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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

NINETEENTH CONGRESS
First Regular Session

House Bill no, 8942

Introduced by Representative Midy N. Cua
Lone District, Quirino

AN ACT PROVIDING FOR A COMPREHENSIVE NURSING LAW, PROMOTING A
MORE RESPONSIVE AND EFFECTIVE HEALTH CARE SYSTEM, AND
APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

Republic Act No. 9173 otherwise known as the “Philippine Nursing Act of 2002" was enacted to
provide for protection and improvement of nursing profession by instituting measures that shall result
in relevant nursing education, humane working conditions, better career prospects and dignified
existence for nurses. However, as this law was enacted in 2002, significant factors critical to the
development of the nursing practice in the country have emerged. One factor is the growing number
of Philippine nurses, reaching 80,000 graduates each year across 470 universities offering nursing
programs’.

The overall purpose of this bill is to regulate the profession of nursing to ensure that patients receive
safe and effective care from qualified professionals who adhere to established standards of practice
and conduct. Thus, it seeks to develop competent, productive, and well-rounded nurses through
‘education, training, licensure examinations, regulatory measures, programs, and activities. Among the
salient provisions of the bill are the following items, among others:

‘* Education and training requirements to become a licensed nurse. These requirements include
completing the necessary degree program in nursing, passing the national licensure exam, and
completing ongoing continuing education requirements to maintain licensure,

© Licensure or Certification Processes for obtaining and renewing a license or certification to
practice nursing. Including demonstrating a certain level of competency and maintaining
continuing education requirements.

The bill also establishes standards of professional conduct for nursing, outlining the ethical
principles and behaviors of individuals practicing in this profession. These standards include
guidelines on handling professional misconduct.

This measure previously passed the third reading in the 18* Congress. It was proposed by
Representatives Rommel Rico Angara, Rufus B. Rodriguez, Vilma Santos-Recto, Alyssa Sheena P.
Tan, Luis Raymund “Lray” F. Villafuerte Jr., Joy Myra Salvador-Tambunting, Ferdinand Martin G.
Romualdez, Yedda Marie K. Romualdez, Juan Miguel Macapagal Arroyo, Anna Marie Villaraza-

' Berdida, Daniel Joseph E, and Rizal Angelo N Grande. “Academic Stress, COVID 19 Anxiety, and
Quality of Life among Nursing Students: The Mediating Role of Resilience.” International
Nursing Review 70, no. 1 (May 31, 2022): 34-42. https://doi.org/10.1111/inr.12774.


Suarez, Ma. Lourdes T. Arroyo, Yasser Alonto Balindong, Leonardo L. Babasa Jr., Fredenil “Fred”
H. Castro, Gerardo “Gerryboy” J. Espina Jr., Roger G. Mercado, Wilter “Sharky” Wee Palma I,
Geraldine B. Roman, Hector S. Sanchez, Christian S. Unabia, Prospero A. Pichay Jr., Sonny “SL” L
Lagon, Sergio C. Dagooc, Adriano A. Ebcas, Lorenz R. Defensor, Romeo S. Momo, Jose Gay G.
Padiernos, Presley Cheng De Jesus, Godofredo N. Guya, Amolfo “Amie” A. Teves Jr., Rodante D.
Marcoleta, Alfred C. Delos Santos, Eric L. Olivarez, Frederick W. Siao, Eric G. Yap, Rose Marie
“Baby” J. Arena, Jose L. Atienza Jr., Evelina G. Escudero, Ferdinand L. Hemandez, Strike B. Revilla,
Deogracias Victor “DV” B. Savellano, Kristine Singson-Meehan, Tyrone D. Agabas, Christiopher
VP. De Venecia, Stella Luz A. Quimbo, Elenita Milagros “Eileen” Ermita-Buhain, Lorna P. Bautista-
Bandigan, Luis N. Campos Jr., Junie E. Cua, Luisa Lloren Cuaresma, Paul Ruiz Daza, Rudys Cesar
G. Farifias 1, Vincent Franco “Duke” D. Frasco, Greg G. Gasataya, Ed Christopher S. Go, Ruwel
Peter S, Gonzaga, Sandro L. Gonzalez, Teodorico T. Haresco Jr., Romeo M. Jalosjos Jr., Jocelyn Sy
Limkaichong, Corazon T, Nufiez-Malanyaon, Manuel T. Sagarbarria, Joey Sarte Salceda, David “Jay-
Jay” C. Suarez, “Kuya” Jose Anton io R. Sy-Alvarado, Alfred Vargas, Micaela S. Violago, Manuel F.
Zubiri, Antonio “Tonypet” T. Albano, Angelo marcos Barba, Alfel M. Bascug, Jose Francisco “Kiko”
B. Benitez, Gabriel H. Bordado Jr., Fernando T. Cabredo, Carl Nicolas C. Cari, Maximo Y. Dalog Jr.,
Abdullah D, Dimaporo, Mohamad Khalid Q. Dimaporo, Faustino “Inno” A. Dy V, Faustino Michael
Carlos T. Dy Ill, Ann K. Hofer, Cesar “Jawo” I. Jimenez Jr., Glona G. Labadlabad, Maricel G.
Natividad-Nagafio, MD, Jonathan Keith T. Flores, Mark . Go, Virgilio S. Lacson, Florida “Rida” P.
Robes, Estrellita B. Suansing, Paz C. Radaza, Jocelyn F. Fortuno, Ramon “Mon-Mon” V. Guico Ill,
and Eduardo “Eddie” R. Gullas as principal authors thereof.

