Professional adjustment/ Bioethics FELONIES- acts or omissions punishable by law.

Elements:
1. deceit (dolo)- deliberate intent
NURSING JURISPRUDENCE- department of law which 2. fault (culpa)- results from imprudence,
comprise all legal rules and principles affecting the practice of negligence, lack of foresight
nursing.
Stages of crimes:
NURSING LEGISLATION- the making of laws, or the body 1. Consummated
of laws already enacted affecting the practice of nursing. 2. frustrated
3. attempted
LAW- a rule of civil conduct prescribed by the supreme power
in a state commanding what is right and prohibiting what is Degree of crimes:
wrong. 1. Grave- capital punishment, or penalty of above 6 yrs
and one day, or fine of more than 6 thousand pesos.
LEGAL RIGHT- a claim which can be enforced by legal 2. Less grave- penalty of 1 month and 1 day- 6 yrs, or
means against a person whose duty is to respect it. fine 0f not more than 6k but not less than 200 pesos.
3. Light- penalty of 1day to 30 days, or fine of not more
COURT MECHANISM: than 200 pesos.

LAWSUIT- proceeding in court for a purpose. Classification of persons criminally liable:

Purpose: 1. Principal
1. to enforce a right a. by direct participation
2. to redress a wrong b. by inducement
c. by indispensable cooperation
Civil case- Complainant/ defendant
Criminal case- Plaintiff/ accused 2. Accomplice- “ accessory before the fact”
3. Accessory- “ accessory after the fact”
STATUTE OF LIMITATIONS- the length of time following a. profiting themselves or assisting others to
the event during which the plaintiff may file a lawsuit. profit
Example: negligence- filed within 2-3 years from occurrence. b. concealing/ destroying the evidence of the
crime
DUE PROCESS- is fair and orderly process which aims to c. harboring or assisting the escape of the
protect and enforce a person’s right. principal
Fundamental requirements of Due Process:
1. right to be informed Circumstances affecting criminal liability:
2. right to remain silent 1. Justifying circumstance- not criminally liable
3. right to have competent counsel a. lawful self-defense
4. no use of violence, threat, torture elements:
1. unlawful aggression
TRIAL- facts are presented and determined; law is applied at 2. reasonable necessity of the means employed
the end by the offender
3. lack of sufficient provocation
SUMMONS- is a writ commanding an authorized person to
notify a party to appear in court to answer a complaint made b. obedience to an lawful order of superior
against him. 2. Exempting circumstance- exempted from criminal
SUBPOENA- is an order that requires a person to attent at a liability
specific time and place to testify as a witness. a. imbecile/ insane, except lucid interval
SUBPOENA DUCES TECUM- is a subpoena that requires a b. person below 9 years old
witness to bring documents/ papers in his possession. c. person above 9 and below 15 unless acted
with discernment
WITNESS- person giving necessary details. d. performance of a lawful act

Nurses as witness: 3. Mitigating circumstance- reduces penalty

Could not divulge PRIVILEGED COMMUNICATION in a a. below 18 y/o or over 70 y/o
civil case- means that the nurse is incompetent to testify on the b. does not meet all requisite circumstances
communications made to him by the patient, all the advice c. offender is deaf, dumb, blind or with
given and all information gathered by observation. physical defect
Duration of seal of secrecy except: d. voluntary surrender
1. criminal case e. illness diminishing exercise of the will
2. with patient’s consent power
3. patient sued doctor for damages
4. Aggravating circumstance- increases liability
a. take advantage of public position
Testimonies of fact- factual information b. committed with abuse of confidence
- no opinion unless an expert c. on occasion of earthquake, epidemic,
witness. calamity
Perjury- is the willful telling of a lie under oath. d. for price or reward
Hearsay evidence- rumors not admissible in evidence e. fire, poison, explosion
Dying declaration- considered hearsay unless the dying person f. evident premeditation
is a victim of a crime. g. craft, fraud or disguise
h. treachery
NURSES AND CRIMINAL LIABILTY
5. Alternative circumstances-

