Handouts in Jurisprudence and Prof Ad
Transcript of Handouts in Jurisprudence and Prof Ad
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Law and Jurisprudence in Nursing Practice
Three Basic liabilities in the Nursing Practice are:
Civilpayment of money; damages
Criminal - imprisonment
Administrativedisciplinary action
Civil Action
2 Types of Civil Liability :
1.Culpa Contractual2.Culpa Aquiliana
Culpa contractual ( breach of contract) - when a nurse is contractually
obligated to perform a particular health
service or intervention to a patient and caused death or injury to
the latter
Contract ( Art. 1305, Civil Code) - is a meeting of minds between two
persons whereby one binds himself, with respect to the other,
to give something or to do some service.
Culpa Aquiliana
(Tort/Quasi-delict)
Culpa- aquiliana - absence of contractual relationship, a nurse may be
liable for damages or injuries arising from negligent conduct
It is a liability which arises from breach of a duty to any person fixed
by the laws and such breach constitutes violation of a private legal right,
without any contract
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Criminal Action
- Arises when a person perpetrates a crime or violates a specialpenal law or local government ordinance
Felony- violations of crimes listed under the Revised Penal Code; crimes
Mala- in se (deceit/dolo)Offenseviolation of a Special law; crimes Mala prohibita
Infractionviolation of an Ordinance
Criminal Negligence- commission of a crime through fault ( culpa)
Criminal Negligence
- also called Imprudence
- a kind of negligence suit which arises from the failure of the nurse or
health care professional to apply to his profession that degree of care
and skill which is ordinarily employed by his profession under similar
conditions
- may also pertain to a criminal action for malpractice against a nurse
Administrative
- An administrative Offense means every act or omission whichamounts to, or constitutes, any ground for disciplinary action
- An administrative disciplinary action against a nurse may arise from an
administrative offense or any ground for
Disciplinary action
- For purposes of determining the administrative liability of a nurse, it is
important to know whether he/she is
employed in government or private hospitals/ institutions
Governmentcomplaints against nurses may be filed at the Civil Service
Commission, Ombudsman, Head of
Government Office (Mayor/Governor)
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Privatefiled with the private employer/hospitals
Contracts
- A meeting of minds between two persons whereby one binds himself,
with respect to the other, to give something orto render some service
Requisites of a Contract
1.Object certain - which is the subject matter of the contract2.Cause of the obligation - which is established (Art 1318 Civil Code )3.Consent
Consent
-Manifested by the meeting of the offer and the acceptance upon the
thing and the cause which constitute the contract
-Approval of what is proposed by another
-May be express or implied
-Should not be given through mistake, violence, intimidation, undue
influence or fraud
Object
- Must be within the commerce of man- Must be licit, or not contrary to law, morals, good customs, public
policy or public order
- Must be possible- Must be determinate as to its kind
Cause
-the why of the contract
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- The essential reason which impels the contracting parties to enter
into the agreement
Breach of Contract
- Unjustified failure to perform all or part of the contractual duty
- If the breach is substantial, the entire agreement may be broken and damages may result
- If only part of the contract is breached, the remaining part of the
contract maybe in effect
Employment Contract
-Need not be in writing
- Oral contracts though can cause problems since memories fail
Criminal negligence- committed by means of fault or culpa
Mala in se committed by means of dolo or deceit (murder, theft,
adultery,abortion)
Mala prohibita those which are punished by special laws ( dangerous
drugs law, illegal possession of firearms,
anti-fencing law)
Kinds of Criminal Negligence
Reckless imprudence- doing or failing to do an act resulting to
injuries or death due to an inexcusable lack of precaution
Simple imprudenceis a mere lack of precaution in a situation
where the threatened harm is not immediate or the
impending danger is not openly visible or manifest
Negligence
- The omission of that degree of diligence which is required by the nature
of the obligation
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- Failure to exercise the care that a prudent person usually exercises
Doctrine of Negligent Conduct
- the nurse is liable for damages or injuries to the patient as a result
of negligent performance or non-performance of the nurses obligation inthe hospital
Malpractice
-Defined as any professional misconduct or any unreasonable lack of skill
or fidelity in the performance of professional duties
-Improper or unethical conduct by a professional, resulting in harm,
injury, or death of another
- Practice contrary to established rules and standards
Elements of Malpractice
1. Duty duty of a nurse to employ her training, care, and skill in the
care of the patient commences at the time her employment is engaged
by the patient
2. Breach breach of professional duties, skill, and care, or their
improper performance by the nurse]
3. Damage or injurycaused to the body or health of the patient
4. Proximate causation
a) whether the nurses actions causes harm to the patient
b) whether these actions are the proximate cause of the injury
Misdemeanor
- Applied to all crimes and offenses for which the law has not
provided a particular name
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Ex. Any person who practices nursing in the Philippines without
a certificate of registration
Criminal liability is incurred by:
- Any person committing a felony although the wrongful act donebe different from that which he intended;
- Any person performing an act which should be an offense againstpersons or property, were it not for inherent impossibility of
its accomplishment or on account of the employment of
inadequate or ineffectual means.
