spiritual health needs while in the institution and helps him and his family plan for his further
healthcare needs when he returns home. The nurse's functions involve assessment of the patient’s needs for nursing and
planning for giving or providing the care indicated whether this be personal care, rehabilitation measures or health
instructions. These functions include participation in the research and training activities carried on in the hospital, teaching
auxiliary personnel, and assisting in teaching and supervision of nursing and/or midwifery students, if there are affiliates in
the said institution.

Advantages of Staff Nursing in Hospitals

1. There is always a supervisor whom one can consult if problems exist.
2. Nurses are updated with new trends in medicine and in the nursing care of patients.

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3. They undergo rotation to different units and have a chance to determine their special area of choice before they are
assigned permanently in one area such as Medicine, Pediatrics, Surgery, ICU-CCU, Obstetrics, Operating Room,
Delivery Room, etc.
4. They have an eight-hour day and a forty-hour week duty which provide for two days of rest away from duty. They have
provisions for sick leaves, holidays, and vacations with pay according to personnel policies of the institution.
5. They have the chance to get promoted to higher positions if they are qualified.
6. Salary increases are given periodically according to merit system thereby increasing their initiative and best efforts.
7. They are considered an important member of the health team in providing care to the patients.
8. More staff development programs are available in hospitals.

Disadvantages of Staff Nursing in Hospitals

The disadvantages usually do not outweigh the advantages
1. There is a great the advantages, possibility of understaffing which may require nurses to put in overtime work and
sacrifice some of their plans. This is especially true in hospitals where budget for personnel is limited.
2. Because of the bulk of work, some staff nurses do not find time to improve their skills through continuing education
programs. Or, if the hospitals are in far-flung areas, no continuing education programs are provided.
3. Administrative problems and overwork may tend to dissatisfy the staff nurse.

Qualifications of Nursing Service Administrators

Section 29 of RA 9173 specifies that a person occupying supervisory or managerial position requiring knowledge of
nursing must:
(a) be a registered nurse in the Philippines;
(b) have at least two (2) years of experience in general nursing service administration;
(c) possess a Bachelor of Science degree in Nursing, with at least nine (9) units in management and administration courses
at the graduate level; and
(d) be a member of good standing of the accredited professional organization of nurses.
It is provided, however, that a person occupying the position of chief nurse or director of nursing service shall, in addition
to the foregoing qualifications, possess:
(a) at least five (5) years of experience in a supervisory or managerial position in nursing; and
(b) a master's degree in Nursing.
It is further provided that for primary hospitals, the minimum 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 agencies, those who have a master's degree in public health/community 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 have completed the General Staff Course (GSC): Provided, finally, That those occupying
such positions before the effectivity of this Act shall be given a period of (5) years within which to qualify.
Anew trend in hospital nursing is clinical specialization. Nurses train in a special field of nursing of their choice. Courses
to prepare nurses desiring to perfect their clinical opportunities are offered in universities, usually at the master’s level.
These nurses must have the experience required before applying for a position as an expert practitioner.
Memorandum Circular No. 2000-05, series of 2000 of the Professional Regulation Commission, Board of Nursing,
mandates the implementation of this provision of the Philippine Nursing Act.

Nursing Specialty Certification

In this country, a Nursing Specialty Certification Program has been adopted by the Board of Nursing through Resolution
No. 14 series of 1999, and created a Nursing Certification Council under it to oversee the administration of new programs by
the Specialty Certification Boards.
SEC. 29. 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 of
continuous service.
SEC. 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.

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Benefits of Certification
Certification offers advantage to the individual nurse, the nursing profession, and the healthcare delivery system.
1. Nurses certified to be above minimum standards improve the quality of patient care.
2. Certification measures expertise beyond that which is measured in basic licensure.
3. Certification ensures continued competence in the changing world of healthcare.
4. Certification is a means of confronting the demands of healthcare.
5. It is a lifelong learning that advances nursing skill and knowledge to move the profession forward.
6. It enhances the nurse's self-image and the public's view of the profession.
What is the future of hospital nursing? All indications point to the development of additional nursing specialization that
will attract large numbers of nurses with varied educational backgrounds and who have had many kinds of clinical
experiences such as critical care nursing, neonatal care nursing, and rehabilitative nursing. Hospitals will continue to be the
principal employers of registered nurses in the foreseeable future.

PUBLIC HEALTH/COMMUNITY HEALTH NURSING

Public health community health nursing have often been used interchangeably. The National League of Philippine
Government Nurses, in developing the Standards of Public Health Nursing Practice in the Philippines (2006), differentiated
the two as follows:
a. Public Health Nursing refers to the practice of nursing in the 7 local, national and city health departments which
include health centers and public schools. It is community health nursing practice in the public sector.
b. Community health nursing is broader as it encompasses nursing practice in a variety of roles, which at times
include independent nursing practice.
In the nursing curriculum and in the licensure examination for nurses, the term used is community health nursing.
It includes parish nursing, in community mental health nursing, and school nursing.
The National Health Program of the Philippines gives as much emphasis on the promotion of health and prevention of
diseases rather than care of the sick. It needs a deeper involvement and close cooperation among all members of the health
team such as physicians, nurses, epidemiologists, dentists, sanitary inspectors, sanitary engineers, nutritionists, health
educators, social workers, the community, and the barangay leaders.
Effective coordination can best be achieved if all members have an understanding of, and respect for, each other's
function.

