EIGHTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES.)
Second Regular Session )

HOUSE OF REPRESENTATIVES

__ Introduced by Representative Rufus B. Rodriquez

House Bill No. 743.
EXPLANATORY NOTE

Nurses are essential and valuable to the healthcare of all Filipinos. At almost 500,000
strong, nurses comprise approximately 60% of the total human resource for health (HRH) in
all settings of healthcare delivery. They are the core providers of safe, quality and equitable
care by applying evidence-based and coordinated care to patients, families, population
groups, and communities. Nurses are care integrators, working in partnership with health and
Non-health care team members and networks using innovative, nurse-driven and
contextualized client/patient care models.

Equipped with the needed competencies in the science of care, organizational skills,
and a strong commitment to address safety risks and promote population health, nurses have
established themselves as the backbone of the health system, significantly contributing to
national health. They are crucial to the achievement of national targets in ensuring patient
safety, health, weliness, and management of communicable and non-communicable
diseases, disaster preparedness and resilience, and the successful delivery of Universal
Health Care

However, despite having 467,053 active nurse professionals in the country (PRC
Information Communication Technology Services, August 6, 2020), there are persistent
quantity and distribution challenges adversely affecting the number of nurses needed to meet
Population needs stemming from a lack of plantilla positions, migration, geographic
maldistribution, unjust compensation, and poor working conditions (Dayrit et al., 2018). In the
advent of global and national challenges, there is a dire need to ensure that nurses are
empowered, enabled, and supported by policies that optimize their impact through effective
leadership, sound workforce and workload management, healthy practice environments, and
a scope of practice that is responsive to the needs of the Filipino people.

As such, this bill seeks to protect and care for nurses through just employment, welfare.
compensation, and practice environments through: (1) strengthening the regulation of the
profession through the empowerment of the Professional Regulatory Board of Nursing, (2)
ensuring top level leadership in nursing regulation, education, service and research, (3)
promoting competent and credentialed professionals through continuing professional
development and career progression, (4) ensuring safe staffing and nursing skill mix for
quality care through the institutionalization of the Nursing Human Resource for Health
Management System (NHRHMS) in all settings and sectors, and (5) preparing, credentialing,
and recognizing nurses for advanced practice in nursing to meet the gap created by
increasingly complex healthcare needs, the strong focus of universal healthcare on primary
care, and the need to reach Filipinos in inaccessible or underserved settings.

In view of the foregoing, the immediate approval of this bill is earnestly sought

RUFUS B. Ri IGUEZ


EIGHTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES.)
Second Regular Session )

HOUSE OF REPRESENTATIVES

Introduced by Repre

House Bill No. 7431

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS A QUALITY HEALTH
CARE SYSTEM, APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:
ARTICLE|
GENERAL PROVISIONS
SEC. 1. Title. - This Act shall be known as the “Philippine Nursing Practice Act of 2020.”

SEC. 2. Declaration of Policy. - in pursuit of the constitutional mandate that Health is a right
of every Filipino, it is hereby declared as the policy of the State to uphold the health workforce
as an important instrument in the achievement of the Universal Health Care (UHC) through
Primary Health Care. It is likewise declared as the policy of the State to uphold the dignity of
and respect for Nurses and to improve the practice of the Nursing profession by instituting
measures to promote comprehensive and relevant nursing practice standards towards the
promotion of the health and safety of the public, just and humane conditions of work, and the
professional growth of Nurses. Nurses comprise a great majority of the health workforce, both
in the institutional and community levels. Thus, the State recognizes Nurses as prime movers
of national development and contributors to intemational cooperation and understanding

The State furthermore guarantees the delivery of accessible, affordable, and
available quality healthcare through the implementation of an adequate and comprehensive
Nursing Human Resource for Health Management System (NHRHMS) throughout the
country.

SEC. 3. Definition of Terms. - The following terms as used in this Act shall mean:

a) Accredited Professional Organization (APO) refers to the national professional

organization of Nurses duly accredited by the Professional Regulation
Commission;

b) Advanced Practice Nurse (APN) refers to a nurse who has acquired substantial
and higher level of theoretical knowledge and decision-making skills in a specialty
area of nursing practice and demonstrated proficiency in clinical utilization of such
knowledge and skills in providing expanded, autonomous or collaborative expert
care. An APN must be endorsed by a Specialty Organization based on the
recommendation of the Career Progression and Specialization (CPS) Council, and
certified by the Board and the Commission. An APN must have at least a master’s
degree in Nursing and must possess substantial specialty experience. The scope
or practice is Individual-based health services as defined in RA 11223 and acts as
navigator, coordinator, and initial and continuing point of contact of the patient to
ensure care continuity during transitions of care. The APN is eligible for PhilHealth
payments using performance-driven, close-end, prospective payments based on
disease or diagnosis related groupings and validated costing methodologies as
described in RA 11223 or the Universal Care Act

¢) Advanced Practice Nursing refers to the specialized and expanded role of an APN.
It involves certification of Nurses with higher degree of qualifications by the Board,

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thereby, providing the former with opportunities for role recognition within the
human resource for health framework and expanded professional scope of
practice. It maximizes the use of graduate education in nursing and the Nurse's
expertise to ensure safe, holistic and quality care to individuals, families,
population groups or communities towards achieving quality, accessible, and
affordable health care for all Filipinos;

Bachelor of Science in Nursing (BSN) refers to the baccalaureate program that
provides sound and liberal professional education that equips graduates with
competencies for registration and is the sole required academic standard for entry
into nursing practice in the Philippines, in accordance with the appropriate
qualification framework. The BSN program is effectively promulgated under the
enabling Policies, Standards and Guidelines (PSG) prescribed and issued by the
Commission on Higher Education (CHED);

Career Progression and Specialization Council for Nursing (CPSCN) is the body
deputized by the Professional Regulation Commission to develop differentiated
nursing-level standards, establish mechanisms and criteria for credentialing of
specialty organizations and interest groups, certification of individuals at different
levels of Post - Baccalaureate nursing and advanced practice for recommendation
to the Board.

Career Progression and Specialization Program for Nursing (CPSPN) refers to the
Program of differentiating nursing-level standards, the system of credentialing
specialty organizations and interest groups, and certification of individuals at
different levels of practice, recognized by the PRC and Board of Nursing
Certification refers to the process of validating achievements through a variety of
measures and assessment strategies to confirm or attest to the competency of an
Advanced Practice Nurse upon completion of a specialty program andlor
Continuing Professional Development (CPD) program. Certification is issued by
the Board and the Commission upon endorsement of the specified recognized and
credentialed specialty organization in accordance with the prescribed guidelines.
Chief Nursing Officer (CNO) is the highest nursing administrative and clinical
official in healthcare facilities. The CNO is responsible for leading and
coordinating an organization's nursing department/services and its daily operation
The CNO is the primary spokesperson for nurses in the facility and must be a
Registered Nurse

Clinical Practice refers to any professional practice rendered in any healthcare
setting like institutional, public health, and any healthcare industry.