Classification according to Gravity
Grave felonies- those which the law attaches the capital punishment
(death) or periods which have the penalty of
imprisonment from 6 years and 1 day to life imprisonment, or a fine
exceeding P 6,000.00
Less Grave - those which the law punishes penalties that are
correctional, with imprisonment of 1
month and 1 day to 6 years or fine not
exceeding Php 6,000.00 but not less
than Php 200.00
- Light - 1 day to 30 days or fine of not exceeding Php 200.00 or
both
Justifying Circumstances
- the act/crime of the person is in accordance with the law; person is
free from both criminal and civil liability
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1. Self-Defense
2. Defense of Relatives
3. Defense of Stranger
4. Avoidance of Greater Evil or Injury
5. Fulfillment of Duty or Lawful Exercise of Office
Exempting Circumstances
- grounds for exemption from punishment because there is lacking
in the offender any of the conditions which makes the act voluntary (lack
of intelligence, freedom of action or intent)
1. Insanity
2. Person under 9 years of age
3. Person over 9 years and under 15 years without discernment (menta
capacity to appreciate the consequences of an act)
4. Person who acts under the compulsion of an irresistible force
5. Accident without fault or intention of causing it
Mitigating Circumstances
- circumstances which does not entirely free the offender from
criminal liability but only reduces the penalty
1. Under 18 or over 70 years old
2. No intention to commit so grave a wrong
3. Provocation or threat
4. Passion (acted upon impulse)
5. Surrender and confession of guilt
Aggravating Circumstances
- increase the penalty of the offense
1. Taking advantage of public position
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2. Crime is committed in the presence of public authorities
3. Crime is committed in the palace of the Chief Executive
4. Crime is committed in the nighttime or in an uninhabited place
5. Crime is committed on the occasion of an earthquake, epidemic,
shipwreck or calamity
6. Crime is committed with the aid of armed men7. Crime be committed in consideration of a price, reward, or promise
8. The act be committed with evident premeditation
9. Superior strength
10. Means are employed to weaken the defense
11. That as a means to the commission of a crime, a wall, roof, door, or
window is broken
12. Crime is committed by means of motor vehicles, airships, or other
similar means
Other criminal actions and offenses
Parricide - the highest form of destruction of human life; committed
when one kills his father, mother or child, whether legitimate or
illegitimate, or any of his ascendants or descendants, or his spouse
Murder- committed when a person kills another, other than his
father, mother, or child, or any of his ascendants or descendants,
or his spouse, and which killing is attended by treachery, abuse of
superiority, employment of
means to weaken defense, evident premeditation, price, reward
or promise and other qualifying circumstances
Homicide- the killing of a human being which is neither parricide nor
murder.
