Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

TWENTIETH (20°) CONGRESS.
First Regular Session

HOUSE BILL NO. 2644

Introduced by KAMANGGAGAWA Partylist
Representative ELIJAH R. SAN FERNANDO

EXPLANATORY NOTE

Nurses play a vital role in delivering essential health services, forming the
backbone of the healthcare system in both the public and private sectors. Despite their
contributions, many nurses face systemic challenges, including inadequate
compensation, poor working conditions, limited career growth, and understaffing, which
undermine their welfare and professional dignity.

The current legal framework, Republic Act No. 9173 or the Philippine Nursing Act
of 2002, while landmark at the time of its passage, is no longer fully responsive to the
evolving needs of nurses and the country’s broader healthcare system. Significant
changes in global health standards, migration trends, local workforce demands, and the
realities exposed by the COVID-19 pandemic highlight the urgent need to update and
strengthen existing nursing legislation.

This proposed measure seeks to address the longstanding gaps in the professional,
economic, and social welfare of Filipino nurses by institutionalizing fair compensation,
decent work standards, just compensation in private institutions, access to benefits and

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social protection mechanisms, and ensuring adequate staffing in both public and private
health facilities through legally mandated nurse-to-patient ratios.

Additionally, this bill strengthens the regulatory functions of the Professional
Regulatory Board of Nursing to ensure high standards of nursing education, licensure,

and practice.

It also encourages local retention and reintegration of nurses by promoting decent
employment opportunities in the Philippines, establishing nursing practice as a critical
pillar of national health care delivery in public health, research, community development,
and health education.

This measure was previously filed in the 16th Congress, and was duly approved
by the House of Representatives on Third Reading on February 1, 2016.

In solidarity with the working class, the passage of this bill is earnestly sought.

EL, /AN FERNANDO
Repre fve
KAMANGGAGAWA PaRrrVList

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Republic of the Philippines
HOUSE OF REPRESENTATIVES,
Quezon City

TWENTIETH (207) CONGRESS
First Regular Session

HOUSE BILL NO. 2644

Introduced by KAMANGGAGAWA Partylist
Representative ELIJAH R. SAN FERNANDO

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

Beit enacted by the Senate and House of Representatives of the Philippines in Congress assembled:

Article I
GENERAL PROVISIONS,

SECTION 1. Short Title. - This Act shall be known as the “Comprehensive Nursing Law
of 2025.”

SEC. 2. Declaration of Policy. ~ It is hereby declared the policy of the State to uphold the
dignity of the nurses and assume responsibility for the protection, respect, and
improvement of the nursing profession by instituting measures that will ensure the
adaption of just and humane conditions of work, and the promotion of professional
growth. Thus, the State recognizes nurses as prime movers of national development and

contributors to international cooperation and understanding.

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The state further guarantees the delivery of accessible, affordable, and available
quality health care to all the people through the establishment of an adequate and
dynamic Nursing Personnel System (NPS) in the country.

SEC. 3. Defiition of Terms. - As used in this Act:

(a) “Accredited Professional Organization (APO)” refers to the duly integrated
and accredited professional organization of registered and licensed nurses as
per Republic Act No. 8981 or the “PRC Modernization Act of 2000";

(b) “Advanced Practice Nurse (APN)" refers to a nurse who acquired substantial
theoretical knowledge and decision-making skills in a specialty area of
nursing practice and proficient clinical utilization of this knowledge in
implementing independent and interdependent nursing interventions.
Specialties can be differentiated according to function, disease, pathology,
systems, age, gender, acuity, setting, technology, and therapies. An APN must
be given credentials certification by the Board. An APN must be a master’s

degree in nursing;

() “Bachelor of Science in Nursing (BSN)” refers to the basic program for nursing

education;

(d) “Certification/Credentialing” refers to the process undertaken by an
individual nurse to be recognized to practice in a specifically defined
profession such as General Nursing, Nursing Specialty / Advanced Practice,
Nursing Education, and Leadership and Governance. The Professional
Regulatory Board of Nursing confers the certification or credential after a

validation process based on promulgated guidelines and mechanisms;

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(c) “Health Facility” refers to an institution, establishment, or clinic that offers
health services and nursing care, such as a hospital, barangay health center,

and clinic;

() “Nurse” refers to a person who passed the Philippine Nurse Licensure Exams
(PNLE) and whose license has not been revoked by the law. It pertains to a
Registered Nurse (RN) who may be append before one’s name the title

“Nurse”, “Nars”, or “Nrs.” or the initials “RN” after one’s name;