In view of the foregoing, approval of this measure is eamestly sought.

MIpy/. CUA
Reprbfentative
Lone Djtrict, Quirino


Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

NINETEENTH CONGRESS
First Regular Session

House Bill No894 2

Introduced by Representative Midy N. Cua
Lone District, Quirino

AN ACT PROVIDING FOR A COMPREHENSIVE NURSING LAW, PROMOTING A
MORE RESPONSIVE AND EFFECTIVE HEALTH CARE SYSTEM, AND
APPROPRIATING FUNDS THEREFOR

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

SEC. 2, Declaration of Policy. — In pursuit of the constitutional precept that Health is a right of every
Filipino, it is hereby declared the policy of the State to uphold the welfare of healthcare workers as an
important objective towards achieving the goals of universal health care in the country. It is likewise
declared as the policy of the State to uphold the dignity of nurses, to accord them the respect befitting
the service they render to the nation, and to improve the practice of the nursing profession by
instituting measures to ensure their professional growth, promote comprehensive and relevant nursing
practice standards, and provide just and humane working conditions in every health facility,
institution, or establishment in order to ensure their well-being and the health and safety of the public.
Nurses comprise a great majority of the healthcare workers both in the institutional and community
levels. Thus, the State recognizes nurses as prime movers of national development and contributors to
international cooperation and understanding.

The State furthermore, recognizes the necessity of implementing an adequate and
comprehensive Nursing Human Resource for Health Management System (NHRHMS) throughout the
country in order to adequately deliver accessible, affordable, and quality health care.

SEC. 3. Definition of Terms. — As used in this Act:

a) Accredited Professional Organization (APO) refers to the national professional organization
of nurses duly accredited by the Professional Regulation Commission (PRC);

b) Bachelor of Science in Nursing (BSN) refers to the baccalaureate program that provides sound
and liberal education that equips graduates with competencies for registration as a professional
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


d)

°)

8)

h)

a)

k)

promulgated under Memorandum Order No. 15, series of 2017, on the Policies, Standards and
Guidelines for the Bachelor of Science in Nursing (BSN) Program prescribed and issued by
the Commission on Higher Education (CHED);

Career Progression and Specialization Council for Nursing (CPSCN) refers to the body
deputized by the Professional Regulation Commission to develop standards of practice for
each 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 Nurses (CPSPN) refers to the Program
recognized by the PRC and the Board involving the progressive transfer of knowledge and
skill for the various levels of the nursing, practice the system of credentialing specialty
organizations and interest groups, and the certification of individuals at different levels of
practice;

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 Advance Practice Nurse
(APN) upon completion of a specialty program or Continuing Professional Development
(CPD) program, or both, The certification is issued by the Board and the PRC upon the
endorsement of the specified recognized and credentialed specialty organization in accordance
with the PSG;

Chief Nursing Officer (CNO) refers to the highest nursing administrative and clinical official
in healthcare facilities. The CNO is responsible for leading and coordinating an organization's
nursing 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 professional practice rendered in any healthcare setting whether in
the private or public sector;

Credentialing refers to the formal recognition of a specialty organization or interest group
conferred by the PRC and the Board, upon the recommendation of the CPSPN, after
complying with the policies, standards and guidelines issued by the Board;

Decent Work refers to aspirations by people in their working lives. It involves opportunities
for productive work that delivers a fair income, affords security in the workplace, social
protection for families, better prospects for personal development, psychological well-being,
‘opportunities for social integration, including the freedom for people to express their concerns
and organize and participate in decisions that affect their lives, and promotes 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 the scope of nursing practice. An APN has a recognized autonomous role 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;

Healthcare Facility refers to a public or private institution, establishment or clinic devoted
primarily to the provision of services that include the following: nursing, health promotion,
prevention of illness, diagnosis, treatment, rehabilitation, and palliation of individuals
suffering from illness, disease, injury or disability, or deformity, or in need of obstetrical,


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psychiatric or other medical and nursing care, and includes hospitals, barangay health centers,
and other clinics;

Individual-based Health Services refer to services which can be accessed remotely or within a
health facility that focuses primarily on treating individuals;

National Chief Nursing Officer (NCNO) refers to the highest-ranking nursing official of the
Department of Health (DOH) whose main function is to promote 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 expert advice based on timely accurate local data and national and
international evidence, and by promoting quality nursing standards in the nursing profession
and the healthcare industry;

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

Nursing care refers to the 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;

‘Nursing Human Resource for Health Management System (NHRHMS) refers to an organized
human resource management and development information system based in the DOH and
directed by the NCNO, that provides meaningful data used to support policies affecting nurses
and nursing;

Nursing practice refers to 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, school age, adolescence, adulthood to old age, be it performed independently or
collaboratively with other professions.

