NURSING JURISPRUDENCE

Defined as the department of law that

comprises all the legal rules and principles
affecting the practice of nursing.
It deals with:
1. All laws, rules and regulations.
2. Legal principles and doctrines governing
and regulating the practice of nursing.
3. Legal opinions and decisions of
competent authority in cases involving
nursing practice.

Sources of Nursing Jurisprudence in the

Philippines:
1. The Constitution of the Republic of the Philippines,
particularly the Bill of Rights.
2. Republic Act No. 9173 otherwise known as the Philippine
Nursing Law of 2002
3. Rules and regulations promulgated by the Board of
Nursing and/or Professional Regulation Commission
pertaining to nursing practice.
4. Decisions of the Board of Nursing and/or Professional
Regulation Commission on nursing cases.
5. Decisions of the Supreme Court on matters relevant to
nursing.
6. Opinions of the Secretary of Justice in like cases.
7. The Revised Penal Code.
8. The New Civil Code of the Philippines.
9. The Revised Rule of Courts.
10. The National Internal Revenue Code as amended

Types of Law
Civil Law

Civil lawsuits involve personal injuries,

business disputes, land deals, libel and
slander, and various other commercial
interests.

Civil law actions must be brought by an

attorney hired by the injured party (the
plaintiff) against the alleged wrongdoer
(the defendant).

In the NURSING
Profession
Civil Liability: the basis is the damage
suffered by the aggrieved party (patient)
on the account of negligence of the
nurse. ; its in the form of payment or
compensation.
Different kinds of damages
1. Actual Damage expenses incurred by
the patient

Scenario
Patient underwent surgery, everything
was alright
Nurse mistakenly gave or applied
wrong medicine to patients wound
resulting to allergy on the last day of
confinement
Patient had to stay longer
*****Expenses on the additional days
of confinement = actual damages

2. Exemplary damage those that are

imposed by the court; usually imposed
in cases of gross negligence (
repeatedly giving of wrong medications)
3. Moral Damages compensates mental
anguish and sufferings,; sleepless nights
4. Lost of Income

Complaint maybe filed in the Municipal Trial

court if less than P200,000.00 or
Regional Trial
Court if patients claim is more than
P200,000.00

Doctrine of Vicarious Liability

by virtue of employer-employee
relationship . If nurse is not capable of
paying damages, court may order the
hosp to pay

The Captain of
the Ship
Doctrine
wherein the surgeon is
presume to be responsible
for everything that
happens within the
operating room

Administrative law

is the body of law that governs the

activities of the administrative agencies.
Administrative law is considered a
branch of public law.
deals with the decision-making of
administrative units of government
(e.g., taxation, immigration, transport,
manufacturing)

In the NURSING
Profession
Administrative Liability: violation of any
admin law in RA9173.
Filed in the BON under PRC
Purely personal, meaning license of
hosp is not affected by the negligence of
the nurse
However, the hosp has its own liability
under hospital regulations and laws
Either reprimand or penalty

Criminal law
those dealing with homicide, illegal drugs,
theft, and other antisocial behavior--are
enforced by agents of the state against
specific persons or corporations.
is designed to protect society as a whole
rather than to compensate individuals who
have been victims of criminal activity.

In the NURSING
Profession

Criminal Liability incurred by a guilty

nurse having found guilty from homicide
resulting from reckless imprudence or
gross negligence

Unlike in a civil liability, neither the

Captain of the ship nor the Doctrine of
Vicarious Liability applies.
Complaint filed to the Public Prosecutors
Office

PRIVATE OR CIVIL LAW

body of law that deals with
relationship among private
individuals

PUBLIC LAW
body of law for the welfare of the
general public; relationship
between individuals and the
government and government
agencies

COURT
An agency in the
government wherein the
administration of justice
is delegated.

LEGAL RIGHT

a claim which can be

enforced by legal means
against a person whose
duty is to respect it.

