HOUSE OF REPRESENTATIVES,

RECEIVED
Republic of the Philippi -
HOUSE OF REPRESENTATIVES DA&TI=04 AUG 2016
Quezon City Tv: 2
ay

SEVENTEENTH CONGRESS

First Regular Session a
254 Rr PATON UNIT.
HOUSE BILL No. BULLS AN) ANOTX SERVICE

Introduced by Bayan Muna Party-list Rep. CARLOS ISAGANI T. ZARATE

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS SAFE AND
QUALITY HEALTH CARE SYSTEM, REPEALING FOR THIS PU RPOSE
REPUBLICT ACT 9173
OTHERWISE KNOWN AS THE PHILIPPINE NURSING ACT OF 2002, AND
APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

This bill aims to address the issues and concerns of nurses and the nursing profession, with the
end goal of contributing to the development of comprehensive, safe, quality, free and accessible
health services especially for the poor Filipinos.

The country’s health situation remains poor, with chronic poverty afflicting most of the
Population despite the much-touted “economic growth”. In fact, based on the Fifth Progress
Report ~ Millennium Development Goals (MDG) Executive Summary Published by the
National Economic Development Authority and United Nations Development Program, the
Poverty incidence of 25.2 % in 2012 is stil far from the MDG target of 17.2% by 2015. Not
surprisingly, the prevalence of underweight-for-age under-five children since 1990 was not
declining fast enough to halve the incidence of malnutrition, and maternal mortality rate of
221/100 live births is far from the targeted 52/1,000 live births in 2015,

Instead of alleviating the dismal health status, health human resources are plagued with problems
Preventing our health workers and professionals to fully and effectively perform their functions
towards improving people's health.

Nurses are the most numerous health professionals in clinical setting, but like most health
workers, ate overworked and underpaid. Inadequate salaries and benefits, lack of jobs and
Security of tenure, and inhumane working conditions push many nurses to seck better
opportunities abroad.

lronically, while the Philippines is the top exporter of nurses in the world, many barangays are
without a nurse. Overcrowded public hospitals are manned by nurses at 1:40-80 nusse te patient
tatio, greatly compromising the quality of health care and the safety of the patients.

Yet, based on reports, some 200,000 nurses are unemployed’. Contractual, on-the job-training
purses and trainees who ate paid below the minimum or even not paid at all are made to perform

| http:/www.neda.gov.ph/wp-contentuploads/2014/0 MDG-Progress-Report- pdf
* Alliance of Health Workers, October 15 2014, hit X : 10/1 5/14/how-many-

1


the tasks of staff nurses. The Department of Budget and Management and Department of
Health, despite protests and recommendations from health and nurses groups, failed to increa
the plantilla positions for nurses and enforce a healthy nurse-patient ratio of 1:4° for general,
medical, surgical wards, based on recommendations of many nutsing associations in the world,

Instead of providing additional plantilla positions, the government embarked on “taining
programs” that utilized the “trainees” to fill the gaps in understaffed hospitals and health units
while getting paid a measly allowance of P8,000 and a Certificate of Training, These programs,
called Nurses Assigned to Rural Services (NARS) program and Registered Nurses for Health
’nhancement and Local Service (RNHEALS), was changed to Nurse Deployment Program!
which “employed” nurses under “contract of services” for six months to two years with a
monthly salary equivalent to that of Nurse 1 in public hospitals or P18, 549.

‘The government failed to ensure adequate pay and benefits for nurses. ‘The provision in the
Nursing Act of 2002 prescribing salary grade 15 as the entry salary grade for nurses in public
health facilities was never implemented at all. Worse, in 2009 with the passage into law of Salary
Standardization Law III of Joint Resolution No 4, entry salary grade for nurses in public sector
was set at salary grade 11 denying the nurses of the rightful salary due them since 2002. Even
Executive Order No. 201 signed by former President Benigno Aquino III on February 19, 2016
failed to reinstate the entry Salary Grade 15 for nurses. EO 201 pegged the Nurse 1 position at
Salary Grade 11 and provided an increase of P2,205 spread out in four years, ot additional
additional P528-575 per year, or P17.60-19.17 basic salary increase per day.

“Off in lieu" implemented for those who work for 16-24 hour duties circumvent existing labor
and civil service laws and unjustly deay nurses of the mandated benefits including overtime pay,
nightshift differential, and on-call pay.

Nusses in the private sector are ia worse situation, with no security of tenure, no hazard pay,
with some receiving a monthly salary of P6,000, an amount which is even below the mandated
‘minimum wage in National Capital Region at P 491 /day’ or P 10,802/month.

‘The nursing education which is run like a business enterprise, is generally expensive, repressive,
of substandard quality and produces graduates who are inclined to work abroad.

Addressing the issues and concerns of the nurses and the nursing profession become more
urgent and imperative as we face emerging and re-emerging health threats like the Middle Bast
Respiratory Syndrome Coronavirus (MERSCoV), ebola virus, dengue, measles, HIV/AIDS, ete.
Unless we act with urgency, we will face the renewed onslaught of massive brain drain and
farther exploitation of nurses with the full implementation of the ASEAN Economic
Community in December 2015, which in the end, will affect health cate provision and the health
of our people.

By passing a nursing law that considers the above reality, and putting in place clear provisions for
the salary, benefits, rights and general well-being of nurses and for the improvement of the
nursing profession towards more relevant care, we can get closer to our vision of a
comprehensive quality, pro-people health care and a healthy citizenry.

In this light, the passage of this bill is earnestly sought.

filipino-nurses-are-jobless
> htip:/www.nat vissues/entry/ratios
Department of Health Circular No 2013-0403 dated September 20, 2013

* hup://www.nwpe.dole.gov.ph/pages/ner/emwrhtml



Approved,

Bayan Muna Party-list


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS

Introduced by Bayan Muna Party-list Rep. CARLOS ISAGANI 'T, ZARATE,

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS SAFE AND
QUALITY HEALTH CARE SYSTEM, REPEALING FOR THIS PURPOSE
REPUBLICT ACT 9173
OTHERWISE KNOWN AS THE PHILIPPINE NURSING ACT OF 2002, AND
APPROPRIATING FUNDS THEREFOR,

Be it enacted by the Senate and the Hlouse of Representatives ofthe Republic of the Philippines in Congress
assembled:

ARTICLEI
Gencral Provisions

Section 1. Title. - This Act shall be known as the "Compzchensive Nursing Law of 2016."