‘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 CNO;

Patient Acuity refers to the intensity of care provided to a patient by a registered nurse, o the
use of patient classification systems that can forecast patient care requirements for nursing
care and are therefore vital in the management of nursing personnel;

Philippine Professional Nursing Practice Standards (PPNPS) refers to the authoritative
statements of the core competencies and duties that all registered nurses, regardless of role,
designation, or specialty, are expected to perform. The PNPS promotes, guides, and directs
professional practice;

Philippine Professional Nursing Roadmap (PPNR) refers to a program towards good
governance of the nursing profession, the goal of which is to develop and promote a culture of
excellence and dynamic leadership in Philippine nursing. The PPNR is anchored on five
initiatives: collaborative partnership, competency enhancement, linkages, social impact,
‘embedding the core values and positive qualities of the Filipino nurse;

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


x) 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;

y) Precarious work refers to working conditions which are contingent, atypical or non-standard.
It is usually characterized by characterized by uncertainty and instability in one's employment
status, such as when there is a threat of change or diminution in one's rank or position, or when
there is ambiguity in the employee-employer 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 in order to avail of the right to bargain collectively;

2) Primary Care refers to initial-contact, continuous, comprehensive and coordinated, and
culturaily 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;

aa) Public Health Institution (PHD) refers to any government-led, owned, or controlled institution
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 national to local Health Care Delivery System (HCDS), which include rural
health units (RHUs) and barangay healthcare centers; research facilities such as the Research
Institute for Tropical Medicine, and the like; training resource facilities such as the University
of the Philippines College of Public Health and State or Local Colleges or Universities
offering health-related programs; the DOH and all retained healthcare facilities, and the like;

bb) Return Service Agreement refers to an agreement whereby graduates of the nursing course
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. No. 11223,
otherwise known as “The Universal Health Care Act”;

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

ARTICLE IL
BOARD OF NURSING

SEC. 4. Creation and Composition of the Board, ~ There shall be created, under the administrative
supervision of the PRC, the Professional Regulatory Board of Nursing which shall be composed of
seven (7) Members who shall elect from 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 and ranked from
a list of at least three (3) nominees per vacancy as provided by the APO. Preferably, 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 Professional Regulatory Board of Nurses. - 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 the nursing profession safely. Pursuant
thereto, the Board shall regulate the practice of nursing and in collaboration with the CHED, review
and approve nursing education programs to be offered by authorized higher education institutions.


The Board, acting in accordance with the highest standards of ethics, accountability,
efficiency, effectiveness, and transparency, shall approach 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 Chairperson and Members of the Board. ~ The Chairperson and
Members must be natural-born citizens of the Philippines and have resided therein for at least five (5)
consecutive years immediately preceding the date of their respective appointments. Furthermore, at the
time of their appointment, they must possess the following:

a) A valid and current certificate of registration and professional identification card;

b) A Master's Degree in nursing, and preferably, with relevant Doctorate Degree conferred by a
duly recognized HEI;

©) At least ten (10) continuous years nursing practice prior to appointment: Provided: That the
last five (5) years of such practice must have been served in the Philippines;

4) Good moral character as evidenced for not having convicted of any offense involving moral
turpitude; and

) Physical and mental fitness.

SEC. 7. Prohibition as Members of the Board. ~ The Members of the Board shall not, at the time of
their appointments and during their incumbency, hold any position nor have pecuniary interest, direct
or indirect, in any HEI offering BSN, or in any review or training center for the PNLE, training
hospital or healthcare facility with nursing affiliates, and is not an officer of the APO.

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 or a total of six (6) 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 PRC.

SEC. 11. Limited Practice of the Profession. — 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.

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 PRC. 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 PRC. The PRC 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 examination applications,
test development, administration of the examination, and the 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 professional standards in the practice of
nursing towards optimal health and the common good;

©) Ensure quality nursing in coordination with the CHED through the monitoring of HEI
offerings, The continuing review of the nursing curriculum and the timely application for
authority to offer new nursing education programs in order to ensure that the standards of
nursing education are properly complied with and systematically updated in accordance with
the latest development in health care;

4) Within one (1) year from the effectivity of this Act, promulgate a Code of Ethics and Ethical
Standards that is responsive to the needs of the nursing profession, in coordination with the
APO for nurses;

€) Prescribe and operationalize a Career Progression and Specialization Program for Nursing
(CPSPN) which shall include the recognition and credentialing of organized nursing groups
and the certification of advanced practice nurses to ensure the continuing professional
development of nurses;

f) Work in partnership with the appropriate agencies to identify and utilize resources earmarked
for national nursing development,

g) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and to submit
recommendations to authorities and agencies to aid in policy formulation 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
PRC;

h) Spearhead and oversee the Philippine Profession 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 or subpoena duces tecum, or both, to
require the appearance of respondents and witnesses or the production of documents, or both
and to penalize for contempt persons obstructing, impeding or otherwise interfering with the
conduct of such proceedings, upon application with the regular courts;

j) Issue, suspend, revoke, or reinstate certificate of registration and special temporary permits for
the practice of nursing; and

k) Ensure performance of mandated duties and functions.

