Republic Acts RA 7164 - Philippine Nursing Act of 1991 RA 9173 - Philippine Nursing Act of 2002 RA 1080 - Civil Service Eligibility for those who passed board and bar exams RA 2328 - Philippine Medical Act RA 8344 An Act penalizing the refusal of Hospitals and Medical Clinics to administer initial medical treatment and support in emergency cases RA 1612 - Privilege Tax Law - professional tax payment RA 5181 - Permanent residence and Reciprocity RA 1082 - Rural Health Units all over the Philippines
LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Republic Acts RA 4073 - Liberalizes leprosy treatment RA 1054 - Free emergency medical treatments to employees and laborers RA 4226 - Hospital Licensure Act RA 5901 - 40 hours/week for nurses in with 100- bed capacity... RA 3573 - Reporting of Communicable Diseases RA 6111 - Medicare Act RA 6675 - Generics Act of 1988 RA 6713 - Code of Conduct and Ethical Standards for Public Officials/Employees
LEGAL ASPECTS LEGAL ASPECTS THAT AFFECTS THE NURSING PROFESSION
Board of Nursing
RA 877 - An act regulating the practice of nursing profession in the Philippines RA 4704 - Philippine Nursing Law, June 19, 1953 PD 223 - Creation of Board of Nursing RA 7164 - Professional Regulation Commission has the power to recommend nominee members of the board to the President of the Republic, June 22, 1973 RA 9173 - New Nursing law by Gloria Macapagal Arroyo, July 2, 2002 will be known as the Philippine Nursing Act of 2002 LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Republic Acts
RA 6758 - Salary Standardization Law RA 7305 - Magna Carta for Public Health Workers RA 7277 - Magna Carta of Disabled Persons RA 7624 - Drug Education Law RA 6972 - Day Care Center for every barangay RA 7160 - Local Autonomy Code RA 7170 - Organ Donation RA 349 - Legalized use of human organs for scientific purposes RA 6809 - Amended Article 34 of Family Code, 18 years is majority age
LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Presidential Decree
PD 69 - Four children for tax exemption PD 48 - Four children for maternity privilege PD 965 - Family Planning and Responsible Parenthood PD 442 - New Labor Code of the Philippines PD 603 - Child and Youth Welfare Code PD 626 - Employee Compensation and State Insurance Fund PD 1519 - Medicare Benefits for all government employees PD 1636 - Compulsory membership to SSS of self- employed persons LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Presidential Decree
PD 223 - Professional Regulation Commission (PRC) PD 541 - Practice of profession in the Philippines by former professionals PD 651 - Birth Registration Law PD 856 - Sanitation Code PD 996 - Compulsory immunization of children under 8 years PD 491 - Nutrition Program Law PD 825 - Penalty for improper garbage disposal PD 143 - Woman and Child Labor Law (no child below 14 shall be employed) LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Executive Order
EO 51 - Milk Code EO 209 - Family Code EO 180 - Government worker's CBA EO 857 - Compulsory Dollar Remittance Law EO 174 - National Drug Policy (availability, affordability or safe, effective, quality drugs)
LEGAL ASPECTS LAWS AFFECTING NURSING PRACTICE
Board Resolution
No. 633 series of 1984 - ICN Code of Ethics No.1955 s. 1989 - PNA Code of Ethics No.1930 s. 1985 - CPE for Nurses No.187 s. 1991 - Renewal of Professional license No. 217s. 1992 - Delisting of delinquent professionals
Letters of Instructions
LOI 949 - Legal Basis of Primary Health Care LOI 100 - Preference given to members of accredited professional organization for employment and seminars
LEGAL ASPECTS PRONOUNCEMENTS
Nurse's Week - Last week of October National Cancer Consciousness Week - Second week of January International Women's Day - March 8 World Health Day - April 7 Earth Ray - April 2 National Health Worker's Day - May 7 World Red Cross Day - May 8 International Nurse's Day - May 12 World Diabetes Day - June 27 International Day for Drug Abuse and Child Trafficking - January 2 World Breastfeeding Day - August 1 World AIDS Day - December 1
RESPONSIBILITY AND ACCOUNTABILITY FOR THE PRACTICE OF PROFESSIONAL NURSING
Nurses employed in an agency, institution or hospital are directly responsible to their immediate supervisors. Private duty nurses, being independent practitioners, are held to a standard of conduct that is expected of reasonable prudent nurse
WHAT IS LIABILITY? Is an obligation or debt that can be enforced by law. A person who is liable for malpractice is usually required to pay for damages.