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 a. relationship Types of contracts:
b. intoxication 1. Implied- terms are inferred from the actions of the
c. degree of instruction/ education parties
2. Expressed- verbal/ written, terms are specified
Crimes concerning nurses:
1. Parricide Breach of Contract: failure without legal excuse to perform
2. homicide any promise which forms the whole or part of the contract.
3. murder
4. infanticide Will- an act whereby a person is permitted with formalities of
5. abortion law to control to a certain degree the disposition of a state to
6. illegal detention/ false imprisonment take effect after his death.
7. simulation of birth
8. misdemeanor Decedent- person whose property is transmitted through
9. robbery succession
10. theft Testator- a decedent who left a will
11. assault
12. battery Two kinds of wills:
13. invasion of privacy 1. Notarial
14. defamation- slander 2. Holographic
- libel
Nurse’s obligation in the execution of a will:
Guidelines to prevent criminal liability: 1. Note the soundness of cliet’s mind
1. be familiar with Phil Nursing Law 2. that the will is signed by the testator
2. be familiar with laws affecting the nursing practice 3. that the witnesses shall be present at the time and
3. know agency rules, regulations, policies sign in the p-rese4nce of the testator.
4. upgrade skills and competence
5. develop good IPR Gifts Mortis Causa- disposing of gifts by a person in
6. consult superior as needed anticipation of death/ belief in approaching death.
7. verify vague/ erroneous orders - limited to personal properties
8. always keep doctor updated regarding patient - acceptance by the recipient
9. ensure accurate recording and reporting - gifts are revocable and subject to
10. informed consent the claims of creditor’s without
proof of intent of defrauding them.
Legal considerations in charting:
1. don’t tamper with medical records
2. observe agency’s standards on documentation
- complete, concise, specific, use
standard abbreviations
- telephone orders NEGLIGENCE AND MALPRACTICE
NEGLIGENCE- Doing of that thing which a reasonably
Tips for avoiding legal pitfalls: prudent person would not have done; or the failure to do that
1. Patient falls thing which a reasonably prudent person would have done in
- do proper assessment like or similar circumstances.
- appropriate assistance is given
- use protective measures * 3 ESSENTIAL CONDITIONS FOR ACTIONABLE
- document all nursing interventions NEGLIGENCE:
1. Existence of a duty on the part of the person
2. Medication error charged to protect the complaining party from the
- observe 7 R’s of drug injury received.
administration 2. Failure to perform that duty.
- check dr’s order 3. Injury resulting from such failure.
- consult drug handbook/ pharmacy
- not exempt from liability for  Burden of Proof: complaining or injured
following dr’s order party

3. Equipment injuries * DOCTRINES UNDER NEGLIGENCE:

- refuse to use a device not knopw 1. Doctrine of “ Res ipsa Loquitur “- the thing speaks
how to operate for itself
- report adverse events to superiors Three Conditions:
- monitor patient regularly A) Accident must be of a kind which
ordinarily does not occur in the absence of
Nurses and Contracts/ Wills someone’s negligence;
B) The accident must be caused by an agency
Contract- agreement between atleast two parties which create or instrumentality within the exclusive
an obligation recognized by law. There must be acceptance of control of defendant;
the obligation. C) Not have been due to any voluntary action
or contribution on the part of injured
Elements of a valid contract: party.
1. given freely
2. competent parties Examples of Cases:
3. lawful object - Negligence resulting to injury to a
4. valid consideration delirious patient
Maki vs Murray Hospital
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 - Liability for sponge left in the b. Appointment to vacancy shall be for the
patient’s abdomen unexpired portion of the term
Ales vs Ryan c. proper oath of office
2. Doctrine of “ Respondeat Superior” – Let the - Powers, functions and duties:
principal answer for the acts of his agent a. conduct licensure exam for nurses
b. issue, suspend or revoke certificates of
Application: registration for the practice of nursing
Failure of servant to use such care necessary in c. monitor and enforce quality standards of
the course of employment. nursing practice
- not applied if acting outside the d. ensure quality nursing education
legitimate scope of his authority. e. conduct hearings and investigations to
resolve complaints against nurse
Examples of Cases: practitioners
- Liability for burns due to hot water f. promulgate a code of ethics
bag g. recognize nursing specialty organizations
Aderhold vs Bishop h. prescribe, adopt, issue and promulgate
- Liability for death of infant due to guidelines, regulations, measures and
overdose of Digitalis decisions as maybe necessary
Nortow vs Argonaut Ins. - Grounds for Removal or suspension of a
Company member:
a. continued neglect of duty or incompetence
3. Effect of “ Force Majeur”- Act of God; Irresistible b. commission or tolerance of irregularities in
or superior force the licensure examination
- Neither foresee or c. unprofessional, immoral and dishonorable
prevent; fortuitous event conduct
- Requirements upon qualification:
Not answerable unless: a. Immediately resign from any teaching
A) Expressly specified by the law. position in any institution offering BSN
B) Declared by stipulation. and/or review program;
C) Nature of obligation requires assumption of b. Immediately resign from any govt or private
risk. employment;
c. Not have pecuniary interest in, or
* THE NURSE AND THE DOCTOR’S ORDERS administrative supervision in any istitution
- it is expected that nurses exercise reasonable offering BSN or review classes.
judgment/ sound discretion in carrying out doctor’s orders.
II. EXAMINATION AND REGISTRATION
- if life of patient is endangered, liable for criminal
negligence or reckless imprudence - Qualification for admission to the licensure
exam:
 Somera Case a. Citizen of the Philippines or by reciprocity;
b. Good Moral Character;
• Suspended by PRC Resolution No.
MALPRACTICE- Any professional misconduct, or any 2004-192
unreasonable lack of skill or fidelity in the performance of Reasons:
professional or fiduciary duties: 1. Proliferation of enterprising
- Objectionable practice/ Contrary to professionals victimizing
established rules; examinees from the provinces;
2. Reports that pre-signed
Example: Nurse giving out prescription of drugs certificates of GMC are also
allegedly being sold outside;
3. Additional expenses
c. Holder of BSN Degree from a school duly
PHILIPPINE NURSING ACT ( RA 9173) recognized
- Ratings
I. BOARD OF NURSING a. General average of atleast 75% with a rating
- composed of a chairperson and six members of not below 60% in any subject;
- appointment: b. If above 75% but with a subject below 60%,
- appointed by president of the republic of the must repeat that subject with a rating above
phils. 75%
- Oath taking
- qualification: - Issuance of Certificate of Reg/Prof License
a. natural born citizen and resident of the phils a. Bearing – full name of the registrant;
b. member of good standing - serial number;
c. be a registered nurse and holder of master’s - signature of the Chairperson and
degree in nursing, education or other allied members of the Board;
medical profession
d. ten years of continuous practice, last five - official seal of the Commission
years in the phils and the Board
e. no conviction of any offense involving b. PRC CARD – bears :- Date of Registration;
moral turpitude
- License Number;
- Term of office: - Date of Issuance
a. Appointed for 3 years/ reappointment for two and Expiration Date
years or two terms only
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 - Renewal- Third year on birth month
- DUTIES OF NURSES:
REGISTRATION BY RECIPROCITY: 1. Provide nursing care
Conditions before nurses registered in a foreign country can 2. Establish linkages with community resources
practice in the phils: 3. Provide health education
1. the requirements for registration in their country are 4. Teach, guide and supervise students in nursing programs
substantially the same in our country; 5. Undertake research and training, professional continuing
2. Under their laws, Filipino nurses are granted the same education
privileges and on the same basis as their citizens. 6. Observe Code of Ethics