Section 2. Declaration of Policy. - It is hercby declared the policy of the state to uphold the
dignity of the nurses and assume responsibility for the protection, respect, and improvement of
the nursing profession by instituting measures towards competent and relevant nursing practice
for health and safety of the public, just and humane conditions of work, and promotion of
professional growth. ‘Thus, the State recognizes nurses as prime movers of national development
and contributors to international cooperation and understanding,

The State further guarantees the delivery of accessible, affordable, and available quality health
cate to all the people through implementation of adequate and competent Nursing Personnel
em (NPS) throughout the country.

Section 3, Definition of Terms. - ‘The following terms when used in this act shall mean:

(@) Aaredied Profesional Organization (APO), refers to a professional organization of nurses duly
accredited by the Professional Regulation Commission as per RA No. 8981
(b) Advanced Practice Nurse (APN), tefers to a nurse who acquired substantial theoretical
knowledge, decision making skills in the specialty area of nursing practice and proficient clinical

utilization of this knowledge in implementing independent and interdependent nursing
can be differentiated in categories, according to function, disease,

interventions. Specialties


pathology, systems, age, sex, acuity, setting, technology, and therapies. They must be given
credentialing certification by the specialty association.

(©) Bachelor of Science in Nursing (BSN), tefers to the basic program for nursing education.
(O) Centfication/ Credentialing refers to the process undertaken by an individual nurse to be
recognized to practice in a specifically defined professional tract, i. General Nursing, Nursing
Specialty Advanced Practice, Nursing Education, and Leadership and Governance. The Board
confers the certification or credential after a validation process based on promulgated guidelines
and mech
(©) Commission on Higher Education (CHED), refers to the body created by law to promulgate
Policies, standards and guidelines in the implementation of basic and graduate program for

isms.

nursing education.
(9 Health Facility refers to an institution, establishment, clinic that offers health services and
nursing care, such as hospitals, barangay health centers, and clinics.

() Nurs, as provided for in this Act, refers to a person who passed the Philippine Nurse
Licensure Exams (PNLE) and whose license has not been revoked by the law. ‘Thus, it pertains
to a Registered Nurse (RN). A nurse may append before his/ her name the title "Nurse", "Nats",
or "Nts." or after his/ her name the title R. N.

(h) Nursing Personne! System (NPS), refers to a system of human resource management in an
institution that classifies the structure, organization, and coordination within the workforce both
in private and public health care facilities and nursing educational institutions to advance the
welfare and protect the rights of the nurses and to ensure the employer-cmployee relationship,
security of tenure, just compensation, humane conditions of work, and professional growth
@ Philippine Nurse Licensure Exams (PNLE), refers to a written examination given by the Board in
order to obtain license to practice nursing,

@) Prvarious Work is the term used to described substandard employment conditions, such as
under-payment, absence of salary, no security of tenure, lack of employer - employee
relationship, no benefits, poor working conditions; and, deviation from the standard
employment relationships, such as contractual, false volunteerism, job orders thru agencies, part
time, self-employment, fixed term work, temporary, on call, home workers, call center jobs, few
benefits, nck of collective _ bargaining representation, and no job security
() Professional Regulation Commission (PRC), refers to the government agency pursuant to Republic
Act No, 8981 or as may hereafter be amended or repealed. It shall be referred to in this law as
the Commission,

@ Professional Regulatory Board of Nursing (BON), refers to the administrative body created by law
to supervise and regulate the practice of the nursing profession in the Philippines. As such, the
Board shall be the ultimate authority in the practice of the profession in the Philippines. It shall
be refetted to in this law as the Board.

(m) Public Health Institution (PHD, refers to any government-led, owned ot controlled institutions
which pursues and realizes the lofty goals and objectives of providing and managing. safe,
efficient, effective and quality public health programs and services and advocacies for health, in
all levels of the Health Care Deli stem (HCDS - national to local) which include among
others: Rural Health Units (RHUs/ Barangay Health Centers); Research Facilities e.g. Research
Institute for Tropical Medicine, ete; Training Resource Facilities eg, the U.P. College of Public
Health and State or Local Colleges or Universities offering Health-Related Programs; the
Department of Health and all retained health facilities, and the like



(2) Special Permit refers to the permit to practice nursing in the Philippines issued by the Board to
licensed nurses of foreign nationalities.

(0) Temporary Permit refers to the permit to practice nursing in the Philippines issued by the Board
to Filipino nurses, who does not have a professional license from the Philippines or have not
renewed their license for five (5) years, but are licensed from foreign countries.

ARTICLE IL
Board of Nursing

Section 4. Creation and Composition of the Board. - There shall be created a Professional
Regulatory Board of Nursing composed of seven (7) members who shall clect among themselves
4 Chairperson to serve for one (1) term, without re-election. The President of the Republic of
the Philippines shall appoint the members of the Board from among those recommended by the
Commission and ranked from a list of three (3) nominees, per vacancy, of the accredited
ation of nurses in the Philippines and who possess the qualific
Act. Provided, that the membership of the Board shall come from the different areas of nursing,

tions in this

professional organ

including education, service, and community.

Section 5. Qualifications of the Members of the Board, - ‘The members of the Board must
possess the following qualifications:

@) Must be a natural born citizen and resident of the Philippines for the past five (5)
consecutive years;

(©) Must be a Nurse in the Philippines and a holder of a valid and updated certificate of
registration and a current professional identification card;

(©) Must be a holder of a master’s degree in nursing or other _ health-related masteral
Program and preferably with a doctorate degree conferred by a university duly
recognized and accredited by the government;

(@) Must have at least ten (10) years of continuous practice of the nursing profession prior to
appointment. Provided, however, that the last five (5) years of which must be in the
Philippines; and

(©) Must be of good moral character and has not been convicted of any offense involving
moral turpitude.