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 PRC, giving a detailed account of
its proceedings and the accomplishments during the year and recommending 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 PRC 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
4) Non-disclosure of conflict of interest.
ARTICLE III
EXAMINATION AND REGISTRATION

SEC. 16. Philippine Nurse Licensure Examination (PNLE). ~ In order to obtain certificate of
registration and professional identification card, 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 PRC.

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 PNLR. — At the time of the filing of application for the
PNLE, an applicant must be:

a) A holder of a BSN degree from an HEI that is compliant 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. Examination Professional Nurse Licensure and Registration Fees. - Applicants for the
PNLE and registration must pay the prescribed fees set by the PRC.

SEC. 20. Professional Nurse Licensure Examination Ratings. ~ To be considered as having passed the
PNLE, an examinee must pass 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 it
any further without first undertaking 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. ~ The certificate
of registration and professional identification card compliance with all shall be issued to all successful
examinees, upon the requirements for registration. The certificate of registration shall show the full
name of the registrant, certificate of registration number, and date of initial registration, The same
must be duly signed by the Chairperson and Members of the Board and the Chairperson of the PRC,
with their corresponding seals.


The professional identification card shall bear the full name of the registrant, the certificate of
registration number, date of initial registration, and date of the expiration, and which must be duly
signed by the Chairperson of the PRC. The professional identification card shall be renewed every
three (3) years upon satisfaction by the applicant of the requirements set by the PRC, including the
payment of the required fees and compliance with the Continuing Professional Development (CPD)
requirement.

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

SEC. 23. Registry of Nurses. - The PRC 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 PRC may become members preferably of the APO for nurses, 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 certificate of registration and
professional identification card 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 based on qualifications, and professional and moral standards as approved by the
Board and the PRC to the following persons:

a) Registered or 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 a
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 provide aid
during declared disasters and calamities.

b) Nursing graduates with 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 special temporary permit issued to registered and licensed nurses of foreign citizenship
shall be effective only for the duration of the project, health mission, or engagement, but which in no
case shall exceed one (I) year, subject to renewal. The special temporary permit issued to nursing
graduates with Philippine citizenship 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 PRC after the conduct of such
project, medical mission, engagement or contract. In the case of nurses of Philippine citizenship who
rendered services during an epidemic or national emergency, the completion report shall be submitted
by the registered murse authorized to supervise them.

The Board shall issue the corresponding guidelines in the issuance of the special temporary
permit pursuant to this Section.

10


SEC. 27. Non-Registration and Non-issuance of Certificate of Registration, Professional
Identification Card, Special 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
certificate of registration, professional identification card, or a special temporary permit.

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

SEC. 28, Revocation and Suspension of Certificate of Registration, Professional Identification Card,
Special Temporary Permit. - The Board shall have the power to reprimand a nurse or revoke or
suspend the certificate of registration, professional identification card, or special temporary permit,
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 and Ethical Standards for nurses, and other policies,
tules and regulations of the Board and the PRC;

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

4) Commission of fraud, non-disclosure of disqualification, or misrepresentation in obtaining a
certificate of registration, professional identification card, or special temporary permit;

©) 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

2) Other grounds analogous to the foregoing

If the penalty imposed is suspension or revocation of a nurse's license, the certificate of
registration and professional identification card issued to the respondent shall be surrendered to the
PRC.

SEC. 29. Reinstatement and Re-issuance of Revoked Certificate 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, 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. Scope of Nursing Practice. — The scope of nursing practice is the range of roles, functions,
responsibilities, and activities on which a registered nurse is educated, competent, and has authority to
perform. It includes nursing service, education, research, leadership, and governance as defined in this
Act. A person shall be deemed practicing the nursing profession 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-illness status, in any health care, industrial or community setting.
‘Additionally, nurses shall utilize the full extent of their education, training and experience and shall
perform work that requires their highest skill set.

Nurses are primarily responsible for the promotion of health and prevention of illness. 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- of-life care.

In performing independent and collaborative functions, it shall be the duty of the nurse to:

a) Provide nursing care through the conscientious observance of the nursing process and
established protocols. Basic nursing care is holistic care which includes, the provision of
physiological, 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 perinea; laceration and
immediate care of the newborn; performance of perioperative care covering before and
after surgery; provision of life-saving interventions during emergency and disasters;
palliative and end-of-life care;

b) Provide advanced nursing care based on the Career Progression Specialization Program
for Nursing (CPSPN) and the Philippine Qualifications Framework (PQF), a 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 PQF is competency-based,
labor-market driven and an assessment-based qualification recognition;

c) Establish linkages with community resources and coordination with the healthcare
workers 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 people living with a serious illness by providing relief from the
symptoms of pain and stress of illness;

¢) 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 consultation services and
private nursing practice;

2) 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 PPNPS as well as engage
in CPD and lifelong learning within the context of the CPSP;

12


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

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

k) Exercise the core competencies in the performance of their respective roles and
responsibilities, in accordance with the PPNPS.