SPECIAL OR TEMPORARY PERMIT TO PRACTICE -QUALIFICATIONS OF NURSING

FOR LICENSED FOREIGN NURSES: ADMINISTRATORS
1. well-known specialists or outstanding expert
2. on a medical mission 1. Supervisory or Managerial positions
3. employed as exchange professors - Qualifications:
• permit valid for the duration of the project, mission or a. registered nurse in the Philippines
employment contract. b. atleast two years experience in nursing
administration
GROUNDS FOR REVOCATION AND SUSPENSION OF c. with atleast nine units in management and
PROFESSIONAL LICENSE: administration
1. Conviction by final judgment of any criminal offense d. member of good standing of accredited
involving moral turpitude, immoral or dishonorable professional org of nurses
conduct, having unsound mind 2. if the position is for chief nurse or director:
2. Unprofessional or unethical conduct a. Same with supervisors;
3. Gross incompetence or serious ignorance b. atleast five years of experience in a
4. Malpractice or negligence supervisory or managerial position
5. Use of fraud, deceit or false statements in obtaining a cert c. a master’s degree major in nursing
of registration
6. Violation of RA 9173, Code of Ethics for nurses BR 220 3. Chief nurse for primary hospital:
7. Practicing profession during suspension a. two years experience in general nursing
service administration
REQUIREMENTS FOR RE-ISSUANCE OF REVOKED b. nine units management and
CERTIFICATE OR REPLACEMENT OF LOSS administration course
CERTIFICATE:
1. Expiration of a maximum of four years from date of 4. Chief nurse in public health agencies:
revocation a. master’s degree in public health/ CHN
2. Cause of revocation has disappeared or has been corrected be given priority
3. Request is to replace lost, destroyed or mutilated cert/
license 5. Chief nurse in military hospitals:
4. Proper application a. master’s degree in nursing and
5. Payment of required fees completion of the General Staff Course