Damages - refer to compensation in money recoverable for a loss of damage.
PROFESSIONAL NEGLIGENCE NEGLIGENCE Refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not to, and acting or the non-acting of which is the proximate cause of injury to another person to his property. PROFESSIONAL NEGLIGENCE ELEMENTS OF PROFESSIONAL NEGLIGENCE 1. Existence of a duty on the part of the person charged to use due care under circumstances 2. Failure to meet the standard of due care 3. The foreseeability of harm resulting from failure to meet the standard
4. The fact that the breach of this standard resulted in an injury to the plaintiff
5. Errors due to family assistance
6. Administration of medicine without a doctors prescription PROFESSIONAL NEGLIGENCE SPECIFIC EXAMPLES OF NEGLIGENCE 1. Failure to report observations to attending Physicians.
2. Failure to exercise the degree of diligence which the circumstances of the particular case demands.
5. Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients.
PROFESSIONAL NEGLIGENCE CONDITIONS THAT ARE NECESSARY FOR THE APPLICATION OF THE DOCTRINE:
1. The accident must be a kind which ordinarily does not occur in the absence of someones negligence.
2. The accident must be caused by an agency or instrumentality within the exclusive control of the defendant. 3. The accident must not have been due to any voluntary action or contribution on the part of the plaintiff (injured party).
LEGAL DEFENSE IN NEGLIGENCE
The most common defense in a negligent action is when nurses know and attain that standard of care in giving service and that they have documented the care they give in a concise and accurate manner.
If the patients careless conduct contributes to his own injury, the patient cannot bring suit against the nurse.
PROFESSIONAL NEGLIGENCE THE DOCTRINE OF RES IPSA LOQUITUR
The thing speaks for itself When the harm that resulted from negligence and the responsibility for the harm are clear that anyone would agree on it, the term res ipsa loquitur is used MALPRACTICE
MALPRACTICE MALPRACTICE
Implies the idea of improper or unskillful care of a patient by a nurse. It also denotes stepping beyond ones authority with serious consequences
MALPRACTICE Elements of Malpractice
Duty to client - Owed to the client by nature of employment and standards of care by which the nurse must practice. Breach of duty - A failure to meet the standard of care owed to the client. Causation - A direct relationship between the failure to meet the standard of care and the clients harm.
MALPRACTICE Elements of Malpractice
Damages - It must be proved that the client/patient has incurred harm through the unsafe nursing practice.
Forseeability - The nurse must recognize or have prior knowledge that failing to meet a standard of care may cause this type of harm to the client/patient.
MALPRACTICE EXAMPLES OF MALPRACTICE: . Misdiagnosis of an illness, failure to diagnose or relay diagnosis
Birth Injuries
Surgical Complications
Prescription errors
Failure to provide treatment
Anesthesia related complications
Failure to follow advance directive
Failure of hospital or pharmacy to dispense the right medicine, dosage
DOCTRINES DOCTRINE OF FORCE MAJEURE
It is an irresistible or superior force, one that cannot be foreseen or prevented; a fortuitous event, and act of God. No person shall be held liable for nonperformance of what was expected of him/her if the cause of the nonperformance was a force majeure (e.g. devastating typhoons, earthquakes and other calamities)
DOCTRINE OF RESPONDENT SUPERIOR
Means let the superior answer; let the principal answer for the acts of his agent The doctrine is founded on the principle that he who expects to derive advantage from an act which is done by another for him must answer for any injury which a third person may sustain from it.
The doctrine rests upon the proposition that, in doing the acts out of which the accident arose, the servant was representing the master at the time
DOCTRINE OF RESPONDENT SUPERIOR
EXAMPLES:
The hospital will be held liable, if, in an effort to cut down on expenses it decides to hire underboard nurses or midwives in place of professional nurses, and these persons prove to be incompetent.