Commission on Higher Education (CHED) refers to the national govemment
agency created by law to promulgate the PSG for baccalaureate and graduate
programs offered by Higher Educational institutions (HEIs);

Credentialing refers to the formal recognition of a specialty or interest group
conferred by the PRC and Board of Nursing upon the recommendation of the
CPSC after complying with prescribed guidelines;

Decent Work refers to aspirations by people in their working lives. It involves
opportunities for work that is productive and delivers a fair income, security in the
workplace and social protection for families, better prospects for personal
development, psychological well-being and social integration, freedom for people
to express their concems, organize and participate in decisions that affect their
lives, and equality of opportunity or treatment regardless of ethnicity, gender,
position, or religion;

Expanded Role refers to the broadening of the roles of an APN by virtue of the
nurse's expertise and professional scope of nursing practice. An APN has
recognized role autonomy within a specialized field of practice;
Geographically-isolated and Disadvantaged Areas (GIDAs) — refer to barangays
specifically disadvantaged due to the presence of both physical and socio-
economic factors;


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Health Facility refers to a public or private institution, establishment or clinic
devoted primarily to the provision of services, including nursing, for health
promotion, prevention, diagnosis, treatment, rehabilitation, and palliation of
individuals suffering from illness, disease, injury or disability, or deformity, or in
need of obstetrical, psychiatric or other medical and nursing care, including, but is
Not limited to hospitals, barangay health centers and other clinics;
Individual-based Health Services refer to services which can be accessed within
a health facility or remotely that can be definitively traced back to one (1) recipient,
has limited effect at a population level and does not alter the underlying cause of
illness, such as ambulatory and inpatient care, medicine, laboratory tests and
procedures, among others.

‘National Chief Nursing Officer (NCNO) is the highest-ranking nursing official of the
Department of Health whose main function is to influence safe nursing and quality
standards and implement nursing policies for both the public and private sectors.
The responsibility of the NCNO is to assist the government to achieve the health
goals of the country through nursing, by provision of expert advice based on timely
accurate local data and national and international evidence, and through
professional networks of influence and professional understanding;

Nurse refers to a person duly registered and licensed to practice the nursing
profession, with all the rights and privileges appurtenant thereto;

Nursing is a profession based on caring science. Those who practice it have
substantial judgment and skills to perform safe and quality care; are able to work
autonomously and/or in collaboration with others to enable individuals, families,
communities and populations to achieve their optimum level of health;

Nursing Human Resource for Health Management System (NHRHMS) refers to
an organized human resource management and development information system
based in the Department of Health (DOH) and directed by the National Chief
Nursing Officer, that provides meaningful data used to undergird policies affecting
nurses and nursing.

Nursing Service refers to an office within a public or private healthcare institution,
responsible for administrative and clinical supervision of nurses and nursing
personnel, headed by a Chief Nursing Officer (CNO) who is a Registered Nurse;
Philippine Nurse Licensure Examination (PNLE) refers to the written examination
given by the Board to qualified BSN graduates to be registered and licensed to
practice nursing in the Philippines;

Philippine Qualifications Framework (PQF) refers to the quality assured national
system for the development, recognition and award of qualifications at defined
levels based on standards of knowledge, skills and values acquired in different
ways and methods by professionals, learners and workers. The POF is
competency-based, labor-market driven and an assessment-based qualification
recognition

Population-based Health Services refer to interventions such as health promotion,
disease surveillance, and vector control, which have population groups as
recipients;

Positive practice environment refers to a practice setting that promotes economic
welfare, professional autonomy, job satisfaction and retention of nurses by
ensuring safe staffing, managerial support, professional development,
occupational safety and psychological health and prevention of workplace
violence to promote patient and nurse safety:

Precarious Work refers to working conditions which are contingent, atypical or
non-standard. It is usually characterized by uncertainty as to the duration of
employment, multiple possible employers or a disguised or ambiguous
employment relationship, lack of access to social protection benefits usually
associated with employment, low pay and substantial legal and practical obstacles
to joining a trade union and bargaining collectively;



aa) Primary Care refers to initial-contact, continuous, comprehensive and coordinated,
and culturally appropriate care that is accessible at the time of need including a
range of services for all presenting conditions, and the ability to coordinate
referrals to other health care providers in the health care delivery system, when
necessary;

bb) Professional Regulation Commission (Commission) refers to the national
government agency created by law that is mandated to enforce, administer and
implement the policies of the national government with respect to the licensing and
regulation of the professions and occupations under its jurisdiction;

ce) Professional Regulatory Board of Nursing (Board) refers to the administrative body
created by law to supervise and regulate the practice of the nursing profession in
the Philippines;

dd) Public Health Institution (PHI) refers to any government-led, -owned or
-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
Delivery System (HCDS — national to local) which include, among others: Rural
Health Units (RHUs/ Barangay Health Centers); Research Facilities, e.g
Research Institute for Tropical Medicine, etc.; Training Resource Facilities, e.g.
the U.P. College of Public Health and State or Local Colleges or Universities
offering Health-Related Programs; the Department of Health (DOH) and all
retained Health Facilities, and the like;

ee) Return Service Agreement refers to an agreement whereby graduates of nursing
and other health-related courses who are recipients of government-funded
scholarship programs are required to serve in priority areas in the public sector,
Subject to the conditions prescribed by R.A. 11223 or the Universal Health Care
Act;

ff) Special Temporary Permit (STP) refers to the authority to engage in limited nursing
practice granted to foreign registered/licensed nurses and Filipino nursing
graduates under the conditions set forth in this Act

ARTICLE II
BOARD OF NURSING

SEC. 4. Creation and Composition of the Board. — There shall be created a Professional
Regulatory Board of Nursing, hereinafter referred to as the Board, under the administrative
supervision of the Professional Regulation Commission, hereinafter referred to as the
Commission. The Board shall be composed of seven (7) Members who shall elect among
themselves a Chairperson to serve for one (1) year only but may be re-elected as Chairperson
on a year-to-year basis. 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 at least three (3) nominees per vacancy as provided by the APO. Preferably, that the
membership of the Board shall be distributed to proportionately represent both nursing service
and nursing academe, and that the members’ areas of expertise cover all the areas of the
licensure examination.

SEC. 5. Mission of the Board - The mission of the Board is to protect and promote the welfare
of the people of the Philippines by ensuring that each person holding a license as a nurse in
the Philippines is competent to practice safely. The Board fulfils its mission through the
regulation of the practice of nursing and the approval of nursing education programs, the latter
which is done in collaboration with the Commission on Higher Education (CHED). This
mission, derived from the Philippine Nurse Practice Act of 2020, supersedes the interest of
any individual or any special interest group.

Acting in accordance with the highest standards of ethics, accountability, efficiency,
effectiveness, and transparency, the Board approaches its mission with a deep sense of
purpose and responsibility and affirms that the regulation of nursing is a public trust.


SEC. 6. Qualifications of the Members of the Board, - The Members of the Board must, at
the time of their appointments, possess the following qualifications:

a) Natural born citizens and residents of the Philippines for five (5) consecutive
years immediately preceding their date of appointment;

b) Holders of valid Certificates of Registration (CORs) and current Professional
Identification Cards (PICs) as Nurses;

¢) Holders of master’s degree in Nursing, and preferably, with relevant Doctorate
Degree conferred by an HEI duly recognized by the goverment;

@) 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;

€) Of good moral character and have not been convicted of any offense involving
moral turpitude; and

f) Must be physically and mentally fit

SEC. 7. Prohibition as Members of the Board. — The Members of the Board shall not hold
any position nor have pecuniary interest, direct or indirect, in any HEI offering BSN, or in any
review or training center for the Philippine Nurses Licensure Examination (PNLE), training
hospital or health facility with nursing affiliates, and is not an officer of the APO at the time of
appointment.

