UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER

katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

SEPTEMBER 29, 2022 – WEEK 08  The injury would not happen unless it was DOCTRINE OF “FORCE MAJEURE”
RECORDED LECTURE an act of negligence from someone o DUE TO “AN IRRESISTBLE OR SUPERIOR FORCE”
- The accident was caused by an instrumentality No person will be held liable for events which could
LEGAL LIABILITIES or agency within the exclusive control of the
o
not be foreseen, or which though foreseen, were
IN NURSING PRACTICE defendant inevitable except cases specified by the law
- There is no voluntary action or contribution on o ex. Falls, Fire, Earthquake, etc.
THE JUDICIAL PROCESS the part of the plaintiff - Nurses who fail to render service in these
o Nurses are liable for their actions o EXAMPLES moments are not held negligent
o Nurses who committed an error/crime is subjected - A patient walks going to OPD, he was injected - Heavy traffic → not as excuse for force majeure
to the judicial process prior to serving in the buttocks and experienced extreme pain
o Functions to settle disputes peacefully and in → the sciatic nerve was injured LEGAL ROLES OF NURSES
accordance with the law - The presence of sponges n the patient’s o PROVIDER OF SERVICE
o The judicial procedure is to ascertain facts by abdomen after surgery o EMPLOYEE OR CONTRACTOR FOR SERICE
hearing evidence, determine which facts are - Fracture of a newly delivered baby born by o CITIZEN
relevant, apply the appropriate principal of law breach presentation
and past judgement AREAS OF POTENTIAL LIABILITY IN NURSING
o This procedure is done to undergo a due process of DOCTRINE OF “RESPONDEAT SUPERIOR” CRIME
the law o “LET THE SUPERIOR OR PRINCIPAL ANSWER” o An act committed in violation of public law and
- Liability is expanded to the master as well as punishable by a fine and/or imprisonment
STEPS IN THE JUDICIAL PROCESS the employee, not a shift of liability from the
o PLANTIFF FILES A COMPLAINT subordinate to the master FELONY
- The accuser is known as the complainant or a o In doing the acts out of which the accident arose, o A crime of a serious nature punishable by a term in
plaintiff the servant was representing the master at the time prison
o AN ANSWER WILL BE MADE BY THE DEFENDANT o Only to those actions performed by the employee
- The accused is known as the respondent or within the scope of his employment MISDEMEANOR
defendant o EXAMPLE o An offense of a less serious nature and is punishable
o DISCOVERY - Hospital hires underboard nurses/midwives by a fine or short–term jail sentence
o TRIAL despite being incompetent
o DECISION/VERDICT - Surgeon is held responsible if a procedure pack TORT
is left in the patient’s abdomen o A civil wrong committed against a person or a
CONCEPTS OF A REASONABLY PRUDENT MAN o Private duty nurses are considered independent person’s property
o When a person engages in an activity, he or she contractors → they are liable for their own negligent o Usually litigated in court by a civil action between
has a legal duty to act as an ordinary prudent actions individuals and is based on fault
reasonable person would act o CONDITIONS/TEST OF LIABILITY
- The power to control INTENTIONAL
STANDARD OF REASONABLENESS  If the master cannot command the o May arise in nursing due to urgent needs
DOCTRINE OF “RES IPSA LOQUITOR” alleged servant, then the acts of the latter
o “THE THING SPEAKS FOR ITSELF” are not his, and he is not responsible for FRAUD
- The injury would not have happen if someone them o False representation of some fact with the intention
was not negligent that no further proof is - If the principal cannot control and direct the that it will be acted upon by another person
required alleged agent, then he is not his agent - INVASION OF RIGHT TO PRIVACY AND BREACH
o The thing causing the accident lies within the - The rule is when the general employer assigns TO CONFIDENTIALITY – a direct wrong of
exclusive control of the defendant his servants to duty for another and surrenders personal nature through revealing information
o CONDITIONS to the other, direction and control is hence that will affect the person’s standing in the
- The accident won’t happen in the absence of shifted to that person (ex. Hospital direction community or group where he belongs
someone’s negligence and control of the surgeon in the OR)  Patient has the right to be left alone

