Professional Adjustment
Profession - requires advance training ,
experience & knowledge in a specified
field that provides services to people.
Professional Nurse - a licensed
professional that has completed a basic
nursing education program.
Professional Nursing - art & science
dominated by an ideal of service; has a
skillful care for the well being of the
patient.
Professional Adjustment - growth and
development of the whole individual to
make them fit for the position.
License - Professional License or
Certificate of Registration (COR) is a
legal document given by the
government that permits a person to
offer to the public their skills and
knowledge in a particular jurisdiction.
Registration - Recording of names of
persons who have qualified under the
law to practice their respective
professions.
CRITERIA OF A PROFESSION

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Service
Education
Autonomy
Theory
Code of Ethics
Caring
Continuing Education
QUALITIES AND ABILITIES OF A NURSE
A professional nurse must
possess these qualifications and abilities:
 Have a license to practice nursing in
the country.
 Have a Bachelor of Science degree
in Nursing
 Be physically and mentally fit
PROFESSIONAL FIELD IN NURSING
Hospital or Institutional - hospital &
related facilities.
Public Health/Community Health focuses on prevention and promotion.
In-Service Education - training and
development of nurses in hospitals &
improve quality of service in own
institution.
Private Duty Nursing  RNs in private practice
 General private duty nurse
 Private duty nurse specialist
THE LAW & THE SOCIETY
Importance of Laws to Society
- It is man made and regulates
social conduct in a formal way. It
command what is right and wrong.
Importance of Knowledge of Law
- Order of society can be
achieved by preventing infractions
rather allowing them and punishing
offenders afterwards.
- Ignorance can’t be used as an
excuse.
Two Classifications of Law According to
Origin
Divine Law - God is the author (ex; 10
commandments)
Human Law - Man is the author
 Public Law - Law that affects
general public (criminal laws)
 Private Law - Law that affects the
relationship of an individual to
another individual.
Functions of Law - A framework for
establishing what nursing actions in the
care of patients are legal.
Jurisprudence in Nursing - Department
of Law which compromises all the legal
rules and principles affecting the
practice of nursing.
Professional Negligence
- Refers to the commission or omission
of act that a reasonably person in the
same or similar circumstance would or
would not do, and acting or the nonacting of which is the proximate cause
of injury to another person or his
property.
Doctrine of Ipsa Loquitor (common
knowledge doctrine)
- “the thing speaks for itself” it’s the
nature of the wrongful act or injury is
suggestive of negligence.
Doctrine of Respondeat Superior
- “let the master for acts of the
subordinate”, the liability is expanded
to include the master as well as the
employee.
Doctrine of Force Majeure
- Unforeseen or inevitable event.
Incompetence- is the lack of ability to
discharge the required duty. Although a
nurse is registered , if in the
performance of her duty she manifests
incompetency, there is chance for
revocation or suspension of her
certificate of registration.
Torts - a legal wrong, committed against
a person or property independent of a
contract that renders the person who
commits it liable for damages in a civil
action. The person who has been
wronged seeks compensation for the
injury.
Assault - the imminent threat of
harmful or offensive bodily contact. It is
unjustifiable to touch another person,
or to be threatened.
Battery - an intentional, not consented
touching of another person .
False imprisonment or Illegal
Detention - means the unjustifiable
detention of a person without a legal
warrant within boundaries fixed by the
defendant .
Invasion of Right to Privacy committed when the nurse divulge
information from a patient's chart to
unauthorized persons.
Breach of Confidentiality - committed
through publication of any picture of a
patient (e.g. a malformed baby),
without consent of the parents, or
revelation of contents of patient’s
records.
Defamation - Character assassination,
be it written or spoken, constitutes
defamation.
Slander - oral defamation;
speaking unprivileged or false words by
which a reputation is damaged.
Libel - defamation by written
words, that cause a person to be
avoided, or make fun of.
NURSES AND CRIMINAL LIABILITIES
- Crime is defined as an act committed
or omitted in violation of the law.
Criminal offenses are composed of two
elements:
1. criminal act
2. evil / criminal intent. In criminal
action, the state seeks the
punishment of the wrongdoers.
Misdemeanor - is a name for a criminal
offense that does not in law amount to
felony.
Felony - is a public offense from which a
convicted person is liable to be
sentenced to death or to be imprisoned
in a prison.
Classes of Crimes
 Attempted - offender commences
the commission by open acts but
not able to perform all the acts
which shall produce the felony.
 Frustrated - offender performs all
the acts which shall produce the
felony but do not produce the act
by reason independent of the will
of the perpetrator.
 Accessories - those who having
knowledge of the commission of
the crime and without having
participated.
Circumstances affecting Criminal
Liability
 Justifying Circumstances
 defense of self or spouse
 fulfillment of duty
 refusing orders unlawful orders