Advantages of Community Health Nursing

1. The focus of nursing care is on family and community health rather than on an individual basis. Here, the nurse will be
able to see the total picture of family and community health situation.
2. It gives the nurse a better perspective of the health conditions of the community and the health programs conceived and
implemented by the government, and to appreciate the nurses' role in nation building.
3. It maximizes efforts to improvise where there are no sufficient facilities, supplies, and equipment.
4. It enables the nurse to utilize various community resources and maximize coordination with other members of the health
team.
5. Focus of care is more on educational and preventive aspects. Thus, nurses have the privilege of contributing to the
program for healthy citizenry especially among the rural poor.
6. Individuals, families and communities are motivated to assume responsibility for their own healthcare.

Disadvantages of Community Health Nursing

1. Cases found in community health nursing are limited mostly to chronic and/or communicable diseases.
2. There are more hazards in public health than in hospital nursing, such as exposure to elements (inclement weather,
heat of sun, rain), dog or snake bites, accidents, etc.
3. There are no fixed hours of work. The nurse may be called upon any time of the day or night.
4. Some claim that community health nursing is not as exciting nor as glamorous as hospital work.
5. Facilities for care of the sick are limited so that practice or skills may also be limited.
6. The community health nurse may not be immediately aware of changes or trends in the fields of medicine or nursing.
7. Community health nursing is not a place for introverts. A nurse has to be outgoing to meet people.
8. There is no immediate supervisor to consult in case of emergency.
With the implementation of Primary Health Care, public health nurses are kept up-to-date through various continuing
education programs conducted by the Department of Health and Regional Health Offices. The entry salary of a community
health nurse is the same as that of a Senior or Head Nurse in government hospitals.

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NURSES IN IN-SERVICE EDUCATION PROGRAMS
In-service education programs have been in existence for many years both in hospitals and public health agencies. This
is one way of improving service in these agencies. Many tertiary hospitals and public health agencies have nursing staff in
charge of staff development training and research.
Nurses in this field need:
1. skills in nursing practice, therefore they must have at least two years experience in basic nursing practice;
2. understanding of skills in teaching, supervision, and consultation;
3. understanding of the relationship of these persons to the process of administration and research;
4. understanding of the broad problems and desirable practices in patient care planning; and
5. understanding of and skill in the use of problem-solving approach to resolve everyday problems in the practice of
nursing and in-service education in the areas of concern;
6. understanding of the role and functions of the revising personnel in this area of in education;
7. understanding of self and others involved in in-service education within the various agencies in nursing; and
8. ability to plan and implement programs for different kinds of nursing personnel.
Nursing Coordinators for Staff Development need to have at least four years of clinical practice and research and a
Master's Degree in Nursing. Nurse Instructors for in-service training programs need at least two years of experience in
clinical practice and research and a Master's Degree in Nursing preferably with a clinical specialization.
With the advent of Quality Assurance Programs in health services, nurses may also be employed as Quality Assurance
Coordinators in agencies where these programs are required. Nurses in this field need experience in clinical nursing and
research too.

PRIVATE DUTY NURSING

Nurses in private practice are expected to be expert clinicians as well as expert generalists in nursing. They use the title
Private Duty Nurse, Private Nurse Practitioner, Special Duty Nurse or Private Duty Nurse Specialist.

Definition of Private Duty Practitioner

A private duty nurse is a registered nurse who undertakes to give comprehensive nursing care to a client on a
one-to-one ratio. She/he is an independent contractor. The patient may be provided care in the hospital or in the home.
Private duty nurse practitioners are grouped into two categories.
1. General Private Duty Nurse. The general private duty nurse has the capabilities for providing basic nursing care to
any type of patient, among which are:
a. assessment of the physical conditions and interpretation of the significance of his/her findings as basis for
planning the nursing care;
b. identification of emotional and social factors and relating these to signs and symptoms observed;
c. application of scientific principles in the performance of nursing techniques;
d. working with patient's family so that they gain understanding of his/her illness and cooperate towards
promoting early recovery of the patient;
e. utilization of laboratory and diagnostic tests in promoting progress of care and enhancing his/her own
usefulness as a health teacher and counselor;
f. knowledge and recognition of pharmacological effects of drugs and medications, their implications for nursing
actions as needed; and
g. interpretation of doctor's orders concerning medicines and treatments and communicating the same
effectively to the patient and carrying them out promptly and accurately with understanding of cause and
effects.
2. Private Duty Nurse Specialist. In addition to the foregoing abilities expected of the general nurse practitioner and
as a result of his/her specialized preparation, a private duty nurse specialist also demonstrates the following
competencies:
a. skill in handling, operating, and monitoring other complicated devices;
b. skill in interpreting data gathered from ECG, EEG, laboratory diagnostic results and vital signs;
c. skill in observing signs and symptoms and their favorable or untoward significance in the progress of patient
care; and
d. promptness and adeptness in instituting appropriate nursing measures.