1
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

 When nurses leak patient charts to o Unlawful restraint or detention of another person - Comply with the established set of the
unauthorized persons against his or her standards of care
o Unjustifiable detention of a person without a legal - Document actions taken as well as the
DEFAMATION warrant outcome of such interventions accurately and
o Communication that is false, or made with a o If the patient has communicable disease, hospital completely
careless disregard for the truth, and results in injury cannot be charged of false imprisonment if it
to reputation of a person compels the patient to stay in the hospital MALPRACTICE
- LIBEL o Mental health patients may be contained in the o Any professional misconduct, or any unreasonable
 Defamation by means of printing, writing or hospital if there is a danger that may jeopardize lack of skill or fidelity on the performance of
pictures their lives and property of others professional or fiduciary duties
- SLANDER o Patients intending to leave the hospital cannot be o It means objectionable practice, or a practice
 Defamation by means of spoken words, detained, but the probable consequences of their contrary to established rules
stating unprivileged (not legally protected) actions must be explained by a competent doctor o Loosely refer to the negligence of a member of any
or false words by which someone’s or medical staff professional group
reputation is damaged o EXAMPLES
o Exchange of remarks between two persons does UNINTENTIONAL - Medication errors
not constitute defamation, there must be a third NEGLIGENCE - Sponges or other small things left inside a
person witness to consider it a defamation o Doing of that thing which a reasonably prudent patient during surgery
o Nurses should be careful with their statements person would not have done, or the failure to do a - Burning a patient
especially regarding their patients and their co thing that a reasonably prudent person would have - Fall
workers done in like or similar circumstances - Mistaken identity
o If the statements are justifiable and not for a o Indicates deficiency of perception and lack of - Failure to observe and take appropriate
malicious person then truth is an acceptable foresight actions
defense o IMPRUDENCE – a deficiency of action involving a o ELEMENTS OF MALPRACTICE
- ex. Head nurse tells the chief nurse on one of lack of skill - DUTY OWED THE PATIENT
the inefficiencies of the staff nurses o RECKLESS IMPRUDENCE – does an act or fails to do it  NATURE OF DUTY – existence of duty +
voluntarily without malice from which material standard of care that represent minimum
ASSAULT AND BATTERY damage results immediately requirement for an acceptable practice
o ASSAULT – an attempt or threat to touch another o SIMPLE IMPRUDENCE – that the person or nurse did  BREACH OF THE DUTY – after establishing
person unjustifiably not use precaution and the damage was not the standard of care, show that defendant
o BATTERY – intentional unconsented touching of immediate or the impending danger was not fall below the standard of care
another person that may or may nor cause harm evident or manifested - FORESEEABILITY
o Any procedures to be done on the person, consent o SPECIFIC EXAMPLES OF NEGLIGENCE  Certain events may reasonably be
must be secured, unconsented procedures makes - Failure to report observations to attending expected to cause specific results
nurse liable to battery physician - CAUSATION
o When a person comes to the hospital, it is implied - Failure to exercise the degree of diligence  The nurse’s action or lack of action directly
that he consents to be treated, however, he may which the circumstances of the particular case cause specific results
refuse certain contacts (ex. Injection) demands - INJURY
o Is the nurse still administers the injection without - Mistaken identity  the resultant harm must be physical, not
consent, they will be charged with battery - Errors in medication merely psychological, or transient
o Another is when patient is injured under restraints - Defects In equipment - DAMAGES
may cause the nurse to be liable for assault and - Errors due to family assistance  The plaintiff must show financial harm
battery - Administration of medicine without a doctor’s before the court will allow a finding of
prescription liability against the defendant nurse or
FALSE IMPRISONMENT o LEGAL DEFENSE IN NEGLIGENCE hospital
o Also known as illegal detention - Know the standards of care