(g) “Nursing Personnel System (NPS)” refers to the system of human resource
management that classifies the structure, organization, and coordination
within the workforce both in private and public health care facilities and
nursing educational institutions designed to advance the welfare and protect
the rights of the nurses, enhance the employer-employee relationship, ensure
security of tenure, just compensation, humane conditions of work, and

professional growth;

(h) “Philippine Nurse Licensure Exams (PNLE)” refers to a written examination
given by the Philippine Regulatory Board of Nursing in order to obtain license

to practice nursing;

(i) “Precarious Work” refers to substandard employment conditions such as
underpayment, absence of salary, no security of tenure, lack of employer-
employee relationship, inadequate or no work benefits, poor working
conditions; deviation from the standard employment relationship such as in
contractual hiring, false volunteerism, job orders through agencies; part-time,
temporary, on call, or self-employment; fixed term work, home worker, call

center jobs; lack of collective bargaining representation; and no job security;

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() “Public Health Institution (PHI)” refers to any governmentled, or
government-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 Health Care Delivery System (HCDS - national to local) which
include, among others: rural health units (RHUs/barangay health centers);
research facilities such as the Research Institute for Tropical Medicine, training
resource facilities as the U.P. College of Public Health and state or local
colleges or universities offering health-related programs; the Department of
Health and all retained health facilities;

(k) “Special Permit” refers to the permit to practice nursing in the Philippines
issued by the Professional Regulatory Board of Nursing to licensed nurses of
foreign nationalities; and

() “Temporary Permit” refers to the permit to practice nursing in the Philippines
issued to a Filipino nurse, who does not have a professional license from the
Philippines or has not renewed the license for five (5) years, but is licensed to

practice in a foreign country; and as provided under Section 23 hereof.

Article II
BOARD OF NURSING

SEC. 4. Creation and Composition of the Board. - There shall be created a Professional
Regulatory Board of Nursing, herein referred to as the Board, composed of seven (7)
members who shall elect from among themselves a Chairperson to serve for one (1) term,
without reelection. The President of the Republic of the Philippines shall appoint the
members of the Board from among those recommended by the Professional Regulation
Commission (PRC) established under Republic Act No. 8981 and ranked from a list of

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three (3) nominees, for each vacancy, of the APO of nurses in the Philippines and who
possess the qualifications for the position as provided for in this Act. The membership of

the Board shall comprise the scope of nursing practice.

SEC. 5. Qualifications of the Members of the Board, - A member of the Board must possess
the following qualifications:

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

consecutive years;

(b) Must be a Registered Nurse in the Philippines and a holder of a valid and updated

certificate of registration and a current professional identification card;

(©) Must have been conferred a master’s degree in nursing and, preferably, a doctorate
degree from a university duly recognized by the government;

(d) Must have continuously practiced the nursing profession for at least ten (10) years
prior to appointment: Provided, however, that the last five (5) years of practice
must have been performed in the Philippines; and

(€) Must be of good moral character and must not have been convicted of any offense

involving moral turpitude.

SEC. 6. Prohibition as Member of the Board. - A member of the Board shall not hold a
position nor have pecuniary interest in any educational institution offering BSN program,
review or training center for PNLE, or any training hospital or health facility with nursing

affiliates.

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

years.

SEC. 8. Vacancy. - Any vacancy in the Board that arises after its institution must be filled
in the manner prescribed in this Act and the member thus elected shall serve only the
unexpired portion of the term. A member of the Board shall take the proper oath of office

prior to the performance of duties.

SEC. 9. Compensation. - The members of the Board shall receive compensation and
allowances comparable to the compensation and allowances received by the members of

other regulatory boards.

SEC. 10. 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, and administrative and
other investigative cases conducted by the Board must be under the custody of the PRC
which shall designate the Secretary of the Board and shall provide the secretariat and

other support services to implement the provisions of this Act.