Qualifications of a Private Nurse Practitioner

A private nurse practitioner must:
1. be a registered nurse in the Philippines;
2. have the following documents for the current year:
a. Professional Tax Receipt (PTR)
b. Professional Regulation Commission Card (PRC), and
c. Residence Certificate;

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Education (Department of Nursing) 4 of 14
3. have at least two (2) years of bedside nursing experience as a professional nurse in a general hospital immediately prior
to application;
4. be acceptable to the Director of Nursing Service as suitable for orientation to do private duty nursing;
5. be a full time private duty nurse;
6. preferably have undergone a Critical Care Nursing Course; and
7. be a certified I.V. Nurse therapist by the ANSAP (Association of Nursing Science Administrators of the Philippines).

Requirements
A private nurse practitioner is required
1. to undergo orientation in the hospital as conducted by the Nursing Service office;
2. to have the complete paraphernalia, e.g., blood pressure apparatus, pen light, bandage scissors, red and blue or black
pens, and clip board;
3. to wear full white nurse's uniform (cap, stockings, closed white shoes, I.D. Pin). Uniform blazers may be used if required
by the hospital;
4. to have medical certificate from a certified medical center or laboratory with chest-x-ray result, complete blood count,
urine and stool examination;
5. to give two (2) character references;
6. to acquire, for succeeding years, certificate of three( 3) seminars or continuing education programs attended; and
7. to show certification as an I.V. Therapist by the ANSAP.
The private duty nurse is expected to follow the rules and regulations of the hospital regarding nursing procedures, use
and procurement of equipment and supplies, system of medications, charting, diets, precaution techniques and others. As in
other fields of nursing, he/she is expected to adhere to the code of ethics and practice.

General Guidelines
1. Although a private duty nurse is considered an independent contractor, she/he is directly under the supervision of the
nursing service in the hospital, or of the Head Nurse in the unit. She/he is expected to make a comprehensive verbal
report to the Chief Nurse or Supervisor when they visit the patient and submit a written report to the Head Nurse at the
close of the shift. If relief is needed during meals or in time of other necessities, the Head Nurse should be notified so
that a reliever can be provided.
2. The private duty nurse is responsible for the nursing care of the patient. Nursing care encompasses the patient's welfare
physically, mentally and spiritually. The nurse is equally responsible for maintaining a safe, sanitary, and healthful
environment for the patient, and for the care of equipment used and other facilities provided in the room.
3. The private duty nurse shall endeavor to give complete nursing care before going off-duty.
4. While the private duty nurse on house case is directly responsible to the 'attending physician of the patient, a regular
monthly service audit shall be given to the Director of Nursing Service who referred her/him for employment.

Policies and guidelines for nurses accompanying patients out of the country
1. Passport and other travel papers. All expenses for fees and processing of visa and travel papers are paid for by the
patient or his/her representative.
a. Passport, paid round-trip ticket, and other papers should be in the possession of the private duty nurse at all times.
b. A travel and accidental insurance in the amount of P50,000.00 shall be provided for the private duty nurse and
paid for by the patient or his representative effective 72 hours before departure and throughout the period of stay
abroad while in the employment of the patient.
c. The corresponding amount of salary computed at eight (8) hours multiplied by two (2) shifts and the number of
days the patient plans to be out of the country shall be left in the Philippines for ready withdrawal by the private
duty nurse's authorized representative on designated dates per agreement of parties concerned.
d. A daily travel allowance in addition to the Private Duty Nurse's regular salary while out of the country is negotiable
with the employer.
e. The female private duty nurse who is caring for a male patient must be provided a separate room for rest periods.
f. All hotel, lodging and food expenses while out of town or out of the country shall be paid for by the employer.
2. The private duty nurse is required to:
a. leave with the Private Duty Nurses' Association in the Philippines her/his possible address of destination and
tentative duration of duty;
b. report presence to the nearest nursing organization in the area; and
c. report to the Philippine Nurses Association his/her arrival in the country.

Advantages of Private Duty Practice

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Private duty practice gives the following advantages:
1. the chance to see life as it really is, to study human nature and to know at close range interesting people of different
nationalities, cultures, religion and status;
2. the opportunity to make real friends through close association with the patient and his family;
3. the chance to travel and see the world
4. the ability to own time, adjust work and private life satisfactorily, and direct off-duty time into enjoyable leisure;
5. the chance to keep abreast with new knowledge and procedures which provide an exciting, stimulating experience, with
infinite variety of problems to solve and personal satisfaction to be gleaned; and
6. the challenge of giving his/her best in providing care and having the satisfaction of seeing its results.