SEC. 31. 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. A nurse may practice in special areas, such as a high dependency unit, critical care unit,
disaster areas, or in a special procedure or interventional area: Provided, That the nurse has acquired
relevant competencies.

a) General Practice Nursing refers to the role of a newly licensed nurse in the provision of safe,
holistic and to advocate quality care to individuals, families, population groups, or
communities, which include the assessment, planning, implementation and evaluation of
evidence-based care to the clients, A general practice nurse must have the following minimum
qualifications:

1. Must be a BSN graduate from an HEI recognized by the goverment;

2. Must have a valid certificate of registration and current professional identification card
as a nurse issued by the PRC;

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 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 government;

2. Must have a valid certificate of registration and current professional identification card
as a nurse issued by the PRC;

3. At least three (3) years of clinical experience in the area of specialization;

4. Must have received a CPD Council-Accredited specialty training from a Career
Progression and Specialization Council for Nurses 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

13


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

©) Advanced Practice Nursing refers to the specialized and expanded role of an Advanced
Practice Nurse (APN). It involves certification of nurses with higher degree of qualifications
by the Board and the PRC, thereby providing 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. It also refers to a
navigator, coordinator, and initial and continuing point of contact of the patient to ensure care
continuity during transitions of care. An APN must have at least a master’s degree in nursing
and must possess substantial specialty experience. An APN must be endorsed by specialty
organization based on the recommendation of the Career Progression and Specialization
Council for Nurses (CPSCN), and certified by the Professional Regulatory Board for nurses
and the PRC.

The scope of practice is Individual-based health services as defined in Republic Act
No. 11223, otherwise known as “The Universal Health Care Act.”

The APN is cligible to receive performance-driven, close-end, prospective payments
from the PhilHealth based on disease or diagnosis related groupings and validated costing
methodologies as described in R.A. No. 11223.

‘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 APN must have the following minimum qualifications:

1. A graduate with relevant master's degree from a goverment 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 APN shall have 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 healthcare facility;
2. Provide direct primary-care services to patients of all ages;

3. Diagnose diseases and injuries;

4, Provide continuum of care of disease conditions;

5. Provide promotive, preventive, rehabilitative and end-of-life care;

6. Exercise prescriptive authority;

7. Order and interpret laboratory and diagnostic tests;

14


8. Provide anesthetic care;

9. Refer patients to specialists, other health professionals, and institutions for
appropriate care; and

10, Initiate patient discharge

SEC. 32. Continuing Professional Development (CPD). — All nurses shall abide by the requirements,
rules and regulations on the CPD to be promulgated by the PRC, 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. 33. Requirement for Inactive Nurses Returning to Practice. ~ Inactive nurses intending to return
to practice must undergo a refresher course as prescribed by the Board. Nurses are considered to be
inactive under any of the following circumstances:

a) They have not utilized nursing competencies as defined in the scope of nursing practice for at
least five (5) consecutive years;

b) They have not renewed their professional identification card for five (5) years; or
c) They do not have proof of five (5) years of continuous nursing practice;

SEC. 34. Salary and Compensation. — Nurses shall, at all times, receive compensation that is just and
due them and commensurate to the level of education, training, experience and complexity of nursing
skill required for the services rendered. Nurses providing nursing services in both government and
private sectors, and who 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.

The minimum base pay of all nurses, whether they are working in the public sector, in private
healthcare facilities, in industrial or community settings shall not, upon entry, be lower than the rate
assigned to Salary Grade 15 (SG 15) in the government service.

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-government or private healthcare facilities, or both, institutions and industrial
establishments shall comply with the salary rate requirement in tranches within three (3) years from
the effectivity of this Act.

Subject to existing labor laws, outsourcing nursing work is acceptable under certain
circumstances to be provided in the rules and regulations to be issued to implement this Act.

SEC. 35. Incentives and Benefits. - The Board shall, in coordination with the DOH, other concerned
government and non-government institutions, association of hospitals and the APO for nurses,
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. 36. Non-Diminution of Benefits and Incentives. - The implementation of Sections 34 and 35 of
this Act shall not result in the diminution of existing grants of salaries, benefits and incentives for

nurses.

ARTICLE V

15


NURSING EDUCATION

SEC. 37. 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 a Graduate Program for Nursing Education pursuant to Republic Act No.
No. 7722, otherwise known as the “Higher Education Act of 1994”.

SEC. 38, Education Baccalaureate Program for Nursing. ~ The Baccalaureate Program for Nursing
Education refers to the basic nursing education program which is envisioned as a sound and liberal
professional education that will adequately equip nursing students with the necessary competencies for
entry level nursing practice.

Admission to the Bachelor of Science in Nursing Program requires passing the National
‘Nursing Admission Test (NNAT).

‘The curriculum and the Related Learning Experiences (RLE) of the Baccalaureate Program for
Nursing Education must be in accordance with the Policies, Standards and Guidelines.

SEC. 39. 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.