2
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

DUE PROCESSES OF LAW AND LEGAL PROCEDURES - FRUSTRATED - Unlawful aggression on the part of the offender
ELEMENTS OF CRIMINAL OFFENSE - ATTEMPTED - Reasonable necessity for the means employed
o CRIMINAL ACT o BASED ON THE DEGREE OF PUNISHMENT by the person to defend himself
- The state seeks the punishment of the - GRAVE - Lack of sufficient provocation
wrongdoers - LESS GRAVE o IN THE DEFENSE OF FAMILY MEMBERS / RELATIVES
o EVIL / CRIMINAL INTENT - LIGHT - When he or she acts in defense of the person or
rights of a stranger provided first and second
CONSPIRACY TO COMMIT CRIME DEGREE OF EXECUTION requisites mention in the first circumstances and
o Persons who commit felonies can either be o CONSUMMATED the person defending is not induced by
principals, accomplices, or accessories - All the elements necessary for its execution and revenge, resentment, or other evil motives or in
o PRINCIPAL accomplishment are present any person in order to avoid injury does an act
- For those who take a direct part in the o FRUSTRATED which causes damage to another provided
execution of the act - When the offender performs all the acts or that the evil sought to be avoided actually
- Who directly force or induce others to commit it execution of the felony but which do not exists
- Who cooperate in the commission of the crime produce it by reasons independent of the will. o IN DEFENSE OF STRANGERS / RIGHTS OF STRANGERS
without by another act without which it would The perpetrator - Any person who acts or defend the rights of
not have been accomplished o ATTEMPTED any person or their spouse does not incur
o ACCOMPLICE - When the offender commences the criminal liability
- Those who, not being principals cooperate in commission of the felony by overt acts, and o AVOIDANCE OF GREATER EVIL OR INJURY
the execution of the crime by previous or does not perform all the acts or execution by - Evil exists, injury feared is greater or no other
simultaneous act reason of some cause or accident other than practical or less harmful way to prevent it
- To hold the person liable of accomplice, they his spontaneous desistance - No other practical or less harmful means to
must have knowledge of the criminal intention avoid it
of the principal DEGREE OF PUNISHMENT o ACTS IN FULFILLMENT OF DUTY, OR LAWFUL EXERCISE
- Their knowledge may be seen in previous o GRAVE FELONIES OF RIGHT OR OFFICE
simultaneous acts that contribute to the - Those with capital punishment (death) or - Any person who acts in a fulfillment of a duty or
offense penalties which in any of their periods are in the lawful exercise or right of office shall not
o ACCESSORIES afflictive (imprisonment ranging from 6 years also incur any criminal liability where such acts
- Those who, having the knowledge of the and one day to life imprisonment or a fine not results in the commission of the crime
commission of the crime, either as principals or exceeding P6,000.00) o OBEDIENCE TO A LAWFUL ORDER
accomplices take part subsequent to its o LESS GRAVE FELONIES - When a nurse is under order of his superior, he
commission by - Those with penalties which are correctional or she should be able to discern whether the
 Profiting themselves or assisting the (ranging from 1 month and 1 day to 6 years) or order is lawful or not because if such order will
offender to profit from the effects of the a fine not exceeding P6,000.00 but not less than result in the commission of the crime, he or she
crime P200.00) shall be criminally liable
 Concealing or destroying the body of the o LIGHT FELONIES
crime, or the effects or instruments thereof - Those with the penalty of arresto menor EXEMPTING CIRCUMSTANCES
in order to prevent its discovery or (imprisonment for one day to 30days or a fine o Certain circumstances where a person is exempted
 Harboring, concealing, or assisting in the not exceeding P200.00) from a criminal liability
escape of the principal of the crime, o IMBECILITY OR INSANITY
provided the accessories act with abuse of CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY - Unless the person has acted during an interval
their public functions or are known to be JUSTIFYING CIRCUMSTANCES o BEING NINE YEARS OF AGE OR LESS OF AGE
habitually guilty of some other crimes o Those circumstances which make the act of a o OVER 9 YRS AND UNDER 15 YRS UNLESS HAS NOT
person to be legal and not criminal, so he is ACTED WITH DISCERNMENT
CLASSES OF FELONIES deemed not to have violated the law and is free o PERFORMING A LAWFUL ACT WITH DUE CARE BUT
o BASED ON THE DEGREE OF THE ACTS OF EXECUTION from both criminal and civil liability CAUSED AN INJURY BY MERE ACCIDENT
- CONSUMMATED o SELF DEFENSE o UNDER THE COMPULSION OF IRRESISTIBLE FORCE