Disadvantages of Private Duty Practice

1. Some private duty nurses create a situation in which the patients become totally dependent on them.
2. Many private duty nurses graduated so long ago and have not upgraded their knowledge and skills.
3. There are not enough nurses for evening and night shifts, for holiday, weekends, and vacation periods.
4. Being a lone practitioner minimizes opportunity for developing good relationships with other hospital personnel.
5. Some private duty nurses resent supervision by hospital staff.
6. Little assistance is given by the Head Nurse when the patient is critically ill and the private duty nurse needs help in
giving treatment or in changing the position of the patient. The private duty nurse sometimes goes without meals
because the Head Nurse does not arrange for relief when the patient cannot be left alone.
7. Private duty nurses have very little or no participation in professional activities. If they ever do, they do so on their own
time and expense.
8. Nurses who are very experienced and well-qualified receive the same fees as the new graduates.
9. Private duty nurses face problems in private practice being independent contractors and there is greater need for liability
insurance.
10. There are no retirement, insurance and medicare benefits unless the private duty nurses provide these for themselves.
The Private Duty Nurses Association of the Philippines defined the categories of the private nursing practitioners in
1975. In February 1976, it submitted to the Philippine Nurses Association the proposal to revise the rates from a twelve-hour
basis to an eight-hour basis. Standard rates for Private Duty Nursing was approved by the Board of Directors of the
Philippine Nurses Association in February 1976.
The rates to be charged for private duty are determined by the Private Duty Nurses Association of the Philippines.
Anyone interested may verify from the Philippine Nurses Association Headquarters or at the Nursing Service Office of
Lourdes Hospital in Mandaluyong City.

OCCUPATIONAL HEALTH NURSING OR INDUSTRIAL NURSING'

Occupational Health Nursing was once called industrial nursing. In 1958, industrial nurses in the United States elected
to call themselves occupational health nurses to reflect the broader and changing scope of practice within the specialty.
Most of these nurses have experienced working in hospitals, in public health or some other branch of the profession.
Few nurses go into occupational health nursing. This is because occupational health nurses often work alone, and must
therefore possess maturity, experience, and wise judgment.
Occupational health nursing is the specialty practice that provides and delivers healthcare services to workers. The
practice focuses on promotion, protection, and supervision of workers' health within the context of a safe and healthy work
environment. Occupational health nursing is autonomous and occupational health nurses make independent nursing
judgements in providing health services.
Since occupational health nurses work alone in situations where they may have to give immediate care to patients with
serious injuries, they need to be fully informed about their legal responsibilities. The first consideration is the patient's
welfare. They must make use of whatever first aid and nursing measures they judge necessary, bearing in mind their
professional limitations. Emergency or more extreme measures may be used during life-and-death situations. Their actions
will be judged against the yardstick of reasonable, prudent nursing practice.
As in other fields of nursing, a Bachelor's Degree in Nursing is required of occupational health nurses. This field of
nursing requires special skills. A good preparation is a year or more in emergency nursing, such as actual nursing
experience under the direction of a skillful nurse in this field. Helpful skills include ability to take and read ECGs, eye
screening, audiometer testing, laboratory tests, and X-ray.
In addition, industrial nurses must know company policies on personnel, insurance benefits, sick leave, pay rates, health
programs, medical matters and records. Since industrial nurses may have only part-time or on-call medical direction, they
may find themselves custodians of employees' health records, counselors and advisers of the workers, interpreters of
company policies, health and safety teachers as well as first aiders to the injured.
Most occupational nurses have to bargain individually for their salaries. Only few employers hire enough nurses to make
up a bargaining unit. This has hurt salaries in industrial nursing to an extent and pay is probably less than in hospital work.
But there are compensations. Often, the industrial nurse works only during day hours. They are off duty on weekends most

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of the time. Exceptions to these are nurses in large plants which may require overtime work. There are usually seniority
wage increases, pensions, and insurances.
Fortunately, beginners in this field have a wide variety of help available. Valuable literature may be obtained from many
sources. They may also seek support from fellow practitioners through the Occupational Health Nurses Association of the
Philippines.

NURSING EDUCATION
Career opportunities in nursing education are better today than before. There is a chronic teacher shortage in all nursing
education programs. Nurses who like to consider teaching as their field of expertise will have to consider the following
qualifications.