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

functions:

(a) Ensure the proper conduct of the PNLE, which includes the application, test
development, examination, correction and release of results. The use of
appropriate technologies and modalities during the conduct of the PNLE is

encouraged to enhance efficiency while upholding integrity;

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(b) Issue, suspend, revoke or reissue certificates of registration for the practice of

nursing and ensure the widest publication through electronic and written media;

() Enforce and monitor safe and quality standards of nursing practice, study the
conditions affecting the nursing practice in the Philippines, and exercise the
powers necessary to ensure the maintenance of efficient, ethico-moral, technical,
and professional standards in the practice of nursing towards the optimal health

and common good of the nation;

(d) Ensure quality nursing education by examining and monitoring higher
educational institutions offering and seeking permission to open nursing
education programs and to ensure that standards of nursing education are
properly complied with and maintained at all times: Provided, that the Board and
the Commission on Higher Education (CHED) shall have joint authority to open

and close nursing education programs offered by higher educational institutions;

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

() Promulgate a Code of Ethics that is responsive to the needs of the nursing

profession in coordination with the APO of nurses, within a year from the

effectivity of this Act;

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

(h) Ensure the performance of mandated duties and functions with the provision of
operational resources including human, financial, and spatial resources to ensure
the confidentiality and sanctity of functions as provided through the annual
budget of the PRC as promulgated in the General Appropriations Act;

(

Source and utilize funds earmarked for national nursing development;

0

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

(k) Create a council for nursing recognition, accreditation and certification that will

assist the Board in:

(1) Recognizing organized nursing groups;

(2) Setting standards for advanced nursing practice, education, research, and
management;

(3) Accrediting specialty and advanced nursing programs based on established

mechanisms;

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(4) Credentialing individual registered nurse based on accepted criteria; and

(3) Monitoring and evaluating specialty and advanced nursing practice,
education,

research, and management.

SEC. 12. Annual Report. - The Board shall, at the close of each calendar year, submit an
annual report to the President and Congress of the Philippines, through the PRC,
rendering a detailed account of its proceedings and accomplishments during the year and
submitting recommendations on measures that have to be undertaken to upgrade and

improve the practice of the nursing profession.

SEC. 13. Removal or Suspension of Board Members. - The President may remove or suspend

any member of the Board, after due process, on the following grounds:

(a) Continued neglect of duty or incompetence;

(b) Commission or toleration of irregularities in the PNLE; and

(©) Unprofessional, immoral, or dishonorable conduct.

Article II
EXAMINATION AND REGISTRATION

SEC. 14. Philippine Nurse Licensure Examination (PNLE). - In order to obtain a certificate
of registration, professional license, and professional identification card, all nursing
graduates must take and pass the PNLE. The Board shall administer the PNLE in such
place and date as designated by the PRC: Provided, that no nursing educational

institution may withhold any requirement or document, or both, of any nursing graduate

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for the purpose of preventing them to apply for the PNLE. All nursing educational
institutions must ensure that their nursing graduates will take the nearest scheduled
PNLE after graduation. Any delay in taking the PNLE must be accordingly justified by
the President, Registrar or Dean of the educational institution through a public

instrument.

SEC. 15. Scope of Examination. - The Board shall determine the scope of the PNLE by
taking into consideration the nursing core competencies, the nursing curriculum, the

scope and areas of nursing practice, and other related disciplines.

SEC. 16. Qualifications for Admission to the PNLE. - In order to be admitted to the PNLE,
an applicant:

(a) Must have been conferred a Bachelor of Science in Nursing degree by a recognized
educational institution that is duly recognized by the CHED as compliant with the

standards of nursing education;

(b) Must be of good moral character and must not have been convicted, by final
judgment, of any criminal offense involving moral turpitude, or is not guilty of
immoral or dishonorable conduct, or declared by the court to be of unsound mind;

and

(©) Must be a citizen of the Philippines, or a citizen or subject of a country which
permits Filipino nurses to practice within its territorial limits on the same basis as
the subject or citizen of such country: Provided, that the requirements for the
registration or licensing of nurses in the foreign country are substantially the same

as those prescribed in this Act.

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SEC. 17. Fees for Examination and Registration. - Applicants for licensure and for
registration must pay the fees prescribed by the PRC.

SEC. 18. Ratings. - In order to pass the PNLE, an examinee must obtain at least seventy-
five percent (75%) in all tested areas of competencies. An examinee who has failed the
PNLE three (3) times shall be barred from further taking any PNLE.

SEC. 19. Issuance of Certificate of Registration, Professional License and Professional
Identification Card. - A certificate of registration and professional license shall be issued
to all successful examinees, subject to Section 14 of this Act. A certificate of registration
and professional license shall show the full name of the registrant, the signature of the
Chairperson of the PRC, and the members of the Board. The certificate shall bear the logo
of the Board and the official seal of the PRC.

The PRC shall likewise issue the professional identification card. The card must bear the
following: full name of the registrant nurse, the serial number, the date of issuance and

expiration, the signature of the Chairperson of the PRC, and date of registration.

SEC. 20. Oath of Profession. - All successful examinees must take an oath of profession
before the Board or any government official authorized to administer oaths prior to

practicing the profession.