3
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

o UNDER AN IMPULSE OF AN UNCONTROLLABLE FEAR o Taking advantage of public position effects of the crime and other conditions attending
OF AN EQUAL OR GREATER THAN INJURY o Contempt of or insult to public authorities its commission
o FAILED TO PERFORM AN ACT REQUIRED BY LAW, o Committed with disregard of rank, age, or sex o Relationships, intoxication, degree of instruction and
WHEN PREVENTED BY SOME LAWFUL CAUSE o Committed in the dwelling of the offended party education of offender
o Committed with abuse of confidence - RELATIONSHIP – when the offended party is
MITIGATING CIRCUMSTANCES o Obvious ungratefulness related by affinity in the same degree of the
o Those that do not constitute justification or excuse o Palace of the Chief Executive of the country offender
of the offense in question but which in fairness and o Committed in place of worship - INTOXICATION
mercy may be considered as extenuating or o Committed in consideration of a price, reward,  Taken into consideration as a mitigating
reducing the degree of moral promise or fortune circumstance when the offender has
o INCOMPLETE JUSTIFYING OR EXEMPTING o Committed by means of inundation, fire, poison, committed a felon in a state of intoxication
CIRCUMSTANCES explosions, intentional damage, etc.  When the intoxication is intentional, it is
o NO INTENTION TO COMMIT SO GRAVE A WRONG AS o Committed with evident premeditation or after an considered as aggravating circumstance
THE ONE COMMITTED unlawful entry - Illiteracy is not considered mitigating, there
o BEING UNDER 18 Y/O OR OVER 70Y/O o When craft, fraud, or disguise is employed must be lack of sufficient intelligence and
o WITH SUFFICIENT PROVOCATION OR THREAT ON THE o Where public authorities are engaged in the knowledge of the full significance of once act
PART OF THE OFFENDER discharge of their duties - Lack of education is not mitigating
o IMMEDIATE VINDICATION OF A GRAVE OFFENSE o Wrong done in the commission of the crime is
- Partly precedes the act for the act Is deliberately augmented by doing other wrongs not PENALTIES
committed in the immediate vindication of a necessary for its commission o is the suffering being inflicted by the State for the
great offense to the one committing the felony o Committed on the occasion of calamity or commission of the crime
his or her spouse, ascendants, descendants, misfortune
legitimate/natural/adopted siblings, relative or o Nighttime or during period of darkness THEORIES JUSTIFYING PENALTY
family within the same degree o In an uninhabited place o PREVENTION – Penalty prevents the danger to
o ACTS UPON IMPULSE SO POWERFUL AS NATURALLY o By a band or cuadricilla or a group f more than 3 society that may arise from crimes
TO HAVE PRODUCED PASSION OR OBFUSCATION armed men o SELF–DEFENSE – penalty is a measure of self–defense
- When the person acts on impulse so powerful o With the aid of armed men intended to protect society from the threat and
to have produced an obfuscation o RECIDIVISM – when one who at the time of his trial wrong inflicted by the criminal
o VOLUNTARY SURRENDER OR CONFESSION OF HIS for 1 crime shall have been previously convicted of o REFORMATION – penalty is intended to correct and
GUILT another crime by final judgement reform the offender
- When the offender voluntary surrenders himself o HABITUALITY – have been previously punished with o EXEMPLARITY – the criminal is penalized as an
to the authority that he or she voluntarily an equal or greater penalty or with a lighter penalty example to deter others from committing crimes
confesses his or her guilt before the court prior o Utilization of the offender’s superior strength o JUSTICE – penalty is imposed as an act of retributive
to the presentation of the evidence for the o When means to weaken defense are employed justice/or vindication of right and moral law
prosecution o Treachery violated by the criminal
o WITH PHYSICAL DEFECT, DEAF OR DUMB, BLIND o Add Ignominy to the natural effects of the felony
WHICH RESTRICTS HIS MEANS OF ACTION, DEFENSE, (make the effects more humiliating/shameful) CAUSES OF TITAL EXTINCION OF CRIMINAL LIABILITY
OR COMMUNICATION WITH HIS FELLOW BEINGS o Breaking a wall, roof, floor, door or window as a o DEATH OF THE CONVICT
o ILLNESS OF THE OFFENDER THAT DIMINISHES THE means o SERVICE OF THE SENTENCE
EXERCISE OF HIS WILLPOWER o With the aid of minors or by means motor vehicles, o AMNESTY – general pardon of a class of person who
o SIMILAR AND ANALOGUES CIRCUMSTANCES – AS airships or other similar means are guilty of high political crimes
IMPULSE OF JEALOUSY AND EXTREME OVERTY AND o Cruelty o ABSOLUTE PARDON – an act of grace which
NECESSITY exempts the convict from the punishment of his
ALTERNATIVE CIRCUMSTANCES crime without any condition
AGGRAVATING CIRCUMSTANCES o Those which must be taken into consideration as o PRESCRIPTION OF THE PENALTY – the forfeiture or loss
o Increases the criminal liability of the offender or aggravating or mitigating according to nature and of the right of the State to execute the final
makes it more severe sentence after the lapse of a certain time