Exempting Circumstances
- These are certain
circumstances under which the law
exempts a person from criminal liability
for the commission of the crime.
 imbecile / insane persons
 over 9 & under 15 yrs
 performance of lawful act with
due care, causes injury which is
merely accident without fault
 acting under compulsion of an
irresistible force
 acting on impulse or
uncontrollable force

 Consummated - when all the
elements necessary for the
accomplishment and the execution
of the crime are present.
Conspiracy to commit a crime
- Persons who commit felonies.
 Principals - those who directly
force or induce others to commit it.
 Accomplice - persons who
cooperate in the execution of the
offense by previous or
simultaneous act that contribute to
the commission of the crime.
Mitigating Circumstances
- Are those that do not
constitute justification or excuse of the
offense in fairness and mercy, may be
considered as extenuating degree of
moral culpability.

Aggravating Circumstances
- Are those attending the
commission of a crime that which
makes the offender feel guilt.

Alternative Circumstances
- Are those that must be taken
into consideration as aggravating or
mitigating according to the nature and
effects of the crime and other
conditions attending its commission.
Crimes which Concern Nurses: those
crimes against persons and community
at large which a nurse may commit.
Among these crimes are the following :
the criminal liability of the
 Parricide - crime committed by
one who kills his father, mother,
or child, whether legitimate or
illegitimate.
 Murder - committed by killing
another person, other than
those mentioned in parricide,
with evident premeditation
and criminal intent.
 Homicide - killing of another
person; it may be committed
without criminal intent or any
circumstance attending the
commission of a murder .
 Infanticide - killing of a child
less than 3 days of age.
 Abortion - expulsion of the
fetus at a period of uterogestation so early that it has
not acquired the power if
sustaining an independent life .
 Illegal detention - any private
individual who deprive him of
his liberty.
 Simulation of births - a crime
against the civil status
committed by substituting one
child for another or abandon
any legitimate child with intent
to cause such child to lose civil
status.
Consent . Contracts & Wills Contract
- meeting of minds between two
persons whereby one binds himself,
with respect to the other, to render
service.
- a legally binding exchange of
agreement between parties that creates
an obligation and which the law will
enforce.
Kinds of Contracts
 Formal - required to be in
writing by some special law
 Informal - oral or written
where the law does not require
the same to be in writing
 Express - condition & term are
given orally or written
 Implied - one that is concluded
as a result of acts of conduct of
the parties
 Void - in existent from the very
beginning
 Illegal - one that is expressly
prohibited by law
Consent
- granting permission to perform a
procedure
2 Types:
1. Informed - write , sufficient
information has been given to give
consent.
2. Implied - when consent can't be
obtained through writing.
Who can give consent?
1. 18 yrs old & above, conscious &
coherent, competent.
Who can't give consent?
1. Minors
2. Unconscious
3. Mentally ill persons
Wills
- " testament "; legal declaration of a
person's intention upon death.
- a document by which a person ( the
testator ) regulates the rights of others
over his or ;
 Decedent - a person whose
property is transmitted through
succession whether or not he left a
will also called Testator/Testatrix if
he left a will.
 Heir - person called to succession
either by provision of a will or by
operation of the law.
 Testate - a person who died leaving
a will
 Intestate - a person who died
without leaving a will
 Probate - validation of a will in
court
 Holographic Will - a will that is
written, dated & signed by the
testator
 Noncupative Will - a will that is
made orally
Note :
Witnesses to wills must be at least 18
years old, not deaf, blind or dumb.
*Allowance and dis-allowance of wills
necessary - meaning it should be proved
and allowed in the probate court.
- passive & permissive, non directive ,
inactive
- members may work independently
LEADERSHIP
- the process of influence in which the
leader influences others toward goal
achievement.
TYPES OF LEADERS:
Informal leader - Does not have official
sanction to direct activities of others;
chosen by the group itself ; Usually
become leaders because of age, an
inviting personality or ability to
communicate with and counsel others.
Formal or appointed - Chosen by
administration, and given official
legitimate authority to act.
STYLES OF LEADERSHIP
1. AUTHORITARIAN / AUTOCRATIC
- Strong control over the group or
directive approach.
- involves centralized decision making,
with the leader making the decision &
using power to command & control
others.
2. DEMOCRATIC OR PARTICIPATIVE
- Leaders focuses on involving
subordinates in decision making
- Democratic is participator , with the
authority delegated to others,
influential by having close and personal
relationship with the subordinates.
3. LAISSEZ - FAIRE OR PERMISSIVE
-Delegating approach
-Little or no direction is provided to
subordinates
Authority - Legitimate power to direct
others
Power - It is one's capacity to influence
others
Sources of power:
 Expert power - it is derived from
the knowledge & skills one possess
 Legitimate power - is derived from
the position one holds in a group &
indicates authority but not
