WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY 2012 PNLE PEARLS OF SUCCESS PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH (PALMER) PROFESSIONAL ADJUSTMENT/ NURSING JURISPRUDENCE Be a registered nurse and holder of a master's degree in nursing, education or other allied medical profession conferred by a college or university duly recognized by the Government: Provided, That the majority of the members of the Board shall be holders of a master's degree in nursing: Provided, further, That the Chairperson shall be a holder of a master's degree in nursing; Have at least ten (10) years of continuous practice of the profession prior to appointment: Provided, however, That the last five (5) years of which shall be in the Philippines; and Not have been convicted of any offense involving moral turpitude A. Patient’s Bill of Rights The patient has the right to considerate & respectful care, irrespective of socio-economic status. The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment and prognosis in terms the patient can reasonably be expected to understand. The patient has the right to receive from his physician information necessary to give informed consent prior to start of any procedure and or treatment (except in emergencies). The patient has the right to refuse treatment / life-giving measures, to the extent permitted by law and to be informed of the medical consequence of his action. The patient has the right to every consideration of his privacy concerning his own medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. The patient has the right to expect that all communication and records pertaining to his care should be treated as confidential. The patient has the right that within its capacity, a hospital must make reasonable response to the request of patient for services. The patient has the right to obtain information as to any relationship of the hospital to other health care and to other health care and educational institutions in so far as his care is concerned. The patient has the right to refuse or participate in such research projects. The patient has the right to expect reasonable continuity of care. The patient has the right to examine and receive an explanation of his bill regardless of source of payment. The patient has the right to know what hospital rules and regulations apply to his conduct as a patient. B. Nursing as a Profession Nursing is a profession. A profession possesses the following primary characteristics: Education, requires an extended education of its members, as well as basic liberal foundation. Theory, has a theoretical body of knowledge leading to defined skills, abilities and norms. Service Autonomy Code of ethics Caring The Board shall supervise and regulate the practice of the nursing profession and shall have the following powers, duties and functions: CIMECPRP Conduct the licensure examination for nurses; Issue, suspend or revoke certificates of registration for the practice of nursing; Monitor and enforce quality standards of nursing practice in the Philippines. Ensure quality nursing education Conduct hearings and investigations to resolve complaints against nurse practitioners Promulgate a Code of Ethics Recognize nursing specialty organizations in coordination with the accredited professional organization Prescribe, adopt issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the improvements of the nursing practice The president may remove or suspend any member of the Board after having been given the opportunity to defend himself/herself in a proper administrative investigation, on the following grounds: Continued neglect of duty or incompetence; Commission or toleration of irregularities in the licensure examination; and Unprofessional immoral or dishonorable conduct. D. Licensure Examination In order to be admitted to the examination for nurses, an applicant must, at the time of filing his/her application, establish to the satisfaction of the Board that: He/she is a citizen of the Philippines, or a citizen or subject of a country which permits Filipino nurses to practice within its territorial limits on the same basis as the subject or citizen of such country: Provided, That the requirements for the registration or licensing of nurses in said country are substantially the same as those prescribed in this Act; He/she is of good moral character; and He/she is a holder of a Bachelor's Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency. C. Organization of the Board of Nursing The Board is composed of a Chairperson and six (6) members That the membership to the Board shall represent the three (3) areas of nursing, namely: nursing education, nursing service and community health nursing. The Chairperson and Members of the Board shall possess the following qualifications: Be a natural born citizen and resident of the Philippines Be a member of good standing of the accredited professional organization of nurses; In order to pass the examination, an examinee must obtain a general average of at least seventy-five percent (75%) with a rating of not below sixty percent (60%) in any subject. POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE An examinee who obtains an average rating of seventyfive percent (75%) or higher but gets a rating below sixty *Patterned on the previous board exams from December 2006 – December 2011… the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming July 2012 PNLE WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY 2012 PNLE PEARLS OF SUCCESS PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH (PALMER) percent (60%) in any subject must take the examination again but only in the subject or subjects where he/she is rated below sixty percent (60%). In order to pass the succeeding examination, an examinee must obtain a rating of at least seventy-five percent (75%) in the subject or subjects repeated. A special/temporary permit may be issued by the Board to the following persons subject to the approval of the Commission and upon payment of the prescribed fees: Licensed nurses from foreign countries/states whose service are either for a fee or free if they are internationally well-known specialists or outstanding experts in any branch or specialty of nursing; Licensed nurses from foreign countries/states on medical mission whose services shall be free in a particular hospital, center or clinic; and Licensed nurses from foreign countries/states employed by schools/colleges of nursing as exchange professors in a branch or specialty of nursing; The Board shall have the power to revoke or suspend the certificate of registration/professional license or cancel the special/temporary permit of a nurse upon any of the following grounds: Person convicted by final judgment of any criminal offense involving moral turpitude or any person guilty of immoral or dishonorable conduct or any person declared by the court to be of unsound mind For unprofessional and unethical conduct; For gross incompetence or serious ignorance; For malpractice or negligence in the practice of nursing; For the use of fraud, deceit, or false statements in obtaining a certificate of registration/professional license or a temporary/special permit; For violation of this Act, the rules and regulations, Code of Ethics for nurses and technical standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the temporarily/special permit; or For practicing his/her profession during his/her suspension from such practice; E. Nursing Education and Practice A member of the faculty in a college of nursing teaching professional courses must: Be a registered nurse in the Philippines; Have at least one (1) year of clinical practice in a field of specialization; Be a member of good standing in the accredited professional organization of nurses; and Be a holder of a master's degree in nursing, education, or other allied medical and health sciences conferred by a college or university duly recognized by the Government of the Republic of the Philippines. In addition to the aforementioned qualifications, the dean of a college must have a master's degree in nursing. He/she must have at least five (5) years of experience in nursing. Possess a degree of Bachelors of Science in Nursing, with at least nine (9) units in management and administration courses at the graduate level; and Be a member of good standing of the accredited professional organization of nurses; Provided, That a person occupying the position of chief nurse or director of nursing service shall, in addition to the foregoing qualifications, possess: At least five (5) years of experience in a supervisory or managerial position in nursing; and A master's degree major in nursing A person occupying supervisory or managerial positions requiring knowledge of nursing must: Be a registered nurse in the Philippines; Have at least two (2) years experience in general nursing service administration; F. Laws Affecting Nursing Profession PD 442 PD 651 PD 825 PD 856 PD 996 EO 51 RA. 1136 RA. 3573 RA. 4073 RA. 6425 RA. 6675 RA. 7160 RA. 7170 RA. 7277 RA. 7305 RA. 9257 RA. 7600 RA. 7610 RA. 8172 RA. 8423 RA. 8504 RA. 8976 RA. 9173 Labor Code Birth registration following delivery (all health workers shall identify and encourage the registration of all births within 30 days following delivery) Anti- improper garbage disposal Code of Sanitation Compulsory immunization for all children below eight (8) years old against six (6) immunizable diseases Milk Code Tuberculosis Law Reporting communicable Disease Liberalized the treatment of Leprosy Dangerous Drug Act – the sale, administration, delivery, distribution and transportation of prohibited drugs is punished by law. Generics Act of 1988 – this promotes, requires and ensures the production of an adequate supply, distribution, use an acceptance of drugs and medicines identified by their generic names. Local Government Code Organ Donation Law Magna Carta for Disabled persons Magna Carta for Public Health workers Expanded Senior Citizen Act of 2003 Rooming –In and Breast feeding Act Anti-Child Abuse Law Asin Law / Iodize Salt Law Traditional and Alternative Medicine Act Philippine AIDS Prevention and Control Act Food Fortification Act The Nursing Act of 2002 G. Inform Consent Requisites for Validity of Informed Consent Written permission is best and legally accepted. To ensure that the client understand the nature of the treatment including the potential complications and disfigurement (explained by AMD) Signature is obtained with the client’s complete understanding of what to occur. - adult sign their own operative permit - obtained before sedation For minors, parents or someone standing in their behalf, gives the consent. Note: for a married emancipated minor parental consent is not needed anymore, spouse is accepted For mentally ill and unconscious patient, consent must be taken from the parents or legal guardian POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE *Patterned on the previous board exams from December 2006 – December 2011… the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming July 2012 PNLE WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY 2012 PNLE PEARLS OF SUCCESS PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH (PALMER) If the patient is unable to write, an “X” ia accepted if there is a witness to his mark Secured without pressure and threat A witness is desirable – nurse, physician or authorized persons. When an emergency situation exists, no consent is necessary because inaction at such time may cause greater injury. (permission via telephone/cellphone is accepted but must be signed within 24hrs.) H. Living Will It is a legal declaration of a person’s intentions upon death. The nurse should note the soundness of the patient’s 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. Advance Directive Signed request to be allowed to die when life can be supported only mechanically or by heroic measures Includes the decision to accept or refuse any treatment, service or procedure used to diagnose or treat his/her physical or mental condition and decisions to provide Health Care Proxy The patient designates a health care representative, usually a member of the family, a friend or a family physician to make decisions for him/her when he/she is unable, due to physical or mental incapacity, accept or refuse treatment, service or procedure used to diagnose or treat his/her physical or mental condition and decisions to provide, withhold or withdraw life sustaining measures I. 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. Elements of Negligence: Existence of a duty on the part of the person charged Failure to meet the standard of due care Harm resulting from failure to meet the standard Specific examples of Negligence: 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 Errors due to family assistance Doctrine of Negligence 1. RES IPSA LOQUITOR “the things speak for itself” - the injury is enough proof of negligence 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 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 J. 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 one’s authority RN exceeding the scope of nursing practice & does an MD’s job. K. Torts Assault is a unjustifiable attempt to touch another person or even the threat of doing so 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 it is making someone wrongfully feel that he or she cannot leave the place. L. Restraints Restraints are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity. R-equires physician’s order; consent E-mergency, get MD’s order ASAP S-hortest duration, least restrictive type T-o protect pt. and others R-enew order every 24 hours A-ssess every 15 to 30 minutes and document I-ndividualized supervision N-ever used as a punishment T-otal documentation S-eclusion as last step M. Crimes Conspiracy to commit a crime: POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE Principals- are those who take a direct part in the execution of the act, who’s directly force or induce others to commit it; or who cooperate in the commission of the offense by another act without which it would not have been accomplished. 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. *Patterned on the previous board exams from December 2006 – December 2011… the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming July 2012 PNLE WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY 2012 PNLE PEARLS OF SUCCESS PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH (PALMER) Degree of the acts of execution: 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. LEADERSHIP AND MANAGEMENT A. Leadership Style Authoritarian leadership style or autocratic leader keeps strict, close control over followers by keeping close regulation of policy and procedures given to followers. Democratic leadership style consists of the leader sharing the decision-making abilities with group members by promoting the interests of the group members and by practicing social equality. Laissez faire style is sometimes described as a "hands off" leadership style because the leader delegates the tasks to their followers while providing little or no direction to the followers Transactional Leadership Focuses on management task Caretaker Transformational Leadership Identify common values Is committed Non Experimental, the researcher collects data without introducing any treatment or making any changes. Quasi – Experimental, is like experimental research because it actively introduces some form of treatment or manipulation of an independent variable. Quantitative Research, a formal, objective, systematic process in which numerical data are used to obtain information about the world. Qualitative Research, systematic, interactive, subjective approach used to describe life experiences and give them meaning. Phenomenological Research, begin with accumulation of evidence when little topic is known or when studying new topic it involves gathering of fresh perspective. Grounded Theory Research, the primary purpose of grounded theory research is to develop a theory. The concepts and theories discovered through this research approach are derived directly from the data. Ethnographic Research, a tool for studying cultures Narrative Research, Focus on story as the object of inquiry, to determine how individuals make sense of events in their lives. B. Differences Between Conceptual and Theoretical Model Conceptual Model or Paradigm It is a pre-theoretical basis from which substantive theories may be derived It is highly abstract Concept are related and multidimensional