4
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

o MARRIAGE OF THE OFFENDED WOMEN or the o SEDUCTION causing further harm, and as needed to prevent
marriage of the offender, in good faith, with the o ABDUCTION further harm
offended woman after the commission of the crime o Apply rules of first aid; assess for and prevent
of Rape, Acts of Lasciviousness, Seduction or CRIMES AGAINST CIVIL STATUS OF THE PERSON bleeding; asses for the need to initiate CPR, cover
abduction o SIMULATION OF BIRTH patient with blanket
o SUBSTITUTION OF ONE CHILD FOR ANOTHER o Continuously assess and reassess then person for
SOME CRIMES OR FELONIES o CONCEALEMENT OR ABANDONMENT OF A additional injuries and communicate findings to
CRIMES AGAINST PERSONS LEGITIAMTE CHILD patient/relatives
o PARRICIDE – killing of a persons’ father, mother, or - With intent that the child lose their civil status o Have someone call or go for additional help while
child shall be punishable for simulation of birth with you stay with the injured party
o MURDER – an unlawful killing by a person of another prison and a fine not exceeding P1000 o Stay with the person until equally or more qualified
committed due to the following circumstances o USURPATION OF ANOTHER’S CIVIL STATUS help arrives
treachery, reward, promise, inundation, fire, poison, o BIGAMY o Give as complete description as possible of the
etc. o MARRIAGE CONTRACTED AGAINST THE PROVISIONS care you have rendered to the police and
o HOMICIDE – unlawful killing by a person of another OF LAW emergency medical personnel so that continuity of
without the presence of the circumstances care exists
qualifying it as murder CRIMES AGAINST HONOR o Do not accept any compensation
o GIVING ASSIATANCE TO SUICIDE o LIBEL – written public r malicious act to discredit or o Should you choose not to stop and render aid; stop
o INFANTICIDE – killing of a child less than 3 days of dishonor a person at the nearest phone and report the incident to
age o SLANDER – oral defamation proper authorities
o ABORTION o SLANDER BY DEED – one who performs an act to
o DISPENSING OF ABORTIVES dishonor or discredit someone
o MUTILATION
o PHYSCIAL INJURIES PROFESSIONAL LIABILITY INSURANCE
o RAPE o Protect nurses from liability, there is professional
insurance
CRIMES AGAINST PERSONAL LIBERTY o Defrays legal fees, settlement made out of court
o KIDNAPPING – when you deprive somebody of his o Covers all costs incurred by the nurse up to the face
liberty value of the policy
o ABANDONMENT OF PERSONS IN DANGER o Not yet that popular in the Philippines
o ABANDONMENT OF ONE’S VICTIM
o THREATS GOOD SAMARITAN LAW
o GRAVE COERCION o Designed to protect healthcare providers who
provide assistance at the scene of the emergency
CRIMES AGAINST POVERTY against claims of malpractice
o ROBBERY o Unless it can be shown that there was a gross
o THEFT departure from the normal standard of care or willful
o SWINDLING OR ESTAFA wrongdoing
o DESTRUCTIVE ARSON
o MALICIOUS MISCHIEF THINGS TO REMEMBER IN BEING A GOD SAMARITAN
o Make decision quickly as to whether or not you will
CRIMES AGAINST CHASTITY stay and help. Remember there is no common law
o ADULTERY – committed by a married woman who or duty to stop and render aid
has sexual intercourse with a man not her husband o Ask the injured person for permission to help. Don’t
o CONCUBINAGE – cohabits with a woman not his force your services
wife in any other places o Care for the injured party where you can do safely.
o ACTS OF LASCIVIOUSNESS Move the injured part only if you must do so without