Qualifications of the Faculty

A member of the faculty in a college of nursing teaching professional courses must:
(a) be a registered nurse in the Philippines;
(b) have at least one (1) year of clinical practice in a field of specialization;
(c) be a member of good standing in the accredited professional organization of nurses; and
(d) 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.
The practice of some schools to hire as faculty members those underboard nurses or those without any experience
contributes to the poor quality of nursing students who later will become incompetent nurses themselves. This practice also
subjects said nurses and their employers to legal problems that may arise later.
Personal qualities and special abilities of faculty members include:
1. capability to promote interest in the subject they teach; stimulate the minds of the students, arouse enthusiasm,
quicken imagination, and awaken ambition;
2. competence in the particular field they teach;
3. resourcefulness with infinite patience, understanding, confidence and perseverance. They must be able to inspire
students to develop their fullest potential; and
4. expertise in providing nursing care in the chosen field aside from the qualities of good role models.
The career ladder in nursing education starts with a Clinical Instructor's position up to that of a Dean of a College of
Nursing.
A dean in a college of nursing should possess a Master's Degree in Nursing and must have at least five (5) years of
experience in teaching and supervision as per R.A. 9173. Those teaching at the Graduate Programs for nurses must
possess post-Master's Degree or a Doctoral Degree in Nursing.
Generally, salaries of those in the field of nursing education are higher than of those working in the hospitals. These vary
according to the teachers' experience, their fields of specialization and their educational attainments.
Nursing education is an interesting, important, and challenging field and the opportunities for well-prepared nursing
educators are numerous.

MILITARY NURSING
The Nurse Corps
When the famed Tandang Sora led the nursing of the sick and wounded Katipunan revolutions in 1890, military nursing
in the Philippines may be said to have begun. However, the Nurse Corps we know today dates back more precisely about
three decades ago, shortly before the outbreak of World War II.
Commonwealth Act No. 1, commonly know as the National Defense Act, clearly provided the establishment of a medical
service in the army of the Philippines. However, the component corps were not specified. On September 5, 1938, the
National Defense Act was amended by Commonwealth Act. No. 385 whereby the different corps of the medical services
were explicitly spelled out, with the Nurse Corps being one of them. This is the date celebrated by the Nurse Corps as its
foundation day.
Inspite of the legal basis for its existence, the Nurse Corps was not organized until about mid-1940, when President
Manuel L. Quezon issued Executive Order No. 2167, dated April 15, 1940. This provided for the rules of the organization of
the Philippine Army Nurse Corps Reserve intended to be mobilized in the event the Philippines would be involved in the
impending war in the Far East. In accordance with this new legislation, nurses began to be commissioned as early as July
1940. At about this time in the US Army, the Army nurses were given only relative ranks as officers. Perhaps this was the
reason why those who were first commissioned under the Nurse Corps were only given relative ranks as second and third
lieutenant depending on their age, education, and experience.
To emphasize the female composition of the Corps, the term Nurse Corps as provided for in C.A. 385, was changed to
the Female Nurse Corps, pursuant to Commonwealth Act No. 569, dated June 7, 1940. By the end of 1941, there were
about 200 nurses commissioned into the Nurse Corps. For some unknown reasons, the legal basis of the Nurse Corps'
existence under the Philippine government became Executive Order No. 267, the provision of which was very far from the
benefits given by the USAFFE. To prevent a retrogression in the status of the military nurses, they began the long and

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tedious fight because the military authorities were not very sympathetic with the plight of military nurses. With the aid of the
Philippine Nurses Association, the military nurses were able to lobby at the Congress for the passage of a bill that would
re-designate the female nurses as a component of the Medical Service. As Nurse Corps, the members would be guaranteed
the same rights and privileges as those granted Nor. 203 the other members of the military. This resulted in the approval of
Republic Act on May 12, 1948 by Pres. Elpidio Quirino, placing the Nurse Corps in proper perspective among the other
military organizations.
R.A. 479 of June 10, 1950 amended R.A. 203, and gave credit to the services of military nurses during men war. It also
provided basis for determining the grade and rank, seniority, and retirement of NC officers. In August 1952, the title Army
Nurse Corps, Medical Service, was changed to Nurse Corps, AFP. Regular officers were integrated in 1953.
Prior to 1973 the Chief Nurse was merely a staff of the Office of the Surgeon General and had no direct management
and administrative functions in the AFP Nursing Service. With the activation of the Office of the Chief Nurse in the Armed
Forces of the Philippines and the designation of the Chief Nurse as Technical Staff of General Headquarters on June 21,
1973, the Chief Nurse has been afforded the prerogative to decide on matters purely affecting the Nurse Corps and the
nursing personnel in the Armed Forces of the Philippines. This position now holds the rank of a Brigadier General. The first
military nurse to hold this rank was Brig. Gen. Elvegia R. Mendoza.

Functions of the Nurse Corps, AFP

The AFP Nurse Corps provides comprehensive and quality nursing care to all military personnel, their dependents and
authorized relatives.
The functions of the AFP Nurse Corps may be grouped into three (3) broad areas:
1. to meet the nursing needs of today's patients in AFP medical facilities;
2. to prepare each Nurse Corps Officer (regular and reserve) for future assignments at a higher level of responsibility
in the different stations and general hospitals in times of peace and war; and
3. to teach and train enlisted personnel who perform nursing functions under supervision. Special emphasis is on
enlisted members who function in settings where there are no nurses.

