Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

NINETEENTH CONGRESS
First Regular Session

House Bill No.__ 1590.

Introduced by
HON. YEDDA MARIE K. ROMUALDEZ
and
HON. JUDE A. ACIDRE

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

EXPLANATORY NOTE

This bill seeks to institute reforms to further protect and develop the nursing
profession, repealing for the purpose Republic Act No. 9173 (R.A. No. 9173),
otherwise known as the “Philippine Nursing Act of 2002.” R.A. No. 9173 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.

The bill provides for the scope and practice of nursing to include certification,
specialization, and educational requirements; expansion of the powers of the Board of
Nursing to strengthen its role in decision-making processes concerning the nursing
practice; and, enumeration of educational requirements for different levels of nursing

practice to ensure competitiveness.


The bill also addresses the increasing number of Filipino health workers going
to other countries by strengthening the nursing profession in the country and
institutionalizing a better practice environment by providing better working conditions,

competitive salary, and proper recognition.

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

Rep. YEDDA MARIE K. ROMUALDEZ
Representative/Tingog Sinirangan

Rep. JUDEA. ACIDRE
Representative, Tingog Sinirangan


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

NINETEENTH CONGRESS
First Regular Session

House Bill No.__ 1590

Ss

Introduced by
HON. YEDDA MARIE K. ROMUALDEZ
and
HON. JUDE A. ACIDRE

—_—

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 |
GENERAL PROVISIONS
Section 1. Title. This Act shall be known as the “New Philippine Nursing
Practice Act”.

Section 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 health care 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 health
care 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.

Section 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);
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 promulgated under Memorandum Order No. 15, series of 2017,
on the Policies, Standards and Guidelines for the 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 PRC to develop standards of practice for each
nursing-level standards, establish mechanisms and criteria for credentialing
of specialty organizations and interest groups, and issue certification of
individuals at different levels of Post Baccalaureate nursing and advanced
practice, for recommendation to the Board;

d) 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

b)

©)

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 Advanced Practice Nurse (APN) upon completion of a
specialty program or Continuing Professional Development (CPD) program,

2


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hy

k)

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 also 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 CPSCN, after complying with the policies, standards
and guidelines issued by the Board;

Decent Work refers to aspirations by people in their working lives. Itinvolves
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, psychiatric or other
medical and nursing care, and includes hospitals, barangay health centers,
and other clinics;


™m) 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;

0) Nurse refers to a person duly registered and licensed to practice the nursing

profession, with all the rights and privileges appurtenant thereto;

n)

P) Nursing care refers to the physiological, psychological, spiritual, social and
emotional care, essential healthcare, safety and comfort measures, and
health teachings; execution of healthcare 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)
Tefers 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, healthcare 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

q

t)

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;

s) 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;

t) Patient Acuity refers to the intensity of care provided to a patient by a

4


registered nurse, or 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;
u) 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

v)

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;
w) 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 and instability in
one's employment status, such as when there is a threat of change or

x)

y)

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 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 healthcare providers in the healthcare
delivery system, when necessary;


aa)Public Health Institution (PHI) 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 It
BOARD OF NURSING

Section 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.


Section 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.

Section 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 professionalism
identification card;

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

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

d) Good moral character as evidenced for not having evicted of any
offense involving moral turpitude; and,

e) Physical and mental fitness.

Section 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.


Section 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 or
qualified.

Section 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.

Section 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.

Section 11. Limited Practice of the Profession. During their incumbency, the
Members of the Board may be allowed to practice their profession or maintain their
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.

Section 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.

Section 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


b)

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d)

e)

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of the PNLE is encouraged to enhance efficiency while upholding
integrity;

Enforce and monitor safe and quality standards of nursing practice,
study the conditions affecting nursing practicing 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 are properly complied with and ‘systemically
updated in accordance with the latest development in healthcare;
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 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;

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

Spearhead and oversee the Philippine Profession Nursing
Roadmap;

Conduct hearings and investigations to resolve complaints against
nurses for unethical or unprofessional conduct of any violation of this
Act, or its rules and regulations, and in connection therewith, issue
subpoena ad testificandum or subpoena duces tecum, 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.

Section 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.

Section 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;
C) Unprofessional, immoral, or dishonorable conduct; or,

d) Non-disclosure of conflict of interest.

ARTICLE Ill
EXAMINATION AND REGISTRATION

Section 16. Philippine Nurse Licensure Examination (PNLE). In order to
obtain a 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.

Section 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.


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

a) A holder of a BSN degree from an HE! 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 deciared 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.

Section 19. Professional Nurse Licensure Examination and Registration
Fees. Applicants for the PNLE and registration must pay the prescribed fees set by
the PRC.

Section 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.

Section 21. Issuance of Certificate of Registration and Professional
Identification Card. The certificate of registration and professional identification card
Shall be issued to all successful examinees, upon compliance with all 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.

Section 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.

Section 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.

Section 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.

Section 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
as the subjects or citizens of said country or State.

ino nurses to practice within its territorial limits on the same basis

Section 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

12


b)

Section
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

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
HEIs 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.

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 (1) 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 nurse authorized to
supervise them.

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

27. Non-Registration and Non-issuance of 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.

13


Section 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 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, rules and regulations of the Board and the
PRC;

¢) Negligence, misconduct, or incompetence in the nursing practice

resulting to injury, harm, disability, or death;
Commission of fraud, non-disclosure of disqualification, or
misrepresentation in obtaining a certificate of registration,

d)

professional identification card, or special temporary unit;

e) 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.