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Infanticide - the killing of any child less than three days old, whether the
killer is the parent or grandparent, or any relative of the child, or
even a stranger
Abortion-
intentional- intent is present; the offender acted purposely to expel the
fetus to bring about the abortion;
unintentional- not intended but violence inflicted upon the pregnant
woman is intended;
unintentional abortion through reckless imprudence - the violence is due
to negligence, imprudence, lack of foresight or lack of skill
Giving Assistance to Suicide
- Assisting another to commit suicide to the extent of doing
the killing himself
Illegal Detention
- May arise in the enforcement of quarantine regulations;
isolation of patients
- Not allowing patients to leave the hospital if not cleared with
payable account
Simulation of Birth
Crime against the civil status of persons punishable acts:
1) substitute one child for another or who shall conceal or abandon any
legitimate child with intent to cause such child to lose its civil status
2) Any physician or surgeon or public officer who in violation of the
duties of his profession or office shall cooperate in the commission of
the crime
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Rape-
traditional view: carnal knowledge of a woman against her will
sexual assault: committed when (1) penis inserted into the analorifice of a male or female; (2) an instrument or object is inserted
into the genital or anal orifice
Sexual harassment is committed in the work place, school, or training
environment, by someone who has authority, influence, or mora
ascendancy over the victim.
- Committed by the former who demands, requests or
otherwise requires any sexual favor from the latter,
regardless of whether such demand, request or requirement for
submission is accepted
Mutilation - is the lopping or clipping off of some parts of the body
resulting to the deprivation, of some essential
organs for reproduction
Physical Injury - committed when a person wounds, beats, or assaults
another resulting to serious, less serious or slight injuries
Physical Injuries
Serious - ill or incapacitated for labor for more than 30 days, or lost
any part of the body
Less serious - incapacity lasted 10 days or more/ required medica
attention during said period
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Slight - incapacitated from 19 days
Wills
- An act whereby a person is permitted, with the formalities prescribedby law, to control to a certain degree the disposition of his/her estates or
properties, to take effect after his/her death (Art. 783, New Civil Code)
Decedent a person whose property is transmitted through succession
whether or not he left a will; if he left a will, he is called a testator
Succession
- a mode of acquisition by virtue of which the property, rights, and
obligations to extent of the value of the inheritance of a person, are
transmitted through his death to another either by will or by operation of
law.
Testamentary Capacitythe capacity to make or execute a will
Requirements:
At least 18 years of age
Sound mind
Two kinds of wills
1) Notarial willssigned by the testator himself or by the testators
name written by another person in his presence and by his express
direction
- requires an attestation clause and an acknowledgement
before a notary public
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- needs at least 3 credible witnesses to testify that the
testator signed the will
Requirements for Witnesses to Notarial Wills
1) Of sound mind2) Able to read and write
3) Not blind, deaf or dumb
4) At least 18 years old
5) Domiciled in the Philippines
6) Has not been convicted of falsification of document or perjury
2) Holographic willa will which is entirely written, dated, and signed by
the testator
- does not need an attestation or acknowledgement
- does not need 3 witnesses, as long as one witness can prove
that the signature
belongs to the testator
JURISPRUDENTIAL DOCTRINES
1) Accountabilitythe nurse is responsible
for her own acts as well as those that affect her patients in
relation to the care that is given to the latter
2) Respondeat superior let the master answer for the acts of his
subordinates
- the negligence of the employee is presumed to be the negligence
of the employer
3) Bonus pater familiasgood father of a family
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- the employer becomes liable on his own upon a finding that he has
been negligent in the selection and supervision of his employees
4) Res ipsa loquitor - the thing or transaction speaks for itself
- the injury itself is a proof of negligence
5) Damnum absque injuriaalthough there was physica
damage, there was no legal injury
6) Force majeurean act of God
- an event which is unforeseen or inevitable which causes damage or
injury to a patient may exempt a nurse from any criminal liability
7) Nolo Contendere
- a plea of guilty or a plea of no contest
- considered as an admission of guilt for a crime charged
8) Malfeasance, misfeasance, nonfeasance
Malfeasancethe performance of some act which ought not to be
done (e.g.
insertion of IV w/out training)
Misfeasancethe improper performance of some act which might
lawfully be done
(e.g. NGT gavage w/out checking
placement of NGT tube)
Nonfeasancethe omission of some act which ought to be performed
(e.g.
failure to administer O2 therapy order)
9) Doctrine of Informed Consent
two parts of the consent:
a) informationfull disclosure
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b) consentmust be voluntary
- based on the principle that every human being has the right to
determine what shall be done with his own body
Essentials Elements of Informed Consent
1) the diagnosis and explanation of the condition
2) 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) materials rights if any
6) the prognosis, if the recommended care or procedure, is refused
Who can give Consent?
