History of Nursing Law

Act No. 2493 (115)

• An act to amend No. 310 regulating the practice of medicine in the Philippines
• Provided for the examination and registration of nurses
• Nurses must apply for registration to the Director of Health
• Requirements: Good moral character, good health and 21 years old

Act No. 2808 (1919)

• An act regulating practice of nursing profession
• the first "True Nursing Law"
• created the board of examiners composed of 3 members
• Examination date on the 2nd Monday of June and December
• First board exam: 10920

Act No. 3025 (1922)

• Amplification of the definition of the nursing profession
• Granting the privilege of registering as nurses without exams the Registered Nurses from the United States
• Change the date of exam: 2nd Monday of April and October

Act No. 4007 (1932)

• Reorganization law of 1932
• Conduct of examination was placed under the direct supervision of Bureau of Civil Service
• Change of jurisdiction over the Board of Examiner under the Department of Public Instruction

Executive Order No. 317 (1941)

• Pursuant to Commonwealth Act 430, transfer of jurisdiction of the board to the Department of Health and Public Welfare

Republic Act No. 546 (1953)

• Organization of the Board of Examiners of nurses
• Provisions regarding nursing schools and colleges, examinations, registration of nurses including sundry provisions relative to the practice of nursing
• Two important sections pertained to the need for registration as nurse before anyone could practice nursing in the country
1. No person shall practice or offer to practice nursing in the Philippines as defined in the Act, without holding a valid certificate of registration as nurse issued by the Board of Examiners for Nurses
2. Not only prohibit the practice of nursing without a certificate of registration issued by the Board of Nursing but also provides the penalty for doing so

Republic Act 4704 (1966)

• Amended certain portions of Republic Act 877
• The membership of the Board of Examiners for nurses was increased 3 to 5 members
• Members of the Board were to be appointed by the President of the Philippines with the consent of the Commission on Appointments and no longer upon the recommendation of the Commission of Civil Service
• The requisite academic degree for members of the Board was a Master's Degree instead of Baccalaureate Degree in Nursing
• No person was eligible for membership in the board if he/she was over 65 years of age
• The academic qualification for Dean, Directors and Principals of colleges and schools of nursing was raised to that of Master's Degree in Nursing
• The minimum age required of applicants for admission to the nurse's examination was lowered from 21 to 18 years of age, but no candidate who passed the examination was permitted to practice the profession until he/she reached the age of 21 years

Republic Act 6136 (1970)

• The application and execution of legal orders in writing of physicians concerning treatments and medications including the application of hypodermic and intramuscular injection; provided that intravenous and other injection may be administered under the direction and in the presence of the said physician

Republic Act 7164 or the "Philippine Nursing Act of 1991

• Redefinition of the scope of nursing practice to emphasize
1. The use of nursing process as a scientific discipline in arriving at an appropriate nursing action and care
2. The teaching, management, leadership and decision making roles of the nurse
3. The undertaking of and participation in studies and research by nurses
• Requiring a faculty member who was appointed to the Board of Nursing to resign from his/her teaching position at the time of appointment and not one year preceding his/her appointment as provided in Republic Act 877
• Updating a faculty's educational qualification by requiring a Master's Degree in Nursing or related fields or its equivalent in terms of experience and specification as pre-requisite to teaching
• Specification of qualifications of administrators of nursing services
• Inclusion of the phrase "unethical conduct" as one of the reasons for revocation and suspension of certificate of registration

Republic Act 9173 or the "Philippine Nursing Act of 2002"