‘The Graduate Program for Nursing Education shall be offered only through accredited HEIs in
accordance with the prevailing policies, standards and guidelines of the CHED on the graduate
program for nursing education,

SEC. 40, Qualifications of the Dean, —

a) The Dean of the College of Nursing of a BSN program shall formulate policies and plans, in
collaboration with the school officials and stakeholders and must adhere to the prescribed
curriculum for the advancement of nursing education. The Dean must have the following
qualifications:

1. Bea Filipino citizen, physically and mentally fit, and with good moral character;

2. Be a holder of a valid certificate of registration and a current professional identification
card issued by the PRC;

3. Be a holder of a Master's Degree in Nursing conferred by an HEI duly recognized by the
government;

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

5. Preferably be a member of the organization of Deans duly recognized by the Board;
6. Not hold a concurrent Dean position in another HEI and no other teaching assignments or
administrative functions in other public/private institution or higher education institution;

and

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

16


b)

‘The Dean or administrator of the academic unit shall be a holder of a doctorate 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. —

a)

b)

For the Baccalaureate Program in Nursing Education. A member of the faculty teaching in an

undergraduate program must possess the following qualifications:

1. Bea 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 a
master’s degree in health-related programs for teaching non-professional nursing subjects
conferred by a duly recognized HEI;

4, Be a holder of a valid certificate of registration and a current professional identification
card as a nurse issued by the PRC;

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.

For the Graduate In-Nursing Education. A member of the faculty teaching in post-graduate
program must possess the following qualifications:

1, Be a Filipino citizen, physically and mentally fit, and with good moral character;
2. Bea BSN degree holder;

3. Bea holder preferably of a Doctorate Degree in Nursing or allied field conferred by a duly
recognized HEI;

4. Bea holder of a valid and current certificate of registration and professional identification
card as a nurse issued by the PRC;

5. Have at least three (3) years clinical experience in any nursing practice setting;
6. Have published works in refereed Nursing or health-related journals; and

7. Preferably be a member of an accredited integrated professional nursing organization of
‘good standing and of a specialty nursing organization.

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. It
includes the provision of general nursing services, specialized, and advanced practice of nursing,

7


including nursing management in various health, industry, or community settings where the
competencies of a nurse are required.

SEC. 44. 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; maternal 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. 45. Public Health Nurse (PHN). ~ Public Health Nurses participate in the delivery of essential
health care services as described in Sec. 44. 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 treating
common diseases. A PHN may progress to become a Public Health Nurse Specialist (PHNS) after
obtaining specialty training focused on public health-based programs and substantial experience in
‘managing public health conditions.

A PHNS may progress to become an APN in public health after obtaining advanced nursing
education either through a master’s or doctoral degree with emphasis on public health sciences, or their
equivalencies as promulgated by the CHED, and as defined in Section 31 of this Act.

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 and 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 responses; monitoring population health status and evaluating
‘outcomes. Indirect care consists of engaging in policy change, education and training of
public health nurse practitioners in interdisciplinary research, and acting as consultants to
policy makers; and

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

SEC. 46. The Chief Nursing Officer (CNO) and the National Chief Nursing Officer. ~ There shall be a
nursing service office in every healthcare institution and in all levels and classifications of these
institutions, whether administrative or clinical, with a complement of 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,

Within the framework of health care delivery, nursing services in private and public
institutions or community settings must be led and managed by a CNO, or the equivalent of Chief
Nurse (CN) or Director of Nursing. The CNO shall be bestowed full administrative responsibility as
Teader 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.

18


There shall also be a National Chief Nursing Officer (NCNO) in the DOH who shall oversee
and coordinate national nursing personnel utilization nurses' welfare, the observance of decent work
standards in all healthcare facilities and institutions, and the adaptation of nursing care development
trends in nursing education and practice in both the public and private sectors.

The NCNO, being the highest-ranking nursing official in the DOH, 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 datal 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. Further, the NCNO
shall serve a term of three (3) years, subject to renewal

ACNO and NCNO must possess the qualifications as prescribed under the Policies, Standards
and Guidelines to be promulgated by the Board.

The CNO must have the following minimum qualifications:
1. Be a registered nurse in the Philippines;

2. Bea holder of a Master's degree in Nursing conferred by an HEI duly recognized by the
‘government;

3. Be a holder of a valid certificate of registration and a current professional identification
card as nurse issued by the PRC; and

4. Have at least five (5) years of experience in general nursing service administration with
experience in policy development;

5. Preferably be a member of good standing of the APO of nurses; and

6. Preferably be a member of the organization of nursing service administrators duly
recognized by the Board.

‘The NCNO must have the following minimum qualifications:
1, Be a registered nurse in the Philippines;
2. Have a degree of Bachelor of Science in Nursing;

3. Be aholder of a Doctorate degree conferred by an HEI duly recognized by the government
in a relevant healthcare and business administration field;

4, Be holder of a valid certificate of registration and a current professional identification card
as a nurse issued by the PRC;

5, Must have the necessary Career Executive Service Officer (CESO) rank;

6. Have at least five (5) years of experience in general nursing service administration with
experience in policy development;


7. Preferably be a member of good standing of the APO of nurses; and

8. Preferably be a member of the organization of nursing service administrators duly
recognized by the Board.

ATICLE 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, such as:

a)

b)

4)

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;

Information and knowledge management and communication technology;

Regulation of nursing standards, competencies and the process of credentialling; and

Socio-economic welfare for nurses like occupational health and safety, human resources
planning and policy, remuneration, career development.