5
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

OCTOBER 06, 2022 – WEEK 09 o GUIDELINES  Medical dx, treatment plans, prescriptions,
RECORDED LECTURE - NURSES SHALL RESPECT THE FOLLOWING RIGHTS health insurance, genetic information,
WHEN RENDERING CARE clinical research records, mental health
LEGAL RESPONSIBILITIES  Cultural and religious beliefs records
OF THE NURSE  Privacy - A lack of privacy could lead to personal
 Confidentiality of information embarrassment, public humiliation and
o Like any member of other profession, as professional - Nurses shall provide the patients all pertinent discrimination
has many legal responsibilities to assume in the information except those which may be o To expect all communication and records
practice of their professions deemed harmful to their well–being pertaining his care should be treated confidential
o These legal responsibilities are entwined in every - They shall ensure that patient’s records are o To review the records pertaining to his care and
service she renders to the patient, they may be felt available only to those who are professionally have then explained or interpreted as needed
by her specially when questions arise involving and directly involved in their care except when o To expect response to the request for appropriate
negligence in the performance of their duties or in required by law and medically indicated care and services
the care or supervision of the patient, or in the - When conflict arises regarding management of o To ask and be informed of the existence of business
fulfillment of contractual obligations patient care, the patient’s right are upheld relationship among hospital, educational
o Important to nurse that she knows her legal institutions, other health care providers that may
responsibilities attached to the aurous phases of her PATIENT’S BILL OF RIGHTS influence the patient’s treatment and care
professional practice so that she may be properly o To considerate and respectful care o To consent or refuse participation in research
guided in the discharge of her function - Otherwise known as non–discrimination studies or human experimentation
o A nurse who knows her legal responsibilities will find - Is the right to be treated with dignity and o To expect continuity of care and to be informed of
it easier to avoid incurring criminal liability respect and is not to be discriminated against available and realistic care options when hospital
o To know what these responsibilities are, she doesn’t for any reason regardless of their sex, race, care is no longer appropriate
need a mastery of law, it is efficient that she possess age, origin, ethnicity, religion, sexual o To be informed of hospital policies and practices
such working knowledge of her legal responsibilities orientation, gender identity or expression may that relate to patient care, treatment and
and avoid criminal liability they be veteran or any other military status, responsibilities
religion or any other basis prohibited by the law
LAW - They also have the right to be treated IMPLEMENTING MEDICAL ORDERS OF REFERRALS
o The legal responsibility of the nurse is regulated by a humanely and never be subjected to o RA 6675
law degrading treatment by any healthcare - Only valid registered medical, dental and
o It pertains the rules made by humans that regulate profession veterinary practitioner are authorized to
social conduct in a formally prescribed and legally o To obtain from his doctor complete current info prescribe drugs; prescribed drugs be written in
binding manner about his diagnosis, treatment and prognosis in their generic names
terms that the patient or the person in his behalf o RA 2832, RA 4419
DEFINITION OF TERMS can understand - Prescriptions made by unauthorized persons
o LEGAL RIGHTS – a claim that can be enforced by o To make decision about the plan of care prior to constitute illegal practice of medicine, dentistry
legal means against the person of the community and during course of the treatment and to refuse and veterinary medicine
whose duty is to respect it treatment and to be informed the consequences of o In accordance with RA 5921 (PHARMACY ACT), all
o ACCOUNTABILITY – being answerable when this action prescriptions must contain the following information:
carrying out professional responsibilities o To have an advance directive concerning - Name of the prescriber
o LIABILITY – being legally bound treatment or designation a surrogate–decision - Office address
o RESPONSIBILITY – an obligation to perform some act maker - Professional registration number
for which one can be held answerable o To every consideration of his privacy - Professional tax receipt number
- The most basic right of every patient - Patient’s name, age and sex
PATIENT’S RIGHTS - They have the right to decide to whom, when - Date of prescription
o Nurses are the advocates of the patients; they take and to what extent their private individuality o RA 6675 requires that drugs should be written in their
appropriate steps to safeguard the patient’s rights identifiable health information is disclosed generic names
and privileges - The information includes but not limited to:

