EIGHTEENTH CONGRESS: )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES

“Introduced by Representative Rufus B. Rodrig
1877

_
House Bill No.
EXPLANATORY NOTE

This bill was originally introduced as House Bill No. 5592 during the 15" Congress
where it was approved by the Committee on Civil Service and Professional Regulation and
substituted with House Bill No. 6878. It was subsequently approved on 2” reading,
approved on 3" reading and was transmitted to the Senate where it was not acted upon. It
was also re-filed during the 16” Congress and the 17” Congress.

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

RA 9173 was enacted in 2002 to provide a comprehensive definition and
understanding of the nursing profession. It delineates the scope of work of registered
Filipino nurses, establishes linkages with community resources and requires the updating of
professional knowledge in the nursing field, patient care, levels of nursing practice and
development of nursing education. This is in recognition of the vital role nurses play in the
delivery of quality health services not only in the country, but all over the world

‘Since the enactment of RA 9173 almost a decade ago, significant factors critical to
the development of nursing practice in the country have emerged. This includes providing
humane and globally competent nursing care, ensuring positive practice environment for
nurses, strengthening the Philippine nursing profession as a recognized leader in primary
health care, enforcing quality standards in nursing education and practice, and providing
guidelines toward nursing career progression.

RA 9173 must be amended to achieve the vision of the Philippine professional
nursing care to be the best for the Filipino and the choice of the world by 2030. Such
amendments provide restructuring of the scope and practice of nursing to include
certification, specialization and educational requirements, expanding the powers of the
Board of Nursing to strengthen its role in decision-making processes concerning the nursing
practice, providing additional educational requirements for different levels of nursing practice
to ensure competitiveness and further strengthen the nursing profession and provide a better
practice environment

Nursing remains the top career choice among Filipinos. The Commission on Higher
Education reported that the number of nursing students rose from 30,000 in 2000 to 450,000
in 2007. The total number of registered nurses as of 2003 was 332,206 according to data
provided by the Professional Regulation Commission. in addition, demand for Filipino
nurses abroad has risen steadily over the past two decades. Given the statistics, it is but
necessary to institute reforms RA 9173 so that the nurses are accorded further protection
and their welfare enhanced. It must be amended to better respond to the needs of nurses,
their patients and the whole nursing practice.

In view of the foregoing, immediate passage of this bill is earnestly requested.

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EIGHTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES

“introduced by Representative Rufus B. Rodriquez

House Bill No, 1877

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS A QUALITY HEALTH
CARE SYSTEM, AND APPROPRIATING FUNDS THEREFOR, REPEALING FOR THE
PURPOSE REPUBLIC ACT NO. 9173, OTHERWISE KNOWN AS THE “PHILIPPINE
NURSING ACT OF 2002”

Be it enacted by the Senate and the House of Representative of the Republic of the
Philippines in Congress assembled:

ARTICLE |
General Provisions
Section 1. Title. — This Act shall be known as the “Comprehensive Nursing Law’.

SEC 2. Declaration of Policy. - It is hereby declared the policy of the state to
uphold the dignity of 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,

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

SEC. 3. Definition 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 R.A.
No. 8981 or the "PRC Modemization 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 have a master's degree in nursing

(c) 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 professional such as General
Nursing, Nursing Specialty! Advanced Practice, Nursing Education, and Leadership
and Govemance. The Professional Regulatory Board of Nursing confers the
certification or credential after a validation process based on promulgated guidelines
and mechanisms.

(e) 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.



(f) 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 append before ones 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

() Precarious Work refers to substandard employment conditions such as under-
payment, 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.

() Public Health Institution (PHI) refers to any government-led, 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
Regulatory Board of Nursing to licensed nurses of foreign nationalities.

() 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 Sec. 23 hereof

ARTICLE I
Board of Nut

SEC 4. Creation and Composition of the Board. ~ There shall be created a
Professional Regulatory Board of Nursing, hereinafter referred to as the Board, composed
of seven (7) members who shall elect among themselves a Chairperson to serve for one (1)
term, without re-election. The President of the Republic of the Philippines shall appoint the
members of the Board from among those recommended by the Professional Regulation
Commission (PRC) established under Republic Act No. 8981and ranked from a list of three
(3) nominees, for each vacancy, of the APO of nurses in the Philippines and who possess
the qualifications for the position as provided in this Act. The membership of the Board shall
comprise the scope of the 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;


(c) Must have been conferred a master's degree in nursing and preferably, a
doctoral 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

{e) 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, of any training hospital or health facility with
nursing affiliates.

SEC.7. Term of Office. - The members of the Board shalll 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;

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

(c) 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 and 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;

(f) 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;

(a) 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 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;

(i) Source and utilize funds earmarked for national nursing development;

(j) 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;

4. credentialing individual registered nurse based on accepted criteria; and

5. 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 the 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,
(c) Unprofessional, immoral or dishonorable conduct.

ARTICLE Ill
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 documents, or both, of any nursing graduate for the
purpose of preventing them to apply for the PNLE. Alll 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 have not 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,

(c) 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.

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 16 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 the 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:
ofa foreign State or country: Provided, That the requirements for registration or 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 grants the same privileges to a
Professional Registered Nurse of the Philippines on the same basis as the subjects or
citizens of the foreign State 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) License 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;

(c) 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 Non-issuance of Certificate of Registration,
Professional License, Professional Identification Card, Special Permit or Temporary
Permit. — No person convicted 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, and 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;

(c) 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 permit or temporary permit

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

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 Re-lssuance 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
cerlificate 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 re-issue 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: (1) nursing education; (2) nursing service; (3) nursing research; and, (4)
nursing leadership and governance.