Section 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


Section 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-ilness
Status, in any healthcare, 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 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 healthcare, the application of
traditional, complementary, and innovative approaches, the
therapeutic use of self-rendering healthcare 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
periportal 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

15


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;

©)

Establish linkages with community resources and coordination with
the healthcare workers in any healthcare, industrial or community
setting;

d) 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

ing with a serious illness by providing relief from the symptoms of
pain and stress of illness;

e) 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;

Supervise nursing and ancillary nursing personnel in the delivery of

safe and quality healthcare services in varied settings;

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;

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;

9)

h)


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.

Section 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

government;

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.
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”.

b)


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,

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 healthcare 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 a 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.

18


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

The APN is eligible 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
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 APN shall have 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 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;

8. Provide anesthetic care;


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

10. Initiate patient discharge.

Section 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.

Section 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:

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

2. They have not renewed their professional identification card for five
(5) years; or,

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

Section 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.

20


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.

Section 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.

Section 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
NURSING EDUCATION

Section 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”.

Section 38. Baccalaureate Program for Nursing Education. 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.

21


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

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

Section 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.

Section 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 HE! 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

22


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.

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
referred journals in one of the disciplines under the academic unit.

Section 41. Qualifications of the Faculty.

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

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

2. Be a BSN degree holder;

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

23


4. Be aholder of a valid and current certificate of registration and
accurrent professional identification card as a nurse issued by
the PRC;

5. Have atleast three (3) years clinical experience in any nursing
practice setting;

6. Have published works in referred 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.

Section 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

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

Section 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 healthcare
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.

24


Section 45. Public Health Nurse (PHN). Public Health Nurses participate in
the delivery of essential healthcare services as described in Section 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,

Exercising collaborative leadership and political skills for successful
population outcomes.

°)

Section 46. The Chief Nursing Officer (CNO) and the National Chief
Nursing Officer (NCNO). 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.

25


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 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.

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 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. Further, the NCNO shall serve a term of three
(3) years, subject to renewal.

A CNO 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:

a) Be a registered nurse in the Philippines;
b) Be a holder of a Master's degree in Nursing conferred by an HEI duly
recognized by the government;

26


°)

Be a holder of a valid certificate of registration and a current

professional identification card as a nurse issued by the PRC;

Have at least five (5) years of experience in general nursing service

administration with experience in policy development;

Preferably be a member of good standing of the APO of nurses; and,
f) Preferably be a member of the organization of nursing service

administrators duly recognized by the Board.
The NCNO must have the following minimum qualifications:

d

e)

a) Be a registered nurse in the Philippines;

b) Have a degree of BSN;

c) Be a holder of a Doctorate degree conferred by an HEI duly
recognized by the government in a relevant healthcare and business
administration field;

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

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

f) Have at least five (5) years of experience in general nursing service

d)

e)

administration with experience in policy development;

Preferably be a member of good standing of the APO of nurses; and
Preferably be a member of the organization of nursing service
administrators duly recognized by the Board.

9)
h)

27


ARTICLE Vil
NURSING RESEARCH, POLICY DEVELOPMENT, AND PLANNING

Section 47. Nursing Research and Policy Development. Nursing Research
and Policy Development shall involve the study of nurse-related issues, such as:

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) Regulation of nursing standards, competencies and the process of
credentialing; and,

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

ARTICLE Vill
NURSING LEADERSHIP AND GOVERNANCE

Section 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 or
Secretaries.

b) A Middle Level Service Manager is responsible for the leadership and
governance of more than one (1) nursing unit, particularly them

28


management of operational systems, financial resources, and
human resources.

c) 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:
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) For a 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.
c) For an executive position in nursing:
1. A post-graduate degree in nursing or health
management-related sciences;
2. At least three (3) years of clinical work and three (3)
years of management experience; and,
3. Conduct of at least two (2) research projects related to
the improvement of quality of healthcare.

ARTICLE IX
NURSING HUMAN RESOURCE FOR HEALTH MANAGEMENT SYSTEM

29


Section 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.

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.

Section 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) 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

30


nurse, nurse-sensitive patient, organizational and system outcomes;
c) Non-substitution of nurses by other healthcare professionals in
performing nursing functions;
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;
Timely adjustments to nurse staffing based on changes in patients
and population healthcare needs; and,

d)

e)

g

1)

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 be 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-

31


compliance shall be referred to the Board for action.

Anurse 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.

‘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.

Section 51. 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

Section 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,

32


°)

d)

e)

9)

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;

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

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;
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:

i, 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;
ii. 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

33


vi.

vii.

vill.

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 acquired 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

34


mandated by law; and
xi. 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.

Section 53. Sanctions. - A 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 less 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 prohibited acts enumerated in Section
52(b), (c), (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
as co-principal with the other participants, if any.

Section 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
Section 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

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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 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, 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 HEls with regard to nursing
education programs and curriculum.

Section 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.

Section 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.

Section 58. Implementing Rules and Regulations. - Within ninety days (90)
after the effectivity of this Act, the PRC and the Board shall, in consultation with the

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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.

Section 59. Separability Clause. - Should any provision of this Act be declared
unconstitutional, the remaining parts not affected thereby shall remain valid and
operational.

Section 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.

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

Approved,

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