Professional Documents
Culture Documents
Nursing Research
• Kerlinger - the systematic, empirical, controlled and critical
investigation of a hypothetical proposition in relation to a natural
phenomena/ problem
• Conducted to affirm or deny a hypothesis
Phenomenon.
• everyday phenomenon that affects the nurse (eg. bacteria,
drugs, physician)
Florence Nightingale
• Birthplace – Italy
• Training Ground – Germany
• Greatest Contribution – environmental Theory, training RNs in Crimean
War
• School – Saint Thomas School of Nursing
Ethics of a Researcher
• S – Scientific Objective – conductive research for a good
purpose or object for your pt
• C – Cooperation and Consent. Do not conduct
data/experiment w/o a consent (legally the patient owns the
chart. However the hospital owns the chart)
• I – Integrity – worked hard on the research
• E – Equitable – acknowledging works or contribution of others
• N – Nobility – protect the rights of your subjects
o Right not to be harmed
(physical, mental, moral harm) usually done during
experimental research
Physical Harm/ Negligence - undeliberate physical
harm
• Commission – done outside the standard
practice of nursing (eg. urinary catheter placed
on the nose of the pt)
• Omission – from the very start, you did not do
something about it.
Moral Harm
• Assault – mental fear/threat without physical
harm
• Battery – physically you harm the pt
Restraint is never an independent nursing order
• physical restraint – eg. Jacket
• chemical restraint – eg. use of psychotropic
drug
Moral harm
• Slander – oral defamation
• Libel – published or placed in the newspaper
o Right to self-determination
o Right to privacy
Anonymity – identity of subject may not be
disclosed. Privacy of the Informant (pt) eg. conduct a
study on HIV pt. but the pt wants his name to be
written in the newspaper as Mr. X, Mr. Y or Mr. W
Confidentiality – information acquired must be
disclosed. Privacy of the information eg. conduct a
study on HIV pt. but the pt wants the nurse should
only know
• T – Truthfulness – put only the data you have collected
• I – Importance – importance to the nursing profession
• F – Factual – facts or data
• I – Ideal (follow the 11 steps of research)
• C – Courage
• Extraneous Variable
o External infuences that can be changed
o Example: citizenship, educational status
• Dichotomous Variable
o 2 choices/ 2 results
o Example: Male/ Female
• Polychotomous Variable
o Multiple choices
o Example: Preferred foods – Chinese,
Japanese, American. . . . .
Examples
“A comparative Study in the Income of Filipino Nurses
Employed in P.G.H. and N.Y.G.H.”
Research:
1. Identify the Problem
2. Purpose – objective using SMART (Systematic, Measurable,
Attainable, Realistic, Time Bounded)
3. Define Terms
a. Conceptual Definition – dictionary definition
b. Operational Definition – defined in accordance on how the
researcher used the word
4. Revision of Terms
LEADERSHIP
Nursing Leadership
• style or process whereby a person is called by a nurse leader
were influence of group of people called his followers for the
purpose of attaining only one goal/objective.
Leadership styles
• Authocratic/Authoritarian/dictatorial/”hard” leader
o unilateral style of leadership. Only the leader here
performs the decision making without getting the inputs
from his members.
o One sided style of leadership Behavior :
A – apathy – insensitive to others
B – Boisterous speech
C – consistency
D – Dominating
E – Exploitative behavior
F – ferocious behavior, to coerce or compel the group to
follow him
• C – Communication skill
o transfer of information with understanding
o Communication barriers/communication backlog – eg.
Dialect differences, noise, deaf, high level of anxiety,
hallucinating
• D – Decision making skills
o Steps
identify the problem
identify person affected
gather options/alternative
• brainstorming
• delphitechnique – gathering solutions outside
the group (eg. specialized nurse)
choose and implement
Evaluation
• E – Ethics
o Principles
o Principle of Autonomy
independent judgment or decision making
in all situation the pt himself is the one who should
decide for his own care
Consent
• respect the decision of the pt
• explain the risk to the patient/SO
• waiver - a legal doc when the pt refuse for
treatment.
o Principle of Veracity
telling the truth to the patient
#1 the patient has the right to know from the
PHYSICIAN (not the nurse)
o Principle of Double Effects
if the pt is made to choose between 2 equal danger
and he only needs to choose one, choose the one
that will produce one good effect and less evil effect.
o Principle of Beneficence
doing good to the patient (eg. providing therapeutic
communication, providing privacy)
o Principle of Non-Maleficence
do no harm
3 types of Harm
• Physical – negligence by commission
• Mental – assault and battery
• Moral – slander and libel
o Principle of Justice
Prioritize the needs of the patient.