sufficient as one's only source of
power.
 Referent power - derived from
respect & trust coming from any
individual group or organization.
 Reward power- it comes from the
ability to recognize others for
complying.
 Coercive power - is based on fear
of punishment if one fails to
conform.
 Connection power- it comes from
coalition & interpersonal
relationship.
 Informational power- it comes
from knowledge & access to
information.
MANAGEMENT
- Process that involves guidance,
direction of a group of people toward
organizational goals or objectives.
- the act of planning, organizing,
directing, controlling.
MANAGEMENT LEVELS
the organization's workload.
- Chain of command, with lines
indicating who reports to whom
and why what authority
 FIRST LEVEL - supervises the
operative employee.
BASIC TYPES
 MIDDLE LEVEL - plan and
coordinate activities of the
organization.
A. Informal - consists of the personal
and social relationship of the members
in the organization
 TOP LEVEL - manages the
organization as a whole.
B. Formal - describes the positions,
responsibilities and those occupying the
positions and their relationships.
STEPS IN MANAGEMENT
1. PLANNING
- Forecasting or setting the broad
outline of work to be done.
> Mission - purpose of existence and
reason behind organizational structure.
>Philosophy - statements of shared
values and beliefs.
>Goals - statement of intent derived
from the purposes of the organization,
usually stated broadly and generally.
>Objectives - specific aims, purposes or
targets that will have to be.
accomplished
2. ORGANIZING
- Grouping of activities providing
assignments, supervising, defining
means of coordinating
activities to accomplish goals and
objectives.
CHARACTERISTICS OF
ORGANIZATIONAL STRUCTURE
- Division of work in which each
boxes represent an individual
responsible for a given part of
ORGANIZATIONAL CHART
- Diagrammatic representation of the
organizational structure
1. Line Organization - Is the simplest
and most direct type of organization in
which position has general authority
over the lower position in the hierarchy.
2. Functional Organization - Is one
where each unit is responsible for a
given part of the organization's
workload.
3. Staff Organization - Is purely advisory
to the line structure with no authority
to put recommendations into action.
A. STAFFING
- Is the process of determining and
providing the acceptable number and
mix of nursing personnel to produce a
desired level of care to meet the
patient's demand.
Patient Classification System
-quantify the quality of nursing care by
matching patients needs to numbers
and kinds of nursing
personnel using time as the unit of
measure.
SCHEDULE
- It is a timetable showing planned work
days and shift for nursing personnel.
- Is to assign working days and days off
to the nursing personnel so that
adequate patient care is assured.
 Cyclic staffing - sets a basic time
pattern that is repeated in cycles.
 Modified workweeks - include
systems of scheduling personnel
such as 10-hour and 12-hour shifts,
weekend alternative, team rotation,
and flexible hours.
 Self-scheduling - is a method of
scheduling in which the nurse
manager determines the needs per
day and shift and the nursing staff
schedule themselves to meet these
needs.
B. DIRECTING
- Issuance of assignments, orders and
instructions that permits the worker
what is expected of the to achieve
organizational goals and objectives.
C. CONTROLLING
- The process by which managers
attempt to measure if actual activities
conform to planned activities.
- A process wherein the performance is
measured and corrective action is taken
to ensure the accomplishment of
organization goal.
PERFORMANCE APPRAISAL
EVALUATION SYSTEM
- Process of evaluating employee's
performance against standards.
QUALITY ASSURANCE PROGRAM
- Process of establishing a standards of
excellence of intervention and taking
steps to ensure that each patient
receives the expected level of care.
FRAMEWORK OF QUALITY ASSURANCE
1. Structure - instrumentalities in the
delivery of care (personnel, supplies
etc).
2. Process - how the service was
delivered.
3. Outcome - results expected of the
service.
NURSING AUDIT
- Official examination of: nursing
records, physical facilities, personnel
involved in patient care.
Quantitative - objective, has tight
controls, can generalize findings.
- A systematic search for and validation
of knowledge about issues of
importance to the nursing
profession.
Nursing Research
- Concerned with knowledge that
directly or indirectly influences clinical
nursing practice.
- Systematic, objective process of
analyzing phenomena of importance to
nursing.
Evidence-based Nursing Practice
1. Research Utilization (RU)
- Use of findings from disciplined
research in a practical application
unrelated to original.
2. Evidence-based Practice (EBP)
research.
- Begins with a clinical question (best
approach to solving the problem)
3. Cochrane Collaboration
- prepares, maintains, and disseminates
systematic reviews of the effects
of health care interventions.
Types of Nursing Research According to
Purpose
Basic Research - to generate new
knowledge, to test or generate new
theories.
Applied Research - to use
knowledge/research findings to solve
immediate problems.
Classification of Nursing Research
According to Design:
Qualitative - studies the subjective
meaning of an experience to a person
QUANTITATIVE
 hard,
replicable,
reliable
 manipulation
and control of
phenomena
verification of
results using
empirical data
 testing of
hypothesis
Deductive
 Limited by
existing
theories