Section 6, Prohibition as Member of the Board. -.\ member of the Board shall not hold a
Position nor have pecuniary interest in any educational institution offering BSN, any review ot
training center for PNLE, training hospitals and health facilities with nursing affiliates,

Section 7. Term of Office. - ‘The members of the Board shall hold office for a term of three (3)
years, Any member of the Board may serve for two (2) terms or a maximum of six (6) years

Section 8, Vacancy. - Any vacancy in the Board must be filled in the manner prescribed in this
Act and only for the unexpired portion of the term. Each member of the Board shall take the
proper oath of office prior to the performance of dutics.



Section 9. Compensation. - ‘The members of the Board shall receive compensation and
allowances compatable to the compensation and allowances received by the members of other
regulatory boards.

Section 10. Administrative Supervision of the Board, Custodian of its Records, Secretariat
and Support Services. - The Board shall be under the administrative supervision of the
Commission. All records of the Board, including applications for examinations, administrative
and other investigative cases conducted by the Board must be under the custody of the
Commission. The Commission shall designate the Secretary of the Board and shall provide the
secretariat and other support services to implement the provisions of this Act.

Section 11. Powers and Duties of the Board. - The Board shall supervise and regulate the
practice of the nursing profession and shall have the following powers, duties and functions:

(@) Ensure the proper conduct of the PNLE, which includes the application, test
development, examination, correction and release of results. The use of appropriate
technologies and modalities during the conduct of the PNLE is encouraged to enhance
efficiency while upholding integrity;

©) Issue, suspend, revoke oF reissue certificates of registration for the practice of nursing
and ensure the widest publication through electronic and written media;

(© Enforce and monitor safe and quality standards of nursing practice, study the conditions
affecting the nursing practice in the Philippines, and exercise the powers necessary to
ensure the maintenance of efficient, ethico-rnoral, technical and professional standards in
the practice of nursing towards the optimal health and common good of the nation;

(@ Ensure quality nursing education by examining and monitoring higher educational
institutions offering and secking permission to open nursing education programs and to
ensure that standards of nursing education are properly complied with and maintained at
all times. Prowided, that the Board and the CHED shall have joint authority to open and
close nursing education programs offered by higher educational institutions;

(©) Create policies to govern nursing review programs, monitor and regulate implementation
of such, and close institutions and centers that violate said policies;

( Conduct hearings and investigations to resolve complaints against actively. practicing
nurses for unethical and unprofessional conduct and violations of this Act, or its rules
and regulations and in connection therewith, issue svbpoena duces tecum and subpoena ad
‘estfcandum to require the appearance of respondents and witnesses and the production
of documents and penalize with contempt persons obstructing, impeding or otherwise
interfering with the conduct of such proceedings, upon application with the Board of
Nursing;

(@ Promulgate a Code of Ethics that is responsive to the needs of the nursing profession in
coordination with the APO of nurses within a year from the effectivity of this Act;

@) Prescribe and operationalize, via necessary infrastructures, a National Nursing Career
Progression Program to ensure continuing professional development of Filipino nurses,
create the Council for Nursing Advancement, Recognition, and Specialization as well as
the various Nursing Specialty Boards to assist the Board for this purpose;

@ Ensure performance of mandated duties and functions with the provision of operational
resources including human, financial and spatial resources to ensure the confidentiality

7



and sanctity of their functions as provided through the annual budget of the Commission
as promulgated in the General Appropriations Act;

@) Source and utilize funds earmarked for national nursing development;

(W) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and influence
authorities and agencies on decision-making as may be necessary for the improvement of
nursing practice, advancement of the profession, and for the proper and full enforcement
of this Act, subject to review and approval by Commission.

Create a council for nursing recognition, accreditation and certification that will assist the
Board in:

a. Recognizing organized nursing groups;

b. Setting standards for advanced nursing practice, education, research, and
management;

© Accrediting specialty and advanced nursing programs based on
established mechanisms;

4. Approving criteria for credentialing individual registered nurse to be
implemented by specialty associations; the Department of Health, or the
University of the Philippines through its Health Sciences Center and the
Philippine General Hospital, as the case maybe, for pioneering nursing
specialization; and,

© Monitoring and evaluating specialty and advanced nursing practice,
education, research and management.

Section 12. Anaual Report. -The Boatd shall, at the close of its calendar yeat, submit an annual
Fepott to the President and Congress of the Philippines through the Commission giving a
Gemled account of its proceedings and the accomplishments during the year and making
recommendations for the adoption of measures that will upgrade and improve the conditions
affecting the practice of the nursing profession

Section 13, Removal or Suspension of Board Members. - The President may remove ot
suspend any member of the Board, after due process, on the following grounds:

(2) Continued neglect of duty or incompetence;
(©) Commission or toleration of irregularities in the PNLE; and,
(©) Unprofessional, immoral or dishonorable conduct.

ARTICLE III
Examination and Registration

Section 14, Philippine Nurse Licensure Examination (PNLE). - In order to obtain a
certificate of registration, professional license, and professional identification card, all nu ing
graduates must take and pass the PNLE. ‘The Board shall administer the PNLE in such place and
date as designated by the Commission: Provided, that no nursing educational institution may
withhold any requirement or documents, or both, of any nursing graduate for the purpose of
Preventing them to apply for the PNLE. All nursing educational institution must ensure that
‘heit nursing graduates will take the nearest scheduled PNLE after graduation Any delay in



taking the PNLE must be accordingly justified by the President, Registrar or Dean of the
educational institution through a public instrument.