SEC. 8. 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 a maximum of two (2) terms of a total of six
(© years, or until their successors shall have been appointed and qualified.

SEC. 9. 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 duties.

SEC. 10. Compensation. - The Members of the Board shall receive compensation and
allowances comparable to those received by the Members of other regulatory boards under
the Commission.

SEC. 11. Limited Practice. — During their incumbency, the members of the Board may be
allowed to practice their profession or maintain employment or affiliation in the public or private
sector subject to the conditions and limitations prescribed by law and upon proper and timely
disclosure of possible or actual conflict of interest as input for the Commission's action

SEC. 12, 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.

SEC. 13. 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:
a) Ensure the proper conduct of the PNLE, including the evaluation of exam
applications, test development, administration of the examination, correction and
release of the results thereof. The use of appropriate technologies and modalities
on the conduct of the PNLE is encouraged to enhance efficiency while upholding
integrity;
b) Enforce and monitor safe and quality standards of nursing practice, study the
conditions affecting nursing practice in the Philippines, and exercise the powers
necessary to ensure the maintenance of efficient, ethico-moral, technical and

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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 HEls offering and
seeking permission to open nursing education programs to ensure that the
standards of nursing education are properly complied with and maintained at all
times.

d) Promulgate a Code of Ethics that is responsive to the needs of the nursing
profession, in coordination with the APO for Nurses, within one (1) year from the
effectivity of this Act;

€) Prescribe and operationalize, via necessary infrastructures, a Career
Progression and Specialization Program for Nursing (CPSPN) to ensure the
continuing professional development of Nurses, and for this purpose, create the
CPS Council for Nursing (CPSCN), in collaboration with the various Nursing
Specialty organizations, to support the Board in implementing and monitoring of
the Career Progression and Specialization Program, including recognition and
credentialing of organized nursing groups and certification of advanced practice
nurses.

f) Ensure performance of mandated duties and functions with the provision of
operational resources including human, financial and special resources
as provided in the annual budget of the Commission as promulgated in the
General Appropriations Act;

9) Collaborate with appropriate agencies to identify and utilize resources
earmarked for national nursing development;

h) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and
to submit recommendations to authorities and agencies to aid in policy- and
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 the review and approval of the Commission;

i) Spearhead and oversee the Philippine Nursing Development Plan (or Nursing
Roadmap);

i) Conduct hearings and investigations to resolve complaints against Nurses for
unethical or unprofessional conduct or any violation of this Act, or its rules and
regulations, and in connection therewith, issue subpoena ad testificandum
and/or subpoena duces tecum to require the appearance of respondents and
witnesses and/or the production of documents and to penalize for contempt
persons obstructing, impeding or otherwise interfering with the conduct of such
proceedings, upon application with the regular courts; and

k) Issue, suspend, revoke or reinstate CORs and Special Temporary Permits
(STPs) for the practice of nursing;

SEC, 14. Annual Report. - The Board shall, at the close of every calendar year, submit an
annual report to the President and Congress of the Philippines, through the Commission,
giving a detailed 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

SEC. 15. Removal or Suspension of Board Members. — The President may remove or
suspend any Member of the Board, after due process, upon recommendation of the
Commission on any of the following grounds:

a) Continued neglect of duty or incompetence;
b) Commission or toleration of irregularities in the conduct of the PNLE;
©) Unprofessional, immoral, or dishonorable conduct; or

d) Non-disclosure of conflict of interest.


ARTICLE Ill
EXAMINATION AND REGISTRATION

SEC. 16. Philippine Nurse Licensure Examination (PNLE). - In order to obtain CORs and
PICs, all nursing graduates must take and pass the PNLE. The Board shall administer the
PNLE in such places and dates as may be designated by the Commission.

SEC. 17. Scope of Examination. - The Board shall determine the scope of the PNLE, taking
into consideration the nursing core competencies, the nursing curriculum, the scope and areas
of nursing practice, and other related disciplines.

SEC. 18. Qualifications for Admission to the PNLE. — At the time of the filing of application
for the PNLE, an applicant must be:

a) Aholder of a BSN degree from an HE! that complies with the standards of nursing
education recognized by the government;

b) Of good moral character and has not been convicted by final judgment of any
criminal offense involving moral turpitude or found guilty of immoral or
dishonorable conduct, or judicially declared to be of unsound mind; and

©) A citizen of the Philippines, or of a foreign country or state which permits Filipino
Nurses to practice within its territorial limits on the same basis as the subject or
citizen of such country or state: Provided, That the requirements for the
registration or licensing of Nurses in said country or state are substantially the
same as those prescribed in this Act.

SEC. 19. Fees for Examination and Registration. - Applicants for the PNLE and registration
must pay the prescribed fees set by the Commission.

SEC. 20. Ratings. - To be considered as having passed the PNLE, an examinee must obtain
at least seventy-five percent (75%) of the tested areas of all the nursing competencies. An
examinee who has failed the PNLE three times (3x) shall not be allowed to take any further
PNLE, without having undertaken a refresher program in a duly accredited institution. The
Board shall issue the guidelines on the refresher program requirement.

SEC. 21. Issuance of Certificate of Registration and Professional Identification Card. —
CORs and PICs shall be issued to all successful examinees, upon compliance with all the
requirements for registration. The COR shall show the full name of the registrant, COR number
and date of initial registration. The same must be duly signed by the Members of the Board
and Chairperson of the Commission, with the corresponding seals of the Board and the
Commission

The PICs shall bear the full name of the registrant, the COR number, date of initial
registration and date of expiration of the PIC, and which must be duly signed by the
Chairperson of the Commission. The PIC shall be renewed after every three (3) years upon
satisfying the requirements set by the Commission, including the payment of the required fees
and compliance with the Continuing Professional Development (CPD).

‘SEC. 22. Oath of Profession. — All successful examinees must take the Oath of Professional
before any Member of the Board or government official authorized to administer oaths prior to
practicing the nursing profession.

SEC. 23. Registry of Nurses. - The Commission shall maintain a roster of Nurses which
shall serve as the centralized database of Nurses for purposes of documentation, verification
of registrants, statistics, research, and development.