- patient gives consent on his own behalf
- if incompetent or physically unable, consent must be taken
from another who is authorized to give it in his behalf
Emergency Situation
- during an emergency situation, no consent is necessary
because inaction at such time may cause greater injury
10) Doctors order rule
- may be made verbally or in writing
- it is legally safe to follow a written order because
the physician cannot deny what he has written or signed
Telephone Order
- there are legal risks in telephone orders; they may be
misunderstood or misinterpreted by the receiving nurse; leads to
serious errors
- Doctors should limit telephone orders to extreme
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emergency situations where there is no
alternative
- the nurse should read back the order to the physician and make
certain the order has been correctly written w/in 24 hours
- nurse should sign the name of the doctor per her
own and note the time the order was made11) Nurse as a witness rule
- as a witness, a nurse can only testify on matters he/she has
direct or personal knowledge of
- a nurse can be an ordinary or
expert witness
12) Hospital records as evidence
Medical Records
- supplies rich material for medical and nursing research (scientific)
- serves as a legal protection for the hospital, doctor, and
nurse by reflecting the
disease or condition of the patient and
his management
- record fully, accurately, legibly, and promptly their observations
NOTE: If it was not charted, it was not observed or done
Charting Done by Nursing Students
- when a nurse or clinical instructor countersigns the charting of
a nursing student, he/she attests that he/she has personal knowledge of
information and that such is accurate and authentic
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13) Duties of Doctors
- a physician who holds himself out as a specialist should be
held to the standard of care and skill of the average member of the
profession practicing the specialty
14) Captain of the Ship Doctrine
- the head surgeon is made liable for everything that goes
wrong within the four corners of the operating room
15) Doctors are not Warrantors principle
- physicians are not warrantors of cures or insurers against
personal injuries or death of the patient
16) Liability of Hospitals and consultants
- there is no employer-employee relationship between the
hospital and a physician admitted in the said hospitals medical staff
- principle of respondeat superior will not apply
17) Legal Risks for Defective Equipment
- duty of the nurse is to make sure that the equipment used in
procedures and treatments is not defective
- document if there is improper functioning of equipment
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POINTS TO OBSERVE IN ORDER TO AVOID CRIMINAL LIABILITY
1. Be very familiar with the Philippine Nursing Law
2. Beware of laws that affect nursing practice
3. At the start of employment, get a copy of your job description, the
agencys rules, regulations, and policies
4. Upgrade your skills and competence
5. Accept only such responsibility that is within the scope of your
employment and your job description
6. Do not delegate your responsibility to other
7. Determine whether your subordinates are competent in the work you
are assigning them
8. Develop good interpersonal relationships with your co-workers,
supervisors, peers, or subordinates
9. Consult your superiors for problems that may be too big to handle
10. Verify orders that are not clear to you or those that seem to be
erroneous
11. The doctors should be informed about the patients conditions
12. Keep in mind the value and necessity of keeping accurate and
adequate records
13. Patients are entitled to an informed consent
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Other Related Laws
1) Proclamation No. 539 (Oct 17, 1958) declared the last week
of October every
year as Nurses Week
2) RA 6425Dangerous Drugs Act; prohibited the sale, administration,
delivery, distribution, and transportation of
prohibited drugs
3) RA 9262Violence against women and their Children Act
4) Letter of Instruction 47integration of family planning in the
curriculum of schools of nursing, medicine, midwifery, and allied health
sciences
5) PD 965requires couples intending to get married to undergo family
planning counseling
6) RA 4226Hospital Licensure Act; requires all hospitals in the Phils to
be licensed
7) PD 442Labor Code of the Phils
8) RA 6675Generics Act of 1988
9) RA 7160Local Government Code; transfers responsibilities for
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delivery of basic services from the national govt to the local govt units
10) RA 7600Rooming-in and Breastfeeding Act of 1992
Professional adjustment
-The growth of the whole individual and the development of all his
capacities- physical, mental, emotional, social, and spiritual.