Section 15. Scope of Examination. - ‘The Board shall determine the scope of the PNLE by
taking into consideration the nursing core competencies, the nursing curriculum, the scope and
areas of nursing practice, and other related disciplines.

n order to be admitted to the

Section 16. Qualifications for Admission to the PNLE.
PNLE, an applicant:

(@) Must be a holder of a Bachelor of Science in Nursing degree from a recognized
educational institution that complies with the standards of nursing education duly
recognized by CHED;

&) Must be of good motal character and have not been convicted, by final judgment, of
any criminal offense involving moral turpitude or guil
conduct, or any person declared by the court to be of unsound mind; and,

(© Must be a citizen of the Philippines, or a citizen or subject of a country which
Permits Filipino nurses to practice within its territorial limits on the same basis as the
Subject or citizen of such country; Provided, that the requirements for the registration
of licensing of nurses in said countries are substantially the same as those prescribed
in this Act.

of immoral or dishonorable

Section 17. Fees for Examination and Registration. - Applicants for licensuse and for
registration must pay the prescribed fees set by the Commission.

Section 18. Ratings. -In order to pass the PNLE, an examinee must obtain at least seventy-five
mg: Pa y
percent (75%) of tested areas of all competencies.

Section 19. Issuance of Certiticate of Registration, Professional License and Professional
Identification Card, - \ certificate of registration and professional license shall be issued to all
successful examinees, subject to Section 14 of this Article. A cettificate of registration and
professional license shall show the full name of the registrant, the signature of the Chaixperson
of the Commission, and the members of the Board, The certificate shall beat the logo of the
Board and the official seal of the Commission,

ue the professional identification card. The card must bear the
full name of the registrant nurse, the serial number, the date of issuance and

espitation, the Signature of the Chairperson of the Commission; date of registration.

Section 20. Oath of Profession. - All successful examinees must take an oath of profession
before the Board or any government official authorized to administer oaths ptior to entering
‘upon the nursing practice.

Section 21. Roster of Nurses. - The Commission shall maintain a roster of nurses pursuant to
the PRC Automated System, The Roster of Nurses shall serve as the centralized d, base for
nursing professionals for purposes of documentation, verification of registrants, statistics,
research, and development.



Section 22. Registration by Reciprocity. - The Board may issue a certificate of registration/
professional license, without examination, to a nurse registered under the laws of a foreign state
oF country: Provided, That the requirements for registration or licensing of nurse in said country
are substantially the same as those prescribed under this Act: Provided further, that the laws of such
state or country grants the same privileges to Professional Registered Nurse of the Philippines on
the same basis as the subjects or citizens of such foreign state or country.

Section 23. Practice Through Special or Temporary Permit, - The Board may issue a special
ot temporary permit for specific period and purposes, to the following persons based on
qualifications, and professional standards; Provided, that a completion report. shall be submitted
to the Board at the end of the specified period, either by those issued with the special permit or
its local counterpart of sponsor, to wit:

(@) Licensed nurses from foreign countries whose services are either for a fee ot free if they
are internationally well-known specialists or outstanding experts in any branch ot
specialty of nursing;

©) Licensed nurses from foreign countries who are engaged by colleges /universities offering
the nursing program as exchange professors in a branch or specialty of nursing; and

(© Licensed nurses from foreign countries who are in community or institutional
integration, or international health advocacy work, or similar activities in the country, in
coordination with a local people’s or government organization, or advocacy group.

Provided, that no permit is required for foreign or licensed nurses from foreign countries on
medical mission or those who come to aid during declared disasters and calamities whose
services shall be free in a particular hospital, center, clinic or community. This is only for the
duration of the project or medical mission.

Section 24. Non-registration and Non-issuance of Certificate of Registration,
Professional License, Professional Identification Card, Special Permit or
Temporaty Permit,
‘moral turpitude or any person guilty of immoral or dishonorable conduct or any person declared
by the court to be of unsound mind may be registered and issued a cettificate of registration,
Professional license, professional identification card, or a special or temporary permit.

No person convicted by final judgment of any criminal offense involving

The Board shall furnish the applicant a written statement setting forth the reasons for the
actions, which shall be incorporated in the records of the Board.

Section 25. Revocation and Suspension of Certificate of Registeation, Professional
License, and Professional Identification Card and Cancellation of Special or Temporary
Permit, - The Board shall have the power to revoke or suspend the certificate of registzation,
Professional license, professional identification card, or cancel the special or temporary permit of
a nurse upon any of the following grounds:

@) Conviction, by final judgment, of any criminal offense involving moral turpitude or guilty
of immoral or dishonorable conduct or any person declared by the court to be of
unsound mind;

10



(b) Violation of this Act, its policies, rules and regulations, and of the Philippine Code of

ithics for Nurses;

(©) Gross negligence, grave misconduct,
practice;

(@ Fraud, concealment, misrepresentation, or false statements in obtaining a certificate of
registration, professional license, professional identification card, special permit or
temporary

(€) Practice of the nursing profession pending suspension of license.

ignorance, and incompetence in the nursing

permit;

The suspension of the certificate of registration, professional license, and professional
identification card, shall be for a pe xceed four (4) years.

iod not to

Section 26. Reinstatement and Re-Issuance of Revoked Certificates of Registration,
Professional License, and Professional Identification Card. — ‘the Board may, after the
expiration of a maximum of four (4) years from the date of revocation of a cettificate of
registration, professional license, and professional identification card, for reasons of equity and
justice, and when the cause for revocation has disappeared or has been cured and corrected,
upon proper application thercof and the payment of the required fees, reinstate and re-issue the
certificate of registration, professional license, and professional identification card.

ARTICLE IV
Nursing Practice

Section 27. Nursing Practice. - The administration of nursing care through the utilization of
the nursing process: assessment, nursing diagnosis, planning, implementation, and evaluation,
Nursing practice encompasses various stages of human growth and development towards the
promotion of health, prevention of illness, health care techniques and procedures, restoration of
health, alleviation of suffering, and end-of life care, may it be performed independently or
collaboratively.

