LEGAL ASPECTS OF CUSTOMER CARE FOR NURSESBy: Atty. Mai Endico-Ruez

RECALL

your

Nursing Laws

Question No. 1What law currently governs Nurses and Nursing Practice in the Philippines? Philippine Nursing Act of 2002Comprehensive Nursing Law of 2013Philippine Nursing Practice Reform Act of 2013

The Correct Answer is:A Philippine Nursing Act of 2002or Republic Act 9173

Question No. 2What is the penalty provided for by law for those who violate the Code of Ethics for Nurses?

Suspension of LicenseRevocation of LicenseBoth a & b

The Correct Answer is:C Suspension of not more than 4 years or Revocation of License

Question No. 3Under RA 9173, a nurses professional license may be suspended or revoked on the following ground:Unprofessional and unethical conductGross Incompetence or Serious IgnoranceMalpractice or negligence in the practice of NursingAll the above

The Correct Answer is:D All of the above

Question No. 4Liability of nurses for negligence in the practice of their profession include:Administrative Liability Criminal Liability Civil Liability Only a & cLetter a, b & c

The Correct Answer is:E Administrative, Civil and Criminal Liability

Question No. 5The governing body for the regulation of the Nursing Profession in the Philippines is called:Board of Trusted Nurses in the PhilippinesJurado ng mga ManggamotProfessional Regulatory Board of Nursing

The Correct Answer is:C Professional Regulatory Board of Nursing

Tie-Breaker QuestionUnauthorized practice of the nursing profession in the Philippines is punishable by:Fine of P50,000 to not more than P100,000Imprisonment of 1 year to not more than 6 years Either of the 2 or Both, at the discretion of the court

The Correct Answer is:C Fine of P50k-100k and/or Imprisonment of 1 year to 6 years

What the speaker will be sharing with you:Fundamentals of LawImportance of Knowing Your Laws Highlights of RA 9173 or the Philippine Nursing Act of 2002Types of Liabilities Philippine Jurisprudence on Medical Malpractice/Medical NegligenceSome Tips to Avoid Complaints & Law Suits

Law defined - A body of rules and regulations enacted by the law-making body of the State in order to control relationships between the State and the individuals and between the individuals themselves.

Fundamentals of Law

Types of Law - Natural LawsDivine LawsPositive Laws RA 9173 is a positive law. It allows injured parties to go to court and ask remedy

Fundamentals of Law

Why is it important to know your laws?Ignorantia Legis Non Excusat (Ignorance of the law excuses no one)Lawsuits are very costly and time-consumingLiabilities include administrative, civil and criminal which could lead to imprisonment

R.A. 9173 Philippine Nursing Act of 2002Comprehensive Nursing Law of 2013 (Binay)Philippine Nursing Practice Reform Act of 2013 (Angara)

R.A. 9173 Philippine Nursing Act of 2002An act providing for a more responsive Nursing ProfessionAuthorizes the creation of a Professional Regulatory Board of Nursing (PRBON)Enumerates the Powers and Duties of the BoardRequirements for Licensure Examination

R.A. 9173Citizen of the Philippines or a citizen of a country with whom the Philippines have reciprocity benefitsGood Moral CharacterBS Nursing graduate of a duly recognized college or university

Requirements for Nursing Licensure Exam

Sec. 22 - Conviction by final judgment of any criminal offense involving moral turpitudePerson guilty of immoral or dishonorable conduct Person declared by court to be of unsound mind

Grounds for Revocation and Suspension of Certificate of Registration/Professional License (Section 22 & 23):

Sec. 23 - Unprofessional and unethical conductGross incompetence or Serious IgnoranceMalpractice or Negligence in the Practice of Nursing Fraud, deceit or false statements in obtaining his certificate of registrationViolation of this Act, IRR, Code of Ethics for NursesPractice of profession during Suspension period

Suspension vs. Revocation

The former means that the nurse is not allowed to practice temporarily until final judgment of the case is rendered. The license is not confiscated.Revocation means the license to practice is confiscated either temporarily or perpetually.