SEC. 24. Accredited Professional Organization (APO). - All Nurses whose names appear
in the Registry of Nurses of the Commission may become members of the APO for Nurses,

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and shall receive all the benefits and privileges therefrom, upon payment of membership fees
and duties. Membership in other organizations of Nurses shall not be barred

SEC. 25. Foreign Reciprocity. — No foreign Nurse shall be given a COR and PIC or be
entitled to any of the privileges under this Act unless the country or state of which such foreign
Nurse is a subject or citizen permits Filipino nurses to practice within its territorial limits on the
same basis as the subjects or citizens of said country or state

SEC. 26. Limited Practice Through Special Temporary Permit. - The Board may issue
Special Temporary Permits (STPs) to the following persons based on qualifications, and
professional and moral standards as approved by the Board and the Commission:
a) Registered/Licensed nurses of foreign citizenship: (i) whose
services are either for a fee or free if they are internationally well-
known specialists or outstanding experts in any branch or specialty
in nursing; (ii) who are on medical mission whose services shall be
free in particular hospital, center or clinic; (iii) who are engaged by
HEls offering the BSN program as exchange professors in a branch
or specialty of nursing; or (iv) who come to aid during declared
disasters and calamities.
b) Nursing graduates of Philippine citizenship who may render
nursing service during epidemics or national emergencies under the
supervision of a registered and licensed nurse. Provided, that they
have graduated within the last five (5) years prior to the occurrence
of the epidemic or national emergency in which they shall serve.
The STP issued to those belonging to sub-item a (i), (i), (i) and (jv) shall be effective
‘only for the duration of the project, health mission, engagement, but which in no case shall
exceed one (1) year, subject to renewal. The STP issued to those belonging to sub-item (b)
shall automatically cease upon the lifting or termination of the epidemic or national emergency.
A completion report shall be submitted to the Board and the Commission after
completion of the project, medical mission, engagement or contract. In the case of sub—item
(b), the completion report shall be submitted by the registered nurse having supervision over
the nursing graduate(s),
The Board shall issue the corresponding guidelines in the issuance of the STP
pursuant to this Section

SEC. 27. Non-Registration and Non-issuance of Certificate of Registration, Professional
Identification Card, Special Permit or Temporary Permit. — Any person who has been
convicted by final judgment of any criminal offense involving moral turpitude or found guilty of
immoral or dishonorable conduct or judicially declared to be of unsound mind shall not be
registered and issued a COR, PIC or an STP

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

SEC. 28. Revocation and Suspension of Certificate of Registration, Professional
Identification Card and Cancellation of Special Temporary Permit. — The Board shall have
the power to reprimand a Nurse or revoke or suspend his/her COR, PIC or STP, after due
notice and hearing, on any of the following grounds:

a) Conviction by final judgment of any criminal offense involving moral turpitude or
of immoral or dishonorable conduct or having been judicially declared to be of
unsound mind;

b) Violation of this Act, the Code of Ethics for Nurses and other policies, rules and
regulations of the Board and the Commission;

©) Negligence, misconduct, or incompetence in the nursing practice resulting to
injury, harm, disability or death;


d) Commission of fraud, conceaiment, or misrepresentation in obtaining a COR,
PIC, or STP;

) Practicing the nursing profession during the period of suspension of license;

f) Breach of ethical practice in research in accordance with prevailing national and
international guidelines; or

g) Other grounds analogous to the foregoing,

If the penalty imposed is suspension or revocation of the license, the respondent

shall be required to surrender their COR and PIC

SEC. 29. Reinstatement and Re-Issuance of Revoked Certificates of Registration and
Professional Identification Card. - The Board may, upon proper application therefor and
payment of the required fees, reinstate or reissue a revoked certificate of registration after two
(2) years from the effectivity of the period for revocation, which is the date of surrender of the
certificate and professional identification card, for reasons of equity and justice, and when the
cause for revocation has disappeared or has been cured or corrected,

ARTICLE IV
NURSING PRACTICE

SEC. 30. Nursing Practice. — Nursing practice embraces various stages of 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. It encompasses the care of
clients in various stages of human growth and development from conception, labor, delivery,
infancy, childhood, toddler, pre-school, schoo! age, adolescence, adulthood to old age, be it
performed independently or collaboratively with other professions.

SEC. 31. Scope of Nursing Practice. - The scope of Nursing practice includes nursing
service, education, research, leadership, and governance as defined in this Act-A person shall
be deemed practicing nursing when singly or in collaboration with other professionals, with or
without fee or compensation, the person assumes any or all of the four (4) roles: (1) provider
of direct client care, (2) educator, (3) researcher, and (4) manager and leader.
The nurse's clients shall include individuals, families, population groups, and communities,
with varying age groups, gender, health-iliness status, in any health care, industrial or
community setting,
Nurses are primarily responsible for the promotion of health and prevention of illness.
‘As a member of the health team, Nurses shall collaborate with other health care providers for
the promotive, preventive, curative and rehabilitative aspects of care, restoration of health,
alleviation of suffering and when recovery is not possible, in the provision of palliative and end-
oflife care,
In performing independent and collaborative functions, it shall be the duty of the Nurse
to
a) Provide nursing care through the utilization of the nursing process. Basic nursing
care is holistic care which includes, but is not limited to, the provision of
physiologic, psycho-social, emotional and spiritual care. This shall comprise any
or combination of essential primary health care, the application of traditional,
complementary, and innovative approaches, the therapeutic use of self,
rendering health care procedures and interventions, safety and comfort
measures, health education, health counselling and administration of written
prescription for treatment, therapies, oral topical and parenteral medications,
performance of peripartal care covering pre-intra-postpartum care, including the
performance of internal examination during labor in the absence of antenatal
bleeding, management of normal delivery and suturing of perineal laceration and
immediate care of the newborn; performance of perioperative care covering pre-
intra-postsurgical care intervention; provision of life-saving interventions during
emergency and disasters; palliative and end-of-life care;


b) Provide advanced nursing care based on the CPSCN and the Philippine
Qualifications Framework (POF);

©) Establish linkages with community resources and coordination with the health
team in any health care, industrial or community setting;

@) Provide health education and health counselling to empower individuals
families, population groups and communities towards the promotion of health,
prevention of illness, and caring towards a peaceful and good death;

e) Teach, guide and supervise students in nursing education programs, including
the administration of nursing services in varied settings such as hospitals, clinics
and other health, industrial or community settings where practice of the nursing
profession exists;

f)_ Provide duly compensated professional nursing services, such as but not limited
to consultation services and private/independent nursing practice:

9) Supervise nursing and ancillary nursing personnel in the delivery of safe and
quality healthcare services in varied settings;

h) Maintain competence by adhering to the CPSP standards and the Philippine
Professional Nursing Practice Standards (PPNPS) as well as engage in CPD
and lifelong learning within the context of the CPSP;

i) Observe, at all times, the Code of Ethics for Nurses promulgated by the Board,
uphold the standards of safe and quality nursing practice, and demonstrate
cultural and gender sensitivity and social responsibility; and

i) Undertake nursing and health human resource development training and
research for continuous quality improvement and evidence-based practice.

SEC. 32. Nursing Care. - 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, and health teachings; execution of health care techniques and
procedures and traditional and innovative approaches to individuals, families, population
groups and communities from conception to death

SEC. 33. Roles, Responsibilities, and Competencies of a Nurse. — A Nurse shall possess
and exercise the core competencies in the performance of their respective roles and
responsibilities, in accordance with the PPNPS.

SEC. 34. Continuing Professional Development (CPD). - All Nurses shall abide by the
requirements, rules and regulations on the CPD to be promulgated by the Commission, in
coordination with the APO for Nurses, and the duly authorized representative of the
organization of deans of HEls offering the BSN program. For this purpose, a CPD Council
shall be created to accredit CPD providers and programs for Nurses

SEC. 35. Requirement for Inactive Nurses Returning to Practice. - Nurses are considered
to be inactive under any of the following circumstances’

a) They are not utilizing nursing competencies as defined in the scope of nursing

practice for five (5) consecutive years;
b) They have not renewed their PIC for five (5) years; or
©) They do not have proof of five (5) years of continuous nursing practice;
Inactive nurses intending to return to practice must undergo a refresher course as may

be prescribed by the Board.