Section 28. Scope of Nursing Practice. - The following are the scope of nursing practice: (1)
fussing education; (2) nursing service; (3) nursing research and informatics; (4) nursing
leadership and governance; and (5) community health nursing,

Section 29. Nursing Care. - includes, but is not limited to: the provision of physiological,
Psychological, spiritual, social and emotional care; essential health care, safety and comfort
measures, health teachings; executing health care techniques and procedures; and, traditional and
innovative approaches to individuals, families, population groups and communities from

conception to death,

A nurse shall be deemed to be practicing nursing when he or she, for a fee, salary ot
compensation, singly of collaboratively, performs nursing care to individuals, families, population
groups, and communities

Section 30. Roles, Responsibilities, and Competencies of a Nurse. - A aurse shall poss
and exercise the core competencies in the performance of the roles and responsibilities, in
accordance with the standards set by the Board.

1


Section 31. Continuing Professional Development (CPD). - All nurses shall undertake CPD
programs. The Board shall provide a mechanism to continuously improve and enhance the
nurses’ competence by updating them on the latest scientific, technological, ethical and other
applicable trends in the local and global practice of nursing.

It shall be the duty of the APO, the accredited specialty organizations, the Department of
lth, and the University of the Philippines through its Health Sciences Center and the
Philippine General Hospital, to provide free continuing professional development program to its
members. Other than those aforementioned, only authorized providers accredited by the Board
shall be allowed to offer CPD programs. Such accredited programs how
free to it

ver, shall be offered

constituents.

S

be inactive when:

tion 32. Requirement for Inactive Nurses Returning to Practice. - Nurses ate deemed to

@) They are not utilizing nussing competencies as defined in the scope of nursing practice
for five (5) consecutive years;

(b) They have not renewed their professional identification card for five (5) years; and

(2) They do not have proof of five (5) years of continuous nursing practice

Inactive nurses are required to undergo one (1) month didactic training and three (3) months
practicum in hospitals accredited by the Board.

ARTICLE V
‘Nursing Education

Section 33. Nursing Education, - Refers to the formal learning and training in the science and
art of nursing provided by higher educational institutions duly recognized and accredited by the
CHED.

There shall be a standard Basic and Graduate Program for Nursing Education which must be
pursuant to the CHED Law (RA 7722).

Provided, that higher educational institutions offering Nursing education shall be required to
maintain a passing rate of least 40% in the PNLE among its graduates. Failure to do so in three
consecutive years shall be a cause for the closure of the nursing program in accordance with
Section 11 (d) of this Act.

Section 34. Basic Program for Nursing Education, - Refers to the nursing, education
Program primarily designed based on the health care needs of the Filipino people, imbues
graduate nurses with service orientation, love of country and fellow Filipinos, and equips them
with the necessary knowledge, skills and attitudes for safe, relevant and quality nursing practice

The curriculum and the Related Learning Experiences (RIE) must be in accordance with the
National Nursing Core Competency Standards promulgated by the Board and implemented
through the Policies, Standards, and Guidelines of the CHED. The curriculum and RLE should
include community integration and immersion to encourage more graduates to work in

community setting,

12


Section 35. Graduate Program for Nursing Education, - Refers to the post baccalaureate
nursing program, which builds on the experiences and skills of a nutse towards mastety,
expertise, and leadership in practice, research, and education. It includes a master's degree and
doctorate degree in nursing founded on the philosophies, and the scientific body of knowledge

and practice.

Graduate Program for Nursing Education shall be offered only in higher educational institutions
ED Policies, Standards and Guidelines (PSG) for Graduate

as prescribed by the prevailing C
‘ducation,

Section 36. Qualifications of the Dean. - The Dean of the College of Nursing (Dean) shall
formulate policies, plans in collaboration with the administration/ school officials and
stakeholders. The Dean must adhere to the prescribed curriculum for the advancement of
nursing education.

‘The Dean:

(@) Must be a holder of a certificate of registration and a current professional identification
card issued by the Commission;

(©) Must have the appropriate certificate of nursing proficiency, of its equivalent, to be
issued by the BON;

(© Must be a holder of a master's degree in aursing, conferred by a university duly
recognized and accredited by the Government of the Republic of the Philippines;

(@ Must have at least five (5) years of experience in teaching and supervision in Nursing
Education; and

(©) Must have at least three (3) years clinical experience in a general nursing service.

Section 37. Qualifications of the Faculty. ~

(1) Basic Program for Nursing Education. - A member of the faculty in a College of Nursing
teaching professional courses:
(@) Must be a registered nurse in the Philippines and holder of a certificate of registration
tion card issued by the Commission;
(0) t three (3) years of nursing practice;
(9 Must be a holder of any masteral degree, conferred by a university duly recognized and
accredited by the Government of the Republic of the Philippines; and
(@ Must have the appropriate certificate of nursing proficiency, ot its equivalent, to be
issued by the BON.
2) Graduate Progeam for Nursing Education. - A member of the faculty teaching graduate
professional cours
(@) Must follow prescriptions 1 and 2 of basic nursing education; and
©) Must be a holder of must be a holder of any doctoral degree conferred by a university
duly recognized and accredited by the Government of the Republic of the Philippines.

Section 38. Faculty - Student Ratio. - There must be a faculty to student ratio to be
determined by the CHED and BON

13


ARTICLE VI
Nursing Service

Section 39. Nursing Service. - Is the promotion of health and prevention of illness which
includes, but not limited to, nursing care provided by a nurse, cither independently or
collaboratively, to any individual, family or group in various health care settings.

Nursing Service shall include the following functions: (1) Provide health education to individuals,
families and communities; 2) Ensure that information on healthy lifestyle are incorporated in his
or her health teachings; (3) Seck opportunities to promote a healthy lifestyle within his or her
influence; (4) Accept that he ot she is a role model for a healthy lifestyle; (3) Enable people to
increase control over their health and to improve health; (6) Build healthy public policy; (7)
Create supportive environment; (8) Strengthen community action for health; and, (9) Establish
linkages with community resources and coordination of services with the health team.