- The preparation of a student nurse for the responsibilities of
professional and social life, by the development of her capacities in a way
that would make him/her fit to enter upon the practice of nursing
What is a profession?
A profession is a calling that requires special knowledge, skill and
preparation.
(Kozier)
It is governed by its own code of ethics.
Its ideal is public service, not monetary gain.(Dionisio et al.)
Characteristics of a Profession
1. Systematic theory and knowledge base
theory- fund of knowledge that has been organized into a consistent
system from which the skills that characterize a profession flow from..
2.Authority
3. Community sanction
4. Code of ethics
5. Professional culture
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Differences between an occupation and a profession:
OCCUPATIONTraining may occur on the job
Length of training varies.
Relies largely on experience or trial and error to guide decision making
Values, ethics, beliefs not prominent features of preparation.
Commitment and personal identification vary.
Workers are supervised.
People often change jobs.
Material reward is main motivation.
Accountability rests with employer.
PROFESSION
Education in college or university
Education is prolonged.
Science or theoretical constructs to guide decision making
Are strong.
Are autonomous.
Unlikely to change professions.
Commitment transcends material reward.
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Rests with the individual.
Values, ethics and beliefs are prominent features of preparation.
ANA standards of professional performance1.The RN systematically enhances the quality and effectiveness of nursing
practice.
2.The RN attains knowledge and competency that reflects current nursing
practice,
3.The RN evaluates ones own practice in relation to professional practice
standards and guidelines, relevant statutes, rules and regulations.4.The RN interacts with and contributes to the professional development
of peers and colleagues.
5.The RN collaborates with patient, family and others in the conduct of
nursing practice.
6.The RN integrates ethical provisions in all areas of practice.
7.The RN integrates research findings into practice.8.The RN considers factors related to safety, effectiveness, cost, and
impact on practice in the planning and delivery of nursing services.
9.The RN provides leadership in the professional practice setting and the
profession.
Functions of a NurseCaregiverhelp to regain health, maximal level of independent function
through the healing process.
Advocate - protect the clients human and legalrights, provide assistance
in asserting those rights if the need arises.
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Educatorexplain concepts and facts about health, demonstrate
procedures, reinforce learning or behavior , evaluate clients progress.
Communicator - Quality communication is critical in meeting the needs
of individuals, families , and communities.
ManagerCoordinates of nursing staff, personnel, policy and budgetaryresponsibilities, evaluate performance goals, monitoring professional
standards of practice, recruiting and hiring, staff development and CE,
evaluating employees, and implements quality improvement.
Roles of the Professional Nurse
Care ProviderCommunicator / Helper
Teacher
Counselor
Client Advocate
Change Agent
LeaderManager
Researcher
Career Roles
Nurse Researcher
Nurse educatorMilitary Nurse
Industrial Nurse
Private Duty nurse
Office nurse
Nurse Generalist
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Nurse Clinician
Nurse Practitioner
Nurse Specialist
Nursing Administrator
Advanced Practice Nursing
a. Clinical nurse specialist (CNS)
-An APN with nursing expertise in specialized area of practice /
or with any field of disease and may work in any practice setting usually
in a hospital .
b. Nurse practitioner- Provides health care usually in the OPD, ambulatory care or
community -based setting. Categories include acute care, adult , family,
pediatric, womens, geriatric.
- Manage self-limiting and chronic stable medical conditions.
C. Certified nurse-midwife (CNM)
- A registered nurse who is also educated and certified as midwife.- independent care for women in normal pregnancy, labor and
delivery; for the newborn, gynecological services and family planning.
D. Certified nurse-anesthetist (CRNA)
- A registered nurse with advanced training in nurse anesthesia
program; provide surgical anesthesia under the guidance /supervision ofthe anesthesiologist.
Basic Values of a Nurse:
ADVOCACY
-For the safety, health and rights of clients.
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-Reporting of any occurrence of incompetent, unethical, illegal or
impaired practice by any health care member that has the potential to
affect the clients health or safety.
RESPONSIBILITYWillingness to respect obligations and to follow through on promises.