COURT MECHANISM
LAWSUITproceeding in court
for a purpose.
Purpose:
Enforce a right
Redress a wrong

STATUTE OF LIMITATIONS
Refers to the length of time following the
event during which the plaintiff may file a
suit.
Example:
negligence- filed within 2-3 years from
occurrence.

DUE PROCESS
A fair and orderly process which aims to
protect and enforce a persons right.

FUNDAMENTAL REQUIREMENTS
OF DUE PROCESS:
1. Right to be informed
2. Right to remain silent
3. Right to competent counsel
4. No use of violence, threat, torture
5. Right to know the witness face to face

PHASES OF DUE
PROCESS

PRE-TRIAL- eliminate matters not

in dispute, agree on issues or
settle procedural matters.

TRIAL- facts are presented and

determined; law applied at the
end.

WRITTEN ORDERS OF
COURT
WRIT- legal notes from court
SUBPOENA- an order in court

Duces tecum (papers) bring

documents, objects, materials, chart to

court
Ad testificandum (person) testify as
witness at a specified time and place
SUMMON- a writ commanding an
authorized person to notify a party to
appear in court to answer a complaint
made against him.

WARRANT- a writing from a competent

authority in pursuance of law, directing
the doing of an act addressed to a person
competent to do it
Warrant of arrest- a court order to
arrest or detain a person
Search warrant- a court order to search
for properties

LAWS THAT PROMOTE THE

WELFARE AND WELL-BElNG OF
NURSES

P.D. 442- Labor Code

Defines among other things, hours of
work, contract and nurse staffing in
industrial clinics
P.D. 807- Civil Service Law
Provide for the recruitment and
selection of employees in government
service; qualification standards;
personnel evaluation system; and
personnel discipline

R.A. 7305- Magna Carta for Public

Health Workers
Has provisions on benefits, rights and
responsibilities of public health
workers
R.A. 8344 No Deposit Policy
Prohibits hospitals and clinics from
demanding advance payments/cash
deposits before patients are admitted
or treated

LEGAL CONCEPTS AND

ISSUES IN NURSING

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 failure to do
something which a
reasonable & prudent
person should have done.
2 types:
1. Commission wrong
doing
2. Omission total neglect
of care didnt do anything

If the patients
careless conduct
contributes to his
own injury, the
patient cannot bring
suit against the
nurse.

Negligence results from.

Injury that is unintentional due to failure to
take the usual precautions expected or the
legal standards of care.
ELEMENTS OF NEGLIGENCE
1. Duty an obligation
2. Breach of duty failed to follow the
standards
3. Injury harm demonstrated by the nurse
4. Causation legal cause of injury

SPECIFIC EXAMPLES OF
NEGLIGENCE
1.
2.

3.
4.

5.

Failure to report observations to attending

Physicians
Failure to exercise the degree of diligence which the
circumstances of the particular case demands
Mistaken Identity
Wrong medicine, wrong concentration, wrong
route, wrong dose
Defects in the equipment such as stretchers and
wheelchairs may lead to falls thus injuring the
patients

 Burns resulting from hot water bags,

heat lamps, vaporizers, sitz bath

Objects left inside the patients body;
sponges suction tips
Falls of the elderly, confused,
unconscious, sedated patients
Falls of children whose bed rails were
not pulled up and locked
Mistaken identity- drug given to the
wrong patient
Wrong medicine, wrong concentration,
wrong route, wrong dose
Defects in the equipment

DOCTRINES OF
NEGLIGENCE
1. RES IPSA LOQUITOR
- the things speak for itself
- the injury is enough proof of negligence
A patient came in walking to the out-patient
clinic for injection. After injection was
administered to his buttocks, the patient
experienced extreme pain, leg weakness, and
was subsequently paralyzed.
The presence of sponges in the patient's
abdomen after an operation.
Fracture on a newly-delivered baby born by
breech presentation.

2. RESPONDEAT SUPERIOR
- Let the master answer for the acts of
the subordinate
- The liability is expanded to include the
master as well as the employee and
not a shift of liability from the
subordinate to the master.