The surgeon will be held responsible in case a laparotomy pack is left in a patients abdomen.
MALPRACTICE Practice to Strive For
Best Practices for Reducing the Risk of Malpractice Litigation:
I. Maintain good communication with the clients in your care.
II. Always keep your knowledge and skills up to date.
III. Follow and know your institutions policies and procedures, and always pay close attention to your clients changing health status.
IV. Always seek attention for a clients changing health status, and question physician orders if they are unclear or not in keeping with the clients condition.
INCOMPETENCE
INCOMPETENCE
Is the lack of ability, legal qualifications or fitness to discharge the required duty.
Although a nurse is registered, if in the performance of her duty she manifests incompetency, there is ground for revocation or suspension of her certificate of registration.
LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES
Nursing aides perform selected nursing activities under the direct supervision of nurses. They usually given on-the-job- training by the Training Staff. Their responsibilities usually pertains to the routine care of chronically ill patients. They are therefore responsible for their own actions.
LIABILITY FOR THE WORK OF NURSING STUDENTS Under the Philippine Nursing Act of 2002 R.A. 9173, nursing students do not perform professional nursing duties. They are to be supervised by their clinical instructors.
GUIDELINES TO AVOID MISTAKES OF NURSING STUDENTS
1. Nursing students should always be under the supervision of their clinical instructors. 2. They should be given assignments that are at their level of training, experience, and competency. 3. They should be advised to seek guidance especially if they are performing the procedure for the first time. 4. They should be oriented to the policies of the nursing unit where they are assigned. 5. Their performance should be assessed frequently to determine their strengths and weaknesses 6. Frequent conferences with the students will reveal their problems which they may want to bring to the attention of their instructors or vice- versa. Discussion of these problems will iron out doubts and possible solutions may be provided.
INTENTIONAL WRONGS
INTENTIONAL WRONGS A nurse may be held liable for intentional wrongs
INTENTIONAL WRONGS TORTS
A tort is a legal wrong, committed against a person or property independent of a contract which renders the person who commits it liable for damages in a civil action. A person who has been wronged seeks compensation for the injury or wrong he has suffered from the wrong doer.
INTENTIONAL WRONGS EXAMPLES OF TORT:
ASSAULT AND BATTERY. Assault is an unjustifiable attempt to touch another person or even the threat of doing so while Battery is the actual carrying out of the threatened physical contact
DEFAMATION of character occurs where a person discusses another individual in terms that diminish reputation. LIBEL is written defamation. SLANDER is oral Defamation
False Imprisonment use of physical restraints. Practitioners are liable for false imprisonment when they unlawfully restrain the movements of their pts. Physical restrains should be applied only with a physical direct order.
MEDICATIONS, IV THERAPY AND LEGAL IMPLICATIONS
MEDICAL ORDERS, DRUGS, AND MEDICATIONS
R.A. 6675 states that only validly registered medical, dental, and veterinary practitioners, whether in private institution/corporation or in the government, are authorized to prescribe drugs.
In accordance with R.A. 5921, or the Pharmacy Act as amended, all prescriptions must contain the following information: name of the prescriber, office address, professional registration number, professional tax receipt number, patients/clients name, age, and sex, and date of prescription. R.A. 6675 requires that the drugs be written in their generic names.
IV Therapy and Legal Implications Philippine Nursing Act of 1991 Section 28
- states that in the administration of intravenous injection, special training shall be required according to protocol established
Board of Nursing Resolution No. 8
- states that without such training and who administers intravenous injections to patients shall be held liable either criminally under Sec 30 Art. VII of said law or administratively under sec 21 Art III or both (whether causing or not an injury or death to the patient)
IV Therapy and Legal Implications SCOPE OF DUTIES AND RESPONSIBLITIES IN IV THERAPY
1. Interpretation of the doctors orders for IV therapy. 2. Performance of venipuncture, insertion of needles, cannulas except TPN and cutdown. 3. Preparation, administration, monitoring and termination of intravenous solutions such as additives, intravenous medications, and intravenous push. 4. Administration of blood/blood products as ordered by the physicians. 5. Recognition of solutions and medicine incompatibilities. 6. Maintenance and replacement of sites, tubings, dressings, in accordance with established procedures. IV Therapy and Legal Implications SCOPE OF DUTIES AND RESPONSIBLITIES IN IV THERAPY
7. Establishment of flow rates of solutions, medicines, blood and blood components. 8. Utilization of thorough knowledge and proficient technical ability in the use/care, maintenance, and evaluation of intravenous equipment. 9. Nursing management of total parenteral nutrition, outpatient intravenous care. 10. Maintenance of established infection control and aseptic nursing interventions. 11. Maintenance of appropriate documentation, associated with the preparation, administration and termination of all forms of intravenous therapy.