ACCOUNTABILITY
Ability to answer for ones own actions to your clients or your employer
CONFIDENTIALITYConfidential protection of clients personal health information without
diminishing access to quality care
Cannot copy or forward medical records without client consent; cannot
share clients lab results, diagnosis, prognosis unless necessary in the
course of care
Nursing Stereotypes (Huston, 2006)
1. Angel of Mercy
- From Florence Nightingale, 1930s depiction of nursing as a holy
vocation.
- Demonstration of supreme emotional strength, doing everything tosave lives at a risk to oneself.( movie The
English Patient)
- The angel is compliant, willing, caring and dedicated.
2. Love Interest
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- Started in 1930-1940s when nursing was a prestigious profession,
requiring intelligence, capability, dedication to care-giving unless she
met a husband (usually a physician)
- Depictions of romantic relationships between nurses and doctors
continue however most are not love interests but sexual liaisons.
3. Sex bombshell/naughty nurse
- Nurses have been portrayed in motion pictures and televisions
as sexual mascots in mini skirts, low cut tops, high heels fulfilling
someone elses sexual fantasies instead of caring for patients.
4. Hand Maiden to the Physician
- The most pervasive stereotype where the nurse simply serves
as an adoring backdrop to the omnipotent physician, demonstrating little,
if any, independent thought or action.
- The nurse is pictured as obedient, permissive, conforming,
flexible and serene (Kalisch and Kalisch, 1982)5. Battle Axe
- A picture of an overweight, authoritarian senior nurse who struts
around with an air of self-importance, making the junior nurses cry and
the patients quake under their sheets.
6. Male Nurses Stereotypes-Male nurses are homosexuals/effeminate
-Male nurses are non-achievers for going into nursing rather than
another occupation such as medicine or physiotherapy.
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-Male nurses were characterized as being lazy, career driven,
preferring technical rather than caring tasks, and disproportionately used
for manual work such as lifting patients. ( Young, 2002)
Consequences of Stereotypes
-Recruitment challenge
-Threat to the collective identity of nurses
-Threat to the self esteem of nurses
Changing the Nursings Image1.Finding a voice in the press.
2.Reclaiming the title of Nurse.
3. Positive Talk by Nurses, About Nursing.
4. Emphasizing the uniqueness of Nursing.
5. Participating in the political arena.
6. Corporate initiatives and coalition efforts.
PROFESSIONAL POWER
derived from latin verb potere- to be able
- enables the individual or a group to accomplish goals
- gives the individual the potential to change the attitudes and behaviorsof others
Factors contributing to Powerlessness in Nursing (Huston , 2006)
-Oppression of Nurses as a group.
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-Nursings failure to fully align with the feminist movement.
-Limited collective action by nurses.
-The socialization of women to view power and politics negatively.
-Inadequate recognition of nursing as an educated profession with EBP.
-The professions history of being reactive rather than proactive innational policy-making.
ACTION PLAN
1. Place more nurses in positions that influence public policy.
2. Nurses must stop acting like victims- if a nurse is unhappy in nursing,
he needs to address what is wrong, rather than whine about nursing andact like a victim.
3. Become better informed about all health care policy efforts.
COMPETENCE
Competence- application of knowledge and the interpersonal, decision
making and skills expected for the nurses practice role withinthe contextof public health, welfare and safety.
Assumptions Regarding Continuing Competence (ANA 2000)
The purpose is the protection of the public and advancement of the
profession through professional development.
The public has the right to expect competence throughout the nursescareers.
Any process of competency assurance must be shaped and guided by the
profession of nursing.
Assurance of continuing competence is a shared responsibility of the
profession, regulatory bodies, organizations,& individuals
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Assurance of Provider competence
PROFESSIONAL LICENSURE
- a process by which a government agency grants permission to anindividual to engage in a given profession upon finding that the applicant
has attained the essential degree of competency necessary to perform a
unique scope of practice.
- define what is necessary for safe practice
required for activities that are complex, require special knowledge, skill,
and independent decision-making.- A licensed individual is deemed to have met the minimal
competency standards.
