NURSING
JURISPRUDENCE IN
CLINICAL PRACTICE
ELMER A. SANTOS, M.A.N., Ed.D.
Associate Professor III
MMSU Graduate School/CHS Department of Nursing
Learning Outcomes
At the end of the 1 hour lecture discussion, each
participant must have;
1. distinguished all related ethico-legal bases for
nursing practice;
2. recognized all the elements of due process,
3. differentiated all relevant jurisprudential doctrines
applicable to nursing practice, and
4. recalled situations which are relevant to integrate
learned concepts in nursing jurisprudence.
Review of the Ethico-legal Bases for
Nursing Practice
1. RA 9173
AN ACT PROVIDING FOR A MORE RESPONSIVE
NURSING PROFESSION,REPEALING FOR THE
PURPOSE REPUBLIC ACT NO. 7164, OTHERWISE
KNOWN AS "THE PHILIPPINE NURSING ACT OF
1991" AND FOR OTHER PURPOSES
2. CODE OF ETHICS
Fourfold responsibility of the nurse,
universality of nursing practice, the scope of
their responsibilities to the people they serve,
to their co-workers, to society and
environment, and to their profession. (1984)
International Council for Nurses.
2. CODE OF ETHICS
In 1984, the Board of Nursing adopted the
Code of Ethics of the ICN, adding “promotion
of spiritual environment” as the fifth-fold
responsibility of the nurse.
2. CODE OF ETHICS
In July 14, 2004, a new Code of Ethics for
Filipino Nurse was adopted under R.A. 9173
and was promulgated by the BON.
2. CODE OF ETHICS
Article II - Registered Nurses and
People
1. Values, customs, and spiritual beliefs of
individuals shall be respected.
2. Individual freedom to make rational and
unconstrained decisions be respected.
3. Personal information be held in strict
confidence.
2. CODE OF ETHICS
Article III - Registered Nurses and
Practice
1. Human life is inviolable.
2. Quality and excellence in care of patients.
3. Accurate documentation of actions is the
hallmark of nursing accountability.
2. CODE OF ETHICS
Article III - Registered Nurses and
Practice
4. Registered nurses are the advocates of the
patients.
5. Registered Nurses are aware that their
actions have professional ethical, moral and
legal dimensions.
2. CODE OF ETHICS
Article IV - Registered Nurses and Co-
Workers
1. Solidarity with other members of the health
care team.
2. Collegial and collaborative working
relationship with other healthcare providers.
2. CODE OF ETHICS
Article V - Registered Nurses, Society, and
Environment
1. Preservation of life, respect for human rights,
and promotion of healthy environment.
2. Linkages with the public in promoting local,
national, and international efforts.
2. CODE OF ETHICS
Article VI - Registered Nurses and the
Profession
1. Loyalty to the nursing profession and
preservation of its integrity are ideal.
2. Compliance with the by-laws of the
accredited professional organization (PNA) and
other professional organizations.
2. CODE OF ETHICS
Article VI - Registered Nurses and the
Profession
3. Commitment to continual learning.
4. Contribution to the improvement of the socio-
economic conditions and general welfare of
nurses through legislation.
3. National Nursing Core Competency
Standards (NNCCS)
The PNA 2002 (Article III, Section 9)
The PRBON monitors and enforces standards
of nursing practice in the Philippines ensuring
efficient ethical and technical, moral and
professional standards.
3. National Nursing Core Competency
Standards (NNCCS)
2005-BON Resolution No. 112 series of
2005, adopted and promulgated the Core
Competency Standards of Nursing Practice
in the Phils.
3. National Nursing Core Competency
Standards (NNCCS)
The Standards are directed to be utilized:
1. practice of the profession
2. nursing education/curriculum
3. development of tests questions for the NLE
DUE PROCESS
DUE PROCESS IN NURSING PRACTICE
A law which hears before it condemns which proceeds
upon inquiry and renders judgment only after trial.
Element
s: Right to notice, be actual or constructive.
1.
e.g. The head nurse issues a memorandum to concerned
nurses
2. Be reasonable. Opportunity is given to defend his/her right.
e.g. The complained nurse is given an opportunity to
exhaust all means to defend.