SEC. 21. Roster of Nurses. - The PRC shall maintain a roster of nurses pursuant to the PRC
Automated System. The Roster of Nurses shall serve as the centralized database for
nursing professionals for purposes of documentation, verification of registrants,

statistics, research, and development.

SEC. 22. Registration by Reciprocity. - The Board may issue a certificate of
registration/ professional license, without examination, to a nurse registered under the

laws of a foreign State or country: Provided, that the requirements for registration or

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licensing of nurse in the foreign country are substantially the same as those prescribed
under this Act: Provided, further, that the laws of such State or country grant the same
privileges to a Professional Registered Nurse of the Philippines on the same basis as the

subjects or citizens of the foreign State or country.

SEC. 23. Practice Through Special or Temporary Permit. - The Board may issue a special or
temporary permit to practice the nursing profession to the following persons if they meet

the professional and moral standards set by the PRC:

(a) Licensed nurses from foreign countries whose services are either for a fee or free
if they are internationally well-known specialists or outstanding experts in any

branch or specialty of nursing;

(b) Licensed nurses from foreign countries on medical mission whose services shall

be free in a particular hospital, center or clinic;

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

nursing; and

(d) Licensed nurses from foreign countries who come to aid during declared disasters

and calamities.

The special or temporary permit shall be effective only for the duration of the project,
medical mission or engagement contract. A completion report shall be submitted to the

PRC after every mission.

SEC. 24. Non-Registration and Nonissuance of Certificate of Registration, Professional License,

Professional Identification Card, Special Permit or Temporary Permit. - No person convicted

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by final judgment of any criminal offense involving moral turpitude or any person guilty
of immoral or dishonorable conduct or any person declared by the court to be of unsound
mind may be registered and issued a certificate of registration, professional license,
professional identification card, or a special or temporary permit.

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

SEC. 25. Revocation and Suspension of Certificate of Registration, Professional License,
Professional Identification Card, and Cancellation of Special or Temporary Permit. - The Board
shall have the power to revoke or suspend the certificate of registration, professional
license, professional identification card, or cancel the special or temporary permit of a

nurse upon any of the following grounds:

(a) Conviction, by final judgment, of any criminal offense involving moral turpitude
or guilty of immoral or dishonorable conduct or any person declared by the court

to be of unsound mind;

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

(©) Gross negligence, grave misconduct, ignorance, and incompetence in the nursing

practice;

(d) Fraud, concealment, misrepresentation, or false statements in obtaining a
certificate of registration, professional license, professional identification card,

special or temporary permit; and

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

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The suspension of the certificate of registration, professional license, and professional
identification card, shall be for a period not to exceed four (4) years.

SEC. 26. Reinstatement and Reissuance of Revoked Certificates of Registration, Professional
License, and Professional Identification Card. - The Board may, after the expiration of a
maximum of four (4) years from the date of revocation of a certificate of registration,
professional license, and professional identification card, for reasons of equity and justice,
and when the cause for revocation has disappeared or has been cured and corrected,
upon proper application thereof and the payment of the required fees, reinstate and
reissue the certificate of registration, professional license, and professional identification

card.

Article IV
NURSING PRACTICE

SEC. 27. Nursing Practice. - The practice of nursing refers to the administration of nursing
care through the utilization of the nursing process: assessment, nursing diagnosis,
planning, implementation, and evaluation. Nursing practice encompasses various stages
of development towards the promotion of health, prevention of illness, health care
techniques and procedures, restoration of health, alleviation of suffering, and end-of-life

care, may it be performed independently or collaboratively.
SEC. 28. Scope of Nursing Practice. - The following comprises the scope of nursing practice:

(a) nursing education; (b) nursing service; (c) nursing research; and (d) nursing

leadership and governance.

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SEC. 29. Nursing Care. - Nursing care includes the provision of physiological,
psychological, spiritual, social and emotional care; essential health care, safety and
comfort measures, health teachings; executing health care techniques and procedures;
and traditional and innovative approaches to individuals, families, population groups

and communities from conception to death.

A nurse shall be deemed to be practicing the nursing profession when one performs
nursing care to individuals, families, population groups, and communities, for a fee,

salary or compensation, singly or collaboratively.

SEC. 30. Roles, Responsibilities, and Competencies of a Nurse. ~ A nurse shall possess and
exercise the core competencies in the performance of the roles and responsibilities, in

accordance with the standards set by the Board.