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

3. FORCE MAJEURE
- Irresistible force; unforeseen or
inevitable event
- No person shall be responsible
for those events which cannot
be foreseen
Ex. Flood, fire, earthquake

INCOMPETENCE: lack of ability,

legal qualifications or fitness to

discharge the required duty

LIABILITY OF NURSES FOR THE

WORK OF NURSING AIDES
Nursing

aides perform selected nursing

activities under the direct supervision of
nurses.
They are usually given on-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

Nursing students should

always be under the
supervision of their clinical
instructors

They should be advised to seek guidance

especially if they are performing
procedure for the first time
They should be oriented to the policies of
the nursing unit where they are assigned
They should be advised to seek guidance
especially if they are performing
procedure for the first time
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.

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.

 R.A.

MEDICAL ORDERS,
DRUGS, AND
MEDICATIONS

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.

Ruling:
Do not follow unless 3 vital information
given above are present.
1. name of physician,
location of office, PTR/PRC license no.
2. Patients name, age, sex,
3. Name of the drug itself : both generic
and brand name (RA 6675)

RA 6675 the Generics Act of 1988 which

requires that all prescriptions of drugs should
include the generic name and the brand name
or the generic name alone.
Purpose : to let the patient choose among the
different brand names available of a specific
generic drug name

Impossible prescription : are

prescriptions written by a doctor in which

the generic and brand names do not
correspond to each other.
Exception to RA 6675 : The physician
can only be allowed to write only the
brand name if only one brand is
available for the particular drug being
prescribed. Ex. : Alaxan, Minocin

General Rule : A nurse should never

prescribe any medication nor administer
drugs without a valid doctors order.
Exceptions to the general rule :
1. In case of emergency
2. In cases of national calamity
3. In cases of epidemic PLUS : theres no
doctor around and the patient is in grave
danger of death. Good Samaritan Act

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)

SCOPE OF DUTIES AND RESPONSIBLITIES IN IV

THERAPY
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
1.

5. Recognition of solutions and medicine

incompatibilities
6. Maintenance and replacement of sites, tubings,
dressings, in accordance with established
procedures
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, out-patient
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.

MALPRACTICE

Doing acts or conducts that are not

authorized or licensed or competent
or skilled to perform, resulting to
injuries or non-injurious
consequences
Stepping beyond ones authority
Negligent act committed in the
course of professional performance
RN exceeding the scope of nursing
practice & does an MDs job.

ELEMENTS OF
MALPRACTICE
A. Standard of Care:
Failing to assess serious changes
in patient condition, such as
failure to check neurological
status, vital signs, or blood
glucose levels on time.
Failure to take appropriate action
or notify physician when
significant changes of pts..

If the nurse successfully demonstrates that

he/she has met an acceptable standard
of care, then there is no malpractice.

Remember what your nursing instructors

always used to say, "If you didn't
document it, it didn't happen!" - in other
words proper documentation can be
your best defense!

B. Duty
By accepting the assigned patients the
nurse has assumed a duty to treat the
patient with that degree of skill, care,
and diligence possessed or exercised by
competent and careful nurses.

C. Legal Causation
A legal cause of action for negligence
usually exists when it is determined that
the breach of the standard of care
proximately caused damages, usually
physical or emotional in nature to the
victim.

D. Damages: Substantial injuries caused by

breach of the standards of care that satisfy the
"damages" element of a medical malpractice
claim include:
Death
Disability
Deformity
Additional hospitalization or surgery to correct a
medical error
Severe and prolonged pain

Telephone Orders and Reports

When reporting via telephone,
the nurse must demonstrate
courtesy and professionalism.
organize information
beforehand to ensure that
reports made by telephone
are brief and clearly
understood by the receiver.

when reporting changes in the client's

condition to the attending physician, it is
prudent for the nurse to review his/her
notes and have assessment data ready
before placing the call.