Telephone Orders Telephone Orders
Doctors should limit telephone orders to extreme emergency where there is no alternative. The use of telephone in a non emergency as a substitute for the physician himself can lead to serious error and may border on malpractice.
Nurse should read back such order to the physician to make certain the order has been correctly written.
Such order should be signed by the physician within 24 hours.
The nurse should sign the physicians name per her own and note the time and order was received.
LEGAL SAFEGUARDS CHARTING LEGAL CONSIDERATIONS IN CHARTING
PURPOSE OF THE PTS. CHART Communication and continuity Assurance of quality care Research Legal document Statistics of the disease
*The chart is owned by the hospital
CHARTING DOS & DONTS IN CHARTING DOS Full, factual and objectively accurate Legible Immediate Personal
DONTS Language or unacceptable words Improper corrections Spaces & skips Abbreviation, not standard
CHARTING DOS & DONTS IN CHARTING
Dont tamper the medical record by: Adding Rewriting Destroying original record
Observe agencys standards on documentation Complete & Concise Specific & Standard abbreviations
CHARTING Writing an Incident Report
A tool used as a means of identifying and improving client care. They are usually made immediately after its occurrence and validated immediately by co-workers.
Purpose: to provide accurate documentation of occurrences affecting the client as to have basis for its intervention.
CHARTING The following are common situations that require an incident report:
MOST OF THEM ARE NEGLIGENT ACTS Falls, burns & medication error Break in the aseptic technique Incorrect sponge count during surgery Failure to report the clients condition
Rules in Incident Report Dont use the word error or include lawful judgment or inflammatory words
CONSENT
CONSENT TO MEDICAL AND SURGICAL PROCEDURE Consent is defined as a free and rational act that presupposes knowledge of the thing to which consent is being given by a person who is legally capable to give consent.
Nature of consent - an authorization by the patient or a person authorized by the law to give the consent on the patients behalf.
Informed Consent - A written consent should be signed to show that the procedure is the one consented to and that the person understands the nature of the procedure.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE The nurses responsibility in witnessing the giving of informed consent involves:
(1)witnessing the exchange b/w the client and the physician (2)witnessing the client affix his signature (3) establishing that the client really understood.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE ESSENTIAL ELEMENTS OF INFORMED CONSENT:
1. The diagnosis and explanation of the condition.
2. A fair explanation of the procedures to be done and used and the consequences.
3. A description of alternative treatments or procedures.
4. A description of the benefits to be expected.
5. Material rights if any + 6. The prognosis, the recommended care, procedure is refused
CONSENT TO MEDICAL AND SURGICAL PROCEDURE WHO MUST CONSENT?
Patient must consent in his own behalf
If he is incompetent, or physically unable, and is not in emergency case, consent must be taken from another who is authorized to give it in his own behalf.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE CONSENT OF MINORS
Parents or someone standing in their behalf, gives the consent to medical or surgical treatment of a minor. Parental consent is not needed if the patient is married or emancipated.
CONSENT OF MENTALY ILL
A mentally incompetent person cannot legally consent to medical or surgical treatment. The consent must be taken from parents or legal guardian.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE MENTAL COMPETENCY All patients are presumed to be competent unless declared incompetent by a court of law. Supporting documentation of the patients behaviors, speech, decision making and physical and mental status are very useful in establishing his/her mental competency.