6
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

o Carry out doctor’s order provided that they are TELEPHONE ORDERS IMPLEMENTING DELEGATED AND INDEPENDENT NURSING
written legal order of the physician and bear the o Done only in extreme emergency cases and when INTERVENTIONS
doctor’s signature no other resident or intern is available should a o Function within the scope of your education, job
o Help plan and implement patient care nurse receive telephone orders description and area nurse practice act
o Report’s patient’s condition including results of o Such order should be signed by the physician in o Follow the procedure and policies of the employing
therapies to properly monitor and modify the his/her next visit within 24 hours institution
management of care o The nurse should sign the name of physician per her o Observe and monitor the patient accurately
o NOTE: Written orders must be clear, specific, own and note the time the order was received o Communicate and record significant changes in
complete and legible in order to minimize errors the patient’s condition to the physician
REFERRALS o Check any other orders that a patient questions
MANAGING THE OMITTED OR REFUSED DRUG o The process of sending or guiding someone to o Identify patients before initiating interventions.
OMITTED DRUGS another source for assistance o Protect patients from falls and preventable injuries.
o THESE DRUGS MAY BE OMITTED INTENTIONALLY FOR - A patient may be referred by a hospital to a o Document all nursing assessments and interventions
THE FOLLOWING REASONS: community–health nursing service for accurately.
- The patient is to have a diagnostic test and is to assistance with home care o Ask for assistance and supervision in situations for
fast prior to the test - A school nurse may refer a student to a hospital which you feel inadequately prepared.
- Oral drugs are usually omitted or their emergency room o Delegate tasks to persons with the knowledge and
administration is delayed, depending on the - A referral may be used within a particular skill to carry them out.
physician’s wishes agency. o Build and maintain good rapport with patients.
- The problem for which the medication is  ex. a hospital out–patient clinic may refer a
intended no longer exists patient to the hospital’s in–service facilities DAMA (DISCHARGE AGAINST MEDICAL ADVICE)
- The patient is suspected of having an allergy to - Most institutions have policies related to o The right to refuse treatment includes the right to
the medication; any suspected allergy should referrals. Policies usually indicate who may leave the hospital against medical advice
be reported to the physician initiate a referral and how it is to be done o Recognize a potential patient walk–out
o IF THE PATIENT INSISTS ON LEAVING:
REFUSED DRUG CARRYING OUT A PHYSICIAN’S ORDER - FOLLOW THE POLICY OF THE HOSPITAL
o THE RESPONSIBILITIES OF THE NURSE TO TAKE DURING o Only when the orders concerning treatment and REGARDING DAMA
REFUSAL TO TAKE MEDICATION ARE THE FOLLOWING: medications are in writing and bear the physician’s - IF THE HOSPITAL DOESN’T HAVE A POLICY ABOUT
- Report promptly to the physician signature does the nurse have the legal right to DAMA:
- Note properly in the patient’s chart regarding follow it  Contact the patient’s significant other and
the refusal o It is expected that nurses know basic information explain
- NOTE: The nurse play an important role in about procedures and medications ordered by the  Give the client a DAMA form and ask the
determining the reason for the refusal and to physician patient to sign
clarify any misconceptions o It is the responsibility of the nurse to clarify  Provide routine discharge care
- Patients have the right to refuse therapy, and ambiguous or seemingly erroneous orders form the
the nurse should recognize and respect that prescribing physician and then to other sources DEALING WITH AN ESCAPE
right o Notify the nursing supervisor and security
THE ORDERS THAT NURSES MUST QUESTION TO PROTECT immediately
INTRAVENOUS THERAPY AND LEGAL IMPLICATIONS THEMSELVES LEGALLY o Notify patient’s family
o PHILIPPINE NURSING ACT OF 1991 SECTION 28 states o Question any order the patient questions o Collect patient’s belonging and document it
that “In the administration of intravenous o Question any order if the patient’s condition has
administration of intravenous injections, special changed INFORMED CONSENT
training shall be required according to protocol o Question and record verbal orders to avoid CONSENT TO MEDICAL AND SURGICAL PROCEDURES
established” miscommunication o DEFINITION – “free and rational act that
o Nurses should use the Intravenous Nursing Standards o Question standing orders especially if the nurse is presupposes knowledge of the thing to which
of Practice developed by the Association of Nursing inexperienced consent is being given by a person who is legally
Service Administrators of the Philippines (ANSAP) capable to give consent.”

