Handouts in Jurisprudence and Prof Ad

8/13/2019 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