EMERGENCY SITUATION No consent is necessary because inaction at such time may cause greater injury. If time is available and an informed consent is possible, it is best that this be taken to protect all the parties concerned.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE REFUSAL TO CONSENT
A patient who is mentally and legally competent has the right to refuse the touching of his body or to submit to a medical or surgical procedure no matter how necessary, nor how imminent the danger to his life or health if he fails to submit to treatment.
CONSENT TO MEDICAL AND SURGICAL PROCEDURE MEDICAL RECORDS
Was created as a means of communication among health care practitioners. Today medical records serve two important functions: to provide legal documentation, and obtain third party payments (e.g. Medicare) They are good evidence in legal suits but are not admissible evidence against the patient.
If information is not charted, it was not done or observed
LEGAL RISKS FOR SAFETY EQUIPMENT The nurse should exercise reasonable care in selecting equipment to be used in patients. Generally, a nurse is not liable for a nonobservable and non-discoverable defect in the equipment.
CONTRACT
CONTRACT WHAT IS A CONTRACT?
o Is a meeting of minds between two persons where they bind themselves to give something or to render some services. o Practically anything could be subjected to a contract as long as these are not contrary to law, morals, good customs, public order and public policy.
CONTRACT Kinds of Contracts
Formal Contracts - refers to an agreement b/w parties and is required to be in writing. E.g. marriage contracts
Informal Contracts - one in which concluded as the result of a written document where the law does not require the same to be in writing.
Express Contracts - The one in which the conditions and terms of contract are given orally or in writing by the parties concerned. E.g. PDN under the doctrine of facio ut des means I do that you may give.
CONTRACT Kinds of Contracts
Implied Contracts - one that is concluded as a result of acts of conduct of the parties to which the law ascribes an objective intentions to enter into a contract.
Void contracts - one that is inexistent from the very beginning and therefore may not be enforced.
Illegal contracts - one that is expressly prohibited by law
CONTRACT Illegal Contracts
Those that are made in protection of the law
Consent obtained by fraud
Those obtained under duress
Those obtained under undue influence
Those obtained through material misrepresentation
NURSES AND WILLS
NURSES AND WILLS WILLS - legal declaration of a persons intentions upon death. - Called a testamentary document because it takes effect after the death of its maker - An act whereby a person is permitted with the formalities prescribed by law, to control a certain degree the deposition of his estate, to take effect after death.
Decedent a person whose property is transmitted through succession whether or not he left a will
Testator a person who left a will.
Testatrix a woman who is making a will
Heir a person called to succession either by the provision of a will or by operation of law
NURSES AND WILLS Testate a person who dies leaving a will Intestate a person who died without leaving a will Probate validation of a will in court Administrator one who administers the provision of the will Estate the interest a person has in lands or in any other subject to property Attestation Clause- means the clause wherein the witness certifies that the instrument has been executed before them, and the manner of the same.
NURSES AND WILLS TYPES OF WILLS
o Holographic will a will is written, dated and signed by the testator o Nuncupative will or Nuncupation- an oral will
WHO CAN MAKE A WILL? Sound mind Eighteen years old & above Not prohibited by law
WHO CAN WITNESS? Sound mind Eighteen years old & above Able to read and write Not blind, deaf or dumb
NURSES AND WILLS The Nurses obligation in the Execution of a Will Note the soundness of the pts mind Ensure there was freedom from fraud or under influence The pt should be above 18 years of age Note the will was signed by the testator and that the witnesses signed the will in the presence of the testator For protection, the nurse must make a notation on the pts chart
NURSES AND WILLS ADVANCE CARE DIRECTIVE - a document written or completed by the client and used by a facility or hospital to provide care at a time when client cannot make his own decision
SUBJECTS: 1. Show risk for early dementia 2. Show risk for stroke 3. Activities- severe head injuries 4. Severe and recurring psychiatric illness 5. Terminally ill
NURSES AND WILLS Characteristics of Advance Directives
a. Allows clients to participate in choosing health care providers b. Allows also in choosing the type of medical treatment the client desires. c. Allows clients to consent or refuse treatments
NURSES AND WILLS TYPES:
1. INSTRUCTIVE DIRECTIVE - specifies life-sustaining treatment to be withheld or withdrawn. LIVING WILL - legal document stating person does not wish to have extraordinary life saving measures when not able to make decisions about his own care. -applicable for life saving treatment only. Example: DNR
2. PROXY OR DURABLE POWER OF ATTORNEY - legal document giving designated person authority to make health care decisions on the clients behalf when the client is unable to do so.