To be able to provide nursing care to the patient,
provide the nursing process.
Nursing Process characteristics :
• A – acceptable universally
• B - based patients assessment needs
• C – client focused
• D – dynamics – base on the ever changing
needs of the pt
• E – equitable care
• F – familiarity/rapport to the patient
• G – goal directed towards solving the assess
needs of the patient (SMART)
o Principle of Respect/Inviolability of life
Suicide and abortion is violation of this principle
• F – Face/solve Conflicts
o any clash of ideas resulting to crisis
o Methods of resolving conflict
avoidance – by paying attention
smoothing – appealing to ones conscience and
kindness
unilateral action – use of forced fear or threat
negotiation – best method in resolving conflict. The
head nurse should offer negotiation between
conflicting parties.
NURSING MANAGEMENT
NURSING MANAGEMENT
choosing the right person and giving them the appropriate task
for the purpose of achieving their goal/objective in achieving
total care
Delegate Task
• They can only delegate to subordinates the
Routinary task (standard, unchanging
procedure) eg. monitoring of I&O, bathing,
ambulating, toileting, shampooing, transporting,
feeding, clothing, wiping
• Stable patient - predictable outcome (eg.
postmortem care with direct supervision of the
nurse only)
• Supervision – need guidance
Staff Schedule/ Staffing
• Schedules (How many hours)
o Traditional – 8hrs a day/40hrs/wk
o Ten hour shift/4 days a week
o Baylor plan – it consist of two shifting
nurses
traditional – mon-fri 8hrs
2nd shift – 12hr shift during
weekends
o Part-time work – fewer working hours per
day and may choose the day or work.
Less than 8hrs job
o On – call – during shortage of nurses/staff
but increase in the number of patients.
Methods of Nursing care Delivery
• Different Methods
o Primary – 24hrs a day
Primary nurse is the only nurse
who is responsible to make a care
plan of the patient from the
moment of admission till the
moment of discharge. (eg. private
duty nurse or special nurse)
o Functional Method
DOH format/government hospitals
Assign nurse :
• Duty/task
• One nurse, one task
• Highly recommended during
a period of shortage of
nurses and budget
poorest method of delivery
because communication is
hindered
o Case Method/Case Nursing
provide total care within your shift.
Used in ICU department
C – Case Method
T – total care to the patient
O – one is to one ratio
Directing/Delegation stage
o a job or a task is done or performed by another perform for
you
o What you cannot delegate:
you cannot delegate total control of the procedure
you can’t delegate discipline of subordinates or staff
members.
Confidential task
Technical task
Medical task performing surgical procedure is done
by the doc not the nurse
Coordination/Collaboration
o the nurse needs to collaborate to other members of the
health care team.
o Multi-interdisciplinary approach – to be able to provide
holistic approach to the patient.
o Types of Collaboration
Interpersonal/Intradepartmental
• One patient, one unit.
• Collaboration between one nurse to another
healthcare team in one unit/department
• Eg. MI patient - nurse, dietary, specialized in
cardio
Interdepartmental
• 4 units in one hospital.
• Coordination of the patients care between 2-
more units/departments but still under one same
hospital or institution
• Eg. patient due for appendectomy is
transferred to the OR
Inter Agency/Institutional
• Coordination of patient’s care between 2 or
more hospitals/health care institution for the
benefit of the patient
• Eg. lying – in due for C/S and was transferred to
a hospital
Evaluation/Controlling
o stage wherein you determine whether or not your plans for
your patient is met or achieved
o Methods of evaluating staff performance
Checklist
• it is being evaluated higher than you. (eg.
nurse manager/supervisor or head nurse)
Nursing rounds
• it is being evaluated higher than you. (eg.