Qualifications of the Military Nurse

Principle. The nurse consciously and scientifically intervenes in the health and illness environment for the purpose of
ensuring that the soldier, his family and other significant groups will have adequate personal care, maintenance, safety, and
comfort.
Rationale. The military nurse works at different health settings with various levels of responsibilities. As such, he/she must
have the professional, personal and other qualifications commensurate with job responsibilities.

Criterion I - Qualifications for Commission in the Reserve Force Nurse Corps

Anyone who wants to be commissioned in the Reserve Force Nurse Corps must
a. have a Bachelor of Science degree in Nursing from a duly recognized university/college;
b. be licensed to practice nursing;
c. be a natural-born Filipino citizen;
d. be single or has never been married for both male and female candidates. Female applicants must not positively be
found to have given birth to a living or still-born child;
e. be mentally and physically fit for military service and cleared by appropriate security agencies;
f. have a pleasing personality and a good moral character;
g. be skillful in
(1) applying the nursing process in meeting health/nursing needs of individuals/families/groups/communities,
(2) communicating and relating with others, and
(3) making sound/rational judgment in a given situation;
h. be interested and willing to work in both peaceful and wartime conditions;
i. not be more than thirty two (32) years of age at the time of commission; and
j. satisfy the following height requirements-
1) minimum of sixty two (62) inches for males, and a
2) minimum of sixty (60) inches for females.

Qualifications for Commission in the Regular Force, Nurse Corps

In addition to the requirements for commission in the Reserve Force, anyone who wants to be commissioned in the Regular
Force, Nurse Corps must
a. successfully pass the rigid screening and battery test for the purpose;
b. satisfy the height requirements of (PLEASE SEARCH THE INTERNET FOR THE LATEST HEIGHT REQUIREMENT)
1) minimum of 64 inches for males, and a
2) minimum of 62 inches for females; and
c. not be more than 26 years of age at the time of regular commission.

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Qualifications for Call to Active Duty (CAD)
Anyone who seeks to be qualified for CAD
a. must be commissioned;
b. must have at least one year nursing experience in a reputable health agency;
c. must have been cleared by appropriate security agency; and
d. must have passed the physical and mental examinations conducted by the appropriate authorities.

Qualifications for General Duty Nurse

Anyone who desires to be qualified as General Duty Nurse
a. would have the rank of Second Lieutenant;
b. must have adequate knowledge of general nursing theory and practice, including basic knowledge about biological,
social, and medical sciences and their application;
c. must have knowledge of new developments in the nursing field; and
d. must demonstrate ability to perform comprehensive nursing care,

Characteristics of the Work

As in other civilian hospitals, nursing service in the military seeks to provide the highest quality of nursing care to
patients: in-patients in the hospitals and out-patients in the dispensaries. Like in other hospitals, they also maintain different
sections like the surgical intensive care unit, the Operating Room and the Anesthesia Sections, The Recovery Ward,
OB-Gyne, Pediatrics, Neuropsychiatry, Nuclear Medicine Section, and the Family Planning Section manned by nurse
specialists who have been trained locally and abroad.
The medical corpsmen are highly trained enlisted personnel who help in the care of patients, especially the males.
Nursing attendants are unskilled non-professionals, who assist nurses and doctors in the wards. In times of emergency and
as the exigency of the service so requires, the corpsmen and attendants are authorized to do other medico-surgical
procedures like injection, giving medications, catheterizations, castings, intravenous infusions, circumcisions, suturing of
wounds, and other duties as may be required of them. Each of these medical assistants has his/her own specialized training
and is under the direct supervision and responsibility of the nurse or the surgeon.

Privileges and Benefits of a Military Nurse

Enumerated below are the benefits and privileges which military nurses are entitled to receive.
1. High salary rate and allowances according to rank:
a. as Second Lieutenant, they will initially receive the same base pay as officers of equivalent rank, incentive pay,
subsistence allowance, quarters allowance, clothing allowance, and others when applicable;
b. flight pay for flight nurses which is 50% of base pay;
c. hazard pay (radiation hazard pay) which is 20% of base
d. cold weather clothing allowance for those assigned in pay; cold regions like PMA in Baguio, or areas abroad; and
e. overseas pay when detailed to foreign countries on schooling, or on missions.
2. Glamour and prestige of the uniform, rank and position. All junior officers and enlisted personnel will salute and accord
them due military courtesy.
3. Hospitalization and free medical benefits for parents, dependents, authorized relatives with specialists' care.
4. Military schooling and basic training at the Armed Forces Medical Service School at the V. Luna Medical Center
(VLMC).
5. Opportunity to meet people who hold key positions in the AFP and in the government.
6. Opportunity to attend gala, social functions and parade.
7. Opportunity to travel abroad.