DNR DO NOT RESUSCITATE (DNR)
Factors in giving order of resuscitation: 1. Clients will and advance directives 2. Disease prognosis such as cancer or HIV 3. Clients ability to cope 4. Whether CPR will be given or not
Reasons for refusing to perform resuscitation o Epidemic or widespread disease or debilitating condition & that CPR is not beneficial o CPR will aggravate or prolong the agony of the client against cultural & religious suffering o Advance directives & Will
ORGAN DONATION
ORGAN DONATION REQUIREMENTS:
Any person 18 years of age or older may become an organ donor by written consent.
Informed choice to donate an organ can take place with the use of a written document signed by the client prior to death, a will, or a donor card or an advance directive.
In the absence of appropriate documentation, a family member or legal guardian may authorize donation on the descendants organs.
In case of newborns, they must be full term already (more than 2000 grams)
ORGAN DONATION TYPES: 1. Autotransplantation- donor and recipient are one and the same Ex: skin and bones
2. Heterologous- donor and recipient are two different individuals. a. animal to human c. cadaver donor b. human to human d. living donor
Types of organs used : 1. Those that regenerate 2. Those that come in pair - bone marrow, skin - kidneys, eyes
ORGAN DONATION Religions that have different views regarding organ donations
Russian Orthodox: permits all donations EXCEPT THE HEART.
Jehovahs Witness: DOES NOT ALLOW organ donation and all organ to be transplanted must be drained of blood first.
Judaism: They permit organ donation as long as with RABBINICAL CONSULTATION. Islam: will NOT USE ORGAN STORED IN ORGAN BANKS.
CODE OF ETHICS
ICN Code of Ethics An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2005. PREAMBLE Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal.
Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status. PREAMBLE
Nurses render health services to the individual, the family and the community and co-ordinate their services with those of related groups. ELEMENTS OF THE CODE 1. REGISTERED NURSES AND PEOPLE
Ethical Principles:
Values, customs and spiritual beliefs shall be respected Individual freedom to make decisions Personal information acquired must be held in confidence
GUIDELINES TO BE OBSERVED:
a. individuality and totality of patients b. respect c. uphold the rights of individuals d. take into consideration culture and values * in the event of conflict, welfare and safety take precedence
CODE OF ETHICS FOR RN 2. REGISTERED NURSES AND PRACTICE
Ethical Principles a. Human life is inviolable b. Quality and excellence in the care of patients c. Accurate documentation- nursing accountability
GUIDELINES TO BE OBSERVED: a. know the definition and scope of nursing practice b. be aware of duties and responsibilities c. acquire and develop competence in knowledge, skills and attitude d. optimum standard of safe nursing practice e. be morally and legally responsible f. patients records considered confidential
CODE OF ETHICS FOR RN RNS are aware that their actions have professional, ethical, moral and legal dimensions
GUIDELINES TO BE OBSERVED: 1. Duties in conformity with law
2. Not allow to be used in advertisements that demean image of the profession
3. Decline any gift, favor or hospitality from patient
4. Not demand and receive any commission, fee for recommendations made
5. Avoid any abuse of relationship
CODE OF ETHICS FOR RN REGISTERED NURSES AND THE PROFESSION
Ethical Principles: 1. Maintain loyalty 2. Compliance with by laws of accredited professional organizations 3. Commitment to continual learning 4. Contribute to the improvement of the socio-economic conditions and welfare of nurses
GUIDELINES TO BE OBSERVED: a. Be a member of accredited prof organization (PNA) b. Strictly adhere to nursing standards c. Strive to secure equitable working conditions through appropriate legislation and other means d. Assert for the implementation of labor and work standards
CODE OF ETHICS FOR RN REGISTERED NURSES AND CO-WORKERS
The nurse sustains a co-operative relationship with co-workers in nursing and other fields.
The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a coworker or any other person.