ISSUES: 1. Licensure mechanism has little relevance to the different
competencies achieved in various types of education programs for
nurses.2. Reliability and validity of the exam
Continuing Education
Definition: a planned learning experience beyond basic nursing
education, designed to promote knowledge, skills, and attitudes for theenhancement of nursing practice, thereby improving health care
provided to the public.
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Rationale: it is an obligation of every practicing nurse to maintain
competency due to the rapid changes in the delivery of health care and
the public demand for more extended and improved health care.
- Nurses must actively participate in professional development and in CEto meet the increasing and ever-changing demands of the profession and
community.
ISSUES:
1. Seat time in continuing education programs does not guarantee
learning.
2. Lack of courses for experts and specialists.
CERTIFICATION
- A type of credential that affords title protection, recognition of
competence,
- Protection of the public. Enables anyone to identify competent
people more readily- aids the profession by encouraging and recognizing professional
achievement
- Recognizes specialization, enhances professionalism
Issues on Certification:1. certification does not have an impact on patient outcomes
2. whether continuing competence can be assessed in a single
certification exam
3. whether recertification should be by licensure and not by completion
of CE
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REFLECTIVE PRACTICE
- A self-regulatory assessment of ones practice identity and seeking
learning opportunities to promote continued competence.
- Portfolios allows an individual to record items or challenges of
learning that are unique for each individual. Documents professional
growth and career paths.
Portfolios may contain:
VideosTranscripts, licenses, awards
Recommendation letters, certificates of recommendation
Newspaper clippings about ones abilities
Publications
Sample academic/professional output
Other artifacts / photographs.Narrative self reflection of practice
ISSUES: 1. Reform is better than recorded competence.
2. Portfolios can be discoverable evidences for law suits.
SOCIALIZATIONThe process by which a person acquires the technical skills of his or her
society, the knowledge of the kinds of behavior that are acceptable in
society, and the attitudes and values that make conformity with social
rules personally meaningful and gratifying.
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NEGATIVE SOCIALIZATIONHorizontal
Violence
Bullying, Harassment, Verbal abuse, Intimidation
Not all nurses are interested in the development of others or theprofession
Inappropriate workplace relationship
POSITIVE SOCIALIZATIONMentoring and empowerment
Mentoringan intense , positive, exclusive, oneon-one relationshipbetween an experienced professional and a less experienced novice.
Characteristics of an effective mentorpositive attitude, caring towards
others, experienced practitioner, good communicator, dedicated to
learning, worthy of trust and admiration. (Roberts 2003)
Stages of Mentor-Mentee Relationship1.Selecting a mentor and defining expectations2.Development of Role Competencies3.Growing Independence4.The Dissolution of the relationship
Stages of Nursing Expertise (Benner, 2001)1. NOVICE
- Beginning nursing student, or any nurse entering a situation in
which there is no previous level of experience.
- The learner learns via a specific set of rules, protocols or
procedures,
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which are usually stepwise
and linear.
- Ability is extremely limited;
Inflexible
2. ADVANCED BEGINNER- A nurse who has had some level of experience with the situation.
This experience may only be observational in nature, but the nurse is able
to identify meaningful aspects or principles of nursing care.
3. Competent
- A nurse who has been in the sameclinical position for 2-3 years.
- The nurse understands the organization; is a competent
practitioner who is able to anticipate nursing care and long-range goals
- Usually has experience with all types of psychomotor skills required
by a specific group of clients; knows how to prioritize- Lacks the speed and flexibility of a proficient nurse.
4. Proficient
- A nurse with greater than
2-3 years of experience in the
same clinical position.- The nurse perceives the clients situation as a whole, able to assess
the entire situation, and can readily transfer knowledge gained from
multiple previous experiences to a situation.
- Focuses on managing care as opposed to managing and performing
skills.
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5. Expert
- A nurse with diverse experience;
- able to zero in on the problem and focus on multiple dimensions of
the situation.- Skilled at identifying client-centered problems and problems
related to the health care system
- Highly skilled analytical ability that can be transferred to situations
JOB APPLICATIONSResumemaking
Letter Writing
Job Interview
Resume or Curriculum Vitae- a summary of personal information relevantto the job you seek.