• The Board is now composed of a Chairman and 6 members instead of a Chairman and 4 members
• Submission of names of qualified nominees by the Accredited Professional Organization (APO) to the Commission, three (3) nominees per vacancy, not later than three months before the vacancy
• The Commission submits to the Office of the President two (2) nominees per vacancy not later than two months before the vacancy occurs. The appointment must be issued not later than thirty (30) days before scheduled licensure examination
• Qualifications of Board Members
1. Educational requirement for members of the Board is not limited to registered nurses with Master's Degree in nursing but also to registered nurses with master's degrees in education, or other allied medical profession provided that the Chairperson and majority of the members are holders of a Master's degree in nursing
2. Of the ten years of continuous practice of the profession prior to appointment, the last five (5) years must be in the Philippines
• Added the powers and duties of the Board
1. Adopt and regulate a Code of Ethics and Code of Technical Standards for the practice of nursing within one year from the effectivity of this act
2. Recognize specialty organization in coordination with accredited professional organization
• Licensure Examination and Registration
1. Specific age of applicants has been deleted
2. Specific dates of examination has been deleted
• Specific dates of examination - not earlier than one (1) month and not later than 2 months after the closing of each semestral term
• Ratings
1. Specific number of times an examinee may take the licensure examination has been deleted
2. Added: removal examination shall be taken within two (2) years after the last failed examination
• Revocation and Suspension of Certificate of Registration
1. Added: Implementing Rules and Regulations, Code of Ethics, Code of Technical Standards, for nursing practice and policies of the Board and the Commission
2. Added: Section 28 for practicing the profession during the period of suspension
3. Period of Suspension of the certificate of registration/professional license not to exceed four (4) years
• Nursing Education
1. Added: requirement for inactive nurses returning to practice - nurse who have not actively practiced the profession shall undergo one (1) month of didactic training and three (3) months of practicum
2. Qualifications of Faculty - requirement of clinical experience in a field of specialization has been reduced from three (3) years to one (1) year in a field of specialization
3. The Dean of the College of Nursing must have at least five (5) years of experience in teaching and supervising a nursing education program
• Nursing Practice
1. Scope of Nursing - Duties and responsibilities of the nurse
• Deleted: special training for intravenous injections but Nursing Service Administrators still require formal training for the safety of the patient and the protection of the nurse and of the institution
• Added: special training for suturing the lacerated perineum. (Note: This is being undertaken by the Association of Nursing Service Administrators of the Philippines (ANSAP) with the Maternal and Child Association of the Philippines (MCNAP))
• Added: observe the Code of Ethics and the Code of Technical Standards maintain competence through continual professional education
• Health human resource production and utilization additions
• Comprehensive Nursing Specialty Program
1. The Board is mandated to formulate and develop a comprehensive nursing specialty program that would upgrade the level of skills and competency of specialty nurse clinicians in the country
• Salary. Minimum base pay of nurses in public health institutions shall not be lower than the first step or hiring rate prescribed for Salary Grade 15 pursuant to Republic Act 6758, otherwise known as Compensation and Classification Act of 1989
• Funding for the comprehensive Nursing Specialty Program. The annual financial requirements to rain at least ten (10) percent of the nursing staff of the participating hospital shall be chargeable against the incomes of the Philippine Charity Sweepstakes
• Incentives and Benefits. Incentives and benefits shall be limited to non-cash benefits such as free hospital care for nurses and their dependents and scholarship grants
• Penal and Miscellaneous Provisions
• Penalty for violation of this Act in fines has been increased to not less than fifty thousand pesos (P50,000) not more than one hundred thousand pesos (P100,000)
• Imprisonment of not less than one (1) year nor more than six (6) years or both fine and imprisonment upon the discretion of the Board

COMPREHENSIVE NURSING SPECIALTY PROGRAM

• Nursing Specialty Certification Program has been adopted and a Nursing Specialty Certification Council has been created on the basis of Republic Act No. 7164
• It was done through Resolution No. 14 of the Board of Nursing on February 18, 1999
• The adoption and creation were perceived to oversee the administration of the program by the Specialty Certification Board
• These Specialty Certification Boards were scheduled for creation in each of the four major groups of nursing specialties with the assistance of the Clinical Nurse Association of the Philippines Inc.
• The purpose of this program is to upgrade the level of skill and competence of specialty nurse clinicians in the country

Resolution No. 14 

• contained developments that served as premises and justifications for its issuance
• includes:
1. increasing emphasis on the climate for specialization - advances in science and technology direct initiatives toward high quality performance in a field of choice
2. emergence of the concept of globalization - as imposed by the national laws of countries all over the world, this facilitates the removal of barriers in trade, industry and services
3. response to increasing demands of developments - impels people in the service sector to address the challenges imposed by changes resulting from advancement and innovations in facilities and strategies of healthcare delivery
4. adoption of a system of incentives and benefits - recognizes individual and collective efforts as a process in inspiring nurses and other stakeholders toward preparing practitioners to acquire expertise in delivering service to their clientele
5. current trend of specialization in nursing practice recognized by the International Council of Nurses - the deepening and refining of nursing practice and applying it to the Philippine setting enhances the quality of nursing care and consequently benefits the Filipino clientele
6. the need for a framework of the program, and detailing the mechanics, guidelines and procedures for its implementation - the consultation of the Board of Nursing with the leaders of national nursing association and other concerned nursing groups led to the decision of tasking a special group of nurses to study and prepare a position paper that captures the process of implementing the Nursing Specialty Certification Program. As a consequence, resolution no. 14, series of 1999, details the mechanics, guidelines and procedures for its implementation
• the scope of Resolution 14 is covered in the following headings:
1. the framework
2. definition
3. assumption
4. nursing specialty certification council
• the term, Specialty Certification, in the Resolution is defined in three (3) perspectives:
1. a process
2. as a mechanism
3. as an act
• Special Certification
1. the process whereby qualified agents based on a variety of measures and assessment strategies, confirm or attest that individual nurses who underwent training and instruction for advanced nursing practice in specialized nursing services meet minimum standards set at specified times
2. It is a mechanism that is used to validate achievement of a level of clinical specialty of functional expertise and competence that goes beyond the level of basic licensure
3. the act of a competent authority, embodied in a document certifying that one has fulfilled the requirements of and may practice in a particular level and field of specialization
• Nursing Specialty Certification Council is described in Resolution No. 14 under nine (9) sub-topics, including:
1. Mission
2. Commitment of the Board of Nursing
3. Function of the Nursing Specialty Certification Council
4. Creation of the Sub-specialty Boards
5. Organizational structure
6. Creation of the Appeals panel
7. Creation of the Specialty Certification Board
8. Formulation of the criteria for the selection and qualifications of committee members
9. Levels of certification
• The three (3) levels subject to certification are:
1. Level 1 - Nurse Clinician
2. Level 2 - Nurse Clinician II
3. Level 3 - Clinical Nurse Specialist