Flight Nursing in the Philippines

One field of nursing that is considered peculiar only to the military and to the Air Force is flight nursing or aero-space
nursing. A flight nurse is responsible for patients, military or otherwise, who have been evacuated from battle areas to the
nearest installation for treatment.
Air evacuation relieves congested areas, giving way to forward-moving vehicles and troops. It also reduces medical
personnel and supply requirements of military operations. Furthermore, it prevents the possible loss of life due to shock or
injuries and cuts down permanent disability to the minimum. Early hospitalization and faster relief from pain bolster the
morale of both patients and effective troops left in battle areas and places of assignment.
The aero-medical section of the different air bases of the Philippine Air Force is tasked with carrying out this mission in
line with the overall objective of the AFP Medical Service which is to conserve the fighting strength of the troops.
A flight nurse is a commissioned officer of the Nurse Corps in the active service, usually assigned in Philippine Air Force
(PAF), and who has undergone special training and instruction about flight nursing in the Philippines or abroad. To be

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Education (Department of Nursing) 9 of 14
considered really competent, he/she must be genuinely interested in flying and attending to patients even under the most
trying conditions around the clock; yet still able to perform regular hospital nursing duties when not on flight alert. If he/she
does not possess enough maturity and sense of responsibility, these taxing obligations are sufficient to make him/her a
liability.
A great percentage of flight missions include evacuation of civilians, mostly indigents, who come from areas not usually
reached by commercial airlines. On such missions, the flight nurse is the most important member of the aeromedical team.
More often than not, medical missions are performed without a flight surgeon. When such situations arise, the flight nurse
assumes full responsibility for the care of the patients.

SCHOOL HEALTH NURSING

School health nursing is very different from hospital nursing. School health nurses must like children a lot. They often
work alone, out of touch with other nurses, the hospital and all professional supports they have known. They are responsible
for the school's activities in the areas of health service, health education, and environmental health and safety.
The primary function of the school is education. The health program of each school is geared toward making the
students and faculty understand those programs which emphasize health promotion, prevention of disease, and
follow-through of any findings that may indicate a need for medical care and treatment. They perform a wide variety of
services including basic screening for vision, hearing, and risk factors that would interfere with the development of a healthy
lifestyle.
For a school nurse, team relationship with other members of the school staff and participation in their activities will
depend on the size of the school, the community, the health needs of the pupils, and availability of other personnel such as
social workers or guidance counselors.
Some responsibilities of the school nurse are:
1. organizing and implementing the school health program;
2. coordinating school health programs;
3. undertaking functions directly related to pupil's health;
4. evaluating school health programs; and
5. carrying out functions related to the health of school personnel.

Advantages of School Health Nursing

School nursing affords one the opportunity to watch children advance from grade to grade in school health. Hours are
usually good and there is no shift duty.

Disadvantages
Many school nurses do not update themselves on the current issues in nursing making them unaware of changes in the
nursing practice.
School nurses should enjoy working with children and should be able to work through, and with others to achieve their
objectives. They should accept the educational functions of the school and be committed to the promotion of health through
education.

CLINIC NURSING
Clinic nursing requires that a nurse possess general skills. Usually a doctor has been in general practice for a number of
years. It is with him that the nurse acts as a receptionist, answers phone, does the billing, takes x-rays and ECGs, changes
dressings, gives injections (such as BCG, DPT, or measles vaccine), and assists in physical examinations. The nurse may
even do autoclaving of instruments, keep records, order and store supplies, make follow-up calls and referrals for patients.
Teaching patients and their families has become an important function of the clinic nurse. Nurses in this field must have
excellent teaching and communication skills, exhibit organizational and leadership ability, possess good assessment skills,
and have good insight in order to anticipate and interpret the needs of their patients.
The advantages of clinic nursing are favorable working hours, the satisfaction of working with people they know and like
and who know and like them in return. Efficient clinic nurses are trusted in their judgement and share in planning the care of
the patient.
Generally, and on the average, clinic nurses receive a slightly lower salary than hospital nurses. A written contract
setting forth the professional and personal arrangements between the nurse and the employer can be mutually beneficial.

ADVANCED PRACTICE NURSING

This field of nursing is synonymous with specialization. Even specialization is a hallmark of a mature discipline. The
advanced practice nurse is an umbrella term for nurses who have specialized education and experience beyond the basic
nursing program. This advanced practice requires the knowledge skills and supervised skills obtained through graduate
study in nursing (either master's or doctoral degree). This field covers the role of the clinical nurse specialist.
The Clinical nurse specialist is also known as a nurse specialist, nurse clinician or clinical specialist. The clinical
specialist is an expert practitioner within a specialized field of nursing. Some may concentrate on cancer, rehabilitation, care

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Education (Department of Nursing) 10 of 14
of patients with ostomies, neurological conditions, psychiatry, and many other subspecialties. These nurses participate in a
range of subroles including direct patient care, research, teaching, consultation, and management.