Nurse manager/supervisor or head nurse)
• Psychiatric ward is not done by nursing rounds
Peer review
• same rank or level is being evaluated you
• poor method
Performance appraisal
• the patient evaluates you
• best method in evaluation
PROFESSIONAL ADJUSTMENT AND
NURSING JURISPRUDENCE
Professional
A calling in which its members profess to have acquired special
values, knowledge, training or by experience so that they may
guide others in that special field.
Nursing is a profession
• Calling – service oriented
• Others – patients
Characteristics by profession
• A – accountability/liability for the result
• C – caring profession Central Focus
• C – competent
• E – ethics
• S – service oriented
• S – specialized scientific body of knowledge and skills
4. Clinical Instructor
o Qualifications :
A – accredited nursing Org
M – MAN in nursing or other health courses
O – One yr clinical experience
R – R.N.
Professional Negligence
Negligence
• failure to do something which are reasonable and prudent nurse
should have done something under a particular situation. (eg.
failure to raise side rales when the pt is unconscious)
• 3 elements of negligence
o duty on part of the nurse
o failure to do said duty
o injury, harm, death – most important negligence
Malpractice
• injury, harm or death is not important in malpractice
• The nurse is allowed to perform episiorrhapy
• with proper training but not episiotomy
• The nurse is allowed to perform IE but with 2 conditions :
o fetal aberration/ abnormal delivery
o prior to complete delivery
Abortion
• is the expulsion or termination of a product of conception before
the stage of viability. (3-6month/12-24weeks)
Infanticide
• kill the person in less than 3days or 72hrs of life.
Parricide
• killing another person to whom you have a relationship (mother,
father, husband)
Homicide
• unintentionally killing another person without any relationship
(eg. negligence in giving meds)
Murder
• intentionally killing another person without any relationship
Simulation of birth
• committed by any person who shall substitute one child to
another child or alter his identities for the purpose of losing his
civil status. (eg. the midwife failed to report the birth of the baby,
giving wrong information of the gender of the baby)
PD 651 (Birth registration act)
• law any person who assist in giving birth to report within 30 days
to the Local Civil Registration Office
• B – BSN RN
• A – Accredited
Org
• N – 9 units
• T – 2 yrs
Chief/Director
RN + MAN + Add only MAN +
5 yrs supervisor master’s in GSC
experience PHN or (Gen.
(N.B. if primary CHN Staffing
hosp) Course)
o Examinees
CGM (Good Moral Character)
Proofs of Valid Holder of Filipino Citizenship
Proofs of valid holder of a BSN Degree only
from schools whose curriculum is approved by the
CHED
3 docs sub to PRC
RLE certificate
TOR with Scanned picture
List of cases
Examination fee is P900
Last day Is :
Other related laws
• PD 223 – PRC Act
• RA 1080 – Civil Service exam Cum Laude,
Board passer – eligible in taking CSE
• RA 6425 – Dangerous drugs Act
o punishable with 2 chemical substances
Prohibited drugs
• chemical substance totally, abosultely can’t be
consumed by human being (eg. Shabu,
Mariana, Cocaine, Opium)
Regulated drugs
• you can use this drug provided the pt has the
prescription and the AMD has appropriate
license coming from the BFAD or Dangerous
Drugs
• RA 7600 – Baby Friendly Hospital.
o Early bonding for mother is Early Rooming in and early
baby breast technique for early bonding Early bonding for
father is thru cuddling
• E.O. 51 – Milk Code (Breast Milk)
o Avoid manufactured or formula milk
• How to be an R.N. under 9173
o Have all qualifications
o take the exam
o acquire the required ratings
o In order to pass the examination, an examinee must obtain
a general average of at least 75 % with a rating of not
below sixty percent (60%) in any subject
o An examinee who obtains an average rating of 75% or
higher but gets a rating below 60% in any subject must
take the examination again but only in the subject or
subjects where he/she us treated below 60 % (60%). In
order to pass the succeeding examination, an examinee
must obtain a rating of at least 75% in the subject or
subjects repeated.”
• RA 8981 –Modernization Act.