3. A tribunal is constituted as to give reasonable assurance of
honesty/impartiality/competent jurisdiction.
e.g. A grievance committee is formed from the office of
the chief nurse/chief of hospital to conduct hearings and render
impartial judgement based from existing CSC policies/DOLE
DUE PROCESS IN NURSING PRACTICE
Element
s:
4. Findings and decision is made by the tribunal supported by a
substantial evidence.
e.g. The grievance committee shall render a judgement
substantiated by accurate, valid, and legal evidences which can
still be appealable within prescribe period of time.
DOCTRINES
1. BONUS PATER FAMILIAS
- “good father of a family”
e.g. Nurse supervisors and staff nurses are guided by the
concept of family relationships.
2 Concepts:
1) Culpa in Eligiendo
- “selection of his employees”
- implements/measures/selects/ best employees
e.g. Chief nurses/nurse supervisors selects the most
qualified novice/to be promoted staff nurses
2) Culpa in Vigilando
- “supervision of his employees”
e.g. Nurse supervisors/charge nurses/senior nurses are to
ensure quality nursing care by strict supervision of frontline
services
2. DOCTRINE OF NEGLIGENT CONDUCT
- damages/injuries as a result of negligent
performance
- commission/omission of an act pursuant to a
duty that a reasonable prudent person in the
same similar circumstance would and would
not do.
❏ documented care in concise and accurate
manner
- best defense for negligence
e.g. The nurse comprehensively documents
3. DOCTRINE OF DAMNUM ABSQUE
INJURIA
- physical damage with no physical injury
- e.g.
A sudden flashing occurs while an IV therapy
nurse performs his duty, resulting to temporary
blindness that caused an injury to the site of
insertion.
✓ damage
X legal injury
4. STARE DECISIS ET NON QUIETA
MOVERE
- standby decisions and do not move what has been decided.
e.g. Promoted nurses based from legally accepted
policies during the time of retiring chief nurses and are still to
be enforced shall no longer be repeated in terms of the
promotion
5. processes OF NOLO
PRINCIPLE
- “No contest, I will not defend it.”
CONTENDERE
- plea of guilty
e.g. The evidence of using DTRs as an exhibit for
tardiness or absences during trial.
6. MALFEASANCE
- performance of some act which is not to be done by a
professional nurse.
e.g. The OR nurse prescribes/dispenses medications for
7. MISFEASANCE
patients.
- improper performance of some act which might be lawfully
done.
e.g. The OR nurse inflicts rib fracture while doing CPR.
8. NONFEASANCE
- omission to perform a required duty or the failure to act when
a duty to act existed.
e.g. The OR nurse failed to conduct skin sensitivity test for
a prescribed antibiotic that had resulted to anaphylactic shock.
9. DOCTRINE OF INFORMED CONSENT
- full disclosure surrounding the disease
- Consent - dignity, rights for autonomy
Elements:
➔ voluntary
➔ legal capacity (18 years old above)
➔ sufficient understanding
➔ patient is enlightened
10. DOCTRINE OF INFORMED CONSENT
Types:
➔ Expressed - patient needs to sign
➔ Implied - emergency
Advanced directives
- plan of care initially planned
Administrative consent
- the chief house in-charge of the day is allowed by law
because it is reasonable and practical.
11. DOCTOR’S ORDER RULE
4 Standards:
1)Have another nurse listen to the phone, who
then initials the orders for verification and
accuracy.
2)Repeat the order aloud to the physician and
ask, “Is this correct?”
3)Write doctor’s order on appropriate form,
including date and time, and what prompted
the call.
4)Secure the physician’s signature on the order
upon arrival at the clinical area.
12. DOCTRINE OF FORCE MAJEURE
- “irresistible or greater force”
- e.g.
Typhoon causing massive floods hence the
nurse cannot report to clinical duty.
A nurse fails to perform/comply or
prevent certain harm because of an
extraordinary event.
13. DOCTRINE OF RESPONDEAT
SUPERIOR
- negligence of the employee is conclusively
presumed to be the negligence of the
employer
- acts should be committed within the
scope/course of employment
14. DOCTRINE OF RES IPSA LOQUITOR
- “the thing speaks for itself”
- it shows without proving that the accident
resulted because there is lack of standard
care
e.g. Bed sores develop in hospital indicates
the care rendered.
The smell of the ward defines ward
management.
To be a novice is not equated to being a NOBODY
but an opportunity ahead to be SOMEBODY
Imperfection is not equated to being INEFFICIENT
but a reminder to become EFFICIENT
But being a novice with countless IMPERFECTIONS
For sure, today and tomorrow are unevitable
SUSPENSIONS
- Aling Iska
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