The nurse should also document in the

nurses' progress notes the following:
the date and time of the telephone report
the name of the physician the nurse spoke
with
the data reported, and any order given by
the physician in relation to the telephone
report accomplished by the nurse.

Things to consider:
Telephone orders should be brief and
the person receiving it should read the
order to the physician verbatim.
When taking medication orders, the
nurse should spell the name of the drug
to the physician to avoid errors.
The use of abbreviations such as "U"
for units and "mcg" for micrograms is
also avoided.

the nurse should accomplish the following:

record the date and time the order was given
and write the order as dictated by the
physician.
The nurse also signs the order beginning
with a t.o. (telephone order), the physician's
name followed by her (the nurse's) name and
signature and the signature of another nurse
who witnessed the telephone order.

 The

nurse
should ensure
that the
physician
countersigns
the telephone
order within
24.

For physician's orders transmitted via fax,

the order should bear the physician's name
and signature. The nurse should also call
the physician to verify if he or she initiated
the order.
The nurse documents the telephone order in
the nurses' progress notes immediately after
the call.

Verbal or telephone order

General rule: as possible avoid T.O.
whatever is not written is not an order
Exception: During extreme emergency only!
What to do?
1. Nurse should read back such order to the
physician to make certain the order has been
correctly written.
2. Such order should be signed by the physician
within 24 hours.
3. The nurse should sign the physicians name
per her own and note the time and order was
received.

INTENTIONAL WRONGS
TORTS: A legal

wrong, an injury
committed against a person or
property
TYPES:
1. Unintentional- do not require
intent but do require the element
of harm.
Ex. Negligence and malpractice

2. Intentional- the act was done on purpose

or with intent; no harm,
injury or damage is needed to be liable.
ASSAULT- an attempt or threat to touch
another person unjustifiably; mental or
physical threat
Ex.- forcing a pt. to take his medication
or treatment

BATTERY- physical harm through

willful touching of person or
clothing without consent.
Ex. giving of injection without
pts consent

FALSE IMPRISONMENT
- Unjustifiable detention of a
person without a legal warrant
- occurs when the person is not
allowed to leave a health care
facility when there is no legal
justification to detain the client.

INVASION OF PRIVACY

Right to privacy is the right to be

left alone
Right to be free from unwarranted
publicity
Exposure to public view
Divulge information from patients
chart to improper sources or
unauthorized person

 PRIVILEGED

COMMUNICATION:
Statements uttered in good
faith; not permitted to be
divulged in court of justice

Exceptions: Confidential
information can be
revealed!
Pt. consent, if there is a
Crime, child abuse,
Communicable diseaseEthics

DEFAMATION
Character assassination
There must be a third person who
hears or read the comment before it
can be considered defamation
TYPES:
Slander-oral defamation
Libel-written words

RESTRAINTS
Restraints are protective devices
used to limit the physical activity of a
client or to immobilize a client or an
extremity.
TYPES:
Physical restraints: restrict clients
movement through the application of
a device
e.g. restraint jacket, straps,
Chemical restraints: Medications
given to inhibit a specific behavior or
movement.
e.g. sedation, psychotrophic drug

Points to consider
Restraints

are applied only when

absolutely necessary and are used as a
last resort.
Restraints are applied to protect the client
and others from injury.
Restraints are never used as a form of
punishment or used for the nurse's
convenience.

 Before

applying restraint to a
client, know the healthcare
facility's policy on restraints first.
The use of restraints is ordered
by a physician and the order
should be signed, dated, and
should specify the type of
restraint used and for how long.

In emergency situations, restraints may

be applied by an authorized and
qualified member of the healthcare unit.
However, an order should be obtained
from a physician within 24 hours.
Ideally, a physician's order should be
obtained within the first hour and a
registered nurse should evaluate the
need for continued restraint after the first
four hours of use.

Always obtain consent from a competent

client or from the guardian in the case of a
legally incompetent client before the
application of restraint to avoid legal
complications (the nurse may be charged
with false imprisonment, battery, and lack of
informed consent).
If an ordered restraint is refused by the client
or the guardian, check the policy on
restraints immediately. --- waiver needed.