ARTICLE V
NURSING EDUCATION

SEC. 36. Basic Nursing Education. - Nursing education refers to the formal learning and
training in the science and art of nursing provided by HEIs duly recognized by the CHED.


There shall be a standard Baccalaureate and Graduate Program for Nursing Education
pursuant to R. A. No. 7722 or Higher Education Act of 1994.

SEC 37. Baccalaureate Program for Nursing Education. - The Baccalaureate Program for
Nursing Education refers to the basic nursing education program which envisions a sound and
liberal professional education that will adequately equip nursing students with the necessary
competencies for entry-level nursing practice.

Admission to the Baccalaureate Program for nursing Education requires passing a
National Nursing Admission Test (NNAT).

The curriculum and the Related Leaming Experiences (RLE) must be in accordance
with the appropriate PSG of the CHED.

SEC. 38. Graduate Program for Nursing Education. - The Graduate Program for nursing
education refers to the post baccalaureate nursing program which builds on the experiences
and skills of a Nurse towards mastery, expertise, and leadership in practice, education, and
research. This includes the master’s degree and Doctorate Degree in Nursing,

Graduate Program for Nursing Education shall be offered only by an accredited
program of HEIs in accordance with the prevailing CHED PSG for Graduate Education
SEC.39. Qualifications of the Dean. - The Dean of the College of Nursing of a BSN program
shall formulate policies and 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:

a) Be a Filipino citizen, physically and mentally fit and with good moral character:

b) Be a holder of a valid COR and a current PIC issued by the Commission;

¢) Be aholder of a master’s degree in Nursing conferred by an HE! duly recognized
by the government;

) Have at least three (3) years of clinical experience in any nursing practice setting;

) Have at least a total of five (5) years’ experience in teaching, administration, and
supervision in nursing education.

f) Be a member of the organization of Deans duly recognized by the BON.

9) Must not hold a concurrent Dean position in another HE! and no other teaching
assignments or administrative functions in other public/private institution or
higher education institution; and

h) Has a duly notarized employment contract as dean of the nursing program of at
least one (1) academic year with corresponding academic rank renewable
annually.

SEC. 40. Qualifications of the Dean/Administrator of the Graduate Program. — The Dean/
administrator of the academic unit shall be a holder of a doctoral degree in the discipline or
allied field and has published works in refereed journals in one of the disciplines under the
academic unit.

SEC. 41. Qualifications of the Faculty. ~

@) Baccalaureate Program in Nursing Education. — A member of the faculty in a
College of Nursing teaching professional courses must:

1. Be a Filipino citizen, physically and mentally fit and with good moral
character,

2. Bea BSN degree holder;

3. Be a holder of a master’s degree in nursing for teaching professional
nursing subjects or health related programs for teaching non-professional
subjects conferred by an HEI duly recognized by the government;

4, Be a holder of a valid COR and a current PIC as a Nurse issued by the
Commission;

12


5, Have at least three (3) years clinical experience in any nursing practice
setting; and

6. Preferably be a member of an accredited professional nursing
organization of good standing and of a specialty nursing organization

b) Graduate Program for Nursing Education. - A member of the faculty teaching
Graduate professional courses must:
1. Be a Filipino citizen, physically and mentally fit and with good moral
character:
2. Bea BSN degree holder,
3. Be a holder of a valid COR and a current PIC as a Nurse issued by the
Commission;
4, Have at least three (3) years clinical experience in any nursing practice
setting;
5. Be a holder of a Doctorate degree in Nursing conferred by an HE! duly
recognized by the government; and
Has published works in refereed Nursing or health-related journals.
Preferably be a member of an accredited professional nursing
organization of good standing and of a specialty nursing organization

NO

SEC. 42. Faculty-to-Student-Ratio. — The faculty-to-student ratio must be in accordance with
the standards to be determined and prescribed by the CHED.

ARTICLE VI
NURSING SERVICE

SEC. 43. Nursing Service. - Nursing service refers to the healthcare services provided by
Nurses in accordance with Section 29, Article IV of this Act. It includes the provision of
beginning, specialized, and advanced practice of nursing, including nursing management in
various health, industry or community settings where the competencies of a Nurse are
required.

SEC. 44, Qualifications of a Registered Nurse. — A Nurse shall have a broad and coherent
knowledge and skills in the field of nursing to provide safe and quality care to an individual,
family, population group or community, independently or as part of a team. A Nurse must be
able to assess, plan, implement, and evaluate the care provided to clients based on evidence
derived from practice and research. They may practice in special areas, such as but not limited
to high dependency unit, critical care unit, disaster areas, special procedure or interventional
area: Provided, that they have acquired relevant competencies

a) General Practice Nursing refers to the beginning roles of the Nurses in the
provision of safe, holistic and quality care to individuals, families, population
groups, or communities, and which include the assessment, planning,
implementation and evaluation of evidence-based care to the clients
A Nurse must have the following minimum qualifications
4. Must be a BSN graduate from an HE! recognized by the government;

2. Must have a valid COR and current PIC as a Nurse that is issued by the
Commission;

3. Must be physically, mentally and psychologically fit to practice nursing; and

4. Must not be convicted of any crime involving moral turpitude.


b) Specialty Practice Nursing refers to the practice of a Nurse in a specialty area of
the nursing practice for which the Nurse needs to obtain specialty recognition
after having undergone specialty training. Specialties can be differentiated in
categories, according to function, disease, pathology, systems, age, sex, acuity,
setting, technology, and therapies. Nurses who practice within this field are
referred to as “Specialists.”

A Specialty Practice Nurse or Specialist must have the following minimum
qualifications:
1. Must be a BSN graduate from an HEI recognized by the govemment;

2. Must have a valid COR and current PIC as a Nurse that is issued by the
Commission;

3. With at least 3 years of clinical experience in the area of specialty;

4. Must have received a specialty training in the area of specialty practice, and
this training is CPD Council-accredited and provided by a CPS Council-
credentialed organization.

5. Must be physically, mentally, and psychologically fit to practice nursing;
6. Must not be convicted of any crime involving moral turpitude; and

7. Preferably a member of the appropriate Board-credentialed Specialty
organization

©) Advanced Practice Nursing refers to the direct, autonomous or collaborative
expert care of Nurses with higher level competencies as defined in this Act. An
APN must have acquired substantial theoretical knowledge and decision-making
skills reflecting specialized and expanded competencies over and above the
General Practice Nurse requirements.
‘An Advanced Practice Nurse must have the following minimum qualifications:
1. A graduate with relevant master’s degree from a government recognized
HEI, with substantial specialty experience as may be determined by the
Board;
2. Must have satisfied the requirements for certification as promulgated by
the Board; and
3. Preferably be a member of the appropriate Board-credentialed Specialty
organization
An Advanced Practice Nurse has the following responsibilities in collaboration
with, and under the terms specified in a Collaborative Agreement, with a Collaborating
Physician.
1. Initiate patient admission to a primary, secondary, or tertiary health
facility;
Provide direct primary-care services to patients of all ages;
Diagnose diseases and injuries;
Treat continuum of care of disease conditions;
Provide promotive, preventive, rehabilitative and end-of-life care;
Exercise prescriptive authority;
Order and interpret laboratory and diagnostic tests;
Provide anesthetic care;
Refer patients to specialists, other health professionals, and institutions
for appropriate care; and
10. Initiate patient discharge.