III. NURSING EDUCATION V. Comprehensive Nursing Specialty Program

- Inactive nurses for a period of Five (5) Consecutive - Beneficiaries are 1. Issued a Certificate of
years can return to practice after one month didactic Completion
training and three months of practicum. The Board 2. Must serve in any Phil.
shall accredit hospitals to conduct said training. Hospital for atleast two years of
continuous service
- FACULTY OF NURSING
- Qualifications: Incentives and benefits:
a. registered nurse - limited to non-cash benefits such as: - free hospital
b. atleast one year clinical experience care for nurses and their dependents;
c. member of good standing -
d. holder of master’s degree in nursing, scholarship grants and others
education or other allied medical and health
sciences VI. Penal and Miscellaneous Provisions

- DEANS Prohibitions in the practice:

Qualifications: Any person practicing nursing
a a. Same with faculty; 1. without a Cert of registration/ prof license and
b. Atleast five years of experience in teaching PRC Card
and supervising a nursing education program 2. uses an invalid certificate;
3. uses a suspended or revoked Certificate or
IV. NURSING PRACTICE expired or cancelled permit
4. gives false evidence to the Board
- SCOPE OF NURSING PRACTICE: 5. falsely poses or advertises or conveys the
1. singly or in collaboration with another, initiates and impression that he is a registered nurse
performs nursing services to individuals,families and 6. who appends BSN, RN without authority
communities 7. who as aregistered nurse, assists illegal practice
2. provide nursing care from delivery up to old age of a non-qualified person
3. as independent practitioner, primarily responsible for the
promotion of health and prevention of illness Penalties:
4. collaborates with other members of health team
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• a fine of not less than P50000. Nor more than their duties with utmost responsibility, integrity,
P100,000. Or imprisonment of not less than 1 year nor competence and uphold public interest
more than six years, or both, upon the discretion of the RA 8344- An act penalizing the refusal of Hospitals and
court. medical Clinics to administer appropriate initial treatment and
support in emergency cases
RA 7160- Local Government Code
LAWS AFFECTING NURSING PRACTICE - general features include decentralization and
local autonomy
I. LAWS AFFECTING HEALTH/ STATUS - the Local chief executive have the power over
RA 6675- GENERIC DRUG ACT OF 1988 budgets for health, implementation of programs
Generic name- identification of drugs with scientifically and appointment of personnel.
and internationally recognized active ingredients.
Brand name- propriety name given by manufacturer
Essential drug list- list of drugs prepared by DOH on the PROFESSIONAL ADJUSTMENT
basis of health conditions in the Phils as well as internationally - growth of the individual and development of his
accepted criteria. capacities- physical, mental, emotional, social and
spiritual.
Relevant provisions: Characteristics of a profession:
- All government and private agencies and their a. Altruism- work for the good of society
personnel shall use the generic terminologies b. Autonomy- self- determination
for drug quality in all instances. c. Authority- based on knowledge
- The label of all drugs and medicines shall have d. Accountability- answerable for their conduct and
the following: name, country of manufacture, responsible for their practice.
date of manufacture and expiration e. Code of Ethics- relevance to social values
- Prescription should include generic and trade f. Distinct identity
name of the drug, quantity, doctor’s signature,
license number and PTR number NURSING ETHICS

RA 953 – NARCOTIC DRUG ACT ETHICS- study of the norm of human acts as guided by
human reason.
- registration and imposition of license on all
persons who deal in narcotic drugs and the
Theories:
control of the legal traffic in narcotic drugs.
1. EGOISM- self-interest of the doer determines goodness
- Narcotics- drugs which produces insensibility,
of the act.
stupor, melancholy or dullness of mind, habit
2. UTILITARIANISM- consequentialism
forming
Ethical if: - minimizes pain and suffering
- Prohibited drugs- drugs with opium, coca leaf,
- maximizes pleasure
heroine, morphine,LSD
- seeks happiness of the majority
- Regulated drugs- self-inducing sedatives,
3. DEONTOLOGISM- legalistic view
secobarbitals, hypnotic drugs
- “ what is legal is not necessarily
RA 6425- provision of S2- code of selected doctors who can
ethical
prescribe narcotic drugs
4. RELATIVISM/ SUBJECTIVISM- standard of right or
wrong is relative to people, to time and to place.
PD 603- CHILD AND YOUTH WELFARE CODE
5. SITUATIONALISM- “ love theory’
- highlights the role of the nurse which include
6. NATURAL LAW THEORY- work of creator
immediate registration of births, child’s
- if acts preserves life, it is good; if
enjoyment of highest standard of health, uphold
rejects life, it is bad.
child’s freedom of expression, child’s inherent
right to life, access to basic health services.