QUALITATIVE
rich, real,
deep, valid
in-depth
description of
people or
events - data
gathered thru
unstructured
interviews and
participant
observation
concerned
with patterns
and themes
Inductive
Must be open
to new
theories
Qualitative Research - Focuses on
gaining insights and understanding of
events.
A. Phenomenological Studies
 Lived experiences".
 Examines human experiences
through descriptions provided by
the people involved.
 Bracketing - the researcher
releases expectations and biases
prior to doing the research
B. Ethnographic Studies
- Collection and analysis of data about
cultural groups
C. Case Study
- In-depth examination of people or
institutions
 To determine what knowledge
already exists on the topic to be
studied
D. Grounded Theory Studies
- Data are collected and analyzed and
then a theory is developed that is
grounded on the data.
 To develop a conceptual and
theoretical framework for the study
E. Historical studies
- Identification, location, evaluation,
&synthesis of data from the past
 To help the researcher plan the
study methods (eg. Instruments or
tools)
Step 4: Develop a Theoretical or
Conceptual Framework
Classification of sources can be:
Primary - an account of the event from
the person himself
Secondary - summarized or retold by
another
- To assist in the selection of the
study variables and in defining them
 Theory-set of related statements
that describes or explains
phenomena in a systematic way
Evaluation of data source:
External Criticism -authenticity or
genuineness of the source
 Concept-a word picture or mental
idea of a phenomenon. The
building blocks of a theory.
Internal Criticism - accuracy of the data
in the source
 Construct- highly abstract, complex
phenomenon.
Quantitative Research
Step 1: Identify the Problem
 Proposition- statement or assertion
of the relationship between
concepts.
A. Correlational Statement
B. Comparative Statement
 Hypothesis-predicts the
relationship between two variables.
Step 2: Determine the purpose of the
study
 Deductive reasoning -proceeds
from general to specific.
- Defines why the study is being made
(often mistakenly interchanged with
problem statement)
 Inductive reasoning -proceeds from
specific to general
Step 5: Identify the Study Assumptions
- Must state the significance and use of
the study results in order to get
approval
Step 3: Review of Related Literature
Assumptions - beliefs that are held to
be true but have not necessarily been
proven.
Step 6: Acknowledge the Limitations of
the Study
Step 8: Define Study Variables and
Terms
A. Limitations - uncontrolled variables
that may affect the study results and
limit the generalizability of the findings.
Perceived weaknesses of the study
findings.
1. Operational definition - indicates
how a variable will be observed or
measured.
B. Delimitations - limitations placed on
the research by the researcher himself.
2. Dictionary definition/Theoretical
definition - obtained from literature
sources
Step 9: Select the Research Design
C. Scope - the extent to which the study
will be made.
Research design- the PLAN for
how the study will be conducted
Step 7: Formulate the Hypothesis
 Hypothesis - predicts the
relationship between two or more
 Classifications of Hypotheses
Simple vs. Complex
1. Simple - relationship between one
independent and one dependent
variable
2. Complex - relationship between two
or more independent or dependent
variables.
Null vs. Research
1. Null - no relationship exists between
two variables
2. Research - there is a relationship;
states the expected relationship
Nondirectional vs. Directional
1. Nondirectional - mere prediction
that a relationship exists
2. Directional - researcher further
predicts the type of relationship;
director inverse
Exploratory - conducted when little is
known about the topic of interest is
examined
Descriptive - phenomena is described
or the relationship between variables is
examine
Explanatory - searches for causal
relationships
Types of Experimental Designs
 True Experimental - researcher has
great deal of control over the
research situation.
 Quasiexperimental - missing one
criteria for true experimental
design.
 Pre-experimental design - weak
design, researcher has little control
over the research
Types of Non-experimental Research
design
 Correlational Studies - researches
extent to which one variable (X) is
related to another variable.
 Survey studies - self report data are
collected from samples with the
purpose of describing
 populations on some variable/s of
interest
 Comparative Studies - Examines
the differences between intact
groups on some dependent
 Retrospective studies dependent variable identified
in the present, and the
independent
 variable that occurred in the
past is determined
 Prospective studies independent variable is
identified at the present time,
and the subjects
 are followed in the future to
observe the dependent
variable.
 Ex post facto studies - data are
collected "after the fact"
variations in the independent
variable are studied after the
variations have
 Occurred, rather than at the
time of occurrence.
 Accessible population - that group
which is actually available for the
study.
Step 11: Select the sample
o Sample - a subgroup chosen to
represent the population and used to
make generalizations about
the population.
o Sampling frame - a listing of all
elements of a population Two major
types of sampling
Probability Sampling Methods
 Simple Random Sampling - ensures
that each element of the
population has an equal and
independent chance of being
chosen.
 Stratified Random Sampling population is divided into
subgroups or strata, according to
some variable/s of importance.
 Cluster Random Sampling - large
groups or samples become the
sampling units.
 Systematic Random Sampling sample is taken from every kth
element of the population.
Step 10: ldentify the population
Non-probability Sampling Methods
 Population - complete set of
individuals or objects that possess
some common characteristic that is
of interest to the researcher
 Target population (aka Universe)
the group of people or objects to
which the researcher wishes to
generalize the findings of a study.
 Convenience Sampling (accidental
or incidental) - choosing readily
available people or objects for a
study.
 Snowball sampling - study subjects
help refer additional subjects study.
 Quota sampling - similar to
stratified random but selection
Time frame for studying the
accurate
 Purposive/Judgmental sampling based on a set of tine (6 months or
more).
Interviews - interviewer obtains
responses from a subject in a face-toface encounter or via a call
 Unstructured interview interviewer given a great deal of
freedom to direct the course