ARTICLE VIL

NURSING LEADERSHIP AND GOVERNANCE

SEC. 48. Nursing Leadership and Governance. - Nursing leadership and governance involve 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. To accomplish this, nursing services
must be managed by competent nursing personnel.

Nursing service management refers to the management and administration of nursing services

by nurses who must be equipped with the following necessary competencies on governance and
leadership:

a) A First Level Service Manager is responsible for the management of a nursing unit and
supervision of nursing support personnel including, Caregivers, Healthcare Dialysis
Technicians, Medication Technicians, Orderlies, Orthopedics Technicians, Patient Care
Technicians, Sitters, Surgical Technicians, and Ward Clerks of Secretaries.

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

©) An Executive Level Service Manager iS responsible for establishing the strategic direction
for the entire nursing division, and the development and implementation of policies,
standards and guidelines in nursing services.

Nursing Service Managers shall have the following minimum qualifications:

a) Fora first level managerial position in nursing:

20


1, Completion of at least eighteen (18) units of nursing management and clinical subjects
in a Master of Arts Degree Program in Nursing or Master of Science in Nursing
Degree Program, with at least three (3) years of clinical work experience, and

2. Participation in at least one (1) research project related to the improvement of the
quality of care.

b) Fora middle level managerial position in nursing:

1, Completion of all the academic requirements of a Master of Arts in Nursing Degree
Program or Master of Science in Nursing Degree Program;

2. At least three (3) years of clinical work and two (2) years of management experience,
and

3. Conduct of at least one (1) research project related to the improvement of the quality
of care.

©) Foran executive position in nursing:
1. A post-graduate degree in nursing or health management-related sciences,
2. Atleast three (3) years of clinical work and three (3) years of management experience,

3. Conduct of at least two (2) research projects related to the improvement of quality of
health care.

ARTICLE IX
NURSING HUMAN RESOURCE FOR HEALTH MANAGEMENT SYSTEM.

SEC. 49. 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, and 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.

Healthcare 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 structures to support competency development, career and
professional growth, and promote job delight which is a state of mental and emotional satisfaction over
‘one's productivity, conditions at work, and job fulfilment.

It shall be mandatory for each healthcare facility to employ an evidence-based human
resources for health (HRH) assessment tool for nursing workload and workload pressure, preferably
the World Health Organization Workload Indicators for Staffing Needs, to determine annually
minimum safe staffing needs for registered nurses and nursing personnel. 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 for a healthcare facility to be granted continued permission to operate the
facility. The facility must use this assessment to plan and provide a budget for regular and plantilla
positions to ensure that safe and quality care is provided by the institution.

SEC. 50. Nursing Staff Complement, - The Board shall, in consultation with the DOH and other

stakeholders, ensure the provision of a safe nursing workforce for any healthcare setting guided by the
following principles:

a


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

b) Regular review and updating of staffing based on up-to-date evidence and best nursing
practices within healthcare facility, and nurse, nurse-sensitive patient, organizational and
system outcomes;

©) Non-substitution of nurses by other healthcare professionals in performing nursing functions;
d)_Non-delegation of nurses in management positions to augment staff limitations;
©) Respect for nurses’ professional judgment in determining the required safe workforce staffing;

f) Active involvement of direct care nursing staff and nursing management in all stages and
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.

h) The nursing workforce complement is designed to ensure patient safety, quality service
delivery, and the maintenance of a positive practice environment that promotes economic
welfare, professional autonomy, job satisfaction and retention, and ensures safe staffing,
managerial support, professional development, occupational safety and psychological health
and patient and nurse safety.

The appropriate number of nurses must be available at all times across the continuum of care, and
a suitable mix of education, skills, and experiences must be maintained to ensure that patient care
needs are met and the working environment is kept safe and conducive to optimal performance of
support staff.

The maximum number of patients cared for by each nurse assigned in a healthcare facility,
setting, or unit shall bel determined by the ratio of staff nurse-to-patient in a general nursing service, or
in the case of a 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 ten (10). Thus, the minimum safe staffing ratio standard for general units is 1:10 or
‘one nurse for every ten patients. However, this staff-to-patient 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.

‘A nurse may invoke the process of safe harbour for protection against employer retaliation,
suspension, termination, discipline, discrimination, licensure sanction when asked to accept an unsafe
assignment in activities beyond the scope of the nursing practice, or in an unprofessional and illegal
act. In this case, the nurse shall submit a written notification to the supervisor who requested the
conduct of such unsafe, unprofessional or illegal assignment invoking safe harbor. If a nurse is unable
to submit such written notification due to patient care needs, the nurse may orally invoke it, and the
supervisor must record the record the request in writing.

22


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

In the community, there shall be a nurse in every barangay health center, primary, secondary, and
tertiary school, and industrial establishment, subject to the applicable staffing ratio by the appropriate
government agency.

SEC. 2. Return Service Agreement. ~ All nursing graduates 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) years, with compensation, and under the supervision of the DOH: Provided, That those who will
serve for an additional two (2) years shall be provided with additional incentives as determined by the
DOH. Graduates of nursing from state universities and colleges and private schools shall be
encouraged to serve in these areas.