PD 996- provided for compulsory basic immunization for

Principles:
infants and children below 8 years old
1. BENEFICENCE- means to do good and not to do harm.
PD 949- Primary health care
2. NON- MALEFICENCE- one ought not to inflict evil or
RA 3573- an act providing for the prevention and suppression
harm.
of dangerous communicable diseases
3. AUTONOMY- means self-determination
4. JUSTICE- refers to the obligation to be fair to other
people.
II. LAWS THAT PROMOTE THE WELFARE AND WELL
5. VERACITY- refers to telling the truth or not intentionally
BEING OF NURSES
deceiving or misleading patients
RA 7305- Magna Carta of Public Health Workers
6. STEWARDSHIP- not harm our body because it is God’s
- has provisions on the benefits, rights and
not ours.
responsibilities of public health workers
PD 442 – Labor Code of the Philippines
PATIENT’S BILL OF RIGHTS
PD 807- Civil Service Law- provides for recruitement and
1. Right to considerate and respectful care
selection of employees in govt service
- nurse avoids discriminating acts that tends to bring the
RA 7877- Anti- Sexual Harassment Act
appearance of favoritism
- “ tender loving care attitude”
III. LAWS THAT PROVIDE THE RESPONSIBILITY OF
2. Right to information about diagnosis, treatment and
THE EMPLOYEES
prognosis
RA 6713- Code of conduct and Ethical Standards for Public
3. Right to informed consent
Officials and Employees
- refers to the capacity of the patient to accept or refuse
- public officials and employees shall at all times treatment options offered by the health care provider.
be accountable to the people and shall discharge Elements:
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a. voluntariness 4) CONTRACEPTION- is any act done befor, during, or
b. information after the act of intercourse that purposely frustrates begetting
c. capacity of new life.
4. Right to refuse treatment
- waiver signed Types:
5. Right to Privacy 1) Direct- deliberately intended
6. Right to confidentiality a) Artificial
- all records and communications held in confidence - Mechanical =
- when to divulge information: condom,diaphragm,cervical cup,
a. patient placed in serious danger IUD
b. public welfare - Chemical = cervical sponge,
c. legal proceeding vaginal suppository, vaginal jelly
7. Right to services and to transfer - Surgical = tubal ligation,
- referrals vasectomy
8. Right to know relationship with other health care and
educational institutions b) Natural
9. Right not to be subjects of research or
experimentation 2) Indirect
10. Right to expect reasonable continuity of care
- follow up consultations Argument that support contraception:
11. Right to examine and receive an explanation of his bill - Woman’s autonomy or right
12. Right to know what hospital rules and regulations - Situationalism ( Love Theory)
apply to his conduct as a patient
- Utilitarianism (Sexual pleasure or
happiness)
NURSING CODE OF ETHICS
- BR # 220 - Population “Time Bomb”

Four basic ethical principles: 5) ABORTION- Termination of pregnancy, which begins at

a. Fundamental responsibility of the nurse is four fold the moment of conception, when the sperm fertilizes the egg,
b. Nurse renders service regardless of race, creed, and ends at the birth of the child.
nationality or political belief.
c. Nurse protects life and respects the dignity of man.
d. Nurse works in collaboration with members of the health
team. Types:
1) Spontaneous Abortion- miscarriage, kind
BIOETHICS- is the study of human conduct in the area of that occurs without medical or some other
the life sciences and health care using moral values and kind of intervention.
principles. - Complete- all content in uterus
Examples: abortion, euthanasia, contraception, art. expelled
Insemination etc. - Incomplete- part or entire placent
is retained
- Missed abortion- fetus is retained
in the uterus for a period of time
ETHICAL DILEMMAS after its death.
2) Direct, induced or procured Abortion-
elective or therapeutic abortion
1) ARTIFICIAL INSEMINATION- is a procedure or - Early Uterine Evacuation or
process whereby the fertilization of an egg is the result of Vacuum aspiration- suctioning
the sperm being introduced into the female reproductive
- Dilatation and Evacuation,
system other than the natural, that is, other than the sexual
Dilatation and Curettage (D & C)
act or intercourse.
- Prostaglandin and Saline
injection- through amniotic sac
Types:
1) Artificial Insemination by the Husband - Hysterectomy
(AIH) or Homologous Type
2) Artificial Insemination by a Donor(AID) or 3) Indirect Abortion- necessary result of
Heterologous Type another medical procedure.