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

SEC. 32. Requirement for Inactive Nurses Returning to Practice. ~ Nurses are deemed to be

inactive when:

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

practice for five (5) consecutive years;

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

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

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

Article V
NURSING EDUCATION

SEC. 33. Nursing Education, ~ Nursing education refers to the formal learning and training
in the science and art of nursing provided by higher educational institutions duly
recognized by the CHED. There shall be a standard of Basic and Graduate Program for
Nursing Education which must be pursuant to the Republic Act No. 7722, otherwise
known as the “The Higher Education Act of 1994”.

SEC. 34. Basic Program for Nursing Education. ~ The basic program for nursing education
is a sound, liberal and professional program which aims to equip basic nursing students
with the necessary competencies for safe and quality entry level nursing practice.
Admission to the Basic Program for Nursing Education requires passing a National
Nursing Admission Test (NNAT). The basic nursing curriculum and related learning
experiences (RLE) afforded by the program must be in accordance with the National
Nursing Core Competency Standards promulgated by the Board and implemented
through the policies, standards, and guidelines of the CHED.

SEC. 35. Graduate Program for Nursing Education. -The post baccalaureate nursing
program for nursing education shall build on the experiences and skills of a nurse
towards mastery, expertise, and leadership in practice, research, and education. It
includes a masteral degree and doctorate degree in nursing founded on the philosophies,
and the scientific body of knowledge and practice. Graduate Program for Nursing
Education shall be offered only in higher educational institutions as prescribed by the
prevailing CHED policies, standards, and guidelines for Graduate Education.

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

of nursing education, and must possess the following qualifications:

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

(b) Must have been issued the appropriate certificate of nursing proficiency, or its
equivalent, from the Board;

(©) Must have been conferred a master’s degree in nursing by a university duly

recognized by the Government of the Republic of the Philippines;

(d) Must have gained at least five (5) years of experience in teaching and supervision

in Nursing Education; and

(e) Must have gained at least three (3) years clinical experience in a general nursing

service.

SEC. 37. Qualifications of the Faculty. -

(a) Basic Program for Nursing Education. - A member of the faculty in a College of

Nursing teaching professional courses must possess the following qualifications:

(1) Must be a registered licensed professional nurse duly certified by the PRC;

(2) Must have gained at least three (3) years of nursing practice;

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(3) Must been conferred a master’s degree in nursing, conferred by a university
duly recognized by the Government of the Republic of the Philippines; and

(4) Must have been certified by the Board and issued the appropriate certificate
of nursing proficiency.

(b) Graduate Program for Nursing Education. - A member of the faculty teaching

graduate professional courses:

(1) Must follow prescriptions a and b of basic nursing education; and

(2) Must have been conferred a doctorate degree in nursing by a university

duly recognized by the Government of the Republic of the Philippines.

SEC. 38. Faculty-Student Ratio. - The CHED must determine a reasonable and feasible
faculty to student ratio that shall be observed in all nursing educational institutions.

Article VI
NURSING SERVICE

SEC. 40, Nursing Service. - Nursing Service is the promotion of health and prevention of
illness which includes nursing care provided by a nurse, either independently or
collaboratively, to any individual, family or group in various health care settings.

Nursing Service shall include the following functions:

(a) Provide health education to individuals, families, and communities;

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(b) Ensure that information on healthy lifestyle are incorporated in his/her health
teachings;

(c) Seeking opportunities to promote a healthy lifestyle within the nurse’s influence;

(d) Accepting that one is a role model for a healthy lifestyle;

(e) Enabling people to exercise control over their health and to improve health;

(f) Building healthy public policy;

(g) Creating a supportive environment;

(h) Strengthening community action for health; and

(i) Establishing linkages with community resources and coordinating with the health
team to promote healthy lifestyle and preventing illnesses.

SEC. 40. Nursing Interventions. - In accordance with Sections 27 and 29 hereof, nursing
interventions include any or a combination of essential primary health care, the
application of traditional and innovative approaches, health counseling, and
administration of written prescription for treatment, or therapies that may consist of oral,
topical, or 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, attending to normal child delivery, suturing of perineal
laceration and immediate care of the newborn; performing perioperative care covering

pre-intra-post surgical care interventions; care during emergency and disaster.

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

the health team.

SEC. 43. Advanced Practice Nursing (APN). - APN is a specialized and expanded mode of
nursing care pursuant to Sec. 45 hereof. It is a form of specialized training, obtained
through an Advanced Practice Nursing Program that is formulated by the concerned
agencies. A nurse who has successfully completed the APN Program and passed the
qualifying examinations to be conducted by the Board may be certified by the Board upon
compliance with the requirements that the Board shall set. A registered nurse who seeks

to be an APN must obtain a master’s degree in nursing.