OONOHAON

1a


SEC 45. Public Health Nursing Service. - There shall be adequate provision of essential
health services in every local health facility to effectively implement public health programs for
community and population groups. These essential services shall include: health information
and education; expanded program of immunization against major infectious diseases;
matemal and child health care including family planning and counselling: micronutrient and
nutritional food supplementation; prevention, treatment and control of communicable and non-
communicable diseases including locally endemic diseases; mental health promotion:
‘occupational health and safety; safe water and environmental sanitation; basic drugs supply;
and, emergency and disaster management

SEC 46. Public Health Nurse (PHN). -Public Health Nurse function in the delivery of
essential health services as described in SEC. 45. They work with the individuals, families,
and population groups that are the nucleus of the community. They collaborate with other
members of the service delivery network with the goal of promoting health, preventing disease
and disability, and treatment of common diseases. PHN may progress to become a Specialist
in PHN who obtained specialty training focused on public health-based programs and
substantial experience in managing public health conditions. A PHN Specialist may progress
to become Advanced Practice Nurse in Public Health who obtained an advanced nursing
preparation, either a master’s or doctoral degree with emphasis on public health sciences, or
their equivalencies issued according to promulgation by the Commission on Higher Education
(CHED), and as defined in SEC. 44.

‘As Advanced PHN Practitioners, their duties and responsibilities include the following:

a) Delivering population-centered services and programs and other public health
services such as occupational health; school health; emergency and disaster;
and, home health/hospice services;

b) Providing direct and indirect care to population groups and communities. Direct
care consists of assessing and diagnosing population or communities; planning
nursing actions; mobilizing community response; monitoring population health
status and evaluating outcomes. Indirect care consists of engaging in policy
change, education and training of PH practitioners and in interdisciplinary
research; acting as consultants to policy makers; and,

©) Exercising collaborative leadership and political skills for successful population
outcomes.

ARTICLE Vil
NURSING RESEARCH, POLICY DEVELOPMENT, AND PLANNING

SEC. 47. Nursing Research and Policy Development. — Nursing Research and Policy
Development shall involve the study of nurse-related issues, to include as follows:

a) Professional nursing practice and nursing development such as advancing
nursing knowledge, health and nursing governance to ensure quality nursing
care for all and advocacy for sound health policies nationally and globally;

b) Information and knowledge management and communication technology;

c) Nursing regulation on credentialing, Code of Ethics, standards and
competencies; and

4) Socio-economic welfare for Nurses like occupational health and safety, human
resources planning and policy, remuneration, career development

ARTICLE VI
NURSING LEADERSHIP AND GOVERNANCE

SEC. 48. Nursing Leadership and Governance. — Nursing leadership and governance
involves the process of influencing other people through the exercise of authority, direction,
control, and regulation in the practice of the nursing profession to achieve desired goals.


SEC. 49. Nursing Service Management. - Nursing service management refers to the
management and administration of nursing services by Nurses who must be equipped with
necessary competencies on governance and leadership, to wit

a) First Level Manager is responsible for the management of a nursing unit and
supervision of nursing support personnel including, but not limited to Patient Care
Technician |, Orderlies, Caregiver |, Healthcare Sitter, Caregiver Il, Patient Care
Technician Ii, Surgical Technician, Dialysis Technician, Orthopedics Technician,
Medication Technician, and Ward Clerk/Unit Secretary

b) Middle Level Manager is responsible for the leadership and governance of more
than one (1) nursing unit, particularly management of the operational systems,
financial and human resources.

c) Executive Level is responsible for establishing the strategic direction for the
entire nursing division, particularly on the development of policies, standards and
guidelines and has full authority in their implementation.

Nursing Service Managers must have the following minimum qualifications:

a) For first level managerial position in nursing: Must have at least eighteen (18)
units of nursing management and clinical subjects in Master of Arts in Nursing or
Master of Science in Nursing, with at least three (3) years of clinical work
experience, and must have participated in at least one (1) research project to
improve quality of care

») For middie level managerial position in nursing: Must have completed all the
academic requirements in Master of Arts in Nursing or Master of Science in
Nursing, with at least three (3) years of clinical work and two (2) years of
management experience, and must have conducted at least one (1) research
project to improve quality of care.

©) For executive position in nursing: Must have a post-graduate degree in nursing
or health management-related sciences, with at least three (3) years of clinical
work and three (3) years of management experience and must have conducted
at least two (2) research projects to improve quality of care.

For all managerial positions — Must have satisfied the requirements for certification as
promulgated by the Board.

‘SEC. 50. Nursing Service and the Chief Nursing Officer (CNO). - There shall be a nursing
service office in every health institution, be it administrative or clinical, with at least ten (10)
Nurses. Nursing services must be under the control and management of a registered nurse
designated as Chief Nursing Officer (CNO) in each health institution. There shall also be a
National Chief Nursing Officer (NCNO) instituted at the Department of Health (DOH) to
oversee and coordinate national nursing personnel utilization, welfare, decent work and
nursing development covering both the public and private sectors.

Within the framework of health care delivery, nursing services in private and public
institutions or community settings must be led and managed by a Chief Nursing Officer (CNO),
or equivalent (i.e., Chief Nurse (CN), Director of Nursing). The CNO shall be bestowed full
administrative responsibility as leader and manager of nursing services within each institution.
The CNO shall have the authority and accountability over the planning, organizing, directing,
and controlling including monitoring, evaluation, and policy development of nursing resources
related to nursing services. The CNO responsibilities include strategic and operational
planning, financial and resource allocation, policies and procedures development,
professional and organizational involvement to address issues that have relevance for
nursing,

The NCNO, being the highest-ranking nursing official in the Department of Health, shall
be responsible for overseeing and coordinating strategic management, financial and resource
allocation, policies and standards development, professional and organizational development
to relevantly address national epidemiologic and nursing personnel supply, demand, and
distribution trends. The NCNO shall oversee the development of the Nursing Human Resource
for Health Management System (NHRHMS), a national nursing information system and utilize


statistical data and other nursing outcome metrics in the exercise of good governance and full
accountability over nursing personnel systems in both private and public health care and
community settings. The NCNO shall also act as the advocate for the rights and welfare of
Nurses in both public and private institutions,
A CNO and NCNO must be qualified and credentialed based on the PSG as
promulgated by the Board.
‘The CNO must have the following minimum qualifications:
a) Be a registered nurse in the Philippines;
b) Have a degree of a Master's degree in Nursing
©) Be a holder of a master’s degree in nursing conferred by an HEI duly
recognized by the government;
d) Be a holder of a valid COR and a current PIC as a Nurse issued by the
Commission; and
) Have at least five years’ experience in general nursing service administration
with experience in policy development;
f) Preferably be a member of good standing of the accredited professional
organization of nurses; and
9) Preferably be a member of the organization of nursing service administrators
duly recognized by the BON.
The NCNO must have the following minimum qualifications
a) Must be a registered nurse in the Philippines
b) Must have a degree of Bachelor of Science in Nursing
c) Bea holder of a Doctorate degree conferred by an HEI duly recognized by the
government in a relevant healthcare and business/administration field
d) Be a holder of a valid COR and a current PIC as a nurse issued by the
Commission
) Must have the necessary Career Executive Service Officer (CESO) rank
f) Have at least five years’ experience in general nursing service administration
with experience in policy development;
9) Preferably be a member of good standing of the accredited professional
organization of nurses
h) Preferably be a member of the organization of nursing service administrators
duly recognized by the BON

ARTICLE VII
NURSING HEALTH HUMAN RESOURCE MANAGEMENT SYSTEM

SEC. 51. Nursing Human Resource for Health Management System. - The
Nursing Human Resource for Health Management System (NHRHMS) shall cover all nursing
human resources in the nursing service of both public and private sectors, i.e. in the
healthcare, industrial and community settings. Institutions shall be mandated to report their
information to ensure accurate nursing human resource and workforce projections and to
reconcile these with supply data from CHED and PRC.