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 shall 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
(c) they do not have proof of five (5) years of continuous nursing practice.
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 RA . No. 7722, otherwise known as “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 aim 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.

SEC. 36. Qualifications of the Dean. - The Dean of the College of Nursing shall
formulate policies, plans in collaboration with the administration’ school officials and
stakeholders. The Dean must adhere to the prescribed curriculum for the advancement of
nursing education, and must possess the following qualifications:

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

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

(c) 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. ~
(1) Basic Program for Nursing Education. — A member of the faculty in a College of
Nursing teaching professional courses must possess the following qualifications

(a) Must be a registered licensed professional nurse duly certified by PRC.

(b) Must have gained at least three (3) years of nursing practice:

(c) Must have been conferred a masteral degree in nursing, conferred by a
university duly recognized by the Government of the Republic of the
Philippines; and

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

(2) Graduate Program for Nursing Education. - A member of the faculty teaching
graduate professional courses:

(a) Must follow prescriptions 1 and 2 of basic nursing education; and

(b) 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. 39. 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: (1) Providing health education
to individuals, families and communities; (2) Ensuring that information on a healthy lifestyle
is incorporated in the nurse's health teachings; (3) Seeking opportunities to promote a



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healthy lifestyle within the nurse's influence; (4) Accepting that one is a role model for a
healthy lifestyle; (5) Enabling people to exercise control over their health and to improve
health; (6) Building healthy public policy; (7) Creating a supportive environment; (8)
Strengthening community action for health; and, (9) Establishing linkages with community
Tesources and coordinating with the health team to promote healthy lifestyle and preventing
illness.

SEC. 40. Nursing Interventions. - In accordance with Sections 27 and 29, nursing
interventions include, any or 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.

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. 42. Advanced Practice Nursing (APN). — APN is a specialized and expanded
mode of nursing care pursuant to Sec. 45 hereof. It is a form 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:

(a) 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

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

(d)

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

ARTICLE VII
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 an organizational structure,
especially in formulating policy in health facilities and 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 healthcare leaders to establish 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 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 nursing care
for patients. There shall 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.

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:
(1) Must have been conferred a Bachelor of Science in Nursing degree by a higher
educational institution recognized by the CHED;
(2) Must be a registered nurse with a current certificate of registration and professional
identification card issued by the PRC;
(3) Must be physically, mentally, and psychologically fit to practice nursing; and
(4) 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:

(1) First Level Manager, shall be directly responsible directly for the physical set -up of the
unit, structure and other human resources for health care provision:

(2) 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

(3) 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:

{a) 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
have participated in at least one (1) research project on the improvement of the
quality of nursing care;

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

(©) a top level manager in nursing, must have completed a post-graduate degree in
nursing or health management — related sciences and at least three (3) years of
clinical work and three (3) years of management experience, and 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 |, Nurse
Administrator Il, Nursing Administration Specialist).

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
healtheare in a public health practice or community set-up shall be under the control and
supervision of a CNO. The CNO shall 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 in a 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 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.


—The NS shall be in charge of planning, organizing,
directing,and controlling activities within a demographic unit. A NS must have completed @
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. 55. Nurse Supervisor (NS)

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 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

SEC. 57. Prohibited Acts. The following shalll be considered untawful:

(a) practicing the nursing profession in the Philippines without a certificate of registration,
professional license, professional identification card, special permit 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 permit 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 permits;

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

(e) appends the words “Nurse”, “Nars’, or the contraction "Nrs.” before one’s name, or
the acronym or B.S.NJR.N after one's name without having been conferred said
degree or registration; or

() abets or assists to the illegal practice of a person who is not lawfully qualified to
practice nursing:

(@) offering the BSN courses without having complied with the requirements prescribed
by law;

(h) conducting review classes for both local and foreign examination without
permiticlearance from the Board and the Commission,

i) or 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 Commission;

(k) subscribing or providing sub-standard quality of nursing care and/or nursing
practice, such as non-compliance with the nurse-patient ratio;

()_ promoting illegal practices on the workplace, such as:

4. contracting or availing of the services of a nurse either without salary, or
allowance, or salary below the applicable wage prescribed under this Act,
whether or not under the pretext of a training, development program,
certification course and /or seminar;

2. 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,



5. 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-ime 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;

(m) Any violation of the provisions of this Act.

SEC, 58. Sanctions. — A fine of not less than One hundred thousand pesos
(P100,000.00) nor more than Three hundred thousand pesos (P300,000.00) or
imprisonment of not less than one (1) year nor more than six (6) years, or both, upon the
discretion of the court, shall be imposed upon violation of any prohibited acts enumerated in
Section 59 (a) hereof. A fine of not less than Three hundred thousand pesos (P300,000.00)
nor more than Five hundred thousand pesos (P500,000.00) 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 59 (b), (c), (d), and (e) hereof. In additi
‘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 59 (d) 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 Department of Health 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 educational institutions, CPD providers and health facilities. The CHED is
similarly designated as the agency tasked to monitor the compliance with and
implementations of the provisions of this Act by educational institutions with regard to
nursing education programs and its curriculum.

SEC. 61. Appropriations. — The Chairperson of the Professional Regulation
Commission shall immediately include in the Commission's Programs the implementation of
this Act, the funding of which shall be included in the General Appropriations Act

SEC. 62. Implementing Rules and Regulations. ~ Within ninety days (90) after the
effectivity of this Act, the PRC, the Board, the APO, the Civil Service Commission, the
Department of Budget and Management, the Department of Health and other concerned
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, the remaining parts not affected thereby shall remain valid and operational


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

SEC. 65. Effectivity. — This Act shall take effect fifteen (15) days after its publication
in the Official Gazette or in a_ newspaper of general circulation in the Philippines.

Approved,