Article VII
NURSING RESEARCH AND POLICY DEVELOPMENT

SEC. 43, Nursing Research and Policy Development. - Nursing Research and Policy
Development involves the study and pursuit of nurse-related issues encompassing the

following areas:

(@) Professional nursing practice such as advancing nursing knowledge to ensure

quality nursing care for all and advocacy for sound health policies globally;

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

and

(c) Socioeconomic welfare for nurses like occupational health and safety, human

resources planning and policy, renumeration, and career development.

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SEC. 44. Studies for Nursing Human Resource Needs, Production, Utilization, and
Development. - The Board, in coordination with the integrated APO and appropriate
government or private agencies, shall initiate, undertake and conduct studies on health

care human resources production, utilization, and development.

SEC. 45. Advanced Practice Nursing Program. ~ Within ninety (90) days from the effectivity
of this Act, the Board, in coordination with the integrated APO, recognized specialty
organizations, and the Department of Health (DOH), shall formulate and develop an
Advanced Practice Nursing Program that is aimed at upgrading the level of skill and
competence of specialty nurse clinicians in the country, such as the areas of critical care,
oncology, renal, and such other areas as may be determined by the Board: Provided, that
the beneficiaries of this Program are obliged to serve in any Philippine hospital for a

period of at least two (2) years of continuous service.

SEC. 46. Incentives and Benefits. - The Board, in coordination with the DOH, other
concerned government and non-government institutions, association of hospitals and the
integrated APO, shall establish an incentive and benefit system in the form of free
hospital care for nurses and their dependents, scholarship grants and other noncash
benefits.

Article VIL
NURSING LEADERSHIP AND GOVERNANCE

SEC. 47. Nursing Leadership. - As part of the workforce that toil and labor for the
improvement of the health of the citizenry, nurses shall adapt to changes and trends in
the health sector. They shall be required to perform specific roles in organizational
structure, especially in formulating policy in health facilities, and in providing guidelines
and mentorship on best practices in nursing and patient care. They shall be involved in

nurse recruitment, training and retention, and work with health care leaders to establish

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an appropriate compensation and benefit program. Nurses in management positions
shall develop patient-care programs, plan new patient services, establish nursing policies
and procedures, participate in cross-departmental decision making, conduct
performance improvement activities, represent the profession and provide expert and
technical guidance on sentiment issues before relevant boards of directors and other

stakeholders.

SEC. 48 . Nursing Governance. - Governance in the practice of nursing empowers each
nurse to participate in decision-making processes that affect the practice of the profession,
including its administrative aspect. Each nurse is tasked to be involved in the
organization and in the implementation of plans and policies for patients and

communities.

Article IX
NURSING PERSONNEL SYSTEM

SEC. 49, Nursing Personnel System. - The Nursing Personnel System covers the following
fields: nursing service administration in the hospital setting, community health practice,
and the academe. There shall be an administrative or clinical nursing service office in
every health institution with at least ten (10) nurses. The nursing service office must be

under the control and management of a chief nursing officer.

SEC. 50. Ratio. - The ratio of a staff nurse to a patient in a general nursing service or
general ward of a hospital shall be set at 1:12, in order to ensure the quality of nursing
care for patients. There shalll be a nurse for every barangay and industrial establishments:
Provided, that the nurse shall supervise other health workers in the work area. There
shall be a nurse for every school, may it be private or public, primary, secondary or

tertiary, subject to the applicable ratio prescribed by the appropriate government agency.

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SEC. 51. Beginning Registered Nurse. - A beginning registered nurse shall provide for safe
and quality care to an individual, family, or group that is independent or as part of a
team. The nurse must be able to assess, plan, implement, and evaluate the care provided

to clients based on evidence derived from research.

A beginning registered nurse must have the following minimum qualifications:

(a) Must have been conferred a Bachelor of Science in Nursing degree by a higher
educational institution recognized by the CHED;

(b) Must be a registered nurse with a current certificate of registration and
professional identification card issued by the PRC;

(©) Must be physically, mentally, and psychologically fit to practice nursing; and

(d) Must not have been convicted of any crime involving moral turpitude.
SEC. 52. Nursing Service Management. - The management and administration of nursing
services shall be performed by nurses equipped with the necessary competencies on

governance and leadership characterized as follows:

(a) First Level Manager shall be directly responsible for the physical setup of the unit,

structure and other human resources for health care provision;
(b) Middle Level Manager, shall be directly responsible for the department or section

handling more than one (1) or two (2) units, and takes care of the financial, logistic,

and operational functions, among others; and

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(©) Top Level Manager shall oversee all nursing units in terms of financial and human

resources for health such as nurses and nursing assistants/adjuncts.