2) IN VITRO FERTILIZATION- Laboratory procedure

whereby one or a few eggs are surgically taken from a Right of the mother versus Right of the unborn/ fetus
woman’s ovary, fertilized with sperm in a petri dish, and
transferred to and implanted in the woman’s uterus, hoping for Principle of Double Effect- refers to an act that
a normal pregnancy to happen. causes two immediate effects: one,good,the
other bad.
- Conditions:
3) HUMAN CLONING- Refers to the production of one or 1) The act must either be
more living human beings that are genetically identical to an good or at least
original human being. indifferent.
Types: 2) The intention is to
1) Embryo Cloning- “ Artificial Twinning” achieve the good effect.
2) Adult DNA Cloning 3) The expected good effect
3) Therapeutic Cloning ( Somatic Cell Nuclear must be equal to or
Transfer) greater than the harmful
effect that is expected.
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 4) The good effect must 1. INSTRUCTIVE DIRECTIVE- specifies life- sustaining
follow from the action,or treatment to be withheld or withdrawn.
at least,must happen as Ex: living will
immediately as the bad
effect. 2. PROXY OR DURABLE POWER OF ATTORNEY-
assigns a surrogate if becomes unconscious or mentally
6) EUTHANASIA- “ MERCY KILLING”, is the intentional incompetent
taking of the life of an ailing person, for any of the following
reasons: Incurability of illness, Unbearable intensity of
physical or emotional pain, unbearable financial burden LEADERSHIP AND MANAGEMENT
arising from the illness.
Leadership: is a learned behavior involving influence and
Types: role modeling that inspires people to achieve personal and
1) By Reason of the manner of attaining death group goals.
A) Active or Direct Euthanasia- the active
taking of steps by the physician or the
caregiver to end the life of the patient.
B) Passive or Indirect Euthanasia- the Attributes of a good leader:
intentional omission or non- • Self awareness
administration of medical treatmentto • Self confidence
cause or hasten the death of the patient. • Advocacy
• Accountability
2) By reason of patient’s consent
A) Voluntary Euthanasia- the patient Different leadership styles:
consciously and directly requests the Autocratic
health care provider to take the steps to -leaders exert total control over members
put an end to the patient’s life. -focus is on productivity
B) Involuntary Euthanasia- the act of Democratic
seeking the death of the patient is -leader shares control with group members
without the patient’s consent or Laisez-faire
knowledge. -leader relinguishes control to group members.
-there is total freedom in a hihgly permissive atmosphere.
Argument favoring Euthanasia: Multi critic
- compassion for the patient and -leader utilizes varying styles depending on the situation.
shortening the period of suffering
of the patient Management
-process of coordinating and supervising personnel and
Argument disapproving Euthanasia: resources to accomplish organizational goals.
- it is intrinsically wrong since it
rejects life. Attributes of an effective manager:
• Vision to plan for the future of the organization
7. PHYSICIAN ASSISTED SUICIDE- the patient
requests from the physician to provide the means to end
• Increased trust
his life. • Sound communication
• Increased decision making ability
8. HUMAN TRANSPLANTATION- surgiccal procedure • Organizational skills
whereby an organ or tissue is transferred from one part of • Neutral(ability to balance)
the body to another or from one organism to another
organism. Nursing management functions:
-Planning
TYPES: -organizing
1. Autotransplantation- donor and recipient are one and the
staffing
same directing
Ex: skin and bones
controlling
2. Heterologous- donor and recipient are two different
individuals.
PLANNING:
a. animal to human -forecasting of events, and based on which decisions are made,
b. human to human
goals are set and prioritized and policies and standards are
 cadaver donor developed.
 living donor Different types of planning:
1. long range or strategic planning
Ethical considerations: -extends from 3-5 years into the future
1. Principle of totality 2. short range or operational planning
Body mutilation is ethical for the sake of saving the whole -deals with day to day maintenance activities.
body or of preserving life. Purposes of Planning:
D-irects the organization
ADVANCE CARE DIRECTIVE- makes known in writing I-mproves efficiency
the wishes or preferences of the patient when no longer able to R-esources are maximized
speak for himself. E-fective for controlling
C-ost effective measures are identified
TYPES: T-otal enhancement of communication and coordination