Choose a type of restraint appropriate for the

client.
Restraints are applied securely and in such a
way that it can be easily removed in cases of
emergency.
Restraints should support normal anatomic
position of body parts to prevent
complications.

Ongoing assessments should be performed

every 30 minutes. Watch out for cyanosis,
pallor, broken skin, or coldness.
Restraints should also be removed for 10
minutes every 2 hours to provide for ROM
exercises, repositioning, ambulation, and
skin care.

When restraints are temporarily

removed, the client is never left
unattended or left with a family member.
If necessary, responsibility should only
be delegated to an authorized qualified
personnel and never to the client's
family member.

Proper documentation should be

accomplished.
Documentation should include the rationale
for restraining the client, type of restraint
used, explanations given to client and
significant others, client's consent, times
restraint was applied and removed,
alternative to restraints tried, protective
care rendered, clients responses, and
notification of the physician.

ALTERNATIVES TO
RESTRAINTS

Before restraints offer explanations,

ask someone to stay with the client,
use clocks, calendars, TV & radio (to
decrease disorientation) or any
relaxation techniques.

Assign confuse and disoriented

clients to rooms near the nurses
station.

Maintain toileting routines & institute

exercise and ambulation schedules
as the client condition allows.

CRIMES & OTHER ACTS

CRIME: An act committed or
omitted in violation of the law
Two elements:
1. Criminal act
2. Evil/criminal intent

Criminal negligence
Reckless imprudence- person does an
act /failing from to do an act by which
damage results immediately
(imprisonment 1-4 yrs)
Simple imprudence- did not use
precaution and the damage was not
immediate(imprisonment 1-6 months)

Felony- a public offense

committed with deceit and fault
Manner of commission:
Deceit (dolo) when act is performed

with deliberate intent

Fault (culpa) when the wrongful act
results from imprudent, negligence
or lack of foresight and skills

ELEMENTS OF A FELONY
1. An act or omission
2. Done voluntarily
3. Punishable by law

Intentional Felonies
Physical injuries,
murder,
parricide,(highest form
of destruction),
infanticide, abortion,
rape, mutilation

Persons liable for the crime

Principals- are those who take a direct part in
the execution of the act, who directly force or
induce others to commit it;
Accomplices- are those who, not being
principals, cooperate in the execution of the
offense by previous and simultaneous act.
Accessories- are those who, having the
knowledge of the commission of the crime.
Assisting the offender to profit from the crime
either by disposing the body, concealing or
assisting in escape of the principal of the
crime.

Classes of Felonies
Consummated- when all the elements necessary
for its execution and accomplishment are present.
Frustrated- when the offender performs all the acts or
execution which will produce the felony as a
consequence but which nevertheless, do not
produce it by reason of causes independent of the
will of the perpetrator.
Attempted- when the offender commences the
commission of the same directly by overt acts, and
does not perform the acts which shall produce the
felony.
Consummated felonies as well as attempted and
frustrated are all punishable by law.

Felonies according to degree of punishment

Grave Felonies- are those to which the law attaches the

capital punishment or penalties which in any of their
periods are afflictive. (imprisonment ranging from 6 yrs
and 1 day with fine not exceeding P6,000)

Less Grave Felonies- are those which the law punishes

with penalties which in their maximum period are
correctional (imprisonment ranging from 1 month and 1
day to 6 yrs or fine not exceeding 6,000 but not below
200)

Light Felonies- are those infractions of law for the

commission of which the penalty of arresto menor
(imprisonment for 1 day to 30 days or a fine not exceeding
200 or both of which are imposed)

JE MAA
Circumstances
affecting criminal
liability

JUSTIFYING
SELF-DEFENSE
These are the defenses in which
the accused is deemed to have
acted in accordance with the law
and therefore the act is lawful.
Since the act is lawful, it follows
that there is no criminal, no
criminal liability and no civil
liability

When he acts in defense of his

rights
When he acts in defense of his
relatives rights
When he acts in defense of a
strangers rights and that the person
defending is not induced by revenge
or evil motives.
In order to avoid evil or injury
In a fulfillment of a duty

EXEMPTING
There is a crime committed but there is no criminal
on account of the absence of a freewill and
voluntariness to act.