Nursing service managers must have the following minimum qualifications in addition

to the requirements of a Beginning Registered Nurse:

(1) A first level manager in nursing must have completed eighteen (18) units of
nursing management and clinical subjects in a Master of Arts in Nursing
Program or Master of Science in Nursing Program, at least three (3) years of
clinical work experience, and must have participated in at least one (1)

research project on the improvement of the quality of nursing care;

(2) A middle level manager in nursing must have completed all academic
requirements in Master of Arts in Nursing or Master of Science in Nursing, at
least three (3) years of clinical work and two (2) years of management
experience, and has initiated at least one (1) research project to improve the

quality of care;

(3) A top level manager in nursing must have completed a post-graduate degree
in nursing or health management-related sciences, at least three (3) years of
clinical work and three (3) years of management experience, and has initiated
at least two (2) research projects on the improvement of the quality of nursing

care; and

(4) All nursing managers must fulfill the requirements for the issuance by the
Board of the Certificate of Nursing Proficiency, or its equivalent, in line with
the Nursing Leadership and Governance Certification Program (Nurse

Administrator I, Nurse Administrator II, Nursing Administration Specialist).

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The above qualifications shall apply to all nurses occupying supervisory or managerial

positions across all health facilities.

SEC. 53. Public Health Practice, - Nursing service shall be organized and operationalized
in every local health agency in order to ensure the inclusion of the nursing component of
public health programs. Thus, an ideal of having at least one (1) nurse in every barangay
shall be the thrust of public health in order to provide accessible, available, and affordable
quality health care to all. The ideal of having at least one (1) nurse in every school,
whether in private or public, shall be prioritized in every primary, secondary and tertiary
educational institutions in order to instill health awareness at an early stage and to

improve the health status of the students.

SEC. 54. The Chief Nursing Officer (CNO). - The nursing service and delivery of health care
ina public health practice or community setup shall be under the control and supervision
of a CNO. The CNO shall have the authority to plan, organize, direct, and control public
health nurses. A CNO must have completed a minimum of three (3) years practice ina
community setting as a Public Health Nurse, and must have completed at least five (5)
years experience in relevant nursing practice setting. In addition, the CNO in a public
health agency must have been conferred a relevant master’s degree by an educational

institution duly recognized by the Government of the Republic of the Philippines.

The CNO shall be responsible for the formulation of policies, strategic and operational
planning, financial planning and resource allocation, policy and procedure development,
professional and organizational involvement to address epidemiologic problems and
provide statistical data, and shall exercise good governance and accountability of the
nursing personnel in a public health setting. The CNO shall also act as the advocate for
the rights and welfare of public health nurses.

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SEC. 55. Nursing Supervisor (NS). ~ The NS shall be in charge of planning, organizing,
directing, and controlling activities within a demographic unit. A NS must have
completed a minimum of three (3) years practice in a community setting as a Public

Health Nurse, and must be a master’s degree holder in Public Health Nursing.

SEC. 56. The Public Health Nurse (PHN). - The PHN shall perform the functions and

activities of health promotion, such as the prevention and treatment of various diseases
and illnesses in a particular public setting. The PHN shall exercise a supervisory role to
the midwives and barangay health workers within his/her catchment area. The PHN
shall initiate and participate in developing policies and guidelines to promote basic

nursing services.

Article X
PROHIBITED ACTS AND PENAL SANCTIONS

SEC. 57. Prohibited Acts. - The following shall be considered unlawful:

(a) Practicing the nursing profession in the Philippines without a certificate of
registration, professional license, professional identification card, special or
temporary permit or without having been declared exempt from examination in
accordance with the provision of this Act;

(b) Using a certificate of registration, professional license, professional identification

card, special or temporary permit of another nurse;
(c) Using an invalid certificate of registration, professional license, a suspended or

revoked certificate of registration, professional license, or an expired or cancelled

special or temporary permit;

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(d) Misrepresents oneself or submits false evidence in order to obtain a certificate of
Tegistration, professional license, professional identification card, special or
temporary permit;

(e) Appends the words “Nurse”, “Nars”, or the contraction “Nrs.” before one’s name,
or BS.N./RN. after one’s name without having been conferred said degree or

registration;