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Phases of Planning: -to provide safe, quality care.
1. determining objectives Determinants of Staffing:
2. collecting data • Number of personnel
3. developing a plan of action • Mix of personnel
4. evaluating the plan • Number of patients
• Type of patient care delivery system
BUDGETING: • Classification of patients
-planning and controlling resources that affect the organization
-involves examining resources, anticipating costs and Types of Staffing:
predicting gains and shortfalls. 1. centralized staffing:
-assignment of personnel is made by the nurse manager at the
Purposes of Allocation of Budget: organizational level.
1. promotes proper allocation of resources 2. decentralized staffing
2. promotes smooth and efficient organizational operation -allocation of nursing personnel at the unit level.
3. serves as a tool for modification and changes in the
organization DIRECTING:
4. ensures availability or resources for the organizations -Is the issuance of assignment, orders and instructions that
achievement of goals permit the worker to understand what is expected of him or
5. enables the management to control the organization by her and guidance and overseeing of the worker so that he or
allocating resources. she can contribute effectively and efficiently to the attainment
of organizational goals.
Two commonly used approaches to budgeting: POWER-the ability to impose the will of one person or group
1. Incremental Budgeting to bring about certain behaviors in other persons or groups.
-budget is developed annually based on the previous years AUTHORITY-is the legitimate right to give commands.
expenditure Different forms of Power:
2. Zero-based Budgeting
-each year the budget begins at zero.
NURSING RESEARCH
Processes involved in Budgeting:
1. planning Nursing Research-scientific process that validate
2. preparation and refines existing knowledge and generate new
3. modification and approval knowledge that directly influence nursing
4. monitoring practice.
ORGANIZING: -includes the study of all aspects, components, activities and
-structuring the agency to accomplish the tasks necessary to phenomena relating to health and of interest to nurses.
meet the agency goals.
Different Functions of the Nurse in Organizing: Importance of Research In Nursing:
-establishing objectives So that we could: describe, explain, predict and control
-establishing the structure to carry out plans
-determining the most appropriate type of patient care delivery Purpose:
-grouping activities to meet unit goals 1. to generate new knowledge
-working with in the structure of the organization 2. to develop new gadgets, techniques
-understanding and using power and authority 3. to evaluate a program or technique
MISSION: 4. to validate theories
-describes and reflects an organizations core value.
VISION: TYPES:
-provides an image of the desired future. 1. According to motive or purpose
PHILOSOPHY: a. basic- for knowledge sake
-is a statement of belief that influences nursing practice b. applied- practical, knowledge generated
Different types of organizing client care 2. According to methodology
1. Case Nursing a. descriptive- exploration and description of a
-oldest approach phenomena in real life situations
-a nurse is responsible for all the care required for a particular
- may use survey method
patient
-usually used in critical care units - common methods used are
2. Functional Nursing questionnaire, interview,
–task-oriented observation
–a nurse performs specific tasks and procedures according to b. Correlation- examines linear relations between 2 or
schedule more variables
3. Team Nursing - determines the type ( + or - ) and
-based on group approach degree of relationship
-staff members work as a team c. Quasi- experimental- examines cause and effect
4. Primary Nursing - done in partially controlled
-involves comprehensive care of patients situations
-the primary nurse has a 24-hour responsibility for the - Quasi experiment may or may not
assigned patients. have control groups and random
assignment may or may not be
STAFFING: made.
-refers to the required number and mix of nursing personnel in
a nursing unit with in a 4 hour period.
Main purpose of Staffing: d. experimental- examines cause and effect

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 - done in highly controlled conditions 2. Secondary data- involve someone who is not directly the
- independent variable is manipulated source of information
True experiment has three features: Ex: opinions, write ups
1. subjects are randomly assigned
2. experimental variable is manipulated Data collected based on time orientation:
3. with at least 2 groups-experimental and control. 1. retrospective- certain events in the present is linked to a
particular phenomenon in the past.
e. historical- study conducted regarding the past. 2. Cross-sectional- involves different age groups
3. Longitudinal- one group is studied for a longer period of
Limitations in Nursing research: time
1. Ethico- legal considerations
2. Measurement problem Framework:
a. face validity- doing pretests by giving questionnaire Is an abstract logical structure of meaning that guides the
b. contrast validity- done by giving the tool to group of development of the study and enables the researcher to link
experts the findings to nursing body of knowledge.

Differences between the two Basic Types of Research: A conceptual framework deals with abstractions that are put
1. Qualitative- collection of narrative data together because of their relevance to a common theme.
- undertaken to describe natural Unlike a theoretical framework, it does not have a deductive
phenomena without controlling or system or propositions that assert a relationship between the
manipulating variables concepts.
- examples: historical
research,researches regarding Hypothesis:
beliefs and practices, experiences -is a statement of the anticipated or expected relationship
2. Qualitative- collection of numerical data between the independent and dependent variables.
- statistical analysis, control research Types:
conditions 1. Null hypothesis- states no relationship between variables
2. Research hypothesis- gives the predicted relationship
- examples: experimental studies,
extent of knowledge, effectiveness
Complexity of Hypothesis:
1. Simple- one independent and one dependent variable
Steps in the Research Process:
2. Complex or Multivariate- 2 or more independent or
1. Identify the problem
dependent variable
2. Conduct literature review
3. Identify theoretical/conceptual framework
Variable
4. Formulate hypothesis
-Is any quality of a person, institution or situation that varies
5. Operationalize variables
or takes on different values.
6. Select research design
7. Ascertain and select sample
Independent vs dependent variables:
8. Conduct a pilot study
An independent variable is the presumed “cause” while the
9. Collect data
dependent variable is the presumed “effect”. The variability in
10. Analyze data
the dependent variable is presumed to be due to the variability
11. Interpret results
in the independent variable.
12. Disseminate information
Extraneous vs intervening
Research Problem:
Extraneous variables are other factors that affects the
Is a situation in need of description or quantification, solution,
measurement of the IV or DV
imrovement or alteration.You can evaluate these problems by
Example: knowledge, attitude
using the following criteria:
Intervening variables are any factor that are not directly
1. Significance of the problem
observable in research situation but which maybe affecting the
2. Researchability of the problem
behavior of the subject.
3. Feasibility
4. Interest to the researcher