Sec. 28 Scope of Nursing PracticeThose who singly or in collaboration with another initiates and performs nursing services to individuals, families and communities in any health care setting;Nursing care during conception, labor, delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood and old age.

Sec. 28 Scope of Nursing Practice cont.This section shall not apply to Nursing students who perform nursing functions under the direct supervision of a qualified faculty;Provided further, that the nurse is duty bound to observe the Code of Ethics for Nurses and uphold the standards of Safe Nursing Practice.

CHARTING DONE BY STUDENT NURSESWhen a nurse or clinical instructor counter signs the charting of the nursing student, he/she has personal knowledge of information and that such is accurate and authentic.Anyone who countersigns without verification commits herself to possible legal risks.

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Liabilities of nurses for the work of nursing aidesNurses should not delegate their functions to nursing aides since the Philippine nursing act specifies the scope of nursing practice of professional nurses.Nurses are enjoined to supervise their subordinates and see to it that they perform only those which they been authorized and those which they are capable of doing.

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Sec. 28 Scope of Nursing Practice continued..The nurse is required to maintain competence by continual learning through Continuing Professional Education provided by an accredited professional organization

Sec. 35 Prohibitions in the Practice of NursingPractice without valid licenseUses as his/her own another persons licenseFalsely poses or advertises as RN even if he/she is notAppends BSN/RN to his/her name even if such is not the caseAbets or assists in the illegal practice of a person who is not qualified to practice nursing

Penalties for violation of Section 35:Fine of not more than P50,000 to not more than P100,000Imprisonment of one 1 year to not more than 6 yearsBoth at the discretion of the court

Progress of Discussion:Fundamentals of LawImportance of Knowing Your LawsHighlights of RA 9173 or the Philippine Nursing Act of 2002Types of Liabilities Philippine Jurisprudence on Medical Malpractice/Medical NegligenceSome Tips to Avoid Complaints & Law Suits

Baby scotch taped in Cebu

Patient shoots doctor dead

Types of Liabilities:Administrative Liability Suspension Revocation of LicensePayment of Fine

PRBON

Civil LiablityPayment of Damages

Civil Courts

Types of Liabilities cont:Criminal Liability (under Art. 365, RPC)Imprisonment Payment of FineSuspension of Rights

Criminal Courts Company Liability File Cross-claimsTermination from employment

Just causes for Termination of Employment under the Labor Code (Art. 282):Serious MisconductWillful Disobedience to a Lawful OrderGross and Habitual Neglect of DutiesFraud or Willful Breach of Trust/Loss of ConfidenceCommission of a crime against employer or the latters immediate familyAnalogous cases

Some Philippine Jurisprudence on Medical Malpractice/Medical Negligence

Medical Malpractice/Medical NegligenceNegligence, general

refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstances would do or not do; and which resulted to the injury to another person or his property.

Some Philippine Jurisprudence on Medical Malpractice/Negligence:Reyes, et. Al vs. Sisters of Mercy Hospital, G.R. No. 130547, Oct. 3, 2000 -

Medical malpractice is a form of negligence which consists in the failure of a physician or medical practitioner to apply his skill which is ordinarily employed by the profession (standard) generally under similar conditions.

Some Philippine Jurisprudence on Medical Malpractice/Negligence:Reyes, et. Al vs. Sisters of Mercy Hospital, G.R. No. 130547, Oct. 3, 2000 -

The standard is based on several factors:State of medicine and science at that time The standards of the locality The general principles of medicine which he followsNature of the case and condition of the patient

Some Philippine Jurisprudence on Medical Malpractice/Negligence cont.Garcia-Rueda vs. Pascasio, et. Al, G.R. No. 118141, Sept. 5, 1997 -

Four (4) elements of Medical Negligence (DBIC):1.) There is a duty on the part of the medical practitioner. 2.) There was breach of that duty. 3.) The patient suffered death or injury.4.) There is a causal relation that the death or injury was due to the breach of duty by the medical personnel.