Section 40. Nursing Interventions, - In accordance with Sec. 27 and 29, nursing interventions
include, but is not limited to: any or combination of essential primary health care, the application
of traditional and innovative approaches, health counseling, and administration of written
Prescription for treatment, therapies, oral, topical, and parenteral medications, perform peripartal
care covering pre-intra- postpartum care including the performance of internal examination
during labor in the absence of antenatal bleeding, attend to normal delivery and suturing of
Petineal laceration and immediate care of the newborn; perform perioperative care covering pre-
intra-post-surgical care interventions; care during emergency and disaster.

Section 41. Health Interventions in Collaboration with Other Members of the Health
Team. - From promotion of health to end-of-life care, nurses collaborate with other members
of the health team.

Section 42. Advanced Practice Nursing. - Is a specialized and expanded nursing care pursuant
to Sec. 45 hereof. Advanced Practice Nursing is specialty training, through an Advanced Practice
Nursing Program formulated by the concerned agencies with certification to be issued by the
accredited specialty association after passing the qualifying examination.

Provided, that in the interest of national need, public service, and advances in health care, and.
notwithstanding any contrary provision in this Act, the Department of Health, ot the University
of the Philippines through its Health Sciences Center and the Philippine General Hospital, as the
case maybe, may also cteate and develop additional and pioneering Advanced Practice Nursing
specialty or specialties, that shall automatically be recognized by the Board. Certified nurses
under said pioneering nursing specialty, may create its own specialty organization that shall be
registered with the Board; and, develop the certifying or qualifying examination for future
entrants,

ARTICLE VII
Nursing Research, Policy Development, and Planning

Section 43. Nursing Research and Policy Development, - Shall involve study and pursuit of
nurse related issues encompassing the following areas:

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@) Professional nursing practice such as advancing nursing knowledge to ensure quality
‘oursing care for all and advocacy for sound health policies globally.

(©) Nursing regulation on credentialing, code of ethics, standards and competencies

(©) Socio-economic welfare for nurses like occupational health and safety, human resources
planning and policy, remuneration, carcer development.

Scetion 44. Studies and Implementation of Nursing Human Resource Needs,
Production, Utilization and Development. - The Board, in coordination with the accredited
Professional organization and appropriate government or private agencies shall initiate,
undertake and conduct studies on healthcare human resources production, utilization and
development and take the lead in the implementation of a comprehensive nursing human
resource development from nursing education to nurses deployment.

Section 45. Advanced Practice Nursing Program. - Within ninety (90) days from the
effectivity of this Act, the Board in coordination with the accredited professional organization,
recognized specialty organizations, the Department of Health, and the University of the
Philippines through the UP College of Nursing and the Nursing Service of the Philippine
General Hospital, is hereby mandated to formulate and develop an Advanced Practice Nursing
Program that would upgrade the level of skill and competence of specialty nurse clinicians in the
countzy, such as, but not limited to, the areas of critical care, oncology, renal, and such other
areas as may be determined by the Board: Provided, that the beneficiaries of this program are
obliged to serve in any Philippine hospital for a period of at least two (2) years continuous
service

Section 46. Funding for the Advanced Practice Nursing Program. - The annwal financial
requirement needed to train at least ten percent (10%) of the nursing staff of the participating
government health facility shall be chargeable against the funds of the said facility.

Provided, that the Department of Health, in coordination with the accredited professional
organization, recognized specialty organizations, shall set the criteria for the availment of this
program.

Section 47. Salary. - ‘The minimum base pay of nurses working in the governmental health
institutions, upon entry, shall not be lower than P25,000 or equivalent to salary grade (SG) "15"
of Salary Standardization Law III. This is to enhance the general welfare, commitment to service,
and professionalism of nurses. In non - governmental and/or private health institutions, the
minimum base pay for the nurses upon entry shall be equivalent to that of SG "15" in the public
health facilities,

Section 48. Incentives and Benefits. ~ Nurses in public and private sectors shall be provided
with all applicable benefits prescribed under Magna Carta of Public Health Workers or
Republic Act No. 7305, including overtime pay, night-shift differential, on-call pay; hazaed pay
Subsistence allowance, housing facility or housing allowance and free annual physical
examination.

In addition, the Board, in coordination with the DOH, other concerned government and non-
government institutions, association of hospitals and the APO, shall establish an incentive and

15


benefit system in the form of free hospital care for nurses and their dependents, scholarship
grants and other non-cash benefits.

Section 49. Protection from Mega! Dismissal and Unjust Termination of Employment. ~
No nurse shall be unjustly dismissed or illegally terminated from service pursuant to Articles
279-286, Book VI of Labor Code.

ARTICLE VII
Nursing Leadership and Governance

Section 50. Nursing Leadership. - Nursing is a dys
through the changing aspects of the health sector as they are part of the workforce that will toil

mic field that requires leaders who will go

and labor for the improvement of the health of the citizenry. Nurses adapt specific roles in
organizational structure, from being the policy makers in health facilities and giving guidance to
senior management on best practices in nursing and patient care. They work with healthcare
leaders to establish compensation and benefit programs and are involved in nurse recruitment,
training and retention. ‘Thus, nurses in the management positions shall develop patient-care
programs, manage nursing budgets, plan new patient services, establish nursing policies and
procedures, participate in cross-departmental decision making, conduct _ performance
improvement activities and represents the scope of nursing practices at Board of director
meetings and other stakeholder.

Section 51. Nursing Govemance. - Governance in nursing practice is shifting from the
traditional yiew that nurses are subordinate and passive employees towards having more
proactive involvement of taking charge of the organization to be the antecedent in decision
making and implementation of plans and policies for the patients and communities. Governance
in the practice of nursing shall empower each nurse in decision-making over theit profe
practice while extending their power and control over the administrative aspect of their practice

‘ional

ARTICLE IX
Nursing Personnel System

Section 52. Nursing Personnel System.
fields: nursing service administration in the hospital setting, community health practice, and the
academe, There shall be a nursing service office in every health institution, may it be
administrative or clinical, with at least ten nurses. The nursing service office must be under the
control and management of a chief nursing officer.