It provides a perspective for science Uses trade-offs to meet goals Shared values not identified Inspires other with vision Has a long term vision It is derived from systematic observation and intuition. Examines causes Uses contingency reward Looks at effect Empowers other It is developed through the process of intuition RESEARCH A. Types of Research Basic / Pure Research, it is done for the intellectual pleasure of learning to search for knowledge for its own sake and eventually filter down the result into real life situation. Applied Research, seeks for practical application of theoretical or abstract knowledge. The truth is adapted to every situation. Action Research, the process involves the study of certain problem and from that experience, decisions, actions and conclusion are drawn. Correlational Research, involves the systematic investigation of relationship between or among variables. Experimental, an objective, systematic, highly controlled investigation for the purpose of predicting and controlling phenomena in nursing practice. It must be evaluated through logical grounds and cannot be empirically tested. Theoretical Model or Framework It proposes a framework derived from theories It is less abstract Concepts are narrowly bounded, specific and explicitly interrelated. It postulates relationship. It is descriptive, explanatory or predictive. It is constructed from available theories and findings of empirical research. It is develop through the process of induction and deduction. It permits empirical tests. C. Variables Independent Variables (CAUSE), These are factors that are being manipulated by the researcher and the focus of the inquiry. Dependent Variable (EFFECT), This is the factor or variable that is affected or influenced by the independent variable. Intervening Variable (MEDIATOR), This is a factor or variable that exists between the independent and the dependent variable. Moderator Variable, This is a variable that affects the strength or direction of the relationship between the independent and the dependent variables. POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE *Patterned on the previous board exams from December 2006 – December 2011… the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming July 2012 PNLE WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY 2012 PNLE PEARLS OF SUCCESS PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH (PALMER) Examples IV Independent Variables DV Dependent Variable Self-Concept, Personal and Professional Characteristics of Staff Nurses (IV) in Relation to Patient’s Satisfaction Index (DV) Thermoregulation of Infants (DV ) utilizing Mineral Water Container and Droplight (IV) D. Hypothesis Simple Hypotheses – predicts the relationship between one independent variable and one dependent variable. Example: Performance in the College of Nursing is related to success in the nurse’s licensure exam. Complex Hypotheses – predicts the relationship between two or more independent variables and two or more dependent variables. Example: Heredity, home environment and quality of instruction are related to intelligence, motivation and performance of school. Directional/Predictive Hypotheses – specifies the direction of relationship between the variables being studied. Example: People who smoke are more prone to lung cancer than those who do not smoke. Non Directional Hypotheses – predicts only that there is a relationship between the variables being studied but does not specify what it is. Example: There is a difference in the level of anxiety of pre-operative patients who receive preoperative instruction than those who do not receive such instruction. Statistical / Null Hypotheses – is an assumption that there is no difference between the studied variables. Example: There will be no correlation between liberalization attitudes and completion of a course in human sexuality. Research Hypotheses – this is also referred to as substantive or declarative hypotheses or statement of expected relationship between variables. Example: There is a significant relationship between maternal heroin addiction and birth weight of infants. Systematic Sampling – consist of taking every nth person in a school, community telephone directory. Cluster Sampling – small sample is taken from various section of a total population. Convenience or Accidental Sampling – data is collected from anyone most conveniently available. Snowball or Network Sampling – involves subjects suggesting or referring other subjects who meet the researcher’s criteria. Judgmental or Purposive Sampling – researcher selects and studies a specific number of a special group that represent the target population with regards to certain characteristics such as age, sex or economic status. Cross-cultural Sampling – conducted in a variety of cultural settings. Longitudinal Sampling – given group of subjects are studied for an extended period of time Cross-sectional Sampling – subjects are observed at only one point in time. Quota Sampling – identifies the strata of the population and determines the proportion of elements. E. Sampling Technique Simple Random Sampling – the selection of sample is done by chance. e.g Lottery draw Stratified Random Sampling – population is subdivided into areas, section then random sample as are taken from each. POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE *Patterned on the previous board exams from December 2006 – December 2011… the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming July 2012 PNLE