Health facilities and institutions, including industrial establishments that hire Nurses,
shall implement strategic NHRHMS in all levels of the nursing service, and in this pursuit, shall
adopt and define appropriate nursing organizational structure to support competency
development, career/professional growth, job delight, productivity and conditions for “decent
work" of their Nurses.

It shall be mandatory for each healthcare facility to employ an evidence-based HRH
assessment tool for nursing workload and workload pressure (preferably the WHO Workload
Indicators for Staffing Needs or WISN) to determine minimum safe staffing needs for
registered nurses and nursing personnel under nurse supervision on an annual basis. These
nursing staffing ratios, nursing plantilla, and skill-mix standards are requisites for safe and
quality care for patients and must be upheld and practiced to be granted continued permission


to operate the facility. The facility must use this assessment to plan and provide a budget for
regular plantilla positions to ensure that safe and quality care is provided by the institution.
Additionally, a registry of nursing professionals shall be incorporated in the NHRHMS
in coordination with DOH, private institutions, and nursing organizations and groups,
indicating, among others, their current number of practitioners and location of practice.

SEC. 52. Nursing staff complement. - The Board, in consultation with the DOH and other
stakeholders, ensures safe nursing workforce complement for any healthcare setting guided
by the following principles:

a) Use of evidence-based, reliable, and up-to-date staffing/workforce data.

b) Regular review and updating of staffing based on up-to-date evidence and best
practice on the nurses’ practice environment and nurse, nurse-sensitive patient,
organizational and system outcomes.

c) Nurses must not be substituted with other cadres of workers in performing
functions within the scope of nursing.

d) Nurses in management positions must not be delegated to augment staffing
limitations to fully perform their administrative roles and function to lead, support
and mentor nursing staff.

) Respect for nurses’ professional judgement in determining the required safe
workforce staffing,

f) Active involvement of direct care nursing staff and nursing management in all
stages/aspects of the institution's HRH design, policy development, and decision
making,

g) Timely adjustments to nurse staffing based on changes in patients and
population healthcare needs

The nursing workforce complement is planned to ensure that patient safety, quality
service delivery, and positive practice environment is present. Safe Staffing Standard means
that the ‘appropriate number of nurses are available at all times across the continuum of care,
with a suitable mix of education, skills and experience to ensure that patient care needs are
met and that the working environment and conditions support staff the delivery of safe, quality
care (ICN, 2018).

Hence, ‘safe staffing’ or the maximum number of clientele cared for by each nurse
assigned in a healthcare facility, setting or unit shall be determined by the ratio of staff nurse-
to-patient in a general nursing service or general ward of a hospital shall be based on patient
acuity, complexity of work, nurse competencies, and nursing modalities to effectuate positive
practice environment, safe, and quality nursing care for patients.

For general units, the maximum number of patients that a nurse may effectively and
safely handle at any given time is 10. Thus, the minimum safe staffing ratio standard for
general units is 1:10 or one nurse for every 10 patients. However, this staffing
complementi/ratio may vary based on the assessed Safe Staffing Standard.

Failure to comply with the above minimum safe staffing ratios must be justified through
the assessment tool findings and analysis as provided in this section. Non-compliance shall
be referred to the Board for action

The Board, in consultation with the DOH and other stakeholders, shall from time to
time, review and modify the nurse to population ratio as may hereinafter be established for the.
healthcare and industrial settings; and for the community, by taking into consideration the
current community characteristics and population needs.

In the community, there shall be a Nurse in every barangay; primary, secondary, and
tertiary school; and industrial establishment, subject to the applicable ratio prescribed by the
appropriate government agency.

SEC. 53. Return Service Agreement — All graduates of allied and health-related courses,
like nursing, who are recipients of government-funded scholarship programs shall be required
to serve in priority areas in the public sector for at least three (3) full years, with compensation


and under the supervision of the DOH. Provided, further, that those who will serve for an
additional two (2) years shall be provided with additional incentives as determined by the DOH;
provided further that graduates of allied and health-related courses, including nursing, from
state universities and colleges and private schools shall be encouraged to serve in these
areas.

ARTICLE Vill
PROHIBITED ACTS AND PENAL PROVISIONS

SEC. 54, Prohibited Acts. -

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

1. Without a COR, PIC, STP or without having been declared exempt from
‘examination in accordance with the provision of this Act;

2. Who uses the COR, PIC, or STP of another;

3. Who uses fraudulent, suspicious, false, or an expired, suspended or
revoked COR, PIC or STP;

4. Who, by misrepresentation, false evidence, or concealment, has obtained
a COR, PIC or STP;

5. Who falsely poses or advertises as a Nurse or uses other means that tend
to convey the impression that he/she is a Nurse;

6. Who appends B.S.N. or R.N (Bachelor of Science in Nursing/Registered
Nurse) or APN (Advanced Practice Nurse) to their name without having
been conferred said degree, registration, or certification;

b) Who abets or assists in the illegal practice of the nursing profession as a Nurse.

¢) No HEI offering the BSN program shall withhold any requirement or document,
or both, of any graduate for the purpose of preventing them to apply for the PNLE
without any justifiable reason.

d) Any natural or juridical person or health facility which subscribes to sub-standard
quality of nursing care and/or nursing practice, such as non-compliance with the
nurse-patient ratio requirement;

e) Any natural or juridical person or health facility which exercises and promotes
precarious working conditions for Nurses, such as, but not limited to, the
following:

1. Contracting or availing of the services of a Nurse either without salary or
allowance, or for salary below the applicable salary grade/rate prescribed
under this Act, whether or not under the pretext of a training, development
program, certification or course and/or seminar,

2. Depriving or denying a Nurse of the incentives and benefits as provided for
under existing laws;

3. Collecting any fee from a Nurse or from any person or his/her agent in
exchange for a Nurse’s voluntary services in a health, industrial or similar
facility or institution:

4. Requiring or obliging a volunteer Nurse to perform the regular work
functions and/or regular work load expected from a regular staff Nurse
without proper compensation, or to render full time service as a condition
for the continued availment of her/her volunteer services, and/or to be the
sole Nurse on duty, except during disasters, calamities, public emergencies
and war;