The nursing personnel system covers the following

Section 53. Ratio. - ‘The ratio of staff nurse to patient in a hospital setting shall be based on
patient acuity, the complexity of patient health status, and the environment by which care is
delivered. Staffing ratio shall also consider the presence or absence of significant others
responsible in the care of the patient such as patient immediate relative and other licensed or
unlicensed personnel. Based on the foregoing assumption, the pre:
saurse shall be the following:

cribed patient load for a

General Ward:
Low or minimal Care - 1:8
Moderate Care - 1:4

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Emergency Room ~ 1:4
‘Trauma/ICU patients in the ER ~ 1:2

Ante-partum — 1:4

Labor and Delivery ~ 1:2

Post-partum with Rooming-in babies - 1:4

Neonatal Intensive Care ~ 1:2

Operating Room (not including the circulating support staff) — 1:1
Post Anesthesia Care ~ 1:2

Intensive/Critical/Special Care ~ 1:2

The ratios are the maximum number of patients assigned to a nurse at any time during a shift. A
non-registered nurse or attendant shall not be allowed to substitute for the duties and
responsibilities for a full time registered nurse.

‘There shall have one nurse for a barangay with at least 5,000 population; one nurse for a school
or school district, high school or college with at least 2,000 pupils or students; one nurse for
every business/industrial establishment with at least 400 employees.

‘The Department of Health, in coordination with the officials of public hospitals and health
facilities, APO, and accredited specialty organizations, shall review and update the existing
standard staffing pattern for public hospitals and other public health facilities, and make
proposals for additional plantilla items for nurses to reflect the nurse-patient ratio.

Section 54. Nursing Service Management. - Refers to the Management and Administration
of Nursing Services by Nurses equipped with the necessary competencies on governance and
leadership characterized to wit:

(1) First Level Manager or Head Nurse

Q) Second Level Manager or Nurse Supervisor

(3) Third Level Manager, Chief Nursing Officer ot Chief Nurse Executive

Section 55. First Level Manager or Head Nurse ~ is in-charge of the planning, organizing,
ing unit or section of a hospital or health
facility. He/She must have at least 12 units of post graduate studies leading to any masteral
degree

directing and controlling of a particular ward, nu

Section 56. Second Level Manager or Nurse Supervisor ~ is in charge of the planning,
directing and controlling of a specific nursing specialty or nursing unit or geogeaphical
aggrupation of a hospital, health facility, healthcare institution, or health care company. It may
Tange from a loosely- aggregated nursing units, shift (e.g. afternoon ot night shift supervisor) of
up to chief of an organizational division of the healthcare institution. ‘The person holding this
position shall have at least 24 units of post-graduate
or equivalent, for chief of a division and must have at least three (3) years of related experience
as first level manager ot head nurse.

studies or at least with any masteral degree

Section 57. Third Level Manager, Chief Nursing Officer (CNO) or Chief Nurse
Executive — otherwise called as Chief Nurse, Nursing Director or Nurse Executive, ot

7


equivalent, as recognized by the Civil Service Commission. The nursing service and deliv
healthcare in a hospital, community set-up or any health care institution or company must be
under the control and management of the CNO. The CNO shall catty full administrative
responsibility and shall have the authority on planning, organizing, directing, and controlling of
nurses. A CNO m
addition, the CNO must be a master’s degree holder in relevant nursing practice setting,
conferred by an educational institution duly recognized and accredited by the Government of the
Philippines.

have at least five (5) years experience in relevant nursing practice setting, In

The CNO is responsible for the formulation of policies, strategic and operational planning,
financial pla
organizational involvement to address epidemiologic problems and provide statistical data, and
shall exercise good governance and accountability of the nursing personnel. ‘The CNO shall also
act as the advocate for the rights and welfare of nurses.

and resource allocation, policies and procedure development, professional and

‘To ensure full professional autonomy, the CNO shall be at the executive level reporting directly
to the Chief Executive of the hospital, public health or community set-up, ot any health care
institution or company. In an institution where the nurse or nursing personnel is only part of a
small health service unit, the Chief Executive of such agency or company shall ensure that the
nurses are afforded professional autonomy in the performance of their duty as nurses.

Section 58. Public Health Practice. - Nursing service shall be organized and operationalized in
every local health agencies in order to ensure the nursing component of public health programs,
‘Thus, an ideal nurse in every barangay shall be the thrust of public health in order to provide
accessible, available, and affordable quality health care to all. More so, a nurse in every school,
may it be private or public, shall be prioritized in every primary, secondary and tertiary
educational institutions in order to instill health awareness at an eatly stage and to improve the
health status of the students.

Section 59. The Public Health Nurse (PHN). - The PHN shall perform the functions and
activities of health promotion, such as the prevention and treatment of various diseases and
illnesses in a particular public setting. The PHN shall exercise a supervisory role to the midwives
and barangay health workers within her catchment area. The PHN shall initiate and participate in
developing policies and guidelines to promote basic nursing service

ARTICLE X
Prohibited Acts and Penal

Section 60. Prohibited Acts. - Any of the following shall constitute unlawful and illegal acts:

(@) Any person who is practicing the nursing profession in the Philippines:

18


(1) Without a certificate of registration, professional license, professional identification
jared exempt

card, special permit or temporary permit or without having been de
from examination in accordance with the provision of this Act;

Q) Who uses a certificate of registration, professional license, profess

rd, special permit or temporary permit of another;

(3) Who uses an invalid certificate of registration, professional license, a suspended or
revoked certificate of registration, professional license, or an expired or cancelled

ional identification

special or temporary permits;

(4) Who, by any means of misrepresentation, false evidence, ot concealment, obtained a
certificate of registration, professional license, professional identification card, special
permit or temporary permit,

(5) Who falsely poses or advertises as a registered and licensed nurse or uses any other
‘means that tend to convey the impression that he/she is a registered and licensed
nurse;

(6) Who appends "Nurse", "Nars", or "Nrs." before his or her name or BS.N./R.N.
(Bachelor of Science in Nursing/Registered Nurse) after his ot her name without
having been conferred said degrce or registration; or