Philippine Jurisprudence cont. Ramos vs. Court of Appeals, GR No. 124354, Dec. 29, 1999 -

Doctrine of Res Ipsa Loquitur (The thing speaks for itself)

Conditions for Res Ipsa Loquitur:That the injury was of such nature that would not normally occur unless there was somebody negligentThat the injury was caused by an agency within the control of the defendantThat the plaintiff/complainant himself did not engage in any manner that would tend to bring about the injury (no contributory negligence)

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Some Philippine Jurisprudence on Medical Malpractice/Negligence cont.Cruz vs. Court of Appeals, GR No. 122445, Nov. 18, 1997 -

Some acts or omissions constituting negligence or malpractice:Wrong diagnosis due to lack of skill or care;Operating without patients or guardians consentFailing to give the patient or his family proper and necessary instructions as to the care to be given to patient

Cont.Allowing a foreign substance to enter or remain in the body of the person operated (i.e. sponges, pads, gauzes, etc.)Abandonment of a case without providing notice to patient or providing another medical attendant

Other Acts of Negligence: BurnsObjects left inside the patients bodyFalls of elderlyFalls of childrenFailure to observe and take appropriate action as needed

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Acts of Negligence Cont.Failure to report observations to attending physiciansFailure to exercise the degree of diligence which the circumstances of the particular case demandsMistaken identity Wrong medicine, wrong concentration, wrong route and wrong dose.

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Injury to patientSponge left in the patients abdomenSafety pin left in patients abdomenDeath of patient who jumped from window of his room

Negligence cont.

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Rupture of surgical woundBurns from hot water bagsDeath of infant resulting from wrongful injection of digitalis

Negligence cont.

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Basis for Liability under the Civil Code:Art. 19. Every person must, in the exercise of his rights and in the performance of his duties, act with justice, give everyone his due, and observe honesty and good faith.

Art. 20. Every person who, contrary to law, willfully or negligently causes damage to another, shall indemnify the latter for the same.

Basis cont. Art. 2176. Whoever by act or omission causes damage to another, there being fault or negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual relation between the parties, is called a quasi-delict and is governed by the provisions of this Chapter.

Art. 2177. Responsibility for fault or negligence under the preceding article is entirely separate and distinct from the civil liability arising from negligence under the Penal Code. But the plaintiff cannot recover damages twice for the same act or omission of the defendant.

Some Tips to Avoid Law Suits & Liabilities:1. Read and be very familiar with the Philippine nursing law.2. Beware of laws that affect nursing practice3. Upgrade you skills and competence4. Do not delegate your responsibilities to others.5. Determine whether your subordinates are competent in the work you are assigning them.

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6. Develop good interpersonal relationships with everyone: primarily your customers, peers, supervisors and subordinates.7. Consult your superior for problems that maybe TOO BIG for you to handle.8. Verify orders that are not clear to you or those that seem to be erroneous. Follow rules on taking orders. Some Tips to Avoid Law Suits & Liabilities cont.

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Some Tips to Avoid Law Suits & Liabilities cont.9. Practice the 5 Rights of Medication:

The 5 Rights in Giving Medication:1. Right Medication- Is this the medication the provider ordered?2. Right Dose- How may milliliters, tablets, or does are to given?3. Right Time- What time of day should the medication be taken?4. Right Route- Should the medication be given by mouth, via feeding tube, or is it an injectable medication?5. Right Patient- Is the medication for this patient or is it for someone else?

10. The doctors should be informed about the patients conditions11. Keep in mind the values and necessity of keeping accurate and adequate records12. Patients are entitled to an informed consent and confidentiality of records13. Always remember your Code of Ethics by heart.

Some Tips to Avoid Law Suits & Liabilities cont.

Preamble of Code of Ethics of Nurses 2004Health is a fundamental right of every individual. xxx believing in the worth and dignity of each human being. xxx

Patients are less likely to sue whenThey feel respected.Most patients understand that everyone makes an honest mistake. Personality becomes more important than technical ability when it comes to lawsuits.The medical staff is candid and spends more time answering their questions. Medical staff apologizes for the event and empathizes with the patient or his family. Does not necessarily mean admission of a wrong

Genuine Customer Care

-END-Thank you for actively listening!You are now ready to become world-class customer care providers.Congratulations!

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