Insane
Under 9 y/o
Under compulsion of uncontrollable force or by mere
accident without intention
Under impulse of uncontrollable fear
Failure to perform an act required by law when
prevented by some lawful cause

MITIGATING
Lessens the penalty
Under 18y/o or over 70 y/o
No intention to commit so grave
a wrong
Voluntary surrender
Deaf & dumb/ with physical defect
Suffer from such illness that
diminishes willpower

AGGRAVATING
Increases the penalty
Treachery/taking advantage of superior strength
or position
Price, reward
Use of fire, poison, explosion
Calamities
Fraud or disguise employed
Cruelty

ALTERNATIVE
May increase/ decrease criminal liability
depending on the nature and effects of
the crime
Relationship
Voluntary surrender
Disguise in being employed
Defense of a stranger
Acts under the impulse of an uncontrollable fear
Offender is insane

CRIMES
CONCERNING
THE NURSE

MORAL TURPITUDE

Are acts contrary to the accepted and

customary rule of right

1. Rape:
a.) Ordinary rape forcible
penetration of sex organ to a sex
organ
b.) Sexual assault anything forcibly
inserted to any orifice.

Intervention
Safety (emotional and physical)
Report the incidence
Referral (if the father is the rapist,

ANTI- RAPE LAW (RA 8353)

R.A. 7877 Anti-sexual

Harassment Act
1.Any person who
exercises authority
2.Asking sexual favors in
exchange of another
favor

2.MURDER- killing of another with

intent
3. HOMICIDE- unintentional killing
of another person
4. PARRICIDE
Killing of a person to whom you
have a relationship
1. father
2. mother
3. brothers/sisters
4. ascendants
5. descendants
6. spouse

5. ABORTION- termination of
product of conception before
the age of viability.

6. INFANTICIDE
- the killing of an infant less than
three days or 72 hours.

7. ROBBERY
-

Anyone who gets the

personal property of
another with the use
of force, violence or
intimidation.

8. THEFT- -anyone who gets the personal

property of another without the latters
permission.

9. SIMULATION OF
BIRTH
1. Pretend that a woman gave birth
2. Substitution or exchanging of babies
in the nursery
3. Intentionally putting wrong
information in the birth registration
form
P.D. 651 Birth Registration Act - requires
any person (RN,OB, midwife) who shall
assist in giving birth to report within 30
days without penalty any live birth at Local
Civil Registrars Office.

10. DISPENSING OF PROHIBITED

DRUGS
R.A. 6425 (1965) Dangerous Drugs
Act
A. Prohibited chemicals or substances
that are totally and absolutely cant be
consumed by human being.
Ex. Shabu, cocaine, cannabis
B. Regulated can use this drug - with
appropriate prescription - MD with
appropriated license
Ex.- Valium, dormicum

PENALTY FOR
VIOLATING THE ACT
For licensed health care providers
Fines
Imprisonment
Automatic revocation of license

GUIDELINES TO PREVENT
CRIMINAL LIABILITY:
1. Be very familiar with the Philippine Nursing law
2. Be familiar with the laws affecting nursing
practice
3. Know agency rules, regulations, policies
4. Upgrade skills and competence
5. Develop good IPR with co-workers
6. Consult superior as needed
7. Verify vague/ erroneous orders
8. Always keep doctor updated regarding patient
9. Ensure accurate recording and reporting
10. Get informed consent
11. Do not delegate responsibilities to others

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

 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.

ESSENTIAL ELEMENTS OF
INFORMED CONSENT:
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. The prognosis, the recommended care,
procedure is refused
1.

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.