@ Who, as a registered and licensed nurse, abets or assists to the illegal practice of a
person who is not lawfully qualified to practice nursing;

(b) Any natural or juridical person, educational institutions offering BSN without fall
compliance with the requirements prescribed by law, conducts review classes for both
local and foreign examination without permit/clearance from the Board and the
Commission, or conducts Continuing Professional Development for nurses without
accreditation from the Board; Or any natural or juridical person or health facility who
undertakes or offers ia-service training programs, for a fee and without permit/clearance
from the Board and the Commission;

(©) Any natural or juridical person or health facility who subscribes to sub-standard quality
of nursing care and/or nursing practice , such as non-compliance with the nutse-patient

ratio;

(@ Any natural or juridical person, health facility who exercises
working conditions to nurses, such as, but not limited to, the following:
1. Contracting or availing of the services of a nurse either without salary, for allowance,
for salary below the applicable wage prescribed under this Act, whether or not under the
pretext of a training, development program, certification course and/or seminar;
2. Deptiving or denying a nurse of the incentives and benefits
existing laws;
3. Collecting any fees from a nurse or from any person or agent in his or her behalf in
exchange for a nurse's voluntary services in a health facility

and promotes precatious

s provided for by the

4, Requiring or obliging a volunteer nu:
regular work load expected from a regular staff nurse employed by the health facility
without proper compensation, to render full-time service as a condition for the
continued availment of his/her volunteer services, and/or to be the sole nurse on duty,
cept during disasters, calamities, and war;

to perform the regular work functions and/or

es

19


5. Contracting or availing of the services of a volunteer nurse, under the pretext of OJT,
contract of service, and/or job orders, in order to fill-up a vacant position that requires
the hiting of a full-time regular employed nurse, or for free in exchange for any type of
certification to be issued by the health facility for purposes of the nurse's employment
application;

6. Contracting or availing of the services of a nurse, under the pretext of training ot
certification course, but requires the nurse to render the tasks and responsibilities
expected of a regular staff or public health nurse, in violation of Section 47 heteof; ot

©!

Section 61. Sanctions. - A fine of not less than one hundred thousand pesos (P100,000,000)
nor mote than three hundred thousand pesos (P300,000,000) or imprisonment of not less than
one (1) year not more than six (6) years, or both, upon the discretion of the court, shall be
imposed upon violation of any prohibited acts enumerated in Section 58 (a) hercof,

ny violation of the provisions of this Act.

A fine of not less than three hundred thousand pesos (P500,000,000) and/or imprisonment of
not less than one (1) year nor more than six (6) years shall be imposed upon violation of any
Prohibited acts enumerated in Section 58 (b), (c), (@), and (¢) hereof. In addition, suspension or
revocation of license to operate may be granted upon the discretion of the court,

Section 62. Refund and Compensation. - Any nurse found to have been a victim of Section
58 (@) hereof shall be entitled to a full sefund of al fees illegally collected and payment of unpaid
salaty, which should not be less than the applicable wage for services rendered.

Section 63. Liability of the Agency. ~ In cases of violations committed by government
agencies, juridical persons, including local government units or any other entity, and for any
untoward incident that may result from violations of Section 58 (b), (c), (@), and (¢) the head of
the agency and Board of Directors or executive officials of the agency shall assume full
responsibility.

Prowided, that in no case shall the individual nurse be held liable for untoward incidents that may
result from the violations of the juridical persons /agency.

ARTICLE XI
Miscellaneous

Section 64, Implementing Agencies. - ‘The Department of Health is hereby designated as the
agency tasked with monitoring the compliance with and implementation of the provisions of this
Act by public health facilities. The Department of Labor and Employment is designated as the
agency tasked with monitoring the compliance with and implementations of the provisions of
this Act by private health facilites. The Commission and the Board is designated as the agency
tasked with monitoring the compliance with and implementations of the provisions of this Act
by educational institutions, CPD providers and health facilities. ‘The CHED is similarly
designated as the agency tasked with monitoring the compliance with and implementations of
the provisions of this Act by educational institutions with regard to nursing education programs
and its curriculum.

20


Section 65. Appropriations. - The amount necessary to carry out the provisions of this Act
shall be charged to the General Appropriations Act immediately upon effectivity hereof.

Section 66. Implementing Rules and Regulations, - Within ninety (90) days after the
effectivity of this Act, the Board of Nursing and the Department of Health shall jointly take the
lead in the formulation of the Implementing Rules and Regulations. Representatives from the
Civil Service Commission, the Department of Budget and Management, the Department of
Labor and Employment, the Department of Interior and Local Government, the Commission
on Higher Education, the Professional Regulation Commission, the UP College of Nursing and
the Nursing Service of the Philippine General Hospital, the Department of Education, the
accredited professional organization, the nursing unions and nursing specialty organizations, the
Union of Local Authorities of the Philippines, and all other concerned nursing organizations and
government agencies, shall be part of the body that shall formulate the implementing rules and
regulations of this Act.

Provided, that the full implementation of the provisions contained in this Act pertaining to the
Nursing Board, Examination and Registration, Practice, Education, Service, Research, Policy
Development, and Planning, Leadership and Governance, and Personnel System, shall be within
five (5) years from the passage of this Act.

Provided further, that the Implementing Rules and Regulations shall become effective fifteen (15)
days after publication in the Official Gazette or in a newspaper of national circulation.

Section 67, Separability Clause. - Should any provision of this Act be declared
unconstitutional, the remaining parts not affected thereby shall remain valid and operational.

Section 68. Repealing Clause. - Republic Act No. 9173, otherwise known as the "Philippine
Nursing Act of 2002" is hereby repealed. All other laws, decrees, orders, circulars, issuances,
rules and regulations and parts thereof which are inconsistent with this Act are hereby repealed,
amended or modified accordingly.

Section 69, Effectivity. - This Act shall take effect fifteen (15) days after its publication in the
Ofjial Garee or in any two (2) newspapers of general circulation in the Philippines.

Approved,

2a