It lists your accomplishments and experiences in a way that tells
employers who you are and what you can contribute
to their enterprise.
Its purpose is to impress a potential employer and get you an interview.
Types of Resume
Chronological Resume- Positions are described beginning with the
present or most recent regardless of how relevant they are.
Functional Resume- Emphasizes experiences and skills according to
the writers priority on the value of experiences.
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Combination Resume
Targeted Resume- focused on achievements
Electronic Resume/Scannable Resume
- uses key words that describe what you can do.
Resume Requirements
Neat, professional tone/appearance
No negative information
All words spelled correctly
Brief content, concise
Use font between 10-14May use bold font; avoid underlining words.
Use white paper to maximize contrast
Use portrait mode
All information is the truth
Evidence of what the candidate has to offer the employer
Application Letters
Consider the following:
You want a certain position
You are fit for it by:
-your education-your experience
-you want the position for a reason
-you tell your reader something about yourself
-secure action
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What makes a good cover letter?
No spelling or typing errors.
Address it to the person who can hire you.
Write it in your own words.
Be natural.Show that you know something about the company and the industry.
Use terms and phrases that are meaningful to the employer
Checklist for an application letter
Lengthone page of 3-4 paragraphs.High quality Paperwhite; substance 20-25
Font styleTimes new Roman, Helvetica, Arial
Font size10-12
PrintLaser printed or type-set.
Balanced page- center letter; full or modified block style
With current address and dateEnclosures- resume, transcript, references (Enc. Or enclosures) after the
signature block
Beginning the letter:
The opening sentences of the application letter should arouse the
immediate attention of the reader. Good beginning sentences are directand simply phrased.
Poor: Replying to your recent advertisement I wish to apply for the
position of nurse
Better: In applying for the position of staff nurse, I offer my
qualifications, which I believe, will meet your exacting requirements.
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Ending the letter:
End with a request for an interview rather than for the job itself. Give
attention to the individuality and the force of ending. Avoid weak or
hackneyed endings.Poor: If you think I can fill the position, I shall be glad to talk with you.
Better: If my application convinced you of my ability, I welcome the
opportunity to talk with you, that you may judge my qualifications
further.
The InterviewThis assessment of individual personality tells the interviewer about the
candidates disposition, attitude, interests, and personality traits.
It can be done as one-on-one or panel interview.
Preparing for the interview
1.Remember to find out as much as possible about the company.2.Find out as much as you can about the position.
3.Practice reviewing your strengths, skills and accomplishments.
4.Be aware of typical interview questions and practice your answers.
5.Prepare a list of questions for the employer to answer.
6.Have an idea of what the competitive salary is for the position and
know your own salary requirements.7.Collect any information you think you may need for the interview.
8.Select and prepare the proper clothing.
9.Prepare mentally and use the power of positive visualization.
Interview Behavior
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Good eye contact
Appropriate body language
Appropriate voice melody
Active listeningGood choice of words
TELEPHONE INTERVIEWS
Telephone dos
Prepare yourself before calling
Practice answering questions with a friendPrepare beforehand as you would for any interview
Set up a daily plan
Keep pen and paper handy for notes
Keep a log of your activities
Keep a smile on your face
Time your call carefullyKeep a record of your applications in a file next to the telephone
Smileit comes through in your voice
Use gestures as in normal conversation
Be enthusiastic
Sit in a comfortable chair
Speak clearly
Telephone Donts
Dont drink a beverage, chew gum,smoke
Allow background distractions or noises
Sound as if you are reading a script
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Speak too softly
Talk too technical
Rush though your presentation
Interrupt your contact
Act as if your contact cant see youBe overbearing
Leave a message
Say ah, er, hmm and other
unnecessary expressions
Resigning from a JobIt is suggested that nurses keep their positions for at least two years if the
position is acceptable to them.
Think of the whole situation; seek assistance in decision-making; do self -
analysis
Leave a friendly feeling towards
superiors and co-workers.Use prudence in accepting another
position.
Give advance notice. (1-6 months)
Leave with a clean record in the most
gracious professional manner.
DURA LEX SED LEX - The law is harsh but it is the Law