5. Contracting or availing of the services of a volunteer Nurse, under the
pretext of On-The-Job Training (OJT), contract of service, and/or job
orders, in order to fill-up a vacant position that requires the hiring of a full-
time regular employed Nurse, or for free in exchange for any type of
certification to be issued by the health facility or institution or industrial
establishment for purposes of the Nurse's employment application; or


6. Contracting or availing of the services of a Nurse, under the pretext of
training or certification course, but requiring the Nurse to render the tasks
and responsibilities expected of a regular staff or public health Nurse; and

7. Practicing job-splitting or hiring two part-timers in place of one fulltime
employee and deploying the two nurses on a full-time basis

8. Making mandatory, as a pre-hire requirement, training that should have
been acquired during the BSN program or which, rightfully should be
provided by the hiring institution;

9. Repeatedly subjecting or allowing the nurse to experience prejudice,
violence, or discrimination;

10. Imposing mandatory overtime;

41. Non-compliance with the minimum safe staffing requirement in Sec. 52

f) Any violation of the provisions of this Act

SEC. 55. Sanctions. - A fine of not less than One Hundred Thousand Pesos (P100,000.00)
nor more than Three Hundred Thousand Pesos (P300,000.00) or imprisonment of not less
than one (1) year nor more than six (6) years, or both, shall be imposed, at the discretion of
the court, for the commission of any of the prohibited acts enumerated in Section 54 (a) of this
Act.

A fine of not less than Three Hundred Thousand Pesos (P300,000.00) nor more than
Five Hundred Thousand Pesos (P500,000.00) or imprisonment of not less than one (1) year
or more than six (8) years, or both, shall be imposed, at the discretion of the court, for the
commission of any of the prohibited acts enumerated in Section 54 (b), (c), (d) and (e) hereof.
In addition, suspension or revocation of license to operate the health facility or institution or
industrial establishment may be ordered at the discretion of the court. In case the violation is
committed by a partnership, corporation, association, or any other juridical person, the
managing partner, president, managing director/s, and/or manager who has committed or
consented to such violation shall be held directly liable and responsible for the acts, as
principal or as co-principal/s with the other participants, if any.

SEC. 56. Refund and Compensation. — Any Nurse found to have been a victim under Section
54 (d) hereof shall be entitled to a full refund of all fees illegally collected and the payment of
unpaid salary, if any, which should not be less than the applicable wage for services rendered.
This is without prejudice to the other liabilities of the violators under applicable laws.

ARTICLE IX
SUNDRY PROVISIONS

SEC. 57. Salary and Compensation. — Nurses shall, at all times, receive compensation that
is just and due them and commensurate with their education, training, and experience and the
complexity of nursing skill required for the services rendered. Nurses working to provide
nursing service, in both government and private sectors, are integral to the functioning of
hospitals and healthcare institutions, must be classified as regular staff after a reasonable
probationary period, as mandated by law. Outsourcing nursing work is acceptable under
certain circumstances as reflected in the IRR.

The minimum base pay of all nurses working in government and non-government
health, industrial and community settings shall, upon entry, be not lower than Salary Grade 15
(SG 15) based on the prevailing Salary Standardization Law.

The pay for nurses working in Nursing Education, both in government and non-
government schools and universities, shall be in accordance with academic rank.

Non-govemment and/or private health facilities and institutions and industrial
establishments shall comply with the requirement on the salary rate in tranches within three
(3) years from the effectivity of this Act.


SEC. 58. Incentives and Benefits. - Tne Board, in coordination with the DOH, other
concerned government and non-government institutions, association of hospitals and the APO
for Nurses, shall establish an incentive and benefit system in the form of free hospital care,
scholarship grants and other non-cash benefits for Nurses and their dependents subject to
existing regulations.

SEC. 59. Non-Diminution of Benefits and Incentives. - The implementation of Sections 57
and 58 of this Act shall not result in the diminution of existing grants of salaries, benefits and
incentives.

SEC. 60. implementing Agencies. - The Department of Budget and Management (DBM),
Department of Health (DOH), Department of Labor and Employment (DOLE), Department of
Interior and Local Government (DILG), Civil Service Commission (CSC), Commission on
Higher Education (CHED), and Department of Education, Culture and Sports (DECS) are the
designated agencies responsible for the implementation and monitoring of the compliance of
the provisions of this Act

The DOH, DILG, and CSC are responsible for monitoring the compliance and
implementation of the provisions of this Act by public health facilities and institutions. The DOH
shall be lead monitor the compliance and implementation of the provisions of this Act by public
health facilities and institutions.

The DOLE shall be the agency responsible for monitoring the compliance and
implementation of the provisions of this Act by private health facilities and institutions and
industrial establishments. In addition, DOLE must create another category for health workers
befitting the professional and complex work that nurses and other health professionals do that
are not captured justly by their being categorized as “non-agricultural” workers.

The Commission and the Board are designated as the agencies responsible for
monitoring the compliance and implementation of the provisions of this Act by Nurses, HEIs,
CPD providers, health facilities and institutions, and industrial establishments. The CHED shall
be the agency responsible for monitoring the compliance and implementation of the provisions
of this Act by HEIs with regards to nursing education programs and curriculum.

‘The PRC and the PRBON are designated as the responsible agencies for monitoring
the compliance with and implementation of the provisions of this Act by Nurses, HEIs, CPD
providers, health facilities and institutions, and industrial establishments.

The CHED is similarly designated as the agency responsible for monitoring the
compliance and implementation of the provisions of this Act by HEIs with regards to nursing
education programs and curriculum,

The Commission and Board shall designate a third party to conduct an annual
evaluation on the compliance to the implementation of the provisions of this Act

SEC. 61. Appropriations. - The amount necessary to carry out the provisions of this Act
shall be charged to the savings of the concerned agencies immediately upon effectivity hereof.
Every year thereafter, the amounts necessary to effectively implement the provisions of this
Act shall be included in the annual budget of the concerned agencies to be incorporated in the
General Appropriations Act (GAA).

In order to effectively carry out the APN role, the annual financial requirement needed
to train at least ten percent (10%) of the nursing staff of the participating government and non-
government hospitals and institutions shall be chargeable against the income of the Philippine
Charity Sweepstakes Office (PCSO), Philippine Health Insurance Corporation (PhilHealth)
and the Philippine Amusement and Gaming Corporation (PAGCOR), which shall equally share
in the costs, subject to the usual government accounting and auditing procedures.

SEC. 62. Implementing Rules and Regulations. — Within ninety days (90) after the effectivity
of this Act, the Commission, the Board, the APO for Nurses, the Civil Service Commission
(CSC), the Department of Budget and Management (DBM), the DOH and other concemed


nursing organizations and government agencies shall formulate the implementing rules and
regulations (IRR) necessary to carry out the provisions of this Act.

SEC.63. Separability Clause. - Should any provision of this Act be declared unconstitutional,
the remaining parts not affected thereby shall remain valid and operational

SEC. 64. Repealing Clause. - Republic Act No. 9173, otherwise known as the “Philippine
Nursing Act of 2002" is hereby repealed. Alll 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.

SEC. 65. Effectivity. - This Act shall take effect fifteen (15) days after its publication in the
Official Gazette or in any two (2) newspapers of general circulation in the Philippines.

Approved,