Sources of problem:
1. experience
Examples:
2. review of rel literature
1. Problems and coping strategies of COPD Patient.
3. issues and popular concern
IV- COPD, DV- Degree of seriousness, IV- problems and
4. replication studies
coping strategies
5. intellectual curiosity
2. Difficulties of nursing students in doing nursing research:
A basis for research enhancement
IV- nsng research, DV- difficulties, EV- a basis for
research enhancement
Purposes of a literature review:
3. Transcultural care rendered by staff nurses to
1. Search for research ideas/topics
hypertensive patients.
2. Be oriented on what is known
IV- transcultural care, DV-level of care
3. Establish the conceptual context of our study
4. Assess the feasibility of the study that we are planning
Operational Definition:
5. Be informed on research approach
Is a specification of the operations that researcher must
Sources of data:
perform to collect the required information.
1. Primary data- provided directly by the subjects under
study, the most unbiased raw material
Examples of data collection methods:
Example: letters, diaries, speeches, interview
-physiological/biological measures

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-observational methods-use of checklists and rating scales Protection of the participants that their identities will not be
-interviews linked to the information they provided and will never
-use of questionnaires publicly divulged.
-psychological measures
-content analysis 5. Beneficence
-diaries Implies the benefits of the research to the research
subject/participants. This should be adequately explained to
Difference between validity and reliability: the participants.
The validity of research tool is the extent to which the
instrument actually reflects the construct or variable being 6. Nonmaleficence
examined. -means avoidance of harm or reduction of risks to the research
External- applicability and generality of findings subject. The researcher should weigh the risks and the benefits
Internal- truth value of findings of the study. The benefits should be far greater than the risks.

Reliability is concerned with how consistently the 7. Social Justice

measurement technique measures the concept of interest. Includes these issues:
1. right to be represented in the sample
Different levels of measurement in research: 2. right of equal access to knowledge
NOMINAL is used when data can be organized into categories 3. right not to be discriminated against
of a defined property but the categories can not be compared. This ethical value is prominent in experimental studies,
ORDINAL is used when data can be assigned to categories of particularly those studies that have great promise to do good
an attribute that can be ranked. (e.g. drug that may cure a disease) to the participants.
INTERVAL have equal numerical distances between intervals
in the scale; there is no absolute zero point. Elements of an ethical research:
RATIO is the highest form of measure; similar to interval 1. protecting subjects’ rights
except that it has an absolute zero point. 2. balancing the benefits and risks in a study
3. obtaining informed consent
Difference between non-probability and probability sampling: 4. obtaining institutional approval for research
In non-probability sampling, not every element of the
population has an opportunity to be included. NUREMBERG CODE- guide researchers to conduct human
Examples: accidental/convenience, quota, purposive and experimentation – informed consent
network/snowballing.
In probability sampling, every member of the population has a DECLARATION OF HELSINSKI- experiment should not be
probability of being included in the sample. done in violation of human rights.
Examples: simple random sampling, stratified random
sampling, cluster sampling and systematic sampling. ## -------------------##

dcgallman
Data Summary and Analysis:
Frequency tabulations
Measure of central tendency-mean, median, mode

Difference between internal and external validity:

Internal Validity: is the extent to which the results of the study
can actually be attributed to the action of the independent
variable, and not something else.

External Validity: is the degree to which the findings of the

study are generalizable to the target population.

Ethical issues and considerations in research:

Autonomy:
The researcher should get the research
participants/respondents’ informed consent.
Informed consent implies that:
1. the participant received adequate information about the
research project
2. the participant understood what he/she is expected to do
and the implications of his/her participation
3. he/she participated voluntarily.

2. Right to privacy:
The researcher should ensure the anonymity of the research
participants and the confidentiality of the data/information
collected from them.

3. Anonymity:
Protection of participants in a study that even the researcher
can not link them with the information they provided.

4. Confidentiality:

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