Structured interviews - asking the
same questions in the same order
and in the same manner of all
respondents in the study. Even
subtle changes in the wording of
the interview may not be permitted.

Semi-structured interview interviewers are generally required
to ask a certain number of specific
questions but additional probing
questions are allowed or even
encouraged.
 Longitudinal study - follows the
subject over a period of time (6
months or more) More accurate
study of changes that occur over
time
 Cross sectional study - examines
the subjects at one point in time.
Less expensive and easier to
 conduct.
Step 12: Conduct a pilot study
- Pilot study: Miniature, trial version of
the planned study. Can prevent a
researcher from conducting a largescale study that might be an expensive
disaster
Observation Method - gathering data
through visual observation.
1.
Structured - carried out when the
researcher has prior knowledge
about the phenomenon of interest.
Uses a checkist.
2.
Unstructured - researcher attempts
to describe events or behaviors as
they occur, with no preconceived
idea of what will be seen.
Step 13: Collect the data
Data collection methods:
Questionnaires - paper and pencil, selfreport instrument.
Types of questions:

Demographic - data on the
characteristics of the subjects. Age,
educational background, religion

Open-ended questions - essay, fillin-the blank

Closed-ended questions respondent is asked to choose from
given alternatives.
 Physiological Measures - involve
the collection of physical data from
the subjects. Generally more
objective and accurate than many
of the other data collection
methods.
 Attitude Scales - self-report, datacollection instruments that ask
respondents to report their
attitudes or feelings on a
continuum
 Delphi Technique - uses several
rounds of questions to seek a
consensus on a particular topic
from a group of experts. To obtain
group consensus without a face-toface meeting.
Step 14: Organize the Data for Analysis
Level of Measurement of Data
 Percentile - a datum point below
which lies a certain percentage of
the values in a frequency
distribution
 Standard Deviation - Indicates the
average deviation or variation of all
values in a set of values from the
mean value of those data.
Step 16: interpret the findings
1. Nominal - objects or events are
named or categorized
2. Ordinal - data that can be arranged
by rank
- Made in light of the study hypothesis
or research question and the theoretical
framework
Step 17: Communicate the findings
3. Interval -"real” numbers
4. Ratio -a true or natural zero can be
specified
Step 15: Analyze the data
- Measures of Central Tendency
 Mode - category or value that
occurs most often in a set of data
under consideration
 Median - middle score or value in a
group of data.
 Mean- the average sum of a set of
values found by adding all values
and dividing by the total number of
values.
Measures of Variability - measures how
spread out values are in a distribution
of values.
 Range - distance between the
highest and lowest value in a group
of values or scores.
- The final step in the research process
and yet the most important one for
nursing. No matter how significant the
findings may be, they are of little value
to the nursing profession if not
communicated to other colleagues.