ARTICLE X
PROHIBITED ACTS AND PENAL PROVISIONS
SEC. 52. The following acts are prohibited:
a) Practicing the nursing profession without a certificate of registration, professional
identification card, special temporary permit or without having declared exempted from taking

the licensure examination in accordance with this Act;

b) Using the certificate of registration, professional identification card, or special temporary
permit of another registered nurse;

©) Using fraudulent, suspicious, or an expired suspended or revoked certificate of registration,
professional identification card, or special temporary permit;

d) Misrepresenting one's self or proffering false evidence to obtain a certificate of registration,
professional identification card or special temporary permit;

e) Falsely advertises one's self through any means to convey the impression that one is a nurse;

£ Appending to one's name the abbreviations “B.S.N” “R.N” or “APN” for Bachelor of Science
in Nursing, Registered Nurse and Advance Practice Nurse, respectively, without having been
conferred the corresponding degree, registration, or certification by the PRC;

g) Abetting or assisting in the illegal practice of the nursing profession through the following acts
and entities:

1, An HEI offering the BSN program which 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;

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

3. Any natural or juridical person or health facility that abets and promotes precarious
working conditions for nurses, such as the following:

23


ii,

iii,

iv.

vi.

vii.

viii.

ix.

xi,

Contracting or availing of the services of a nurse but provides compensation
below the rate prescribed under this Act, whether or not under the pretext of a
training development program, certification, or course, or seminar;

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

Collecting any fee from a nurse or from any person or agent in exchange for a
nurse's voluntary services in a health, industrial or similar facility or institution;

Requiring or obliging a volunteer nurse to perform regular work functions or 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 their
volunteer services, or to be the sole nurse on duty, except during disasters,
calamities, public emergencies and war;

Contracting or availing of the services of a volunteer nurse, under the pretext of
On-The-Job Training, contract of service, or job orders, in order to fill-up a vacant
position that requires the hiring of a fulltime 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;

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;

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

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

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

Imposing mandatory overtime service without valid reason or corresponding
compensation, as mandated by law; and

Non-compliance with the minimum safe staffing requirement mandated in Sec.
50.

h) Any violation of the provisions of this Act or any existing laws such as the Labor Code of the
Philippines and the civil service laws.

SEC. 53. Sanctions. — fine of not less than One hundred thousand pesos (Php 100,000.00) nor more
than Three hundred thousand pesos (Php300,000.00) 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 52 (a) of this Act.

‘A fine of not ess than Three hundred thousand pesos (Php300,000.00) nor more than Five
hundred thousand pesos (Php500,000.00) or imprisonment of not less than one (1) year or more than
six (6) years, or both, shall be imposed, at the discretion of the court, for the commission of any of the

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prohibited acts enumerated in Section 52(b), (¢), (d) and (e) hereof. In addition, the court may, at its
discretion, order the suspension or revocation of the license to operate of the erring healthcare facility,
institution, or industrial establishment In case the violation is committed by a partnership, corporation,
association, or any other juridical person, the managing partner, president, managing director/s, or
officer who has committed or consented to such violation shall be held directly liable and responsible
for the acts as principal, or co-principal with the other participants, if any.

SEC. 54. Refund and Compensation. — Any nurse found to have been a victim under Section 53 (e)
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 without prejudice to
other reliefs that may be claimed under applicable laws.

ARTICLE XI
MISCELLANEOUS PROVISIONS

SEC. 55. 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),
shall be responsible for the implementation and monitoring of the compliance with the provisions of
this Act.

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

The DOLE shall pe 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, the DOLE shall create a separate category for health workers befitting the importance and
complexity of the work performed by nurses and other healthcare professionals.

The PRC and the Board shall be the designated agencies responsible 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 shall be the agency responsible for monitoring the compliance with and
implementation of the provisions of this Act by HEIs with regard to nursing education programs and
curriculum.

SEC. 56. Funding for the Advance Practice Nurse (APN) Training. — The participating government
hospitals and institutions shall include their budgets the annual financial requirement needed to train at
least ten percent (10 %) of their nursing staff: Provided however, That non-government hospitals and
institutions shall support the training requirements of their nursing staff employed by them. Nothing in
this provision shall prevent, diminish or otherwise revoke existing company policies that are more
favorable to the employee.

SEC. 57. Appropriations. ~ The Chairperson of the Professional Regulation Commission and the
Secretary of the Department of Health shall immediately include in their program the implementation
of this Act, the funding of which shall be included in the annual General Appropriations Act.

SEC. 58. Implementing Rules and Regulations. ~ Within ninety (90) after the effectivity of this Act,
the PRC and the Board shall, in consultation with the APO for nurses, CSC, DBM, DOH and other
‘concerned nursing organizations and government agencies formulate the implementing rules and
regulations (IRR) necessary to carry out the provisions of this Act.

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SEC. 59. Separability Clause. — If any provision of this Act is held unconstitutional or invalid, all
other provisions not affected thereby shall remain valid.

SEC. 60. 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.

SEC. 61. Effectivity. ~ This Act shall take effect fifteen (15) days after its publication in the Official
Gazette or in a newspaper of general circulation.

Approved,

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