(6) Abets or assists to the illegal practice of a person who is not lawfully qualified to

practice nursing;

(g) Offering BSN courses without having complied with the requirements prescribed
by law;

(h) Conducting review classes for both local and foreign examination without

permit/clearance from the Board and the PRC;

(i) Conducts CPD for nurses without accreditation from the Board;

() Undertaking or offering in-service training programs for a fee and without

permit/clearance from the Board and the PRC;

(k) Subscribing or providing substandard quality of nursing care and/or nursing

practice, such as noncompliance with the nurse-to-patient ratio;

() Promoting illegal practices in the workplace, such as

(1) Contracting or availing of the services of a nurse either without salary or

allowance, or salary below the applicable wage prescribed under this Act,

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whether or not under the pretext of a training, development program,

certification course and/or seminar;

(2) Depriving or denying a nurse of the incentives and benefits as provided for

by existing laws;

(3) Collecting any fee from a nurse or from any person or agent in exchange for

a nurse’s voluntary services in a health facility;

(4) Requiring or obliging a volunteer nurse to perform the regular work
functions and/or regular work load expected from a regular staff nurse
employed by the health facility without proper compensation, to render
full-time service as a condition for the continued availment of the volunteer
services, and to be the sole nurse on duty, except during disasters,

calamities, and war;

(6) Contracting or availing of the services of a volunteer nurse, under the
pretext of on-the-job training (OJT), contract of service, and job orders, in
order to fill up a vacant position that requires the hiring of a full-time
regular employed nurse, or for free in exchange for any type of certification
to be issued by the health facility for purposes of the nurse’s employment

application; or

(6) Contracting or availing of the services of a nurse, under the pretext of
training or certification course, but requires the nurse to render the tasks
and responsibilities expected of a regular staff or public health nurse, with
the so-called allowance with or without benefits, below the applicable

minimum wage for both private and public institutions; and

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(m) Any violation of the provisions of this Act.
SEC. 58. Sanctions. - A fine of not less than one hundred thousand pesos (Php100,000.00)
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, upon the discretion of the court,
shall be imposed upon violation of any prohibited acts enumerated in Section 57(a), (b),
(©), (@), (©) and (6) hereof. A fine not less than three hundred thousand pesos
(Php300,000.00) nor more than five hundred thousand pesos (Php500,000.00) and/or
imprisonment of not less than one (1) year nor more than six (6) years shall be imposed
upon violation of any prohibited acts enumerated in Section 57(g), (h), (i), @, (K), (1) and
(m) hereof. In addition, suspension or revocation of license to operate may be granted

upon the discretion of the court.

SEC. 59. Refund and Compensation. - Any nurse found to have been a victim of Section
57(g), (h), (i), (), (R), and () hereof shall be entitled to a full refund of all fees illegally
collected and payment of unpaid salaries, which shall be computed at not less than the
applicable wage.

Article XI
MISCELLANEOUS

SEC. 60. Implementing Agencies. - The DOH is hereby designated as the agency tasked to
monitor the compliance with and implementation of the provisions of this Act by public
health facilities. The Department of Labor and Employment is designated as the agency

tasked to monitor the compliance with and implementation of the provisions of this Act

by private health facilities. The PRC and the Board are designated as the agencies tasked

to monitor the compliance with and implementation of the provisions of this Act by
ities. The CHED is similarly

educational institutions, CPD providers and health faci

designated as the agency tasked to monitor the compliance with and implementation of

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the provisions of this Act by educational institutions with regard to nursing education

programs and its curriculum.

SEC. 61. Appropriations. - The Chairpersom of the PRC shall immediately include the
Commission's programs the implementation of this Act, the funding which shall be
included in the General Appropriations Act.

SEC. 62, Implementing Rules and Regulations (IRR). - Within sixty (60) days after the
effectivity of this Act, the PRC, the Board, the APO, the Civil Service Commission, the
Department of Budget and Management, the DOH and other concemed nursing
organizations and government agencies shall formulate the implementing rules and
regulations necessary to carry out the provisions of this Act. The implementing rules and
regulations shall be published in the Official Gazette or in a newspaper of general

circulation.

SEC. 63. Separability Clause. - Should any provision of this Act be declared

unconstitutional or invalid, the remaining provisions shall remain in full force and effect.

SEC. 66. Repealing Clause. - Republic Act No. 9173, otherwise known as the “Philippine
Nursing Act of 2002”, is hereby repealed. All other laws, decrees, executive orders, rules,

and regulations inconsistent with this Act are hereby repealed or modified accordingly.

SEC. 67. 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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