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

A mentally incompetent person

cannot legally consent to
medical or surgical treatment.
The consent must be taken
from parents or legal guardian

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

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.

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.

Sterilization is the termination of the ability to

produce offspring's. The husband and the wife
must consent to the procedure if the operation is
primarily to accomplish sterilization. If emergency
cases like ectopic pregnancy and abruptio
placentae, consent from patient is sufficient.

MEDICAL RECORDS
created as a means of communication among
health care practitioners.
serve two important functions: 1.to provide legal
documentation, and 2.obtain third party payments
(e.g. Medicare)
good evidence in legal suits but are not
admissible evidence against the patient.

The nurse should exercise reasonable

care in selecting equipment to be used
in patients. Generally, a nurse is not
liable for a non-observable and nondiscoverable defect in the equipment.

WILL
An act whereby a person is permitted by
law to have control in the manner of
disposing his estate but will take its
effect at the time of his death.

Important terms
Decedent : a deceased person
Testator : the dead person who made
the will (male)
Testatrix : the dead person who made
the will (female)

Two types of succession by heirs

1. Testate succession : the mode of
succession wherein the heirs inherit by
virtue of a last will and testament.

2. Intestate : succeeding by law and not

governed by a will.
* Without a last will and testament : heirs
should divide estate in equal sharin

Two types of last will and testament

Concerning properties & Concerning
body / life

Notarial/Ordinary will
2. Holographic will
1.

Notarial or Ordinary Wills : The

following are the nursing
considerations :
1. Check the patients level of consciousness :
the nurse must ascertain that the patient is
capacitated to make a will
2. Check the proper locations of the
signatures :
a. at the end of the will written by the patient
b. in all pages at the sides of the paper, by the
testator/testatrix and 3 witnesses.
3. Presence of three witnesses

Holographic Will : wills that are executed

during emergencies but the patient is still
conscious.
Requisites of a holographic will :
1. It should be entirely handwritten
2. It should be dated and signed using the
hands of the testator/testatrix.
* If nobody witnessed the writing of the will,
comparison to other documents made by
the testator/testatrix is necessary to ensure
its validity.

Advanced directives : are directions or

instructions made by the patient in
advance with what to do with the
patients body, such :
1. Living will
2. Instructions for DNR, cremation,
organ donation, and funeral services

Legal rights of a nurse and illegal

detention :

Illegal detention is a crime if a person,

such as a nurse, will limit the freedom of
a patient to move or travel from one
position / place to another
Exception : when there are quarantine
regulation orders such as what happen
in migration

HEIR is a person called to succession either by

the provision of a will or by operation of law
There should be a witness who knows the
handwriting and signature of the testator explicitly
declares that the will and the signature are in the
handwriting of the testator
ORAL WILL is also called as NUCUPATIVE WILL
or NUNCUPATION it is during the last illness, that
it is done in the place in which a he dies, that he
asked one or more witness to the will, that the will
be put in writing within a given number of days,
that it be for probate within a specified time

NURSES OBLIGATION IN THE

EXECUTION OF A WILL
The nurse should note the soundness of the
patients mind and that there was free from
fraud or undue influence and that the patient
was above 18 years or of age .
The patient should write that the will was
signed by the testator, that the witnesses
were all present at the same time and
signed the will I the presence of the testator

WHAT SHOULD A NURSE REMEMBER ABOUT

WILLS?

A nurse especially those taking care of well-to-do

patients should remember that the main requisite
for making a will is testamentary capacity or sanity.
The person who makes a will should at least be 18
years old and is not prohibited by law. T
The will is written and should be witnessed by
three credible witnesses, unless it is holographic
will.
There is no legal reason for the nurse to refuse to
witness the preparation of a will.

WHAT IS AN INCIDENT REPORT

It is an administrative report that is required
of nurses if there are violations of standards
and policies whether or not injury occurs.
Through incident reports, hospital
administration can monitor quality of patient
care and institute some measures to prevent
similar incidents in the future.