7
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

o Only in case of emergency where the consent o Benefits and risks TERMS
requirement does not apply o Alternative treatment or procedure o ESTATE – interest a person has on land and other
o The physician should give as much information o Possible effects of not having the treatment or properties
about contemplated procedure and the patient procedure o DECEDENT – a person whose property is transmitted
should receive enough information to allow him to thru succession whether or not he left a will
give an informed consent for such procedure NURSES’ RESPONSIBILITIES o PROBATE – validation of will in court
o The key to true and valid consent is patient o Witnessing the exchange between the doctor and o ADMINISTRATOR – one who administers the provision
comprehension the patient of a will
o “Every human being of adult years and of sound o Establishing that the patient did understand. o TESTATOR – the person who left the will
mind has the right to determine what shall be done o Witnessing the patient’s signature o TESTATRIX – a woman who made a will
with his own body” o CONCEPTS o HEIR – a person called to the succession either by
o WHO MUST CONSENT - Prevention of battery provision of will or by operation of law
- The patient is the one who gives consent on his - Person’s right to control what is done to his o TESTATE – a person who died with will
own behalf body o INTESTATE – a person who died without a will
- In case that the patient is incompetent (minor o EXCEPTIONS TO CONSENT
or mentally ill) or physically unable and is not an - Emergency situations ESSENTIALS OF A WILL
emergency case, consent must be taken from - Therapeutic privileges o TESTATOR
another who is authorized to give it in his behalf - Patient waiver - Expressed intention, not under 18 years old,
 CONSENT OF MINORS - Prior patient knowledge sound mind, free of undue influence.
 Parents or someone standing in their - Testator should name the administrator.
behalf gives consent WILLS o Estate must be disposed of in accordance with the
 Parental consent is not needed o An act whereby a person is permitted by law to legal requirements
however, if the minor is married or control to a certain degree the disposition of his o Will be signed by the testator, attested and signed
otherwise emancipated estate which will take effect after his death by at least three witnesses
 CONSENT OF MENTALLY ILL o NATURE OF THE ACT o WITNESSES
 Consent must be taken from the - The making of the will is strictly a personal act; it - Not under 18 years old, sound mind, not blind,
parents of legal guardian cannot be left in whole or in part to the not deaf, literate, Filipino citizen, no record of
 CONSENT FOR STERILIZATION discretion of a third person, or accomplished perjury.
 The husband and the wife must through the instrumentality of an agent or
consent to the procedure if the attorney PARTS OF A LEGAL WRITTEN FORM OF A WILL
operation is primarily to accomplish o CAPACITY TO MAKE A WILL o AUTHENTICATION CLAUSE
sterilization - Physical ailments and debility due to old age - Signature of the testator at the end of the will
 In cases of abruptio placentae, do not preclude the possession of mental - If he cannot sign, may be written by another
ectopic pregnancy, or ruptured uterus, capacity to make a will; to have testamentary person in his presence and direction
where sterilization is medically capacity does not necessarily mean that the - Signature of at least 3 witnesses
necessary, the patient’s consent alone testator should be in full possession of all his o ATTESTATION CLAUSE
is sufficient reasoning faculties; the presumption is that - That clause wherein the witnesses certify that
every adult is sane the instrument has been executed before
ESSENTIAL ELEMENTS OF AN INFORMED CONSENT - No presumption of incapacity arises from them, and the manner of the execution of the
o COMPLETE INFORMATION blindness alone. same
o COMPETENCE o If the nurse witnesses a will, the nurse should note on o ACKNOWLEDGEMENT OF WILL REQUIRED
o VOLUNTARINESS the patient’s chart the fact that a will was made - Every will must be acknowledged before a
and the nurse’s perception of the physical and notary public by the testator and the witnesses
INFORMATION SHOULD INCLUDE mental condition of the patient - If the testator is deaf, or a deaf–mute, he must
o Description of the treatment or procedure personally read the will, if able to do so;
o Name and qualification of the person who will otherwise, he shall designate 2 persons to read
perform the procedure

8
 UST COLLEGE OF NURSING NURSING PROFESSIONAL ADJUSTMENT LECTURE (PRELIM) NUR81025 | 4TH YEAR: 1ST SEMESTER
katrina martinez | ivan martinez | angelica mercado | alex mercurio | miguel mirabueno | dianne montecillo | zysha marquez | gel montenegro | isla morales | 4NUR6

it and communicate to him, in some o Provide data for use in continuing education and
practicable manner research.
- If blind, the will shall be read to him twice; o NOTE: If it was not charted, it is not observed or
once, by one of the witnesses, and again, by done
the notary public

ADVANCE DIRECTIVE
o A document made by a competent individual to
establish desired health care for the future or give
someone else the right to make health care if the
individual becomes incompetent. (Example: living
will and durable power of attorney)

DOCUMENTATION
MEDICAL RECORD
o A document which could describe the patient’s
medical event in a systematic, organized manner
including the patient's problems, reactions, and
responses to procedure, treatment, medications,
and diet

PURPOSE OF MEDICAL RECORDS

o Means of communication among health care
providers
o To provide legal documentation and obtain third
party payments (e.g. Medicare)
o Serves as good evidence in legal suits but are not
admissible evidence against the patient

NURSES’ RESPONSIBILITY IN MEDICAL RECORDS

o Write chronologically, truthfully and accurately on
the patient’s clinical record what he/she has seen,
encountered, or observed in connection with the
care and treatment of the patient.
o Assist in planning patient care and in continuing the
evaluation of patient’s condition and ongoing
treatment.
o Document the course of the patient’s medical
evaluation, treatment and change in condition.
o Document communication between the
practitioner responsible for the patient and any
other health professional who contributes to the
patient's care.
o Assist in protecting the legal interest of the patient,
the hospital and the practitioner responsible to the
patient.
goodluck future RN! you can do it! ☺