INDEPENDENT NURSING PRACTICE

How would you like to hang at your gate or window a sign bearing your name and the words "Independent Nurse
Practitioner?" Here in the Philippines, there are already few nursing clinics, a group of nursing specialists, and a project
subsidized by the Philippine Nurses Association, wherein nurses do independent nurse practice.
As the term implies, "independent" means the nurse is self-employed and provides professional nursing services to
clients/ patients and their families. While some independent nursing practitioners set up their clinics near a hospital (as in the
case of the Psychiatric Nursing Specialists, Inc.), most of them are community-based. These nurses reach out and offer their
services rather than expect clients to seek their help. They perform both independent and collaborative roles. Healthcare
assessment, formulating plans for health maintenance, prevention strategies, continuation of supportive activities in critical
and complex health problems are all within the scope of nursing practice. They make referrals and collaborate with
physicians and other disciplines as needed by the client or family.
Independent nurse practitioners are accountable for their decisions. Whether their role is independent or collaborative, it
is based on the fact that each health care discipline offers an area of knowledge and expertise. Collaborative work is needed
for effective, efficient, and economical care. It is essential therefore that independent nurse practitioners acquire working
knowledge of the skills and expertise of other health workers.

Predicted Outcomes of the New Role of Nurses as Independent Nurse Practitioners

The growing interest in independent nursing practice is expected to contribute much to the improvement of health care
in the country.
1. It will encourage professional nurses to extend their capabilities and assume greater responsibilities for designated
areas of generalized nursing practice.
2. The amount of health care will be more increased and accessible to people.
3. The nurse's involvement in the client's family or community will increase the nurse's sensitivity and response to their
clients' needs.
4. Improvement of health services will help prevent serious illnesses and maintain positive community health programs.
5. It will provide data for nursing education, to validate and legitimize extended role practices for nurses.
Although independent nursing practice is a growing trend in our country today, several questions are hereby posed in
this regard.
1. Are our present graduates prepared to do independent nursing practice? If they are not, who shall provide this training?
2. At what point in their professional life may the nurses start this kind of practice?
3. Does our present curriculum provide for preparation in this field?
4. How does a nurse survey the field or area to determine the size of market for a particular service?
5. Can independent nursing practice support a practitioner economically?
6. How much shall they charge for their services? When can they expect to break even? When can they expect a liveable
income?
7. How can they advertise their services within ethical bounds?
8. What liabilities are common in this kind of practice?
9. How soon and how best will they be accepted within the community of their choice?
10. At these times when thousands of nurses are unemployed, is independent practice an answer to nursing
unemployment?
It is time that we assess our own resources to explore this new field of practice. But the initial preparation for this kind of
practice should have been incorporated first in nursing programs before nurses can assume this role effectively.

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 20 minutes for this activity:

Multiple Choice

1. Nursing in hospitals and related health facilities such as extended care facilities, nursing homes, and neighborhood
clinics, comprises all of the basic components of comprehensive patient care and family health. This field of nursing is:
a. Hospital or Institutional Nursing
b. Public Health Nursing or Community Health Nursing
c. Industrial or Occupational Health Nursing
d. Nursing Education
ANSWER: ________

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Education (Department of Nursing) 11 of 14
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

2. In what section of the RA 9173 are qualifications of nursing service administrators be found?
a. 28
b. 29
c. 31
d. 33
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

3. The beneficiaries of the comprehensive nursing specialty program are obligated to serve for how long in any Philippine
hospital?
a. 1 year
b. 2 years
c. 3 years
d. 4 years
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

4. Public Health nursing refers to:

a. the practice of nursing in the 7 local, national and city health departments which include health centers and
public schools
b. nursing practice in a variety of roles, which at times include independent nursing practice
c. Both are correct
d. None are correct
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________________

5. The following are the qualifications of Nursing Coordinator for Staff Development, except.
a. 2 years clinical experience
b. 4 years clinical experience
c. Master’s Degree
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

6. Private duty nurses use the following titles: SATA

a. Private Nurse Practitioner
b. Special Duty Nurse
c. Private Duty Nurse Specialist
d. Caregivers
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

7. Private duty nurses should be an IV therapist certified by

a. PRC
b. BON
c. PNA

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Education (Department of Nursing) 12 of 14
 d. ANSAP
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

8. Which of the following should a dean in a college of nursing have?

a. 1 year of clinical practice in a field of specialization
b. Post-Master’s Degree
c. Doctoral Degree in Nursing
d. 5 years teaching experience
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

9. Who led the nursing of the sick and wounded Katipunan revolutionaries in 1890?
a. Elipido Quirino
b. Tandang Sora
c. Nurse Corps
d. Manuel Quezon
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

10. The following are the responsibilities of a school nurse. SATA

a. organizing and implementing the school health program;
b. coordinating school health programs;
c. undertaking functions directly related to pupil's health;
d. evaluating school health programs
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
6. ANSWER: ________

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Education (Department of Nursing) 13 of 14
 RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
7. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
8. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
9. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
10. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: Do Now Strategy

This activity is to evaluate what you learned after the discussion and the activity.

What field of nursing did you find interesting?

________________________________________________________________________________

Site 3 reasons
1. ________________________________________________________________________________
2. ________________________________________________________________________________
3. ________________________________________________________________________________

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Education (Department of Nursing) 14 of 14